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A child with a right pulmonary contusion is intubated and ventilated. When positioned with the affected side down, O₂ saturation drops. The most likely cause is:
An 18-month-old child is irritable and restless. Retractions, grunting with crackles, and an S3 gallop are noted. Vital signs:
BP: 70/56
HR: 160
RR: 60
Temp: 99°F (37.4°C)
Which of the following types of shock is this patient most likely experiencing?
A school-aged patient who was admitted with an acute asthma exacerbation has improved and is now ready for transfer to the floor. In preparation for discharge, the nurse should evaluate:
An irritable child has an acute fever, conjunctivitis, rash, and a strawberry tongue. A prolonged PR interval is observed on the ECG monitor. These findings are most likely due to:
After arterial switch surgery, an infant shows ST elevation, low oxygen saturation, and frothy secretions. Most likely cause?
Following an arterial switch operation, an infant develops symptoms of myocardial ischemia. The etiology is most likely related to:
Following a traumatic brain injury, an intubated 2-year-old patient requires an infusion of cisatracurium (Nimbex) to assist with intracranial pressure. On day 3, the ventilator’s mean airway pressure begins to alarm frequently and suctioning needs have increased. The patient’s vital signs are:
BP: 99/58
HR: 148
RR: 20
T: 102.2°F (39°C)
ICP: 19
CPP: 53
WBC: 22,000
Na⁺: 153 mEq/L
A nurse should anticipate the patient will require:
A nursing practice council is reviewing a protocol for flushing unused IV lines. A team member questions the use of saline vs. dextrose. What should the council do first?
A 3-year-old heart transplant patient is experiencing signs of rejection. Which of the following best supports this?
When evaluating the effectiveness of a new skin care protocol, a nurse should assess the:
While ventilating with 100% FiO₂ via Ambu bag, an intubated child desaturates. Breath sounds are decreased in all fields. What is the best action?
A patient on prolonged mechanical ventilation and in an unresponsive state is showing no signs of progression toward recovery. The healthcare team suggested a comfort care approach. Family members are conflicted. Which of the following should the nurse suggest as the next course of action?
In a patient with status asthmaticus on a terbutaline drip, serum electrolytes are ordered because frequent administration of a beta-agonist can cause:
An adolescent is admitted with toxic shock syndrome. In addition to blood cultures, which of the following lab orders should a nurse anticipate?
A 2-month-old with ventricular septal defect (VSD) and CHF should be managed with:
What is the best method to ensure parents of a child with a new tracheostomy are adequately prepared for home care?
CSF analysis shows: glucose 36 mg/dL, protein 110 mg/dL, and WBCs (PMNs) 1,000/microliters. These findings are indicative of:
A patient is postoperative day 1 from a laparotomy for appendicitis. Which intervention best prevents surgical wound infection?
A child’s ABG reveals pH 7.58, PaCO₂ 40, HCO₃ 30. What electrolyte change is expected?
One hour after starting a continuous IV insulin, a patient’s glucose drops by 145 mg/dL. What should the nurse monitor for?
A 10-year-old child presents with peri-umbilical pain, rebound tenderness, nausea, and fever up to 102°F (38.9°C). The pain prevents him from standing up straight. Which of the following should a nurse anticipate first?
A patient with suspected abdominal compartment syndrome has a bladder pressure of 8 mmHg. Which of the following actions should the nurse take first?
A 12-year-old presents with behavior changes and new-onset tonic-clonic seizures. Likely brain tumor location?
A child with spinal muscular atrophy type I (SMA) is admitted with respiratory syncytial virus (RSV). The child is hypotonic and tachypneic with moderate subcostal retractions and nasal flaring. After suctioning, the child’s respiratory status does not improve. Arterial oxygen saturations are 93% with an FiO₂ of 50%. Which of the following interventions should the nurse anticipate next?
A child is heading to the OR for internal injuries. The parents refuse blood products due to religious beliefs. What should the nurse do first?
A 2-year-old child in septic shock is receiving nitroprusside (Nipride). Which of the following findings indicates the need to increase the nitroprusside dosage?
What is the most common cause of neurologic dysfunction associated with spinal cord injury?
After a disaster drill, several issues related to notification of personnel and their role in the disaster were revealed. Which action should be done first?
An adolescent with recurrent leukemia expresses a desire to die peacefully. Weeks later, the patient is critically ill and the parents ask whether to escalate care. The nurse’s most appropriate response is:
A family member asks permission to visit a patient after work at 12:30 AM. On previous visits, the family member has been disruptive. To address the situation, a nurse should:
A 13-year-old with systemic lupus erythematosus has hypotension, CVP of 15 mm Hg, cool extremities, gallop rhythm, and coarse breath sounds. What treatment is expected?
The most beneficial nursing action to minimize avoidable patient safety incidents is:
A child with hepatic failure received volume replacement. Following this therapy, laboratory tests reveal:
PT: 14 sec
PTT: 40 sec
Hct: 36%
Albumin: 3.5 g/dL
Before the patient undergoes a closed liver biopsy, further replacement should include:
A school-age child is admitted in acute respiratory failure requiring mechanical ventilation. Endotracheal aspirate Gram staining is positive for an acid-fast bacillus. The nurse’s initial action should be to:
A 9-year-old patient with a history of tachycardia and syncope is connected to a monitor that shows a HR of 190, with regular P-P and R-R intervals. The patient is awake, crying, anxious, and has a BP of 94/60. Which of the following is the initial nursing intervention?
A 6-month-old patient presents with bronchiolitis and respiratory distress. Upon admission, the patient has mild retractions, scattered crackles, copious secretions, diarrhea with significant diaper dermatitis, and weight/height/head circumference less than the 5th percentile. The patient's vital signs are:
BP: 80/45
HR: 150
RR: 42
Temp: 98.8°F (37.1°C)
SpO₂: 96% on 4L heated high flow nasal cannula
A nurse should consider that the patient:
A child presents with new-onset right-sided weakness, slurred speech, and headache. Which chronic condition most likely predisposes the child to this presentation?
Twenty-four hours after a severe burn and inhalation injury, a child develops increased tachypnea and desaturation. The most likely cause is:
TESTED 04 Jun 2025