Chapter 30, 32, 33, 34

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.

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

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.

Correct Response C) blood vessels near the skin are constricted.

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

Correct Response A) Sexual activity

Which of the following statements regarding the use of nasopharyngeal airways in children is correct? A) They are rarely used in infants younger than 1 year. B) It is the recommended adjunct for children with head trauma. C) They are usually not well tolerated in children with a gag reflex. D) Blanching of the nares after insertion indicates correct placement.

Correct Response A) They are rarely used in infants younger than 1 year.

An infant or child with respiratory distress will attempt to keep his or her alveoli expanded at the end of inhalation by: A) grunting. B) wheezing. C) assuming a tripod position. D) retracting the intercostal muscles.

Correct Response A) grunting.

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.

Correct Response 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.

Correct Response A) neonatal period.

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

Correct Response A) shins

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) altered mental status.

Correct Response A) sunken fontanelles.

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

Correct Response A) their chest walls are thinner.

The normal respiratory rate for a newborn should not exceed ______ breaths/min. A) 50 B) 60 C) 70 D) 80

Correct Response B) 60

With regard to the legal implications of child abuse: A) child abuse must be reported only if it can be proven. B) EMTs must report all suspected cases of child abuse. C) you should document your perceptions on the run form. D) a supervisor can forbid you from reporting possible abuse.

Correct Response B) EMTs must report all suspected cases of child abuse

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

Correct Response B) Electrocution from poor wiring

Which of the following groups of people is associated with the lowest risk of meningitis? A) Newborns B) Females C) Children with shunts D) Children with HIV/AIDS

Correct Response B) Females

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

Correct Response B) Hypertension

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

Correct Response B) a rash.

During the attempted resuscitation of an infant with suspected SIDS: A) discourage the family from observing. B) allow the family to observe if they wish. C) a law enforcement officer must be present. D) give detailed updates to the infant's parents.

Correct Response B) allow the family to observe if they wish.

General communication techniques with the elderly include...

Frequently asking the patient if they understand

A productive cough, fever and chills in an 80 yr old patient with a compromised immune system should make you suspiscious for

Pneumonia

Toilet training is typically mastered at what age level?

Preschool age

When caring for an elderly patient who is hearing- impaired, you should...

Recall that elderly patients have difficulty hearing high-frequency sounds

When an elderly patient presents with multiple OTC medications that the are taking, it is important to...

Recall that the patient is at risk for negative medication interactions

Which of the following is NOT a common cause of shock in pediatric patients

Renal failure

Blood levels of medicatiosn may rise in elderly, sometimes toxic, this is most likely due to...

Renal insufficiency

Which of the following is NOT appropriate when treating pediatric patients with seizures?

Restrain the patient

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

The baroreceptors have become less sensitive to blood pressure

Which of the following MOST accurately describes hyperthermia?

The body is exposed to more heat than it can lose

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

Use plain language and simple terms

Osteoporosis is most accurately defined as...

a decrease in bone mass and density

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

a rash

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

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

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

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

alcohol

Blood loss in a child exceeding _____ of his or her total blood volume significantly increases the risk of shock. a.) 5% b.) 15% c.) 25% d.) 35%

25%

Blood pressure is usually not assessed in children younger than _____ years.

3

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

6 years

School-Age

6-12 years old -familiar with physical examinations -direct questions -act like more adults -peer pressure

The normal respiratory rate for a newborn should not exceed ________ breaths/min. a.) 50 b.) 60 c.) 70 d.) 80

60

What type of patient is high risk for pulmonary embolism

71 year old male with recent surgery to a lower extremity

A person's ability to shiver is lost when his or her body temperature falls below:

90°F (32°C).

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.

A fracture of the femur is rare and is a major source of ___ in the pediatric population

blood loss

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

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

bradycardia

The diving reflex may allow a person to survive extended periods of submersion in cold water secondary to:

bradycardia and a slowing of the metabolic rate.

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

bulging fontanelles

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 may: a.) depress the gag reflex b.) cause he child to vomit c.) result in airway swelling d.) result in a soft-tissue injury

cause he child to vomit

An oropharyngeal airway should not be used in children who have ingested a caustic or petroleum-based product because it may:

cause the child to vomit

An oropharyngeal airway should not be used in children who have ingested a caustic or petroleum-based product because it may:

cause the child to vomit.

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

caused by the inability of the body to cool itself

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

caused by the inability of the body to cool itself.

Children with N meningitides would MOST likely present with:

cherry-red spots or a purplish rash

Children with N. meningitides would MOST likely present with:

cherry-red spots or a purplish rash.

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 adults c.) children are more likely to experience diving-related injuries d.) inexperience and poor judgment are rare causes of pediatric trauma

children are more likely to experience diving-related injuries

..

circulation to the skin is reduced.

The chief component of connective tissues and bones that deteriorates as people age is called

collagen

All of the following snakes are pit vipers, EXCEPT for the:

coral snake.

Dehydration signs and symptoms

decrease in urine output absence of tears sunken or depressed fontanelle changes in LOC and behavior skin tugor: loss fluid in space below skin able to pull out

A common cause of shock in an infant is:

dehydration from vomiting and diarrhea.

You are dispatched to a skilled nursing care facility for an 80 year old female with abnormal behavior. The patient is confused and asks if you are her husband. As your partner administers oxygen to the patient, you should...

determine patient's baseline mental status

When assessing a geriatric patient, who is possibly experienced an acute ischemic stroke, it is most important to...

determine the onset of the patients symptoms

Causes of delirium in older patients don't include

alzheimer disease

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

an ineffective cough

Signs of a severe airway obstruction in an infant or child include: a.) pink, dry skin b.) crying and anxiety c.) an ineffective cough d.) mild respiratory distress

an ineffective cough

The components of the PAT are:

appearance, work of breathing, and skin circulation

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

grunting

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

has a history compatible with a serious illness.

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

have a female EMT remain with her if possible

When a child experiences a blunt injury to the abdomen:

he or she can compensate for blood loss better than adults

When a child experiences a blunt injury to the abdomen: a.) he or she can compensate for blood loss better than adults b.) his or her blood pressure falls with as little as 5% blood loss c.) your assessment will most often reveal bruising to the abdomen d.) delayed capillary refill indicates a state of decompensated shock

he or she can compensate for blood loss better than adults

Covering a patient's _________ will significantly minimize radiation heat loss.

head

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

head bobbing

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

head bobbing

a 10 to 20% reduction in brain weight and volume would most likely increase an older persons risk for...

head trauma

Causes of infant death that may be mistaken for SIDS include all of the following, EXCEPT:

hyperglycemia

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

hyperglycemia

..

increasing the metabolic rate.

Shivering is a mechanism in which the body generates heat by:

increasing the metabolic rate.

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.

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

intercostal muscles are not well developed

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

intercostal muscles are not well developed

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

intercostal muscles are not well developed.

To obtain the MOST accurate reading of a patient's core body temperature, you should place a special hypothermia thermometer:

into the patient's rectum.

In contrast to the brown recluse spider, the black widow spider:

is large and has a red-orange hourglass mark on its abdomen.

Abdominal aortic aneurysm

is often the result of hypertension and atherosclerosis

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

kyphosis

The venom of a black widow spider is toxic to the:

nervous system.

Infants are ________ breathers rate obstructions

nose 20-60 breaths/minute easily obstructed by secretions, blood, or swelling. Airway size of straw

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

not rule out compensated shock

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

not rule out compensated shock.

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

observe the chest for adequate rise

What is not a social aspect of an older patients

outdated medications

Signs and symptoms of an air embolism include all of the following, EXCEPT:

pale skin.

When assessing an infant's ventilation status, you should:

palpate the abdomen for rise and fall

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 Sp02 is less than 90%

palpate the abdomen for rise and fall

Critical burns in child include: a.) any superficial or partial-thickness burn that involves the legs or arms b.) partial-thickness burns covering more than 20% of the body surface c.) second-degree burns covering more than 10% of the body surface d.) superficial burns covering more than 10% to 15% of the body surface

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

Critical burns in children include:

partialt-hickness burns covering more than 20% of the body surface

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.

pediatric assessment triangle

After using the PAT to form your general impression of a sick or injured child, you should:

perform a hands-on assessment of the ABCs

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:

perform abdominal thrusts

A child who has no recent history of illness suddenly appears cyanotic and cannot speak after playing with a small toy. You should:

perform abdominal thrusts

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

perform abdominal thrusts

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

positioning, ice packs, and extremity elevation.

The EMT must assume that any unwitnessed water-related incident is accompanied by:

possible spinal injury.

When you are performing a scene assessment at an incident involving SIDS, you should focus your attention on all of the following, EXCEPT:

the temperature of the room

Which of the following is FALSE regarding the pediatric airway

the trachea is larger in diameter and shorter in length

Greenstick fractures occur in infants and children because:

their bones bend more easily than an adult's

Breath sounds in the pediatric population are more easily heard because:

their chest walls are thinner

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

they usually do not wish to be observed during a procedure

The MOST common cause of dehydration in pediatric patients is: a.) high fever b.) internal blood loss c.) vomiting and diarrhea d.) refusal to drink fluids

vomiting and diarrhea

Heat loss from the body through respiration occurs when:

warm air is exhaled into the atmosphere.

Signs of vasoconstriction in the infant or child include:

weak distal pulses

Signs and symptoms of a lower airway obstruction include

wheezing

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

why did your child ingest the poison?

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

respiratory or circulatory failure

Early signs of respiratory distress in the child include:

restlessness

Bruising to the _________ is LEAST suggestive of child abuse.

shins

Bruising to the ____________ is LEAST suggestive of child abuse. a.) shins b.) back c.) face d.) buttocks

shins

Respiratory Emergencies

signs and symptoms of increased work of breathing: -nasal flaring -grunting -wheezing, stridor -accessory muscle use -retractions/movement of child's flexible rib cage

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

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

slowed level of activity

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

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.

If a nasopharyngeal airway is too long, it may:

stimulate the vagus nerve

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

stridor

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

stridor

You respond to a local lake where a diver complains of difficulty breathing that occurred immediately after rapidly ascending from a depth of approximately 30 feet. On assessment, you note that he has cyanosis around his lips and has pink froth coming from his nose and mouth. You should:

suction his mouth and nose, apply high-flow oxygen, monitor the patient's breath sounds for a pneumothorax, and contact medical control regarding transport to a recompression facility.

Signs and symptoms of meningitis in the infant or child include all of the following, EXCEPT:

sunken fontanelles

Burns associated with lightning strikes are typically:

superficial.

While drinking beer with his friends near a creek, a 31-year-old male was bitten on the leg by an unidentified snake. The patient is conscious and alert and in no apparent distress. Your assessment of his leg reveals two small puncture marks with minimal pain and swelling. In addition to administering oxygen and providing reassurance, further care for this patient should include:

supine positioning, splinting the leg, and transporting.

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

20g

Blood loss in a child exceeding _____ of his or her total blood volume significantly increases the risk of shock.

25%

Preschool-Age children

3-6 years old -understand directions and can show painful areas -regular food (airway obstructions) fearful-rich fantasy life

A child may begin to show signs of separation anxiety as early as:

6 months

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

6 months

Febrile seizures are MOST common in children between:

6 months and 6 years

Febrile seizures are MOST common in children between: a.) 3 months and 4 years b.) 6 months and 6 years c.) 8 months and 8 years d.) 18 months and 10 years

6 months and 6 years

Seizures

6 months- 6 years old doesn't have to be a very high temp but a sudden rise.

Which of the following represents a low normal systolic blood pressure for a 6-year-old child?

82 mm Hg

Hypothermia occurs when the core body temperature falls below:

95°F (35°C).

The body's natural cooling mechanism, in which sweat is converted to a gas, is called:

evaporation.

Geriatric patients, newborns, and infants are especially prone to hyperthermia because they:

exhibit poor thermoregulation.

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

positioning, ice packs, and emotional support

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

transport them to a hospital they are familiar with

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

use a length-based resuscitation tape measure

The signs and symptoms of poisoning in children:

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

Commmon causes of syncope are not

vasoconstriction

The MOST common cause of dehydration in pediatric patients is:

vomiting and diarrhea

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

wheezing

Toddles

1-3 years old -stranger anxiety, may need toy or blanket -walking, talking

What is the most common mechanism of injury in older patients

Falls

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

Females

An infant's heart can beat as many as ____ times or more per minute if the body needs to compensate

160

The suture of the anterior fontanelle is typically closed by _____ months of age, and the suture of the posterior fontanelle is typically closed by _____ months of age.

18, 6

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

2 seconds

Bronchiolitis usually occurs during the first ___ of life

2 years

Making eye contact, recognizing caregivers, and following a bright light with their eyes are initially noticed in what age group?

2-6 months

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

20 g

Febrile seizures in a child:

may indicate a serious underlying illness

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 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.

What is true regarding decreased level of conscioiusness

It is not a normal part of the aging process

In order for sweating to be an effective cooling mechanism:

It must be able to evaporate from the body.

Which of the following would be the LEAST likely to occur in a patient with a core body temperature of between 89°F (32°C) and 92°F (33°C)?

Tachycardia

A pediatric patient involved in a drowning emergency may present with:

abdominal distension

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

absent urine output

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

may indicate a serious underlying illness

Apparent Life Threatening Events (ALTE)

-infants who are not breathing, cyanotic, and unresponsive sometimes resume breathing and color with stimulation -Respond and found infant fine classic ALTE is characterized by: cyanosis, apnea, distinct changes in muscle tone, choking or gagging

Airway pediatric

-larger, round occiput - proportionately larger tongue -long, floppy, U shaped epiglottis -less well-developed rings of cartilage in trachea -narrowing, funnel shaped upper airway

The secondary assessment of a sick or injured child:

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

Infants

-First year of life -anterior fontanelle -lack communication -flexible bones -fastest HR & RR, lowest BP calls: SIDS, seizures, bronchiolitis, RSV, choking, dehydration, rashes

Circulatory system pediatric

-Infants can beat 160 beats/min or more (primary method used to compensate for decreased perfusion) - ability of children to constrict blood vessels also helps them compensate for decreased perfusion ** they'll be able to sustain it longer good system

If a nasopharyngeal airway is too long, it may: a.) result in tachycardia b.) push the tongue anteriorly c.) stimulate the vagus nerve d.) become obstructed by mucus

.stimulate the vagus nerve..

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.

You are assessing a 33-year-old male who complains of severe abdominal pain, weakness, and nausea. He tells you that he was gathering wood to build a fire when he felt a sudden, sharp pain on the back of his hand. Your assessment reveals that the patient's abdomen is rigid and painful to palpation. You should suspect:

A black widow spider bite.

When examining the head of a pediatric patient, which of the following statements is FALSE?

A bulging fontanelle suggests dehydration

Signs of an upper airway obstruction in an infant or child include all of the following, EXCEPT: A) wheezing. B) a weak cough. C) a cough that resembles the bark of a seal. D) stridorous breathing.

A) wheezing.

What is true about the aging process

Aging is a linear process; the rate at which a person loses functions does not increase with age

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

An aortic aneurysm

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

An unresponsive 5-year-old male with shallow respirations

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

Dementia

With regard to the legal implications of child abuse:

EMTs must report all suspected cases of child abuse

With regard to the legal implications of child abuse: a.) child abuse must be reported only if it can be proven b.) EMTs must report all suspected cases of child abuse c.) you should document your perceptions on the run form d.) a supervisor can forbid you from reporting possible abuse

EMTs must report all suspected cases of child abuse

With regard to the legal implications of child abuse:

EMTs must report all suspected cases of child abuse.

Which of the following is NOT a common exposure when dealing with pediatric burns?

Electrocution from poor wiring

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

Have only 1 emt speak to the patient at the time

The leading cause of death in geriatric patients is

Heart disease

Purpose of GEMS diamond is to

Help EMS remember what is different about elderly patients

Shivering is a mechanism in which the body generates heat by:

Increasing the metabolic rate.

A 48-year-old male was stung on the leg by a jellyfish while swimming in the ocean. He is conscious and alert, but complains of intense pain at the wound site. Specific treatment for this patient includes:

Irrigating the wound with vinegar and immersing his leg in hot water.

Circulatory system contd

Less blood circulating (so slow signs of shock) the'll go into shock more quickly with less blood less

Which of the following is MORE common in children than in adults following a head injury?

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

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

Observe for conditions that may make the residence unsafe

What is right about elderly patients

Older patients have difficulty understanding when they are stressed

What statement regarding suicide in older patients is true

Older patients tend to use more lethal means than younger patients

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

Sexual activity

What does the E stand for in GEMS

The patien'ts residence is cold due to a malfunctioning heater

A silent heart attack occurs when

The usual presentation is not present

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

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.) attempt cooling measures, offer oxygen, and transport c.) place the child in cold water to attempt to reduce her fever d.) suspect that the child has meningitis and transport at once

attempt cooling measures, offer oxygen, and transport

is large and has a red-orange hourglass mark on its abdomen

black widow spider:

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

bleeding in the brain

Your assessment of a 23-year-old female reveals a core body temperature of 93.4°F (34°C). She is conscious, answers your questions appropriately, is shivering, and complains of nausea. Her skin is cold and pale, her muscles appear rigid, and her respirations are rapid. In addition to monitoring her ABCs, administering oxygen, and turning up the heat in the back of the ambulance, you should:

place heat packs to her groin, axillae, and behind her neck; cover her with warm blankets; and avoid rough handling.

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

putting a baby to sleep on his or her back

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

retracting

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

secure the torso before the head

Which of the following would be the LEAST likely to occur in a patient with a core body temperature of between 89°F (32°C) and 92°F (33°C)?

tachycardia

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

talk to the child, not just the caregiver

Syncope in older patients is....

Caused by an interruption of blood flow to the brain

Which of the following statements regarding pediatric trauma is correct?

Children are more likely to experience diving-related injuries

Which of the following statements regarding pediatric trauma is correct?

Children are more likely to experience diving-related injuries.

Which of the following statements regarding a pediatric patient's anatomy is correct?

Children have a larger, rounder occiput compared to adults

Geriatric patients are at a higher risk for heatstroke because:

Circulation to the skin is reduced.

When a warm hand is immersed in water that is 70°F (21°C), heat is transferred from the hand to the water through a process called:

Conduction.

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? A) Vomiting B) Restlessness C) Lethargy D) Tachycardia

Correct Answer A) Vomiting

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

Correct Answer A) bulging fontanelles.

Use of a nonrebreathing mask or nasal cannula in a child is appropriate ONLY if: A) an oral airway has been inserted. B) his or her tidal volume is adequate. C) his or her respirations are shallow. D) he or she is breathing inadequately.

Correct Answer B) his or her tidal volume is adequate.

Which of the following represents a low normal systolic blood pressure for a 6-year-old child? A) 82 mm Hg B) 88 mm Hg C) 90 mm Hg D) 98 mm Hg

Correct Response A) 82 mm Hg

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

Correct Response A) anxiety.

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.

Correct Response A) at the feet.

Death caused by shaken baby syndrome is usually the result of: A) bleeding in the brain. B) multiple open fractures. C) intra-abdominal hemorrhage. D) fracture of the cervical spine.

Correct Response A) bleeding in the brain.

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

Correct Response 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.

Correct Response A) cyanosis.

Padding underneath the torso when immobilizing an injured child is generally not necessary if he or she is: A) older than 8 to 10 years of age. B) complaining of severe back pain. C) immobilized on a long backboard. D) experiencing cardiopulmonary arrest.

Correct Response A) older than 8 to 10 years of age.

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: A) perform abdominal thrusts. B) visualize the child's airway. C) perform a blind finger sweep. D) give oxygen and transport at once.

Correct Response A) perform abdominal thrusts.

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

Correct Response A) stridor.

The signs and symptoms of poisoning in children: A) vary widely, depending on the child's age and weight. B) are typically consistent among all age and weight groups. C) usually present within the first 10 minutes of ingestion. D) are most severe if the child ingested a poisonous substance.

Correct Response A) vary widely, depending on the child's age and weight.

Which of the following an appropriate dose of activated charcoal for a 20-kg child? A) 12.5 g B) 20 g C) 25 g D) 50 g

Correct Response B) 20 g

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.

Correct Response 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.

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

A common cause of shock in an infant is: A) a cardiac dysrhythmia. B) dehydration from vomiting and diarrhea. C) excessive tachycardia. D) cardiovascular disease.

Correct Response B) dehydration from vomiting and diarrhea.

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.

Correct Response 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.

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

Before assessing the respiratory adequacy of a 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.

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

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

Correct Response B) hyperglycemia.

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.

Correct Response B) moderate dehydration.

After determining that an infant or child has strong central pulses, you should: A) assume the child is hypertensive. B) not rule out compensated shock. C) conclude that the child is stable. D) assess his or her respiratory effort.

Correct Response B) not rule out compensated shock.

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

Correct Response B) palpate for a carotid pulse.

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. Correct Response 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.

Correct Response B) stabilize his head and check for a pulse.

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.

Correct Response B) the flexible ribs can be compressed without breaking.

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.

Correct Response B) weak distal pulses.

Which of the following children would benefit the LEAST from a nonrebreathing mask? A) A conscious 4-year-old male with adequate tidal volume B) A responsive 6-year-old male who responds appropriately C) An unresponsive 5-year-old male with shallow respirations D) A semiconscious 7-year-old female with normal ventilation

Correct Response C) An unresponsive 5-year-old male with shallow respirations

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.

Correct Response C) Children are more likely to experience diving-related injuries.

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

Correct Response C) Consistency in the method of injury reported by the caregiver

Which of the following assessment findings should concern the EMT the MOST when assessing a child who experienced a seizure? A) High fever B) Tachycardia C) Neck stiffness D) Short postictal phase

Correct Response C) Neck stiffness

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?

Correct Response C) Why did your child ingest the poison?

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.

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

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

Correct Response C) restlessness.

In contrast to adults, deterioration to cardiac arrest in infants and children is usually associated with: A) irritability of the left ventricle. B) a sudden ventricular arrhythmia. C) severe hypoxia and bradycardia. D) acute hypoxia and tachycardia.

Correct Response C) severe hypoxia and bradycardia.

If a nasopharyngeal airway is too long, it may: A) result in tachycardia. B) push the tongue anteriorly. C) stimulate the vagus nerve. D) become obstructed by mucus.

Correct Response C) stimulate the vagus nerve.

Greenstick fractures occur in infants and children because: A) the growth plate is commonly injured. B) their bones are more brittle than an adult's. C) their bones bend more easily than an adult's. D) twisting injuries are more common in children.

Correct Response C) their bones bend more easily than an adult's.

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.

Correct Response 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.

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

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.

Correct Response D) caused by the inability of the body to cool itself.

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.

Correct Response 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.

Correct Response D) has a history compatible with a serious illness.

All of the following are normal findings in an infant or child, EXCEPT: A) quiet breathing. B) fear or anxiety. C) belly breathing. D) head bobbing.

Correct Response D) head bobbing.

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 general condition of the house. C) the site where the infant was discovered. D) the temperature of the room.

Correct Response D) the temperature of the room.

When ventilating a pediatric patient with a bag-valve mask, the EMT should: A) block the pop-off valve if needed to achieve adequate chest rise. B) squeeze the bag 40 times/min when ventilating an infant. C) use a neonatal device for children younger than 12 months. D) ventilate the child with sharp, quick breaths at the appropriate rate.

Correct Response A) block the pop-off valve if needed to achieve adequate chest rise.

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

Correct Response A) cherry-red spots or a purplish rash.

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.

Correct Response B) have a female EMT remain with her if possible.

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

Correct Response B) positioning, ice packs, and extremity elevation.

Which of the following is NOT a known risk factor of SIDS? A) Mother younger than 20 years B) Low birth weight C) Putting a baby to sleep on his or her back D) Mother smoked during pregnancy

Correct Response C) Putting a baby to sleep on his or her back

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%.

Correct Response C) palpate the abdomen for rise and fall.

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: A) advise the mother that the danger has past and that she can take the child to the pediatrician. B) allow the mother to take her child to the doctor, but inform her that the risk for SIDS is high. C) contact law enforcement personnel and advise them that they are suspicious for child abuse. D) inform that mother that, although the event seems to have resolved, transport via EMS is advisable.

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

Which of the following conditions would be the LEAST likely to increase a person's risk of hypothermia?

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 level is 450 mg/dL. 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 nonketoic coma (HHNC)

Which of the following is NOT a common cause of altered mental status in pediatric patients?

Hypertension

..

Lighting often results in a brief period of asystole that resolves spontaneously.

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

May cause the patient to think that they have no say in decision making

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

Most cases of SIDS occur in infants younger than 6 months

Sudden Infant Death Syndrome (SIDS)

-Leading cause of death in infants younger than 1 years old -attempt CPR if no signs of death -allow family to spend time with infant, and use infant's name

Shaken baby syndrome

-bleeding within the head and damage to the cervical spine -shaking tears blood vessels in the brain, resulting in bleeding around the brain -pressure from blood results i an increase in cranial pressure leading to coma and/or death

Cardiopulmonary Arrest

-in peds associated with respiratory failure and arrest -adults become hypoxic, heart get irritable, and sudden cardiac death comes from arrhythmia -children become hypoxic and their heart slows down, becoming more bradycardic

Integumentary system

-thinner skin and less subcutaneous fat -larger fluid and heat losses due to higher ratio of body surface area -burns easier

Infants begin saying their first word, sitting without support, and teething at 6 to ______ months.

12

Adolescents

12-18 years old -similar to adults, still children on emotional level

If the situation allows, a child should be transported in a car seat if he or she weighs less than _____ lb.

40

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

6 years

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

60

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

Attempt to differentiate between chronic and acute problems

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 emt should suspect left sided heart failure in a geriatric patient who presents with...

Tachypnea and paroxysmal nocturnal dyspnea

An air embolism associated with diving occurs when:

The diver holds his or her breath during a rapid ascent.

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?

The effects of her antihypertensive medication

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 that she is normally alert. When you assess this patient, it is important to note that:

The patient is experiencing delirious behaviour, which suggests a new health problem.

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

An elderly patient may understate or minimize symptoms of illness because...

They fear hospitilization

Which of the following statements regarding lightning strikes is correct?

They often results in a brief period of asystole that resolves spontaneously.

Which of the following is NOT initially seen in children 12-18 months old?

Understand cause and effect

Which of the following statements regarding pediatric asthma is FALSE?

Use strong, forceful breaths when ventilating to get air past the obstruction

Rough handling of a hypothermic patient with a pulse may cause:

Ventricular fibrillation.

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

Vomiting

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

Why did your child ingest the poison?

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

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

You are assessing a 33-year-old male who complains of severe abdominal pain, weakness, and nausea. He tells you that he was gathering wood to build a fire when he felt a sudden, sharp pain on the back of his hand. Your assessment reveals that the patient's abdomen is rigid and painful to palpation. You should suspect:

a black widow spider bite.

Compared to adults, infants and children are at higher risk for hypothermia for all of the following reasons, EXCEPT:

a relatively small surface area.

Breath-holding syncope is caused by a decreased stimulus to breathe and occurs when:

a swimmer hyperventilates prior to entering the water.

Signs of late heatstroke include:

a weak, rapid pulse.

To assess a patient's general body temperature, pull back on your glove and place the back of your hand on his or her skin at the:

abdomen.

To assess a patient's general temperature, pull back on your glove and place the back of your hand on his or her skin at the:

abdomen.

The MOST prominent symptom of decompression sickness is:

abdominal or joint pain.

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

absent urine output

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

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

During the attempted resuscitation of an infant with suspected SIDS:

allow the family to observe if they wish

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

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

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 visualization only d.) gather critical date by performing a rapid hands-on-assessment of the child

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

Common causes of depression in elderly are not...

an acute onset of dementia

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

an unresponsive 5yearold male with shallow respirations

Pupillary response in pediatric patients may be abnormal in the presence of all of the following, EXCEPT:

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

appearance, work of breathing, and skin circulation

A pediatric patient with a fever, pain on palpation of the right lower quadrant, and rebound tenderness is likely suffering from _____

appendicitis

When assessing a 78 year old female who complains of shortness of breath, the EMT should...

ask her how many pillows she uses to sleep

A 30-year-old male was rescued after being lost in the woods for approximately 18 hours. The outside temperature is 30°F (-1°C). He is immediately placed in the warmed ambulance, where you perform a primary assessment. He is unconscious, pale, and apneic. You should:

assess for a carotid pulse for up to 45 seconds.

A 30-year-old male was rescued after being lost in the woods for approximately 18 hours. The outside temperature is 30°F (−1°C). He is immediately placed in the warmed ambulance, where you perform a primary assessment. He is unresponsive, pale, and apneic. You should:

assess for a carotid pulse for up to 60 seconds.

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

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

You respond to a skate park where a 10year-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:

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

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

at the feet

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:

attempt cooling measures, offer oxygen, and transport

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: a.) be prepared to assist her ventilations, transport at once, and request an ALS intercept en route to the hospital b.) continue high-flow oxygen therapy, contact medial control, and request permission to administer more albuterol c.) begin immediate ventilation assistance and ensure that you squeeze the bag forcefully in order to open her bronchioles d.) begin chest compressions if she becomes unresponsive and her heart rate falls below 80 beats/min

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

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 non-rebreathing mask. You should:

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

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

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

When ventilating a pediatric patient with a bag-mask device, the EMT should: a.) block the pop-off valve if needed to achieve adequate chest rise b.) squeeze the bag 40 times/min when ventilating an infant c.) ensure that he or she uses a neonatal device for children younger than 12 months d.) ventilate the child with sharp, quick breaths at the appropriate rate

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

The venom of a brown recluse spider is cytotoxic, meaning that it:

causes severe local tissue damage.

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 adults b.) a child's tongue is proportionately smaller than an adult's c.) children have a larger, rounded occiput compared to adults d.) the child's epiglottis is less floppy and smaller than adult's

children have a larger, rounded occiput compared to adults

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

consistency in the method of injury reported by the caregiver

The transfer of heat to circulating air, such as when cool air moves across the body's surface, is called:

convection.

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

croup

Early signs of respiratory distress in the pediatric patient include all of the following, EXCEPT:

cyanosis

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

decreased ability to cough

Young children can compensate for fluid losses by:

decreasing blood flow to the extrimities

A common cause of shock in an infant is:

dehydration from vomiting and diarrhea

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

dehydration from vomiting and diarrhea

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

depress the tongue with a tongue depresser

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

depress the tongue with a tongue depressor

An older patient with significant dehydration would most likely present with...

dizziness or fainting upon standing

45. 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

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

drooling or congestion

When the body loses sweat, it also loses:

electrolytes

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

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

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

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.

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

ensure that the airway is patent and clear of obstructions

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

High humidity reduces the body's ability to lose heat through:

evaporation.

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

females

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

femoral

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

femoral

Vital BP

for children 1-10 years old 70+(2x child's age in years)= systolic BP

All of the following terms refer to a body part that is cold but not frozen, EXCEPT:

frostbite.

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 relaxtion, a fever greater than 105 degrees, 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

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

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.

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

grunting

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

has a history suggestive of a serious illness

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

his or her tidal volume is adequate

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

his or her tidal volume is adequate.

Common signs and symptoms of heat exhaustion include all of the following, EXCEPT:

hot, dry skin.

Causes of infant death that may be mistaken for SIDS include all of the following, EXCEPT:

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:

inform the child's mother that her child is deceased

In contrast to delirium, dementia,

is usually considered irreversible

..

it must be able to evaporate from the body

You receive a call to a residence for a sick patient. Upon your arrival, you find the patient, a 53-year-old diabetic male, lying down on his front porch. His wife tells you that he had been mowing the lawn in the heat for the past 3 hours. The patient is confused and has hot, moist skin. His pulse is weak and thready, and his blood pressure is 90/50 mm Hg. In addition to administering 100% oxygen, you should:

load him into the ambulance and begin rapid cooling interventions

Motor nerve neuropathy is characterized by...

loss of balance, muscle weakness and spasms

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 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 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

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.) most cases of SIDS occur in infants younger than 6 months d.) the cause of death following SIDS can be established by autopsy

most cases of SIDS occur in infants younger than 6 months

A frostbitten foot can be identified by the presence of:

mottling and blisters.

You are dispatched to a local high school track and field event for a 16-year-old male who fainted. The outside temperature is approximately 95°F (35°C) with high humidity. Upon your arrival, the patient is conscious, alert, and complains of nausea and a headache. His skin is cool, clammy, and pale. You should:

move him into the cooled ambulance.

Which of the following is MORE common in children than in adults following a head injury?

nausea and vomiting

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

neonatal period

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

observe the chest for adequate rise

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

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

older than 8 to 10 years of age.

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

oropharyngeal airway

Children not only have a higher metabolic rate, but also a higher _____, which is twice that of an adult.

oxygen demand

When assessing an infant's ventilation status, you should:

palpate the abdomen for rise and fall.

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

place a towel or folded sheet behind the shoulders

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

place him or her on a firm surface

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

place him or her on a firm surface

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

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

place oxygen tubing through a hole in a paper cup

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

place oxygen tubing through a hole in a paper cup.

Sedentary behavior while healing from a hip fracture would most likely predispose the patient to

pneumonia

Activated charcoal is indicated for pediatric patients who have ingested:

poison

The use of multiple prescription drugs by a single patient causing the potential for negative effects such as overdose is called...

polypharmacy

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

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

proportionately larger and situated more anteriorly

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

putting a baby to sleep on the back

neglect

refusal or failure to provide life necessities

Cardiac arrest in the pediatric population is MOST commonly the result of: a.) a complete airway obstruction b.) respiratory or circulatory failure c.) a congenital cardiovascular defect d.) lethal cardiac rhythm disturbances

respiratory or circulatory failure

Airway obstruction

s/s: not able to talk, weak ineffective cough, leads to blue -infections can cause obstruction -croup is an infection in the airway below he level of the vocal cords -epiglottis is an infection of the soft tissue above the level of the vocal rods s/s: drooling, more serious, stridor, possible neb treatment, 02 humidified 02

You are assessing a man with suspected hypothermia. The patient is conscious and alert, and is actively shivering. His respiratory rate is increased, but his breathing is unlabored, and the pulse oximeter reads 72%. The pulse oximetry reading is MOST likely:

secondary to decreased perfusion in the extremities.

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

secure the torso before the head

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

severe hypoxia and bradycardia

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

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

sexual activity

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

stabilize his head and check for a pulse

Signs and symptoms of meningitis in the infant or child include all of the following, EXPECT: a.) sunken fontanelles b.) headache and fever c.) a stiff or painful neck d.) an altered mental status

sunken fontanelles

The pediatric patient should be removed from his or her car seat and secured to an appropriate spinal immobilization device if:

the car seat is visibly damaged

..

the diver holds his or her breath during a rapid ascent

When a child experiences a blunt chest injury:

the flexible ribs can be compressed without breaking

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...

the injury may be preceded by a medical condition

Greenstick fractures occur in infants and children because: a.) the growth plate is commonly injured b.) their bones are more brittle than an adult's c.) their bones bend more easily than an adult's d.) twisting injuries are more common in children

their bones bend more easily than an adult's

Most of the serious injuries associated with scuba diving are caused by:

too rapid of an ascent.

The signs and symptoms of poisoning in children: a.) vary widely, depending on the child's age and weight b.) are more obvious than in the adult population c.) usually present within the first 10 minutes of ingestion d.) are most severe if the child ingested a poisonous substance

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

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

wheezing