Nokea
When assessing a 6-year-old boy with pain in the right lower quadrant of his abdomen, which action should be performed first?
- A. Avoiding palpation of the abdomen.
- B. Palpating the right lower quadrant first.
- C. Auscultating bowel sounds for 2 minutes.
- D. Palpating the left upper quadrant first.
Correct Answer: D
Rationale: Palpating the left upper quadrant first is the correct approach when assessing abdominal pain in a child. This method helps to minimize causing additional discomfort to the child and allows for a more accurate assessment of their reaction to palpation. By starting on the left upper quadrant, you can gauge the child's pain response before moving to the area of complaint, which may be more sensitive. This approach is essential for a thorough and less distressing abdominal assessment in pediatric patients.
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Following delivery of a newborn, the 21-year-old mother is experiencing mild vaginal bleeding. You note that her heart rate has increased from 90 to 120 beats/min and she is diaphoretic. In addition to administering high-flow oxygen, treatment should include:
- A. treating for shock and uterine massage during transport.
- B. uterine massage and transport.
- C. placing her on her left side and transport.
- D. internal vaginal pads and treating for shock during transport.
Correct Answer: A
Rationale: In this scenario, the mother is showing signs of postpartum hemorrhage with increased heart rate, diaphoresis, and mild vaginal bleeding. The correct approach involves treating for shock by addressing hypovolemia and providing uterine massage to help control bleeding. Administering high-flow oxygen is essential. Therefore, the most appropriate option is to treat for shock and perform uterine massage during transport to manage the postpartum hemorrhage effectively.
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.
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.
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.
A 9-year-old girl was struck by a car while crossing the street. Your assessment reveals a large contusion over the left upper quadrant of her abdomen and signs of shock. Which of the following organs is MOST likely injured?
- A. Liver
- B. Kidney
- C. Pancreas
- D. Spleen
Correct Answer: D
Rationale: The presence of a large contusion over the left upper quadrant of the abdomen, along with signs of shock, points towards a likely injury to the spleen, especially following trauma. The spleen is located in the left upper quadrant of the abdomen and is susceptible to injury due to its position and vulnerability to blunt trauma.