NRNP 6531 STUDY GUIDE TESTED
QUESTIONS WITH COMPLETE ANSWERS
PRACTICE RESOURCE
◉ Epiglottitis s/s. Answer: Acute and rapid onset of high fever, chills,
and toxicity. Severe sore throat and drooling saliva. Will not eat or
drink, muffled (hot potato) voice, and anxiety. Sitting posture with
hyperextended neck with open-mouth breathing. Stridor, tachycardia,
and tachypnea
◉ Epiglottitis prevention. Answer: Haemophilus influenzae type B
(Hib) vaccine
◉ Steeple sign. Answer: a radiologic sign found on radiograph where
the subglottic tracheal narrowing produces a shape of a church steeple
which supports a diagnosis of croup
◉ Foreign body aspiration antibiotic?. Answer: Depends on the nature
of the material aspirated, plus the location and degree of obstruction.
Bronchial or laryngeal foreign body aspiration, a bronchoscopy must
be performed for removal of the foreign body
◉ Antibiotics for bronchiolitis?. Answer: Use of saline drops and
suctioning of the nares. There is no evidence to support the routine
use of antibiotics
,◉ Antibiotics for croup?. Answer: Nebulized epinephrine,
corticosteroids (dexamethasone oral or IM), blow by oxygen or heliox
in severe croup. Racemic epinephrine with the use of corticosteroids
to limit rebound swelling
◉ Antibiotics for epiglottitis?. Answer: Establish an airway preferably
by nasotracheal intubation. Administer IV antibiotics such as rocephin
to cover H.influenzae. Administer oxygen and respiratory support.
Antibiotics should be continued for 10 days. Rifampin prophylaxis 20
mg/kg in a single dose (maximum of 600 mg) for 4 days for infants
and children, 600 mg once a day for adults for 4 days. Should be
provided for household contacts who are at risk (Younger than 4 years
old who is non-immunized or incompletely immunized, children less
than 12 months who have not received primary series of Hib, and
immunocompromised children.
◉ Asthma treatment. Answer: The pharmacological management of
asthma in children is based on the severity of asthma and the child's
age. After initial control, decrease treatment to the least amount of
medication needed to maintain control. Systemic corticosteroids may
be needed at any time and stepped up if there is a major flare-up of
symptoms.
◉ Step 1 Asthma management for children 0-4 years old. Answer:
Step 1: SABA (Short acting beta2-agonist) PRN: With viral
respiratory symptoms short acting beta 2-agonist should be used every
4-6 hours up to 24 hours (longer with a physician consult). Consider
short course of oral systemic corticosteroids if severe exacerbation.
Frequent use of SABA may indicate the need to step up treatment
,◉ Step 2 Asthma management for children 0-4 years old. Answer:
Step 2: Consider consultation with asthma specialist. Low dose of
inhaled corticosteroids.
◉ Step 3 asthma mgmt for children 0-4 yrs. Answer: Step 3: Medium-
dose of inhaled corticosteroids
◉ Steps 4-6 asthma mgmt for children 0-4 yrs. Answer: Step 4:
Medium-dose ICS and Long acting beta2-agonist or montelukast.
Step 5: High dose ICS and Long acting beta 2-agonist or montelukast.
Step 6: High dose of ICS and LABA or montelukast and oral
corticosteroids
◉ Steps 1-3 asthma mgmt for children 5-11 yrs. Answer: Step 1:
SABA (Short acting beta 2-agonist) PRN: Increasing the use of short-
acting beta 2-agonist or use greater than 2 days a week for symptom
relief generally indicates inadequate control and the need to step up
treatment.
Step 2: Consider consultation with asthma specialist. Low dose of
inhaled corticosteroids.
Step 3: Low dose of inhaled corticosteroid and LABA. Or medium
dose of inhaled corticosteroids.
, ◉ Steps 4-6 asthma mgmt for children 5-11 yrs. Answer: Step 4:
Medium-dose ICS and LABA or medium dose of inhaled
corticosteroid and leukotriene receptor antagonist or theophylline. .
Step 5: High dose ICS and LABA or high dose of inhaled
corticosteroid and leukotriene receptor antagonist or theophylline. .
Step 6: High dose of ICS and LABA and oral corticosteroids or high
dose of inhaled corticosteroids and leukotriene receptor antagonist or
theophylline and oral corticosteroids.
** Theophylline levels must be monitored.
◉ Differentials for patient with sore throat. Answer: Strep pharyngitis
Peritonsillar abscess
Viral pharyngitis
Infectious mononucleosis
Epiglottitis
◉ small-for-gestational-age infants: which type of chromosomal
analysis should be included?. Answer: Trisomy 18
Holt-Olram
Trisomy 13
Turner Syndrome
QUESTIONS WITH COMPLETE ANSWERS
PRACTICE RESOURCE
◉ Epiglottitis s/s. Answer: Acute and rapid onset of high fever, chills,
and toxicity. Severe sore throat and drooling saliva. Will not eat or
drink, muffled (hot potato) voice, and anxiety. Sitting posture with
hyperextended neck with open-mouth breathing. Stridor, tachycardia,
and tachypnea
◉ Epiglottitis prevention. Answer: Haemophilus influenzae type B
(Hib) vaccine
◉ Steeple sign. Answer: a radiologic sign found on radiograph where
the subglottic tracheal narrowing produces a shape of a church steeple
which supports a diagnosis of croup
◉ Foreign body aspiration antibiotic?. Answer: Depends on the nature
of the material aspirated, plus the location and degree of obstruction.
Bronchial or laryngeal foreign body aspiration, a bronchoscopy must
be performed for removal of the foreign body
◉ Antibiotics for bronchiolitis?. Answer: Use of saline drops and
suctioning of the nares. There is no evidence to support the routine
use of antibiotics
,◉ Antibiotics for croup?. Answer: Nebulized epinephrine,
corticosteroids (dexamethasone oral or IM), blow by oxygen or heliox
in severe croup. Racemic epinephrine with the use of corticosteroids
to limit rebound swelling
◉ Antibiotics for epiglottitis?. Answer: Establish an airway preferably
by nasotracheal intubation. Administer IV antibiotics such as rocephin
to cover H.influenzae. Administer oxygen and respiratory support.
Antibiotics should be continued for 10 days. Rifampin prophylaxis 20
mg/kg in a single dose (maximum of 600 mg) for 4 days for infants
and children, 600 mg once a day for adults for 4 days. Should be
provided for household contacts who are at risk (Younger than 4 years
old who is non-immunized or incompletely immunized, children less
than 12 months who have not received primary series of Hib, and
immunocompromised children.
◉ Asthma treatment. Answer: The pharmacological management of
asthma in children is based on the severity of asthma and the child's
age. After initial control, decrease treatment to the least amount of
medication needed to maintain control. Systemic corticosteroids may
be needed at any time and stepped up if there is a major flare-up of
symptoms.
◉ Step 1 Asthma management for children 0-4 years old. Answer:
Step 1: SABA (Short acting beta2-agonist) PRN: With viral
respiratory symptoms short acting beta 2-agonist should be used every
4-6 hours up to 24 hours (longer with a physician consult). Consider
short course of oral systemic corticosteroids if severe exacerbation.
Frequent use of SABA may indicate the need to step up treatment
,◉ Step 2 Asthma management for children 0-4 years old. Answer:
Step 2: Consider consultation with asthma specialist. Low dose of
inhaled corticosteroids.
◉ Step 3 asthma mgmt for children 0-4 yrs. Answer: Step 3: Medium-
dose of inhaled corticosteroids
◉ Steps 4-6 asthma mgmt for children 0-4 yrs. Answer: Step 4:
Medium-dose ICS and Long acting beta2-agonist or montelukast.
Step 5: High dose ICS and Long acting beta 2-agonist or montelukast.
Step 6: High dose of ICS and LABA or montelukast and oral
corticosteroids
◉ Steps 1-3 asthma mgmt for children 5-11 yrs. Answer: Step 1:
SABA (Short acting beta 2-agonist) PRN: Increasing the use of short-
acting beta 2-agonist or use greater than 2 days a week for symptom
relief generally indicates inadequate control and the need to step up
treatment.
Step 2: Consider consultation with asthma specialist. Low dose of
inhaled corticosteroids.
Step 3: Low dose of inhaled corticosteroid and LABA. Or medium
dose of inhaled corticosteroids.
, ◉ Steps 4-6 asthma mgmt for children 5-11 yrs. Answer: Step 4:
Medium-dose ICS and LABA or medium dose of inhaled
corticosteroid and leukotriene receptor antagonist or theophylline. .
Step 5: High dose ICS and LABA or high dose of inhaled
corticosteroid and leukotriene receptor antagonist or theophylline. .
Step 6: High dose of ICS and LABA and oral corticosteroids or high
dose of inhaled corticosteroids and leukotriene receptor antagonist or
theophylline and oral corticosteroids.
** Theophylline levels must be monitored.
◉ Differentials for patient with sore throat. Answer: Strep pharyngitis
Peritonsillar abscess
Viral pharyngitis
Infectious mononucleosis
Epiglottitis
◉ small-for-gestational-age infants: which type of chromosomal
analysis should be included?. Answer: Trisomy 18
Holt-Olram
Trisomy 13
Turner Syndrome
