LPN LPN
LPN Pediatrics
1. You are treating a 5-year-old child who has had severe diarrhea and vomiting for 3 days and is now showing signs of shock. Supplemental oxygen has been given, and you have elevated his lower extremities. En route to the hospital, you note that his work of breathing has increased. You should:
- A. begin positive-pressure ventilations and reassess the child.
- B. lower the extremities and reassess the child.
- C. listen to the lungs with a stethoscope for abnormal breath sounds.
- D. insert a nasopharyngeal airway and increase the oxygen flow.
Correct answer: B
Rationale: When the work of breathing increases after elevating the legs, it is important to lower the extremities. Elevating the lower extremities in a child with signs of shock can worsen the condition by reducing venous return to the heart. Lowering the extremities can help improve venous return and potentially alleviate the increased work of breathing.
2. Why is a prolapsed umbilical cord dangerous?
- A. The cord may be wrapped around the baby's neck, causing strangulation.
- B. The cord might pull the placenta from the uterine wall during delivery.
- C. The baby's head may compress the cord, cutting off its supply of oxygen.
- D. The mother may die of hypoxia due to compromised placental blood flow.
Correct answer: C
Rationale: A prolapsed umbilical cord is dangerous because the baby's head may compress the cord, cutting off its supply of oxygen. This compression can lead to oxygen deprivation, potentially causing significant harm to the baby. Immediate medical intervention is crucial in such cases to prevent adverse outcomes.
3. What percentage of total body surface area has been burned in a 5-year-old child who experienced partial-thickness burns to his head, anterior chest, and both upper extremities?
- A. 45%
- B. 63%
- C. 72%
- D. 54%
Correct answer: A
Rationale: According to the pediatric rule of nines, the head and neck represent 18%, the anterior chest and abdomen 18%, and each arm 9%. By adding these percentages (18% + 18% + 9% + 9% = 45%), we find that 45% of the total body surface area has been burned in this child.
4. What is the appropriate treatment for a responsive 4-year-old child with a mild airway obstruction, respiratory distress, a strong cough, and normal skin color?
- A. Oxygen, back slaps, and transport.
- B. Subdiaphragmatic thrusts until the object is expelled.
- C. Assisted ventilations, back slaps, and transport.
- D. Supplemental oxygen and transport.
Correct answer: D
Rationale: For a responsive 4-year-old child with a mild airway obstruction, respiratory distress, a strong cough, and normal skin color, the appropriate treatment includes providing supplemental oxygen and arranging for transport to a healthcare facility. Oxygen helps alleviate the respiratory distress, and transport ensures the child receives further evaluation and care by healthcare professionals. Back slaps and subdiaphragmatic thrusts are not recommended for a child with a mild airway obstruction and normal skin color, as these interventions are typically reserved for more severe cases of airway obstruction.
5. A 3-year-old child has a sudden onset of respiratory distress. The mother denies any recent illnesses or fever. You should suspect:
- A. croup.
- B. foreign body airway obstruction.
- C. lower respiratory infection.
- D. epiglottitis.
Correct answer: B
Rationale: In a 3-year-old child with a sudden onset of respiratory distress and no recent illnesses or fever, the likely cause is a foreign body airway obstruction. Foreign body obstruction can lead to sudden respiratory distress without other preceding symptoms. It is crucial to consider this possibility and act promptly to clear the airway in such cases to prevent serious complications.
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