ATI LPN
Emergency Pediatric Psychiatric Care Questions
Question 1 of 5
Which child in the day-care setting does the nurse identify as having a developmental delay based on the following observations?
Correct Answer: C
Rationale: A 6-year-old should be able to sit still for a short story, and difficulty doing so may indicate a developmental delay. The other options are within normal developmental expectations: a 5-year-old may struggle with zippers, a 2-year-old isn't expected to recite a phone number or cut with scissors. (Note: Original question was multiple-answer; restructured to single-answer focusing on one child, with 'E' shifted to 'D' in original context handled separately below). Additional correct answer from original: An 18-month-old unable to phrase sentences also indicates delay, but here we focus on one for single-answer format.)
Question 2 of 5
A 4-year-old child presents to the Emergency Department after a seizure at home. He remains confused and combative. A bedside glucose evaluation reveals blood glucose of 25 mg/dl. The patient weighs 20 kg. What is the most appropriate dose of glucose to administer to this patient?
Correct Answer: D
Rationale: For hypoglycemia in children, D25 (25% dextrose) at 2-4 ml/kg is commonly used. For a 20 kg child, 40 ml of D25 (2 ml/kg) provides 10 g of glucose, which is appropriate to correct hypoglycemia effectively and safely.
Question 3 of 5
A 10-year-old boy with a history of asthma is brought to the Emergency Department for shortness of breath, cough, subjective fever, and rhinorrhea. His mother has been administering albuterol nebulizer treatments at home with little relief. His initial vital signs are as follows: heart rate 110 beats/minute, respiratory rate 15 breaths/minute, blood pressure 100/60 mm Hg, and oxygen saturation 93% on room air. On examination, the patient has intercostal and supra-costal retractions, poor inspiratory effort, and minimal wheezing in both lungs. He has a history of multiple hospitalizations for asthma exacerbation and has been intubated once for respiratory failure because of asthma exacerbation. What is the most appropriate intervention at this time?
Correct Answer: C
Rationale: Given severe distress (retractions, poor effort, history of intubation), noninvasive ventilation (e.g., BiPAP) is appropriate to support breathing and avoid intubation.
Question 4 of 5
The incidence of septic shock in children in the United States is greatest in:
Correct Answer: A
Rationale: Infants have the highest incidence of septic shock due to immature immune systems and higher infection rates.
Question 5 of 5
An 11-year-old patient who was in a severe motor vehicle collision and sustained multiple fractures and a potential traumatic brain injury (TBI) presents to the ED. The GCS is 5. Multiple direct and video laryngoscopy intubation attempts with in-line cervical spine stabilization have been unsuccessful. What is the most appropriate next step for this patient?
Correct Answer: A
Rationale: In a failed airway with severe trauma and low GCS, surgical cricothyrotomy is the definitive step in children over 8-10 years.