EMT Final (OB and Peds)

A 6-year-old boy complains of pain to the right lower quadrant of his abdomen. Assessment of this child's abdomen should include:

palpating the left upper quadrant first.

A 29-year-old woman, who is 38 weeks pregnant, presents with heavy vaginal bleeding, a blood pressure of 70/50 mm Hg, and a heart rate of 130 beats/min. She is pale and diaphoretic, and denies abdominal cramping or pain. Her signs and symptoms are MOST consistent with a/an:

placenta previa.

Appropriate treatment for an 18-year-old woman with severe vaginal bleeding may include all of the following, EXCEPT:

placing sterile dressings into the vagina.

You should assist with the delivery of the baby's head by:

placing your fingers on the bony part of the skull and applying gentle pressure.

Your assessment of a mother in labor reveals that a fetal limb is protruding from the vagina. Management of this situation should include:

positioning the mother with her hips elevated, administering high-flow oxygen, and providing transport.

Your assessment of a 5-year-old child reveals that he is unresponsive with a respiratory rate of 8 breaths/min and a heart rate of 50 beats/min. Treatment for this child should include:

positive-pressure ventilation, chest compressions, and rapid transport.

After the baby's head delivers, it is usually tilted:

posteriorly, to one side.

Which of the following statements regarding crowning is correct?

Gentle pressure should be applied to the baby's head during crowning.

Which of the following is an abnormal finding?

Heart rate of 80 beats/min in a 3-month-old infant

The appropriate technique for performing two-rescuer CPR on a 4-year-old child includes:

15 compressions to 2 ventilations, compressing the sternum with the heel of your hand, and ventilating until visible chest rise occurs.

A 3-year-old boy is found to be in cardiopulmonary arrest. As you begin one-rescuer CPR, your partner prepares the AED. The appropriate compression to ventilation ratio for this child is:

30:2

A 5-year-old child experienced partial-thickness burns to his head, anterior chest, and both upper extremities. What percentage of his total body surface area has been burned?

45%

A 4-year-old boy ingested an unknown quantity of drain cleaner. He is alert, has a patent airway, and has adequate breathing. You should:

contact poison control and give him oxygen.

After an advanced airway device has been inserted in a 6-month-old infant in cardiopulmonary arrest, you should deliver ventilations at a rate of:

8 to 10 breaths/min.

The 5-minute Apgar assessment of a newborn reveals a heart rate of 130 beats/min, cyanosis to the hands and feet, and rapid respirations. The infant cries when you flick the soles of its feet and resists attempts to straighten its legs. These findings equate to an Apgar score of:

9

In which of the following situations would the EMT MOST likely deliver a baby at the scene?

A tornado has struck and blocked the only route to the hospital.

You are caring for a 6-year-old child with a possible fractured arm and have reason to believe that the child was abused. How should you manage this situation?

Advise the parents that the child needs to be transported.

You are called to a local park for a 7-year-old boy with respiratory distress. During your assessment, you find that the patient is wheezing and has widespread hives and facial edema. What should you suspect has occurred?

Allergic reaction

When is it MOST appropriate to clamp and cut the umbilical cord?

As soon as the cord has stopped pulsating

When you attempt to assess a 22-year-old woman who has been sexually assaulted, she orders you not to touch her. Your MOST appropriate initial action should be to:

Ask a female EMT to attempt to assess the patient.

When you begin to assess a woman in labor, she states that her contractions are occurring every 4 to 5 minutes and lasting approximately 30 seconds each. Which of the following questions would be MOST appropriate to ask next?

At how many weeks gestation are you?

Your assessmment of a newborn reveals cyanosis to the chest and face and a heart rate of 90 beats/min. What should you do first?

Begin artificial ventilations.

Which artery should you palpate when assessing for a pulse in an unresponsive 6-month-old patient?

Brachial

Which of the following injuries is MOST indicative of child abuse?

Bruising to the upper back

In order to maintain neutral alignment of an 18-month-old child's airway, you should:

pad in between the shoulder blades.

Which of the following assessment parameters is a more reliable indicator of perfusion in infants than adults?

Capillary refill

Which of the following is a more reliable indicator of perfusion in children than it is in adults?

Capillary refill

Which of the following statements regarding two-rescuer child CPR is correct?

Compress the chest with one or two hands to a depth that is equal to one third the diameter of the chest

Which of the following is the MOST common cause of shock in infants and children?

Dehydration

Which of the following signs is MOST indicative of inadequate breathing in an infant?

Expiratory grunting

Which of the following is a sign of an altered mental status in a small child?

Inattention to the EMT's presence.

Upon assessing a newborn immediately after delivery, you note that the infant is breathing spontaneously and has a heart rate of 80 beats/min. What is the MOST appropriate initial management for this newborn?

Initiate positive-pressure ventilations.

Which of the following signs or symptoms is more common in children than adults following an isolated head injury?

Nausea and vomiting

You arrive at the scene shortly after a 3-year-old female experienced a seizure. The child, who is being held by her mother, is conscious and crying. The mother tells you that her daughter has been ill recently and has a temperature of 102.5°F. What is the MOST appropriate treatment for this child?

Oxygen via the blow-by technique, remove clothing to help reduce her fever, and transport with continuous monitoring.

A 5-year-old boy was struck by a car when he ran out into the street. When you arrive at the scene and approach the child, you see him lying supine approximately 15 feet from the car. Based on the child's age and mechanism of injury, which of the following should you suspect to be his PRIMARY injury?

Pelvic injury

Which of the following would MOST likely occur in conjunction with a breech presentation?

Prolapsed umbilical cord

A 9-year-old girl was struck by a car while she was crossing the street. Your assessment reveals a large contusion over the left upper quadrant of her abdomen and signs of shock. Which of the following organs has MOST likely been injured?

Spleen

Which position is MOST appropriate for a mother in labor with a prolapsed umbilical cord?

Supine with hips elevated

Which of the following parameters is the LEAST reliable when assessing the perfusion status of a 2-year-old child?

Systolic blood pressure

Which of the following statements regarding pediatric anatomy is correct?

The occiput is proportionately larger when compared to an adult.

Which of the following statements regarding the length-based resuscitation tape measure is correct?

The tape measure can be used in children who weigh up to 75 pounds.

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

Tilt the head back without hyperextending the neck.

A sudden onset of respiratory distress in a 5-year-old child with no fever is MOST likely the result of:

a foreign body airway obstruction.

A 5-year-old child in compensated shock secondary to severe vomiting and diarrhea would be expected to have:

a slow capillary refill time.

Following delivery of a newborn and placenta, you note that the mother has moderate vaginal bleeding. The mother is conscious and alert and her vital signs are stable. Treatment for her should include:

administering oxygen and massaging the uterus.

During transport of a woman in labor, the patient tells you that she feels the urge to push. You assess her and see the top of the baby's head bulging from the vagina. You should:

advise your partner to stop the ambulance and assist with the delivery.

You and your partner are performing CPR on a 2-year-old female in cardiac arrest. During your resuscitation attempt, you should:

allow the chest to fully recoil in between compressions.

Seizures in children MOST often are the result of:

an abrupt rise in body temperature.

A 30-year-old woman has severe lower abdominal pain and light vaginal bleeding. She tells you that her last menstrual period was 2 months ago. On the basis of these findings, you should suspect:

an ectopic pregnancy.

A 3-year-old female presents with respiratory distress. She is conscious, crying, and clinging to her mother. She has mild intercostal retractions and an oxygen saturation of 93%. The MOST effective way of delivering oxygen to her involves:

asking the mom to hold an oxygen mask near her face.

You are dispatched to a residence where an 8-year-old boy was pulled from a swimming pool. When you arrive, a neighbor is performing rescue breathing on the child. After confirming that the child is not breathing, you should:

assess for a carotid pulse for no more than 10 seconds.

You are dispatched to a residence for a 4-year-old female who is sick. Your assessment reveals that she has increased work of breathing and is making a high-pitched sound during inhalation. Her mother tells you that she has been running a high fever for the past 24 hours. Your MOST immediate concern should be

assessing the need for ventilation assistance.

A prolapsed umbilical cord is dangerous because the:

baby's head may compress the cord, cutting off its supply of oxygen.

Following the initial steps of resuscitation, a newborn remains apneic and cyanotic. You should:

begin ventilations with a bag-mask device.

You and your partner are performing CPR on an infant with suspected sudden infant death syndrome (SIDS). An important aspect in dealing with such cases is:

carefully inspecting the environment in which the infant was found.

A 4-year-old boy with a tracheostomy tube is experiencing respiratory distress. He has intercostal retractions, a heart rate of 80 beats/min, and an oxygen saturation of 85%. During his attempts to breathe, a gurgling sound is heard in the tracheostomy tube. You should:

carefully suction the tracheostomy tube.

The MOST important initial steps of assessing and managing a newborn include:

clearing the airway and keeping the infant warm.

A 7-year-old child has an altered mental status, high fever, and a generalized rash. You perform your assessment and administer supplemental oxygen. En route to the hospital, you should be MOST alert for:

convulsions.

During your assessment of a woman in labor, you see the baby's arm protruding from the vagina. The mother tells you that she needs to push. You should:

cover the arm with a sterile towel and transport immediately.

Of the following, the MOST detrimental effect of gastric distention in infants and children is:

decreased ventilatory volume.

The preferred method for inserting an oropharyngeal airway in a small child is to:

depress the tongue with a tongue blade and insert the airway with the downward curve facing the tongue

In contrast to the contractions associated with true labor, Braxton-Hicks contractions:

do not increase in intensity and are alleviated by a change in position.

The MOST effective way to prevent cardiopulmonary arrest in a newborn is to:

ensure effective oxygenation and ventilation.

When assessing a 30-year-old female who was sexually assaulted, it is MOST important for you to:

ensure that all life-threatening injuries are treated.

Prevention of cardiac arrest in infants and small children should focus primarily on:

ensuring adequate ventilation.

General guidelines when assessing a 2-year-old child with abdominal pain and adequate perfusion include:

examining the child in the parent's arms.

A 3-year-old child has a sudden onset of respiratory distress. The mother denies any recent illnesses or fever. You should suspect:

foreign body airway obstruction.

The purpose of the pediatric assessment triangle is to:

form a general impression of the child without touching him or her.

You are assessing a 26-year-old woman who is 38 weeks pregnant and is in labor. She tells you that she was pregnant once before, but had a miscarriage at 19 weeks. You should document her obstetric history as:

gravida 2, para 0.

You receive a call for a 3-year-old girl with respiratory distress. When you enter her residence, you see the mother holding the child, who does not acknowledge your presence. This finding indicates that the child:

has severe hypoxia.

You are responding to a call for a 2-year-old child who fell from a second-story window. With the mechanism of injury and the age of the patient in mind, you should suspect that the primary injury occurred to the child's:

head.

The function of the uterus is to:

house the fetus as it grows for 40 weeks.

After attaching the AED to a 7-year-old child in cardiac arrest, you push the analyze button and receive a shock advised message. After delivering the shock, you should:

immediately perform CPR.

You are assessing a 5-year-old boy with major trauma. His blood pressure is 70/40 mm Hg and his pulse rate is 140 beats/min. and weak. The child's blood pressure:

indicates decompensated shock.

Supplemental oxygen via the blow-by technique is MOST appropriate for a child who presents with respiratory difficulty and:

is agitated, tachycardic, and clinging to his or her parent.

A newborn is considered to be premature if it:

is born before 37 weeks gestation.

If a woman is having her first child, the first stage of labor:

is usually the longest and lasts an average of 16 hours.

You have just delivered a baby girl. Your assessment of the newborn reveals that she has a patent airway, is breathing adequately, and has a heart rate of 130 beats/min. Her face and trunk are pink, but her hands and feet are cyanotic. You have clamped and cut the umbilical cord, but the placenta has not yet delivered. You should:

keep the newborn warm, give oxygen to the mother if needed, and transport.

After clearing the airway of a newborn who is not in distress, it is MOST important for you to:

keep the newborn warm.

You are treating a 5-year-old child who has had severe diarrhea and vomiting for 3 days and is now showing signs of shock. Supplemental oxygen has been given and you have elevated his lower extremities. En route to the hospital, you note that his work of breathing has increased. You should:

lower the extremities and reassess the child.

Upon delivery of the baby's head, you note that the umbilical cord is wrapped around its neck. You should:

make one attempt to gently remove the cord from around its neck.

Following an apparent febrile seizure, a 4-year-old boy is alert and crying. His skin is hot and moist. Appropriate treatment this child includes:

offering oxygen and providing transport.

A 34-year-old woman, who is 36 weeks pregnant, is having a seizure. After you protect her airway and ensure adequate ventilation, you should transport her:

on her left side.

A 4-year-old girl fell from a third-story window and landed on her head. She is semiconscious with slow, irregular breathing and is bleeding from her mouth and nose. You should:

open her airway with the jaw-thrust maneuver while manually stabilizing her head, suction her oropharynx, and assist her ventilations

A 30-year-old woman is 22 weeks pregnant with her first child. She tells you that her rings are not fitting as loosely as they usually do and that her ankles are swollen. Her blood pressure is 150/86 mm Hg. She is MOST likely experiencing:

preeclampsia.

You arrive at a residence shortly after a 4-year-old boy experienced an apparent febrile seizure. The child is alert and crying. His skin is flushed, hot, and moist. His mother tells you that the seizure lasted about 2 minutes. You should:

provide supportive care and transport.

You should suspect physical abuse of a 4-year-old child if you observe:

purple and yellow bruises to the thighs.

While performing a visual inspection of a 30-year-old woman in labor, you can see the umbilical cord at the vaginal opening. After providing high-flow oxygen, you should:

relieve pressure from the cord with your gloved fingers.

Management for a women who presents with a prolapsed umbilical cord includes all of the following, EXCEPT:

relieving pressure off of the cord by gently pulling on it

You are dispatched to a residence for a child having a seizure. When you arrive at the scene, the 4-year-old child's grandfather tells you that he has had several full body seizures over the past 20 minutes, but never woke up in between the seizures. The child's skin is hot and flushed. This is MOST indicative of:

status epilepticus.

Immediately upon delivery of a newborn's head, you should:

suction the mouth.

Treatment for a responsive 4-year-old child with a mild airway obstruction, who has respiratory distress, a strong cough, and normal skin color, includes:

supplemental oxygen and transport.

The transition phase of the pediatric assessment process would be the LEAST appropriate if:

the child is unstable and needs rapid transport

You will know that the third stage of labor has begun when:

the entire baby has delivered.

A 6-year-old boy presents with a high fever, a headache, and a stiff neck. He is conscious, but is not acting as a normal 6-year-old boy should. His mother told you that he vomited once before your arrival. You should be MOST concerned with:

the risk of permanent neurological damage.

The MAIN reason why small children should ride in the backseat of a vehicle is because:

they can experience severe injury or death if the airbag deploys.

A child typically begins to develop stranger anxiety when he or she is a/an:

toddler

Following delivery of a newborn, the 21-year-old mother is experiencing mild vaginal bleeding. You note that her heart rate has increased from 90 to 120 beats/min and she is diaphoretic. In addition to administering high-flow oxygen, treatment should include:

treating for shock and uterine massage during transport.

Upon delivery of a baby's head, you see that the umbilical cord is wrapped around its neck. Initial treatment for this condition should include:

trying to remove the cord from around the neck.

Oxygen and other nutrients are transferred to the developing fetus via the:

umbilical vein.