Neonatal and Pediatric

Question 1

Clinical symptoms of respiratory failure are ominous for what?

Answer 1

Respiratory arrest

Question 2

Hypoxemic blood circulated systemically and oxygenated blood circulated through the pulmonary vasculature is characteristic of which obstructive defect?

Answer 2

Complete transposition of the great vessels (TGV)

Question 3

List clinical symptoms of respiratory failure.

Answer 3

Changing mental status, muscle flaccidity, tachycardia changing to bradycardia, irregular respiratory pattern, loss of vesicular breaths sounds, pallor becoming cyanosis

Question 4

What medications are used to treat sepsis in neonates?

Answer 4

Antibiotics and vasopressors

Question 5

Rapid onset of fever, sore throat, unwillingness to eat or drink, and drooling are clinical manifestations associated with what upper airway disease?

Answer 5

Epiglottitis

Question 6

While rendering care to a pediatric trauma patient, the trauma team does not feel the mechanism of injury was accidental. Who should be notified?

Answer 6

Law enforcement and other agencies deemed appropriate

Question 7

What intravenous fluids are used to correct nondistributive shock?

Answer 7

Isotonic crystalloids and blood products

Question 8

What medications are used in the treatment of distributive shock and why?

Answer 8

Sympathomimetics with strong alpha properties to induce vasoconstriction

Question 9

If left untreated, what can necrotizing enterocolitis (NEC) lead to?

Answer 9

Perforation of the bowel leading to peritonitis and subsequent sepsis

Question 10

What is a common skin finding in the hands and feet of a neonate when they cry?

Answer 10

Cyanosis which is insignificant when the neonate is crying

Question 11

What is the narrowest portion of the pediatric airway?

Answer 11

Glottic opening

Question 12

List findings in compensated respiratory distress.

Answer 12

Tachypnea, accessory muscle use, nasal flaring, grunting, adventitious breath sounds, abdominal wall movement, tachycardia, diaphoresis, pulse oximtry and end-tidal capnography changes

Question 13

Which vessel is cannulated when establishing vascular access via the umbilical cord?

Answer 13

Umblilical vein

Question 14

Barking cough is the hallmark sign of what pulmonary infection?

Answer 14

Croup (laryngotracheobronchitis)

Question 15

What is deficient in neonatal respiratory distress syndrome?

Answer 15

Surfactant

Question 16

A physician orders an epinephrine infusion at 5 mcg/mg/min. Should you question this order?

Answer 16

Yes. The proper dose is 0.1-1 mcg/kg/min

Question 17

What are two common causes of nondistributive shock in pediatrics?

Answer 17

Diarrhea, vomiting

Question 18

Bounding pulses in upper extremities and thready pulses in lower extremities are clinical findings of which heart anomaly?

Answer 18

Coarctation of the aorta (COA)

Question 19

An untreated tension pneumothorax can lead to what type of shock?

Answer 19

Obstructive shock

Question 20

What is the most common viral pulmonary infection in children with recent upper respiratory infections?

Answer 20

Croup (laryngotracheobronchitis)

Question 21

Why is orotracheal intubation avoided in cases of epiglottitis?

Answer 21

Stimulation from the intubation attempt usually causes worsening of the already edematous glottis

Question 22

Methylprednisolone, dexamethasone, and hydrocortisone are what type of medications utilized in the treatment of asthma?

Answer 22

Corticosteroids

Question 23

What is treatment aimed at in the asthmatic patient?

Answer 23

Reversal of bronchospasm, correction of hypoxia, improvement in airway inflammation, and reduction of mucus production

Question 24

What is the predominant causative agent in bronchiolitis?

Answer 24

Respiratory syncytial virus (RSV)

Question 25

What is the leading cause of cardiopulmonary arrest in the pediatric patient?

Answer 25

Respiratory distress

Question 26

Why are neonates not treated with D25 or D50?

Answer 26

Dextrose of these concentrations cause a severe increase in plasma osmolarity thus causing hypernatremia with cerebral and systemic cellular edema

Question 27

What three items are assessed in the pediatric assessment triangle?

Answer 27

Appearance, breathing, and circulation

Question 28

After several attempts to correct a child’s blood pressure with IV fluids, it is determined a dopamine infusion is to be initiated. What is the correct dose?

Answer 28

2-10 mcg/kg/min

Question 29

What is the clinical presentation of Tetralogy of Fallot (TOF)?

Answer 29

Increased work of breathing with tachypnea, tachycardia, nailbed clubbing, and fatigue during feeding

Question 30

Inotropic medications are utilized in which hypoperfusion syndrome?

Answer 30

Cardiogenic shock

Question 31

What three vessels compose the umbilical cord?

Answer 31

Two umbilical arteries and one umbilical vein