ATI LPN
LPN Pediatrics
1. Which of the following statements regarding two-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 delivered.
- B. A compression-to-ventilation ratio of 15:2 should be delivered with pauses in compressions to give ventilations.
- C. The chest should be allowed to fully recoil between compressions to optimize venous return.
- 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: In two-rescuer child CPR, the correct compression depth is one third the diameter of the chest. This depth can be achieved by compressing the chest with one or two hands. It is crucial to follow the correct compression depth guideline to ensure effective chest compressions and circulation during CPR for a child.
2. In which of the following situations would the EMT MOST likely deliver a baby at the scene?
- A. A tornado has struck and blocked the only route to the hospital.
- B. Contractions are 8 to 10 minutes apart and irregular.
- C. The amniotic sac has ruptured, and contractions occur regularly.
- D. The hospital is 15 miles away, and crowning is not present.
Correct answer: A
Rationale: The EMT may be required to deliver a baby at the scene when external factors like a tornado have blocked the only route to the hospital, making it impossible to reach the medical facility in time for delivery. In such emergencies, the EMT must be prepared to manage the childbirth process until further medical assistance can be obtained.
3. Which behavior is most indicative that a 2-year-old is experiencing the initial phase of separation anxiety because his parents cannot stay all day at the hospital with him?
- A. He withdraws from the nursing staff.
- B. He cries when his parents leave.
- C. He lies quietly in bed.
- D. He cries when his parents arrive.
Correct answer: B
Rationale: The most indicative behavior of a 2-year-old experiencing the initial phase of separation anxiety due to parents not staying all day at the hospital is crying when his parents leave. This behavior is a common manifestation of separation anxiety in children, as they struggle with the absence of their primary attachment figures. Choices A, C, and D are less indicative because withdrawing from the nursing staff, lying quietly in bed, or crying when parents arrive do not specifically demonstrate the distress caused by separation from parents, which is the hallmark of separation anxiety in children.
4. The healthcare provider is assessing a newborn who is 2 hours old. Which finding requires immediate intervention?
- A. Acrocyanosis
- B. Respiratory rate of 60 breaths per minute
- C. Grunting with nasal flaring
- D. Heart rate of 140 beats per minute
Correct answer: C
Rationale: Grunting with nasal flaring is a concerning sign of respiratory distress in a newborn that can indicate inadequate oxygenation. This finding requires immediate intervention to ensure the newborn's respiratory status is stabilized and to prevent further complications. Prompt assessment and appropriate intervention are crucial in such cases to prevent respiratory compromise and potential deterioration. Acrocyanosis, which is bluish discoloration of the extremities, is a common finding in newborns and usually resolves on its own. A respiratory rate of 60 breaths per minute and a heart rate of 140 beats per minute are within normal ranges for a newborn and do not indicate immediate intervention is needed.
5. How should the nurse prepare the sibling of a near-drowning accident victim who wants to see his brother in the pediatric intensive care unit, considering the child was present during the accident?
- A. Have the parents explain to the child why the sibling is so sick and inform the child that this could be the last time he sees his brother.
- B. Reassure the sibling not to cry in the child's room to avoid upsetting the ill child.
- C. If death is imminent, avoid informing the child about it and minimize involvement in care to protect the child from further trauma.
- D. Cover tubes and wires with a sheet, wash off any existing blood, and prepare him for what he will see.
Correct answer: D
Rationale: When preparing a sibling to see their brother in the pediatric intensive care unit after a near-drowning accident, it is essential to cover tubes and wires with a sheet, wash off any existing blood, and explain what the sibling will see. This approach helps the sibling understand the situation better and prepares them emotionally for the encounter, reducing potential distress and trauma. By providing information and visual preparation, the sibling can have a more controlled and less overwhelming experience when visiting their brother in the intensive care unit. Choice A is incorrect as informing the child that this could be the last time he sees his sibling may cause unnecessary distress and anxiety. Choice B is incorrect as it dismisses the sibling's emotional response, which is essential to address in a supportive manner. Choice C is incorrect as honesty and appropriate information sharing are crucial, even in difficult situations, to help the child cope effectively with the circumstances.
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