Chapter 34 EMT
After squeezing the end of a child's finger or toe for a few seconds, blood should return to the area within: A. 2 seconds. B. 5 seconds. C. 3 seconds. D. 4 seconds.
A. 2 seconds.
Capillary refill time is MOST reliable as an indicator of end-organ perfusion in children younger than: A. 6 years. B. 4 years. C. 8 years. D. 10 years.
A. 6 years.
With regard to the legal implications of child abuse: A. EMTs must report all suspected cases of child abuse. B. a supervisor can forbid you from reporting possible abuse. C. you should document your perceptions on the run form. D. child abuse must be reported only if it can be proven.
A. EMTs must report all suspected cases of child abuse.
An infant with severe dehydration would be expected to present with: A. absent urine output. B. bulging fontanelles. C. excessive tearing. D. moist oral mucosa.
A. absent urine output.
You are dispatched to a residence for a child with respiratory distress. The patient, an 18-month-old female, is tachypneic, has sternal retractions, and is clinging to her mother. Her skin is pink and dry, and her heart rate is 120 beats/min. The MOST appropriate treatment for this child includes: A. administering blow-by oxygen and transporting the child with her mother. B. allowing the child to remain with her mother and applying a nasal cannula. C. requesting a paramedic ambulance to insert an advanced airway device. D. separating the child from her mother and providing ventilatory assistance.
A. administering blow-by oxygen and transporting the child with her mother.
An oropharyngeal airway should not be used in children who have ingested a caustic or petroleum-based product because it may: A. cause the child to vomit. B. result in airway swelling. C. result in a soft-tissue injury. D. depress the gag reflex.
A. cause the child to vomit.
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: A. encourage him to cough, give oxygen as tolerated, and transport. B. place the child in a supine position and perform abdominal thrusts. C. carefully look into his mouth and remove the object if you see it. D. deliver a series of five back blows and then reassess his condition.
A. encourage him to cough, give oxygen as tolerated, and transport.
An infant or child with respiratory distress will attempt to keep his or her alveoli expanded at the end of inhalation by: A. grunting. B. wheezing. C. assuming a tripod position. D. retracting the intercostal muscles.
A. grunting.
All of the following are normal findings in an infant or child, EXCEPT: A. head bobbing. B. fear or anxiety. C. belly breathing. D. quiet breathing.
A. head bobbing.
A 6-month-old male presents with 2 days of vomiting and diarrhea. He is conscious, but his level of activity is decreased. The infant's mother tells you that he has not had a soiled diaper in over 12 hours. The infant's heart rate is 140 beats/min and his anterior fontanelle appears to be slightly sunken. You should suspect: A. moderate dehydration. B. hypovolemic shock. C. mild dehydration. D. severe dehydration.
A. moderate dehydration.
The MOST accurate method for determining if you are delivering adequate tidal volume to a child during bag-mask ventilations is to: A. observe the chest for adequate rise. B. observe the child's skin color. C. monitor the pulse oximeter reading. D. monitor the child's heart rate.
A. observe the chest for adequate rise.
When administering oxygen to a frightened child, it would be MOST appropriate to: A. place oxygen tubing through a hole in a paper cup. B. have a parent restrain the child as you give oxygen. C. use a nasal cannula instead of a nonrebreathing mask. D. tightly secure the oxygen mask straps to the face.
A. place oxygen tubing through a hole in a paper cup.
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: A. stabilize his head and check for a pulse. B. open his airway and look in his mouth. C. begin immediate rescue breathing. D. perform a head tilt-chin lift maneuver.
A. stabilize his head and check for a pulse.
A high-pitched inspiratory sound that indicates a partial upper airway obstruction is called: A. stridor. B. grunting. C. wheezing. D. rhonchi.
A. stridor.
Signs and symptoms of meningitis in the infant or child include all of the following, EXCEPT: A. sunken fontanelles. B. an altered mental status. C. headache and fever. D. a stiff or painful neck.
A. sunken fontanelles.
Which of the following statements regarding sudden infant death syndrome (SIDS) is correct? A. SIDS is most commonly the result of an overwhelming infection. B. Most cases of SIDS occur in infants younger than 6 months. C. The cause of death following SIDS can be established by autopsy. D. Certain cases of SIDS are predictable and therefore preventable.
B. Most cases of SIDS occur in infants younger than 6 months.
You respond to a skate park where a 10-year-old male fell from his skateboard and struck his head on the ground; he was not wearing a helmet. He is responsive to painful stimuli only and has a large hematoma to the back of his head. After your partner stabilizes his head and opens his airway, you assess his breathing and determine that it is slow and irregular. His pulse is slow and bounding. You should: A. apply high-flow oxygen via a nonrebreathing mask, perform an in-depth secondary assessment, apply full spinal precautions, and transport. B. assist his ventilations, be prepared to suction his mouth if he vomits, apply full spinal precautions, and prepare for immediate transport to a trauma center. C. apply high-flow oxygen via a nonrebreathing mask, obtain baseline vital signs, apply full spinal precautions, and perform a secondary assessment. D. insert an oral airway, hyperventilate him with a bag-mask device, apply full spinal precautions, and transport to the closest trauma center.
B. assist his ventilations, be prepared to suction his mouth if he vomits, apply full spinal precautions, and prepare for immediate transport to a trauma center.
A 2-year-old female has experienced a seizure. When you arrive at the scene, the child is conscious, crying, and clinging to her mother. Her skin is hot and moist. The mother tells you that the seizure lasted approximately 5 minutes. She further tells you that her daughter has no history of seizures, but has had a recent ear infection. You should: A. suspect that the child has meningitis and transport at once. B. attempt cooling measures, offer oxygen, and transport. C. allow the mother to drive her daughter to the hospital. D. place the child in cold water to attempt to reduce her fever.
B. attempt cooling measures, offer oxygen, and transport.
An 8-year-old female with a history of asthma continues to experience severe respiratory distress despite being given multiple doses of her prescribed albuterol by her mother. She is conscious, but clearly restless. Her heart rate is 130 beats/min and her respiratory rate is 30 breaths/min. She is receiving high-flow oxygen via a nonrebreathing mask. You should: A. continue high-flow oxygen therapy, contact medical control, and request permission to administer more albuterol. B. be prepared to assist her ventilations, transport at once, and request an ALS intercept en route to the hospital. C. begin immediate ventilation assistance and ensure that you squeeze the bag forcefully in order to open her bronchioles. D. begin chest compressions if she becomes unresponsive and her heart rate falls below 80 beats/min.
B. be prepared to assist her ventilations, transport at once, and request an ALS intercept en route to the hospital.
Effective methods for providing pain relief to a child with an extremity injury include: A. heat compresses and lowering the injured extremity. B. positioning, ice packs, and emotional support. C. avoiding the placement of a splint, if possible. D. separating the child from his or her parents.
B. positioning, ice packs, and emotional support.
Greenstick fractures occur in infants and children because: A. twisting injuries are more common in children. B. their bones bend more easily than an adult's. C. their bones are more brittle than an adult's. D. the growth plate is commonly injured.
B. their bones bend more easily than an adult's.
The MOST common cause of dehydration in pediatric patients is: A. internal blood loss. B. vomiting and diarrhea. C. high fever. D. refusal to drink fluids.
B. vomiting and diarrhea.
Which of the following statements regarding pediatric trauma is correct? A. Children are less likely than adults to be struck by a car. B. A child's head is less frequently injured than an adult's. C. Children are more likely to experience diving-related injuries. D. Inexperience and poor judgment are rare causes of pediatric trauma.
C. Children are more likely to experience diving-related injuries.
The components of the PAT are: A. mental status, heart rate, and systolic blood pressure. B. activity, respiratory quality, and level of consciousness. C. appearance, work of breathing, and skin circulation. D. skin condition, respiratory rate, and level of alertness.
C. appearance, work of breathing, and skin circulation.
Which of the following is the LEAST reliable assessment parameter to evaluate when determining the presence of shock in infants and children? A. heart rate B. skin condition C. blood pressure D. capillary refill
C. blood pressure
A viral infection that may cause obstruction of the upper airway in a child is called: A. bronchitis. B. asthma. C. croup. D. epiglottitis.
C. croup.
Early signs of respiratory distress in the pediatric patient include all of the following, EXCEPT: A. abnormal airway noise. B. tachypnea. C. cyanosis. D. retractions.
C. cyanosis.
Before assessing the respiratory adequacy of an semiconscious infant or child, you must: A. routinely suction the mouth to remove oral secretions. B. insert a nasopharyngeal or oropharyngeal airway adjunct. C. ensure that the airway is patent and clear of obstructions. D. ensure that his or her head is in a hyperextended position.
C. ensure that the airway is patent and clear of obstructions.
After determining that an infant or child has strong central pulses, you should: A. assess his or her respiratory effort. B. assume the child is hypertensive. C. not rule out compensated shock. D. conclude that the child is stable.
C. not rule out compensated shock.
After using the PAT to form your general impression of a sick or injured child, you should: A. evaluate the child's baseline vital signs. B. obtain a SAMPLE history from the parents. C. perform a hands-on assessment of the ABCs. D. assess the child's heart rate and skin condition.
C. perform a hands-on assessment of the ABCs.
Before positioning an infant or child's airway, you should: 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.
C. place him or her on a firm surface.
Cardiac arrest in the pediatric population is MOST commonly the result of: A. a congenital cardiovascular defect. B. a complete airway obstruction. C. respiratory or circulatory failure. D. lethal cardiac rhythm disturbances.
C. respiratory or circulatory failure.
Bruising to the _________ is LEAST suggestive of child abuse. A. face B. back C. shins D. buttocks
C. shins
When a child is struck by a car, the area of greatest injury depends MOSTLY on the: Select one: A. height of the child and the speed at which the car was traveling. B. speed at which the car was traveling when impact occurred. C. size of the child and the height of the bumper upon impact. D. age of the child and the size of the car that struck him or her.
C. size of the child and the height of the bumper upon impact.
Signs of severe dehydration in an infant include all of the following, EXCEPT: A. delayed capillary refill. B. dry mucous membranes. C. slowed level of activity. D. profound tachycardia.
C. slowed level of activity.
A child may begin to show signs of separation anxiety as early as: A. 12 months. B. 24 months. C. 18 months. D. 6 months.
D. 6 months.
Which of the following statements regarding a 3-month-old infant is correct? A. The infant should be aroused easily from a sleeping state. B. The infant is unable to turn his or her head and focus. C. At this age, the infant typically sleeps for up to 8 hours a day. D. A 3-month-old infant can distinguish a parent from a stranger.
D. A 3-month-old infant can distinguish a parent from a stranger.
A normal level of consciousness in an infant or child is characterized by: A. awareness to place, pink and dry skin, and consistent eye contact. B. crying or combativeness, good muscle tone, and awareness to time. C. normal interactiveness, awareness to time, and pink skin color. D. age-appropriate behavior, good muscle tone, and good eye contact.
D. age-appropriate behavior, good muscle tone, and good eye contact.
Unless he or she is critically ill or injured, you should generally begin your assessment of a toddler: A. en route to the hospital. B. at the head. C. in the ambulance. D. at the feet.
D. at the feet.
Pale skin in a child indicates that the: A. child is in severe decompensated shock. B. child's core body temperature is elevated. C. oxygen content in the blood is decreased. D. blood vessels near the skin are constricted.
D. blood vessels near the skin are constricted.
A common cause of shock in an infant is: A. cardiovascular disease. B. excessive tachycardia. C. a cardiac arrhythmia. D. dehydration from vomiting and diarrhea.
D. dehydration from vomiting and diarrhea.
Burns in children are commonly caused by all of the following, EXCEPT: A. hot items on a stovetop. B. exposure to caustic chemicals. C. scalding water in a bathtub. D. entrapment in a structural fire.
D. entrapment in a structural fire.
Immediate transport is indicated for a child when he or she: A. falls from a height greater than 5′. B. has a possible closed fracture of the radius. C. is experiencing mild to moderate pain. D. has a history suggestive of a serious illness.
D. has a history suggestive of a serious illness.
Causes of infant death that may be mistaken for SIDS include all of the following, EXCEPT: A. severe infection. B. child abuse. C. meningitis. D. hyperglycemia.
D. hyperglycemia.
Febrile seizures in a child: A. typically last less than 30 minutes. B. are usually caused by viral meningitis. C. occur after a week of a febrile illness. D. may indicate a serious underlying illness.
D. may indicate a serious underlying illness.
The secondary assessment of a sick or injured child: A. is most appropriate when your transport time is short. B. is a rapid head-to-toe exam to detect life threats. C. should be performed, regardless of the circumstances. D. may not be possible if the child's condition is critical.
D. may not be possible if the child's condition is critical.
A 4-year-old female ingested an unknown quantity of liquid drain cleaner. Your assessment reveals that she is conscious and alert, is breathing adequately, and has skin burns around her mouth. You should: A. place her supine and elevate her legs. B. give 12.5 to 25 g of activated charcoal. C. determine why the ingestion occurred. D. monitor her airway and give oxygen.
D. monitor her airway and give oxygen.
A child who has no recent history of illness suddenly appears cyanotic and cannot speak after playing with a small toy. You should: A. perform a blind finger sweep. B. give oxygen and transport at once. C. visualize the child's airway. D. perform abdominal thrusts.
D. perform abdominal thrusts.
The signs and symptoms of poisoning in children: A. are most severe if the child ingested a poisonous substance. B. are more obvious than in the adult population. C. usually present within the first 10 minutes of ingestion. D. vary widely, depending on the child's age and weight.
D. vary widely, depending on the child's age and weight.
Signs of an upper airway obstruction in an infant or child include all of the following, EXCEPT: A. a cough that resembles the bark of a seal. B. stridorous breathing. C. a weak cough. D. wheezing.
D. wheezing.
