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ATI Pediatrics Proctored Test
1. Which of the following statements regarding sudden infant death syndrome (SIDS) is correct?
- A. Death as a result of SIDS can occur at any time of the day or night.
- B. Certain cases of SIDS are predictable and therefore preventable.
- C. Most cases of SIDS occur in infants younger than 6 months.
- D. SIDS is uncommon in infants older than 1 year of age.
Correct answer: A
Rationale: The correct answer is A. SIDS can occur at any time of the day or night, although it most commonly occurs during sleep. SIDS is sudden and unpredictable, making it challenging to prevent in all cases. While most cases occur in infants younger than 6 months, it is not limited to this age group. SIDS is not uncommon in infants older than 1 year of age, although less common than in younger infants.
2. You are dispatched to a residence for a child with respiratory distress. The child is wheezing and has nasal flaring and retractions. His oxygen saturation is 92%. You should:
- A. place the child in a supine position.
- B. administer high-flow oxygen.
- C. begin chest compressions.
- D. administer low-flow oxygen.
Correct answer: B
Rationale: In a scenario where a child presents with respiratory distress, wheezing, nasal flaring, retractions, and an oxygen saturation of 92%, the appropriate intervention is to administer high-flow oxygen. This helps to improve oxygenation and alleviate the respiratory distress the child is experiencing. Placing the child in a supine position can worsen their condition by affecting their ability to breathe effectively. Chest compressions are not indicated in this case as the child is not in cardiac arrest. Administering low-flow oxygen may not provide adequate oxygenation for a child in respiratory distress with a saturation of 92%. Therefore, the priority is to administer high-flow oxygen to improve oxygen levels and support the child's breathing.
3. When assisting ventilations in a 4-year-old child with a bag-valve mask, what should the EMT do?
- A. Deliver each breath over 2 to 3 seconds.
- B. Ensure the appropriate mask size is used.
- C. Block the pop-off valve if needed to achieve adequate chest rise.
- D. Reassess the pulse rate after 60 seconds.
Correct answer: C
Rationale: When assisting ventilations in a 4-year-old child with a bag-valve mask, the EMT should block the pop-off valve if needed to achieve adequate chest rise. This action helps ensure effective ventilation and adequate oxygenation in the child. Blocking the pop-off valve allows for better control over the volume of air delivered and can help maintain positive pressure in the airway, assisting in improving oxygenation and ventilation in the child. Choices A, B, and D are incorrect because delivering each breath over 2 to 3 seconds is a general guideline but may need adjustment based on patient response, ensuring the appropriate mask size is important but not the primary concern in this scenario, and reassessing the pulse rate is not directly related to the ventilation technique being discussed.
4. During the pediatric assessment process, which scenario would be the LEAST appropriate for the transition phase?
- A. A parent is available to help keep the child calm.
- B. The child is unstable and needs rapid transport.
- C. You determine that the child's condition is stable.
- D. Your transport time is greater than 30 minutes.
Correct answer: B
Rationale: During a pediatric assessment, the transition phase is a critical period where care is handed over from prehospital providers to the hospital team. If the child is unstable and requires rapid transport, it is not appropriate to delay for a transition phase. In such cases, immediate transport to a higher level of care is paramount to ensure the child's safety and well-being. Choice A is appropriate as having a parent present can help keep the child calm during the transition. Choice C is also appropriate as transitioning a stable child allows for a smoother handover. Choice D, while indicating a longer transport time, does not necessarily affect the need for a transition phase as long as the child's condition remains stable.
5. 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.
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