LPN LPN
LPN Pediatrics
1. 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.
2. Which of the following signs is MOST indicative of inadequate breathing in an infant?
- A. Sunken fontanelles
- B. Heart rate of 130 beats/min
- C. Expiratory grunting
- D. Abdominal breathing
Correct answer: C
Rationale: Expiratory grunting is a significant sign of inadequate breathing and respiratory distress in infants. It indicates that the infant is struggling to exhale properly, which can be a sign of various respiratory issues, including lung problems or airway obstruction. Monitoring and recognizing this sign promptly can help in providing timely interventions to support the infant's breathing and prevent further complications.
3. When inserting an oropharyngeal airway in a small child, what is the preferred method?
- A. Insert the airway with the curvature towards the roof of the mouth and then rotate it 180 degrees.
- B. Insert the airway as you would in an adult, but use an airway that is one size smaller than usual.
- C. Depress the tongue with a tongue blade and insert the airway with the downward curve facing the tongue.
- D. Open the airway with the tongue-jaw lift maneuver and insert the airway until slight resistance is met.
Correct answer: C
Rationale: When inserting an oropharyngeal airway in a small child, it is crucial to depress the tongue with a tongue blade and insert the airway with the downward curve facing the tongue. This technique helps in maintaining an open airway and preventing obstruction by the tongue. Placing the airway with the curve facing the roof of the mouth or using a smaller size is not recommended for small children, as it may not effectively keep the airway patent. The tongue-jaw lift maneuver is not the preferred method for inserting an oropharyngeal airway in small children.
4. You are dispatched to a residence where an 8-year-old boy was pulled from a swimming pool. When you arrive, a neighbor is performing rescue breathing on the child. After confirming that the child is not breathing, you should:
- A. begin chest compressions and reassess in 2 minutes.
- B. assess for a carotid pulse for no more than 10 seconds.
- C. tell the neighbor to continue rescue breathing as you apply the AED.
- D. ask the neighbor how long the child was submerged under the water.
Correct answer: B
Rationale: In cases of drowning, it is crucial to assess for a carotid pulse for no more than 10 seconds to determine if chest compressions are needed. This quick assessment helps determine the next steps in providing appropriate care to the patient. Performing chest compressions without confirming the need may not be beneficial and could potentially harm the patient if unnecessary.
5. What is the purpose of the pediatric assessment triangle?
- A. Detect immediate life threats through a quick hands-on assessment.
- B. Identify if the child has a medical condition or a traumatic injury.
- C. Determine if the child's problem is respiratory or circulatory in nature.
- D. Form a general impression of the child without touching them.
Correct answer: D
Rationale: The pediatric assessment triangle is used to form a rapid, hands-off general impression of the child's condition without directly touching them. This visual assessment helps in identifying children who require immediate attention and further evaluation.
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