Nokea
Which of the following statements regarding febrile seizures in children is correct?
- A. They can occur even after a child has had a fever for longer than 24 hours.
- B. They can be caused by viral or bacterial meningitis.
- C. They do not typically occur on the first day of a fever.
- D. They typically last less than 15 minutes and often do not have a postictal phase.
Correct Answer: D
Rationale: The correct answer is D. Febrile seizures in children typically last less than 15 minutes and often do not have a postictal phase, meaning there is usually no prolonged recovery period or confusion after the seizure. They are commonly associated with the rapid rise in body temperature at the onset of a fever, rather than the duration of the fever itself. Choices A, B, and C are incorrect because febrile seizures can occur even after a child has had a fever for longer than 24 hours, they can be caused by viral or bacterial meningitis, and they do not have a typical pattern of occurring on the first day of a fever.
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During your assessment of a woman in labor, you see the baby's arm protruding from the vagina. The mother tells you that she needs to push. You should:
- A. gently push the protruding arm back into the vagina.
- B. encourage the mother to push and give her high-flow oxygen.
- C. insert your gloved fingers into the vagina and try to turn the baby.
- D. cover the arm with a sterile towel and transport immediately.
Correct Answer: D
Rationale: When encountering a protruding limb during delivery, it is crucial to recognize this as an emergency situation. The correct action is to cover the limb with a sterile towel to prevent injury and transport the mother immediately to a medical facility. Attempting to push the limb back into the vagina or trying to manipulate the baby's position can be harmful and delay necessary medical intervention. Encouraging the mother to push and providing high-flow oxygen is not appropriate in this scenario as immediate transport is essential to ensure the safety of both the mother and the baby.
You are dispatched to a residence for a child with respiratory distress. The child is wheezing and has nasal flaring and retractions. His oxygen saturation is 92%. You should:
- A. place the child in a supine position.
- B. administer high-flow oxygen.
- C. begin chest compressions.
- D. administer low-flow oxygen.
Correct Answer: B
Rationale: In a scenario where a child presents with respiratory distress, wheezing, nasal flaring, retractions, and an oxygen saturation of 92%, the appropriate intervention is to administer high-flow oxygen. This helps to improve oxygenation and alleviate the respiratory distress the child is experiencing. Placing the child in a supine position can worsen their condition by affecting their ability to breathe effectively. Chest compressions are not indicated in this case as the child is not in cardiac arrest. Administering low-flow oxygen may not provide adequate oxygenation for a child in respiratory distress with a saturation of 92%. Therefore, the priority is to administer high-flow oxygen to improve oxygen levels and support the child's breathing.
Following delivery of a newborn and placenta, you note that the mother has moderate vaginal bleeding. The mother is conscious and alert, and her vital signs are stable. Treatment for her should include:
- A. carefully packing the vagina with sterile dressings.
- B. massaging the uterus if signs of shock develop.
- C. treating her for shock and providing rapid transport.
- D. administering oxygen and massaging the uterus.
Correct Answer: D
Rationale: Administering oxygen and massaging the uterus are appropriate interventions to manage postpartum bleeding. Oxygen helps support tissue perfusion, and uterine massage can aid in uterine contraction, controlling bleeding. These actions are indicated when the mother experiences moderate vaginal bleeding post-delivery, as described in the scenario. Careful monitoring for signs of shock should continue while these interventions are implemented to ensure the mother's condition remains stable. Choices A and B are incorrect because packing the vagina with sterile dressings is not recommended for postpartum bleeding unless it is severe and immediate action is needed, while massaging the uterus is a proactive approach and should not be delayed until signs of shock develop. Choice C is also incorrect as rapid transport is not the primary intervention in this scenario where the mother is conscious, alert, and stable, and the focus should be on immediate management of the bleeding.
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.
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.