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What is the MOST effective way to prevent cardiopulmonary arrest in a newborn?
- A. Ensure effective oxygenation and ventilation.
- B. Administer blow-by oxygen as soon as the newborn is born.
- C. Perform an Apgar assessment every 5 minutes.
- D. Suction the newborn's mouth and nose every 3 minutes.
Correct Answer: A
Rationale: The most effective way to prevent cardiopulmonary arrest in a newborn is to ensure effective oxygenation and ventilation. This is crucial in maintaining adequate oxygen supply and preventing respiratory distress or failure, which are significant factors leading to cardiopulmonary arrest. Providing appropriate ventilation support and oxygenation can help sustain the newborn's vital functions and reduce the risk of cardiopulmonary compromise.
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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.
Which of the following signs is MOST indicative of inadequate breathing in an infant?
- A. Sunken fontanelles
- B. Heart rate of 130 beats/min
- C. Expiratory grunting
- D. Abdominal breathing
Correct Answer: C
Rationale: Expiratory grunting is a significant sign of inadequate breathing and respiratory distress in infants. It indicates that the infant is struggling to exhale properly, which can be a sign of various respiratory issues, including lung problems or airway obstruction. Monitoring and recognizing this sign promptly can help in providing timely interventions to support the infant's breathing and prevent further complications.
You are called to a local park for a 7-year-old boy with respiratory distress. During your assessment, you find that the patient is wheezing and has widespread hives and facial edema. What should you suspect has occurred?
- A. Poison oak exposure
- B. Allergic reaction
- C. Heat illness
- D. Acute asthma attack
Correct Answer: B
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
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.
A 7-year-old child has an altered mental status, high fever, and a generalized rash. You perform your assessment and administer supplemental oxygen. En route to the hospital, you should be MOST alert for:
- A. hypotension.
- B. combativeness.
- C. convulsions.
- D. respiratory distress.
Correct Answer: C
Rationale: In a 7-year-old child with altered mental status, high fever, and a generalized rash, the most critical concern is the potential for convulsions. These symptoms could indicate a serious underlying condition, such as a febrile seizure or another type of seizure activity. Monitoring for convulsions is crucial during transport to ensure prompt intervention if they occur, as seizures can lead to additional complications and require immediate management.