Nokea
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.
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You are dispatched to a residence for a 5-year-old child who is not breathing. Upon arrival, you find the child supine on the floor, cyanotic, and unresponsive. You should first:
- A. begin chest compressions.
- B. open the airway and give two rescue breaths.
- C. apply an AED and analyze the rhythm.
- D. ask the parent for the child's medical history.
Correct Answer: B
Rationale: When encountering an unresponsive and not breathing child, the initial step is to open the airway and provide two rescue breaths. This action helps to deliver oxygen to the child's lungs and body, which is crucial in attempting to restore breathing and circulation. Chest compressions are not initiated first in pediatric cases unless the child has no signs of circulation after delivering rescue breaths. Applying an AED and analyzing the rhythm is not the initial step in a pediatric cardiac arrest scenario, as the primary focus should be on providing oxygenation. Asking the parent for the child's medical history is not the immediate priority when the child is unresponsive and not breathing, as interventions to support breathing and circulation should be the primary concern.
Which of the following clinical signs would MOST suggest acute respiratory distress in a 2-month-old infant?
- A. Heart rate of 130 beats/min
- B. Respiratory rate of 30 breaths/min
- C. Abdominal breathing
- D. Grunting respirations
Correct Answer: D
Rationale: Grunting respirations are a key clinical sign of acute respiratory distress in infants. Grunting is a protective mechanism where the infant exhales against a partially closed glottis to increase functional residual capacity and oxygenation. This is often seen in conditions such as respiratory distress syndrome, pneumonia, or other causes of respiratory compromise in infants. Monitoring respiratory patterns like grunting is crucial for early recognition and intervention in infants with respiratory distress. Choices A, B, and C are less specific to acute respiratory distress in infants. While an elevated heart rate and respiratory rate can be present in respiratory distress, grunting respirations are a more direct indicator of significant respiratory compromise in infants.
When assessing a 30-year-old female who was sexually assaulted, what is the MOST important action for you to take?
- A. Have a female healthcare provider perform the assessment.
- B. Advise against showering or changing clothes.
- C. Acknowledge that the patient is a potential crime scene.
- D. Ensure that all life-threatening injuries are treated.
Correct Answer: D
Rationale: In cases of sexual assault, the priority is to address any life-threatening injuries first before proceeding with other aspects of care. Although preserving evidence and approaching the situation with sensitivity are crucial, immediate treatment of life-threatening conditions takes precedence to ensure the patient's well-being and safety. Having a female healthcare provider, advising against showering or changing clothes, and acknowledging the patient as a potential crime scene are important but secondary considerations compared to addressing any life-threatening injuries promptly.
Seizures in children MOST often result from:
- A. a life-threatening infection.
- B. an inflammatory process in the brain.
- C. an abrupt rise in body temperature.
- D. a temperature greater than 102°F.
Correct Answer: C
Rationale: Seizures in children most often result from febrile seizures, which are triggered by an abrupt rise in body temperature. Febrile seizures are common in young children, especially between the ages of 6 months to 5 years, and are usually associated with viral infections that cause a sudden spike in body temperature. Choices A, B, and D are incorrect because while infections, inflammatory processes, and high temperatures can sometimes lead to seizures, the most common cause of seizures in children is an abrupt increase in body temperature, known as febrile seizures.
What is the leading cause of death in geriatric patients?
- A. Hypertension.
- B. Arthritis.
- C. Heart disease.
- D. Altered mental status.
Correct Answer: C
Rationale: Heart disease is the leading cause of death in geriatric patients. It encompasses a range of conditions affecting the heart and blood vessels, such as coronary artery disease and heart failure, which are more prevalent in older individuals. These conditions can lead to serious complications and ultimately result in higher mortality rates among the elderly population. Hypertension (choice A) is a risk factor for heart disease but not the leading cause of death in geriatric patients. Arthritis (choice B) is a chronic condition affecting the joints, not a primary cause of death in this population. Altered mental status (choice D) is a symptom rather than a leading cause of death in geriatric patients.