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A 3-year-old child has a sudden onset of respiratory distress. The mother denies any recent illnesses or fever. You should suspect:
- A. croup.
- B. foreign body airway obstruction.
- C. lower respiratory infection.
- D. epiglottitis.
Correct Answer: B
Rationale: In a 3-year-old child with a sudden onset of respiratory distress and no recent illnesses or fever, the likely cause is a foreign body airway obstruction. Foreign body obstruction can lead to sudden respiratory distress without other preceding symptoms. It is crucial to consider this possibility and act promptly to clear the airway in such cases to prevent serious complications.
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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.
Which position is MOST appropriate for a mother in labor with a prolapsed umbilical cord?
- A. Supine with legs elevated
- B. Supine with hips elevated
- C. Left lateral recumbent
- D. Left side with legs elevated
Correct Answer: B
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
What is the MOST common cause of shock in infants and children?
- A. Severe allergic reaction
- B. Dehydration
- C. Accidental poisoning
- D. Cardiac failure
Correct Answer: B
Rationale: Dehydration is the most common cause of shock in infants and children. In children, the body's fluid reserves are smaller compared to adults, making them more susceptible to dehydration, which can lead to shock if not promptly addressed. Severe allergic reactions, accidental poisoning, and cardiac failure can also cause shock, but dehydration is the most frequent cause in this age group.
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.
A 4-year-old boy ingested an unknown quantity of drain cleaner. He is alert, has a patent airway, and has adequate breathing. You should:
- A. administer 1 g/kg of activated charcoal.
- B. give 15 mL of ipecac and contact medical control.
- C. contact poison control and give him oxygen.
- D. give oxygen and perform a head-to-toe exam.
Correct Answer: C
Rationale: When a child ingests a harmful substance like drain cleaner and remains alert with a patent airway and adequate breathing, the initial steps involve contacting poison control to guide further management. In this scenario, providing oxygen to support respiratory function is essential until definitive care is established. Activated charcoal and ipecac are not recommended in the management of ingested caustic substances like drain cleaner. Performing a head-to-toe exam can wait until the child's immediate respiratory needs are addressed and the poison control center has provided guidance on further management.