when is it most appropriate to clamp and cut the umbilical cord

ATI LPN

LPN Pediatrics

1. When is it MOST appropriate to clamp and cut the umbilical cord?

A. Before the newborn has taken its first breath
B. After the placenta has completely delivered
C. As soon as the cord has stopped pulsating
D. Immediately following delivery of the newborn

Correct answer: C

Rationale: The ideal time to clamp and cut the umbilical cord is when it has stopped pulsating. This allows for the transfer of remaining blood from the placenta to the newborn, which can be beneficial for the baby's health and iron stores. Clamping the cord too early can deprive the newborn of this essential blood volume. Waiting for the pulsations to cease ensures that the baby receives the maximum benefits from delayed cord clamping.

2. Which of the following techniques represents the MOST appropriate method of opening the airway of an infant with no suspected neck injury?

A. Perform the technique as you would for an older child or adult.
B. Lift up the chin and hyperextend the neck.
C. Gently lift the chin while maintaining slight flexion of the neck.
D. Tilt the head back without hyperextending the neck.

Correct answer: D

Rationale: Tilting the head back without hyperextending the neck is the safest way to open an infant's airway. Hyperextending the neck can potentially cause harm to the infant, making option D the most appropriate method for opening an infant's airway without suspected neck injury.

3. Mr. Lopez has a 7-year-old son with growth hormone (GH) deficiency. He shares with the nurse the desire of his son to play ball games. However, his wife feels the child will be in danger since he is smaller than the other children. In planning anticipatory guidance for these parents, the nurse should keep in mind which of the following?

A. The child should be allowed to play because doing so can foster healthy self-esteem
B. The risk for fractures is increased because GH deficiency results in fragile bones
C. Activity could aggravate insulin sensitivity, causing hyperglycemia
D. Activity would aggravate the child's joints, already overtasked by obesity

Correct answer: A

Rationale: Children with GH deficiency may face challenges due to their size, but it is important to encourage their participation in activities like playing ball games to promote healthy self-esteem. Allowing the child to play can help in building confidence and a sense of accomplishment, which are essential for their overall well-being.

4. Which of the following is MOST likely to occur in conjunction with a breech presentation?

A. Vertex presentation
B. Maternal hypertension
C. Prolapsed umbilical cord
D. Premature rupture of the amniotic sac

Correct answer: C

Rationale: In a breech presentation, where the baby's buttocks or feet present first, there is an increased risk of the umbilical cord slipping down alongside or below the presenting part, leading to a prolapsed umbilical cord. This is a serious complication that can compromise fetal blood flow and oxygenation, necessitating prompt intervention to prevent adverse outcomes. Choices A, B, and D are less likely to occur in conjunction with a breech presentation. Vertex presentation is the normal head-first presentation, maternal hypertension is a separate condition that may not be directly related to fetal presentation, and premature rupture of the amniotic sac can happen independently of the baby's presentation.

5. To prevent diarrhea in children, a vaccine is available against which of the following?

A. Adenovirus
B. Rotavirus
C. Enterovirus
D. All of the above

Correct answer: B

Rationale: The correct answer is B - Rotavirus. Rotavirus vaccine is available to prevent diarrhea in children. Rotavirus is a common cause of severe diarrhea in infants and young children globally, and vaccination has been shown to be effective in reducing the burden of this disease. Choices A and C are incorrect because there is no specific vaccine available for Adenovirus or Enterovirus to prevent diarrhea in children. Choice D is incorrect because while vaccines are available for some viruses that can cause diarrhea in children, not all mentioned in the choices have a specific vaccine available.