following the initial steps of resuscitation a newborn remains apneic and cyanotic you should

ATI LPN

ATI Pediatrics Proctored Test

1. Following the initial steps of resuscitation, a newborn remains apneic and cyanotic. What should you do next?

A. begin ventilations with a bag-mask device.
B. gently flick the soles of their feet for up to 60 seconds.
C. immediately suction their mouth and nose.
D. start CPR if the heart rate is less than 80 beats/min.

Correct answer: A

Rationale: If a newborn remains apneic and cyanotic after the initial resuscitation steps, the next appropriate action is to begin ventilations with a bag-mask device. This helps provide oxygen to the newborn and can be crucial in supporting their respiratory efforts. Option B of flicking the soles of their feet is not recommended in this scenario as the priority is addressing the respiratory distress. Option C of suctioning their mouth and nose is not the immediate next step if the newborn is not spontaneously breathing. Option D of starting CPR based only on the heart rate is not the first-line intervention for an apneic and cyanotic newborn.

2. Physical abuse of a 4-year-old child should be suspected if you observe:

A. purple and yellow bruises on the thighs.
B. bruises on the anterior tibial area.
C. the child clinging to his or her parent.
D. curious siblings watching you.

Correct answer: A

Rationale: Purple and yellow bruises on protected areas like the thighs are concerning as they indicate bruises in various stages of healing, which is a red flag for physical abuse. Bruises on the anterior tibial area or a child clinging to a parent are not specific signs of physical abuse. Siblings watching you is unrelated to the suspicion of physical abuse in this scenario.

3. You arrive at the scene shortly after a 3-year-old female experienced a seizure. The child, who is being held by her mother, is conscious and crying. The mother tells you that her daughter has been ill recently and has a temperature of 102.5°F. What is the MOST appropriate treatment for this child?

A. Oxygen via non-rebreathing mask, place the child in a tub of cold water to lower her body temperature, and transport.
B. Oxygen via the blow-by technique, transport, and request a paramedic intercept so an anticonvulsant drug can be given.
C. Oxygen via non-rebreathing mask, avoid any measures to lower the child's body temperature, and transport at once.
D. Oxygen via the blow-by technique, remove clothing to help reduce her fever, and transport with continuous monitoring.

Correct answer: D

Rationale: The most appropriate treatment for a child who has experienced a seizure and has a fever includes administering oxygen via the blow-by technique, removing clothing to help reduce fever, and transporting the child with continuous monitoring. Choice A is incorrect because placing the child in a tub of cold water can lead to hypothermia and is not recommended for fever reduction. Choice B is incorrect as requesting an anticonvulsant drug without proper evaluation and assessment by a healthcare provider is not appropriate. Choice C is incorrect as avoiding measures to lower the child's body temperature can worsen the situation in case of febrile seizures. Therefore, the best course of action is to provide oxygen via the blow-by technique, remove excess clothing to reduce fever, and transport the child while continuously monitoring her condition.

4. When treating Baby John, who has been diagnosed with a lower respiratory infection, the selection of drugs of choice for the treatment depends primarily on:

A. Preference of the physician
B. Selectivity of the organism
C. Sensitivity of the organism
D. Tolerance of the client

Correct answer: C

Rationale: The primary factor in selecting drugs for the treatment of a lower respiratory infection in Baby John is the sensitivity of the organism causing the infection. The choice of antibiotics should be guided by the susceptibility of the specific pathogen to ensure effective treatment and prevent resistance.

5. After the baby's head delivers, how is it usually tilted?

A. with the face up.
B. anteriorly, with the chin up.
C. posteriorly, to one side.
D. posteriorly, face down.

Correct answer: C

Rationale: After the baby's head delivers, it is typically tilted posteriorly to one side to help facilitate the delivery of the shoulders. This positioning is important for the safe and smooth delivery of the baby.