a prolapsed umbilical cord is dangerous because the

ATI LPN

LPN Pediatrics

1. Why is a prolapsed umbilical cord dangerous?

A. The cord may be wrapped around the baby's neck, causing strangulation.
B. The cord might pull the placenta from the uterine wall during delivery.
C. The baby's head may compress the cord, cutting off its supply of oxygen.
D. The mother may die of hypoxia due to compromised placental blood flow.

Correct answer: C

Rationale: A prolapsed umbilical cord is dangerous because the baby's head may compress the cord, cutting off its supply of oxygen. This compression can lead to oxygen deprivation, potentially causing significant harm to the baby. Immediate medical intervention is crucial in such cases to prevent adverse outcomes.

2. Which of the following clinical signs would MOST suggest acute respiratory distress in a 2-month-old infant?

A. Heart rate of 130 beats/min
B. Respiratory rate of 30 breaths/min
C. Abdominal breathing
D. Grunting respirations

Correct answer: D

Rationale: Grunting respirations are a key clinical sign of acute respiratory distress in infants. Grunting is a protective mechanism where the infant exhales against a partially closed glottis to increase functional residual capacity and oxygenation. This is often seen in conditions such as respiratory distress syndrome, pneumonia, or other causes of respiratory compromise in infants. Monitoring respiratory patterns like grunting is crucial for early recognition and intervention in infants with respiratory distress. Choices A, B, and C are less specific to acute respiratory distress in infants. While an elevated heart rate and respiratory rate can be present in respiratory distress, grunting respirations are a more direct indicator of significant respiratory compromise in infants.

3. 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.

4. How should the nurse prepare the sibling of a near-drowning accident victim who wants to see his brother in the pediatric intensive care unit, considering the child was present during the accident?

A. Have the parents explain to the child why the sibling is so sick and inform the child that this could be the last time he sees his brother.
B. Reassure the sibling not to cry in the child's room to avoid upsetting the ill child.
C. If death is imminent, avoid informing the child about it and minimize involvement in care to protect the child from further trauma.
D. Cover tubes and wires with a sheet, wash off any existing blood, and prepare him for what he will see.

Correct answer: D

Rationale: When preparing a sibling to see their brother in the pediatric intensive care unit after a near-drowning accident, it is essential to cover tubes and wires with a sheet, wash off any existing blood, and explain what the sibling will see. This approach helps the sibling understand the situation better and prepares them emotionally for the encounter, reducing potential distress and trauma. By providing information and visual preparation, the sibling can have a more controlled and less overwhelming experience when visiting their brother in the intensive care unit. Choice A is incorrect as informing the child that this could be the last time he sees his sibling may cause unnecessary distress and anxiety. Choice B is incorrect as it dismisses the sibling's emotional response, which is essential to address in a supportive manner. Choice C is incorrect as honesty and appropriate information sharing are crucial, even in difficult situations, to help the child cope effectively with the circumstances.

5. When you attempt to assess a 22-year-old woman who has been sexually assaulted, she orders you not to touch her. Your MOST appropriate initial action should be to:

A. obtain a signed refusal and return to service.
B. transport the patient without performing an assessment.
C. explain to the patient that she must be examined.
D. ask a female EMT to attempt to assess the patient.

Correct answer: D

Rationale: In cases of sexual assault, it's important to respect the patient's wishes and provide a female EMT to attempt the assessment if the patient prefers.