EMT Exam 10

Capillary refill time is MOST reliable as an indicator of end-organ perfusion in children younger than: Select one: a.8 years. b.6 years. c.10 years. d.4 years.

6

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: Select one: a.inform the child's mother that her son is deceased. b.begin high-quality CPR and transport immediately. c.request the medical examiner to perform an autopsy. d.begin high-quality CPR and request an ALS ambulance.

a

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: Select one: a.place her in a left lateral recumbent position. b.carefully place sterile gauze into her vagina. c.position her supine and elevate her legs 12 inches. d.ventilate her with a bag-valve mask.

a

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? Select one: a.History of deep venous thrombosis b.Frequent urinary tract infections c.The patient is prescribed an inhaler. d.The patient's abdomen is swollen.

a

A high-pitched inspiratory sound that indicates a partial upper airway obstruction is called: Select one: a.stridor. b.rhonchi. c.grunting. d.wheezing.

a

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

a

After the fetus has descended into the pelvis at the end of the third trimester, many mothers experience Select one: a.easier breathing. b.a bloated feeling. c.an urge to push. d.mid-back pain.

a

Cerebral palsy is a condition that results from damage or injury to the: Select one: a.brain. b.voluntary muscles. c.peripheral nervous system. d.spinal cord.

a

In contrast to adults, deterioration to cardiac arrest in infants and children is usually associated with: Select one: a.severe hypoxia and bradycardia. b.acute hypoxia and tachycardia. c.irritability of the left ventricle. d.a sudden ventricular arrhythmia.

a

Patients who have experienced even minor-appearing head injuries should be suspected of having a brain injury, especially if they: Select one: a.are taking blood-thinning medications. b.have a history of Alzheimer disease. c.have minor abrasions to the head area. d.do not have deformities to the skull.

a

Patients with autism: Select one: a.have extreme difficulty with complex tasks that require many steps. b.often speak with speech patterns that alternate in tone and speed. c.use and understand nonverbal means of communicating messages. d.prefer to maintain eye contact with whomever is talking with them.

a

Signs and symptoms of preeclampsia include: Select one: a.headache and edema. b.dysuria and constipation. c.marked hypoglycemia. d.dyspnea and bradycardia.

a

Signs of an upper airway obstruction in an infant or child include all of the following, EXCEPT: Select one: a.wheezing. b.a weak cough. c.a cough that resembles the bark of a seal. d.stridorous breathing.

a

Signs of severe dehydration in an infant include all of the following, EXCEPT: Select one: a.bulging fontanelles. b.dry mucous membranes. c.delayed capillary refill. d.profound tachycardia.

a

Signs of vasoconstriction in the infant or child include: Select one: a.weak distal pulses. b.brisk capillary refill. c.warm, dry skin. d.a rapid heart rate.

a

Spina bifida is a developmental defect in which: Select one: a.a portion of the spinal cord or meninges protrudes outside of the vertebrae. b.an excessive amount of cerebrospinal fluid damages the spinal cord. c.the spinal column is severely deformed, resulting in permanent paralysis. d.nerve fibers that arise from the spinal cord do not function properly.

a

Supine hypotensive syndrome occurs when: Select one: a.the pregnant utems compresses the inferior vena cava. b.blood pressure decreases as a result of hypovolemia. c.the superior vena cava is compressed by the uterus. d.a supine position kinks the ascending aorta.

a

When transporting a stable older patient to the hospital, the MOST effective way to reduce his or her anxiety is to: Select one: a.transport him or her to a hospital that he or she is familiar with. b.perform frequent detailed assessments to gain the patient's trust. c.avoid the use of a long backboard, even if trauma is suspected. d.allow at least two family members to accompany the patient.

a

Which of the following statements regarding twins is correct? Select one: a.Most twins are born within 45 minutes of each other. b.Twins are typically larger than single infants. c.Identical twins are typically of different gender. d.Fraternal twins have two cords coming from one placenta.

a

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: Select one: a.keep him warm and ventilate with a BVM. b.assess his skin color and give free-flow oxygen as needed. c.clamp and cut the umbilical cord and keep him warm. d.begin chest compressions and reassess in 30 seconds.

a

common cause of shock in an infant is: Select one: a.dehydration from vomiting and diarrhea. b.a cardiac dysrhythmia. c.excessive tachycardia. d.cardiovascular disease.

a

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. Considering the fact that this patient is probably in shock, what is the MOST likely explanation for the absence of tachycardia? Select one: a.Intrathoracic bleeding and cardiac compression b.The effects of her antihypertensive medication c.Deterioration of the cardiac conduction system d.Failure of the parasympathetic nervous system

b

Abruptio placenta occurs when: Select one: a.the placenta develops over and covers the cervical opening. b.the placenta prematurely separates from the uterine wall. c.a tear in the placenta causes severe internal hemorrhage. d.the placenta affixes itself to the outer layer of the uterus.

b

All of the following are normal findings in an infant or child, EXCEPT: Select one: a.quiet breathing. b.head bobbing. c.fear or anxiety. d.belly breathing.

b

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

b

Because hearing-impaired patients typically have more difficulty hearing high-frequency sounds, it is important for you to: Select one: a.try basic sign language first. b.lower the pitch of your voice. c.increase the pitch of your voice. d.speak in a monotone voice.

b

Blood pressure is usually not assessed in children younger than years. Select one: a.6 b.3 c.4 d.5

b

Death caused by shaken baby syndrome is usually the result of: Select one: a.multiple open fractures. b.bleeding in the brain. c.fracture of the cervical spine. d.intra-abdominal hemorrhage.

b

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: Select one: a.hydrocephalus. b.a cervical spine injury. c.an intracranial hemorrhage. d.a seizure.

b

Placenta previa is defined as: Select one: a.premature placental separation from the uterine wall. b.development of the placenta over the cervical opening. c.abnormal development and functioning of the placenta. d.delivery of a portion of the placenta before the baby.

b

The normal respiratory rate for a newborn should not exceed _______________ breaths/min. Select one: a.80 b.60 c.50 d.70

b

The onset of labor begins with: Select one: a.thinning of the uterus. b.contractions of the uterus. c.full dilation of the cervix. d.increased fetal movement.

b

The slow onset of progressive disorientation, shortened attention span, and loss of cognitive function is known as: Select one: a.paranoia. b.dementia. c.delusion. d.delirium.

b

Use of a nonrebreathing mask or nasal cannula in a child is appropriate ONLY if: Select one: a.an oral airway has been inserted. b.his or her tidal volume is adequate. c.he or she is breathing inadequately. d.his or her respirations are shallow.

b

When enlisting the help of an interpreter who signs, it is important for you to ask the interpreter to: Select one: a.document the answers to the questions that the patient has responded to. b.report exactly what the patient signs and not to add any commentary. c.voice what he or she is signing while communicating with the patient. d.avoid any kind of lip movement while he or she is signing with the patient.

b

Which of the following are normal physiologic changes that occur in the mother's respiratory system during pregnancy? Select one: a.Increased respiratory reserve and decreased oxygen demand b.Increased respiratory rate and decreased respiratory reserve c.Decreased respiratory rate and increased minute volume d.Increased respiratory depth and decreased respiratory rate

b

Which of the following groups of people is associated with the lowest risk of meningitis? Select one: a.Children with HIV/AIDS b.Females c.Newborns d.Children with shunts

b

Which of the following is NOT a component of the Apgar score? Select one: a.Pulse b.Body size c.Grimace d.Activity

b

Which of the following is the MOST common mechanism of injury in older patients? Select one: a.Abuse b.Falls c.Suicide d.Burns

b

Which of the following represents a low normal systolic blood pressure for a 6-year-old child? Select one: a.88 mm Hg b.82 mm Hg c.90 mm Hg d.98 mm Hg

b

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: Select one: a.perform a head tilt-chin lift maneuver. b.stabilize his head and check for a pulse. c.open his airway and look in his mouth. d.begin immediate rescue breathing.

b

A 2-year-old child who has no recent history of illness suddenly appears cyanotic and cannot speak after playing with a small toy. You should: Select one: a.perform a blind finger sweep. b.give oxygen and transport at once. c.perform abdominal thrusts. d.visualize the child's airway.

c

A tube from the brain to the abdomen that drains excessive cerebrospinal fluid is called a: Select one: a.cerebral bypass. b.G-tube. c.shunt. d.CS tube.

c

After squeezing the end of a child's finger or toe for a few seconds, blood should return to the area within: Select one: a.5 seconds. b.3 seconds. c.2 seconds. d.4 seconds.

c

Airway management can be challenging in patients with Down syndrome because their: Select one: a.mandible is large, which inhibits a mask-to-face seal. b.occiput is round, which causes flexion of the neck. c.teeth are misaligned and they have a large tongue. d.tongue is relatively small and falls back in the throat.

c

An elderly patient may understate or minimize the symptoms of his or her illness because: Select one: a.of decreased perception of pain. b.the nervous system has deteriorated. c.he or she fears hospitalization. d.of conditions such as dementia.

c

An infant or child with respiratory distress will attempt to keep his or her alveoli expanded at the end of inhalation by: Select one: a.retracting the intercostal muscles. b.assuming a tripod position. c.grunting. d.wheezing.

c

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 a(n): Select one: a.comminuted fracture. b.compression fracture. c.pathologic fracture. d.idiopathic fracture.

c

Before positioning an infant or child's airway, you should: Select one: a.thoroughly suction his or her airway. b.rule out an injury to the spinal cord. c.place him or her on a firm surface. d.put padding behind his or her head.

c

Bruising to the _______________ is LEAST suggestive of child abuse. Select one: a.back b.face c.shins d.buttocks

c

Drawing in of the muscles between the ribs or of the sternum during inspiration is called: Select one: a.tenting. b.hyperpnea. c.retracting. d.accessory muscle use.

c

During the attempted resuscitation of an infant with suspected SIDS: Select one: a.a law enforcement officer must be present. b.discourage the family from observing. c.allow the family to observe if they wish. d.give detailed updates to the infant's parents.

c

Early signs of respiratory distress in the pediatric patient include all of the following, EXCEPT: Select one: a.abnormal airway noise. b.tachypnea. c.cyanosis. d.retractions.

c

If a newborn's heart rate is less than 60 beats/min following delivery, you should: Select one: a.begin chest compressions. b.flick the soles of his or her feet. c.provide ventilations for 30 seconds. d.resuscitation the mouth only.

c

The umbilical cord: Select one: a.contains two veins and one large umbilical artery. b.carries blood away from the baby via the artery. c.carries oxygen to the baby via the umbilical vein. d.separates from the placenta shortly after birth.

c

When administering oxygen to a frightened child, it would be MOST appropriate to: Select one: a.use a nasal cannula instead of a nonrebreathing mask. b.have a parent restrain the child as you give oxygen. c.place oxygen tubing through a hole in a paper cup. d.tightly secure the oxygen mask straps to the face.

c

When assessing the heart rate of a 6-month-old infant, you should palpate the brachial or _______________ pulse. Select one: a.popliteal b.radial c.femoral d.carotid

c

Which of the following does NOT usually contribute to or cause obesity? Select one: a.Low metabolic rate b.High caloric intake c.Rapid metabolism d.Genetic predisposition

c

Which of the following is MORE common in children than in adults following a head injury? Select one: a.Seizures and hypoxia b.Spinal cord injury c.Nausea and vomiting d.Loss of consciousness

c

Which of the following is NOT a known risk factor of SIDS? Select one: a.Mother younger than 20 years b.Mother smoked during pregnancy c.Putting a baby to sleep on his or her back d.Low birth weight

c

Which of the following patients is at highest risk for a pulmonary embolism? Select one: a.66-year-old active female with a history of hypertension b.78-year-old female who takes blood-thinning medications c.71-year-old male with recent surgery to a lower extremity d.59-year-old male who is recovering from pneumonia

c

Which of the following statements regarding gestational diabetes is correct? Select one: a.Gestational diabetes results in permanent diabetes mellitus after delivery. b.Diet and exercise are typically ineffective in controlling gestational diabetes. c.In some cases, women with gestational diabetes require insulin injections. d.The onset of gestational diabetes typically manifests with hypoglycemia.

c

Which of the following statements regarding suctioning of a newborn's mouth and oropharynx is correct? Select one: a.If the head delivers facedown, the mouth and nose should be suctioned at once. b.Suctioning should be performed on all newborns immediately following delivery. c.Suctioning is indicated prior to cutting the cord if respiratory distress is present. d.Newborns rapidly expel fluid from their lungs and do not require suctioning.

c

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

c

You have just delivered a baby boy. His body is pink, but his hands and feet are blue. His heart rate 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: Select one: a.9 b.6 c.8 d.7

c

he MOST accurate method for determining if you are delivering adequate tidal volume to a child during bag-valve mask ventilations is to: Select one: a.monitor the child's heart rate. b.observe the child's skin color. c.observe the chest for adequate rise. d.monitor the pulse oximeter reading.

c

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

d

An infant is considered to be premature if it: Select one: a.weighs less than 5.5 lbs or is born before 37 weeks' gestation, b.is born before 40 weeks' gestation or weighs less than 7 lb. c.is born before 38 weeks' gestation or weighs less than 6 lb. d.weighs less than 5 lbs or is born before 36 weeks' gestation.

d

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

d

Early signs of respiratory distress in the child include: Select one: a.decreased LOC. b.cyanosis. c.bradycardia. d.restlessness.

d

Following 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: Select one: a.uterine massage increases blood flow to the uterus. b.breastfeeding causes uterine blood vessels to dilate. c.a portion of the placenta was retained in the uterus. d.these actions simulate the production of oxytocin and cause uterine contraction.

d

General care for a patient with a tracheostomy tube includes all of the following, EXCEPT: Select one: a.maintaining the patient in a position of comfort when possible. b.ensuring adequate oxygenation and ventilation at all times. c.suctioning the tube as needed to clear a thick mucous plug. d.removing the tube if the area around it appears to be infected.

d

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

d

Padding underneath the torso when immobilizing an injured child is generally not necessary if he or she is: Select one: a.experiencing cardiopulmonary arrest. b.immobilized on a long backboard. c.complaining of severe back pain. d.older than 8 to 10 years of age.

d

The ONLY indications for placing your gloved fingers in the vagina during delivery are: Select one: a.nuchal cord and presentation of an arm or leg. b.vertex presentation and delivery of the placenta. c.limb presentation and severe vaginal hemorrhage. d.breech presentation and prolapsed umbilical cord.

d

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. Select one: a.6, 12 b.2,4 c.12,4 d.18,6

d

Upon delivery of an infant's head, you note that the umbilical cord is wrapped around its neck. You should: Select one: a.immediately clamp and cut the umbilical cord. b.give high-flow oxygen to the mother and transport. c.provide free-flow oxygen to the infant and transport. d.attempt to slip the cord gently over the infant's head.

d

When assessing a geriatric patient who has possibly experienced an acute ischemic stroke, it is MOST important to: Select one: a.determine if the patient has risk factors for a stroke. b.ascertain if there is a history of atrial fibrillation. c.administer 324 mg of aspirin as soon as possible. d.determine the onset of the patient's symptoms.

d

When assessing or providing care to a patient with an intellectual disability, you should: Select one: a.frequently reassure him or her that everything will be okay. b.explain procedures while in the process of performing them. c.move swiftly and deliberately to quickly accomplish the task. d.be observant for signs of fear or reluctance from the patient.

d

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

d

Which of the following is NOT generally considered an obstetrical emergency? Select one: a.More than 500 mL of blood loss before placental delivery b.Significant bleeding after delivery of the placenta c.Failure of the placenta to deliver after 30 minutes d.Return of contractions following delivery of the baby

d

Which of the following occurs during true labor? Select one: a.Uterine contractions decrease in intensity. b.The uterus becomes very soft and movable. c.Uterine contractions last about 10 seconds. d.Uterine contractions become more regular.

d

Which of the following statements regarding pediatric trauma is correct? Select one: a.Children are less likely than adults to be struck by a car. b.Inexperience and poor judgment are rare causes of pediatric trauma. c.A child's head is less frequently injured than an adult's. d.Children are more likely to experience diving-related injuries.

d

Which of the following statements regarding the placenta is correct? Select one: a.The placenta provides oxygen and nutrients to the fetus and is expelled from the vagina about 30 minutes before the baby is bom. b.The placenta allows for the transfer of oxygen and carbon dioxide between the mother and fetus but prevents most medications from passing between the mother and fetus. c.The placental barrier consists of two layers of cells and allows the mother's blood that contains high concentrations of oxygen to directly mix with the blood of the fetus. d.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.

d

hen immobilizing an injured child in a pediatric immobilization device, you should: Select one: a.secure the head before the torso. b.slide the device under the child. c.pad underneath the child's head. d.secure the torso before the head.

d