NURS 5210 SENTINEL U: ALIA GHANNAM
PEDIATRIC SIMULATION CASE REPORT 350
EXAM QUESTIONS WITH CORRECT
ANSWERS AND RATIONALES
SECTION 1: INITIAL ASSESSMENT & PATIENT PRESENTATION (Questions
150)
1. Upon initial assessment of Alia Ghannam, a 4yearold female, which finding
most warrants immediate intervention?
A) Temperature of 38.5°C (101.3°F)
B) Respiratory rate of 28 breaths per minute
C) Oxygen saturation of 88% on room air
D) Heart rate of 120 beats per minute
Answer: C) Oxygen saturation of 88% on room air
Rationale: Normal SpO2 for a healthy child is >95%. 88% indicates significant
hypoxemia, risking tissue hypoxia and respiratory failure. While fever,
tachypnea (normal for age 4: 2028), and tachycardia (normal for age 4:
80120) are concerning, hypoxemia is an immediate threat to oxygen delivery
and requires urgent intervention such as supplemental oxygen.
,2. Alia presents with a barking cough, inspiratory stridor, and subcostal
retractions. These findings are classic for which condition?
A) Bacterial tracheitis
B) Croup (laryngotracheobronchitis)
C) Foreign body aspiration
D) Epiglottitis
Answer: B) Croup (laryngotracheobronchitis)
Rationale: The triad of barking cough, inspiratory stridor, and retractions is
hallmark for croup, typically viral in origin, causing subglottic edema.
Bacterial tracheitis presents with high fever and toxic appearance. Foreign
body aspiration has sudden onset without prodrome. Epiglottitis presents
with drooling, tripod positioning, and muffled voice.
3. Which parameter is NOT part of the Westley Croup Score?
A) Cyanosis
B) Level of consciousness
C) Chest wall retractions
D) Oxygen saturation
Answer: D) Oxygen saturation
,Rationale: The Westley Croup Score assesses: inspiratory stridor (absent, with
agitation, at rest), retractions (none, mild, moderate, severe), air entry
(normal, decreased, markedly decreased), cyanosis (none, with agitation, at
rest), and level of consciousness (normal, disoriented, lethargic). Oxygen
saturation is not a component of this scoring system.
4. What is Alia Ghannam's age?
A) 2 years old
B) 3 years old
C) 4 years old
D) 5 years old
Answer: C) 4 years old
Rationale: Alia Ghannam is a 4yearold female presenting for a preschool
wellness visit.
5. Alia's weight is documented as:
A) 32 lb / 14.5 kg
B) 39 lb / 17.7 kg
C) 45 lb / 20.4 kg
D) 28 lb / 12.7 kg
, Answer: B) 39 lb / 17.7 kg
Rationale: Alia Ghannam's weight is 39 lb (17.7 kg).
6. Alia's height is documented as:
A) 2' 8" / 81.28 cm
B) 3' 2" / 96.52 cm
C) 3' 6" / 106.68 cm
D) 4' 0" / 121.92 cm
Answer: B) 3' 2" / 96.52 cm
Rationale: Alia Ghannam's height is 3' 2" (96.52 cm).
7. What is Alia's chief complaint upon presentation?
A) Fever and cough for 3 days
B) Difficulty breathing
C) Physical for school entry
D) Ear pain
Answer: C) Physical for school entry
PEDIATRIC SIMULATION CASE REPORT 350
EXAM QUESTIONS WITH CORRECT
ANSWERS AND RATIONALES
SECTION 1: INITIAL ASSESSMENT & PATIENT PRESENTATION (Questions
150)
1. Upon initial assessment of Alia Ghannam, a 4yearold female, which finding
most warrants immediate intervention?
A) Temperature of 38.5°C (101.3°F)
B) Respiratory rate of 28 breaths per minute
C) Oxygen saturation of 88% on room air
D) Heart rate of 120 beats per minute
Answer: C) Oxygen saturation of 88% on room air
Rationale: Normal SpO2 for a healthy child is >95%. 88% indicates significant
hypoxemia, risking tissue hypoxia and respiratory failure. While fever,
tachypnea (normal for age 4: 2028), and tachycardia (normal for age 4:
80120) are concerning, hypoxemia is an immediate threat to oxygen delivery
and requires urgent intervention such as supplemental oxygen.
,2. Alia presents with a barking cough, inspiratory stridor, and subcostal
retractions. These findings are classic for which condition?
A) Bacterial tracheitis
B) Croup (laryngotracheobronchitis)
C) Foreign body aspiration
D) Epiglottitis
Answer: B) Croup (laryngotracheobronchitis)
Rationale: The triad of barking cough, inspiratory stridor, and retractions is
hallmark for croup, typically viral in origin, causing subglottic edema.
Bacterial tracheitis presents with high fever and toxic appearance. Foreign
body aspiration has sudden onset without prodrome. Epiglottitis presents
with drooling, tripod positioning, and muffled voice.
3. Which parameter is NOT part of the Westley Croup Score?
A) Cyanosis
B) Level of consciousness
C) Chest wall retractions
D) Oxygen saturation
Answer: D) Oxygen saturation
,Rationale: The Westley Croup Score assesses: inspiratory stridor (absent, with
agitation, at rest), retractions (none, mild, moderate, severe), air entry
(normal, decreased, markedly decreased), cyanosis (none, with agitation, at
rest), and level of consciousness (normal, disoriented, lethargic). Oxygen
saturation is not a component of this scoring system.
4. What is Alia Ghannam's age?
A) 2 years old
B) 3 years old
C) 4 years old
D) 5 years old
Answer: C) 4 years old
Rationale: Alia Ghannam is a 4yearold female presenting for a preschool
wellness visit.
5. Alia's weight is documented as:
A) 32 lb / 14.5 kg
B) 39 lb / 17.7 kg
C) 45 lb / 20.4 kg
D) 28 lb / 12.7 kg
, Answer: B) 39 lb / 17.7 kg
Rationale: Alia Ghannam's weight is 39 lb (17.7 kg).
6. Alia's height is documented as:
A) 2' 8" / 81.28 cm
B) 3' 2" / 96.52 cm
C) 3' 6" / 106.68 cm
D) 4' 0" / 121.92 cm
Answer: B) 3' 2" / 96.52 cm
Rationale: Alia Ghannam's height is 3' 2" (96.52 cm).
7. What is Alia's chief complaint upon presentation?
A) Fever and cough for 3 days
B) Difficulty breathing
C) Physical for school entry
D) Ear pain
Answer: C) Physical for school entry
