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1. A 2-year-old patient is brought in by parents after being found with their
grandmother's diabetic medication two hours ago. Parents state the bottle
only had 5 tablets in it and they were able to take 3 out of the patient's
mouth before they swallowed them. The child is sleepy, difficult to arouse,
tachypneic and tachycardic. A glucose check reads 43 mg/dL. IV dextrose is
administered without improvement of the glucose level. The nurse knows
the PRIORITY intervention is administration of: - Correct Answer: This
patient likely ingested Metformin, an oral hypoglycemic. This medication
has a long half-life and will cause symptoms over an extended period.
Octreotide is used when the glucose is unresponsive to dextrose
administration at a dose of 1mcg/kg. T
2. A patient presents to the ER with exposure to glass etching chemicals. The
parent says they don't know how much was spilled on the child but are
concerned for exposure. What agent will the nurse anticipate administering
to neutralize the chemical?
1) mineral oil
2) calcium gluconate
3) sodium bicarb
4) potassium chloride - Correct Answer: Calcium gluconate!
Hydrofluoric acid is commonly found in glass etching chemicals. The first
line agent to neutralize the chemical is calcium gluconate. The other agents
, will not cause the chemical neutralization that is needed to stop the burning
process.
3. subluxation of the radial head. is referred to as _______ - Correct
Answer: nursemaids
4. The nurse is caring for a patient who sustained an isolated kick to the neck.
A tracheobronchial injury is suspected and a chest tube has been placed.
The nurse anticipates the following during assessment: - Correct
Answer: Tracheobronchial injury can be the result of a direct blow to the
neck and results in air leaking from the trachea into the mediastinum. This
can cause a continuous, massive air leak into the chest drainage system.
Copious amounts of blood are not expected. Muffled heart tones and
jugular vein distension are expected with cardiac tamponade but not with
tracheobronchial injury
5. A child with a history of sickle cell disease presents with altered level of
consciousness, cool and clammy skin, and hypotension. Which of the
following is the MOST likely cause of these symptoms? - Correct
Answer: splenic sequestration crisis occurs with pooling of red blood cells in
the spleen, resulting in an enlarged spleen, severe anemia, and shock. The
most common manifestation of SCD is vaso-occlusive crisis. This is an acute
painful episode affecting the joints and extremities.
6. paroxysmal cough is a sign of - Correct Answer: pertusis
7. Which of the following is MOST indicative of compartment syndrome?
1) pain out of proportion to the severity of the injury
, 2) compartment pressure of 8mmHg
3) decreased pulse pressure distal to the injury
4)sensory deficit at the injury site - Correct Answer: 1!
Pain is the hallmark sign of compartment syndrome. Pain out of proportion
to the extent of the injury or pain on passive range of motion of the
affected compartment can indicate development of or existing
compartment syndrome. Generally pressures should be >20.
8. The nurse is assisting the intubation of a pediatric patient with asthma. The
physician is unsuccessful with attempts to intubate and a supraglottic
device is used. The nurse understands that: - Correct Answer: some
supraglottic devices do not allow for high pressures. nd would therefore not
be effective in a patient with restrictive airway disease. The need for gastric
emptying is not essential in the immediate ventilation and oxygenation of
the patient but should be considered later. Supraglottic devices are not a
definitive airway as they do not sit below the vocal cords. Most supraglottic
devices for pediatrics are only weight based and not height based.
9. A patient presents to the emergency department following an explosion.
The patient is noted to have bilateral ear drum rupture and confusion along
with numerous wounds. Initial imaging reveals concerns for bowel
perforation. Based on the identified injuries, the nurse is MOST concerned
for:
1) full thickness burns
2)tibial fracture
3)corneal laceration
4) lung injury - Correct Answer: 4!
During the primary phase following an explosion, the blast pressure wave
can cause injuries to air volume organs, for example, lung, gastric/bowel
rupture, TM rupture, and concussion/traumatic Brain Injury (TBI). This
, patient presents with several primary blast injuries which would lead the
nurse to be concerned for risk of additional primary injuries.
10.A toddler presents after drinking windshield wiper fluid. Symptoms of this
ingestion include: - Correct Answer: Windshield wiper fluid contains
methanol which is associated with malaise, headache, dizziness, and visual
impairment
11.s/s of globe fracture after being hit in the eye w a bat - Correct Answer:
The signs and symptoms are indicative of a globe rupture. Facial fracture,
retinal detachment and hyphema usually do not include a misshapen pupil
or loss of vision in the injured eye.
12.A toddler is bought into the Emergency Department by their caregiver who
states "something is not right" with the child. On the family farm, the child
was playing outside and presents now with severe drooling, watery eyes,
vomiting, and diarrhea. What medication would the nurse anticipate
administering? - Correct Answer: Pralidoxime is used for
organophosphate poisoning which is the cause of this child's current
symptoms related to exposure from farming chemicals. They block
acetylcholine and disrupts phosphate-cholinesterase bond.
13.An adolescent patient with a known pelvic fracture is placed in a pelvic
binder. The nurse notes the following vital signs:
BP 76/45 mmHg
HR 134 beats/min
RR 26 breaths/min
What is the MOST appropriate action? - Correct Answer: Initiate MTP!