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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.
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Which of the following is NOT an appropriate treatment for an 18-year-old woman with severe vaginal bleeding?
- A. Covering the vagina with a trauma dressing.
- B. Administering high concentrations of oxygen.
- C. Placing sterile dressings into the vagina.
- D. Keeping her warm with blankets.
Correct Answer: C
Rationale: Placing sterile dressings into the vagina is not an appropriate treatment for severe vaginal bleeding. The correct approach involves applying pressure to the external vaginal area to control bleeding, covering the vagina with a trauma dressing to help with compression, administering high concentrations of oxygen to support oxygenation, and keeping the patient warm with blankets to prevent hypothermia. Placing sterile dressings into the vagina can introduce foreign material, increase the risk of infection, and obstruct proper wound management, making it an incorrect treatment option in this scenario.
After an advanced airway device has been inserted in a 6-month-old infant in cardiopulmonary arrest, you should deliver ventilations at a rate of:
- A. 10 to 12 breaths/min.
- B. 12 to 20 breaths/min.
- C. 6 to 8 breaths/min.
- D. 8 to 10 breaths/min.
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.
Which of the following parameters is the LEAST reliable when assessing the perfusion status of a 2-year-old child?
- A. Capillary refill time
- B. Presence of peripheral pulses
- C. Skin color and temperature
- D. Systolic blood pressure
Correct Answer: D
Rationale: Systolic blood pressure is the least reliable parameter when assessing perfusion status in a 2-year-old child. In young children, blood pressure measurements can be variable, affected by factors like anxiety or crying. Capillary refill time, presence of peripheral pulses, and skin color and temperature are more reliable indicators of perfusion status in this age group.
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.