1. Which of the following would be an abnormal finding in a patient with glomerulonephritis?
Clear urine There is a decrease in urine output for patient's with glomerulonephritis. Urine would be
concentrated and dark brown/tea-colored.
Decreased energy
Hypertension
Nausea, vomiting
2. A 3-year-old is brought to the emergency department with a 2-day history of a runny nose, lowgrade fever, and a "barky" cough at night. The caregiver tells the emergency department nurse
the coughing is getting worse. The child is awake and alert, with stridor. The nurse should
anticipate which of the following?
Administration of nebulized epinephrine Moderate to severe croup is treated with
dexamethasone and nebulized epinephrine.
Delivery of humidified oxygen
Bag-valve-mask ventilations
Suctioning secretions from the oropharynx
3. The neurosurgeon has decided to perform an invasive procedure in the emergency department
to monitor the intracranial pressure on a 5-year-old patient. The family does not speak English
and has identified their religion as Muslim. Which of the following interventions is most
supportive of the family?
Allow the extended to family members to serve as interpreters during the procedure.
Dedicate a healthcare team member to be with the family during the procedure.
Allowing caregivers to remain with the pediatric patient is more supportive in this
situation. Allow family members to serve as interpreters during the procedure
Provide access to nondenominational clergy in a quiet area
4. Which of the following patient presentations should increase suspicion of potential child
maltreatment?
Right radial spiral fracture in a 10-year-old practicing martial arts
Bruising to the left ear of a newborn from sleeping on his side Any bruise in a nonexploratory location in children younger than 4 years and any bruising in a child younger than 4 months
(TEN-4) are cause for suspicion of abuse.
Closed greenstick wrist fracture in a 4 year old who fell off his bicycle
Bruises in various stages of healing to the lower extremities of a 2-year-old
5. A 14-year-old high school student who was pitching for his baseball team was hit in the chest by
the ball and had a sudden cardiac arrest. Of the following, which is the most likely cause of the
cardiac arrest?
Aortic Dissection
Commotio cordis Commotio cordis occurs when the chest is struck during the refractory period of
the cardiac conduction cycle, resulting in a ventricular dysrhythmia or asystole. This type of injury usually
occurs in recreational sports such as baseball or ice hockey.
Pericardial Tamponade
Blunt Aortic Injury
6. A 12-year-old who was recently started on anti-psychotic medication for schizophrenia is brought
to the emergency department with severe muscle rigidity and hyperthermia. These symptoms
are most likely caused by which of the following?
Ecstasy overdose
Neuroleptic malignant syndrome These are classic symptoms of neuroleptic malignant syndrome,
which is a rare reaction to antipsychotic medications.
Serotonin syndrome
Nicotine overdose
7. Which of the following patients should be evaluated first?
A 3-year-old with a dislodged gastrostomy tube
A 12-year-old with left shoulder pain after a handlebar injury
An 18-month-old with bilious emesis Bilious emesis in an 18-month-old is always considered an
emergent symptom indicative of a life-threatening bowel obstruction.
A 3-month-old with periods of inconsolable crying
8. Which of the following tasks can the nurse do to decrease adverse medication events?
Obtain the patient's weight in kilograms This is the preferred measurement for medication
calculations for pediatric and adult patients.
Verifying the patient dose during shift report at nursing station
Dual confirmation of a hard to read order
Confirming patient's attending provider
9. Acute chest syndrome, stroke, and splenic sequestration are complications of which of the
following diseases?
Mononucleosis
Hemophilia
Sickle cell anemia These are all complications of sickle cell anemia.
Acute rheumatic fever
10. During the assessment of a 16-year-old male patient, the ED nurse identifies him as a potential
sex trafficking victim. The trauma informed approach to care emphasizes certain principles in
caring for these types of patients. Which of the following care principles has the highest priority?
Empowerment, voice and choice
Physical and psychological safety Create an environment where patients feel safe, both
physically and psychologically. Increase awareness of the patient’s interpersonal interactions with others to
screen for risk of harm. Prioritize the patient being in a safe location.
Peer support
Trustworthiness and transparency
11. A 6-month-old is brought to the emergency department for a recurrent respiratory infection.
When gathering a history from the caregiver, the emergency nurse learns that, in addition to the
respiratory symptoms, the infant has had fatty stools. The emergency nurse should be
concerned about which of the following disease processes?
Cystic Fibrosis Pancreatic insufficiency leads to fat malabsorption, which results in the fatty stools
seen with cystic fibrosis.
Bronchopulmonary Dysplasia
Pneumonitis
Reactive Airway Disease
12. The emergency nurse is caring for a patient with significant facial trauma and a suspected globe
rupture. Which of the following medication orders would the nurse question?
Ondansetron
Midzaolam
Succinylcholine Succinylcholine may increase intraocular pressure and should be avoided.
Vancomycin
13. A 7-year-old arrives via ambulance. The patient's mother reports witnessing a seizure at home.
The patient has no seizure history. Upon examination, the patient is post-ictal with a heart rate
of 142 beats per minute, respiratory rate of 36 breaths per minute, and blood pressure of 86/72
mm Hg. Significant burns are noted to the patient's back and lower extremities. The mother
states the burns accidentally occurred 3 days ago, but she was afraid to bring patient in due to
an ongoing child welfare investigation. Which of the following are the MOST appropriate
immediate interventions?
Administer lorazepam and a fluid bolus and place on seizure precautions
Draw and send a metabolic panel, administer a fluid bolus, and obtain a point of care
glucose Significant burns can cause electrolyte imbalances. Electrolyte imbalances may be the cause of
the patient's seizure. Electrolyte imbalances need to be identified and treated.
Administer intravenous analgesics, a fluid bolus, and obtain a point of care glucose
Call police and child welfare authorities and have security detain parent
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