Sepsis/Shock
A 4-year-old child with influenza has the following assessment findings:
What stage of sepsis is the child MOST likely experiencing?
Compensated sepsis/early septic shock
A 2-year-old child presents with:
What condition should the nurse suspect?
Croup
A 6-year-old child presents with:
What condition should the nurse suspect?
Meningitis
A patient is receiving vancomycin for a serious bacterial infection.
Morning labs:
What complication is the nurse most concerned about?
Nephrotoxicity
A nurse is caring for a child with suspected epiglottitis.
The child is:
Which nursing action should the nurse question FIRST?
A. Keep the child calm and with the parent
B. Prepare for possible airway intervention
C. Use a tongue depressor to visualize the throat
D. Minimize unnecessary procedures
C. Use a tongue depressor to visualize the throat
A 5-year-old child is admitted with pneumonia.
Over the last 4 hours, the nurse notes:
What is the nurse's priority hypothesis?
The child is progressing towards septic shock.
A 6-month-old infant is admitted with bronchiolitis (RSV).
Assessment findings:
Which findings indicate increased work of breathing?
A. Nasal flaring
B. Intercostal retractions
C. Tachypnea
D. SpO₂ 89%
E. Poor feeding
F. Head bobbing
A,B,C,F
A 10-year-old child with suspected bacterial meningitis has been admitted.
Four hours later, the nurse notes:
What complication should the nurse suspect?
Increased ICP
A patient is receiving gentamicin for a severe infection.
The nurse reviews the following findings:
What complication is the nurse most concerned about?
Ototoxicity
A nurse is caring for a child with suspected bacterial meningitis.
The provider has written the following orders.
Which order should the nurse question FIRST?
A. Initiate seizure precautions
B. Obtain blood cultures
C. Delay antibiotics until all culture results are back
D. Monitor neurologic status frequently
C. Delay antibiotics until all culture results are back
A 7-year-old with a bloodstream infection has the following assessment findings:
Which findings indicate poor perfusion?
A. Delayed cap refill
B. Cool mottled extremities
C. Decreased urine output
D. Lethargy
E. Hypotension
F. Tachycardia
A. Delayed cap refill
B. Cool mottled extremities
C. Decreased urine output
D. Lethargy
E. Hypotension
A 4-year-old child with pneumonia has the following assessment findings:
Earlier the child was:
Now the child is:
The nurse should interpret this change as:
A. Improvement
B. Reduced anxiety
C. Impending respiratory failure
D. Resolution of pneumonia
C. Impending respiratory failure
A child with bacterial meningitis has been receiving treatment for 12 hours.
The nurse notes:
A new nurse says:
"The fever is improving, so the patient must be getting better."
What is the best response?
A. Correct, the infection is resolving.
B. Not necessarily. The neurologic findings suggest the patient is deteriorating despite the improving fever.
B. Not necessarily. The neurologic findings suggest the patient is deteriorating despite the improving fever.
A patient is receiving vancomycin and gentamicin for severe sepsis.
Morning assessment:
Yesterday
Creatinine 0.8
Urine Output Adequate
Hearing Normal
Today
Creatinine 1.6
Decreased Urine Output
Reports ringing in ears
Which finding is MOST concerning?
A. Ringing in the ears
B. Rising creatinine
C. Decreased urine output
D. The trend of worsening toxicity across multiple systems
D. The trend of worsening toxicity across multiple systems
A nurse is caring for a child admitted with RSV bronchiolitis.
The child has:
What complication is the nurse trying to prevent by monitoring intake and output?
A. Hyperkalemia
B. Dehydration
C. SIADH
D. Increased ICP
B. Dehydration
You are assessing four children with infections.
Patient A
Patient B
Patient C
Patient D
Match each patient to the stage:
A. Infection without shock
B. Compensated septic shock
C. Decompensated septic shock
Patient A: B - Compensated septic shock
Patient B: B - Compensated septic shock
Patient C: C - Decompensated septic shock
Patient D: A - Infection without shock
You receive report on four pediatric respiratory patients.
A. Child with croup
B. Infant with bronchiolitis
C. Child with pneumonia
D. Teen with asthma
Which patient do you assess FIRST?
B. Infant with bronchiolitis
You receive report on four pediatric patients.
A. Child with meningitis
B. Child with meningitis
C. Child with febrile seizure
D. Child with viral illness
Which patient do you assess FIRST?
B. Child with meningitis
A child is being treated with acyclovir for a serious viral infection.
The nurse reviews the following trends:
Yesterday:
Creatinine 0.6
Urine Output Adequate
Alert
Drinking well
Today:
Creatinine 1.4
Decreased Urine Output
More lethargic
Poor intake
Which findings support kidney injury?
A. Rising creatinine
B. Decreased urine output
C. Lethargy
D. Poor intake
E. Worsening trend
A. Rising creatinine
B. Decreased urine output
E. Worsening trend
A child is admitted with suspected sepsis.
Assessment:
The nurse receives report from a student nurse:
"The patient has a fever, so I think fever is our biggest problem."
What is the best response?
A. Correct. Fever is the highest priority.
B. The priority problem is impaired perfusion.
C. The priority problem is poor nutrition.
D. The priority problem is pain.
You are charge nurse and receive report on four pediatric patients.
A. Child with pneumonia
B. Child with meningococcal infection
C. Child with RSV
D. Child with cellulitis
Rank the patients from first priority to last
A,B,C,D
Your unit has four newly admitted pediatric patients with respiratory infections.
Patient A
RSV Bronchiolitis
Patient B
Pertussis
Patient C
Suspected Tuberculosis
Patient D
Influenza
Match each patient to the correct isolation precaution.
Isolation Choices
A. Standard
B. Contact
C. Droplet
D. Airborne
Patient A: B. Contact
Patient B: C. Droplet
Patient C: D. Airborne
Patient D: C. Droplet
Patient A
Suspected bacterial meningitis
Which PPE is required before entering the room of Patient A?
Droplet precautions (Surgical masks, if contact with secretions - eye protection, glove, gown)
Rank the patients from first priority to last.
A. Patient on gentamicin
B. Patient with meningitis
C. Patient with RSV
D. Patient with cellulitis
B,A,C,D
A child is admitted with suspected meningococcal meningitis.
Assessment:
RANK THE FOLLOWING FINDINGS FROM MOST → LEAST CONCERNING
1,3,2,4