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An adolescent is admitted with toxic shock syndrome. In addition to blood cultures, which of the following lab orders should a nurse anticipate?
A 3-year-old heart transplant patient is experiencing signs of rejection. Which of the following best supports this?
In diabetic ketoacidosis (DKA), gluconeogenesis is a compensatory mechanism for a perceived deficiency in:
A child was struck by an automobile 24 hours ago. There is an ICP monitor in place which has a spontaneous rise in ICP to 35 mm Hg. A nurse medicates the patient with analgesia and sedative, but the ICP remains elevated. Which of the following should be the next intervention?
An infant with acute exacerbation of bronchopulmonary dysplasia (BPD) is placed on mechanical ventilation. The most appropriate ventilator strategy is:
During an exchange transfusion for sickle cell crisis, the patient becomes anxious and reports tingling and numbness around the mouth. The nurse should administer:
A child ventilated with PEEP of 10 cm H₂O exhibits acute decreases in O₂ saturation, HR, BP, and systemic perfusion. A nurse should notify the physician and prepare for:
A child has fever, chills, back pain, elevated WBC and ESR, and abnormal urinalysis. After IV fluids and antibiotics, what procedure should be anticipated?
A patient has a large intracranial hemorrhage and loss of brainstem reflexes. Prior to official brain death declaration, which must be ensured?
A patient on peritoneal dialysis has high blood glucose. Most likely cause is:
Systemic Inflammatory Response Syndrome (SIRS) is characterized by:
A patient has a right groin central venous catheter with vasoactive infusions. The nurse notices swelling and increased circumference of the right thigh and calf. The first action should be to:
In an infant with bronchopulmonary dysplasia (BPD), pathophysiologic consequences of chronic hypoxia include:
For a 20-kg child experiencing abdominal hemorrhaging, a nurse should expect to administer a fluid bolus of:
A 6-year-old child is admitted following ingestion of an unidentified substance. Assessment reveals:
BP: 120/84
HR: 190
RR: 44
ECG: Sinus rhythm with occasional PVCs
Dilated pupils
Dry mucous membranes
Disorientation
Urinary retention
These findings are consistent with ingestion of:
Which of the following is a prerenal cause of acute renal failure?
One hour after receiving naloxone, a child becomes lethargic again and has a RR of 6. The nurse should anticipate:
A transgender adolescent requests to be addressed by preferred name/pronouns, different from medical record. What is the best response?
A child who nearly drowned received CPR, was resuscitated quickly, and regained consciousness. What should the nurse anticipate?
The plan of care for a child with possible epiglottitis 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:
The positive inotropic effects of dobutamine (Dobutrex) at 7 mcg/kg/min will produce an increase in which of the following hemodynamic parameters?
Following an arterial switch operation, an infant develops symptoms of myocardial ischemia. The etiology is most likely related to:
A 4-day-old infant presents with lethargy, vomiting, acidosis, and has a seizure upon arrival. What is the most likely diagnosis?
A child with RDS is on mechanical ventilation with PEEP 15 cm H₂O and FiO₂ 50%. What is the most likely initial complication?
An infant has hypovolemic shock from severe diarrhea. Which of the following assessments demonstrates adequate tissue perfusion following fluid resuscitation?
Capillary Refill
Urine Output
CVP
BP
a. 2 sec
0.5 ml/kg/hr
2 mm Hg
84/50
b. 3 sec
0.5 ml/kg/hr
6 mm Hg
72/44
c. 3 sec
1.2 ml/kg/hr
4 mm Hg
72/48
d. 2 sec
1.2 ml/kg/hr
8 mm Hg
80/54
A nurse just completed their first-year evaluation and indicates a long-term goal to be a Chief Nursing Officer (CNO). The mentor should recommend the nurse:
Following placement of a central venous catheter, a mechanically ventilated child develops acute tachycardia, hypotension, and arterial desaturation. A nurse should evaluate the need for:
Following resuscitation of a 2-year-old near-drowning patient, which of the following changes is indicative of a poor neurologic outcome?
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?
Fifteen minutes after receiving PO pain medication, a patient reports dull pain in their lower abdomen without nausea. Which of the following interventions should a nurse consider next?
A nurse preceptor and new nurse are caring for a 16-year-old patient following a crush injury. The lab report is significant for a creatine kinase (CK) level of 150 U/L and the patient’s urine is dark yellow. Vital signs are:
BP: 95/60
HR: 115
RR: 22
Temp: 100.5°F (38.1°C)
Which of the following statements by the new nurse is most correct?
A 2-day-old infant develops a tachycardia of 300. A 12-lead ECG reveals narrow complexes and prominent delta waves. The patient most likely has:
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:
An infant presents with poor feeding and a blood glucose level of 50 mg/dL. A nurse should assess for which of the following symptoms?
A 17-year-old on home peritoneal dialysis has new-onset fever and abdominal pain. Dialysate WBC is 185. What order should the nurse anticipate?
One day after a spinal fusion, a child is tachycardic and febrile with decreased bilateral breath sounds. SaO₂ is 92% on 2 L/min and FVC is 10 mL/kg. These symptoms most likely indicate:
Which of the following defines post-coarctectomy syndrome?
Early symptoms of carbon monoxide poisoning include:
High lead levels present a medical emergency because they are associated with the development of:
A patient’s mother shares with a nurse that the patient has been sleeping more than usual, and has expressed feelings of hopelessness and "unbearable pain". Which of the following is the priority nursing intervention?
A 16-year-old patient is unresponsive after a motor vehicle collision. The parents speak another language. While performing the secondary survey, what should the nurse do next?
A young patient is admitted from the PACU to the ICU with complications following surgery. The parents are angry and confused as they were originally told by the surgeon their child was stable and the plan was to transfer the child to a regular room. How should the nurse best address the parents' concerns?
A recently deceased patient's family begins arriving to the ICU, visibly distraught and wailing. What is the nurse's first action?
A patient has visitors whose loud talking and laughing disrupts other patients and visitors in the ICU. Which of the following is the most effective way for a nurse to address this situation?