LPN LPN
LPN Pediatrics
1. 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.
2. A 30-year-old woman is 22 weeks pregnant with her first child. She tells you that her rings are not fitting as loosely as they usually do and that her ankles are swollen. Her blood pressure is 150/86 mm Hg. She is MOST likely experiencing:
- A. a condition unrelated to pregnancy.
- B. gestational diabetes.
- C. a hypertensive emergency.
- D. preeclampsia.
Correct answer: D
Rationale: The symptoms of swollen ankles, tight rings, and elevated blood pressure in a pregnant woman at 22 weeks gestation are concerning for preeclampsia. Preeclampsia is characterized by high blood pressure and signs of organ damage, commonly seen with symptoms such as swelling (edema) and protein in the urine. It is crucial to monitor and manage preeclampsia promptly as it can lead to severe complications for both the mother and the baby.
3. You are caring for a 6-year-old child with a possible fractured arm and have reason to believe that the child was abused. How should you manage this situation?
- A. Inform the parents of your suspicions.
- B. Transport the child to the hospital regardless of the parents' wishes.
- C. Call the police and have the parents arrested.
- D. Advise the parents that the child needs to be transported.
Correct answer: D
Rationale: In cases where child abuse is suspected, the priority is the safety and well-being of the child. Advising the parents that the child needs to be transported for further evaluation and care is the appropriate initial step. This ensures that the child receives necessary medical attention while also addressing the suspicion of abuse through proper channels. It is essential to involve appropriate authorities and follow established procedures to protect the child and investigate any potential abuse further.
4. What is the most likely cause of a sudden onset of respiratory distress in a 5-year-old child with no fever?
- A. Infection of the lower airways.
- B. A progressive upper airway infection.
- C. Inflammation of the upper airway.
- D. A foreign body airway obstruction.
Correct answer: D
Rationale: A sudden onset of respiratory distress in a child without fever is most likely due to a foreign body airway obstruction. This obstruction can rapidly lead to difficulty breathing, stridor, and other signs of respiratory distress without necessarily causing a fever. Prompt recognition and intervention are crucial in such cases to prevent further complications and ensure the child's airway remains clear.
5. When preventing cardiac arrest in infants and small children, the primary focus should be on:
- A. Providing immediate transport.
- B. Ensuring adequate ventilation.
- C. Keeping the child warm.
- D. Avoiding upsetting the child.
Correct answer: B
Rationale: The correct approach to prevent cardiac arrest in infants and small children is to ensure adequate ventilation. In these cases, maintaining proper oxygenation and ventilation is crucial for sustaining life. Providing immediate transport, keeping the child warm, or avoiding upsetting the child are important considerations but ensuring adequate ventilation takes precedence in preventing cardiac arrest and supporting the child's vital functions.
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