Certified Pediatric Emergency Nurse (CPEN) Practice Exam

The indication for advanced airway management in a pediatric patient revolves primarily around the inability to maintain airway patency or achieve adequate ventilation. This can occur in various clinical situations where a child may be unable to protect their own airway, such as in cases of respiratory distress, altered levels of consciousness, or significant airway obstruction.

Maintaining airway patency is crucial because any compromise can lead to reduced oxygenation and potential respiratory failure. Thus, when a patient exhibits signs of respiratory distress or altered mental status that could compromise their ability to protect their airway, advanced airway management becomes necessary to secure the airway and ensure effective ventilation. This often involves procedures such as intubation or the use of other advanced airway devices.

The other options do not indicate a need for advanced airway management. A strong cough may be a sign of an intact airway, while continuous crying typically indicates that the child is breathing adequately. Normal breathing with no distress suggests that the airway is patent and does not require intervention. Therefore, the correct answer highlights the critical need for intervention when a child cannot maintain airway openness or adequate ventilation.