Chapter 34-37

Which of the following questions is of least pertinence when determining whether a mother will deliver her baby within the next few minutes?

"Have you had a sonogram?

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 ot 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

Blood pressure is usually not assessed in children younger than ____years.

3

An obese person is_____over ideal weight.

30% or more

Febrile seizures are most common in children between

6 months to 6 years

The normal respiratory rate for a newborn should not exceed______breaths/min.

60

Which of the following patients is at highest risk for a pulmonary embolism?

71-year-old male with recent surgery to a lower extremity

If a baby is born at 7:52, the second Apgar score should be calculated at

7:57

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.

Causes of delirium in the older patient include all of the following, except

Alzheimer disease

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

An unresponsive 5-year-old male with shallow respirations

During your visual inspection of a 25-year-old woman in labor, you see the baby's head crowning at the vaginal opening. What should you do?

Apply gentle pressure to the baby's head as it delivers

Under what circumstances is a left ventricular assist device used?

As a bridge to heart transplantation while a donor heart is being located

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

Cerebral palsy is characterized by poorly controlled _____movement.

Body

According to the "E" in the DOPE mnemonic, which of the following actions should you perform to troubleshoot inadequate ventilation in a patient with a tracheostomy tube?

Check the mechanical ventilator for malfunction.

You have just delivered a full-term infant. His respirations are rapid and irregular, and he has a strong cry. What should you do next?

Check the pulse rate at the brachial artery.

Which of the following statements regarding pediatric trauma is correct?

Children are more likely to experience diving-related injuries

The tip of a central venous catheter rests in the: 51. Which of the following statements regarding interaction with the caregiver of a child or adult with special health care needs is correct?

Communication with the patient's caregiver or family members is important because they are the most familiar with the patient's condition.

Which of the following statements regarding cerebral palsy is correct?

Conditions such as brain injury at birth, postpartum infections, and fetal hypoxia can cause cerebral palsy.

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.

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

Easier breathing

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

Femoral

Which of the following statements regarding hearing aids is correct?

Hearing aids cannot restore hearing to normal levels.

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?

History of deep venous thrombosis

Which of the following is not a reason why the exact extent and prevalence of elder abuse is unknown?

Human resource agencies fail to investigate.

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

If the cervical spine is injured, it is most likely to be 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.

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 BVM

Which of the following statements regarding communications with the elderly is correct?

Older patients have difficulty understanding when they are stressed.

Which of the following statements regarding suicide in the older patient is correct?

Older patients tend to use more lethal means than younger patients.

Which of the following statements regarding gastrostomy (gastric) tubes is correct?

Patients with a gastrostomy tube may still be at risk for aspiration.

Which of the following statements regarding patients with intellectual disabilities is correct?

Patients with intellectual disabilities are susceptible to the same disease processes as other patients.

Poor maintenance of home, poor personal care, and dietary neglect are all possible indicators of____elder abuse.

Physical

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

Return of contractions following delivery of the baby

Eclampsia is most accurately defined as

Seizures that result from severe hypertension

Bruising to the______is least suggestive of child abuse

Shins

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.

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. Because this patient is probably in shock, what is the most likely explanation for the absence of tachycardia?

The effects of her antihypertensive medication

Which of the following observations or statements represents the "E" in the GEMS diamond?

The patient's residence is cold due to a malfunctioning heater.

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 aging process is correct?

The process of aging is gradual, and the rate at which a person loses functions does not increase with age.

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 would be the most practical method of communicating with a hearing-impaired patient until his or her hearing aids can be located?

Using a piece of paper and writing utensil to ask questions

Which of the following occurs during true labor?

Uterine contractions become more regular

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?

Spina bifida is defined as

a birth defect caused by incomplete closure of the spinal column.

Osteoporosis is defined as

a decrease in bone mass and density.

During the natural process of aging, the number of functional cilia in the respiratory system decreases, resulting in

a decreased ability to cough.

Characteristic anatomic features of Down syndrome include

a round head with a flat occiput.

Down syndrome is a genetic defect that occurs as the result of

a triplication of chromosome 21

An infant with severe dehydration would be expected to present with

absent urine output

A 70-year-old man complains of a sudden onset of difficulty breathing. He has dried blood on his lips and is very anxious. His left leg is red, swollen, and painful. The EMT should

administer high-flow oxygen.

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

According to the Emergency Medical Treatment and Active Labor Act (EMTALA)

all health care facilities must provide a medical assessment and required treatment, regardless of the patient's ability to pay.

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.

Common causes of depression in the elderly include all of the following, except

an acute onset of dementia.

A 73-year-old female experienced a syncopal episode while watching TV. She is now conscious but diaphoretic, tachycardic, and hypotensive. Your assessment reveals abdominal tenderness and a pulsating mass to the left of her umbilicus. You should suspect

an aortic aneurysm.

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

an ectopic pregnancy

Signs of a severe airway obstruction in an infant or child include

an ineffective cough

EMTs are dispatched for a patient whose central venous catheter is malfunctioning. When they arrive and assess the patient, they find bleeding from the tubing attached to the line. The EMTs should

apply direct pressure to the tubing and transport.

Patients who have experienced even minor-appearing head injuries should be suspected of having a brain injury, especially if they

are taking blood-thinning medications.

When interacting with an intellectually disabled patient, the best approach is to

ask your team members to wait until you can establish a rapport with the patient.

You are assessing a 25-year-old woman who is 39 weeks pregnant. She is experiencing regular contractions that are approximately three minutes apart and states that her amniotic sac broke two hours ago. After taking the standard precautions, you should

assess her for crowning.

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.

Because of the complexity of the older patient and the vagueness of his or her complaint, you should

attempt to differentiate between chronic and acute problems.

When faced with a situation in which an older patient with a terminal illness is in cardiac arrest, but written documentation regarding the patient's wishes cannot be located, the EMT should

attempt to resuscitate the patient.

If suctioning of the tracheostomy tube is necessary, the EMT should

attempt to use the patient's suction device first because it is probably already sized correctly.

When documenting a case of suspected elder abuse, it is most important for the EMT to

avoid documenting any unsupported opinions.

You are assessing a 440-Ib man who complains of shortness of breath and lower back pain. The patient is conscious and alert, his blood pressure is 148/98 mm Hg, and his heart rate is 120 beats/min. Your most immediate action should be to

avoid placing him in a supine position if possible and administer oxygen.

When assessing or providing care to a patient with an intellectual disability, you should

be observant for signs of fear or reluctance from the patient.

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.

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

blood pressure

Pale skin in a child indicates that the

blood vessels near the skin are constricted.

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

body size

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.

Clouding of the lenses of the eyes is called

cataracts

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

Syncope in the older patient is

caused by an interruption of blood flow to the brain.

Hyperthermia differs from fever in that it is an increase in body temperature

caused by the inability of the body to cool itself.

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

cervical spine injury

Children with N. meningitides would most likely present with

cherry-red spots or a purplish rash

Vagus nerve stimulators may be an alternative treatment to medication for patients with

chronic seizure disorders.

As a person ages, the heart might enlarge as a result of

chronically increased afterload.

A surgical procedure that creates an opening between the intestine and the surface of the body that allows for elimination of waste products is called an)

colostomy

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

The slow onset of progressive disorientation, shortened attention span, and loss of cognitive function is known as

dementia

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

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

determine the onset of the patient's symptoms.

You are dispatched to a skilled nursing care facility for an 80-year-old female with abnormal behavior. The patient is clearly confused and asks you if you are her husband. You should

determine the patient's baseline mental status.

Upon arriving at the residence of an elderly female who apparently fainted, you find the patient lying supine on her living room floor. She is not moving, and her eyes are closed. A neighbor tells you that she found the patient this way but did not move her. When you gently tap the patient, she does not respond. You should

direct your partner to manually stabilize her head while you quickly visualize her chest for signs of breathing.

A 13-year-old child is on a home ventilator. The parents called because the mechanical ventilator is malfunctioning, and the child has increasing respiratory distress. You should

disconnect the ventilator and apply a tracheostomy collar.

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

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.

Burns in children are commonly caused by all of the following, except

entrapment in a structural fire.

When caring for a morbidly obese patient, you should

establish his or her chief complaint and then communicate your plan to help.

EMTs are dispatched to a residence for an 80-year-old woman who is ill. The patient's daughter states that her mother almost fainted after going to the bathroom and that her pulse was very slow. The patient's pulse rate is 80 beats/min and irregular, and she is conscious and alert. The EMTs should suspect that the patient

experienced a vasovagal response.

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

failure of the respiratory system.

Which of the following is the most common mechanism of injury in older patients?

falls

Unless he or she is critically ill or injured, you should generally begin your assessment of a toddler

feet

Which of the following groups of people is associated with the lowest risk of meningitis?

females

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

Good general communication techniques with the elderly include

frequently asking the patient if he or she understands.

In most children, febrile seizures are characterized by

generalized tonic-clonic activity, a duration of less than 15 minutes, and a short or absent postictal phase.

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

An infant or child with respiratory distress will attempt to keep his or her alveoli expanded at the end of inhalation by

grunting

A service dog is easily identified by its

harness

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

EMS personnel would most likely be called to the residence of a patient receiving home health care when the home care provider

has recognized a change in the patient's health status.

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

To minimize distractions and confusion when assessing an older patient, you should

have only one EMT speak to the patient at a time.

When a child experiences a blunt injury to the abdomen

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

An elderly patient might understate or minimize the symptoms of his or her illness because

he or she fears hospitalization.

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

head bobbing

The reduction in brain weight and volume increases an older person's risk for

head trauma

As many as 40% of patients with Down syndrome have

heart condition

The leading cause of death in the geriatric patient is

heart disease

The purpose of the GEMS diamond is to

help EMS personnel remember what is different about elderly patients.

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

You are assessing a 70-year-old female who complains of intense thirst, frequent urination, and dizziness. She has a history of type 2 diabetes, heart disease, rheumatoid arthritis, and gout. Her blood glucose reads "high." She is conscious but confused. Her blood pressure is 92/52 mm Hg, her pulse rate is 130 beats/min and weak, and her respirations are 22 breaths/min and shallow. This patient's clinical presentation is most consistent with

hyperosmolar hyperglycemic nonketotic syndrome

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

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.

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

inform the child's mother that her son is deceased.

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 leading cause of maternal death during the first trimester of pregnancy is

internal bleeding caused by a ruptured ectopic pregnancy

An abdominal aortic aneurysm

is often the result of hypertension and atherosclerosis.

The term primigravida refers to a woman who

is pregnant for the first time.

By placing one hand on your head and the other hand over your abdomen, you are asking a hearing-impaired patient if he or she

is sick

In contrast to delirium, dementia

is usually considered irreversible.

The stooped posture of some older people, which gives them a humpback appearance, is called

kyphosis

Motor nerve neuropathy is characterized by

loss of balance, muscle weakness, and spasms.

Because hearing-impaired patients typically have more difficulty hearing high-frequency sounds, it is important for you to

lower the pitch of your voice.

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.

Talking about an elderly patient in front of him or her to other members of the family

may cause the patient to think that he or she has no say in making decisions.

Febrile seizures in a child

may indicate a serious underlying illness

The secondary assessment of a sick or injured child

may not be possible if the child's condition is critical.

In contrast to abruptio placenta, placenta previa

might present without significant abdominal pain

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

moderate dehydration

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

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

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

neonatal period

In contrast to conductive hearing loss, sensorineural hearing loss is caused by

nerve damage

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

not rule out compensated shock

Upon entering the residence of a geriatric patient with a medical or trauma complaint, the EMT should

observe for conditions that may make the residence unsafe.

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

Most medical models base a pregnant woman's due date

on the first day of her last menstrual cycle.

You respond to a residence for a 9-year-old female with Down syndrome who is sick. When you arrive at the scene and assess the patient, you determine that she is unresponsive and has gurgling respirations. You should

open her airway with a manual maneuver, suction her oropharynx, and insert a simple airway adjunct.

Fractures of the pelvis in older patients often occur as the result of a combination of

osteoporosis and low-energy trauma.

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.

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 an)

pathologic fracture

EMTs are dispatched for a patient in cardiac arrest. When they arrive, they find that the patient is pulseless, apneic, and wearing an external defibrillator vest. In this situation, the EMTs should

perform CPR and leave the vest in place.

After using the pediatric assessment triangle (PAT) to form your general impression of a sick or injured child, you should

perform a hands-on assessment of the ABCs.

Autism is defined as a

pervasive developmental disorder characterized by impairment of social interaction.

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.

When immobilizing a patient with a kyphotic spine to a long backboard, the EMT would most likely have to

place blankets behind the patient's head.

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

place her in a left lateral recumbent position.

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.

Your 22-year-old patient is in active labor. Upon visual inspection, you note that the infant's leg is protruding from the vagina. Appropriate management of this situation includes

placing the mother supine with her head down and pelvis elevated.

A productive cough, fever, and chills in an 80-year-old patient with a compromised immune system should make you most suspicious for

pneumonia

The use of multiple prescription drugs by a single patient, causing the potential for negative effects such as overdosing or drug interaction, is called

polypharmacy

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 a decreased 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.

The purpose of a ventricular peritoneum shunt is to

prevent excess cerebrospinal fluid from accumulating in the brain.

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

profound tachycardia

Compared to adults, the liver and spleen of pediatric patients are more prone to injury and bleeding because they are

proportionately larger and situated more anteriorly.

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

Three days after delivering her baby, a 30-year-old woman complains of a sudden onset of difficulty breathing. Her level of consciousness is decreased, and she is tachycardic. The EMT should suspect

pulmonary embolism

Upon delivery of the baby's head, you note that its face is encased in the unruptured amniotic sac. You should

puncture the sac and suction the baby's mouth and nose.

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

putting a baby to sleep on his or her back

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

rash

When performing your secondary assessment on an older patient who has been injured, it is important to

recall that it will take a less severe mechanism of injury to cause significant injuries.

When an elderly patient presents you with multiple over-the-counter medications that he or she is taking, it is most important to

recall that the patient is at risk for negative medication interactions.

In contrast to an automated implanted cardioverter/defibrillator, an internal cardiac pacemaker

regulates the patient's heart rate if it falls below a preset value.

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.

When enlisting the help of an interpreter who signs, it is important for you to ask the interpreter to

report exactly what the patient signs and not to add any commentary.

Early signs of respiratory distress in the child include

restlessness

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

retracting

Because a tracheostomy tube bypasses the nose and mouth

secretions can build up in and around the tube.

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

secure the torso before the head

Which of the following conditions would most likely be encountered in a patient with cerebral palsy?

seizure disorder

In contrast to adults, deterioration to cardiac arrest in infants and children is usually associated with

severe hypoxia and bradycardia.

Which of the following inquiries should you make in private when obtaining a SAMPLE history from an adolescent patient?

sexual activity

You are dispatched to a residence for an 80-year-old female who fell. When you arrive, you find the patient conscious, lying in a recumbent position on the floor in her living room. In addition to providing the appropriate treatment, you should ask the patient if

she became dizzy or fainted before falling.

A tube from the brain to the abdomen that drains excessive cerebrospinal fluid is called a

shunt

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

An important aspect in the assessment of a patient who experienced a previous brain injury involves

speaking with the patient and family to establish what is considered normal for the patient.

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

stabilize his head and check for a pulse

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

start of one to the start of the next.

If a nasopharyngeal airway is too long, it might

stimulate the vagus nerve

A high-pitched inspiratory sound that indicates a partial upper airway obstruction is called

stridor

You receive a call for a sick person. When you arrive, you find the patient, a 75-year-old male, lying unresponsive in his bed. His respirations are slow and irregular, and his pulse is slow and weak. His daughter tells you that he fell the day before but refused to allow her to call 9-1-1. His past medical history is significant for hypothyroidism, deep vein thrombosis, heavy alcohol use, and liver cirrhosis. His medications include blood thinners and vitamins. You should be most suspicious that this patient is experiencing

subdural hematoma

An 84-year-old male fell a week ago and has been bedridden since then. Today, he presents with an altered mental status. His skin is pale and cold, and his respirations are rapid and shallow. The EMT should suspect

systemic infection

The EMT should suspect left-sided heart failure in the geriatric patient who presents with

tachypnea and paroxysmal nocturnal dyspnea.

When the mother is experiencing a contraction, you should instruct her to

take quick short breaths

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

talk to the child, not just the caregiver

When caring for a patient who is visually impaired, it is important to

tell him or her what is happening, identify noises, and describe the situation and surroundings.

The presence of meconium in the amniotic fluid indicates

that the baby's airway may be obstructed.

The third stage of labor begins when the

the baby is expelled from the vagina

In contrast to younger patients, older patients are more prone to a decrease in blood pressure (BP) upon standing because

the body is less able to adapt the BP to rapid postural changes.

When a child experiences a blunt chest injury

the flexible ribs can be compressed without breaking

When caring for a geriatric patient with a traumatic injury, it is important to consider that

the injury may have been preceded by a medical condition.

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

the mother may become nauseated and vomit.

In contrast to a living will, a "do not resuscitate" (DR) order becomes valid when

the patient develops cardiac arrest.

A 77-year-old female presents with an acute onset of altered mental status. Her son is present and advises that she has a history of hypertension, atrial fibrillation, type 2 diabetes, and glaucoma. He further advises that she takes numerous medications and is normally alert. When you assess this patient, it is important to note that

the patient is experiencing delirious behavior, which suggests a new health problem.

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.

A "silent" heart attack occurs when

the usual chest pain is not present.

Greenstick fractures occur in infants and children because

their bones bend more easily than an adult's.

When caring for patients with cerebral palsy, it is important to remember that

their limbs are often underdeveloped and are prone to injury.

Many older victims of physical abuse might make false statements or lie about the origin of their injuries because

they fear retribution from the abuser.

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

they usually do not wish to be observed during a procedure

When transporting a stable older patient to the hospital, the most effective way to reduce his or her anxiety is to

transport him or her to a hospital that he or she is familiar with.

You receive a call to a residence for an apneic 2-month-old male. When you arrive at the scene, the infant's mother tells you that her son was born prematurely and that his apnea monitor has alarmed four times in the past 30 minutes. Your assessment of the infant reveals that he is conscious and active. His skin is pink and dry, and he is breathing at an adequate rate and with adequate tidal depth. His oxygen saturation reads 98% on room air. You should

transport the infant to the hospital and bring the apnea monitor with you.

A 70-year-old male complains of shortness of breath. During your assessment, you note that he has bilateral hearing aids. When you ask him questions related to his chief complaint, he does not answer you. You can hear a whistling sound coming from his hearing aids. You should

try repositioning the hearing aid or remove it and turn down the volume.

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

use a length-based resuscitation tape measure.

When explaining the need for a particular procedure to an elderly patient, you should

use plain language and simple terms.

The signs and symptoms of poisoning in children

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

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

The most common cause of dehydration in pediatric patients is

vomiting and diarrhea

Signs of vasoconstriction in the infant or child include

weak distal pulses.

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