ch 33-34
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. 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. place the child in a supine position and perform abdominal thrusts. D. deliver a series of five back blows and then reassess his condition.
B
A common cause of shock in an infant is: Select one: A. a cardiac dysrhythmia. B. dehydration from vomiting and diarrhea. C. cardiovascular disease. D. excessive tachycardia.
B
An infant is considered to be premature if it: Select one: A. is born before 38 weeks' gestation or weighs less than 6 lb. B. weighs less than 5 lb or is born before 36 weeks' gestation. C. weighs less than 5.5 lb or is born before 37 weeks' gestation. D. is born before 40 weeks' gestation or weighs less than 7 lb.
B
Blood pressure is usually not assessed in children younger than _____ years. Select one: A. 5 B. 3 C. 4 D. 6
B
Braxton-Hicks contractions are characterized by: Select one: A. a rupture of the amniotic sac just before the contractions begin. B. alleviation of pain with movement or changing positions. C. regular contractions of progressively increasing intensity. D. pink or red bloody show in conjunction with the contractions.
B
Children with N. meningitides would MOST likely present with: Select one: A. hypothermia and an irregular pulse. B. cherry-red spots or a purplish rash. C. a low-grade fever and tachycardia. D. a generalized rash with intense itching.
B
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: Select one: A. contact law enforcement personnel and advise them that they are suspicious for child abuse. B. inform that mother that, although the event seems to have resolved, transport via EMS is advisable. C. allow the mother to take her child to the doctor, but inform her that the risk for SIDS is high. D. advise the mother that the danger has past and that she can take the child to the pediatrician.
B
Early signs of respiratory distress in the child include: Select one: A. decreased LOC. B. cyanosis. C. restlessness. D. bradycardia.
B
Early signs of respiratory distress in the pediatric patient include all of the following, EXCEPT: Select one: A. retractions. B. cyanosis. C. abnormal airway noise. D. tachypnea.
B
Effective methods for providing pain relief to a child with an extremity injury include: Select one: A. separating the child from his or her parents. B. positioning, ice packs, and extremity elevation. C. avoiding the placement of a splint, if possible. D. heat compresses and lowering the injured extremity.
B
Hyperthermia differs from fever in that it is an increase in body temperature: Select one: A. of more than 2°F to 3°F per hour. B. caused by the inability of the body to cool itself. C. secondary to a severe bacterial infection. D. caused by inflammation of the spinal cord.
B
Signs of an upper airway obstruction in an infant or child include all of the following, EXCEPT: Select one: A. stridorous breathing. B. wheezing. C. a weak cough. D. a cough that resembles the bark of a seal.
B
Signs of vasoconstriction in the infant or child include: Select one: A. brisk capillary refill. B. weak distal pulses. C. a rapid heart rate. D. warm, dry skin.
B
Spina bifida is a developmental defect in which: Select one: A. an excessive amount of cerebrospinal fluid damages the spinal cord. B. a portion of the spinal cord or meninges protrudes outside of the vertebrae. C. the spinal column is severely deformed, resulting in permanent paralysis. D. nerve fibers that arise from the spinal cord do not function
B
Which of the following groups of people is associated with the lowest risk of meningitis? Select one: A. Children with shunts B. Females C. Newborns D. Children with HIV/AIDS
B
Which of the following occurs during true labor? Select one: A. Uterine contractions decrease in intensity. B. Uterine contractions become more regular. C. The uterus becomes very soft and movable. D. Uterine contractions last about 10 seconds.
B
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? Select one: A. Tachycardia B. Vomiting C. Lethargy D. Restlessness
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. begin immediate rescue breathing. B. stabilize his head and check for a pulse. C. open his airway and look in his mouth. D. perform a head tilt-chin lift maneuver
B
A high-pitched inspiratory sound that indicates a partial upper airway obstruction is called: Select one: A. grunting. B. rhonchi. C. stridor. D. wheezing.
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
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. breastfeeding causes uterine blood vessels to dilate. B. a portion of the placenta was retained in the uterus. C. these actions simulate the production of oxytocin and cause uterine contraction. D. uterine massage increases blood flow to the uterus.
C
In contrast to adults, deterioration to cardiac arrest in infants and children is usually associated with: Select one: A. irritability of the left ventricle. B. acute hypoxia and tachycardia. C. severe hypoxia and bradycardia. D. a sudden ventricular arrhythmia.
C
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. complaining of severe back pain. C. older than 8 to 10 years of age. D. immobilized on a long backboard
C
Signs of severe dehydration in an infant include all of the following, EXCEPT: Select one: A. dry mucous membranes. B. profound tachycardia. C. bulging fontanelles. D. delayed capillary refill.
C
Supine hypotensive syndrome occurs when: Select one: A. blood pressure decreases as a result of hypovolemia. B. a supine position kinks the ascending aorta. C. the pregnant uterus compresses the inferior vena cava. D. the superior vena cava is compressed by the uterus.
C
The MOST common cause of dehydration in pediatric patients is: Select one: A. high fever. B. refusal to drink fluids. C. vomiting and diarrhea. D. internal blood loss
C
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. limb presentation and severe vaginal hemorrhage. C. breech presentation and prolapsed umbilical cord. D. vertex presentation and delivery of the placenta
C
The onset of labor begins with: Select one: A. full dilation of the cervix. B. increased fetal movement. C. contractions of the uterus. D. thinning of the uterus.
C
The umbilical cord: Select one: A. separates from the 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
Use of a nonrebreathing mask or nasal cannula in a child is appropriate ONLY if: Select one: A. he or she is breathing inadequately. B. his or her respirations are shallow. C. his or her tidal volume is adequate. D. an oral airway has been inserted.
C
When inserting an oropharyngeal airway in an infant or child, you should: Select one: A. place padding under the child's head. B. ensure that his or her neck is hyperextended. C. depress the tongue with a tongue depressor. D. insert it until the flange rests on the teeth.
C
Which of the following an appropriate dose of activated charcoal for a 20-kg child? Select one: A. 25 g B. 50 g C. 20 g D. 12.5 g
C
Which of the following is NOT a known risk factor of SIDS? Select one: A. Low birth weight B. Mother smoked during pregnancy C. Putting a baby to sleep on his or her back D. Mother younger than 20 years
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
C
While examining a woman in labor, you see the umbilical cord protruding from the vagina. You should: Select one: A. cover the umbilical cord with a dry dressing. B. gently pull on the cord to facilitate delivery. C. push the infant's head away from the cord. D. carefully push the cord back into the vagina.
C
With regard to the legal implications of child abuse: Select one: A. you should document your perceptions on the run form. B. a supervisor can forbid you from reporting possible abuse. C. EMTs must report all suspected cases of child abuse. D. child abuse must be reported only if it can be proven.
C
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: Select one: A. 7 B. 9 C. 8 D. 6
C
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. assess his skin color and give free-flow oxygen as needed. B. keep him warm and ventilate with a BVM. C. clamp and cut the umbilical cord and keep him warm. D. begin chest compressions and reassess in 30 seconds.
C
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. give oxygen and transport at once. B. perform a blind finger sweep. C. visualize the child's airway. D. perform abdominal thrusts
D
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. ventilate her with a bag-valve mask. B. carefully place sterile gauze into her vagina. C. position her supine and elevate her legs 12 inches. D. place her in a left lateral recumbent position.
D
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: Select one: A. severe dehydration. B. hypovolemic shock. C. mild dehydration. D. moderate dehydration
D
A normal level of consciousness in an infant or child is characterized by: Select one: A. awareness to place, pink and dry skin, and consistent eye contact. B. normal interactiveness, awareness to time, and pink skin color. C. crying or combativeness, good muscle tone, and awareness to time. D. age-appropriate behavior, good muscle tone, and good eye contact.
D
Abruptio placenta occurs when: Select one: A. the placenta develops over and covers the cervical opening. B. a tear in the placenta causes severe internal hemorrhage. C. the placenta affixes itself to the outer layer of the uterus. D. the placenta prematurely separates from the uterine wall.
D
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. wheezing. C. assuming a tripod position. D. grunting.
D
Capillary refill time is MOST reliable as an indicator of end-organ perfusion in children younger than: Select one: A. 10 years. B. 8 years. C. 4 years. D. 6 years.
D
Causes of infant death that may be mistaken for SIDS include all of the following, EXCEPT: Select one: A. severe infection. B. meningitis. C. child abuse. D. hyperglycemia.
D
Death caused by shaken baby syndrome is usually the result of: Select one: A. multiple open fractures. B. intra-abdominal hemorrhage. C. fracture of the cervical spine. D. bleeding in the brain.
D
Drawing in of the muscles between the ribs or of the sternum during inspiration is called: Select one: A. accessory muscle use. B. hyperpnea. C. tenting. D. retracting.
D
During the attempted resuscitation of an infant with suspected SIDS: Select one: A. a law enforcement officer must be present. B. give detailed updates to the infant's parents. C. discourage the family from observing. D. allow the family to observe if they wish
D
Febrile seizures in a child: Select one: A. are usually caused by viral meningitis. B. typically last less than 30 minutes. C. occur after a week of a febrile illness. D. may indicate a serious underlying illness.
D
Fetal complications associated with drug- or alcohol-addicted mothers include all of the following, EXCEPT: Select one: A. respiratory depression. B. low birth weight. C. premature delivery. D. profound tachycardia
D
Following delivery of a pulseless and apneic infant who has a foul odor, skin sloughing, and diffuse blistering, you should: Select one: A. dry the infant off to stimulate breathing. B. report the case to the medical examiner. C. begin full resuscitation and transport. D. provide emotional support to the mother.
D
Greenstick fractures occur in infants and children because: Select one: A. the growth plate is commonly injured. B. twisting injuries are more common in children. C. their bones are more brittle than an adult's. D. their bones bend more easily than an adult's
D
If a newborn's heart rate is less than 60 beats/min following delivery, you should: Select one: A. flick the soles of his or her feet. B. begin chest compressions. C. resuction the mouth only. D. provide ventilations for 30 seconds
D
In most children, febrile seizures are characterized by: Select one: A. unresponsiveness, complete body relaxation, a fever greater than 105°F, and a short postictal phase. B. generalized tonic-clonic activity, a duration of less than 15 minutes, and a short or absent postictal phase. C. isolated tonic-clonic activity, a duration of greater than 15 minutes, and a short postictal phase. D. a blank stare, a duration of between 15 and 30 minutes, and a prolonged postictal phase.
D
The EMT should be MOST concerned when a child presents with fever and: Select one: A. ear pain. B. chills. C. a headache. D. a rash.
D
The normal respiratory rate for a newborn should not exceed ______ breaths/min. Select one: A. 50 B. 70 C. 80 D. 60
D
The vagina and the neck of the uterus comprise the: Select one: A. womb. B. fundus. C. cervix. D. birth canal.
D
When administering oxygen to a frightened child, it would be MOST appropriate to: Select one: A. tightly secure the oxygen mask straps to the face. B. have a parent restrain the child as you give oxygen. C. use a nasal cannula instead of a nonrebreathing mask. D. place oxygen tubing through a hole in a paper cup.
D
When immobilizing an injured child in a pediatric immobilization device, you should: Select one: A. secure the head before the torso. B. pad underneath the child's head. C. slide the device under the child. D. secure the torso before the head.
D
When ventilating a pediatric patient with a bag-valve mask, the EMT should: Select one: A. use a neonatal device for children younger than 12 months. B. ventilate the child with sharp, quick breaths at the appropriate rate. C. squeeze the bag 40 times/min when ventilating an infant. D. block the pop-off valve if needed to achieve adequate chest
D
Which of the following are normal physiologic changes that occur in the mother's respiratory system during pregnancy? Select one: A. Increased respiratory depth and decreased respiratory rate B. Increased respiratory reserve and decreased oxygen demand C. Decreased respiratory rate and increased minute volume D. Increased respiratory rate and decreased respiratory reserve
D
Which of the following inquiries should you make in private when obtaining a SAMPLE history from an adolescent patient? Select one: A. Duration of symptoms B. Change in bladder habits C. Past medical history D. Sexual activity
D
Which of the following statements regarding the placenta is correct? Select one: A. 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. B. The placenta provides oxygen and nutrients to the fetus and is expelled from the vagina about 30 minutes before the baby is born. 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
Which of the following statements regarding the use of nasopharyngeal airways in children is correct? Select one: A. Blanching of the nares after insertion indicates correct placement. B. They are usually not well tolerated in children with a gag reflex. C. It is the recommended adjunct for children with head trauma. D. They are rarely used in infants younger than 1 year.
D
Most medical models base a pregnant woman's due date: Select one: A. on the first day of her last menstrual cycle. B. two weeks after her last menstrual cycle. C. two weeks before her last menstrual cycle. D. on the last day of her last menstrual cycle.
A
Signs and symptoms of preeclampsia include: Select one: A. headache and edema. B. dyspnea and bradycardia. C. marked hypoglycemia. D. dysuria and constipation.
A
The 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. observe the chest for adequate rise. B. observe the child's skin color. C. monitor the pulse oximeter reading. D. monitor the child's heart rate.
A
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. 18, 6 B. 2, 4 C. 6, 12 D. 12, 4
A
Upon delivery of an infant's head, you note that the umbilical cord is wrapped around its neck. You should: Select one: A. attempt to slip the cord gently over the infant's head. B. immediately clamp and cut the umbilical cord. C. give high-flow oxygen to the mother and transport. D. provide free-flow oxygen to the infant and transport.
A
When a child experiences a blunt chest injury: Select one: A. the flexible ribs can be compressed without breaking. B. the sudden force against the ribs causes them to fracture. C. there is usually obvious injury to the external chest wall. D. the flexible rib cage protects the vital thoracic organs.
A
When assessing an infant's ventilation status, you should: Select one: A. palpate the abdomen for rise and fall. B. observe the chest for rise and fall. C. give oxygen if the SpO2 is less than 90%. D. rule out hypoxia if cyanosis is absent.
A
Which of the following assessment findings should concern the EMT the MOST when assessing a child who experienced a seizure? Select one: A. Neck stiffness B. Tachycardia C. High fever D. Short postictal phase
A
Which of the following children would benefit the LEAST from a nonrebreathing mask? Select one: A. An unresponsive 5-year-old male with shallow respirations B. A responsive 6-year-old male who responds appropriately C. A conscious 4-year-old male with adequate tidal volume D. A semiconscious 7-year-old female with normal ventilation
A
Which of the following is NOT a component of the Apgar score? Select one: A. Body size B. Grimace C. Pulse D. Activity
A
Which of the following is NOT generally considered an obstetrical emergency? Select one: A. Return of contractions following delivery of the baby B. Failure of the placenta to deliver after 30 minutes C. More than 500 mL of blood loss before placental delivery D. Significant bleeding after delivery of the placenta
A
Which of the following represents a low normal systolic blood pressure for a 6-year-old child? Select one: A. 82 mm Hg B. 90 mm Hg C. 98 mm Hg D. 88 mm Hg
A
Which of the following statements regarding gestational diabetes is correct? Select one: A. In some cases, women with gestational diabetes require insulin injections. B. The onset of gestational diabetes typically manifests with hypoglycemia. C. Gestational diabetes results in permanent diabetes mellitus after delivery. D. Diet and exercise are typically ineffective in controlling gestational diabetes.
A
A child may begin to show signs of separation anxiety as early as: Select one: A. 12 months. B. 18 months. C. 6 months. D. 2 months.
A
A precipitous labor and delivery is MOST common in women who: Select one: A. have delivered a baby before. B. are younger than 30 years of age. C. have gestational diabetes. D. are pregnant for the first time.
A
After determining that an infant or child has strong central pulses, you should: Select one: A. not rule out compensated shock. B. conclude that the child is stable. C. assess his or her respiratory effort. D. assume the child is hypertensive
A
All of the following are normal findings in an infant or child, EXCEPT: Select one: A. head bobbing. B. quiet breathing. C. belly breathing. D. fear or anxiety.
A
Before positioning an infant or child's airway, you should: Select one: A. place him or her on a firm surface. B. rule out an injury to the spinal cord. C. put padding behind his or her head. D. thoroughly suction his or her airway.
A
Bruising to the _________ is LEAST suggestive of child abuse. Select one: A. shins B. back C. buttocks D. face
A
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. begin high-quality CPR and request an ALS ambulance. D. request the medical examiner to perform an autopsy.
A