Quizes ch 33, 34, 35, 36

The suture of the anterior fontanelle is typically closed by _______________ months of age, and the suture of the posterior fontanelle is typically closed by _______________ months of age. a. 12,4 b. 18,6 c. 6, 12 d. 2,4

b. 18,6

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

c. Body size

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

c. dementia.

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

d. the pregnant utems compresses the inferior vena cava.

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

a. 60

You have just delivered a baby boy. His body is pink, but his hands and feet are blue. His heart rate approximately 110 beats/min and his respirations are rapid and irregular. He has a weak cry when stimulated and resists attempts to straighten his legs. His Apgar score is: a. 8 b. 6 c. 9 d. 7

a. 8

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

a. Children are more likely to experience diving-related injuries.

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

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

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

a. Suctioning is indicated prior to cutting the cord if respiratory distress is present.

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

a. allow the family to observe if they wish.

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

a. breech presentation and prolapsed umbilical cord.

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

a. bulging fontanelles.

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

a. cause the child to vomit.

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

a. cyanosis.

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

a. he or she fears hospitalization.

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

a. his or her tidal volume is adequate.

An older woman with osteoporosis presents with pain and deformity to her left hip after she shifted her weight onto her other foot. She has MOST likely experienced a(n): a. pathologic fracture. b. comminuted fracture. c. idiopathic fracture. d. compression fracture.

a. pathologic fracture.

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

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

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

a. removing the tube if the area around it appears to be infected.

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

a. report exactly what the patient signs and not to add any commentary.

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

a. shunt.

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

a. stridor.

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

a. the placenta prematurely separates from the uterine wall.

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

a. weak distal pulses.

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

b. 2 seconds.

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

b. 6 years.

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

b. 71-year-old male with recent surgery to a lower extremity

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

b. 82 mm Hg

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

b. Falls

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

b. In some cases, women with gestational diabetes require insulin injections.

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

b. Rapid metabolism

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? a. Deterioration of the cardiac conduction system b. The effects of her antihypertensive medication c. Failure of the parasympathetic nervous system d. Intrathoracic bleeding and cardiac compression

b. The effects of her antihypertensive medication

Which of the following occurs during true labor? 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. Uterine contractions become more regular.

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

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

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

b. are taking blood-thinning medications.

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

b. be observant for signs of fear or reluctance from the patient.

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

b. determine the onset of the patient's symptoms.

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

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

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

b. head bobbing.

A 2-month-old infant was found unresponsive in his crib by his mother. When you arrive, you determine that the infant is apneic and pulseless. His skin is pale and cold and his arms are stiff. You should: a. begin high-quality CPR and transport immediately. b. inform the child's mother that her son is deceased. c. begin high-quality CPR and request an ALS ambulance. d. request the medical examiner to perform an autopsy.

b. inform the child's mother that her son is deceased.

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

b. lower the pitch of your voice.

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

b. place oxygen tubing through a hole in a paper cup.

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

b. secure the torso before the head.

ruising to the _______________ is LEAST suggestive of child abuse. a. back b. shins c. face d. buttocks

b. shins

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

c. Females

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

c. Increased respiratory rate and decreased respiratory reserve

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

c. Nausea and vomiting

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

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

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

c. Return of contractions following delivery of the baby

Which of the following statements regarding the placenta is correct? a. 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. b. The placenta allows for the transfer of oxygen and carbon dioxide between the mother and fetus but prevents most medications from passing between the mother and fetus. c. The 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. 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 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.

EMTs are dispatched for a fall. The patient, a 16-year-old female with Down syndrome, is experiencing difficulty walking and says that her fingers "feel like needles." The EMTs should suspect: a. a seizure. b. hydrocephalus. c. a cervical spine injury. d. an intracranial hemorrhage.

c. a cervical spine injury.

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

c. a portion of the spinal cord or meninges protrudes outside of the vertebrae.

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

c. bleeding in the brain.

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

c. brain.

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

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

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

c. dehydration from vomiting and diarrhea.

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

c. depress the tongue with a tongue depressor.

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

c. development of the placenta over the cervical opening.

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

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

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. grunting. d. wheezing.

c. grunting.

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

c. have extreme difficulty with complex tasks that require many steps.

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

c. headache and edema.

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 a blind finger sweep. b. visualize the child's airway. c. perform abdominal thrusts. d. give oxygen and transport at once.

c. perform abdominal thrusts.

A 33-year-old woman who is 36 weeks pregnant is experiencing vaginal bleeding. During transport, you note that she suddenly becomes diaphoretic, tachycardic, and hypotensive. You should: a. ventilate her with a bag-valve mask. b. carefully place sterile gauze into her vagina. c. place her in a left lateral recumbent position. d. position her supine and elevate her legs 12 inches.

c. place her in a left lateral recumbent position.

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

c. place him or her on a firm surface.

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

c. provide ventilations for 30 seconds.

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

c. restlessness.

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

c. teeth are misaligned and they have a large tongue.

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

c. these actions simulate the production of oxytocin and cause uterine contraction.

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

d. 3

A 75-year-old woman complains of shortness of breath. Which of the following findings should alert the EMT to the possibility of a pulmonary embolism? a. The patient's abdomen is swollen. b. The patient is prescribed an inhaler. c. Frequent urinary tract infections d. History of deep venous thrombosis

d. History of deep venous thrombosis

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

d. attempt to slip the cord gently over the infant's head.

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

d. contractions of the uterus.

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

d. easier breathing.

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

d. femoral

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. isolated tonic-clonic activity, a duration of greater than 15 minutes, and a short postictal phase. c. unresponsiveness, complete body relaxation, a fever greater than 105°F, and a short postictal phase. d. generalized tonic-clonic activity, a duration of less than 15 minutes, and a short or absent postictal phase.

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

You have just delivered a premature baby. Your assessment reveals that he is breathing adequately; however, his heart rate is 90 beats/min. You should: a. assess his skin color and give free-flow oxygen as needed. b. begin chest compressions and reassess in 30 seconds. c. clamp and cut the umbilical cord and keep him warm. d. keep him warm and ventilate with a BVM.

d. keep him warm and ventilate with a BVM.

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

d. observe the chest for adequate rise.

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

d. older than 8 to 10 years of age.

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

d. retracting.

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

d. severe hypoxia and bradycardia.

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

d. stabilize his head and check for a pulse.

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

d. transport him or her to a hospital that he or she is familiar with.

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

d. weighs less than 5.5 lbs or is born before 37 weeks' gestation,

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

d. wheezing.