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During the 5-minute Apgar assessment of a newborn, you note a heart rate of 130 beats/min, cyanosis in the hands and feet, and rapid respirations. The baby cries when you flick the soles of its feet and resists leg straightening. These findings correspond to an Apgar score of:
- A. 9
- B. 7
- C. 8
- D. 10
Correct Answer: A
Rationale: The Apgar score is a rapid assessment tool to evaluate the newborn's transition to life outside the womb. The Apgar score is based on five components: heart rate (>100 bpm), respiratory effort (rapid breathing), muscle tone (resisting leg straightening), reflex irritability (crying when feet are flicked), and color (cyanosis to extremities). The described findings match a score of 9, indicating good overall condition and adaptation to extrauterine life.
You may also like to solve these questions
What is the purpose of the pediatric assessment triangle?
- A. Detect immediate life threats through a quick hands-on assessment.
- B. Identify if the child has a medical condition or a traumatic injury.
- C. Determine if the child's problem is respiratory or circulatory in nature.
- D. Form a general impression of the child without touching them.
Correct Answer: D
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
You arrive at a residence shortly after a 4-year-old boy experienced an apparent febrile seizure. The child is alert and crying. His skin is flushed, hot, and moist. His mother tells you that the seizure lasted about 2 minutes. You should:
- A. provide supportive care and transport.
- B. give him acetaminophen or ibuprofen.
- C. begin rapid cooling measures at once.
- D. allow the mother to take her child to the doctor.
Correct Answer: A
Rationale: After a febrile seizure, the recommended course of action is to provide supportive care and transport the child to a medical facility. Supportive care may include ensuring a safe environment, monitoring the child, and seeking medical evaluation to determine the underlying cause of the seizure and appropriate management.
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.
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.
Physical abuse of a 4-year-old child should be suspected if you observe:
- A. purple and yellow bruises on the thighs.
- B. bruises on the anterior tibial area.
- C. the child clinging to his or her parent.
- D. curious siblings watching you.
Correct Answer: A
Rationale: Purple and yellow bruises on protected areas like the thighs are concerning as they indicate bruises in various stages of healing, which is a red flag for physical abuse. Bruises on the anterior tibial area or a child clinging to a parent are not specific signs of physical abuse. Siblings watching you is unrelated to the suspicion of physical abuse in this scenario.