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

Correct Answer: D

Rationale: In pediatric nursing, maintaining a patent airway is crucial for ensuring adequate oxygenation. The correct answer, option D, which states to tilt the head back without hyperextending the neck, is the most appropriate method for opening the airway of an infant with no suspected neck injury. This technique is recommended for infants because their airways are more easily obstructed due to their anatomical differences compared to older children or adults. Hyperextending the neck (option B) can actually worsen the airway obstruction in infants. Performing the technique as you would for an older child or adult (option A) may not be effective and could potentially harm the infant. Gently lifting the chin while maintaining slight flexion of the neck (option C) is not ideal as it may not fully open the airway in an infant. It's essential for pediatric nurses to be well-versed in age-appropriate airway management techniques to provide safe and effective care to infants and children.

Correct Answer: D

Rationale: A sudden onset of respiratory distress in a child without fever is most likely due to a foreign body airway obstruction. This obstruction can rapidly lead to difficulty breathing, stridor, and other signs of respiratory distress without necessarily causing a fever. Prompt recognition and intervention are crucial in such cases to prevent further complications and ensure the child's airway remains clear.

Correct Answer: D

Rationale: The correct answer is D) The tape measure can be used in children who weigh up to 75 pounds. This answer is correct because the length-based resuscitation tape measure is designed to provide an estimate of a child's weight based on their length or height. This tool is particularly useful in emergency situations when an accurate weight measurement is not feasible but essential for medication dosing and equipment selection. Option A is incorrect because the resuscitation tape measure estimates weight based on length, not height. Option B is incorrect because the reliability of the tape measure is not limited to children under 5 years of age; it can be used for a broader age range. Option C is incorrect as the red end of the tape measure is typically placed at the child's feet, not the head. For pediatric nurses, understanding and utilizing tools like the length-based resuscitation tape measure are crucial in providing effective and timely care to pediatric patients. It helps in dosing medications, selecting appropriate equipment sizes, and ensuring accurate interventions during resuscitation efforts. Nurses must be knowledgeable about these tools to enhance patient safety and outcomes in pediatric emergencies.

Correct Answer: C

Rationale: When a child ingests a harmful substance like drain cleaner and remains alert with a patent airway and adequate breathing, the initial steps involve contacting poison control to guide further management. In this scenario, providing oxygen to support respiratory function is essential until definitive care is established. Activated charcoal and ipecac are not recommended in the management of ingested caustic substances like drain cleaner. Performing a head-to-toe exam can wait until the child's immediate respiratory needs are addressed and the poison control center has provided guidance on further management.

Correct Answer: C

Rationale: Expiratory grunting is a significant sign of inadequate breathing and respiratory distress in infants. It indicates that the infant is struggling to exhale properly, which can be a sign of various respiratory issues, including lung problems or airway obstruction. Monitoring and recognizing this sign promptly can help in providing timely interventions to support the infant's breathing and prevent further complications.