The correct answer is (C). This describes the rooting reflex, where the infant roots for food (nipple) in response to something touching the cheek. The moro reflex (A) is where the infant spreads out his or her arms and legs in response to being startled. The palmar reflex is where the infant closes his or her hand whenever something touches the palm of the hand. The sucking reflex (D) describes what happens whenever something is inserted into the infant’s mouth.
The correct answer is (A). The anterior fontanel does not fully close until between 12 - 18 months of age. This fontanel is also the largest. The mastoid fontanel (B) generally closes between 6 and 12 months. The posterior fontanel (C) is generally the 1st to close between 1.5 and 3 months of age. The sphenoid fontanel (D) closes at about 6 months of age.
The correct answer is (B). Conventional reasoning follows preconventional reasoning (C), which is where a child performs actions either to get what he or she wants or avoid punishment. It precedes postconventional reasoning (D), which is where the child performs actions according to his or her own moral compass. Common sense reasoning (A) simply does not exist.
The correct answer is (A). The Health Insurance Portability and Accountability Act and other laws pertaining to the rights of privacy and confidentiality state that a minor is considered the individual, particularly when it comes to making decisions regarding pregnancy. Such decisions include testing for STDs, prescription contraceptives, and decisions regarding pregnancy-related care. Respecting the patient’s wishes (B) is always a good idea whenever possible; however, when it comes to a plan of care for a minor, “just because she asks you not to” is not a strong enough reason, except in the aforementioned cases.
The correct answer is (C). This correctly describes why children, particularly infants, are at greater risk for hypothermia in all environments. A thinner chest wall (A) means that children are at greater risk for internal chest injuries. A higher basal metabolic rate (B) has a greater impact on O2 and nutrient consumption and is more likely to help maintain a child’s core temperature. A smaller circulating blood volume (D) means that a child needs to lose less fluid overall before showing signs of shock and has little direct impact on thermoregulation.
The correct answer is (B). This child is showing signs of compensated shock bordering on decompensation and is possibly septic from the infection. The SpO2 indicates that the child is oxygenating effectively, so albuterol (C) and ipratropium bromide (D) are not indicated at this time. CPAP (A) is never an appropriate choice when pneumonia is suspected.
The correct answer is (B). Because this child is almost 2 years old, the equation becomes (16 + 2)/4 = 4.5. Because the answers all indicate cuffed tubes, the size should be reduced by 0.5. Therefore, the answer is 4.0. (C) would be correct if it said “uncuffed.”
The correct answer is (D). This represents D in the DOPE mnemonic. It is possible during transferring the patient from the ground by the pool to the ambulance that the tube became dislodged or pushed deeper. Suctioning (B) represents the O in DOPE and should be done 2nd. Increasing the O2 flow rate (A) likely would not produce better oxygenation. Extubation (C) should always be a last resort.
The correct answer is (B). Hyperglycemia would present with Kussmaul respirations, which are deep and rapid along with the other symptoms mentioned. The child is likely hypovolemic (A); however, this is not the cause of the symptoms but rather a symptom. Drug overdose (C) does not usually cause any of the listed symptoms. This patient is in acidosis; however, it is metabolic in nature, not respiratory. Respiratory acidosis (D) results from decreased ventilation, such as in respiratory arrest.
The correct answer is (D). Most febrile seizures are self-limiting and require little more than monitoring the patient. Starting an intravenous line is optional because rarely do febrile seizures follow 1 after each other. Lorazepam (A) is not recommended in the pediatric population. Active cooling (B) is not usually necessary and could result in causing another seizure if the child begins to shiver. Because it is usually over, diazepam (C) is rarely needed.