Comprehensive Questions with
Verified Answers Graded A+
Unintentional injuries and prevention - Answer: 1. Infants - accidental suffocation, motor vehicle
crashes, drowning
-Back to sleep in own bed in parent's room; review car seat safety guidelines, don't drive under
the influence
2. Ages 1-4 - drowning, falls, MVAs
-Constant supervision around water; personal flotation device; swim lessons at age 4; adequate
fencing around pools; do not leave child unattended near or inside of a vehicle
3. Ages 5-12 - MVAs, drowning, fire/burns
-Car seat safety guidelines; consistent use of seatbelts; swim lessons; adult supervision around
water; if on a boat - life jacket; functioning smoke alarms in house
4. Age 13-19 - MVAs; poisoning, drowning
-Prevent distracted driving, consistent seatbelt use, homes free of firearms, if a firearm is in the
home - store it unloaded and locked with ammunition stored separately
Child maltreatment - Answer: 1. Signs
-Repeated injuries that are unexplainable or unusual
-Overly compliant or exhibits exaggerated fearfulness
-Clingy or indiscriminate attachment
-Extremes in behavior (aggressive or passive)
-Wary of physical contact with adults
,-Frightened of a parent or another caregiver
-Exhibits drastic behavioral changes in and out of parental or caregiver presence
-Withdrawal from family or friends, poor school performance, depression or sadness, anxiety,
aggressive or destructive behavior, or mistreating an animal or pet
-Suicidal (attempts or plans) or engages in self-mutilation
-Displays sleep or eating disorders
2. Steps to take as a provider
-Must report suspected or known maltreatment to the appropriate agencies - CPS or law
enforcement
Abrasions - Answer: -Superficial skin injuries, from falls or friction that involve epidermal trauma
-Findings - determine the extent of the abrasion and the presence of dirt, grime, or other
foreign objects; skin scraped off, oozing of serous fluid and/or blood; pain, swelling, warmth,
erythema, and red streaking of the injured area suggesting a deeper injury or secondary
infection
-Interventions - cleansing the wound by scrubbing with soap or an antibacterial cleanser; may
be open to air or may need a small bandage; larger ones should be kept moist; cover larger ones
with a sterile dressing; antibiotic ointment like bacitracin/polymyxin B may be use; wash every
24 hours until a dry scab; tetanus if significant or has not had one vaccine in 5 years
Animal or snake bite - Answer: -Ask about type of animal, domesticated or feral, and location
-The wound should be assessed; ROM and sensory intactness
-Interventions - tetanus booster, rabies prophylaxis; analgesia or anesthesia; debride tissue and
remove foreign matter; with NS, irrigate the wound; if isolated - soak in tap water and iodine;
antibiotics for all human and cat bites (amoxicillin)
-Refer if severe; obtain a surgical consult if there is evidence about nerve, tendon, and/or
ligament injury
-Report dog and animal bites to animal control
,-Snake - type of snake; severe local reaction after the bite, ecchymosis and swelling with later
fluid filled or hemorrhagic bullae and necrosis; peripheral and central neurological symptoms
including numbness, tingling, diplopia, lethargy, increased salivation, metallic taste in mouth,
sweating, n/v, hematemesis, melena, and hemoptysis; respiratory distress and shock that can
lead to death
-Interventions for snack bite - clean, tetanus prophylaxis, pain medication, oral antibiotic
therapy with Augmentin; if unsure about the snake - poison control and observe patient for 3-4
hours
-For people with more than local symptoms (venomous snake)- rapid transportation to a
medical center, referral to medical specialists, antivenin therapy, an treatment for shock and
respiratory difficulties
-Nonvenomous - clean, tetanus prophylaxis if necessary, pain medication, augmentin for5 days if
wound contaminated or secondary infection
-If uncertainty about snake - poison control and watch for venomous symptoms for 3-4 hours
(severe local reaction after bite with intense pain, burning, discoloration, edema, hemorrhagic
effects, ecchymosis and swelling with later fluid filled or hemorrhagic bullae and necrosis,
neurological symptoms, salivation, metallic taste in mouth, sweating, and n/v, hematemesis,
melena and hemopty
Burns - Answer: -Findings - superficial burns are only the epidermis with symptomatic
treatment; example is a sunburn; partial-thickness burns involve involve the epidermis and the
dermis; superficial partial thickness are red, very painful, mottled, moist, and blistered that heal
in 7-14 days; deep partial thickness - pale, yellow, less painful and weepy , usually scar; full
thickness destroy the epidermis and dermis completely; the skin appears whitish or leathery,
dry, nontender, fluid losses occur, skin grafting needed; full thickness - tendons, nerves, muscle,
fascia, bone and need surgery and skin grafting
-Management - determine the need for admission to a burn center; if more than 20% BSA,
partial thickness burns involving more than 10% TBSA, full thickness burns more than 2% TBSA,
circumferential burn, burns overlying joints or critical areas, such as the hands, feet, genitalia,
and perineum, full thickness burns, chemical burns, electrical burns, inhalation injury, suspicion
of child abuse or unsafe home environment, presence of an underlying chronic illness -
admission
, -Outpatient treatment - superficial burns and partial thickness burns to less than 10% of BSA
Health benefits of exercise for children with asthma - Answer: -Participation in aerobic activity
has demonstrated an improvement to the individual's exercise capacity and reduction in their
airway inflammation
Down Syndrome - Answer: -These patients have low tone and looser ligaments that place them
at greater risk of compression of the spinal cord causing nerve damage - atlantoaxial instability
-May have changes in ambulation, the ability to use upper extremities, complaints of neck pain,
a new fixed head tilt, bowel or bladder dysfunction, or new unexplained weakness
-Signs - weakness, numbness, neck pain, localized neurologic pain, spasticity, gait difficulties,
change in bowel or bladder function
Hours of sleep per age - Answer: -1 week old - 8.25 at night
-1 month old - 8.5 hours
-3 months old - 10 hours
-6 months old - 11 hours
-9 months old - 11.2 hours
-12 months old - 11.7 hours
-18 months old - 11.6 hours
-2 years old - 11.4 hours
-3-5 years old - 12.5 hours
-5-11 years old - 11 hours
-12-17 years old - 8-9 hours
Confusional arousals - Answer: -Occur when a child is awakened from a deep sleep during the
first part of the night and is also known as excessive sleep inertia or sleep drunkenness
-The child will sit up in bed, appear dazed, and often react slowly to questions