Nokea
When is a newborn considered premature?
- A. Weighs less than 6.5 pounds.
- B. Is born to a heroin-addicted mother.
- C. Is born before 37 weeks gestation.
- D. Has meconium in or around its mouth.
Correct Answer: C
Rationale: A newborn is considered premature if it is born before 37 weeks gestation. Premature birth increases the risk of various health problems as the baby may not be fully developed. Choice A is incorrect because the weight alone does not determine prematurity. Choice B is incorrect as it refers to a specific situation but not a direct indicator of prematurity. Choice D is incorrect as the presence of meconium does not solely indicate prematurity.
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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.
A 3-year-old female has had severe diarrhea and vomiting for 4 days. She is now unresponsive with rapid, shallow respirations and thready radial pulses. Her heart rate is 160 beats/min, and her oxygen saturation is 88%. You should:
- A. Ventilate her with a bag-valve mask.
- B. Start chest compressions.
- C. Administer high-flow oxygen via a non-rebreathing mask.
- D. Place her in the recovery position.
Correct Answer: A
Rationale: In a pediatric patient presenting with unresponsiveness, rapid, shallow respirations, thready pulses, high heart rate, and low oxygen saturation, the priority is to ensure adequate oxygenation. Ventilating the child with a bag-valve mask is crucial in this scenario to support her breathing and improve oxygenation, as indicated by her low oxygen saturation and respiratory distress. Starting chest compressions is not indicated as the child has a pulse. Administering high-flow oxygen via a non-rebreathing mask may not be as effective as providing positive pressure ventilation with a bag-valve mask in this situation. Placing her in the recovery position is not appropriate when the child is unresponsive and in respiratory distress.
Which of the following statements regarding SIDS is correct?
- A. SIDS can occur in premature infants.
- B. It is most commonly a result of child abuse.
- C. Death usually occurs during sleep.
- D. SIDS can be prevented by placing the baby on its back to sleep.
Correct Answer: C
Rationale: The correct statement regarding SIDS is that death usually occurs during sleep. Sudden Infant Death Syndrome (SIDS) is the unexpected death of a seemingly healthy infant, typically occurring during sleep. The exact cause of SIDS is not fully understood. While placing the baby on its back to sleep is a recommended preventive measure to reduce the risk of SIDS, it cannot guarantee prevention. Choice A is incorrect as SIDS is not limited to premature infants. Choice B is incorrect as SIDS is not primarily caused by child abuse.
Following the initial steps of resuscitation, a newborn remains apneic and cyanotic. What should you do next?
- A. begin ventilations with a bag-mask device.
- B. gently flick the soles of their feet for up to 60 seconds.
- C. immediately suction their mouth and nose.
- D. start CPR if the heart rate is less than 80 beats/min.
Correct Answer: A
Rationale: If a newborn remains apneic and cyanotic after the initial resuscitation steps, the next appropriate action is to begin ventilations with a bag-mask device. This helps provide oxygen to the newborn and can be crucial in supporting their respiratory efforts. Option B of flicking the soles of their feet is not recommended in this scenario as the priority is addressing the respiratory distress. Option C of suctioning their mouth and nose is not the immediate next step if the newborn is not spontaneously breathing. Option D of starting CPR based only on the heart rate is not the first-line intervention for an apneic and cyanotic newborn.
After attaching the AED to a 7-year-old child in cardiac arrest, you push the analyze button and receive a shock advised message. After delivering the shock, you should:
- A. assess for a carotid pulse.
- B. open the airway and ventilate.
- C. immediately perform CPR.
- D. reanalyze the cardiac rhythm.
Correct Answer: C
Rationale: After delivering a shock, it is crucial to immediately resume CPR. CPR helps circulate oxygenated blood to vital organs until the AED prompts you to stop for further rhythm analysis. This continuous cycle of CPR and defibrillation maximizes the chances of restoring a normal cardiac rhythm and improving the child's chances of survival. Assessing for a carotid pulse is not necessary after a shock as pulse checks are often unreliable during resuscitation. Opening the airway and ventilating is not the immediate step after delivering a shock as CPR takes precedence. Reanalyzing the cardiac rhythm should be done only when prompted by the AED after a set period of CPR.