What should you do immediately upon delivery of a newborn's head?
- A. Suction the nose.
- B. Dry the face.
- C. Cover the eyes.
- D. Suction the mouth.
Correct Answer: D
Rationale: Upon delivery of a newborn's head, the priority is to clear the airway to ensure proper breathing. Suctioning the mouth takes precedence over suctioning the nose or other actions to prevent potential airway obstruction. Choice D is the correct answer as it addresses the immediate need to maintain a clear airway for the newborn. Choices A, B, and C are not the correct actions to take at this moment as they do not directly address the crucial need to establish a clear airway for the newborn.
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Your assessment of a 5-year-old child reveals that he is unresponsive with a respiratory rate of 8 breaths/min and a heart rate of 50 beats/min. Treatment for this child should include:
- A. high-flow oxygen via non-rebreathing mask and rapid transport.
- B. assisted ventilation with a bag-mask device and rapid transport.
- C. positive-pressure ventilation, chest compressions, and rapid transport.
- D. back slaps and chest thrusts while attempting artificial ventilations.
Correct Answer: C
Rationale: In a 5-year-old child who is unresponsive with severe bradycardia and bradypnea, the priority is to provide positive-pressure ventilation to support breathing and perform chest compressions to support circulation. This child is in cardiac arrest, and the recommended treatment according to pediatric basic life support guidelines involves a combination of positive-pressure ventilation and chest compressions to maintain oxygenation and circulation. Rapid transport to a medical facility for further advanced care is crucial in this critical situation. Choices A, B, and D are incorrect because high-flow oxygen via non-rebreathing mask, assisted ventilation with a bag-mask device, and back slaps with chest thrusts are not sufficient in a cardiac arrest situation where the child requires immediate positive-pressure ventilation and chest compressions to maintain oxygenation and circulation.
In contrast to the contractions associated with true labor, Braxton-Hicks contractions:
- A. generally follow rupture of the amniotic sac and occur with regularity.
- B. may be intensified by activity and are accompanied by a pink discharge.
- C. do not increase in intensity and are alleviated by a change in position.
- D. consistently become stronger and are not alleviated by changing position.
Correct Answer: C
Rationale: Braxton-Hicks contractions are irregular and usually do not increase in intensity. Unlike true labor contractions, they tend to alleviate with a change in position, making option C the correct choice. Choices A, B, and D are incorrect because Braxton-Hicks contractions do not follow rupture of the amniotic sac, are not intensified by activity or accompanied by a pink discharge, and do not consistently become stronger or are not alleviated by changing position.
During the pediatric assessment process, which scenario would be the LEAST appropriate for the transition phase?
- A. A parent is available to help keep the child calm.
- B. The child is unstable and needs rapid transport.
- C. You determine that the child's condition is stable.
- D. Your transport time is greater than 30 minutes.
Correct Answer: B
Rationale: During a pediatric assessment, the transition phase is a critical period where care is handed over from prehospital providers to the hospital team. If the child is unstable and requires rapid transport, it is not appropriate to delay for a transition phase. In such cases, immediate transport to a higher level of care is paramount to ensure the child's safety and well-being. Choice A is appropriate as having a parent present can help keep the child calm during the transition. Choice C is also appropriate as transitioning a stable child allows for a smoother handover. Choice D, while indicating a longer transport time, does not necessarily affect the need for a transition phase as long as the child's condition remains stable.
What is the proper depth of chest compressions for a 9-month-old infant?
- A. 1/3 the diameter of the chest or about 1 1/2 inches.
- B. 1/4 the diameter of the chest or about 1 inch.
- C. 1/2 the diameter of the chest or about 2 inches.
- D. 1/3 the diameter of the chest or about 3/4 inch.
Correct Answer: A
Rationale: When performing chest compressions on a 9-month-old infant, the proper depth is 1/3 the diameter of the chest, which equates to approximately 1 1/2 inches. This depth is crucial for effective cardiopulmonary resuscitation (CPR) in infants. Choice B, which suggests 1/4 the diameter of the chest or about 1 inch, is incorrect as it does not provide the recommended depth for infants. Choice C, stating 1/2 the diameter of the chest or about 2 inches, is too deep and may cause harm to the infant. Choice D, mentioning 1/3 the diameter of the chest or about 3/4 inch, is also incorrect as it underestimates the required depth for effective chest compressions on a 9-month-old infant.
What is the MOST appropriate method for assessing a small child's level of responsiveness?
- A. Palpate for a radial pulse.
- B. Shout at the child to see if they respond.
- C. Ask the parent about the child's level of responsiveness.
- D. Tap the child and shout, 'Are you okay?'
Correct Answer: D
Rationale: When assessing a small child's level of responsiveness, the most appropriate method is to tap the child and shout, 'Are you okay?' This approach is more likely to elicit a response from the child, providing a direct assessment of their level of consciousness and responsiveness. Palpating for a radial pulse (Choice A) is not the most direct method for assessing responsiveness in a child. Shouting at the child (Choice B) may startle them and not provide an accurate assessment. Asking the parent (Choice C) does not directly evaluate the child's responsiveness.
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