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RATIONALE
A newborn has cyanosis to the chest and face and a heart rate of 90
beats/min. What should you do?
A) Resuction the mouth
B) Briskly dry off the infant
C) Begin chest compressions
D) Begin artificial ventilations - CORRECT ANSWER ✔✔✔✔✔ D
(Central cyanosis [head, face, and trunk] alone should be treated with
blow-by O2; however, when it is accompanied by HR less than
100bpm, artificial ventilations should be initiated and continued until
the HR exceeds 100bpm. Chest compressions are needed when HR is
less than 60bpm, despited 30 seconds of adequate positive-pressure
ventilation)
A woman is 30 weeks pregnant. During your assessment, she tells
you that she delivered a stillborn baby at 38 weeks and currently has
no living children. How should you document her obstetric history?
A) Gravida 1; para 1
,B) Gravida 2; para 1
C) Gravida 1; para 2
D) Gravida 2; para 2 - CORRECT ANSWER ✔✔✔✔✔ D
(Gravida= # of times a woman has been pregnant, regardless of the
length of the pregnancy. Para= # of babies carried beyond 28 weeks,
regardless of whether the baby was born dead or alive. Since this pt
has surpassed week 28 of her current pregnancy, and delivered her
last baby past 28 weeks, she is para 2)
Following the initial steps of resuscitation, a newborn remains apneic
and cyanotic. You should:
A) immediately resuction its mouth and nose.
B) begin ventilations with a bag-valve-mask.
C) gently flick the soles of its feet for up to 60 seconds.
D) start CPR if the heart rate is less than 80 beats/min. - CORRECT
ANSWER ✔✔✔✔✔ B
(Initial steps of newborn resuscitation: drying, warming, positioning,
suctioning, and tactile stimulation. If newborn remains apneic
[gasping] after initial steps or has a HR less than 100bpm, begin PPV
with BVM at rate of 40-60 breaths/min. Continued tactile stimulation
[flicking soles of feet, rubbing the lateral thorax] of an apneic
newborn WASTES TIME. If the newborn's HR is less than 60bpm
despite effective PPV, you should begin chest compressions)
In contrast to the contractions associated with true labor, Braxton-
Hicks contractions:
A) do not increase in intensity and are alleviated by a change in
position.
B) may be intensified by activity and are accompanied by a pink
discharge.
,C) generally follow rupture of the amniotic sac and occur with
regularity.
D) consistently become stronger and are not alleviated by changing
position. - CORRECT ANSWER ✔✔✔✔✔ A
(Braxton-Hicks: false labor. Do not represent true labor since they do
not increase in intensity, are not regular, and are typically alleviated
by activity or a change in position. Contractions during true labor,
once they begin: consistently get stronger and closer together and
are regular; change in position does not help; may be followed by
rupture of amniotic sac and a pink or red vaginal discharge that is
gen. accompanied by mucus [bloody show])
Compared to nonpregnant women, otherwise healthy pregnant
woman are at greater risk for:
A) joint dislocations.
B) type 1 diabetes.
C) pathologic fractures.
D) congestive heart failure. - CORRECT ANSWER ✔✔✔✔✔ A
(Blood volume, cardiac output and HR all increase with pregnancy. BP
decreases slightly. Uterus expands which affects the respiratory
system by pushing up on the diaphragm which increases the
respiratory rate and decreases minute volume [pregnant women
breathe faster but have a hard time taking a deep breath]. Increased
hormones make the joints looser and less stable; this increases risk
of joint dislocations. Some pregnant women develop gestational
diabetes, which is caused when the pregnancy hormones create
insulin resistance; this is different from Type 1 diabetes, where the
body does not produce any insulin)
A 7-year-old child has an altered mental status, high fever, and a
generalized rash. You perform your assessment and administer
, supplemental oxygen. En route to the hospital, you should be MOST
alert for:
A) hypotension.
B) convulsions.
C) combativeness.
D) respiratory distress. - CORRECT ANSWER ✔✔✔✔✔ B
(High fever and AMS indicate sepsis. A generalized rash should alert
you to the possibility of meningitis [a condition caused by infection
and inflammation of the meninges that protect the brain and spinal
cord]. Children with meningitis are at risk for seizures, usually due to
increased ICP and/or high fever. Seizure deaths are caused by
cerebral hypoxia)
A 4-year-old girl fell from a third-story window and landed on her
head. She is semiconscious with slow, irregular breathing and is
bleeding from her mouth and nose. You should:
A) open her airway with the jaw-thrust maneuver while manually
stabilizing her head, suction her oropharynx, and assist her
ventilations.
B) open her airway by carefully tilting her head back, suction her
oropharynx, and administer high-flow oxygen via nonrebreathing
mask.
C) manually stabilize her head, open her airway with the jaw-thrust
maneuver, insert a nasopharyngeal airway, and suction her
oropharynx.
D) suction her oropharynx, open her airway with the jaw-thrust
maneuver, insert an oropharyngeal airway, and assist her ventilations.
- CORRECT ANSWER ✔✔✔✔✔ A
(In any semiconscious or unconscious pt with a head injury, you
should manually stabilize the head and open the airway with jaw-
thrust maneuver. Suction any secretions. If possible, insert a simple