Your assessment of a newborn reveals cyanosis to the chest and face and a heart rate of 90 beats/min. What should you do first?
- A. Dry the infant briskly.
- B. Suction the mouth.
- C. Begin artificial ventilations.
- D. Begin chest compressions.
Correct Answer: C
Rationale: In a newborn with cyanosis to the chest and face and a heart rate of 90 beats/min, the priority action is to begin artificial ventilations. A heart rate below 100 beats/min with cyanosis indicates a need for immediate respiratory support to improve oxygenation. Drying the infant briskly or suctioning the mouth may be necessary later but are not the initial priority. Chest compressions are not indicated as the heart rate is above 60 beats/min.
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When assessing a geriatric patient who has possibly experienced an acute ischemic stroke, which of the following questions would be MOST appropriate to ask?
- A. When did you first notice the symptoms?
- B. Do you have a history of high blood pressure?
- C. What medications do you take and why?
- D. Have you previously had a heart attack?
Correct Answer: A
Rationale: The most appropriate question to ask when assessing a geriatric patient who may have experienced an acute ischemic stroke is when the symptoms were first noticed. This information is crucial for determining the time window for potential treatments like thrombolytic therapy, as prompt intervention is necessary for stroke management. Option B is not as relevant in the acute assessment of stroke, though important for overall health history. Option C is important but may not be as time-sensitive as determining symptom onset. Option D focuses on a different cardiac event, not directly related to the current concern of a possible stroke.
You arrive at the scene shortly after a 3-year-old female experienced a seizure. The child, who is being held by her mother, is conscious and crying. The mother tells you that her daughter has been ill recently and has a temperature of 102.5°F. What is the MOST appropriate treatment for this child?
- A. Oxygen via non-rebreathing mask, place the child in a tub of cold water to lower her body temperature, and transport.
- B. Oxygen via the blow-by technique, transport, and request a paramedic intercept so an anticonvulsant drug can be given.
- C. Oxygen via non-rebreathing mask, avoid any measures to lower the child's body temperature, and transport at once.
- D. Oxygen via the blow-by technique, remove clothing to help reduce her fever, and transport with continuous monitoring.
Correct Answer: D
Rationale: The most appropriate treatment for a child who has experienced a seizure and has a fever includes administering oxygen via the blow-by technique, removing clothing to help reduce fever, and transporting the child with continuous monitoring. Choice A is incorrect because placing the child in a tub of cold water can lead to hypothermia and is not recommended for fever reduction. Choice B is incorrect as requesting an anticonvulsant drug without proper evaluation and assessment by a healthcare provider is not appropriate. Choice C is incorrect as avoiding measures to lower the child's body temperature can worsen the situation in case of febrile seizures. Therefore, the best course of action is to provide oxygen via the blow-by technique, remove excess clothing to reduce fever, and transport the child while continuously monitoring her condition.
During your assessment of a woman in labor, you see the baby's arm protruding from the vagina. The mother tells you that she needs to push. You should:
- A. gently push the protruding arm back into the vagina.
- B. encourage the mother to push and give her high-flow oxygen.
- C. insert your gloved fingers into the vagina and try to turn the baby.
- D. cover the arm with a sterile towel and transport immediately.
Correct Answer: D
Rationale: When encountering a protruding limb during delivery, it is crucial to recognize this as an emergency situation. The correct action is to cover the limb with a sterile towel to prevent injury and transport the mother immediately to a medical facility. Attempting to push the limb back into the vagina or trying to manipulate the baby's position can be harmful and delay necessary medical intervention. Encouraging the mother to push and providing high-flow oxygen is not appropriate in this scenario as immediate transport is essential to ensure the safety of both the mother and the baby.
A 3-year-old boy is found to be in cardiopulmonary arrest. As you begin one-rescuer CPR, your partner prepares the AED. What is the appropriate compression to ventilation ratio for this child?
- A. 3:01
- B. 30:2
- C. 15:2
- D. 5:1
Correct Answer: B
Rationale: The correct compression to ventilation ratio for a single rescuer performing CPR on a child is 30:2. This ratio ensures adequate circulation and oxygenation during CPR. 30 compressions help maintain blood flow, while 2 rescue breaths provide oxygenation. Choice A (3:01) is incorrect as it does not follow the standard CPR guidelines for children. Choice C (15:2) is incorrect as it is the ratio used for adult CPR. Choice D (5:1) is incorrect as it is not the recommended ratio for child CPR.
You and your partner are performing CPR on a 2-year-old female in cardiac arrest. During your resuscitation attempt, you should:
- A. hyperventilate her due to severe hypoxia.
- B. attach the AED pads after 5 minutes of high-quality CPR.
- C. perform compressions and ventilations at a ratio of 30:2.
- D. allow the chest to fully recoil between compressions.
Correct Answer: D
Rationale: Allowing the chest to fully recoil between compressions is crucial during CPR to ensure proper blood flow. This action allows the heart to refill with blood, enhancing the effectiveness of compressions and circulation. Hyperventilating the patient can lead to decreased cardiac output and is not recommended. Attaching AED pads should be done as soon as possible in a pediatric cardiac arrest situation, ideally within 2 minutes. The correct compression-to-ventilation ratio for pediatric CPR is 30:2, focusing on high-quality compressions to provide adequate perfusion to vital organs.