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You have just delivered a baby girl. Your assessment of the newborn reveals that she has a patent airway, is breathing adequately, and has a heart rate of 130 beats/min. Her face and trunk are pink, but her hands and feet are cyanotic. You have clamped and cut the umbilical cord, but the placenta has not yet delivered. You should:
- A. reassess the newborn every 5 minutes and transport after the placenta delivers.
- B. keep the newborn warm, give oxygen to the mother if needed, and transport.
- C. massage the lower part of the mother's uterus until the placenta delivers.
- D. give the newborn high-flow oxygen via a non-rebreathing mask and transport.
Correct Answer: B
Rationale: In this scenario, the appropriate action is to keep the newborn warm, ensure the mother receives oxygen if needed, and prepare for transport. The newborn is showing signs of central cyanosis (hands and feet being cyanotic), which can be due to various reasons, including inadequate oxygenation. Therefore, ensuring warmth and possible oxygen to the mother are important. Additionally, monitoring both the mother and baby during transport is crucial for their well-being.
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A 5-year-old boy was struck by a car when he ran out into the street. When you arrive at the scene and approach the child, you see him lying supine approximately 15 feet from the car. Based on the child's age and mechanism of injury, which of the following should you suspect to be his PRIMARY injury?
- A. Lower leg injury
- B. Head injury
- C. Upper thorax injury
- D. Pelvic injury
Correct Answer: D
Rationale: Given the mechanism of injury and the distance the child was thrown, a primary pelvic injury should be suspected due to the high impact and force. The pelvis is a common site for significant injury in such cases, and the distance the child was thrown indicates a high-energy impact that could lead to pelvic fractures or injuries.
What is the appropriate technique for performing two-rescuer CPR on a 4-year-old child?
- A. 15 compressions to 2 ventilations, compressing the sternum with your thumbs, and delivering at least 100 compressions per minute.
- B. 30 compressions to 2 ventilations, compressing the chest one third the depth of the chest, and delivering each breath over 1 second.
- C. 15 compressions to 2 ventilations, compressing the sternum with the heel of your hand, and ventilating until visible chest rise occurs.
- D. 30 compressions to 2 ventilations, compressing the sternum with the heel of both hands, and delivering each breath over 1 to 2 seconds.
Correct Answer: C
Rationale: When performing two-rescuer CPR on a 4-year-old child, the appropriate technique involves 15 compressions to 2 ventilations. Compressions should be done by pressing the child's sternum with the heel of your hand. Ventilations should be given until visible chest rise occurs. This technique ensures effective CPR delivery for a child in need of resuscitation.
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.
Which of the following signs or symptoms is more common in children than adults following an isolated head injury?
- A. Changes in pupillary reaction
- B. Tachycardia and diaphoresis
- C. Nausea and vomiting
- D. Altered mental status
Correct Answer: C
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
What is the appropriate treatment for a responsive 4-year-old child with a mild airway obstruction, respiratory distress, a strong cough, and normal skin color?
- A. Oxygen, back slaps, and transport.
- B. Subdiaphragmatic thrusts until the object is expelled.
- C. Assisted ventilations, back slaps, and transport.
- D. Supplemental oxygen and transport.
Correct Answer: D
Rationale: For a responsive 4-year-old child with a mild airway obstruction, respiratory distress, a strong cough, and normal skin color, the appropriate treatment includes providing supplemental oxygen and arranging for transport to a healthcare facility. Oxygen helps alleviate the respiratory distress, and transport ensures the child receives further evaluation and care by healthcare professionals. Back slaps and subdiaphragmatic thrusts are not recommended for a child with a mild airway obstruction and normal skin color, as these interventions are typically reserved for more severe cases of airway obstruction.