module 10 (Ch. 34 & 35)

A newborn infant will usually begin breathing spontaneously within _______ seconds following birth.

15 to 30

A mother who is pregnant with her first baby is typically in the first stage of labor for approximately:

16 hours.

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.

18, 6

After squeezing the end of a child's finger or toe for a few seconds, blood should return to the area within:

2 seconds.

Which of the following is an appropriate dose of activated charcoal for a 20-kg child?

20 g

Febrile seizures are most common in children between:

6 months and 6 years.

Capillary refill time is most reliable as an indicator of end-organ perfusion in children younger than:

6 years.

The normal respiratory rate for a newborn should not exceed ______ breaths/min.

60

You have just delivered a baby boy. His body is pink, but his hands and feet are blue. His heart rate is 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:

8

Which of the following statements regarding a 3-month-old infant is correct?

A 3-month-old infant can distinguish a parent from a stranger.

Which of the following statements regarding a breech presentation is correct?

A breech presentation occurs when the buttocks are the presenting part.

Which of the following children would benefit the least from a nonrebreathing mask?

An unresponsive 5-year-old male with shallow respirations

Which of the following is the least reliable assessment parameter to evaluate when determining the presence of shock in infants and children?

Blood pressure

A 5-year-old child has had severe vomiting and diarrhea for 4 days. Which of the following assessment findings would be the most indicative of decompensated shock?

Blood pressure of 70/40 mm Hg

Which of the following is not a component of the Apgar score?

Body size

Which of the following findings is least suggestive of child abuse?

Consistency in the method of injury reported by the caregiver

Which of the following is an indication of imminent birth?

Crowning of the baby's head

Which of the following statements regarding sudden infant death syndrome (SIDS) is correct?

Death as a result of SIDS can occur at any time of the day or night.

Which of the following is true regarding the legal implications of child abuse?

EMTs must report all suspected cases of child abuse

Which of the following statements regarding spinal injuries in pediatric patients is correct?

If the cervical spine is injured, it is most likely an injury to the ligaments because of rapid movement of the head

Which of the following statements regarding gestational diabetes is correct?

In some cases, women with gestational diabetes require insulin injections.

Which of the following is a normal physiologic change that occurs in the mother's respiratory system during pregnancy?

Increased respiratory rate and decreased respiratory reserve

After a head injury, which of the following is more common in children than in adults?

Nausea and vomiting

Which of the following assessment findings should concern the EMT the most when assessing a child who experienced a seizure?

Neck stiffness

Chapter 34

Obstetrics and Neonatal Care

Chapter 35

Pediatric Emergencies

Which of the following is not a known risk factor of SIDS?

Putting a baby to sleep on his or her back

Which of the following is not generally considered an obstetrical emergency?

Return of contractions following delivery of the baby

Which of the following statements regarding suctioning of a newborn's mouth and oropharynx is correct?

Suctioning is indicated prior to cutting the cord if respiratory distress is present.

Which of the following statements regarding the placenta is correct?

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.

Which of the following statements regarding the use of nasopharyngeal airways in children is correct?

They are rarely used in infants younger than 1 year.

Which of the following statements regarding preschool-age children is correct?

They can usually identify painful areas when questioned.

Which of the following occurs during true labor?

Uterine contractions become more regular.

Which of the following signs or symptoms would most likely cause the EMT to mistake a head injury for an abdominal injury in a child?

Vomiting

When questioning the parent of a child who ingested a poisonous substance, which of the following questions would be of least pertinence initially?

Why did your child ingest the poison?

The EMT should be most concerned when a child presents with fever and:

a rash.

An infant with severe dehydration would be expected to present with:

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:

administering blow-by oxygen and transporting the child with her mother.

A normal level of consciousness in an infant or child is characterized by:

age-appropriate behavior, good muscle tone, and good eye contact.

Submersion injuries in the adolescent age group are most commonly associated with:

alcohol.

Braxton-Hicks contractions are characterized by:

alleviation of pain with movement or changing positions.

During the attempted resuscitation of an infant with suspected SIDS:

allow the family to observe if they wish.

The purpose of the pediatric assessment triangle (PAT) is to:

allow you to rapidly and visually form a general impression of the child.

A history of pelvic inflammatory disease or tubal ligations increases a woman's risk for:

an ectopic pregnancy

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 on 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:

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.

The third stage of labor begins when the:

baby is expelled from the vagina.

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:

be prepared to assist her ventilations, transport at once, and request an ALS intercept en route to the hospital.

By the 20th week of pregnancy, the uterus is typically at or above the level of the mother's:

belly button.

The vagina and the neck of the uterus comprise the:

birth canal.

Death caused by shaken baby syndrome is usually the result of:

bleeding in the brain.

When ventilating a pediatric patient with a bag-valve mask, the EMT should:

block the pop-off valve if needed to achieve adequate chest rise.

Pale skin in a child indicates that the:

blood vessels near the skin are constricted.

The most ominous sign of impending cardiopulmonary arrest in infants and children is:

bradycardia.

The only indications for placing your gloved fingers in the vagina during delivery are:

breech presentation and prolapsed umbilical cord.

Signs of severe dehydration in an infant include all of the following, except:

bulging fontanelles.

The umbilical cord:

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 might:

cause the child to vomit.

Children with N. meningitides would most likely present with:

cherry-red spots or a purplish rash.

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:

cool the child with tepid water and transport to the hospital.

A viral infection that might cause obstruction of the upper airway in a child is called:

croup.

When inserting an oropharyngeal airway in an infant or child, you should:

depress the tongue with a tongue depressor.

Infection should be considered a possible cause of an airway obstruction in an infant or child, especially if he or she presents with:

drooling or congestion.

After the fetus has descended into the pelvis at the end of the third trimester, many mothers experience:

easier breathing.

If a pregnant patient must be placed onto a backboard, you should:

elevate the right side of the board with rolled towels or blankets.

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:

encourage him to cough, give oxygen as tolerated, and transport.

After a baby is born, it is important to:

ensure that it is thoroughly dried and warmed.

Before assessing the respiratory adequacy of a semiconscious infant or child, you must:

ensure that the airway is patent and clear of obstructions.

Cardiac arrest in the pediatric population is most commonly the result of:

failure of the respiratory system.

When assessing the heart rate of a 6-month-old infant, you should palpate the brachial pulse or ________ pulse.

femoral

Following delivery of a full-term baby, you have properly cared for the baby and have clamped and cut the umbilical cord. During transport, you note that the mother is experiencing moderate vaginal bleeding. You should:

firmly massage the uterine fundus with a circular motion.

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

first attempt to slip the cord gently over the infant's head.

While examining a woman in labor, you see the umbilical cord protruding from the vagina. You should:

gently push the infant's head away from the cord.

Immediate transport is indicated for a child when he or she:

has a history compatible with a serious illness.

In contrast to a full-term infant, a premature infant:

has an even proportionately larger head.

When caring for a female child who has possibly been sexually abused, you should:

have a female EMT remain with her if possible.

A precipitous labor and delivery is most common in women who:

have delivered a baby before.

When a child experiences a blunt injury to the abdomen:

he or she can compensate for blood loss better than adults.

All of the following are normal findings in an infant or child, except:

head bobbing.

Use of a nonrebreathing mask or nasal cannula in a child is appropriate only if:

his or her tidal volume is adequate.

Causes of infant death that might be mistaken for SIDS include all of the following, except:

hyperglycemia.

Common causes of seizures in children include all of the following, except:

hyperglycemia.

EMTs are called for an unresponsive infant. When they arrive, they find the mother holding her child. She advises that the child became limp, blue, and stopped breathing. Assessment reveals that the infant is conscious and crying, and has good muscle tone and pink skin color. The mother states that she will take her child to the doctor. The EMTs should:

inform that mother that, although the event seems to have resolved, transport via EMS is advisable.

The amniotic fluid serves to:

insulate and protect the fetus.

Compared to an adult, the diaphragm dictates the amount of air that a child inspires because the:

intercostal muscles are not well developed.

The term primigravida refers to a woman who:

is pregnant for the first time

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:

keep him warm and ventilate with a bag-mask device.

CPR is in progress on a pulseless and apneic 29-year-old woman who is 37 weeks pregnant. When treating this patient, the EMT should:

manually displace the patient's uterus to the left.

In contrast to abruptio placenta, placenta previa:

may not present with heavy vaginal bleeding.

Febrile seizures in a child:

might indicate a serious underlying illness.

A 4-year-old, 16-kg 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:

monitor her airway and give oxygen.

The first month of life after birth is referred to as the:

neonatal period.

After determining that an infant or child has strong central pulses, you should:

not rule out compensated shock.

The most accurate method for determining if you are delivering adequate tidal volume to a child during bag-valve mask ventilations is to:

observe the chest for adequate rise.

Padding underneath the torso when immobilizing an injured child is generally not necessary if he or she is:

older than 8 to 10 years of age.

Most medical models base a pregnant woman's due date:

on the first day of her last menstrual cycle.

While triaging patients at the scene of a motor-vehicle crash, you encounter a 5-year-old child who is unresponsive and apneic. After positioning his airway, you should:

palpate for a carotid pulse.

Severe burns in children include:

partial-thickness burns covering more than 20% of the body surface.

To ensure that the airway of an infant or small child is correctly positioned, you might have to:

place a towel or folded sheet behind the shoulders.

A 26-year-old female who is 34 weeks pregnant is experiencing a seizure. Her husband tells you that her blood pressure has been high and that she had been complaining of a headache for the past few days. You should:

place her on her side, administer high-flow oxygen, and transport.

Before positioning an infant or child's airway, you should:

place him or her on a firm surface.

When administering oxygen to a frightened child, it would be most appropriate to:

place oxygen tubing through a hole in a paper cup.

Effective methods for providing pain relief to a child with an extremity injury include:

positioning, ice packs, and extremity elevation.

Common interventions used to stimulate spontaneous respirations in the newborn include all of the following, except:

positive-pressure ventilations.

Pregnant women are advised to take iron supplements, such as prenatal vitamins, because:

pregnancy causes an increased number of red blood cells, which predisposes the mother to anemia.

A pregnant trauma patient might lose a significant amount of blood before showing signs of shock because:

pregnant patients have an overall increase in blood volume.

Fetal complications associated with drug- or alcohol-addicted mothers include all of the following, except:

profound tachycardia.

After delivery of a pulseless and apneic infant who has a foul odor, skin sloughing, and diffuse blistering, you should:

provide emotional support to the mother.

EMTs are assessing a 2-year-old child who was riding in a car seat when the vehicle struck a tree while traveling at 45 MPH. The child is conscious and appears alert. There are no obvious signs of trauma to the child, and the car seat does not appear to be damaged. The EMTs should:

remove the child from the car seat and secure him to a pediatric immobilization device.

Drawing in of the muscles between the ribs or of the sternum during inspiration is called:

retracting.

When immobilizing an injured child in a pediatric immobilization device, you should:

secure the torso before the head.

Eclampsia is most accurately defined as:

seizures that result from severe hypertension.

Bruising to the _________ is least suggestive of child abuse.

shins

When a child is struck by a car, the area of greatest injury depends mostly on the:

size of the child and the height of the bumper upon impact.

When determining the frequency of contractions, you should time the contractions from the:

start of one to the start of the next.

When assessing an 8-year-old child, you should:

talk to the child, not just the caregiver.

The presence of meconium in the amniotic fluid indicates:

that the baby's airway might be obstructed.

When a child experiences a blunt chest injury:

the flexible ribs can be compressed without breaking.

During delivery, it is most important to position your partner at the mother's head because:

the mother might become nauseated and vomit.

Abruptio placenta occurs when:

the placenta prematurely separates from the uterine wall.

Supine hypotensive syndrome occurs when:

the pregnant uterus compresses the inferior vena cava.

After 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:

the production of oxytocin caused uterine contraction.

The term "bloody show" is defined as:

the small amount of pink-tinged mucus that is discharged from the vagina after expulsion of the mucous plug.

Greenstick fractures occur in infants and children because:

their bones bend more easily than an adult's bones.

When assessing or treating an adolescent patient, it is important to remember that:

they usually do not wish to be observed during a procedure.

The most efficient way to identify the appropriately sized equipment for a pediatric patient is to:

use a length-based resuscitation tape measure.

The signs and symptoms of poisoning in children:

vary widely, depending on the child's age and weight.

The most common cause of dehydration in pediatric patients is:

vomiting and diarrhea.

An infant is premature if it:

weighs less than 5 pounds or is born before 36 weeks' gestation.

Signs of an upper airway obstruction in an infant or child include all of the following, except:

wheezing.