AAOS Exam 10 (Chapters 33-36).
The suture of the anterior fontanelle is typically closed by _______________ months of age, and the suture of the posterior fontanelle is typically closed by _______________ months of age. Select one: a.18,6 b.12,4 c.2,4 d.6, 12
18,6
After squeezing the end of a child's finger or toe for a few seconds, blood should return to the area within: Select one: a.3 seconds. b.2 seconds. c.5 seconds. d.4 seconds.
2 seconds
Blood pressure is usually not assessed in children younger than years. Select one: a.5 b.4 c.6 d.3
3
Capillary refill time is MOST reliable as an indicator of end-organ perfusion in children younger than: Select one: a.6 years. b.8 years. c.4 years. d.10 years.
6
The normal respiratory rate for a newborn should not exceed _______________ breaths/min. Select one: a.60 b.80 c.70 d.50
60
You have just delivered a baby boy. His body is pink, but his hands and feet are blue. His heart rate approximately 110 beats/min and his respirations are rapid and irregular. He has a weak cry when stimulated and resists attempts to straighten his legs. His Apgar score is: Select one: a.6 b.8 c.9 d.7
8
Which of the following represents a low normal systolic blood pressure for a 6-year-old child? Select one: a.90 mm Hg b.82 mm Hg c.88 mm Hg d.98 mm Hg
82 mm Hg
Which of the following patients is at highest risk for a pulmonary embolism? Select one: a.78-year-old female who takes blood-thinning medications b.59-year-old male who is recovering from pneumonia c.66-year-old active female with a history of hypertension d.71-year-old male with recent surgery to a lower extremity
A 71 year-old male with recent surgery to a lower extremity.
EMTs are dispatched for a fall. The patient, a 16-year-old female with Down syndrome, is experiencing difficulty walking and says that her fingers "feel like needles." The EMTs should suspect: Select one: a.a cervical spine injury. b.hydrocephalus. c.an intracranial hemorrhage. d.a seizure.
A cervical spine injury.
Spina bifida is a developmental defect in which: Select one: a.a portion of the spinal cord or meninges protrudes outside of the vertebrae. b.an excessive amount of cerebrospinal fluid damages the spinal cord. c.nerve fibers that arise from the spinal cord do not function properly. d.the spinal column is severely deformed, resulting in permanent paralysis.
A portion of the spinal cord or meninges protrudes outside of the vertebrae.
A normal level of consciousness in an infant or child is characterized by: Select one: a.normal interactiveness, awareness to time, and pink skin color. b.awareness to place, pink and dry skin, and consistent eye contact. c.crying or combativeness, good muscle tone, and awareness to time. d.age-appropriate behavior, good muscle tone, and good eye contact.
Age-appropriate behavior, good muscle tone, and good eye contact.
During the attempted resuscitation of an infant with suspected SIDS: Select one: a.give detailed updates to the infant's parents. b.a law enforcement officer must be present. c.discourage the family from observing. d.allow the family to observe if they wish.
Allow the family to observe if they wish.
Patients who have experienced even minor-appearing head injuries should be suspected of having a brain injury, especially if they: Select one: a.have minor abrasions to the head area. b.do not have deformities to the skull. c.are taking blood-thinning medications. d.have a history of Alzheimer disease.
Are taking blood-thinning medications.
Upon delivery of an infant's head, you note that the umbilical cord is wrapped around its neck. You should: Select one: a.give high-flow oxygen to the mother and transport. b.attempt to slip the cord gently over the infant's head. c.immediately clamp and cut the umbilical cord. d.provide free-flow oxygen to the infant and transport.
Attempt to slip the cord gently over the infant's head.
When assessing or providing care to a patient with an intellectual disability, you should: Select one: a.explain procedures while in the process of performing them. b.move swiftly and deliberately to quickly accomplish the task. c.be observant for signs of fear or reluctance from the patient. d.frequently reassure him or her that everything will be okay.
Be observant for signs of fear or reluctance from the patient.
Death caused by shaken baby syndrome is usually the result of: Select one: a.multiple open fractures. b.intra-abdominal hemorrhage. c.bleeding in the brain. d.fracture of the cervical spine.
Bleeding in the brain.
Which of the following is NOT a component of the Apgar score? Select one: a.Body size b.Grimace c.Pulse d.Activity
Body size
Cerebral palsy is a condition that results from damage or injury to the: Select one: a.peripheral nervous system. b.spinal cord. c.voluntary muscles. d.brain.
Brain
The ONLY indications for placing your gloved fingers in the vagina during delivery are: Select one: a.limb presentation and severe vaginal hemorrhage. b.nuchal cord and presentation of an arm or leg. c.vertex presentation and delivery of the placenta. d.breech presentation and prolapsed umbilical cord.
Breech presentation and prolapsed umbilical cord.
Signs of severe dehydration in an infant include all of the following, EXCEPT: Select one: a.dry mucous membranes. b.profound tachycardia. c.delayed capillary refill. d.bulging fontanelles.
Bulging fontanelles
The umbilical cord: Select one: a.contains two veins and one large umbilical artery. b.carries oxygen to the baby via the umbilical vein. c.separates from the placenta shortly after birth. d.carries blood away from the baby via the artery.
Carries oxygen to the baby via the umbilical vein
An oropharyngeal airway should not be used in children who have ingested a caustic or petroleum- based product because it may: Select one: a.cause the child to vomit. b.result in airway swelling. c.depress the gag reflex. d.result in a soft-tissue injury.
Cause the child to vomit.
Which of the following statements regarding pediatric trauma is correct? Select one: a.Inexperience and poor judgment are rare causes of pediatric trauma. b.Children are more likely to experience diving-related injuries. c.A child's head is less frequently injured than an adult's. d.Children are less likely than adults to be struck by a car.
Children are more likely to experience diving-related injuries.
The onset of labor begins with: Select one: a.increased fetal movement. b.thinning of the uterus. c.contractions of the uterus. d.full dilation of the cervix.
Contractions of the uterus.
Early signs of respiratory distress in the pediatric patient include all of the following, EXCEPT: Select one: a.cyanosis. b.tachypnea. c.abnormal airway noise. d.retractions.
Cyanosis
A common cause of shock in an infant is: Select one: a.dehydration from vomiting and diarrhea. b.cardiovascular disease. c.a cardiac dysrhythmia. d.excessive tachycardia.
Dehydration from vomiting and diarrhea.
The slow onset of progressive disorientation, shortened attention span, and loss of cognitive function is known as: Select one: a.delusion. b.dementia. c.paranoia. d.delirium.
Dementia
When inserting an oropharyngeal airway in an infant or child, you should: Select one: a.insert it until the flange rests on the teeth. b.depress the tongue with a tongue depressor. c.ensure that his or her neck is hyperextended. d.place padding under the child's head.
Depress the tongue with a tongue depressor
When assessing a geriatric patient who has possibly experienced an acute ischemic stroke, it is MOST important to: Select one: a.determine if the patient has risk factors for a stroke. b.determine the onset of the patient's symptoms. c.ascertain if there is a history of atrial fibrillation. d.administer 324 mg of aspirin as soon as possible.
Determine the onset of the patient's symptoms.
Placenta previa is defined as: Select one: a.abnormal development and functioning of the placenta. b.delivery of a portion of the placenta before the baby. c.development of the placenta over the cervical opening. d.premature placental separation from the uterine wall.
Development of the placenta over the cervical opening.
After the fetus has descended into the pelvis at the end of the third trimester, many mothers experience Select one: a.mid-back pain. b.easier breathing. c.a bloated feeling. d.an urge to push.
Easier breathing
A 6-year-old male presents with acute respiratory distress. His mother states that she saw him put a small toy into his mouth shortly before the episode began. The child is conscious, obviously frightened, and is coughing forcefully. You should: Select one: a.deliver a series of five back blows and then reassess his condition. b.encourage him to cough, give oxygen as tolerated, and transport. c.place the child in a supine position and perform abdominal thrusts. d.carefully look into his mouth and remove the object if you see it.
Encourage him to cough, give oxygen as tolerated, and transport.
Before assessing the respiratory adequacy of a semiconscious infant or child, you must: Select one: a.routinely suction the mouth to remove oral secretions. b.ensure that the airway is patent and clear of obstructions. c.ensure that his or her head is in a hyperextended position. d.insert a nasopharyngeal or oropharyngeal airway adjunct.
Ensure the airway is patent and clear of obstructions
Which of the following is the MOST common mechanism of injury in older patients? Select one: a.Abuse b.Bums c.Falls d.Suicide
Falls.
Which of the following groups of people is associated with the lowest risk of meningitis? Select one: a.Children with shunts b.Females c.Children with HIV/AIDS d.Newborns
Females
When assessing the heart rate of a 6-month-old infant, you should palpate the brachial or _______________ pulse. Select one: a.popliteal b.radial c.femoral d.carotid
Femoral
In most children, febrile seizures are characterized by: Select one: a.a blank stare, a duration of between 15 and 30 minutes, and a prolonged postictal phase. b.generalized tonic-clonic activity, a duration of less than 15 minutes, and a short or absent postictal phase. c.isolated tonic-clonic activity, a duration of greater than 15 minutes, and a short postictal phase. d.unresponsiveness, complete body relaxation, a fever greater than 105°F, and a short postictal phase.
Generalized tonic-clonic activity, a duration of less than 15 minutes, and a short or absent postictal phase.
An infant or child with respiratory distress will attempt to keep his or her alveoli expanded at the end of inhalation by: Select one: a.retracting the intercostal muscles. b.wheezing. c.assuming a tripod position. d.grunting.
Grunting
Patients with autism: Select one: a.use and understand nonverbal means of communicating messages. b.often speak with speech patterns that alternate in tone and speed. c.have extreme difficulty with complex tasks that require many steps. d.prefer to maintain eye contact with whomever is talking with them.
Have extreme difficulty with complex tasks that require many steps.
An elderly patient may understate or minimize the symptoms of his or her illness because: Select one: a.the nervous system has deteriorated. b.of conditions such as dementia. c.of decreased perception of pain. d.he or she fears hospitalization.
He or she fears hospitalization.
All of the following are normal findings in an infant or child, EXCEPT: Select one: a.belly breathing. b.head bobbing. c.quiet breathing. d.fear or anxiety.
Head bobbing
Signs and symptoms of preeclampsia include: Select one: a.dyspnea and bradycardia. b.headache and edema. c.dysuria and constipation. d.marked hypoglycemia.
Headache and bradycardia
Use of a nonrebreathing mask or nasal cannula in a child is appropriate ONLY if: Select one: a.he or she is breathing inadequately. b.his or her respirations are shallow. c.his or her tidal volume is adequate. d.an oral airway has been inserted.
His or her tidal volume is adequate.
A 75-year-old woman complains of shortness of breath. Which of the following findings should alert the EMT to the possibility of a pulmonary embolism? Select one: a.The patient is prescribed an inhaler. b.Frequent urinary tract infections c.History of deep venous thrombosis d.The patient's abdomen is swollen.
History of deep venous thrombosis.
Which of the following statements regarding gestational diabetes is correct? Select one: a.In some cases, women with gestational diabetes require insulin injections. b.The onset of gestational diabetes typically manifests with hypoglycemia. c.Diet and exercise are typically ineffective in controlling gestational diabetes. d.Gestational diabetes results in permanent diabetes mellitus after delivery.
In some cases, women with gestational diabetes require insulin injections.
Which of the following are normal physiologic changes that occur in the mother's respiratory system during pregnancy? Select one: a.Increased respiratory depth and decreased respiratory rate b.Increased respiratory reserve and decreased oxygen demand c.Decreased respiratory rate and increased minute volume d.Increased respiratory rate and decreased respiratory reserve
Increased respiratory rate and increased minute volume
A 2-month-old infant was found unresponsive in his crib by his mother. When you arrive, you determine that the infant is apneic and pulseless. His skin is pale and cold and his arms are stiff. You should: Select one: a.request the medical examiner to perform an autopsy. b.begin high-quality CPR and transport immediately. c.inform the child's mother that her son is deceased. d.begin high-quality CPR and request an ALS ambulance.
Inform the child's mother that her son is deceased.
You have just delivered a premature baby. Your assessment reveals that he is breathing adequately; however, his heart rate is 90 beats/min. You should: Select one: a.clamp and cut the umbilical cord and keep him warm. b.assess his skin color and give free-flow oxygen as needed. c.keep him warm and ventilate with a BVM. d.begin chest compressions and reassess in 30 seconds.
Keep him warm and ventilate with a BVM.
Because hearing-impaired patients typically have more difficulty hearing high-frequency sounds, it is important for you to: Select one: a.increase the pitch of your voice. b.try basic sign language first. c.lower the pitch of your voice. d.speak in a monotone voice.
Lower the pitch of your voice.
Which of the following statements regarding twins is correct? Select one: a.Identical twins are typically of different gender. b.Fraternal twins have two cords coming from one placenta. c.Most twins are born within 45 minutes of each other. d.Twins are typically larger than single infants.
Most twins are born within 45 minutes of each other.
Which of the following is MORE common in children than in adults following a head injury? Select one: a.Loss of consciousness b.Seizures and hypoxia c.Spinal cord injury d.Nausea and vomiting
Nausea and vomiting.
The MOST accurate method for determining if you are delivering adequate tidal volume to a child during bag-valve mask ventilations is to: Select one: a.observe the child's skin color. b.observe the chest for adequate rise. c.monitor the pulse oximeter reading. d.monitor the child's heart rate.
Observe the chest for adequate rise.
Padding underneath the torso when immobilizing an injured child is generally not necessary if he or she is: Select one: a.experiencing cardiopulmonary arrest. b.immobilized on a long backboard. c.complaining of severe back pain. d.older than 8 to 10 years of age.
Older than 8 to 10 years of age.
An older woman with osteoporosis presents with pain and deformity to her left hip after she shifted her weight onto her other foot. She has MOST likely experienced a(n): Select one: a.compression fracture. b.comminuted fracture. c.idiopathic fracture. d.pathologic fracture.
Pathologic fracture.
A 2-year-old child who has no recent history of illness suddenly appears cyanotic and cannot speak after playing with a small toy. You should: Select one: a.perform abdominal thrusts. b.give oxygen and transport at once. c.visualize the child's airway. d.perform a blind finger sweep.
Perform abdominal thrusts
A 33-year-old woman who is 36 weeks pregnant is experiencing vaginal bleeding. During transport, you note that she suddenly becomes diaphoretic, tachycardic, and hypotensive. You should: Select one: a.ventilate her with a bag-valve mask. b.carefully place sterile gauze into her vagina. c.position her supine and elevate her legs 12 inches. d.place her in a left lateral recumbent position.
Place her in a left lateral recumbent position.
Before positioning an infant or child's airway, you should: Select one: a.put padding behind his or her head. b.rule out an injury to the spinal cord. c.place him or her on a firm surface. d.thoroughly suction his or her airway.
Place him or her on a firm surface.
When administering oxygen to a frightened child, it would be MOST appropriate to: Select one: a.tightly secure the oxygen mask straps to the face. b.have a parent restrain the child as you give oxygen. c.place oxygen tubing through a hole in a paper cup. d.use a nasal cannula instead of a nonrebreathing mask.
Place oxygen tubing through a hole in a paper cup.
If a newborn's heart rate is less than 60 beats/min following delivery, you should: Select one: a.provide ventilations for 30 seconds. b.begin chest compressions. c.resuscitation the mouth only. d.flick the soles of his or her feet.
Provide ventilations for 30 seconds.
While examining a woman in labor, you see the umbilical cord protruding from the vagina. You should: Select one: a.gently pull on the cord to facilitate delivery. b.cover the umbilical cord with a dry dressing. c.push the infant's head away from the cord. d.carefully push the cord back into the vagina.
Push the infant's head away from the cord.
Which of the following is NOT a known risk factor of SIDS? Select one: a.Mother smoked during pregnancy b.Putting a baby to sleep on his or her back c.Mother younger than 20 years d.Low birth weight
Putting a baby to sleep on his or her back.
Which of the following does NOT usually contribute to or cause obesity? Select one: a.Low metabolic rate b.High caloric intake c.Rapid metabolism d.Genetic predisposition
Rapid metabolism.
General care for a patient with a tracheostomy tube includes all of the following, EXCEPT: Select one: a.suctioning the tube as needed to clear a thick mucous plug. b.removing the tube if the area around it appears to be infected. c.ensuring adequate oxygenation and ventilation at all times. d.maintaining the patient in a position of comfort when possible.
Removing the tube is the area around it appears to be infected
When enlisting the help of an interpreter who signs, it is important for you to ask the interpreter to: Select one: a.report exactly what the patient signs and not to add any commentary. b.document the answers to the questions that the patient has responded to. c.avoid any kind of lip movement while he or she is signing with the patient. d.voice what he or she is signing while communicating with the patient.
Report exactly what the patient signs and not to add any commentary.
Early signs of respiratory distress in the child include: Select one: a.cyanosis. b.restlessness. c.decreased LOC. d.bradycardia.
Restlessness
Drawing in of the muscles between the ribs or of the sternum during inspiration is called: Select one: a.tenting. b.hyperpnea. c.retracting. d.accessory muscle use.
Retracting
Which of the following is NOT generally considered an obstetrical emergency? Select one: a.More than 500 mL of blood loss before placental delivery b.Significant bleeding after delivery of the placenta c.Return of contractions following delivery of the baby d.Failure of the placenta to deliver after 30 minutes
Return of contractions following delivery of the baby.
When immobilizing an injured child in a pediatric immobilization device, you should: Select one: a.secure the torso before the head. b.secure the head before the torso. c.slide the device under the child. d.pad underneath the child's head.
Secure the torso before the head.
In contrast to adults, deterioration to cardiac arrest in infants and children is usually associated with: Select one: a.irritability of the left ventricle. b.severe hypoxia and bradycardia. c.a sudden ventricular arrhythmia. d.acute hypoxia and tachycardia.
Severe hypoxia and bradycardia
Bruising to the _______________ is LEAST suggestive of child abuse. Select one: a.face b.back c.buttocks d.shins
Shins
A tube from the brain to the abdomen that drains excessive cerebrospinal fluid is called a: Select one: a.cerebral bypass. b.G-tube. c.CS tube. d.shunt.
Shunt
You are dispatched to a local elementary school for an injured child. As you approach the child, you note that he is lying at the base of the monkey bars. He is unresponsive and there are no signs of breathing. You should: Select one: a.open his airway and look in his mouth. b.begin immediate rescue breathing. c.stabilize his head and check for a pulse. d.perform a head tilt-chin lift maneuver.
Stabilize his head and check for a pulse.
A high-pitched inspiratory sound that indicates a partial upper airway obstruction is called: Select one: a.stridor. b.rhonchi. c.wheezing. d.grunting.
Stridor
Which of the following statements regarding suctioning of a newborn's mouth and oropharynx is correct? Select one: a.If the head delivers facedown, the mouth and nose should be suctioned at once. b.Newborns rapidly expel fluid from their lungs and do not require suctioning. c.Suctioning is indicated prior to cutting the cord if respiratory distress is present. d.Suctioning should be performed on all newborns immediately following delivery.
Suctioning is indicated prior to cutting the cord if respiratory distress is present.
Airway management can be challenging in patients with Down syndrome because their: Select one: a.occiput is round, which causes flexion of the neck. b.mandible is large, which inhibits a mask-to-face seal. c.teeth are misaligned and they have a large tongue. d.tongue is relatively small and falls back in the throat.
Teeth are misaligned and they have a large tongue.
A 69-year-old female was involved in a motor vehicle crash. She is semiconscious with a blood pressure of 80/50 mm Hg and a heart rate of 74 beats/min that is weak. Her daughter, who was uninjured in the crash, tells you that her mother has a history of hypertension and takes beta-blockers. Considering the fact that this patient is probably in shock, what is the MOST likely explanation for the absence of tachycardia? Select one: a.Failure of the parasympathetic nervous system b.Intrathoracic bleeding and cardiac compression c.The effects of her antihypertensive medication d.Deterioration of the cardiac conduction system
The effects of her antihypertensive medication.
Which of the following statements regarding the placenta is correct? Select one: a.The placenta allows for the transfer of oxygen and carbon dioxide between the mother and fetus but prevents most medications from passing between the mother and fetus. b.The placenta allows oxygen, carbon dioxide, and other products to transfer between the mother and fetus but does not allow blood to mix between the mother and fetus. c.The placental barrier consists of two layers of cells and allows the mother's blood that contains high concentrations of oxygen to directly mix with the blood of the fetus. d.The placenta provides oxygen and nutrients to the fetus and is expelled from the vagina about 30 minutes before the baby is bom.
The placenta allows oxygen, carbon dioxide, and other products to transfer between the mother and fetus but does not allow blood to mix between the mother and fetus
Abruptio placenta occurs when: Select one: a.the placenta prematurely separates from the uterine wall. b.the placenta develops over and covers the cervical opening. c.a tear in the placenta causes severe internal hemorrhage. d.the placenta affixes itself to the outer layer of the uterus.
The placenta prematurely separates from the uterine wall.
Supine hypotensive syndrome occurs when: Select one: a.blood pressure decreases as a result of hypovolemia. b.the superior vena cava is compressed by the uterus. c.a supine position kinks the ascending aorta. d.the pregnant utems compresses the inferior vena cava.
The pregnant utems compresses the inferior vena cava
Following delivery of the placenta, the mother is experiencing vaginal bleeding. After massaging the uterine fundus and allowing the mother to breastfeed, the bleeding stops. This occurred because: Select one: a.a portion of the placenta was retained in the uterus. b.uterine massage increases blood flow to the uterus. c.these actions simulate the production of oxytocin and cause uterine contraction. d.breastfeeding causes uterine blood vessels to dilate.
These actions simulate the production of oxytocin and cause uterine contraction.
When transporting a stable older patient to the hospital, the MOST effective way to reduce his or her anxiety is to: Select one: a.allow at least two family members to accompany the patient. b.perform frequent detailed assessments to gain the patient's trust. c.avoid the use of a long backboard, even if trauma is suspected. d.transport him or her to a hospital that he or she is familiar with.
Transport him or her to a hospital that he or she is familiar with.
Which of the following occurs during true labor? Select one: a.Uterine contractions decrease in intensity. b.The uterus becomes very soft and movable. c.Uterine contractions become more regular. d.Uterine contractions last about 10 seconds.
Uterine contractions become more regular.
Signs of vasoconstriction in the infant or child include: Select one: a.warm, dry skin. b.brisk capillary refill. c.a rapid heart rate. d.weak distal pulses.
Weak distal pulses
An infant is considered to be premature if it: Select one: a.is born before 40 weeks' gestation or weighs less than 7 lb. b.is born before 38 weeks' gestation or weighs less than 6 lb. c.weighs less than 5 lbs or is born before 36 weeks' gestation. d.weighs less than 5.5 lbs or is born before 37 weeks' gestation,
Weighs less than 5lbs or is born before 36 weeks' gestation.
Signs of an upper airway obstruction in an infant or child include all of the following, EXCEPT: Select one: a.a cough that resembles the bark of a seal. b.stridorous breathing. c.a weak cough. d.wheezing.
Wheezing
