Nokea
You are dispatched to a residence for a 4-year-old female who is sick. Your assessment reveals that she has increased work of breathing and is making a high-pitched sound during inhalation. Her mother tells you that she has been running a high fever for the past 24 hours. Your MOST immediate concern should be:
- A. determining if the child has a history of croup.
- B. preparing to treat her for a febrile seizure.
- C. assessing the need for ventilation assistance.
- D. taking her temperature to see how high it is.
Correct Answer: C
Rationale: In a child with increased work of breathing, a high-pitched sound during inhalation, and a high fever, upper airway obstruction should be suspected. The child's condition may require immediate ventilation assistance to ensure adequate oxygenation and ventilation. Therefore, the most immediate concern in this scenario is to assess the need for ventilation assistance.
You may also like to solve these questions
When is it MOST appropriate to clamp and cut the umbilical cord?
- A. Before the newborn has taken its first breath
- B. After the placenta has completely delivered
- C. As soon as the cord has stopped pulsating
- D. Immediately following delivery of the newborn
Correct Answer: C
Rationale: The ideal time to clamp and cut the umbilical cord is when it has stopped pulsating. This allows for the transfer of remaining blood from the placenta to the newborn, which can be beneficial for the baby's health and iron stores. Clamping the cord too early can deprive the newborn of this essential blood volume. Waiting for the pulsations to cease ensures that the baby receives the maximum benefits from delayed cord clamping.
Why should small children ride in the backseat of a vehicle?
- A. They are much less likely to be ejected from the vehicle.
- B. The back of the front seat will provide a cushion during a crash.
- C. They can experience severe injury or death if the airbag deploys.
- D. Their legs are highly prone to injury from striking the dashboard.
Correct Answer: C
Rationale: Small children should ride in the backseat of a vehicle primarily to avoid severe injury or death that may occur if the airbag deploys. In the event of a crash, the force of an airbag deployment can be dangerous for a child seated in the front seat. Placing them in the backseat reduces the risk of serious harm from airbag impact and is a safer seating position for young passengers.
Why is a prolapsed umbilical cord dangerous?
- A. The cord may be wrapped around the baby's neck, causing strangulation.
- B. The cord might pull the placenta from the uterine wall during delivery.
- C. The baby's head may compress the cord, cutting off its supply of oxygen.
- D. The mother may die of hypoxia due to compromised placental blood flow.
Correct Answer: C
Rationale: A prolapsed umbilical cord is dangerous because the baby's head may compress the cord, cutting off its supply of oxygen. This compression can lead to oxygen deprivation, potentially causing significant harm to the baby. Immediate medical intervention is crucial in such cases to prevent adverse outcomes.
A 7-year-old child has an altered mental status, high fever, and a generalized rash. You perform your assessment and administer supplemental oxygen. En route to the hospital, you should be MOST alert for:
- A. hypotension.
- B. combativeness.
- C. convulsions.
- D. respiratory distress.
Correct Answer: C
Rationale: In a 7-year-old child with altered mental status, high fever, and a generalized rash, the most critical concern is the potential for convulsions. These symptoms could indicate a serious underlying condition, such as a febrile seizure or another type of seizure activity. Monitoring for convulsions is crucial during transport to ensure prompt intervention if they occur, as seizures can lead to additional complications and require immediate management.
Following delivery of a newborn, the 21-year-old mother is experiencing mild vaginal bleeding. You note that her heart rate has increased from 90 to 120 beats/min and she is diaphoretic. In addition to administering high-flow oxygen, treatment should include:
- A. treating for shock and uterine massage during transport.
- B. uterine massage and transport.
- C. placing her on her left side and transport.
- D. internal vaginal pads and treating for shock during transport.
Correct Answer: A
Rationale: In this scenario, the mother is showing signs of postpartum hemorrhage with increased heart rate, diaphoresis, and mild vaginal bleeding. The correct approach involves treating for shock by addressing hypovolemia and providing uterine massage to help control bleeding. Administering high-flow oxygen is essential. Therefore, the most appropriate option is to treat for shock and perform uterine massage during transport to manage the postpartum hemorrhage effectively.