Ch 35 Pediatric Emergencies

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3. A child might begin to show signs of separation anxiety as early as: A) 2 months. B) 6 months. C) 12 months. D) 18 months.

ANS: B Complexity: Easy Ahead: Growth and Development Subject: Chapter 35, Page 1285 Title: Pediatric Emergencies Feedback: See Growth and Development Taxonomy: Recall Objective: 35-2 Discuss the physical and cognitive developmental stages of an infant, including health risks, signs that may indicate illness, and patient assessment.

90. EMTs are assessing a 2-year-old child who was riding in a car seat when the vehicle struck a tree while traveling at 45 MPH. The child is conscious and appears alert. There are no obvious signs of trauma to the child, and the car seat does not appear to be damaged. The EMTs should: A) remove the child from the car seat and secure him to a pediatric immobilization device. B) leave the child in the car seat, but pad around the child's head with towels or a pillow. C) remove the child from the car seat and secure both him and his mother to the stretcher. D) secure the child in the car seat with straps and apply a pediatric-sized cervical collar.

ANS: A Complexity: Difficult Ahead: Pediatric Trauma Emergencies and Management Subject: Chapter 35, Page 1331 Title: Pediatric Emergencies Feedback: See Pediatric Trauma Emergencies and Management Taxonomy: Application Objective: 35-25 Discuss the common causes of pediatric trauma emergencies; include how to differentiate between injury patterns in adults, infants, and children.

50. 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 medical control, and request permission to administer more albuterol. C) begin immediate ventilation assistance and ensure that you squeeze the bag forcefully to open her bronchioles. D) begin chest compressions if she becomes unresponsive and her heart rate falls below 80 beats/min.

ANS: A Complexity: Difficult Ahead: Respiratory Emergencies and Management Subject: Chapter 35, Page 1311 Title: Pediatric Emergencies Feedback: See Respiratory Emergencies and Management Taxonomy: Application Objective: 35-13 Describe asthma, its possible causes, signs, and symptoms, and the steps in the management of a pediatric patient who is experiencing an asthma attack.

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

ANS: A Complexity: Easy Ahead: Child Abuse and Neglect Subject: Chapter 35, Page 1336 Title: Pediatric Emergencies Feedback: See Child Abuse and Neglect Taxonomy: Recall Objective: 35-28 Describe child abuse and neglect and its possible indicators, including the medical and legal responsibilities of EMTs when caring for a pediatric patient who is a possible victim of child abuse.

84. Submersion injuries in the adolescent age group are most commonly associated with: A) alcohol. B) child abuse. C) hyperthermia. D) swimming pools.

ANS: A Complexity: Easy Ahead: Drowning Emergencies and Management Subject: Chapter 35, Page 1327 Title: Pediatric Emergencies Feedback: See Drowning Emergencies and Management Taxonomy: Recall Objective: 35-24 Describe the emergency care of a pediatric patient who has experienced a drowning emergency, including common causes, signs, and symptoms.

1. 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.

ANS: A Complexity: Easy Ahead: Growth and Development Subject: Chapter 35, Page 1285 Title: Pediatric Emergencies Feedback: See Growth and Development Taxonomy: Recall Objective: 35-2 Discuss the physical and cognitive developmental stages of an infant, including health risks, signs that may indicate illness, and patient assessment.

73. 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.

ANS: A Complexity: Easy Ahead: Neurologic Emergencies and Management Subject: Chapter 35, Page 1324 Title: Pediatric Emergencies Feedback: See Neurologic Emergencies and Management Taxonomy: Recall Objective: 35-19 Describe the emergency care of a pediatric patient with meningitis, including common causes, signs, symptoms, and special precautions.

17. The components of the pediatric assessment triangle (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.

ANS: A Complexity: Easy Ahead: Patient Assessment Subject: Chapter 35, Page 1294 Title: Pediatric Emergencies Feedback: See Patient Assessment Taxonomy: Application Objective: 35-9 Explain the steps in the primary assessment of a pediatric patient, including the elements of the pediatric assessment triangle (PAT), hands-on XABCs, transport decision considerations, and privacy issues.

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

ANS: A Complexity: Easy Ahead: Patient Assessment Subject: Chapter 35, Page 1299 Title: Pediatric Emergencies Feedback: See Patient Assessment Taxonomy: Recall Objective: 35-11 Describe the emergency care of a pediatric patient in respiratory distress, including the different causes of pediatric respiratory emergencies, the signs and symptoms of increased work of breathing, and the difference between respiratory distress and respiratory failure.

42. 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.

89. 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.

ANS: A Complexity: Easy Ahead: Pediatric Trauma Emergencies and Management Subject: Chapter 35, Page 1331 Title: Pediatric Emergencies Feedback: See Pediatric Trauma Emergencies and Management Taxonomy: Recall Objective: 35-25 Discuss the common causes of pediatric trauma emergencies; include how to differentiate between injury patterns in adults, infants, and children.

74. 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.

ANS: A Complexity: Easy Ahead: Poisoning Emergencies and Management Subject: Chapter 35, Page 1325 Title: Pediatric Emergencies Feedback: See Poisoning Emergencies and Management Taxonomy: Recall Objective: 35-21 Describe the emergency care of a pediatric patient who has been poisoned, including common sources of poisoning, signs, and symptoms.

80. 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.

ANS: A Complexity: Easy Ahead: Poisoning Emergencies and Management Subject: Chapter 35, Page 1327 Title: Pediatric Emergencies Feedback: See Poisoning Emergencies and Management Taxonomy: Recall Objective: 35-22 Describe the emergency care of a pediatric patient who is dehydrated, including how to gauge the severity of dehydration based on key signs and symptoms.

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

ANS: A Complexity: Easy Ahead: Respiratory Emergencies and Management Subject: Chapter 35, Page 1308 Title: Pediatric Emergencies Feedback: See Respiratory Emergencies and Management Taxonomy: Recall Objective: 35-12 List the possible causes of an upper and a lower airway obstruction in a pediatric patient and the steps in the management of foreign body airway obstruction.

46. 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.

ANS: A Complexity: Easy Ahead: Respiratory Emergencies and Management Subject: Chapter 35, Page 1309 Title: Pediatric Emergencies Feedback: See Respiratory Emergencies and Management Taxonomy: Recall Objective: 35-12 List the possible causes of an upper and a lower airway obstruction in a pediatric patient and the steps in the management of foreign body airway obstruction.

49. 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.

ANS: A Complexity: Easy Ahead: Respiratory Emergencies and Management Subject: Chapter 35, Page 1310 Title: Pediatric Emergencies Feedback: See Respiratory Emergencies and Management Taxonomy: Recall Objective: 35-12 List the possible causes of an upper and a lower airway obstruction in a pediatric patient and the steps in the management of foreign body airway obstruction.

58. 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.

ANS: A Complexity: Easy Ahead: Respiratory Emergencies and Management Subject: Chapter 35, Page 1316 Title: Pediatric Emergencies Feedback: See Respiratory Emergencies and Management Taxonomy: Recall Objective: 35-15 List the different oxygen delivery devices that are available for providing oxygen to a pediatric patient, including the indications for the use of each and precautions EMTs must take to ensure the patient's safety.

10. 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.

ANS: A Complexity: Moderate Ahead: Anatomy and Physiology Subject: Chapter 35, Page 1291 Title: Pediatric Emergencies Feedback: See Anatomy and Physiology Taxonomy: Recall Objective: 35-7 Describe differences in the anatomy and physiology of the pediatric patient compared to the adult patient and their implications for EMTs, with a focus on the following body systems: respiratory, circulatory, nervous, gastrointestinal, musculoskeletal, and integumentary.

14. 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 even though 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.

ANS: A Complexity: Moderate Ahead: Anatomy and Physiology Subject: Chapter 35, Page 1292 Title: Pediatric Emergencies Feedback: See Anatomy and Physiology Taxonomy: Recall Objective: 35-7 Describe differences in the anatomy and physiology of the pediatric patient compared to the adult patient and their implications for EMTs, with a focus on the following body systems: respiratory, circulatory, nervous, gastrointestinal, musculoskeletal, and integumentary.

99. 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.

ANS: A Complexity: Moderate Ahead: Child Abuse and Neglect Subject: Chapter 35, Page 1338 Title: Pediatric Emergencies Feedback: See Child Abuse and Neglect Taxonomy: Recall Objective: 35-28 Describe child abuse and neglect and its possible indicators, including the medical and legal responsibilities of EMTs when caring for a pediatric patient who is a possible victim of child abuse.

4. 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.

ANS: A Complexity: Moderate Ahead: Growth and Development Subject: Chapter 35, Page 1286 Title: Pediatric Emergencies Feedback: See Growth and Development Taxonomy: Recall Objective: 35-3 Discuss the physical and cognitive developmental stages of a toddler, including health risks, signs that may indicate illness, and patient assessment.

7. When assessing or treating an adolescent patient, it is important to remember that: A) they usually do not wish to be observed during a procedure. B) it is generally not necessary to explain procedures in advance. C) they often request medication to help in the relief of severe pain. D) they cannot understand complex concepts and treatment options.

ANS: A Complexity: Moderate Ahead: Growth and Development Subject: Chapter 35, Page 1289 Title: Pediatric Emergencies Feedback: See Growth and Development Taxonomy: Recall Objective: 35-6 Discuss the physical and cognitive developmental stages of an adolescent, including health risks, patient assessment, and privacy issues.

72. 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.

ANS: A Complexity: Moderate Ahead: Neurologic Emergencies and Management Subject: Chapter 35, Page 1323 Title: Pediatric Emergencies Feedback: See Neurologic Emergencies and Management Taxonomy: Recall Objective: 35-19 Describe the emergency care of a pediatric patient with meningitis, including common causes, signs, symptoms, and special precautions.

21. 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.

ANS: A Complexity: Moderate Ahead: Patient Assessment Subject: Chapter 35, Page 1296 Title: Pediatric Emergencies Feedback: See Patient Assessment Taxonomy: Recall Objective: 35-9 Explain the steps in the primary assessment of a pediatric patient, including the elements of the pediatric assessment triangle (PAT), hands-on XABCs, transport decision considerations, and privacy issues.

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

ANS: A Complexity: Moderate Ahead: Patient Assessment Subject: Chapter 35, Page 1300 Title: Pediatric Emergencies Feedback: See Patient Assessment Taxonomy: Recall Objective: 35-9 Explain the steps in the primary assessment of a pediatric patient, including the elements of the pediatric assessment triangle (PAT), hands-on XABCs, transport decision considerations, and privacy issues.

36. If the situation allows, a child should be transported in a car seat if he or she weighs less than _____ pounds. A) 40 B) 50 C) 60 D) 70

ANS: A Complexity: Moderate Ahead: Patient Assessment Subject: Chapter 35, Page 1302 Title: Pediatric Emergencies Feedback: See Patient Assessment Taxonomy: Recall Objective: 35-9 Explain the steps in the primary assessment of a pediatric patient, including the elements of the pediatric assessment triangle (PAT), hands-on XABCs, transport decision considerations, and privacy issues.

37. 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

ANS: A Complexity: Moderate Ahead: Patient Assessment Subject: Chapter 35, Page 1303 Title: Pediatric Emergencies Feedback: See Patient Assessment Taxonomy: Recall Objective: 35-9 Explain the steps in the primary assessment of a pediatric patient, including the elements of the pediatric assessment triangle (PAT), hands-on XABCs, transport decision considerations, and privacy issues.

40. 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

ANS: A Complexity: Moderate Ahead: Patient Assessment Subject: Chapter 35, Page 1306 Title: Pediatric Emergencies Feedback: See Patient Assessment Taxonomy: Application Objective: 35-10 Explain the steps in the secondary assessment of a pediatric patient, including what EMTs should look for related to different body areas and the method of injury.

39. Blood pressure is usually not assessed in children younger than _____ years. A) 3 B) 4 C) 5 D) 6

ANS: A Complexity: Moderate Ahead: Patient Assessment Subject: Chapter 35, Page 1306 Title: Pediatric Emergencies Feedback: See Patient Assessment Taxonomy: Recall Objective: 35-10 Explain the steps in the secondary assessment of a pediatric patient, including what EMTs should look for related to different body areas and the method of injury.

109. 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

ANS: A Complexity: Moderate Ahead: Pediatric Trauma Emergencies and Management Subject: Chapter 35, Page 1330 Title: Pediatric Emergencies Feedback: See Pediatric Trauma Emergencies and Management Taxonomy: Analysis Objective: 35-25 Discuss the common causes of pediatric trauma emergencies; include how to differentiate between injury patterns in adults, infants, and children.

92. 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.

ANS: A Complexity: Moderate Ahead: Pediatric Trauma Emergencies and Management Subject: Chapter 35, Page 1331 Title: Pediatric Emergencies Feedback: See Pediatric Trauma Emergencies and Management Taxonomy: Application Objective: 35-25 Discuss the common causes of pediatric trauma emergencies; include how to differentiate between injury patterns in adults, infants, and children.

59. 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.

ANS: A Complexity: Moderate Ahead: Respiratory Emergencies and Management Subject: Chapter 35, Page 1318 Title: Pediatric Emergencies Feedback: See Respiratory Emergencies and Management Taxonomy: Recall Objective: 35-15 List the different oxygen delivery devices that are available for providing oxygen to a pediatric patient, including the indications for the use of each and precautions EMTs must take to ensure the patient's safety.

54. 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.

ANS: A Complexity: Moderate Ahead: Respiratory Emergencies and Management Subject: Chapter 35, Page 1315 Title: Pediatric Emergencies Feedback: See Respiratory Emergencies and Management Taxonomy: Recall Objective: 35-14 Explain how to determine the correct size of an airway adjunct intended for a pediatric patient during an emergency.

70. 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.

ANS: B Complexity: Difficult Ahead: Fever Emergencies and Management Subject: Chapter 35, Page 1328 Title: Pediatric Emergencies Feedback: See Fever Emergencies and Management Taxonomy: Application Objective: 35-18 Describe the emergency care of a pediatric patient who has experienced a seizure, including the different types of seizures and the common causes, signs, and symptoms.

76. A 4-year-old, 16-kg 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: A) place her supine and elevate her legs. B) monitor her airway and give oxygen. C) determine why the ingestion occurred. D) administer 16 g of activated charcoal.

ANS: B Complexity: Difficult Ahead: Poisoning Emergencies and Management Subject: Chapter 35, Page 1325 Title: Pediatric Emergencies Feedback: See Poisoning Emergencies and Management Taxonomy: Application Objective: 35-21 Describe the emergency care of a pediatric patient who has been poisoned, including common sources of poisoning, signs, and symptoms.

81. 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.

ANS: B Complexity: Difficult Ahead: Poisoning Emergencies and Management Subject: Chapter 35, Page 1327 Title: Pediatric Emergencies Feedback: See Poisoning Emergencies and Management Taxonomy: Application Objective: 35-22 Describe the emergency care of a pediatric patient who is dehydrated, including how to gauge the severity of dehydration based on key signs and symptoms.

45. 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.

ANS: B Complexity: Difficult Ahead: Respiratory Emergencies and Management Subject: Chapter 35, Page 1308 Title: Pediatric Emergencies Feedback: See Respiratory Emergencies and Management Taxonomy: Analysis Objective: 35-12 List the possible causes of an upper and a lower airway obstruction in a pediatric patient and the steps in the management of foreign body airway obstruction.

47. 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.

ANS: B Complexity: Difficult Ahead: Respiratory Emergencies and Management Subject: Chapter 35, Page 1309 Title: Pediatric Emergencies Feedback: See Respiratory Emergencies and Management Taxonomy: Application Objective: 35-12 List the possible causes of an upper and a lower airway obstruction in a pediatric patient and the steps in the management of foreign body airway obstruction.

100. Which of the following is true regarding 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) EMTs should document their perceptions on the run form. D) A supervisor can forbid an EMT from reporting possible abuse.

ANS: B Complexity: Easy Ahead: Child Abuse and Neglect Subject: Chapter 35, Page 1336 Title: Pediatric Emergencies Feedback: See Child Abuse and Neglect Taxonomy: Recall Objective: 35-28 Describe child abuse and neglect and its possible indicators, including the medical and legal responsibilities of EMTs when caring for a pediatric patient who is a possible victim of child abuse.

6. 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.

ANS: B Complexity: Easy Ahead: Growth and Development Subject: Chapter 35, Page 1288 Title: Pediatric Emergencies Feedback: See Growth and Development Taxonomy: Recall Objective: 35-5 Discuss the physical and cognitive developmental stages of a school-age child, including health risks, signs that may indicate illness, and patient assessment.

67. 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.

ANS: B Complexity: Easy Ahead: Neurologic Emergencies and Management Subject: Chapter 35, Page 1323 Title: Pediatric Emergencies Feedback: See Neurologic Emergencies and Management Taxonomy: Recall Objective: 35-18 Describe the emergency care of a pediatric patient who has experienced a seizure, including the different types of seizures and the common causes, signs, and symptoms.

16. 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.

ANS: B Complexity: Easy Ahead: Patient Assessment Subject: Chapter 35, Page 1294 Title: Pediatric Emergencies Feedback: See Patient Assessment Taxonomy: Application Objective: 35-9 Explain the steps in the primary assessment of a pediatric patient, including the elements of the pediatric assessment triangle (PAT), hands-on XABCs, transport decision considerations, and privacy issues.

28. Drawing in of the muscles between the ribs or of the sternum during inspiration is called: A) tenting. B) retracting. C) hyperpnea. D) accessory muscle use.

ANS: B Complexity: Easy Ahead: Patient Assessment Subject: Chapter 35, Page 1295 Title: Pediatric Emergencies Feedback: See Patient Assessment Taxonomy: Recall Objective: 35-11 Describe the emergency care of a pediatric patient in respiratory distress, including the different causes of pediatric respiratory emergencies, the signs and symptoms of increased work of breathing, and the difference between respiratory distress and respiratory failure.

22. 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.

ANS: B Complexity: Easy Ahead: Patient Assessment Subject: Chapter 35, Page 1296 Title: Pediatric Emergencies Feedback: See Patient Assessment Taxonomy: Recall Objective: 35-9 Explain the steps in the primary assessment of a pediatric patient, including the elements of the pediatric assessment triangle (PAT), hands-on XABCs, transport decision considerations, and privacy issues.

31. 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.

ANS: B Complexity: Easy Ahead: Patient Assessment Subject: Chapter 35, Page 1299 Title: Pediatric Emergencies Feedback: See Patient Assessment Taxonomy: Recall Objective: 35-9 Explain the steps in the primary assessment of a pediatric patient, including the elements of the pediatric assessment triangle (PAT), hands-on XABCs, transport decision considerations, and privacy issues.

33. 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.

ANS: B Complexity: Easy Ahead: Patient Assessment Subject: Chapter 35, Page 1300 Title: Pediatric Emergencies Feedback: See Patient Assessment Taxonomy: Recall Objective: 35-9 Explain the steps in the primary assessment of a pediatric patient, including the elements of the pediatric assessment triangle (PAT), hands-on XABCs, transport decision considerations, and privacy issues.

91. 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.

ANS: B Complexity: Easy Ahead: Pediatric Trauma Emergencies and Management Subject: Chapter 35, Page 1333 Title: Pediatric Emergencies Feedback: See Pediatric Trauma Emergencies and Management Taxonomy: Application Objective: 35-25 Discuss the common causes of pediatric trauma emergencies; include how to differentiate between injury patterns in adults, infants, and children.

96. 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.

ANS: B Complexity: Easy Ahead: Pediatric Trauma Emergencies and Management Subject: Chapter 35, Page 1335 Title: Pediatric Emergencies Feedback: See Pediatric Trauma Emergencies and Management Taxonomy: Recall Objective: 35-25 Discuss the common causes of pediatric trauma emergencies; include how to differentiate between injury patterns in adults, infants, and children.

51. The most efficient way to identify the appropriately sized equipment for a pediatric patient is to: A) estimate the child's weight based on age. B) use a length-based resuscitation tape measure. C) estimate the child's weight based on appearance. D) ask a relative if he or she knows the child's weight.

ANS: B Complexity: Easy Ahead: Respiratory Emergencies and Management Subject: Chapter 35, Page 1313 Title: Pediatric Emergencies Feedback: See Respiratory Emergencies and Management Taxonomy: Recall Objective: 35-14 Explain how to determine the correct size of an airway adjunct intended for a pediatric patient during an emergency.

56. 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.

ANS: B Complexity: Easy Ahead: Respiratory Emergencies and Management Subject: Chapter 35, Page 1316 Title: Pediatric Emergencies Feedback: See Respiratory Emergencies and Management Taxonomy: Recall Objective: 35-15 List the different oxygen delivery devices that are available for providing oxygen to a pediatric patient, including the indications for the use of each and precautions EMTs must take to ensure the patient's safety.

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

ANS: B Complexity: Moderate Ahead: Anatomy and Physiology Subject: Chapter 35, Page 1291 Title: Pediatric Emergencies Feedback: See Anatomy and Physiology Taxonomy: Recall Objective: 35-7 Describe differences in the anatomy and physiology of the pediatric patient compared to the adult patient and their implications for EMTs, with a focus on the following body systems: respiratory, circulatory, nervous, gastrointestinal, musculoskeletal, and integumentary.

12. 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.

ANS: B Complexity: Moderate Ahead: Anatomy and Physiology Subject: Chapter 35, Page 1292 Title: Pediatric Emergencies Feedback: See Anatomy and Physiology Taxonomy: Recall Objective: 35-7 Describe differences in the anatomy and physiology of the pediatric patient compared to the adult patient and their implications for EMTs, with a focus on the following body systems: respiratory, circulatory, nervous, gastrointestinal, musculoskeletal, and integumentary.

101. 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.

ANS: B Complexity: Moderate Ahead: Child Abuse and Neglect Subject: Chapter 35, Page 1339 Title: Pediatric Emergencies Feedback: See Child Abuse and Neglect Taxonomy: Recall Objective: 35-28 Describe child abuse and neglect and its possible indicators, including the medical and legal responsibilities of EMTs when caring for a pediatric patient who is a possible victim of child abuse.

63. 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.

ANS: B Complexity: Moderate Ahead: Circulation Emergencies and Management Subject: Chapter 35, Page 1320 Title: Pediatric Emergencies Feedback: See Circulation Emergencies and Management Taxonomy: Recall Objective: 35-16 Describe the emergency care of a pediatric patient who is in shock (hypoperfusion), including common causes, signs, and symptoms.

65. Which of the following is the least reliable assessment parameter to evaluate when determining the presence of shock in infants and children? A) Pulse rate B) Blood pressure C) Skin condition D) Capillary refill

107. 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.

ANS: B Complexity: Moderate Ahead: Disaster Management Subject: Chapter 35, Page 1335 Title: Pediatric Emergencies Feedback: See Disaster Management Taxonomy: Application Objective: 35-27 Explain the four triage categories used in the JumpSTART system for pediatric patients during disaster management.

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

ANS: B Complexity: Moderate Ahead: Fever Emergencies and Management Subject: Chapter 35, Page 1328 Title: Pediatric Emergencies Feedback: See Fever Emergencies and Management Taxonomy: Application Objective: 35-23 Describe the emergency care of a pediatric patient who is experiencing a fever emergency, including common causes.

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

ANS: B Complexity: Moderate Ahead: Neurologic Emergencies and Management Subject: Chapter 35, Page 1323 Title: Pediatric Emergencies Feedback: See Neurologic Emergencies and Management Taxonomy: Recall Objective: 35-18 Describe the emergency care of a pediatric patient who has experienced a seizure, including the different types of seizures and the common causes, signs, and symptoms.

71. 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

ANS: B Complexity: Moderate Ahead: Neurologic Emergencies and Management Subject: Chapter 35, Page 1323 Title: Pediatric Emergencies Feedback: See Neurologic Emergencies and Management Taxonomy: Recall Objective: 35-19 Describe the emergency care of a pediatric patient with meningitis, including common causes, signs, symptoms, and special precautions.

23. 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.

ANS: B Complexity: Moderate Ahead: Patient Assessment Subject: Chapter 35, Page 1297 Title: Pediatric Emergencies Feedback: See Patient Assessment Taxonomy: Application Objective: 35-9 Explain the steps in the primary assessment of a pediatric patient, including the elements of the pediatric assessment triangle (PAT), hands-on XABCs, transport decision considerations, and privacy issues.

25. To ensure that the airway of an infant or small child is correctly positioned, you might have to: A) place bulky padding behind his or her occiput. B) place a towel or folded sheet behind the shoulders. C) slightly flex the neck to prevent tracheal kinking. D) hyperextend the neck to ensure adequate alignment.

ANS: B Complexity: Moderate Ahead: Patient Assessment Subject: Chapter 35, Page 1297 Title: Pediatric Emergencies Feedback: See Patient Assessment Taxonomy: Recall Objective: 35-11 Describe the emergency care of a pediatric patient in respiratory distress, including the different causes of pediatric respiratory emergencies, the signs and symptoms of increased work of breathing, and the difference between respiratory distress and respiratory failure.

86. When a child is struck by a car, the area of greatest injury depends mostly on the: A) speed at which the car was traveling when impact occurred. B) size of the child and the height of the bumper upon impact. 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.

ANS: B Complexity: Moderate Ahead: Pediatric Trauma Emergencies and Management Subject: Chapter 35, Page 1329 Title: Pediatric Emergencies Feedback: See Pediatric Trauma Emergencies and Management Taxonomy: Recall Objective: 35-25 Discuss the common causes of pediatric trauma emergencies; include how to differentiate between injury patterns in adults, infants, and children.

94. Severe burns in children 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.

ANS: B Complexity: Moderate Ahead: Pediatric Trauma Emergencies and Management Subject: Chapter 35, Page 1334 Title: Pediatric Emergencies Feedback: See Pediatric Trauma Emergencies and Management Taxonomy: Recall Objective: 35-26 Discuss the significance of burns in pediatric patients, their most common causes, and general guidelines EMTs should follow when assessing patients who have sustained burns.

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

ANS: B Complexity: Moderate Ahead: Poisoning Emergencies and Management Subject: Chapter 35, Page 1326 Title: Pediatric Emergencies Feedback: See Poisoning Emergencies and Management Taxonomy: Application Objective: 35-21 Describe the emergency care of a pediatric patient who has been poisoned, including common sources of poisoning, signs, and symptoms.

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

ANS: B Complexity: Moderate Ahead: Respiratory Emergencies and Management Subject: Chapter 35, Page 1313 Title: Pediatric Emergencies Feedback: See Respiratory Emergencies and Management Taxonomy: Recall Objective: 35-14 Explain how to determine the correct size of an airway adjunct intended for a pediatric patient during an emergency.

61. Cardiac arrest in the pediatric population is most commonly the result of: A) a complete airway obstruction. B) failure of the respiratory system. C) a congenital cardiovascular defect. D) lethal cardiac rhythm disturbances.

ANS: B Complexity: Moderate Ahead: Respiratory Emergencies and Management Subject: Chapter 35, Page 1319 Title: Pediatric Emergencies Feedback: See Respiratory Emergencies and Management Taxonomy: Recall Objective: 35-15 List the different oxygen delivery devices that are available for providing oxygen to a pediatric patient, including the indications for the use of each and precautions EMTs must take to ensure the patient's safety.

105. 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.

ANS: B Complexity: Moderate Ahead: Sudden Infant Death Syndrome Subject: Chapter 35, Page 1339 Title: Pediatric Emergencies Feedback: See Sudden Infant Death Syndrome Taxonomy: Application Objective: 35-29 Discuss brief resolved unexplained event (BRUE), sudden unexpected infant death, and sudden infant death syndrome (SIDS), including its risk factors, patient assessment, and special management considerations related to the death of an infant patient.

110. 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

ANS: C Complexity: Difficult Ahead: Neurologic Emergencies and Management Subject: Chapter 35, Page 1324 Title: Pediatric Emergencies Feedback: See Neurologic Emergencies and Management Taxonomy: Analysis Objective: 35-25 Discuss the common causes of pediatric trauma emergencies; include how to differentiate between injury patterns in adults, infants, and children.

20. 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) requesting a paramedic ambulance to insert an advanced airway device. B) separating the child from her mother and providing ventilatory assistance. C) administering blow-by oxygen and transporting the child with her mother. D) allowing the child to remain with her mother and applying a nasal cannula.

ANS: C Complexity: Difficult Ahead: Patient Assessment Subject: Chapter 35, Page 1295 Title: Pediatric Emergencies Feedback: See Patient Assessment Taxonomy: Application Objective: 35-9 Explain the steps in the primary assessment of a pediatric patient, including the elements of the pediatric assessment triangle (PAT), hands-on XABCs, transport decision considerations, and privacy issues.

8. 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 adult's tracheal rings. B) A child's tongue is proportionately smaller than an adult's tongue. C) Children have a larger, rounder occiput compared to adults. D) The child's epiglottis is less floppy and smaller than an adult's epiglottis.

ANS: C Complexity: Easy Ahead: Anatomy and Physiology Subject: Chapter 35, Page 1290 Title: Pediatric Emergencies Feedback: See Anatomy and Physiology Taxonomy: Recall Objective: 35-7 Describe differences in the anatomy and physiology of the pediatric patient compared to the adult patient and their implications for EMTs, with a focus on the following body systems: respiratory, circulatory, nervous, gastrointestinal, musculoskeletal, and integumentary.

18. After using the pediatric assessment triangle (PAT) to form your general impression of a sick or injured child, you should: A) evaluate the child's baseline vital signs. B) obtain a SAMPLE history from the parents. C) perform a hands-on assessment of the ABCs. D) assess the child's heart rate and skin condition.

ANS: C Complexity: Easy Ahead: Patient Assessment Subject: Chapter 35, Page 1294 Title: Pediatric Emergencies Feedback: See Patient Assessment Taxonomy: Application Objective: 35-9 Explain the steps in the primary assessment of a pediatric patient, including the elements of the pediatric assessment triangle (PAT), hands-on XABCs, transport decision considerations, and privacy issues.

38. The secondary assessment of a sick or injured child: A) is a rapid head-to-toe exam to detect life threats. B) should be performed, regardless of the circumstances. C) might not be possible if the child's condition is critical. D) is most appropriate when your transport time is short.

ANS: C Complexity: Easy Ahead: Patient Assessment Subject: Chapter 35, Page 1304 Title: Pediatric Emergencies Feedback: See Patient Assessment Taxonomy: Recall Objective: 35-10 Explain the steps in the secondary assessment of a pediatric patient, including what EMTs should look for related to different body areas and the method of injury.

85. 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 head. C) Children are more likely to experience diving-related injuries. D) Inexperience and poor judgment are rare causes of pediatric trauma.

ANS: C Complexity: Easy Ahead: Pediatric Trauma Emergencies and Management Subject: Chapter 35, Page 1329 Title: Pediatric Emergencies Feedback: See Pediatric Trauma Emergencies and Management Taxonomy: Recall Objective: 35-25 Discuss the common causes of pediatric trauma emergencies; include how to differentiate between injury patterns in adults, infants, and children.

95. 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 bones. C) their bones bend more easily than an adult's bones. D) twisting injuries are more common in children.

ANS: C Complexity: Easy Ahead: Pediatric Trauma Emergencies and Management Subject: Chapter 35, Page 1335 Title: Pediatric Emergencies Feedback: See Pediatric Trauma Emergencies and Management Taxonomy: Application Objective: 35-25 Discuss the common causes of pediatric trauma emergencies; include how to differentiate between injury patterns in adults, infants, and children.

75. 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?

ANS: C Complexity: Easy Ahead: Poisoning Emergencies and Management Subject: Chapter 35, Page 1325 Title: Pediatric Emergencies Feedback: See Poisoning Emergencies and Management Taxonomy: Recall Objective: 35-21 Describe the emergency care of a pediatric patient who has been poisoned, including common sources of poisoning, signs, and symptoms.

62. 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.

ANS: C Complexity: Easy Ahead: Respiratory Emergencies and Management Subject: Chapter 35, Page 1318 Title: Pediatric Emergencies Feedback: See Respiratory Emergencies and Management Taxonomy: Recall Objective: 35-15 List the different oxygen delivery devices that are available for providing oxygen to a pediatric patient, including the indications for the use of each and precautions EMTs must take to ensure the patient's safety.

103. 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

ANS: C Complexity: Easy Ahead: Sudden Infant Death Syndrome Subject: Chapter 35, Page 1339 Title: Pediatric Emergencies Feedback: See Sudden Infant Death Syndrome Taxonomy: Recall Objective: 35-29 Discuss brief resolved unexplained event (BRUE), sudden unexpected infant death, and sudden infant death syndrome (SIDS), including its risk factors, patient assessment, and special management considerations related to the death of an infant patient.

97. 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

ANS: C Complexity: Moderate Ahead: Child Abuse and Neglect Subject: Chapter 35, Page 1336 Title: Pediatric Emergencies Feedback: See Child Abuse and Neglect Taxonomy: Recall Objective: 35-28 Describe child abuse and neglect and its possible indicators, including the medical and legal responsibilities of EMTs when caring for a pediatric patient who is a possible victim of child abuse.

64. 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

ANS: C Complexity: Moderate Ahead: Circulation Emergencies and Management Subject: Chapter 35, Page 1320 Title: Pediatric Emergencies Feedback: See Circulation Emergencies and Management Taxonomy: Analysis Objective: 35-16 Describe the emergency care of a pediatric patient who is in shock (hypoperfusion), including common causes, signs, and symptoms.

68. 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.

ANS: C Complexity: Moderate Ahead: Fever Emergencies and Management Subject: Chapter 35, Page 1328 Title: Pediatric Emergencies Feedback: See Fever Emergencies and Management Taxonomy: Recall Objective: 35-18 Describe the emergency care of a pediatric patient who has experienced a seizure, including the different types of seizures and the common causes, signs, and symptoms.

11. 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.

ANS: C Complexity: Moderate Ahead: Patient Assessment Subject: Chapter 35, Page 1296 Title: Pediatric Emergencies Feedback: See Patient Assessment Taxonomy: Analysis Objective: 35-9 Explain the steps in the primary assessment of a pediatric patient, including the elements of the pediatric assessment triangle (PAT), hands-on XABCs, transport decision considerations, and privacy issues.

26. 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%.

ANS: C Complexity: Moderate Ahead: Patient Assessment Subject: Chapter 35, Page 1298 Title: Pediatric Emergencies Feedback: See Patient Assessment Taxonomy: Recall Objective: 35-11 Describe the emergency care of a pediatric patient in respiratory distress, including the different causes of pediatric respiratory emergencies, the signs and symptoms of increased work of breathing, and the difference between respiratory distress and respiratory failure.

30. When assessing the heart rate of a 6-month-old infant, you should palpate the brachial pulse or ________ pulse. A) radial B) carotid C) femoral D) popliteal

ANS: C Complexity: Moderate Ahead: Patient Assessment Subject: Chapter 35, Page 1299 Title: Pediatric Emergencies Feedback: See Patient Assessment Taxonomy: Recall Objective: 35-9 Explain the steps in the primary assessment of a pediatric patient, including the elements of the pediatric assessment triangle (PAT), hands-on XABCs, transport decision considerations, and privacy issues.

78. 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.

ANS: C Complexity: Moderate Ahead: Poisoning Emergencies and Management Subject: Chapter 35, Page 1326 Title: Pediatric Emergencies Feedback: See Poisoning Emergencies and Management Taxonomy: Recall Objective: 35-22 Describe the emergency care of a pediatric patient who is dehydrated, including how to gauge the severity of dehydration based on key signs and symptoms.

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

ANS: C Complexity: Moderate Ahead: Respiratory Emergencies and Management Subject: Chapter 35, Page 1308 Title: Pediatric Emergencies Feedback: See Respiratory Emergencies and Management Taxonomy: Recall Objective: 35-11 Describe the emergency care of a pediatric patient in respiratory distress, including the different causes of pediatric respiratory emergencies, the signs and symptoms of increased work of breathing, and the difference between respiratory distress and respiratory failure.

48. 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.

ANS: C Complexity: Moderate Ahead: Respiratory Emergencies and Management Subject: Chapter 35, Page 1309 Title: Pediatric Emergencies Feedback: See Respiratory Emergencies and Management Taxonomy: Recall Objective: 35-12 List the possible causes of an upper and a lower airway obstruction in a pediatric patient and the steps in the management of foreign body airway obstruction.

57. 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

ANS: C Complexity: Moderate Ahead: Respiratory Emergencies and Management Subject: Chapter 35, Page 1316 Title: Pediatric Emergencies Feedback: See Respiratory Emergencies and Management Taxonomy: Analysis Objective: 35-14 Explain how to determine the correct size of an airway adjunct intended for a pediatric patient during an emergency.

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

ANS: C Complexity: Moderate Ahead: Respiratory Emergencies and Management Subject: Chapter 35, Page 1316 Title: Pediatric Emergencies Feedback: See Respiratory Emergencies and Management Taxonomy: Recall Objective: 35-14 Explain how to determine the correct size of an airway adjunct intended for a pediatric patient during an emergency.

106. 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) request the medical examiner to perform an autopsy. C) inform the child's mother that her son is deceased. D) begin high-quality CPR and request an ALS ambulance.

ANS: C Complexity: Moderate Ahead: Sudden Infant Death Syndrome Subject: Chapter 35, Page 1339 Title: Pediatric Emergencies Feedback: See Sudden Infant Death Syndrome Taxonomy: Application Objective: 35-30 Discuss the responsibilities of EMTs when communicating with a family or loved ones following the death of a child.

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

ANS: C Complexity: Moderate Ahead: Sudden Infant Death Syndrome Subject: Chapter 35, Page 1339 Title: Pediatric Emergencies Feedback: See Sudden Infant Death Syndrome Taxonomy: Recall Objective: 35-29 Discuss brief resolved unexplained event (BRUE), sudden unexpected infant death, and sudden infant death syndrome (SIDS), including its risk factors, patient assessment, and special management considerations related to the death of an infant patient.

35. 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 on 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-valve mask, 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.

ANS: D Complexity: Difficult Ahead: Patient Assessment Subject: Chapter 35, Page 1298 Title: Pediatric Emergencies Feedback: See Patient Assessment Taxonomy: Application Objective: 35-11 Describe the emergency care of a pediatric patient in respiratory distress, including the different causes of pediatric respiratory emergencies, the signs and symptoms of increased work of breathing, and the difference between respiratory distress and respiratory failure.

108. 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.

ANS: D Complexity: Difficult Ahead: Sudden Infant Death Syndrome Subject: Chapter 35, Page 1342 Title: Pediatric Emergencies Feedback: See Sudden Infant Death Syndrome Taxonomy: Application Objective: 35-29 Discuss brief resolved unexplained event (BRUE), sudden unexpected infant death, and sudden infant death syndrome (SIDS), including its risk factors, patient assessment, and special management considerations related to the death of an infant patient.

69. 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) might indicate a serious underlying illness.

ANS: D Complexity: Easy Ahead: Fever Emergencies and Management Subject: Chapter 35, Page 1328 Title: Pediatric Emergencies Feedback: See Fever Emergencies and Management Taxonomy: Application Objective: 35-18 Describe the emergency care of a pediatric patient who has experienced a seizure, including the different types of seizures and the common causes, signs, and symptoms.

2. 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.

ANS: D Complexity: Easy Ahead: Growth and Development Subject: Chapter 35, Page 1285 Title: Pediatric Emergencies Feedback: See Growth and Development Taxonomy: Recall Objective: 35-2 Discuss the physical and cognitive developmental stages of an infant, including health risks, signs that may indicate illness, and patient assessment.

19. 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.

ANS: D Complexity: Easy Ahead: Patient Assessment Subject: Chapter 35, Page 1294 Title: Pediatric Emergencies Feedback: See Patient Assessment Taxonomy: Application Objective: 35-9 Explain the steps in the primary assessment of a pediatric patient, including the elements of the pediatric assessment triangle (PAT), hands-on XABCs, transport decision considerations, and privacy issues.

24. 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.

ANS: D Complexity: Easy Ahead: Patient Assessment Subject: Chapter 35, Page 1296 Title: Pediatric Emergencies Feedback: See Patient Assessment Taxonomy: Recall Objective: 35-11 Describe the emergency care of a pediatric patient in respiratory distress, including the different causes of pediatric respiratory emergencies, the signs and symptoms of increased work of breathing, and the difference between respiratory distress and respiratory failure.

27. 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.

34. Immediate transport is indicated for a child when he or she: A) is experiencing mild to moderate pain. B) falls from a height greater than 4 to 5 feet. C) has a possible closed fracture of the radius. D) has a history compatible with a serious illness.

ANS: D Complexity: Easy Ahead: Patient Assessment Subject: Chapter 35, Page 1302 Title: Pediatric Emergencies Feedback: See Patient Assessment Taxonomy: Recall Objective: 35-9 Explain the steps in the primary assessment of a pediatric patient, including the elements of the pediatric assessment triangle (PAT), hands-on XABCs, transport decision considerations, and privacy issues.

93. 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.

ANS: D Complexity: Easy Ahead: Pediatric Trauma Emergencies and Management Subject: Chapter 35, Page 1334 Title: Pediatric Emergencies Feedback: See Pediatric Trauma Emergencies and Management Taxonomy: Recall Objective: 35-26 Discuss the significance of burns in pediatric patients, their most common causes, and general guidelines EMTs should follow when assessing patients who have sustained burns.

79. 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.

ANS: D Complexity: Easy Ahead: Poisoning Emergencies and Management Subject: Chapter 35, Page 1326 Title: Pediatric Emergencies Feedback: See Poisoning Emergencies and Management Taxonomy: Recall Objective: 35-22 Describe the emergency care of a pediatric patient who is dehydrated, including how to gauge the severity of dehydration based on key signs and symptoms.

60. 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 child's heart rate. B) observe the child's skin color. C) monitor the pulse oximeter reading. D) observe the chest for adequate rise.

ANS: D Complexity: Easy Ahead: Respiratory Emergencies and Management Subject: Chapter 35, Page 1316 Title: Pediatric Emergencies Feedback: See Respiratory Emergencies and Management Taxonomy: Application Objective: 35-15 List the different oxygen delivery devices that are available for providing oxygen to a pediatric patient, including the indications for the use of each and precautions EMTs must take to ensure the patient's safety.

13. Which of the following statements regarding spinal injuries in pediatric patients is correct? A) Because of a child's proportionately large head, they are more prone to spinal cord injuries than adults. B) The majority of cervical spine injuries in children are partial transections of the spinal cord, resulting in partial paralysis. C) Most cervical spine fractures in infants and children occur between the first and second cervical vertebrae. D) If the cervical spine is injured, it is most likely an injury to the ligaments because of rapid movement of the head.

ANS: D Complexity: Moderate Ahead: Anatomy and Physiology Subject: Chapter 35, Page 1292 Title: Pediatric Emergencies Feedback: See Anatomy and Physiology Taxonomy: Application Objective: 35-7 Describe differences in the anatomy and physiology of the pediatric patient compared to the adult patient and their implications for EMTs, with a focus on the following body systems: respiratory, circulatory, nervous, gastrointestinal, musculoskeletal, and integumentary.

15. 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) 2, 4 B) 6, 12 C) 12, 4 D) 18, 6

ANS: D Complexity: Moderate Ahead: Anatomy and Physiology Subject: Chapter 35, Page 1293 Title: Pediatric Emergencies Feedback: See Anatomy and Physiology Taxonomy: Recall Objective: 35-7 Describe differences in the anatomy and physiology of the pediatric patient compared to the adult patient and their implications for EMTs, with a focus on the following body systems: respiratory, circulatory, nervous, gastrointestinal, musculoskeletal, and integumentary.

83. 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.

ANS: D Complexity: Moderate Ahead: Fever Emergencies and Management Subject: Chapter 35, Page 1327 Title: Pediatric Emergencies Feedback: See Fever Emergencies and Management Taxonomy: Recall Objective: 35-23 Describe the emergency care of a pediatric patient who is experiencing a fever emergency, including common causes.

5. Which of the following statements regarding preschool-age children is correct? A) They realize that injuries are not a form of punishment. B) Preschoolers are usually not fearful of pain or separation. C) The preschool age begins after the child turns 2 years old. D) They can usually identify painful areas when questioned.

ANS: D Complexity: Moderate Ahead: Growth and Development Subject: Chapter 35, Page 1287 Title: Pediatric Emergencies Feedback: See Growth and Development Taxonomy: Recall Objective: 35-4 Discuss the physical and cognitive developmental stages of a preschool-age child, including health risks, signs that may indicate illness, and patient assessment.

87. After a head injury, which of the following is more common in children than in adults? A) Spinal cord injury B) Loss of consciousness C) Seizures and hypoxia D) Nausea and vomiting

ANS: D Complexity: Moderate Ahead: Pediatric Trauma Emergencies and Management Subject: Chapter 35, Page 1330 Title: Pediatric Emergencies Feedback: See Pediatric Trauma Emergencies and Management Taxonomy: Recall Objective: 35-25 Discuss the common causes of pediatric trauma emergencies; include how to differentiate between injury patterns in adults, infants, and children.

88. 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.

ANS: D Complexity: Moderate Ahead: Pediatric Trauma Emergencies and Management Subject: Chapter 35, Page 1331 Title: Pediatric Emergencies Feedback: See Pediatric Trauma Emergencies and Management Taxonomy: Recall Objective: 35-25 Discuss the common causes of pediatric trauma emergencies; include how to differentiate between injury patterns in adults, infants, and children.

43. The most ominous sign of impending cardiopulmonary arrest in infants and children is: A) pallor. B) retractions. C) nasal flaring. D) bradycardia.

ANS: D Complexity: Moderate Ahead: Respiratory Emergencies and Management Subject: Chapter 35, Page 1308 Title: Pediatric Emergencies Feedback: See Respiratory Emergencies and Management Taxonomy: Recall Objective: 35-11 Describe the emergency care of a pediatric patient in respiratory distress, including the different causes of pediatric respiratory emergencies, the signs and symptoms of increased work of breathing, and the difference between respiratory distress and respiratory failure.

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

ANS: D Complexity: Moderate Ahead: Respiratory Emergencies and Management Subject: Chapter 35, Page 1313 Title: Pediatric Emergencies Feedback: See Respiratory Emergencies and Management Taxonomy: Recall Objective: 35-14 Explain how to determine the correct size of an airway adjunct intended for a pediatric patient during an emergency.

104. Causes of infant death that might be mistaken for SIDS include all of the following, except: A) child abuse. B) meningitis. C) severe infection. D) hyperglycemia.

ANS: D Complexity: Moderate Ahead: Sudden Infant Death Syndrome Subject: Chapter 35, Page 1339 Title: Pediatric Emergencies Feedback: See Sudden Infant Death Syndrome Taxonomy: Recall Objective: 35-29 Discuss brief resolved unexplained event (BRUE), sudden unexpected infant death, and sudden infant death syndrome (SIDS), including its risk factors, patient assessment, and special management considerations related to the death of an infant patient.

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Ch 35 Pediatric Emergencies

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