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Upon assessing a newborn immediately after delivery, you note that the infant is breathing spontaneously and has a heart rate of 80 beats/min. What is the MOST appropriate initial management for this newborn?
- A. Assess the newborn's skin condition and color.
- B. Initiate positive-pressure ventilations.
- C. Start chest compressions and contact medical control.
- D. Provide blow-by oxygen with oxygen tubing.
Correct Answer: B
Rationale: In a newborn with a heart rate below 100 beats/min, the most appropriate initial management is to initiate positive-pressure ventilations. This helps support the newborn's respiratory effort and oxygenation in the setting of a low heart rate, ensuring adequate oxygen supply to vital organs. Assessing the skin condition and color, starting chest compressions, or providing blow-by oxygen are not the priority in this scenario where respiratory support is crucial.
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Which of the following statements regarding the length-based resuscitation tape measure is correct?
- A. The resuscitation tape estimates a child's weight based on his or her height.
- B. It is a reliable tool in children who are less than 5 years of age.
- C. The red end of the tape measure is placed at the top of the child's head.
- D. The tape measure can be used in children who weigh up to 75 pounds.
Correct Answer: D
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
A 4-year-old boy with a tracheostomy tube is experiencing respiratory distress. He has intercostal retractions, a heart rate of 80 beats/min, and an oxygen saturation of 85%. During his attempts to breathe, a gurgling sound is heard in the tracheostomy tube. You should:
- A. Ventilate through the tracheostomy tube.
- B. Place an oxygen mask over the tracheostomy tube.
- C. Remove the tracheostomy tube and clean it.
- D. Carefully suction the tracheostomy tube.
Correct Answer: D
Rationale: In this scenario, the 4-year-old boy with a tracheostomy tube is showing signs of respiratory distress, including intercostal retractions, a low heart rate, and decreased oxygen saturation. The gurgling sound indicates a possible airway obstruction. Correctly, the immediate action should be to carefully suction the tracheostomy tube. Suctioning can help clear any secretions or obstructions, thus improving the child's ability to breathe effectively. Ventilating through the tube, placing an oxygen mask over it, or removing and cleaning the tube would not address the potential obstruction and could worsen the respiratory distress.
What is the appropriate technique for performing two-rescuer CPR on a 4-year-old child?
- A. 15 compressions to 2 ventilations, compressing the sternum with your thumbs, and delivering at least 100 compressions per minute.
- B. 30 compressions to 2 ventilations, compressing the chest one third the depth of the chest, and delivering each breath over 1 second.
- C. 15 compressions to 2 ventilations, compressing the sternum with the heel of your hand, and ventilating until visible chest rise occurs.
- D. 30 compressions to 2 ventilations, compressing the sternum with the heel of both hands, and delivering each breath over 1 to 2 seconds.
Correct Answer: C
Rationale: When performing two-rescuer CPR on a 4-year-old child, the appropriate technique involves 15 compressions to 2 ventilations. Compressions should be done by pressing the child's sternum with the heel of your hand. Ventilations should be given until visible chest rise occurs. This technique ensures effective CPR delivery for a child in need of resuscitation.
After the baby's head delivers, how is it usually tilted?
- A. with the face up.
- B. anteriorly, with the chin up.
- C. posteriorly, to one side.
- D. posteriorly, face down.
Correct Answer: C
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
What is the most likely cause of a sudden onset of respiratory distress in a 5-year-old child with no fever?
- A. Infection of the lower airways.
- B. A progressive upper airway infection.
- C. Inflammation of the upper airway.
- D. A foreign body airway obstruction.
Correct Answer: D
Rationale: A sudden onset of respiratory distress in a child without fever is most likely due to a foreign body airway obstruction. This obstruction can rapidly lead to difficulty breathing, stridor, and other signs of respiratory distress without necessarily causing a fever. Prompt recognition and intervention are crucial in such cases to prevent further complications and ensure the child's airway remains clear.