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After arterial switch surgery, an infant shows ST elevation, low oxygen saturation, and frothy secretions. Most likely cause?
CSF analysis shows: glucose 36 mg/dL, protein 110 mg/dL, and WBCs (PMNs) 1,000/microliters. These findings are indicative of:
The primary pulmonary pathophysiological change leading to respiratory distress syndrome (RDS) is:
A stat abdominal x-ray reveals free air and a large loculated fluid collection presumed to be blood. The priority of care should be:
A child’s ABG reveals pH 7.58, PaCO₂ 40, HCO₃ 30. What electrolyte change is expected?
An infant is admitted with tonic-clonic movement of the lower extremities. The most likely etiology of the seizure is:
A 2-year-old child in septic shock is receiving nitroprusside (Nipride). Which of the following findings indicates the need to increase the nitroprusside dosage?
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 a pediatric patient with viral myocarditis, clinical manifestations of decreased urine output, cool hands and feet, and pulmonary edema are most likely indicative of:
A teenage patient has an abrasion on her right forearm after a fall from a bicycle 3 days ago. The arm is cool, pale, and tight, capillary refill is greater than 5 seconds, and movement of her fingers is limited. Which of the following should a nurse anticipate as the initial treatment?
The parents of a teenager with terminal neuroblastoma are preparing to withdraw life-sustaining treatment. The parent states, "I would like their sibling to be here, but I’m not sure if that is a good idea.” Which of the following is the best response by a nurse?
An infant with acute exacerbation of bronchopulmonary dysplasia (BPD) is placed on mechanical ventilation. The most appropriate ventilator strategy is:
A 17-year-old presents with history of progressive exercise intolerance. He is admitted with a diagnosis of hypertrophic cardiomyopathy. The vital signs are as follows:
BP: 78/55
HR: 110
RR: 20
T: 98.3°F (36.8°C)
SpO₂: 89% on room air
The patient's vital signs reflect:
Following an arterial switch operation, an infant develops symptoms of myocardial ischemia. The etiology is most likely related to:
An adolescent is admitted with toxic shock syndrome. In addition to blood cultures, which of the following lab orders should a nurse anticipate?
A nurse managing a patient with carbon monoxide poisoning should consider the possibility of an inaccurate:
A patient asks the nurse to join in saying bedtime prayers. The nurse is not comfortable with this practice. Which of the following is the nurse’s most appropriate response?
A child with sickle cell anemia develops chest pain, SOB, and tachypnea. What is the most likely diagnosis?
For a 20-kg child experiencing abdominal hemorrhaging, a nurse should expect to administer a fluid bolus of:
A 2-month-old previously healthy infant is admitted for seizures. Lab values include:
Na: 119 mEq/L (low)
K: 4.8 mEq/L (normal)
Cl: 92 mEq/L (low)
Glucose: 78 mg/dL (normal)
Head CT: Normal
The nurse’s most appropriate action is to:
A 1-month-old presents with a 3-day history of fever, nausea, and vomiting. On assessment:
Pink, warm, dry skin
Slightly sunken fontanel
BP: 80/40
HR: 120
RR: 42
Which of the following changes indicate deterioration?
What is the most common cause of neurologic dysfunction associated with spinal cord injury?
One hour after receiving naloxone, a child becomes lethargic again and has a RR of 6. The nurse should anticipate:
An infant is diagnosed with a proximal esophageal atresia with a distal fistula. A nurse should anticipate:
A child is admitted following chest trauma, and a small pneumothorax (less than 10%) is noted. A nurse should anticipate which of the following?
Following a traumatic brain injury, an intubated 2-year-old patient requires an infusion of cisatracurium (Nimbex) to assist with intracranial pressure. On day 3, the ventilator’s mean airway pressure begins to alarm frequently and suctioning needs have increased. The patient’s vital signs are:
BP: 99/58
HR: 148
RR: 20
T: 102.2°F (39°C)
ICP: 19
CPP: 53
WBC: 22,000
Na⁺: 153 mEq/L
A nurse should anticipate the patient will require:
A 6-year-old with WPW syndrome and SVT episodes is admitted. What intervention is anticipated?
A 2-month-old with a VP shunt has a fever, irritability, and a bulging fontanel. Blood and urine cultures are negative. The most likely cause is:
A child presents with new-onset right-sided weakness, slurred speech, and headache. Which chronic condition most likely predisposes the child to this presentation?
Which action best facilitates a family’s response to discharge from ICU to a medical-surgical unit after a 3-week stay?
A transgender adolescent requests to be addressed by preferred name/pronouns, different from medical record. What is the best response?
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?
To lead a unit-based initiative to decrease central line-associated bloodstream infections, which of the following is the most appropriate approach?
Multiple blood transfusions have been given to a patient with massive blood loss following a motor vehicle crash. Which of the following electrolyte abnormalities should a nurse anticipate?
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 pediatric patient is admitted with severe sepsis and multi-organ dysfunction syndrome (MODS). Which of the following treatments should a nurse anticipate initially?
What is the best method to ensure parents of a child with a new tracheostomy are adequately prepared for home care?
A 13-year-old with systemic lupus erythematosus has hypotension, CVP of 15 mm Hg, cool extremities, gallop rhythm, and coarse breath sounds. What treatment is expected?
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:
A patient on prolonged mechanical ventilation and in an unresponsive state is showing no signs of progression toward recovery. The healthcare team suggested a comfort care approach. Family members are conflicted. Which of the following should the nurse suggest as the next course of action?
TESTED 02 Jun 2025