LPN LPN
ATI Pediatrics Proctored Test
1. You are dispatched to a residence for a 5-year-old child who is not breathing. Upon arrival, you find the child supine on the floor, cyanotic, and unresponsive. You should first:
- A. begin chest compressions.
- B. open the airway and give two rescue breaths.
- C. apply an AED and analyze the rhythm.
- D. ask the parent for the child's medical history.
Correct answer: B
Rationale: When encountering an unresponsive and not breathing child, the initial step is to open the airway and provide two rescue breaths. This action helps to deliver oxygen to the child's lungs and body, which is crucial in attempting to restore breathing and circulation. Chest compressions are not initiated first in pediatric cases unless the child has no signs of circulation after delivering rescue breaths. Applying an AED and analyzing the rhythm is not the initial step in a pediatric cardiac arrest scenario, as the primary focus should be on providing oxygenation. Asking the parent for the child's medical history is not the immediate priority when the child is unresponsive and not breathing, as interventions to support breathing and circulation should be the primary concern.
2. When assessing a 5-year-old boy with major trauma, his blood pressure is 70/40 mm Hg, and his pulse rate is 140 beats/min and weak. The child's blood pressure:
- A. indicates decompensated shock.
- B. reflects adequate compensation.
- C. suggests increased intracranial pressure.
- D. is appropriate based on his age.
Correct answer: A
Rationale: In a 5-year-old boy with major trauma, a blood pressure of 70/40 mm Hg and a pulse rate of 140 beats/min, and weak, indicate decompensated shock. This presentation signifies inadequate perfusion, leading to compensatory mechanisms being overwhelmed, resulting in decompensated shock. Choice B is incorrect as the vital signs suggest the body is unable to adequately compensate for the trauma. Choice C is incorrect as the vital signs are more indicative of shock rather than increased intracranial pressure. Choice D is incorrect as such low blood pressure is not appropriate for a child of this age and indicates a critical condition.
3. 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.
4. 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.
5. Which of the following statements regarding 2-rescuer child CPR is correct?
- A. The chest should be compressed with one hand, and a compression-to-ventilation ratio of 30:2 should be used.
- B. The chest should not be allowed to fully recoil in between compressions.
- C. A compression-to-ventilation ratio of 15:2 should be used if an advanced airway is in place.
- D. Compress the chest with one or two hands to a depth equal to one-third the diameter of the chest.
Correct answer: D
Rationale: During 2-rescuer child CPR, it is important to compress the chest with one or two hands to a depth equal to one-third the diameter of the chest. This technique ensures effective chest compressions are being delivered to help circulate blood and oxygenate the child's body. Choice A is incorrect because both hands should be used for chest compressions in 2-rescuer CPR. Choice B is incorrect as allowing the chest to fully recoil between compressions is essential to create negative pressure and facilitate blood flow back to the heart. Choice C is incorrect as the standard compression-to-ventilation ratio for child CPR is 30:2, regardless of whether an advanced airway is in place.
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