Pediatric Nurse Management of Acute Illness Questions and Answers

Question 1

A 9-month-old infant is brought to the emergency department with a 2-day history of rhinorrhea, cough, and wheezing.
Assessment reveals a respiratory rate of 65 breaths/minute, prominent intercostal retractions, and an oxygen saturation of 91% on room air.
The infant is having difficulty breastfeeding.
Which of the following is the priority nursing intervention?

Accepted Answer

Initiating intravenous fluids and supplemental oxygen.

Answer

Administering a prescribed bronchodilator via nebulizer.

Answer

Obtaining a nasopharyngeal swab for RSV testing.

Answer

Encouraging the mother to continue breastfeeding frequently.

Question 2

A 4-year-old child presents with a 24-hour history of vomiting, watery diarrhea, and a low-grade fever. The nurse assesses the child and notes dry mucous membranes, decreased skin turgor, and a capillary refill time of 3 seconds. The child is awake and alert but irritable. Which of the following is the most appropriate initial management strategy?

Accepted Answer

Initiate oral rehydration solution (ORS) in small, frequent amounts.

Answer

Administer an IV bolus of 0.9% normal saline.

Answer

Provide clear liquids such as water and apple juice as tolerated.

Answer

Administer an anti-diarrheal medication as prescribed.

Question 3

A 2-year-old is brought to the clinic with a 'barking' cough and inspiratory stridor that is worse at night. The parents report the child has had a runny nose and low-grade fever for two days. The child is alert, with no cyanosis, and mild subcostal retractions are noted. Which nursing action is the highest priority for managing this child's condition?

Accepted Answer

Administering a prescribed dose of oral dexamethasone.

Answer

Preparing for immediate endotracheal intubation.

Answer

Obtaining a chest X-ray to rule out pneumonia.

Answer

Keeping the child NPO in anticipation of surgery.

Question 4

Parents call the pediatric clinic after their 18-month-old child experienced a generalized seizure lasting 2 minutes during a febrile illness (temperature 103°F/39.4°C). The child is now postictal but easily arousable. Which of the following pieces of advice is most appropriate for the nurse to provide?

Accepted Answer

"This is likely a simple febrile seizure. Focus on comfort measures and fever control with antipyretics."

Answer

"Bring the child to the emergency department immediately for a full neurologic workup."

Answer

"Administer a dose of aspirin now and another in 4 hours to prevent another seizure."

Answer

"Give the child a cool water bath immediately to lower the temperature quickly."

Question 5

A 7-year-old child is admitted with a suspected diagnosis of acute appendicitis. Which of the following clinical findings would most strongly support this diagnosis?

Accepted Answer

Periumbilical pain that migrates to the right lower quadrant.

Answer

High-grade fever and profuse, watery diarrhea.

Answer

Diffuse abdominal pain with a history of chronic constipation.

Answer

Abdominal cramping that is relieved by having a bowel movement.

Question 6

A 3-year-old female presents with fever, vomiting, and foul-smelling urine. A clean-catch urine sample is obtained. Which of the following urinalysis results would be most indicative of a urinary tract infection (UTI)?

Accepted Answer

Positive for leukocyte esterase and nitrites.

Answer

Positive for ketones and trace protein.

Answer

Negative for nitrites and positive for 1-2 WBCs/hpf.

Answer

Specific gravity of 1.030 and amber color.