1 :

Hint : 🕒 Apply 1 hour early for max numbing

Correct Answers:

  • Apply the cream 1 hr. before the procedure


Rationale :

🧴 Lidocaine and prilocaine cream (EMLA) is a topical anesthetic used to reduce pain during needle procedures.

🧴 The optimal absorption time is at least 60 minutes prior to IV insertion for effective dermal anesthesia.

🧴 The site should be covered with an occlusive dressing to enhance absorption.

🧴 Rubbing the cream reduces its effectiveness and is not recommended.

🧴 Removing the cream prior to IV insertion is also essential to prevent interference with the procedure.


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2 :

Hint : 🧯 NG tube prevents postop GI buildup

Correct Answers:

  • Maintain an Ng tube for decompression


Rationale :

🫁 After surgical repair of Meckel's diverticulum, bowel rest is required until intestinal function returns.

🫁 An NG tube prevents abdominal distension and vomiting by decompressing the stomach.

🫁 TPN is not routinely initiated unless prolonged ileus is present.

🫁 Antibiotics are short-term, and ostomy care is not indicated, as most repairs don’t involve stoma creation.


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3 :

Hint : 🔥 High fever is a key aspirin OD sign

Correct Answers:

  • hyperpyrexia


Rationale :

🌡️ Acetylsalicylic acid (aspirin) toxicity leads to hypermetabolic state, causing hyperpyrexia (extremely high fever).

🌡️ Other expected signs include tinnitus, metabolic acidosis, confusion, and tachypnea.

🌡️ Polyuria and neck vein distension are not classic features.

🌡️ Jaundice might occur in chronic toxicity, not acutely.


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4 :

Hint : 🚫 Low platelets = bleeding precautions

Correct Answers:

  • initiate bleeding precautions


Rationale :

🩸 In acute lymphocytic leukemia (ALL), bone marrow suppression results in thrombocytopenia, increasing bleeding risk.

🩸 Precautions include avoiding rectal temps, soft toothbrushes, and monitoring for bleeding.

🩸 Knee-chest positioning is for cardiac emergencies; viscous lidocaine is contraindicated due to aspiration risk.

🩸 Rectal temps should be avoided due to mucosal trauma risk.


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5 :

Hint : 🫁 Keep lungs open to prevent collapse

Correct Answers:

  • Encourage the adolescent to perform incentive spirometry to maintain lung capacity


Rationale :

💨 Muscular dystrophy progressively weakens respiratory muscles, increasing the risk of pneumonia and atelectasis.

💨 Using incentive spirometry promotes deep breathing and helps maintain lung expansion.

💨 Routine vaccinations are not contraindicated; they are encouraged.

💨 Wheelchair use should be based on functional need, not to limit stress on legs.


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6 :

Hint : 🚸 Walk bikes across busy crossings

Correct Answers:

  • Your child should walk the bicycle through intersections


Rationale :

🚦 The safest way for children to cross intersections is to dismount and walk the bike to avoid unpredictable traffic movement.

🚦 Children under 10 often lack the visual-motor coordination and depth perception to safely navigate intersections while riding.

🚦 Riding against traffic is extremely dangerous and contrary to all standard road safety rules.

🚦 The child's feet should reach the ground slightly for safe balance and control—not hover 3–6 inches above .

🚦 Maintaining proximity to the curb (not too far or close) and obeying traffic laws is part of age-appropriate bicycle safety.


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7 :

Hint : 🍭 Sweet pacifier = pain control for infants

Correct Answers:

  • Provide a pacifier coated with an oral sucrose prior to injections


Rationale :

🍼 For infants, oral sucrose combined with non-nutritive sucking is a well-established, evidence-based method to reduce procedural pain.

🍼 This approach is safe, effective, and easy to administer prior to vaccinations or blood draws.

🍼 Deltoid muscle is not appropriate for infants; the vastus lateralis is preferred.

🍼 A 20-gauge needle is too large for infants; use 25–27 gauge for minimal trauma.

🍼 EMLA cream needs 30–60 minutes to be effective—not immediately prior .


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8 :

Hint : 🤫 Less noise, less change = more calm

Correct Answers:

  • Keep staff visits with the child brief


Rationale :

🧩 Children with Autism Spectrum Disorder (ASD) may become overwhelmed by excessive sensory input or prolonged social interaction.

🧩 Brief, consistent, and predictable interactions support comfort and reduce behavioral triggers.

🧩 A structured routine with minimal changes lowers anxiety in children with ASD.

🧩 Television or background noise can increase sensory overload, worsening agitation.

🧩 A private or quiet room (not semiprivate) and consistent caregivers are preferred for reducing transitions and stimulation.


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9 :

Hint : 🍼 Fontanel flat? Monitor fluids stat!

Correct Answers:

  • Sunken anterior fontanel


Rationale :

💧 A sunken fontanel is a late sign of dehydration and is particularly alarming in a 2-month-old taking furosemide, a potent diuretic.

💧 Furosemide increases urinary fluid and electrolyte loss, placing infants at risk for hypovolemia.

💧 While HR 162/min may be slightly elevated and expected with crying, it is less specific than a sunken fontanel.

💧 Potassium 5.1 mEq/L is mildly elevated but not critical unless symptomatic.

💧 A sunken fontanel indicates the need for urgent fluid replacement and provider notification.


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10 :

Hint : ☁️ Elevate at night = reduce cast swelling

Correct Answers:

  • I will elevate my broken arm on pillows a tonight


Rationale :

🛌 Elevating the arm reduces swelling, enhances venous return, and promotes comfort after casting.

🛌 It also helps in preventing compartment syndrome, a serious complication from swelling under a cast.

🛌 Limiting finger movement is incorrect; finger mobility should be encouraged to promote circulation.

🛌 Persistent swelling may be a sign of impaired circulation and needs further evaluation.

🛌 Baby powder inside the cast should never be used, as it can accumulate moisture and cause skin breakdown or infection.


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Total Questions: 10

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