Pediatric Emergency Nursing Quiz #7

1. A 5-year-old girl has a fever, headache, and complaints of a stiff neck. The physician suspects bacterial meningitis. What is the best test culture site to detect the bacteria?

Lumbar puncture

Clean catch urine

Nasal swab

Blood Culture

Lumbar puncture is the method of choice for detecting the bacteria causing bacterial meningitis and sending a sample for culture, as meningitis infects the meninges and bacteria is present in the cerebrospinal fluid.

Explanation

Lumbar puncture is the method of choice for detecting the bacteria causing bacterial meningitis and sending a sample for culture, as meningitis infects the meninges and bacteria is present in the cerebrospinal fluid.

2. A 14-year-old boy with leukemia is receiving an IV infusion of packed red blood cells. The client reports that he is feeling anxious and short of breath even though his respiratory rate is 24. What should the nurse do in this situation?

Give a dose of diphenhydramine

Give a dose of acetominophen

Stop infusion and notify physician

Give a dose of ibuprofen

Anxiety and the sensation of breathlessness are signs of possible anaphylactic shock, a reaction to the packed red blood cells, so the nurse should stop the infusion immediately and notify the physician.

Explanation

Anxiety and the sensation of breathlessness are signs of possible anaphylactic shock, a reaction to the packed red blood cells, so the nurse should stop the infusion immediately and notify the physician.

3. An 8 year old is being evaluated in the ER for suspected appendicitis. The physician has then lie on their left side and extend the hip, eliciting pain in the RLQ. What is this test called?

Kernig's Sign

Rovsing's Sign

Brudzinski's Sign

Psoas Sign

Kernig's and Bruszinski's signs are used to evaluate for Meningitis. Rovsing's sign also is a test for appendicitis, but is done by applying deep palpation to the RLQ, causing pain.

Explanation

Kernig's and Bruszinski's signs are used to evaluate for Meningitis. Rovsing's sign also is a test for appendicitis, but is done by applying deep palpation to the RLQ, causing pain.

4. A patient is experiencing dizziness, shortness of breath, lightheadedness, and nausea caused by encephalitis. Which of the following descriptions most accurately describes the patient's condition?

Metabolic acidosis

Respiratory alkalosis

Metabolic alkalosis

Respiratory acidosis

Respiratory alkalosis results from hyperventilation, during which extra CO2 is excreted, causing a decrease in carbonic acid (H2CO3) concentration in the plasma. Symptoms include tachycardia, arrhythmias, lightheadedness, nausea, and vomiting.

Explanation

Respiratory alkalosis results from hyperventilation, during which extra CO2 is excreted, causing a decrease in carbonic acid (H2CO3) concentration in the plasma. Symptoms include tachycardia, arrhythmias, lightheadedness, nausea, and vomiting.

5. A 10-year-old is accidentally shot in the forearm by a small caliber firearm. The wound enters the dorsum of the forearm and exits on the ventral side. The patient is ambulatory and has minor pain at the site. What test is likely needed for evaluation of the injury?

CT scan of arm

MRI of arm

Arteriogram

Ultrasound of arm

An arteriogram is needed to assess the vascular supply in the arm after a gunshot wound to ensure that no injury to the ulnar and radial artery has occurred.

Explanation

An arteriogram is needed to assess the vascular supply in the arm after a gunshot wound to ensure that no injury to the ulnar and radial artery has occurred.