Chapter 34 Pediatric Emergencies

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. use a neonatal device for children younger than 12 months C. ventilate the child with sharp, quick breaths at the appropriate rate D. squeeze the bag 40 times/min when ventilating an infant

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

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

A. cyanosis

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

A. has a history compatible with a serious illness

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

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

A. moderate dehydration

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

A. sunken fontanelles

You are dispatched to a residence for a child with respiratory distress. The patient, an 18-month-old female, is tachypneic, has sternal retractions, and is clinging to her mother. Her skin is pink and dry, and her heart rate is 120 beats/min. The MOST appropriate treatment for this child includes: A. allowing the child to remain with her mother and applying a nasal cannula B. administering blow-by oxygen and transporting the child with her mother C. requesting a paramedic ambulance to insert an advanced airway device D. separating the child from her mother and providing ventilatory assistance

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

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

B. cause the child to vomit

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

B. inform that mother that, although the event seems to have resolved, transport via EMS is advisable

When immobilizing an injured child in a pediatric immobilization device, you should: A. secure the head before the torso B. secure the torso before the head C. pad underneath the child's head D. slide the device under the child

B. secure the torso before the head

You are dispatched to a local elementary school for an injured child. As you approach the child, you note that he is lying at the base of the monkey bars. He is unresponsive and there are no signs of breathing. You should: A. begin immediate rescue breathing B. stabilize his head and check for a pulse C. perform a head tilt-chin lift maneuver D. open his airway and look in his mouth

B. stabilize his head and check for a pulse

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

B. wheezing

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

C. 82 mm Hg

A 5-year-old child has had severe vomiting and diarrhea for 4 days. Which of the following assessment findings would be the MOST indicative of decompensated shock? A. Capillary refill time of 4 seconds B. Respiratory rate of 30 breaths/min C. Blood pressure of 70/40 mm Hg D. Pulse rate greater than 120 min

C. Blood pressure of 70/40 mm Hg

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

C. Neck stiffness

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

C. blood vessels near the skin are constricted

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

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

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

C. head bobbing

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

C. his or her tidal volume is adequate

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

C. may indicate a serious underlying illness

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

C. the flexible ribs can be compressed without breaking

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

D (not A)

After squeezing the end of a child's finger or toe for a few seconds, blood should return to the area within: A. 4 seconds B. 5 seconds C. 3 seconds D. 2 seconds

D. 2 seconds

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

D. Consistency in the method of injury reported by the caregiver

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. The cause of death following SIDS can be established by autopsy D. Death as a result of SIDS can occur at any time of the day or night

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

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

D. Putting a baby to sleep on his or her back

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

D. absent urine output

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

D. croup

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

D. grunting

While triaging patients at the scene of a motor-vehicle crash, you encounter a 5-year-old child who is unresponsive and apneic. After positioning his airway, you should: A. categorize him as immediate B. deliver 5 rescue breaths C. categorize him as deceased D. palpate for a carotid pulse

D. palpate for a carotid pulse

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

D. place him or her on a firm surface