A newborn male is evaluated one minute after birth. He was born at 38 weeks gestation to a 28-year-old gravida 3 via vaginal delivery. The patient’s mother received sporadic prenatal care, and the pregnancy was complicated by gestational diabetes. The amniotic fluid was clear. The patient’s pulse is 70/min, and his breathing is irregular with a slow, weak cry. He whimpers in response to a soft pinch on the thigh, and he has moderate muscle tone with some flexion of his extremities. His body is pink and his extremities are blue. The patient is dried with a warm towel and then placed on his back on a flat warmer bed. His mouth and nose are suctioned with a bulb syringe. Which of the following is the best next step in management?
ASupplemental oxygen via nasal cannula and reassessment of Apgar score at 5 minutes
BChest compressions and bag-mask ventilation
CEndotracheal intubation and mechanical ventilation
DIntravenous epinephrine and reassessment of Apgar score at 5 minutes
EPositive pressure ventilation and reassessment of Apgar score at 5 minutes
A 7-year-old boy is brought to the emergency room because of severe, acute diarrhea. He is drowsy with a dull, lethargic appearance. He has sunken eyes, poor skin turgor, and dry oral mucous membranes and tongue. He has a rapid, thready pulse with a systolic blood pressure of 60 mm Hg and his respirations are 33/min. His capillary refill time is 6 sec. He has had no urine output for the past 24 hours. Which of the following is the most appropriate next step in treatment?
AStart IV fluid resuscitation by administering colloid solutions
BProvide oral rehydration therapy to correct dehydration
CGive initial IV bolus of 2 L of Ringer’s lactate, followed by packed red cells, fresh frozen plasma, and platelets in a ratio of 1:1:1
DStart IV fluid resuscitation with normal saline or Ringer’s lactate, along with monitoring of vitals and urine output
EGive antidiarrheal drugs
A first time mother of a healthy, full term, newborn girl is anxious about sudden infant death syndrome. Which of the following pieces of advice can reduce the risk of SIDS?
ASleep supine in a crib with bumpers, head propped up on a pillow, and wrapped in a warm blanket
BSleep supine in a crib with bumpers, head propped up on a pillow, and wrapped in an infant sleeper
CSleep supine in the parent's bed and use a pacifier after 1 month of age
DSleep supine in a crib without bumpers, use a pacifier after 1 month of age, and use a home apnea monitor
ESleep supine in a crib without bumpers, use a pacifier after 1 month of age, and avoid smoking
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