pediatric ICU Nursing ACTUAL
UPDATED QUESTIONS AND CORRECT
ANSWERS
What are the primary priorities for nurses in the Pediatric ICU?
CORRECT ANSWERS✅✅ The primary priorities are airway, breathing, circulation,
neurological status, and temperature control. Nurses perform continuous monitoring of vital
signs, oxygenation, and perfusion. Early identification of deterioration enables rapid
intervention and prevents organ injury. Family-centered communication and education are
integral to care. Infection prevention and safe medication administration are ongoing
responsibilities. Nurses coordinate multidisciplinary care including respiratory therapy and
pediatrics. Accurate documentation ensures continuity and legal/clinical clarity.
How is pediatric airway assessment performed in the ICU?
CORRECT ANSWERS✅✅ Airway assessment includes observing work of breathing,
stridor or wheeze, oxygen saturation, and chest rise. Nurses examine for signs of obstruction,
secretions, and effectiveness of suctioning or airway devices. Age-appropriate anatomic
differences (large tongue, compliant airway) are considered. Assessment guides need for
nebulizers, noninvasive support, or intubation. Rapid sequence readiness and proper
equipment sizing are ensured. Family presence is managed while maintaining safety.
Frequent reassessment is essential after interventions.
How is respiratory failure recognized and managed in pediatric patients?
CORRECT ANSWERS✅✅ Recognition includes tachypnea, bradypnea, retractions, nasal
flaring, grunting, and low SpO₂ despite oxygen. Nurses obtain ABGs or capillary blood gases
and monitor end-tidal CO₂ when available. Management may include oxygen, high-flow
nasal cannula, CPAP/BiPAP, or mechanical ventilation. Positioning, secretion clearance, and
minimizing fatigue are important nursing interventions. Monitor for ventilator-associated
complications and implement VAP prevention bundles. Family education about interventions
and prognosis should be provided. Continuous reassessment directs escalation or weaning.
What are pediatric hemodynamic monitoring priorities in the ICU?
CORRECT ANSWERS✅✅ Priorities include continuous heart rate, blood pressure
(noninvasive or arterial line), perfusion (capillary refill), and urine output. Nurses monitor
trends rather than single readings and compare to age-based norms. Central venous or arterial
lines require strict asepsis and waveform calibration. Early signs of shock may be subtle —
altered mental state or tachycardia precede hypotension. Fluid responsiveness, vasoactive
, support, and lab markers (lactate) guide therapy. Frequent reassessment and clear handoffs
ensure stability. Family communication about lines and therapies is maintained.
How is pediatric septic shock identified and treated?
CORRECT ANSWERS✅✅ Identification includes fever or hypothermia, tachycardia,
delayed capillary refill, altered mental status, and rising lactate. Nurses initiate the sepsis
bundle: blood cultures, broad-spectrum antibiotics, and fluid bolus within the first hour.
Monitor response to fluids with perfusion, urine output, and hemodynamics; start vasoactive
agents if fluid-refractory. Maintain strict infection control and source control measures.
Provide supportive care: oxygen, glucose management, and thermoregulation. Communicate
prognosis and plans with family compassionately. Continuous measurement of lactate and
organ function guides further care.
How is pediatric pain assessed in the ICU?
CORRECT ANSWERS✅✅ Pain assessment uses age-appropriate tools: FLACC for
infants/toddlers, faces or numeric scales for older children. Nurses observe facial expression,
body movement, consolability, and physiologic signs. Regular assessment is documented
before and after interventions. Multimodal analgesia (opioids, acetaminophen, regional
techniques) is individualized and titrated to effect. Monitor for side effects such as respiratory
depression and constipation. Non-pharmacologic measures (swaddling, parental presence) are
used alongside meds. Education for family on pain cues and medication effects is provided.
How is sedation and delirium managed in pediatric ICU patients?
CORRECT ANSWERS✅✅ Use validated sedation scales (e.g., COMFORT-B) and delirium
screening tools appropriate to age. Aim for the lightest effective sedation to facilitate
assessment and reduce delirium risk. Daily sedation interruption or protocolized weaning
should be considered when safe. Treat delirium with environmental measures, sleep
promotion, minimizing benzodiazepines, and medications only when necessary. Monitor for
withdrawal when sedatives/opioids are reduced and use weaning protocols. Engage family to
orient the child and provide familiar objects. Document responses and adverse effects
carefully.
How is fluid management approached in critically ill children?
CORRECT ANSWERS✅✅ Fluid therapy is individualized by weight, age, hemodynamic
status, and diagnosis. Nurses calculate maintenance needs, bolus volumes, and monitor
cumulative balance closely. Hourly urine output, daily weights, and ins/outs are recorded
precisely. Avoid fluid overload in lung injury — use conservative strategy when indicated
and consider diuretics or RRT. Assess electrolytes and correct disturbances promptly. Use
UPDATED QUESTIONS AND CORRECT
ANSWERS
What are the primary priorities for nurses in the Pediatric ICU?
CORRECT ANSWERS✅✅ The primary priorities are airway, breathing, circulation,
neurological status, and temperature control. Nurses perform continuous monitoring of vital
signs, oxygenation, and perfusion. Early identification of deterioration enables rapid
intervention and prevents organ injury. Family-centered communication and education are
integral to care. Infection prevention and safe medication administration are ongoing
responsibilities. Nurses coordinate multidisciplinary care including respiratory therapy and
pediatrics. Accurate documentation ensures continuity and legal/clinical clarity.
How is pediatric airway assessment performed in the ICU?
CORRECT ANSWERS✅✅ Airway assessment includes observing work of breathing,
stridor or wheeze, oxygen saturation, and chest rise. Nurses examine for signs of obstruction,
secretions, and effectiveness of suctioning or airway devices. Age-appropriate anatomic
differences (large tongue, compliant airway) are considered. Assessment guides need for
nebulizers, noninvasive support, or intubation. Rapid sequence readiness and proper
equipment sizing are ensured. Family presence is managed while maintaining safety.
Frequent reassessment is essential after interventions.
How is respiratory failure recognized and managed in pediatric patients?
CORRECT ANSWERS✅✅ Recognition includes tachypnea, bradypnea, retractions, nasal
flaring, grunting, and low SpO₂ despite oxygen. Nurses obtain ABGs or capillary blood gases
and monitor end-tidal CO₂ when available. Management may include oxygen, high-flow
nasal cannula, CPAP/BiPAP, or mechanical ventilation. Positioning, secretion clearance, and
minimizing fatigue are important nursing interventions. Monitor for ventilator-associated
complications and implement VAP prevention bundles. Family education about interventions
and prognosis should be provided. Continuous reassessment directs escalation or weaning.
What are pediatric hemodynamic monitoring priorities in the ICU?
CORRECT ANSWERS✅✅ Priorities include continuous heart rate, blood pressure
(noninvasive or arterial line), perfusion (capillary refill), and urine output. Nurses monitor
trends rather than single readings and compare to age-based norms. Central venous or arterial
lines require strict asepsis and waveform calibration. Early signs of shock may be subtle —
altered mental state or tachycardia precede hypotension. Fluid responsiveness, vasoactive
, support, and lab markers (lactate) guide therapy. Frequent reassessment and clear handoffs
ensure stability. Family communication about lines and therapies is maintained.
How is pediatric septic shock identified and treated?
CORRECT ANSWERS✅✅ Identification includes fever or hypothermia, tachycardia,
delayed capillary refill, altered mental status, and rising lactate. Nurses initiate the sepsis
bundle: blood cultures, broad-spectrum antibiotics, and fluid bolus within the first hour.
Monitor response to fluids with perfusion, urine output, and hemodynamics; start vasoactive
agents if fluid-refractory. Maintain strict infection control and source control measures.
Provide supportive care: oxygen, glucose management, and thermoregulation. Communicate
prognosis and plans with family compassionately. Continuous measurement of lactate and
organ function guides further care.
How is pediatric pain assessed in the ICU?
CORRECT ANSWERS✅✅ Pain assessment uses age-appropriate tools: FLACC for
infants/toddlers, faces or numeric scales for older children. Nurses observe facial expression,
body movement, consolability, and physiologic signs. Regular assessment is documented
before and after interventions. Multimodal analgesia (opioids, acetaminophen, regional
techniques) is individualized and titrated to effect. Monitor for side effects such as respiratory
depression and constipation. Non-pharmacologic measures (swaddling, parental presence) are
used alongside meds. Education for family on pain cues and medication effects is provided.
How is sedation and delirium managed in pediatric ICU patients?
CORRECT ANSWERS✅✅ Use validated sedation scales (e.g., COMFORT-B) and delirium
screening tools appropriate to age. Aim for the lightest effective sedation to facilitate
assessment and reduce delirium risk. Daily sedation interruption or protocolized weaning
should be considered when safe. Treat delirium with environmental measures, sleep
promotion, minimizing benzodiazepines, and medications only when necessary. Monitor for
withdrawal when sedatives/opioids are reduced and use weaning protocols. Engage family to
orient the child and provide familiar objects. Document responses and adverse effects
carefully.
How is fluid management approached in critically ill children?
CORRECT ANSWERS✅✅ Fluid therapy is individualized by weight, age, hemodynamic
status, and diagnosis. Nurses calculate maintenance needs, bolus volumes, and monitor
cumulative balance closely. Hourly urine output, daily weights, and ins/outs are recorded
precisely. Avoid fluid overload in lung injury — use conservative strategy when indicated
and consider diuretics or RRT. Assess electrolytes and correct disturbances promptly. Use
