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1. A 13-year-old patient with asthma just received oxygen and
albuterol via a nebulizer. What is the next most appropriate
intervention?
A. Administer 0.1 mg/kg of adenosine
B. Obtain a blood sample to evaluate arterial or venous blood gases
C. Reassess breath sounds and clinical status
D. Repeat the albuterol treatment
2. A 5-year-old child presents with lethargy, increased work of
breathing, and pale color. The primary assessment reveals that the
airway is open and the respiratory rate is 30/min, with crackles
heard on auscultation. The cardiac monitor shows sinus tachycardia
at a rate of 165/min. The pulse oximeter displays an oxygen
saturation of 95% and a pulse rate of 93/min. On the basis of this
information, which of the following provides the best interpretation
of the oxygen saturation of 95% by pulse oximetry?
A. Reliable; no supplementary oxygen is indicated B. Reliable;
supplementary oxygen should be administered
,C. Unreliable; no supplementary oxygen is indicated
D. Unreliable; supplementary oxygen should be administered
3. A 2-year-old child with a 2-day history of a barking cough presents
with audible stridor on inspiration, intercostal retractions, and
agitation. What is the most appropriate intervention for this child?
A. Lay the child flat on a stretcher
B. Suction the mouth and nose
C. Administer nebulized epinephrine
D. Administer inhaled albuterol
4. The parents of a 7-year-old child who is undergoing
chemotherapy report that the child has been febrile and has not
been feeling well, with recent onset of lethargy. Assessment reveals
the following: The child is difficult to arouse, with pale color. The
child's heart rate is 160/min, respiratory rate is 30/min, blood
pressure is 76/45 mm Hg, capillary refill time is 5 to 6 seconds, and
temperature is 103°F (39.4°C). What is the most appropriate
intervention?
A. Obtain vascular access and administer 20 mL/kg of isotonic
crystalloid over 30 minutes
B. Obtain vascular access and administer 20 mL/kg of isotonic
crystalloid over 5 to 10 minutes
C. Obtain immediate blood cultures and chest x-ray
, D. Obtain expert consultation with an oncologist to determine the
chemotherapeutic regimen
5. A 2-year-old child presents with a 4-day history of vomiting. The
initial impression reveals an unresponsive child with intermittent
apnea and mottled color. Heart rate is 166/min, respiratory rate is
now being supported with bag-mask ventilation, capillary refill
time is 5 to 6 seconds, and temperature is 102°F (38.9°C). What is
the best method of establishing immediate vascular access? A. Two
providers may attempt peripheral vascular access twice each
B. Three providers may attempt peripheral vascular access once
each
C. Place a central venous line
D. Place an intraosseous line
6. Which of the following oxygen saturations indicates the need for
additional intervention?
A. 96% on room air
B. 95% on room air
C. 93% on 4 L of oxygen
D. 97% on 50% oxygen
7. A 3-year-old child presents with a 2-day history of nausea and
vomiting. She is alert, with no increase in respiratory effort, and is