EMT Chapter 33 & 34

Which of the following questions is of LEAST pertinence when determining whether a mother will deliver her baby within the next few minutes? A. "When are you due?" B. "Have you had a sonogram?" C. "Do you feel the need to push?" D. "Is this your first baby?"

B. "Have you had a sonogram?"

Infants begin saying their first word, sitting without support, and teething at 6 to ______ months. A. 8 B. 12 C. 18 D. 24

B. 12

If a baby is born at 7:52, the second Apgar score should be calculated at: A. 7:53 B. 7:57 C. 7:59 D. 8:00

B. 7:57

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? A. Tell the mother not to push and transport her immediately. B. Apply gentle pressure to the baby's head as it delivers. C. Maintain firm pressure to the head until it completely delivers. D. Place your finger in the vagina to asses for a nuchal cord.

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

The vagina and the lower part of the uterus is known as the: A. Fundus B. Birth canal C. Perineum D. Cervix

B. Birth canal

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? A. Respiratory rate of 30 breaths/min B. Blood pressure of 70/40 mm Hg C. Capillary refill time of 4 seconds D. Pulse greater than 120/min

B. Blood pressure of 70/40 mm Hg

The neck of the uterus is known as the: A. Birth canal B. Cervix C. Vagina D. Fundus

B. Cervix

Which of the following statements is NOT true? A. As pregnancy progresses the uterus enlarges and rises out of the pelvis. B. The leading cause of abruptio placenta is in an ectopic pregnancy. C. Some cultures may not permit male EMTs to examine a female patient. D. Gestational diabetes will clear up in most woman after delivery.

B. The leading cause of abruptio placenta is in an ectopic pregnancy.

The EMT should be MOST concerned when a child presents with fever and: A. chills. B. a rash. C. ear pain. D. a headache.

B. a rash.

The purpose of the pediatric assessment triangle (PAT) is to: A. determine if the child's vital signs are within the age-appropriate limits. B. allow you to rapidly and visually form a general impression of the child. C. facilitate a rapid head-to-toe assessment of the child by visualization only. D. gather critical data by performing a rapid hands-on assessment of the child.

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

A pediatric patient with a fever, pain on palpation of the right lower quadrant, and rebound tenderness is likely suffering from _________________. A. croup B. appendicitis C. epiglottitis D. meningitis

B. appendicitis

Signs of severe dehydration in an infant include all of the following, EXCEPT: A. profound tachycardia. B. bulging fontanelles. C. delayed capillary refill. D. dry mucous membranes.

B. bulging fontanelles.

An oropharyngeal airway should not be used in children who have ingested a caustic or petroleum-based product because it may: A. depress the gag reflex. B. cause the child to vomit. C. result in airway swelling. D. result in a soft-tissue injury.

B. cause the child to vomit.

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. allow the mother to drive her daughter to the hospital. B. cool the child with tepid water and transport to the hospital. C. place the child in cold water to attempt to reduce her fever. D. suspect that the child has meningitis and transport at once.

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

Infection should be considered a possible cause of an airway obstruction in an infant or child, especially if he or she presents with: A. extreme restlessness. B. drooling or congestion. C. skin that is cool and dry. D. acute respiratory distress.

B. drooling or congestion.

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. carefully look into his mouth and remove the object if you see it. B. encourage him to cough, give oxygen as tolerated, and transport. C. deliver a series of five back blows and then reassess his condition. D. place the child in a supine position and perform abdominal thrusts.

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

Before assessing the respiratory adequacy of an semiconscious infant or child, you must: A. routinely suction the mouth to remove oral secretions. B. ensure that the airway is patent and clear of obstructions. C. insert a nasopharyngeal or oropharyngeal airway adjunct. D. ensure that his or her head is in a hyperextended position.

B. ensure that the airway is patent and clear of obstructions.

Which of the following groups of people is associated with the lowest risk of meningitis? A. newborns B. females C. geriatrics D. children with shunts

B. 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: A. elevate her legs 6 to 8 inches and cover her with a blanket. B. firmly massage the uterine fundus with a circular motion. C. carefully insert a sterile trauma dressing into her vagina. D. place her legs together and position her on her left side.

B. firmly massage the uterine fundus with a circular motion.

When caring for a female child who has possibly been sexually abused, you should: A. encourage the child to urinate and take a shower. B. have a female EMT remain with her if possible. C. carefully examine the genitalia for signs of injury. D. immediately report your suspicions to the parents.

B. have a female EMT remain with her if possible.

Signs and symptoms of preeclampsia include: A. dyspnea and bradycardia. B. headache and edema. C. marked hypoglycemia. D. dysuria and constipation.

B. headache and edema.

Common causes of seizures in children include all of the following, EXCEPT: A. infection. B. hyperglycemia. C. electrolyte imbalances. D. poisonings or ingestion

B. hyperglycemia.

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: A. begin high-quality CPR and request and ALS ambulance. B. inform the child's mother that her child is deceased. C. begin high-quality CPR and transport immediately. D. request the medical examiner to perform an autopsy.

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

The amniotic fluid serves to: A. assist in a fetal development. B. insulate and protect the fetus. C. transfer oxygen to the fetus. D. remove viruses from the fetus.

B. insulate and protect the fetus.

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. mild dehydration. B. moderate dehydration. C. severe dehydration. D. hypovolemic shock.

B. moderate dehydration.

To ensure that the airway of an infant or small child is correctly positioned, you may have to: A. place bulky padding behind his or her occiput. B. place a towel or folded sheet behind the shoulders. C. slightly flex the neck to prevent tracheal kinking. D. hyperextend the neck to ensure adequate alignment.

B. place a towel or folded sheet behind the shoulders.

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: A. gently pulling on the infant's leg in an attempt to facilitate delivery. B. placing the mother supine with her head down and pelvis elevated. C. carefully attempting to push the infant's leg off of the umbilical cord. D. placing the mother in a recumbent position and rapidly transporting.

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

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. begin immediate rescue breathing. B. stabilize his head and check for a pulse. C. perform a head tilt-chin lift maneuver. D. open his airway and look in his mouth.

B. stabilize his head and check for a pulse.

When assessing an 8-year-old child, you should: A. refrain from taking a blood pressure. B. talk to the child, not just the caregiver. C. use a toe-to-head assessment approach. D. rely solely on the parent for information.

B. talk to the child, not just the caregiver.

The presence of meconium in the amniotic fluid indicates: A. that full newborn resuscitation will be needed. B. that the baby's airway may be obstructed. C. that the fetus is at least 4 weeks premature. D. an expected finding in full-term infants.

B. that the baby's airway may be obstructed.

When a child experiences a blunt chest injury: A. the flexible rib cage protects the vital thoracic organs. B. the flexible ribs can be compressed without breaking. C. the sudden force against the ribs causes them to fracture. D. there is usually obvious injury to the external chest wall.

B. the flexible ribs can be compressed without breaking.

Breath sounds in the pediatric population are more easily heard because: A. the size of their lungs amplifies the sounds. B. their chest walls are thinner. C. children typically have upper airway problems. D. the chest cavity is small in proportion to the rest of the body.

B. their chest walls are thinner.

Following delivery of the placenta, the mother is experiencing vaginal bleeding. After massaging her fundus and allowing the mother to breast feed, the bleeding stops. This occurred because: A. breastfeeding causes uterine blood vessels to dilate. B. these actions stimulate the production of oxytocin and cause uterine contraction. C. a portion of the placenta was retained in the uterus. D uterine massage increases blood flow to the uterus.

B. these actions stimulate the production of oxytocin and cause uterine contraction.

Signs of vasoconstriction in the infant or child include: A. warm, dry skin. B. weak distal pulses. C. a rapid heart rate. D. brisk capillary refill.

B. weak distal pulses.

An infant is considered to be premature if it: A. is born before 38 weeks' gestation or weighs less than 6 lbs. B. weighs less than 5 lbs or is born before 36 weeks' gestation. C. weighs less than 5.5 lbs or is born before 37 weeks' gestation. D. is born before 40 weeks' gestation or weighs less than 7 lbs.

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

By the end of pregnancy, the pregnant patient heart rate increases up to 20%, or about ____________ beats more per minute. A. 10 B. 15 C. 20 D. 30

C. 20

When assisting ventilations in a newborn with a bag-valve-mask, the rate is ____________ breaths/min. A. 35 to 45 B. 20 to 30 C. 40 to 60 D. 30 to 50

C. 40 to 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: A. 6 B. 7 C. 8 D. 9

C. 8

A fluid-filled, bag like membrane inside the uterus that grow around the developing fetus is known as the: A. Cervix B. Placenta C. Amniotic sac D. Endometrium

C. Amniotic sac

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.

Which of the following statements regarding a pediatric patient's anatomy is correct? A. The tracheal rings of a child are more rigid than an adult's. B. A child's tongue is proportionately smaller than an adult's. C. Children have a larger, rounder occiput compared to adults. D. The child's epiglottis is less floppy and smaller than an adult's.

C. Children have a larger, rounder occiput compared to adults.

Which of the following statements regarding sudden infant death syndrome (SIDS) is correct? A. Certain cases of SIDS are predictable and therefore preventable. B. SIDS is most commonly the result of an overwhelming infection. C. Death as a result of SIDS can occur at any time of the day or night. D. The cause of death following SIDS can be established by autopsy.

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

Which of the following is NOT a common exposure when dealing with pediatric burns? A. Scalding water in a bathtub B. Cleaning solvents C. Electrocution from poor wiring D. Hot items in a stove

C. Electrocution from poor wiring

Which of the following are normal physiologic changes that occur in the mother's respiratory system during pregnancy? A. Increased respiratory reserve and decreased oxygen demand B. Increased respiratory depth and decreased respiratory rate C. Increased respiratory rate and decreased respiratory reserve D. Decreased respiratory rate and increased minute volume

C. Increased respiratory rate and decreased respiratory reserve

Which of the following is NOT performed immediately following delivery of the infant? A. Use a sterile gauze pad to wile the infants mouth, then suction again. B. Be sure the head is covered and keep the neck in a neutral position. C. Obtain an Apgar score. D. Wrap the infant in a towel and place it on one side with head lowered.

C. Obtain an Apgar score.

When questioning the parent of a child who ingested a poisonous substance, which of the following questions would be of LEAST pertinence initially? A. What time did the ingestion occur? B. Have you noticed any signs or symptoms? C. Why did your child ingest the poison? D. Do you know what substance was ingested?

C. Why did your child ingest the poison?

Premature separation of the placenta from the wall of the uterus is known as: A. prolapsed cord. B. placenta previa. C. abruptio placenta. D. eclampsia.

C. abruptio placenta.

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. requesting a paramedic ambulance to insert an advanced airway device. B. separating the child from her mother and providing ventilatory assistance. C. administering blow-by oxygen and transporting the child with her mother. D. allowing the child to remain with her mother and applying a nasal cannula.

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

When a child is struck by a car, the area of greatest injury depends MOSTLY on the: A. speed at which the car was traveling when impact occurred. B. size of the child and the height of the bumper upon impact. C. age of the child and the size of the car that struck him or her. D. height of the child and the speed at which the car was traveling.

C. age of the child and the size of the car that struck him or her.

By the 20th week of pregnancy, the uterus is typically at or above the level of the mother's: A. pubic bone. B. xiphoid process. C. belly button. D. superior diaphragm.

C. belly button.

Pale skin in a child indicates that the: A. child is in severe decompensated shock. B. oxygen content in the blood is decreased. C. blood vessels near the skin are constricted. D. child's core body temperature is elevated.

C. blood vessels near the skin are constricted.

The umbilical cord: A. separates from he placenta shortly after birth. B. carries blood away from the baby via the artery. C. carries oxygen to the baby via the umbilical vein. D. contains two veins and one large umbilical artery.

C. carries oxygen to the baby via the umbilical vein.

Children with N. meningitides would MOST likely present with: A. a low-grade fever and tachycardia. B. hypothermia and an irregular pulse. C. cherry-red spots or a purplish rash. D. a generalized rash with intense itching.

C. cherry-red spots or a purplish rash.

Which of the following findings is LEAST suggestive of child abuse? A. evidence of alcohol consumption or drug use at the scene B. burns to the hands or feet that involve a glove distribution C. consistency in the method of injury reported by the caregiver D. an unexplained delay in seeking medical care after the injury

C. consistency in the method of injury reported by the caregiver

You are attending to a 23-year-old female patient who is 16 weeks pregnant with her second child. The patient has apparently fallen and sustained an injury to her upper right arm. When you ask about the incident history, the patient is reluctant to explain what happened and becomes very quiet. Based on this information, you should: A. ask more detailed questions and press the issue until you have a more detailed understanding of the incident. B. immediately remove the patient from the environment and transport. C. continue your care in a private area, document any details regarding the scene and the incident, and reassure her as you provide care. D. contact police and remain at the scene until they arrive and escort you to the hospital.

C. continue your care in a private area, document any details regarding the scene and the incident, and reassure her as you provide care.

In most children, febrile seizures are characterized by: A. a blank stare, a duration of between 15 and 30 minutes, and a prolonged postictal phase. B. unresponsiveness, complete body relaxation, a fever greater than 105°F, and a short postictal phase. C. generalized tonic-clonic activity, a duration of less than 15 minutes, and a short or absent postictal phase. D. isolated tonic-clonic activity, a duration of greater than 15 minutes, and a short postictal phase.

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

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: A. categorize him as immediate. B. categorize him as deceased. C. palpate for a carotid pulse. D. deliver 5 rescue breaths.

C. palpate for a carotid pulse.

When assessing an infant's ventilation status, you should: A. observe the chest for rise and fall. B. rule out hypoxia if cyanosis is absent. C. palpate the abdomen for rise and fall. D. give oxygen if the SpO2 is less than 90%.

C. palpate the abdomen for rise and fall.

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.

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: A. acute pulmonary edema. B. spontaneous pneumothorax. C. pulmonary embolism. D. intra-uterine bleeding.

C. pulmonary embolism.

Early signs of respiratory distress in the child include: A. cyanosis. B. bradycardia. C. restlessness. D. decreased LOC.

C. restlessness.

Once the infant's head has been delivered: A. suction the infant's nose, and then the mouth. B. apply oxygen over the mother's vagina. C. suction the infant's mouth, then the nose. D. apply a nasal cannula at 3 L/min to the infant.

C. suction the infant's mouth, then the nose.

When you are performing a scene assessment at an incident involving SIDS, you should focus your attention on all of the following, EXCEPT: A. signs of illness, including medication, humidifiers, and thermometers. B. the site where the infant was discovered. C. the temperature of the room. D. the general condition of the house.

C. the temperature of the room.

The MOST common cause of dehydration in pediatric patients is: A. high fever. B. internal blood loss. C. vomiting and diarrhea. D. refusal to drink fluids.

C. vomiting and diarrhea.

A mother who is pregnant with her first baby is typically in the first stage of labor for approximately: A. 4 hours B. 8 hours C. 10 hours D. 16 hours

D. 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. A. 2, 4 B. 6, 12 C. 12, 4 D. 18, 6

D. 18, 6

Which of the following statements regarding a 3-month-old infant is correct? A. The infant is unable to turn his or her head and focus. B. The infant should be aroused easily from a sleeping state. 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.

Which of the following is NOT a component of the Apgar score? A. Activity B. Pulse C. Grimace D. Body size

D. Body size

The leading cause of maternal death in the first trimester is internal hemorrhage into the abdomen following rupture of a _____________. A. Placenta previa B. Spina bifida C. Preeclampsia D. Ectopic pregnancy

D. Ectopic pregnancy

Which of the following is NOT a common cause of altered mental status in pediatric patients? A. Drug and alcohol ingestion B. Hypoglycemia C. Seizure D. Hypertension

D. Hypertension

Which of the following statements regarding spinal injuries in pediatric patients is correct? A. Because of a child's proportionately large head, they are more prone to spinal cord injuries than adults. B. The majority of cervical spine injuries in children are partial transections of the spinal cord, resulting in partial paralysis. C. Most cervical spine fractures in infants and children occur between the first and second cervical vertebrae. D. If the cervical spine is injured, it is most likely to be an injury to the ligaments because of rapid movement of the head.

D. 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 twins is correct? A. Fraternal twins have two cords coming from one placenta. B. Twins are typically larger than single infants. C. Identical twins are typically of different gender. D. Most twins are born within 45 minutes of each other.

D. Most twins are born within 45 minutes of each other.

Tissue that develops on the wall of the uterus and is connected to the fetus is known as the: A. Amniotic sac B. Meconium C. Endometrium D. Placenta

D. Placenta

Which of the following statements regarding preschool-age children is correct? A. They realize that injuries are not a form of punishment. B. Preschoolers are usually not fearful of pain or separation. C. The preschool age begins after the child turns 2 years old. D. They can usually identify painful areas when questioned.

D. They can usually identify painful areas when questioned.

An infant with severe dehydration would be expected to present with: A. excessive tearing. B. moist oral mucosa. C. bulging fontanelles. D. absent urine output.

D. absent urine output.

A normal level of consciousness in an infant or child is characterized by: A. normal interactiveness, awareness to time, and pink skin color. B. awareness to place, pink and dry skin, and consistent eye contact. C. crying or combativeness, good muscle tone, and awareness to time. D. age-appropriate behavior, good muscle tone, and good eye contact.

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

A history of pelvic inflammatory disease or tubal ligations increases a woman's risk for: A. preeclampsia. B. gestational diabetes. C. placenta previa. D. an ectopic pregnancy.

D. 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 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. insert an oral airway, hyperventilate him with a bag-mask device, apply full spinal precautions, and transport to the closest 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. 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.

D. 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 ONLY indications for placing your glove finger in the vagina during delivery are: A. nuchal cord and presentation of an arm and a leg. B. limb presentation and severe vaginal hemorrhage. C. vertex presentation and delivery of the placenta. D. breech presentation and prolapsed umbilical cord.

D. breech presentation and prolapsed umbilical cord.

Hyperthermia differs from fever in that it is an increase in body temperature: A. of more than 2°F to 3°F per hour. B. secondary to a severe bacterial infection. C. caused by inflammation of the spinal cord. D. caused by the inability of the body to cool itself.

D. caused by the inability of the body to cool itself.

When inserting an oropharyngeal airway in an infant or child, you should: A. place padding under the child's head. B. ensure that his or her neck is hyperextended. C. insert it until the flange rests on the teeth. D. depress the tongue with a tongue depressor.

D. depress the tongue with a tongue depressor.

Burns in children are commonly caused by all of the following, EXCEPT: A. hot items on a stovetop. B. scalding water in a bathtub. C. exposure to caustic chemicals. D. entrapment in a structural fire.

D. entrapment in a structural fire.

Immediate transport is indicated for a child when he or she: A. is experiencing mild to moderate pain. B. is breathing rapidly. C. has a possible closed fracture of the radius. D. has a history compatible with a serious illness.

D. has a history compatible with a serious illness.

Causes of infant death that may be mistaken for SIDS include all of the following, EXCEPT: A. child abuse. B. meningitis. C. severe infection. D. hyperglycemia.

D. hyperglycemia.

A nuchal cord is defined as an umbilical cord that: A. has abnormally developed blood vessels. B. is lacerated due to a traumatic delivery. C. has separated from the placenta. D. is wrapped around the baby's neck.

D. is wrapped around the baby's neck

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: A. assess his skin color and give free-flowing oxygen as needed. B. clamp and cut the umbilical cord and keep him warm. C. begin chest compressions and reassess in 30 seconds. D. keep him warm and ventilate with a BVM.

D. keep him warm and ventilate with a BVM.

Febrile seizures in a child: A. typically last less than 30 minutes. B. occur after a week of a febrile illness. C. are usually caused by viral meningitis. D. may indicate a serious underlying illness.

D. may indicate a serious underlying illness.

Which of the following is MORE common in children than in adults following a head injury? A. spinal cord injury B. loss of consciousness C. seizures and hypoxia D. nausea and vomiting

D. nausea and vomiting

The MOST accurate method for determining if you are delivering adequate tidal volume to a child during bag-mask ventilations is to: A. monitor the child's heart rate. B. observe the child's skin color. C. monitor the pulse oximeter reading. D. observe the chest for adequate rise.

D. observe the chest for adequate rise.

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: A. ventilate her with a bag-valve-mask. B. position her supine and elevate her legs 12 inches. C. carefully place sterile glaze into her vagina. D. place her in a left lateral recumbent position.

D. 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: A. elevate her legs to improve brain perfusion and keep her warm. B. administer oral glucose for presumed hypoglycemia and transport. C. insert an oral airway and ventilate her with a bag-valve-mask. D. place her on her side, administer high-flow oxygen, and transport.

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

Before positioning an infant or child's airway, you should: A. put padding behind his or her head. B. thoroughly suction his or her airway. C. rule out an injury to the spinal cord. D. place him or her on a firm surface.

D. place him or her on a firm surface.

Common interventions used to stimulate spontaneous respirations in the newborn include all of the following, EXCEPT: A. thorough drying with a towel. B. some form of tactile stimulation. C. suctioning of the upper airway. D. positive pressure ventilation's.

D. positive pressure ventilation's.

A pregnant trauma patient may lose a significant amount of blood before showing signs of shock because: A. pregnancy causes vasodilation and lower blood pressure. B. blood is shunted to the uterus and fetus during major trauma. C. pregnant patients can dramatically increase their heart rate. D. pregnant patients have an overall increase in blood volume.

D. pregnant patients have an overall increase in blood volume.

While examining a woman in labor, you see the umbilical cord protruding from the vagina. You should: A. cover the umbilical cord with a dry dressing. B. carefully push the cord back into the vagina. C. gently pull on the cord to facilitate delivery. D. push the infant's head away from the cord.

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

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. 3 seconds. C. 4 seconds. D. 5 seconds.

A. 2 seconds.

Determine the Apgar score in the following scenario: You arrive at the scene of a home delivery. Upon entering the scene, the father appears upset and hands you a limp baby. The child has a weak cry, is completely cyanotic, and has a pulse of 70 beats/min. Respirations are slow. (pg. 1205) A. 3 B. 9 C. 2 D. 7

A. 3

If the situation allows, a child should be transported in a car seat if he or she weighs less than _____ lb. A. 40 B. 50 C. 60 D. 70

A. 40

A child may begin to show signs of separation anxiety as early as: A. 6 months. B. 12 months. C. 18 months. D. 24 months.

A. 6 months.

____________ is heralded by the onset of convulsions, or seizures, resulting from severe hypertension in the pregnant woman. A. Eclampsia B. Placenta previa C. Placenta abruptio D. Supine hypotensive syndrome

A. Eclampsia

From what internal female organ is the fetus expelled during delivery? A. Uterus B. Vagina C. Cervix D. Perineum

A. Uterus

A pediatric patient involved in a drowning emergency may present with: A. abdominal distension. B. cerebral edema. C. chest pain. D. hypoglycemia.

A. abdominal distension.

Braxton-Hicks contractions are characterized by: A. alleviation of pain with movement or changing positions. B. regular contractions of progressively increasing intensity. C. a rupture of the amniotic sac just before the contractions begin. D. pink or red bloody show in conjunction with the contractions.

A. alleviation of pain with movement or changing positions.

Pupillary response in pediatric patients may be abnormal in the presence of all of the following, EXCEPT: A. anxiety. B. brain injury. C. hypoxia. D. drugs.

A. anxiety.

The components of the PAT are: A. appearance, work of breathing, and skin circulation. B. mental status, heart rate, and systolic blood pressure. C. skin condition, respiratory rate, and level of alertness. D. activity, respiratory quality, and level of consciousness.

A. appearance, work of breathing, and skin circulation.

Unless he or she is critically ill or injured, you should generally begin your assessment of a toddler: A. at the feet. B. at the head. C. in the ambulance. D. en route to the hospital.

A. at the feet.

The onset of labor begins with: A. contractions of the uterus. B. full dilation of the cervix. C. increased fetal movement. D. thinning of the uterus.

A. contractions of the uterus.

A viral infection that may cause obstruction of the upper airway in a child is called: A. croup. B. asthma. C. bronchitis. D. epiglottitis.

A. croup.

Early signs of respiratory distress in the pediatric patient include all of the following, EXCEPT: A. cyanosis. B. tachypnea. C. retractions. D. abnormal airway noise.

A. cyanosis.

Compared to an adult, the diaphragm dictates the amount of air that a child inspires because the: A. intercostal muscles are not well developed. B. rib cage is rigid and provides little flexibility. C. abdominal organs force the diaphragm upward. D. upper airway is smaller and easily collapsible.

A. intercostal muscles are not well developed.

The first month of life after birth is referred to as the: A. neonatal period. B. toddler period. C. start of infancy. D. premature phase.

A. neonatal period.

When preparing a pregnant patient for delivery, you should position her: A. on a firm surface with her hips elevated 2 to 4 inches. B. in a sitting position with her hips elevated 12 inches. C. on her left side with her right leg elevated. D. in a supine position with her legs spread.

A. on a firm surface with her hips elevated 2 to 4 inches.

Compared to adults, the liver and spleen of pediatric patients are more prone to injury and bleeding because they are: A. proportionately larger and situated more anteriorly. B. more vascular despite the fact that they are proportionately smaller. C. spaced further apart, which causes them to shift following trauma. D. lower in the abdominal cavity, where the muscles are not as strong.

A. proportionately larger and situated more anteriorly.

You and your partner are both male and are attending to a 28-year-old female patient complaining of diffuse abdominal pain. The patient is 34 weeks pregnant with her first child. The patient refuses to allow you to examine her, and her husband informs you that their culture does not allow males to examine or care for pregnant women. You should: A. respect the patient's wishes, ensure that the appropriate documentation is completed, and transport the patient. B. call for the police to ensure that patient assessment is carried out. C. insist that the patient requires proper care and that requires an adequate physical assessment and that you cannot be responsible for the outcome. D. inform the patient that by calling for an ambulance, she is agreeing to the care provided and continue with your assessment and management.

A. respect the patient's wishes, ensure that the appropriate documentation is completed, and transport the patient.

Which of the following inquiries should you make in private when obtaining a SAMPLE history from an adolescent patient? A. sexual activity B. past medical history C. change in bladder habits D. duration of symptoms

A. sexual activity

Bruising to the _________ is LEAST suggestive of child abuse. A. shins B. back C. face D. buttocks

A. shins

When determining the frequency of contractions, you should time the contractions from the: A. start of one to the start of the next. B. end of one to the end of the next. C. start of one to the end of the next. D. end of one to the start of the next.

A. start of one to the start of the next.

A high-pitched inspiratory sound that indicates a partial upper airway obstruction is called: A. stridor. B. rhonchi. C. grunting. D. wheezing.

A. stridor.

Signs and symptoms of meningitis in the infant or child include all of the following, EXCEPT: A. sunken fontanelles. B. headache and fever. C. a stiff or painful neck. D. an altered mental status.

A. sunken fontanelles.

When the mother is experiencing a contraction, you should instruct her to: A. take quick short breaths. B. hold her breath. C. push for 30 seconds. D. rest and breathe deeply.

A. take quick short breaths.

When assessing or treating an adolescent patient, it is important to remember that: A. they usually do not wish to be observed during a procedure. B. it is generally not necessary to explain procedures in advance. C. they often request medication to help in the relief of severe pain. D. they cannot understand complex concepts and treatment options.

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

________________ is a developmental defect in which a portion of the spinal cord protrudes outside the vertebrae. (pg. 1208)

Spina bifida

Inserting a(n) __________________ in a responsive patient may cause a spasm of the larynx and result in vomiting. (pg. 1245)

oropharyngeal airway

Children not only have a higher metabolic rate, but also a higher ________________, which is twice that of an adult. (pg. 1224)

oxygen demand

The ________ is a structured assessment tool that allows you to rapidly form a general impression of the pediatric patient's condition without touching him or her. (pg. 1227)

pediatric assessment triangle