Question 1

Which assessment findings would be recognized as late signs of shock in a child? (Select all that apply.)

Accepted Answer

A) Metabolic (lactic) acidosis 
B) Cool skin 
C) Bradycardia 
D) Prolonged capillary refill 
E) Hypotension 
A) Metabolic (lactic) acidosis 
B) Cool skin 
C) Bradycardia 
D) Prolonged capillary refill 
E) Hypotension C, E

Question 2

To determine a child's response to fluid therapy for shock, the healthcare professional should monitor which measurements as the priority?

Accepted Answer

A) Hematocrit and hemoglobin levels 
B) Urine output and specific gravity 
C) Blood pressure and pulse 
D) Arterial blood gases and heart rate 
A) Hematocrit and hemoglobin levels 
B) Urine output and specific gravity 
C) Blood pressure and pulse 
D) Arterial blood gases and heart rate B

Question 3

A healthcare professional assesses that a child's capillary refill time is 4 sec. What does the healthcare professional evaluate that finding to mean?

Accepted Answer

A) The child is in shock. 
B) The child must have septic shock. 
C) The child has compensated shock. 
D) This finding is normal. 
A) The child is in shock. 
B) The child must have septic shock. 
C) The child has compensated shock. 
D) This finding is normal. A

Question 4

The healthcare professional plans care for a child in shock. What are the primary goals for the treatment of shock?

Accepted Answer

A) Maximizing oxygen delivery and minimizing oxygen demand 
B) Maintaining hydration and adequate urinary output 
C) Supporting all facets of the cardiovascular system 
D) Maintaining all vital signs within normal functioning ranges 
A) Maximizing oxygen delivery and minimizing oxygen demand 
B) Maintaining hydration and adequate urinary output 
C) Supporting all facets of the cardiovascular system 
D) Maintaining all vital signs within normal functioning ranges

Question 5

Approximately 80% of all hospital-acquired infections in children are a result of which type of organism?

Accepted Answer

A) Bacteria 
B) Viruses 
C) Fungi 
D) Rickettsia 
A) Bacteria 
B) Viruses 
C) Fungi 
D) Rickettsia

Question 6

Which information does the student learn regarding multiple organ dysfunction syndrome (MODS)? (Select all that apply.)

Accepted Answer

A) Diagnosis requires simultaneous failure of at least two organs. 
B) Primary MODS occurs immediately after the attributing cause. 
C) Secondary MODS occurs within 3 to 7 days of the initial insult. 
D) Chronic illness increases a child's risk for MODS. 
E) Risk factors for MODS include severe or prolonged shock, sepsis, and trauma. 
A) Diagnosis requires simultaneous failure of at least two organs. 
B) Primary MODS occurs immediately after the attributing cause. 
C) Secondary MODS occurs within 3 to 7 days of the initial insult. 
D) Chronic illness increases a child's risk for MODS. 
E) Risk factors for MODS include severe or prolonged shock, sepsis, and trauma.

Question 7

Hypotension is likely to occur when an infant or child is greater than _____ % dehydrated.

Accepted Answer

A) 2 
B) 5 
C) 7 
D) 10 
A) 2 
B) 5 
C) 7 
D) 10

Question 8

A healthcare professional gets an update on four children. Which one should the professional assess as the priority?

Accepted Answer

A) 6-month old, respiratory rate of 42 breaths/min 
B) 2-year-old, respiratory rate of 39 breaths/min 
C) Preschooler, respiratory rate of 26 breaths/min 
D) School-aged child, respiratory rate of 38 breaths/min 
A) 6-month old, respiratory rate of 42 breaths/min 
B) 2-year-old, respiratory rate of 39 breaths/min 
C) Preschooler, respiratory rate of 26 breaths/min 
D) School-aged child, respiratory rate of 38 breaths/min

Question 9

A 33-pound child is in shock. Which fluid bolus should the healthcare professional prepare to administer to this child?

Accepted Answer

A) Hypotonic fluid, 150 mL 
B) Hypotonic fluid, 300 mL 
C) Isotonic fluid, 150 mL 
D) Isotonic fluid, 300 mL 
A) Hypotonic fluid, 150 mL 
B) Hypotonic fluid, 300 mL 
C) Isotonic fluid, 150 mL 
D) Isotonic fluid, 300 mL

Question 10

Which information does the professor teach the class regarding how a child's body compensates for cardiogenic shock? (Select all that apply.)

Accepted Answer

A) Splanchnic arteries are constricted to divert blood from the skin, kidneys, and gut to the heart and brain. 
B) Peripheral blood vessels are constricted to raise blood pressure. 
C) Adrenergic responses produce tachycardia to increase cardiac output. 
D) The renin-angiotensin-aldosterone system is stimulated when renal function decreases. 
E) Compensation prevents the child from developing hepatic or mesenteric failure. 
A) Splanchnic arteries are constricted to divert blood from the skin, kidneys, and gut to the heart and brain. 
B) Peripheral blood vessels are constricted to raise blood pressure. 
C) Adrenergic responses produce tachycardia to increase cardiac output. 
D) The renin-angiotensin-aldosterone system is stimulated when renal function decreases. 
E) Compensation prevents the child from developing hepatic or mesenteric failure.

Question 11

The healthcare professional explains to a student that the most serious outcome resulting from limited glycogen stores in children who have been seriously burned is which of these?

Accepted Answer

A) Poor wound healing 
B) Increased morbidity 
C) Decreased immunity 
D) Loss of adipose tissue stores 
A) Poor wound healing 
B) Increased morbidity 
C) Decreased immunity 
D) Loss of adipose tissue stores

Question 12

A student asks the healthcare professional to explain reperfusion injuries. What explanation by the professional is best?

Accepted Answer

A) Tissue damage that can occur with blood transfusions 
B) Tissue destruction during rewarming in frostbite 
C) Damage from restored blood flow and exposure to oxygen 
D) Fluid overload from intravenous therapy that is too rapid 
A) Tissue damage that can occur with blood transfusions 
B) Tissue destruction during rewarming in frostbite 
C) Damage from restored blood flow and exposure to oxygen 
D) Fluid overload from intravenous therapy that is too rapid

Question 13

What is the most common type of shock in children?

Accepted Answer

A) Hypovolemic 
B) Cardiogenic 
C) Neurogenic 
D) Septic 
A) Hypovolemic 
B) Cardiogenic 
C) Neurogenic 
D) Septic

Question 14

What causes renal failure after electrical burns in children?

Accepted Answer

A) Cytokines are released after the damaged tissue. 
B) Immature kidneys are unable to compensate for the electrical burn. 
C) Cardiac output is reduced. 
D) Myoglobin is released from damaged muscles. 
A) Cytokines are released after the damaged tissue. 
B) Immature kidneys are unable to compensate for the electrical burn. 
C) Cardiac output is reduced. 
D) Myoglobin is released from damaged muscles.

Question 15

A child has septic shock with significant hypovolemia. What interventions should the healthcare professional prepare to complete? (Select all that apply.)

Accepted Answer

A) Aggressive fluid administration 
B) Antibiotic therapy 
C) Titration of inotropes 
D) Vasopressors 
E) Permissive hyperglycemia 
A) Aggressive fluid administration 
B) Antibiotic therapy 
C) Titration of inotropes 
D) Vasopressors 
E) Permissive hyperglycemia

Question 16

A 4-year-old child with a burn injury has entered the catabolic flow phase. What assessment would the healthcare provider correlate with this situation?

Accepted Answer

A) Oxygen saturation normal on room air 
B) 7 pound weight loss in 1 week 
C) Capillary refill <2 sec 
D) Blood pressure 89/56 mmHg 
A) Oxygen saturation normal on room air 
B) 7 pound weight loss in 1 week 
C) Capillary refill <2 sec 
D) Blood pressure 89/56 mmHg

Question 17

A 2-year-old is in shock. The healthcare professional assesses the child's heart rate as 52 beats/min. What action by the healthcare professional is most appropriate?

Accepted Answer

A) Get an ECG. 
B) Increase the intravenous rate. 
C) Sedate the child. 
D) Begin CPR. 
A) Get an ECG. 
B) Increase the intravenous rate. 
C) Sedate the child. 
D) Begin CPR.

Question 18

A healthcare professional is assessing the severity of a burn injury. What factors does the professional include in this assessment? (Select all that apply.)

Accepted Answer

A) Amount of fluid lost over a 24-hour period 
B) Circumference of the burn injury 
C) Depth of the burn injury 
D) Severity of the injury caused to other body systems 
E) Percentage of total body surface area involved 
A) Amount of fluid lost over a 24-hour period 
B) Circumference of the burn injury 
C) Depth of the burn injury 
D) Severity of the injury caused to other body systems 
E) Percentage of total body surface area involved

Question 19

Which cytokines are antiinflammatory mediators? (Select all that apply.)

Accepted Answer

A) IL-4 
B) IL-11 
C) Colony-stimulating factor 
D) Nitric oxide 
E) Arachidonic acid metabolites 
A) IL-4 
B) IL-11 
C) Colony-stimulating factor 
D) Nitric oxide 
E) Arachidonic acid metabolites

Question 20

A child is in cardiogenic shock and the parents ask why the child has hepatomegaly and periorbital edema. What explanation by the healthcare professional is best?

Accepted Answer

A) Mass vasodilation as a result of chemical mediators released from the myocardium 
B) Low cardiac output and systemic venous congestion 
C) Tissue damage to the myocardium, causing increased capillary permeability 
D) Reduced renal perfusion, stimulating the RAAS system 
A) Mass vasodilation as a result of chemical mediators released from the myocardium 
B) Low cardiac output and systemic venous congestion 
C) Tissue damage to the myocardium, causing increased capillary permeability 
D) Reduced renal perfusion, stimulating the RAAS system

Exam 50: Shock, Multiple Organ Dysfunction Syndrome, and Burns in Children

Which assessment findings would be recognized as late signs of shock in a child? (Select all that apply.)

To determine a child's response to fluid therapy for shock, the healthcare professional should monitor which measurements as the priority?

A healthcare professional assesses that a child's capillary refill time is 4 sec. What does the healthcare professional evaluate that finding to mean?

The healthcare professional plans care for a child in shock. What are the primary goals for the treatment of shock?

Approximately 80% of all hospital-acquired infections in children are a result of which type of organism?

Which information does the student learn regarding multiple organ dysfunction syndrome (MODS)? (Select all that apply.)

Hypotension is likely to occur when an infant or child is greater than _____ % dehydrated.

A healthcare professional gets an update on four children. Which one should the professional assess as the priority?

A 33-pound child is in shock. Which fluid bolus should the healthcare professional prepare to administer to this child?

Which information does the professor teach the class regarding how a child's body compensates for cardiogenic shock? (Select all that apply.)

The healthcare professional explains to a student that the most serious outcome resulting from limited glycogen stores in children who have been seriously burned is which of these?

A student asks the healthcare professional to explain reperfusion injuries. What explanation by the professional is best?

What is the most common type of shock in children?

What causes renal failure after electrical burns in children?

A child has septic shock with significant hypovolemia. What interventions should the healthcare professional prepare to complete? (Select all that apply.)

A 4-year-old child with a burn injury has entered the catabolic flow phase. What assessment would the healthcare provider correlate with this situation?

A 2-year-old is in shock. The healthcare professional assesses the child's heart rate as 52 beats/min. What action by the healthcare professional is most appropriate?

A healthcare professional is assessing the severity of a burn injury. What factors does the professional include in this assessment? (Select all that apply.)

Which cytokines are antiinflammatory mediators? (Select all that apply.)

A child is in cardiogenic shock and the parents ask why the child has hepatomegaly and periorbital edema. What explanation by the healthcare professional is best?

Cellular Biology

Altered Cellular and Tissue Biology: Environmental Agents

The Cellular Environment: Fluids and Electrolytes, Acids and Bases

Genes and Genetic Diseases

Genes, Environment-Lifestyle, and Common Diseases

Epigenetics and Disease

Innate Immunity: Inflammation and Wound Healing

Adaptive Immunity

Alterations in Immunity and Inflammation

Infection

Stress and Disease

Cancer Biology

Cancer Epidemiology

Cancer in Children

Structure and Function of the Neurologic System

Pain, Temperature Regulation, Sleep, and Sensory Function

Alterations in Cognitive Systems, Cerebral Hemodynamics, and Motor Function

Disorders of the Central and Peripheral Nervous Systems and the Neuromuscular Junction

Neurobiology of Schizophrenia, Mood Disorders, and Anxiety Disorders

Alterations of Neurologic Function in Children

Mechanisms of Hormonal Regulation

Alterations of Hormonal Regulation

Obesity and Disorders of Nutrition

Structure and Function of the Reproductive Systems

Alterations of the Female Reproductive System

Alterations of the Male Reproductive System

Sexually Transmitted Infections

Structure and Function of the Hematologic System

Alterations of Erythrocytes, Platelets, and Hemostatic Function

Alterations of Leukocyte and Lymphoid Function

Alterations of Hematologic Function in Children

Structure and Function of the Cardiovascular and Lymphatic Systems

Alterations of Cardiovascular Function

Alterations of Cardiovascular Function in Children

Structure and Function of the Pulmonary System

Alterations of Pulmonary Function

Alterations of Pulmonary Function in Children

Structure and Function of the Renal and Urologic Systems

Alterations of Renal and Urinary Tract Function

Alterations of Renal and Urinary Tract Function in Children

Structure and Function of the Digestive System

Alterations of Digestive Function

Alterations of Digestive Function in Children

Structure and Function of the Musculoskeletal System

Alterations of Musculoskeletal Function

Alterations of Musculoskeletal Function in Children

Structure, Function, and Disorders of the Integument

Alterations of the Integument in Children

Shock, Multiple Organ Dysfunction Syndrome, and Burns in Adults

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