Peds CCRN 112 Review Questions
The mother of a recently admitted, technology-dependent child
tells the nurse that she has missed several clinic appointments.
How can the nurse best help in this situation?
A. Inform the social worker about the medical neglect
B. Assess the mother's access to tangible resources
C. Notify the clinic physician that the child is admitted
D. Reassure the mother that she is doing her best - ✔ ✔ B.
Assess the mother's access to tangible resources
-The nurse's first response should be to further assess the
mother's situation and determine why she has missed
appointments.
-Assessing tangible resources, like transportation, may better
elicit the mother's needs and the nurse can then best respond
from a systems thinking perspective.
The nurse caring for a child who was injured in a motor vehicle
crash notes positive Cullen's sign in the right abdomen around the
umbilicus. This is indicative of:
,A. Impending disseminated intravascular coagulopathy
B. Necrotic bowel process
C. Sepsis
D. Intra-abdominal bleeding - ✔ ✔ D. Intra-abdominal
bleeding
In cases of severe intra-abdominal bleeding, Cullen's sign (bluish
discoloration around the periumbilical area) may be seen. The
nurse should be concerned that the child has severe injuries and
may need
surgical exploration or repair.
The nurse is caring for a child with liver failure and who is
experiencing profound
abdominal distention.
What is the primary concern?
A. Renal insufficiency
B. Biliary atresia
C. Intestinal perforation
,D. Respiratory failure - ✔ ✔ D. Respiratory failure
-Children with liver failure can experience profound abdominal
ascites and distention. This process pushes up on the diaphragm
and can result in respiratory distress, which can lead to
respiratory
failure.
-Increased pressure in the abdomen can compromise perfusion to
other abdominal organs, like the kidney. But in this scenario,
respiratory distress is the primary concern.
A 16-year-old crashes her car into a wooden fence and is impaled
through the chest by a fence post. She presents with significant
shortness of breath. You are unable to auscultate breath sounds
on the right side and you palpate crepitus
throughout the right side of the chest. Her HR is 146 and you are
unable to obtain a blood pressure. She is most likely experiencing:
A. Cardiomyopathy
B. Cardiogenic shock
C. Hypertensive crisis
, D. Cardiogenic/obstructive shock - ✔ ✔ D.
Cardiogenic/obstructive shock
-Cardiogenic/obstructive shock occurs when cardiac output is
obstructed and there is an inability to provide adequate tissue
perfusion despite normal intravascular volume and myocardial
function.
-Causes include trauma to the great vessels, tamponade,
pulmonary embolism, valvular stenosis, and coarctation of the
aorta
A toddler who was found unresponsive in a swimming pool is in
respiratory distress. On chest x-ray you see bilateral infiltrates
and the PaO2/FiO2 ratio is 190.
These findings suggest:
A. Aspiration pneumonia
B. Viral pneumonia
C. Acute respiratory distress syndrome
D. Pneumothorax - ✔ ✔ C. Acute respiratory distress
syndrome
The mother of a recently admitted, technology-dependent child
tells the nurse that she has missed several clinic appointments.
How can the nurse best help in this situation?
A. Inform the social worker about the medical neglect
B. Assess the mother's access to tangible resources
C. Notify the clinic physician that the child is admitted
D. Reassure the mother that she is doing her best - ✔ ✔ B.
Assess the mother's access to tangible resources
-The nurse's first response should be to further assess the
mother's situation and determine why she has missed
appointments.
-Assessing tangible resources, like transportation, may better
elicit the mother's needs and the nurse can then best respond
from a systems thinking perspective.
The nurse caring for a child who was injured in a motor vehicle
crash notes positive Cullen's sign in the right abdomen around the
umbilicus. This is indicative of:
,A. Impending disseminated intravascular coagulopathy
B. Necrotic bowel process
C. Sepsis
D. Intra-abdominal bleeding - ✔ ✔ D. Intra-abdominal
bleeding
In cases of severe intra-abdominal bleeding, Cullen's sign (bluish
discoloration around the periumbilical area) may be seen. The
nurse should be concerned that the child has severe injuries and
may need
surgical exploration or repair.
The nurse is caring for a child with liver failure and who is
experiencing profound
abdominal distention.
What is the primary concern?
A. Renal insufficiency
B. Biliary atresia
C. Intestinal perforation
,D. Respiratory failure - ✔ ✔ D. Respiratory failure
-Children with liver failure can experience profound abdominal
ascites and distention. This process pushes up on the diaphragm
and can result in respiratory distress, which can lead to
respiratory
failure.
-Increased pressure in the abdomen can compromise perfusion to
other abdominal organs, like the kidney. But in this scenario,
respiratory distress is the primary concern.
A 16-year-old crashes her car into a wooden fence and is impaled
through the chest by a fence post. She presents with significant
shortness of breath. You are unable to auscultate breath sounds
on the right side and you palpate crepitus
throughout the right side of the chest. Her HR is 146 and you are
unable to obtain a blood pressure. She is most likely experiencing:
A. Cardiomyopathy
B. Cardiogenic shock
C. Hypertensive crisis
, D. Cardiogenic/obstructive shock - ✔ ✔ D.
Cardiogenic/obstructive shock
-Cardiogenic/obstructive shock occurs when cardiac output is
obstructed and there is an inability to provide adequate tissue
perfusion despite normal intravascular volume and myocardial
function.
-Causes include trauma to the great vessels, tamponade,
pulmonary embolism, valvular stenosis, and coarctation of the
aorta
A toddler who was found unresponsive in a swimming pool is in
respiratory distress. On chest x-ray you see bilateral infiltrates
and the PaO2/FiO2 ratio is 190.
These findings suggest:
A. Aspiration pneumonia
B. Viral pneumonia
C. Acute respiratory distress syndrome
D. Pneumothorax - ✔ ✔ C. Acute respiratory distress
syndrome
