LPN LPN
ATI Pediatrics Proctored Test
1. When ventilating an apneic 3-year-old child with a bag-valve mask device, what is the MOST important action to take?
- A. Avoid hyperventilation and ensure adequate chest rise.
- B. Squeeze the bag with both hands and use a pediatric mask.
- C. Immediately insert an oropharyngeal airway.
- D. Provide one breath every 3 to 5 seconds.
Correct answer: A
Rationale: When ventilating an apneic child, the most important action is to avoid hyperventilation and ensure adequate chest rise. Hyperventilation can lead to decreased cardiac output and increased intracranial pressure. Adequate chest rise confirms effective ventilation and minimizes the risk of complications. Choice B is incorrect because using both hands to squeeze the bag may not ensure proper ventilation and can lead to complications. Choice C is incorrect as inserting an oropharyngeal airway is not the initial action in ventilating an apneic child with a bag-valve mask. Choice D is incorrect as providing ventilations every 3 to 5 seconds may not be appropriate for effective ventilation in a pediatric patient.
2. Your assessment of a newborn reveals cyanosis to the chest and face and a heart rate of 90 beats/min. What should you do first?
- A. Dry the infant briskly.
- B. Suction the mouth.
- C. Begin artificial ventilations.
- D. Begin chest compressions.
Correct answer: C
Rationale: In a newborn with cyanosis to the chest and face and a heart rate of 90 beats/min, the priority action is to begin artificial ventilations. A heart rate below 100 beats/min with cyanosis indicates a need for immediate respiratory support to improve oxygenation. Drying the infant briskly or suctioning the mouth may be necessary later but are not the initial priority. Chest compressions are not indicated as the heart rate is above 60 beats/min.
3. You and your partner are performing CPR on a 2-year-old female in cardiac arrest. During your resuscitation attempt, you should:
- A. hyperventilate her due to severe hypoxia.
- B. attach the AED pads after 5 minutes of high-quality CPR.
- C. perform compressions and ventilations at a ratio of 30:2.
- D. allow the chest to fully recoil between compressions.
Correct answer: D
Rationale: Allowing the chest to fully recoil between compressions is crucial during CPR to ensure proper blood flow. This action allows the heart to refill with blood, enhancing the effectiveness of compressions and circulation. Hyperventilating the patient can lead to decreased cardiac output and is not recommended. Attaching AED pads should be done as soon as possible in a pediatric cardiac arrest situation, ideally within 2 minutes. The correct compression-to-ventilation ratio for pediatric CPR is 30:2, focusing on high-quality compressions to provide adequate perfusion to vital organs.
4. 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.
5. What action should you take if a newborn's heart rate is 50 beats/min?
- A. Begin chest compressions.
- B. Reassess in 30 seconds.
- C. Administer blow-by oxygen.
- D. Start positive-pressure ventilations.
Correct answer: D
Rationale: If a newborn's heart rate is below 60 beats per minute, the appropriate action is to start positive-pressure ventilations. Ventilations help deliver oxygen to the newborn's body and support respiratory function, which is critical in cases of bradycardia. Chest compressions are not recommended until the heart rate is below 60 despite adequate ventilation. Reassessment is essential but not the immediate action required in this scenario. Administering blow-by oxygen alone may not effectively address the underlying cause of bradycardia, making positive-pressure ventilations the priority intervention in this case.
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