Nokea
Which artery should you palpate when assessing for a pulse in an unresponsive 6-month-old patient?
- A. Radial
- B. Brachial
- C. Femoral
- D. Carotid
Correct Answer: B
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
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Which of the following is the MOST detrimental effect of gastric distention in infants and children?
- A. Tracheal rupture.
- B. Less effective chest compressions.
- C. Decreased ventilatory volume.
- D. Acute rupture of the diaphragm.
Correct Answer: C
Rationale: Gastric distention in infants and children can lead to a decrease in ventilatory volume. This occurs because the distended stomach can limit the movement of the diaphragm, reducing its ability to contract and expand the chest cavity effectively. As a result, the amount of air entering and leaving the lungs is decreased, impacting ventilation. Tracheal rupture, acute rupture of the diaphragm, and less effective chest compressions are not typically associated with gastric distention.
You arrive at a residence shortly after a 4-year-old boy experienced an apparent febrile seizure. The child is alert and crying. His skin is flushed, hot, and moist. His mother tells you that the seizure lasted about 2 minutes. You should:
- A. provide supportive care and transport.
- B. give him acetaminophen or ibuprofen.
- C. begin rapid cooling measures at once.
- D. allow the mother to take her child to the doctor.
Correct Answer: A
Rationale: After a febrile seizure, the recommended course of action is to provide supportive care and transport the child to a medical facility. Supportive care may include ensuring a safe environment, monitoring the child, and seeking medical evaluation to determine the underlying cause of the seizure and appropriate management.
You are called to a local park for a 7-year-old boy with respiratory distress. During your assessment, you find that the patient is wheezing and has widespread hives and facial edema. What should you suspect has occurred?
- A. Poison oak exposure
- B. Allergic reaction
- C. Heat illness
- D. Acute asthma attack
Correct Answer: B
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
You are treating a 5-year-old child who has had severe diarrhea and vomiting for 3 days and is now showing signs of shock. Supplemental oxygen has been given, and you have elevated his lower extremities. En route to the hospital, you note that his work of breathing has increased. You should:
- A. begin positive-pressure ventilations and reassess the child.
- B. lower the extremities and reassess the child.
- C. listen to the lungs with a stethoscope for abnormal breath sounds.
- D. insert a nasopharyngeal airway and increase the oxygen flow.
Correct Answer: B
Rationale: When the work of breathing increases after elevating the legs, it is important to lower the extremities. Elevating the lower extremities in a child with signs of shock can worsen the condition by reducing venous return to the heart. Lowering the extremities can help improve venous return and potentially alleviate the increased work of breathing.
A 4-year-old boy ingested an unknown quantity of drain cleaner. He is alert, has a patent airway, and has adequate breathing. You should:
- A. administer 1 g/kg of activated charcoal.
- B. give 15 mL of ipecac and contact medical control.
- C. contact poison control and give him oxygen.
- D. give oxygen and perform a head-to-toe exam.
Correct Answer: C
Rationale: When a child ingests a harmful substance like drain cleaner and remains alert with a patent airway and adequate breathing, the initial steps involve contacting poison control to guide further management. In this scenario, providing oxygen to support respiratory function is essential until definitive care is established. Activated charcoal and ipecac are not recommended in the management of ingested caustic substances like drain cleaner. Performing a head-to-toe exam can wait until the child's immediate respiratory needs are addressed and the poison control center has provided guidance on further management.