Nokea
When responding to a call for a 2-year-old child who fell from a second-story window, with the mechanism of injury and the age of the patient in mind, you should suspect that the primary injury occurred to the child's:
- A. chest.
- B. head.
- C. lower extremities.
- D. abdomen.
Correct Answer: B
Rationale: In a scenario where a young child falls from a significant height like a second-story window, the primary injury is more likely to be to the head. This is because young children have proportionately larger head sizes compared to their body, making them more susceptible to head injuries in such falls. The chest (Choice A), lower extremities (Choice C), and abdomen (Choice D) are less likely to sustain the primary injury in this scenario, as the impact of the fall and the child's anatomy predispose the head to be the most affected area.
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Following an apparent febrile seizure, a 4-year-old boy is alert and crying. His skin is hot and moist. Appropriate treatment for this child includes:
- A. allowing the parents to transport the child.
- B. offering oxygen and providing transport.
- C. rapidly cooling the child in cold water.
- D. keeping the child warm and providing transport.
Correct Answer: B
Rationale: After a febrile seizure, the priority is to offer oxygen and provide transport to a medical facility. Oxygen may be necessary to ensure proper oxygenation, and medical evaluation is crucial to determine the cause of the seizure and prevent recurrence. Rapidly cooling the child in cold water is not recommended as it may lead to complications such as hypothermia. Keeping the child warm is also not indicated as the skin is already hot and moist. Therefore, offering oxygen and timely transportation to a healthcare facility is the most appropriate course of action. Allowing the parents to transport the child might delay necessary medical care, and keeping the child warm can exacerbate the existing heat. Rapidly cooling the child in cold water can lead to adverse effects, making it an inappropriate choice.
Your assessment of a newborn reveals cyanosis to the chest and face and a heart rate of 90 beats/min. What should you do first?
- A. Dry the infant briskly.
- B. Suction the mouth.
- C. Begin artificial ventilations.
- D. Begin chest compressions.
Correct Answer: C
Rationale: In a newborn with cyanosis to the chest and face and a heart rate of 90 beats/min, the priority action is to begin artificial ventilations. A heart rate below 100 beats/min with cyanosis indicates a need for immediate respiratory support to improve oxygenation. Drying the infant briskly or suctioning the mouth may be necessary later but are not the initial priority. Chest compressions are not indicated as the heart rate is above 60 beats/min.
Following an apparent febrile seizure, a 4-year-old boy is alert and crying. His skin is hot and moist. Appropriate treatment for this child includes:
- A. allowing the parents to transport the child.
- B. offering oxygen and providing transport.
- C. rapidly cooling the child in cold water.
- D. keeping the child warm and providing transport.
Correct Answer: B
Rationale: After a febrile seizure, it is important to offer oxygen and provide transport to a medical facility for further evaluation and management of the underlying cause. Oxygen may be needed in case of hypoxemia resulting from the seizure. Rapidly cooling the child in cold water is not recommended as it may lead to complications such as hypothermia. Keeping the child warm is also not advisable as the priority is to prevent hyperthermia and provide necessary medical intervention by healthcare providers.
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.
What is the appropriate ventilation rate for an apneic infant?
- A. 8 to 10 breaths/min.
- B. 10 to 12 breaths/min.
- C. 12 to 20 breaths/min.
- D. 20 to 30 breaths/min.
Correct Answer: C
Rationale: During resuscitation of an apneic infant, the appropriate ventilation rate is 12 to 20 breaths per minute. This rate helps provide adequate oxygenation and ventilation without causing harm to the infant. Choice A (8 to 10 breaths/min) is too low and may not provide sufficient ventilation. Choice B (10 to 12 breaths/min) is slightly below the recommended range, which may not be optimal for effective resuscitation. Choice D (20 to 30 breaths/min) is too high and may lead to overventilation and potential harm to the infant by causing hypocapnia.