Pediatric Emergencies and Trauma Care Practice Questions
20 free Pediatric Emergencies and Trauma Care practice questions for the NCLEX Exam. Tap an option to answer — you get instant feedback, the correct answer, and a detailed explanation for every question.
What is the best indicator of compensated hypovolemic shock in children after trauma?
- A Heart rate
- B Blood pressure
- C Capillary refill
- D Skin color
Correct answer: Heart rate
Tachycardia, delayed capillary refill, pale cool skin with normal BP indicate compensated hypovolemic shock in children.
In pediatric trauma airway management, which anatomical difference is crucial to consider?
- A Larger thoracic cavity relative to body size
- B Smaller occiput compared to adults
- C Larger tongue relative to mandible
- D Greater functional residual capacity in lungs
Correct answer: Larger tongue relative to mandible
Children have proportionately larger tongues and occiputs which can obstruct the airway.
What does the 'D' stand for in the primary survey 'ABCDE' approach in pediatric trauma?
- A Disability – neurological status
- B Danger – assessing scene safety
- C Decompression – chest needle placement
- D Depth – assessment of wound severity
Correct answer: Disability – neurological status
'D' in ABCDE primary survey for pediatric trauma stands for Disability which includes neurological assessment.
Why is head-tilt/chin-lift maneuver contraindicated in a child with suspected cervical spine injury?
- A Increases intracranial pressure
- B Worsens cervical spine injury
- C Causes airway obstruction
- D Ineffective due to large tongue size
Correct answer: Worsens cervical spine injury
Head-tilt/chin-lift may exacerbate spinal damage in children with trauma.
In pediatric trauma, which sign is more reliable than blood pressure to indicate poor perfusion?
- A Heart rate alone
- B Skin colour and capillary refill
- C Pulse oximetry oxygen saturation
- D Core body temperature reading
Correct answer: Skin colour and capillary refill
Skin color and delayed capillary refill are earlier indicators of perfusion issues in children.
What is the term for the pattern of injuries involving a femoral fracture, chest injury on the same side, and head injury on the opposite side in a child after a high-speed collision?
- A Pediatric Wilson’s triad
- B Waddell’s triad
- C Pott’s triad
- D Glasgow triad
Correct answer: Waddell’s triad
Waddell's triad describes this specific injury pattern in pediatric trauma.
Why is carbon monoxide exposure particularly dangerous in children with burn injuries?
- A They tolerate inhalation injuries better
- B CO binds hemoglobin more easily
- C They have higher functional residual capacity
- D Inhalation injury is rare in pediatric burns
Correct answer: CO binds hemoglobin more easily
Children have higher metabolic rates and CO binds to hemoglobin more readily, increasing risk in burns.
Which tool is widely recommended for rapid estimation of weight in a pediatric trauma patient?
- A Broselow tape
- B PALS weight chart
- C Adult weight-based guideline
- D BMI percentile only
Correct answer: Broselow tape
Broselow tape allows quick estimation of weight, equipment sizes, and drug doses in pediatric emergencies.
What is the best next step in management for a child with suspected cervical spine injury who cries and lies still when moved after a high fall?
- A Remove the cervical collar and allow free movement
- B Maintain spinal immobilisation and start ABC assessment
- C Sit the child up to improve comfort and breathing
- D Give IV fluids before assessing the airway
Correct answer: Maintain spinal immobilisation and start ABC assessment
Immobilisation must be maintained while proceeding with airway, breathing, circulation assessment in pediatric trauma with suspected spinal injury.
When suspecting non-accidental trauma in a toddler, what is the priority nursing action?
- A Confront and accuse the caregiver immediately
- B Document injuries, ensure safety, and report
- C Focus only on treating the visible injuries
- D Discharge the child after initial treatment
Correct answer: Document injuries, ensure safety, and report
Ensuring the child's safety, documenting findings, and reporting suspicion is critical in cases of suspected child abuse.
What is the best positioning strategy to maintain airway neutrality in a 6-month-old infant with a large occiput and risk of neck flexion?
- A Flat supine with no support
- B Use a shoulder roll to align neck
- C Head-tilt with chin lift
- D Semi-fowler while supine
Correct answer: Use a shoulder roll to align neck
Using a shoulder roll helps maintain neutral alignment and open airway in infants with large occiputs.
Why is a Glasgow Coma Scale adaptation used in pediatric trauma assessment?
- A Children always maintain adult GCS norms
- B Developmental stage affects verbal/motor responses
- C Children cannot sustain conscious responses
- D GCS is not applicable to children under age 10
Correct answer: Developmental stage affects verbal/motor responses
Pediatric trauma scoring needs modification due to age and developmental stage affecting responses.
What is a key consideration in pediatric blunt abdominal trauma assessment?
- A Children tolerate internal injury well
- B Greater circulating volume per kg than adults
- C Minimal external signs despite serious internal injury
- D Imaging is rarely required after blunt trauma
Correct answer: Minimal external signs despite serious internal injury
Children may show subtle signs despite significant internal injury, necessitating a high index of suspicion in trauma assessment.
Which is the most trustworthy indicator of hemorrhagic shock in an infant after trauma?
- A Minor swelling is harmless given large airway reserve in children
- B Edema or bleeding can rapidly cause complete obstruction
- C Airway is half adult size, so obstruction develops slowly
- D Children compensate far longer for airway obstruction
Correct answer: Edema or bleeding can rapidly cause complete obstruction
Tachycardia, delayed cap refill, and altered mental status precede hypotension in hemorrhagic shock in infants.
A child with serious burns is at risk of the 'trauma triad' element that complicates outcomes. What does this triad consist of?
- A Hypertension, hyperglycemia, hyperthermia
- B Hypothermia, acidosis, coagulopathy
- C Hyperthermia, alkalosis, edema
- D Bradycardia, hypercalcemia, hypoglycemia
Correct answer: Hypothermia, acidosis, coagulopathy
The trauma triad includes hypothermia, acidosis, and coagulopathy in major trauma like burns.
What is a correct statement regarding pediatric airway obstruction after trauma?
- A Small swellings are inconsequential due to large airway reserve in children
- B Edema or bleeding can rapidly cause complete obstruction due to small airway diameter
- C Airway size is half that of adults causing slower obstruction
- D Children can compensate longer for airway obstruction
Correct answer: Edema or bleeding can rapidly cause complete obstruction due to small airway diameter
Due to smaller airway diameter in children, even minor edema can lead to significant airway obstruction rapidly.
What is a priority nursing action for a 3-year-old child with chest trauma and abdominal pain from a bicycle handlebar injury?
- A Observe and discharge if stable after 30 minutes
- B Begin pain medication and defer vital sign checks
- C Monitor vitals and assess for internal bleeding
- D Apply an abdominal heat pack to ease the pain
Correct answer: Monitor vitals and assess for internal bleeding
Monitor vital signs and watch for signs of internal bleeding in children with abdominal trauma.
When assessing a conscious child involved in a motor vehicle crash with a seemingly isolated femur fracture, what should the nurse consider?
- A Pediatric femur fractures are always benign
- B High-energy mechanism may indicate multi-system injury
- C No further evaluation needed beyond the fracture
- D Only the bone injury matters, other organs are safe
Correct answer: High-energy mechanism may indicate multi-system injury
High-energy trauma in children may indicate broader multi-system injuries despite an isolated fracture.
What blood pressure reading is most concerning as a late sign of raised intracranial pressure in a child with a suspected head injury?
- A 80/50 mmHg
- B 120/80 mmHg
- C 150/70 mmHg
- D 70/40 mmHg
Correct answer: 150/70 mmHg
Widening pulse pressure and hypertension could indicate increased intracranial pressure in children; 150/70 is concerning.
What is an important nursing instruction to a caregiver before discharge when a toddler has a seemingly trivial injury from a fall?
- A No further monitoring is needed if the child seems fine
- B Watch for neurologic changes and return if they appear
- C Follow-up is unnecessary as such injuries never worsen
- D Be concerned only if the child develops a fever
Correct answer: Watch for neurologic changes and return if they appear
Caregivers should monitor for specific neurologic changes like vomiting or confusion after a head injury in children.