EMT Unit 8

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

B. 20 g

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.

B. 6 months and 6 years.

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.

B. 6 years.

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

B. 60

If a baby is born at 7:52, the second Apgar score should be calculated at: A. 7:53. B. 7:57. C. 7:59. D. 8:00.

B. 7:57.

Causes of delirium in the older patient include all of the following, EXCEPT: A. acute hypovolemia. B. Alzheimer disease. C. low blood sugar level. D. decreased cerebral perfusion.

B. Alzheimer disease.

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

B. EMTs must report all suspected cases of child abuse.

Which of the following statements regarding patients with developmental disabilities is correct? A. Speaking with the patient's family is the least effective way to determine how much the patient understands. B. Patients with developmental disabilities are susceptible to the same disease processes as other patients. C. A developmental disability differs from mental retardation in that it is the result of a congenital abnormality. D. Most patients with developmental disabilities have normal cognitive function, but abnormal physical features.

B. Patients with developmental disabilities are susceptible to the same disease processes as other patients.

Which of the following observations or statements represents the "E" in the GEMS diamond? A. Elderly patients present atypically and deserve your respect. B. The patient's residence is cold due to a malfunctioning heater. C. A patient is assisted with his or her activities of daily living. D. The patient's medications have not been filled in 2 months.

B. The patient's residence is cold due to a malfunctioning heater.

Spina bifida is MOST accurately defined as: A. congenital inflammation of the spinal cord, usually in the neck. B. a birth defect caused by incomplete closure of the spinal column. C. a birth defect in which the child is born without spinal vertebrae. D. chronic pressure on the brain caused by excess cerebrospinal fluid.

B. a birth defect caused by incomplete closure of the spinal column.

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

B. a rash.

Characteristic anatomic features of Down syndrome include: A. a proportionately small tongue. B. a round head with a flat occiput. C. bulging eyes and a large face. D. long hands with wide fingers.

B. a round head with a flat occiput.

You receive a call for a sick person. When you arrive, you find the patient, a 75-year-old male, lying unresponsive in his bed. His respirations are slow and irregular and his pulse is slow and weak. His daughter tells you that he fell the day before, but refused to allow her to call 9-1-1. His past medical history is significant for hypothyroidism, deep vein thrombosis, heavy alcohol use, and liver cirrhosis. His medications include blood thinners and vitamins. You should be MOST suspicious that this patient is experiencing: A. acute hyperglycemia. B. a subdural hematoma. C. acute ischemic stroke. D. diabetic ketoacidosis.

B. a subdural hematoma.

When assessing an older patient who has multiple bruises in various stages of healing, the EMT should do all of the following, EXCEPT: A. factually document all findings. B. accuse a caregiver of physical abuse. C. ask the patient how the bruises occurred. D. review the patient's activities of daily living.

B. accuse a caregiver of physical abuse.

According to the Emergency Medical Treatment and Active Labor Act (EMTALA): A. all health care facilities are legally obligated to provide assessment and care only if the patient is critically ill or injured. B. all health care facilities must provide a medical assessment and required treatment, regardless of the patient's ability to pay. C. a health care facility has the right to refuse assessment and treatment to a patient, but only if his or her condition is not deemed critical. D. a patient maintains the legal right to recant his or her consent to emergency treatment, even after signing in to the emergency department.

B. all health care facilities must provide a medical assessment and required treatment, regardless of the patient's ability to pay.

Braxton-Hicks contractions are characterized by: A. regular contractions of progressively increasing intensity. B. alleviation of pain with movement or changing positions. C. pink or red bloody show in conjunction with the contractions. D. a rupture of the amniotic sac just before the contractions begin.

B. alleviation of pain with movement or changing positions.

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.

B. allow the family to observe if they wish.

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.

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

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

B. are taking blood-thinning medications.

Under what circumstances is a left ventricular assist device used? A. to permanently replace the function of one or both of the ventricles B. as a bridge to heart transplantation while a donor heart is being located C. to reduce ventricular pumping force in patients with aortic aneurysms D. to ensure that the ventricles contract at an adequate and consistent rate

B. as a bridge to heart transplantation while a donor heart is being located

A 2-year-old female has experienced a seizure. When you arrive at the scene, the child is conscious, crying, and clinging to her mother. Her skin is hot and moist. The mother tells you that the seizure lasted approximately 5 minutes. She further tells you that her daughter has no history of seizures, but has had a recent ear infection. You should: A. allow the mother to drive her daughter to the hospital. B. attempt cooling measures, offer oxygen, and transport. C. place the child in cold water to attempt to reduce her fever. D. suspect that the child has meningitis and transport at once.

B. attempt cooling measures, offer oxygen, and transport.

When faced with a situation in which an older patient with a terminal illness is in cardiac arrest, but written documentation regarding the patient's wishes cannot be located, the EMT should: A. try to locate the documentation. B. attempt to resuscitate the patient. C. allow the patient to die in peace. D. contact medical control for advice.

B. attempt to resuscitate the patient.

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

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

Which of the following is the LEAST reliable assessment parameter to evaluate when determining the presence of shock in infants and children? A. heart rate B. blood pressure C. skin condition D. capillary refill

B. blood pressure

Clouding of the lenses of the eyes is called: A. retinitis. B. cataracts. C. glaucoma. D. conjunctivitis.

B. cataracts.

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

B. cause the child to vomit.

Which of the following is an indication of imminent birth? A. rupture of the amniotic sac B. crowning of the baby's head C. irregular contractions lasting 10 minutes D. expulsion of the mucus plug from the vagina

B. crowning of the baby's head

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

B. dehydration from vomiting and diarrhea.

A 13-year-old child is on a home ventilator. The parents called because the ventilator is malfunctioning and the child has increasing respiratory distress. You should: A. attempt to troubleshoot the ventilator problem. B. disconnect the ventilator and use a bag-mask device. C. place a call to the home health agency treating this patient. D. reset the ventilator by unplugging it for 30 to 60 seconds.

B. disconnect the ventilator and use a bag-mask device.

An older patient with significant dehydration would MOST likely present with: A. an increase in blood pressure upon standing. B. dizziness or fainting upon standing. C. weakness to one side of the body. D. a drop in heart rate upon standing.

B. dizziness or fainting upon standing.

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.

B. drooling or congestion.

If a pregnant patient requires spinal immobilization, you should secure her to the backboard and then: A. tilt the board 30° to the right to prevent hypotension. B. elevate the right side of the board with rolled towels or blankets. C. raise the foot of the board 12″ in order to maintain blood pressure. D. elevate the head of the board 6″ to prevent breathing impairment.

B. elevate the right side of the board with rolled towels or blankets.

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.

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

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.

B. ensure that his or her neck is hyperextended.

Before assessing the respiratory adequacy of an 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.

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

Which of the following groups of people is associated with the lowest risk of meningitis? A. newborns B. females C. geriatrics D. children with shunts

B. females

Following delivery of a full-term baby, you have properly cared for the baby and have clamped and cut the umbilical cord. During transport, you note that the mother is experiencing moderate vaginal bleeding. You should: A. elevate her legs 6″ to 8″ and cover her with a blanket. B. firmly massage the uterine fundus with a circular motion. C. carefully insert a sterile trauma dressing into her vagina. D. place her legs together and position her on her left side.

B. firmly massage the uterine fundus with a circular motion.

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.

B. have a female EMT remain with her if possible.

To minimize distractions and confusion when assessing an older patient, you should: A. dismiss the family members from the room or area. B. have only one EMT speak to the patient at a time. C. elevate your voice and speak directly to the patient. D. perform a physical exam and then talk to the patient.

B. have only one EMT speak to the patient at a time.

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.

B. his or her tidal volume is adequate.

For which of the following conditions would you MOST likely encounter a ventricular peritoneum shunt? A. heart failure B. hydrocephalus C. cerebral palsy D. subdural hematoma

B. hydrocephalus

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

B. hyperglycemia.

Which of the following is a normal physiologic change that occurs in the mother's respiratory system during pregnancy? A. decreased respiratory rate and increased minute volume B. increased respiratory rate and decreased respiratory reserve C. increased respiratory reserve and decreased oxygen demand D. increased respiratory depth and decreased respiratory rate

B. increased respiratory rate and decreased respiratory reserve

The amniotic fluid serves to: A. transfer oxygen to the fetus. B. insulate and protect the fetus. C. remove viruses from the fetus. D. assist in fetal development.

B. insulate and protect the fetus.

By placing one hand on top of your head and the other hand over your abdomen, you are asking a hearingimpaired patient if he or she: A. is hurt. B. is sick. C. needs help. D. is nauseated.

B. is sick.

A nuchal cord is defined as an umbilical cord that: A. has separated from the placenta. B. is wrapped around the baby's neck. C. is lacerated due to a traumatic delivery. D. has abnormally developed blood vessels.

B. is wrapped around the baby's neck.

Talking about an elderly patient in front of him or her to other members of the family: A. often causes the patient to become paranoid and untrusting of your help. B. may cause the patient to think that he or she has no say in making decisions. C. will anger the patient and result in his or her refusal to accept care or transport. D. is usually beneficial because the patient's cognitive skills are typically impaired.

B. may cause the patient to think that he or she has no say in making decisions.

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.

B. moderate dehydration.

A 4-year-old female ingested an unknown quantity of liquid drain cleaner. Your assessment reveals that she is conscious and alert, is breathing adequately, and has skin burns around her mouth. You should: A. place her supine and elevate her legs. B. monitor her airway and give oxygen. C. determine why the ingestion occurred. D. give 12.5 to 25 g of activated charcoal.

B. monitor her airway and give oxygen.

In contrast to conductive hearing loss, sensorineural hearing loss is caused by: A. barotrauma. B. nerve damage. C. earwax accumulation. D. eardrum perforation.

B. nerve damage.

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.

B. not rule out compensated shock.

Upon entering the residence of a geriatric patient with a medical or trauma complaint, the EMT should: A. immediately seek out a family member or other caregiver. B. observe for conditions that may make the residence unsafe. C. begin his or her assessment after gathering any medication bottles. D. talk to the patient after performing his or her primary assessment.

B. observe for conditions that may make the residence unsafe.

Critical 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.

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

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

B. place a towel or folded sheet behind the shoulders.

When immobilizing a patient with a kyphotic spine to a long backboard, the EMT would MOST likely have to: A. force the head into a neutral alignment. B. place blankets behind the patient's head. C. secure the patient's head before the torso. D. use a scoop stretcher instead of a log roll.

B. place blankets behind the patient's head.

The use of multiple prescription drugs by a single patient, causing the potential for negative effects such as overdosing or drug interaction, is called: A. potentiation. B. polypharmacy. C. drug tolerance. D. drug dependency.

B. polypharmacy.

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 emotional support. C. avoiding the placement of a splint, if possible. D. heat compresses and lowering the injured extremity.

B. positioning, ice packs, and emotional support.

Fetal complications associated with drug- or alcohol-addicted mothers include all of the following, EXCEPT: A. low birth weight. B. profound tachycardia. C. premature delivery. D. respiratory depression.

B. profound tachycardia.

Upon delivery of the baby's head, you note that its face is encased in the unruptured amniotic sac. You should: A. give the mother 100% oxygen and transport at once. B. puncture the sac and suction the baby's mouth and nose. C. leave the amniotic sac intact until arrival at the hospital. D. note the color of the amniotic fluid before breaking the sac.

B. puncture the sac and suction the baby's mouth and nose.

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

B. 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. ensuring adequate oxygenation and ventilation at all times. B. removing the tube if the area around it appears to be infected. C. suctioning the tube as needed to clear a thick mucous plug. D. maintaining the patient in a position of comfort when possible.

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

Blood levels of medications may rise in the elderly, sometimes to toxic levels. This is MOST likely due to: A. pancreatic failure. B. renal insufficiency. C. intentional overdose. D. splenic dysfunction.

B. renal insufficiency.

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

B. respiratory or circulatory failure.

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.

B. retracting.

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.

B. size of the child and the height of the bumper upon impact.

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

B. slowed level of activity.

Common associated conditions in patients with spina bifida include all of the following, EXCEPT: A. hydrocephalus. B. spastic limb movement. C. extreme latex allergy. D. loss of bladder control.

B. spastic limb movement.

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

B. stabilize his head and check for a pulse.

The EMT should suspect left-sided heart failure in the geriatric patient who presents with: A. fever and a cough that produces green sputum. B. tachypnea and paroxysmal nocturnal dyspnea. C. jugular venous distention and peripheral edema. D. swelling of the lower extremities and weakness.

B. tachypnea and paroxysmal nocturnal dyspnea.

When assessing an 8-year-old child, you should: A. refrain from taking a blood pressure. B. talk to the child, not just the caregiver. C. use a toe-to-head assessment approach. D. rely solely on the parent for information.

B. talk to the child, not just the caregiver.

The presence of thick meconium in the amniotic fluid indicates: A. an expected finding in full-term infants. B. that the baby's airway may be obstructed. C. that the fetus is at least 4 weeks premature. D. that full newborn resuscitation will be needed.

B. that the baby's airway may be obstructed.

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.

B. the flexible ribs can be compressed without breaking.

In contrast to a living will, a "do not resuscitate" (DNR) order becomes valid when: A. the patient has a terminal illness. B. the patient develops cardiac arrest. C. the patient is in a health care setting. D. it is signed by three or more physicians.

B. the patient develops cardiac arrest.

A 77-year-old female presents with an acute onset of altered mental status. Her son is present and advises that she has a history of hypertension, atrial fibrillation, type 2 diabetes, and glaucoma. He further advises that she takes numerous medications and that she is normally alert. When you assess this patient, it is important to note that: A. because of her age and medical history, you should suspect Alzheimer disease. B. the patient is experiencing delirious behavior, which suggests a new health problem. C. her mental status is likely the result of hypoglycemia and you should give her sugar. D. dementia typically presents as an acute onset of deterioration of cognitive function.

B. the patient is experiencing delirious behavior, which suggests a new health problem.

Supine hypotensive syndrome occurs when: A. a supine position kinks the ascending aorta. B. the pregnant uterus compresses the inferior vena cava. C. the superior vena cava is compressed by the uterus. D. blood pressure decreases as a result of hypovolemia.

B. the pregnant uterus compresses the inferior vena cava.

A "silent" heart attack occurs when: A. sweating is the only presentation. B. the usual chest pain is not present. C. a sudden dysrhythmia causes death. D. the patient minimizes the chest pain.

B. the usual chest pain is not present.

When caring for patients with cerebral palsy, it is important to remember that: A. they are unable to walk and are totally dependent upon you. B. their limbs are often underdeveloped and are prone to injury. C. hearing aids are usually ineffective for patients with hearing loss. D. most patients have the ability to walk, but have an unsteady gait.

B. their limbs are often underdeveloped and are prone to injury.

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

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

General treatment guidelines when caring for a woman with traumatic vaginal bleeding include: A. carefully removing impaled objects. B. transporting to an appropriate facility. C. packing the vagina with sterile dressings. D. cleaning external wounds with sterile water.

B. transporting to an appropriate facility.

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.

B. use a length-based resuscitation tape measure.

Which of the following would be the MOST practical method of communicating with a hearing-impaired patient until his or her hearing aids can be located? A. attempting to use body language to determine the problem B. using a piece of paper and writing utensil to ask questions C. using a high-pitched voice while speaking directly into the ear D. contacting dispatch and requesting a sign language interpreter

B. using a piece of paper and writing utensil to ask questions

From what internal female organ is the fetus expelled during delivery? A. vagina B. uterus C. cervix D. perineum

B. uterus

Common causes of syncope in older patients include all of the following, EXCEPT: A. venous pooling. B. vasoconstriction. C. acute hypotension. D. blood volume loss.

B. vasoconstriction.

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.

B. weak distal pulses.

Which of the following questions is of LEAST pertinence when determining whether a mother will deliver her baby within the next few minutes? A. "When are you due?" B. "Is this your first baby?" C. "Have you had a sonogram?" D. "Do you feel the urge to push?"

C. "Have you had a sonogram?"

A newborn infant will usually begin breathing spontaneously within _______ seconds following birth. A. 3 to 5 B. 5 to 10 C. 15 to 30 D. 30 to 60

C. 15 to 30

A person is said to be obese when he or she is ________ over his or her ideal weight. A. 5% to 10% B. 10% to 15% C. 20% to 30% D. 40% to 50%

C. 20% to 30%

Blood loss in a child exceeding _____ of his or her total blood volume significantly increases the risk of shock. A. 5% B. 15% C. 25% D. 35%

C. 25%

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

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

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

C. 8

You have just delivered a full-term infant. His respirations are rapid and irregular, and he has a strong cry. What should you do next? A. Allow the mother to hold her baby. B. Clamp and cut the umbilical cord. C. Assess the brachial or umbilical pulse. D. Begin assisting the newborn's breathing.

C. Assess the brachial or umbilical pulse.

According to the "E" in the DOPE mnemonic, which of the following actions should you perform to troubleshoot inadequate ventilation in a patient with a tracheostomy tube? A. Look for blood or other secretions in the tube. B. Attempt to pass a suction catheter into the tube. C. Check the mechanical ventilator for malfunction. D. Listen to breath sounds to assess for a pneumothorax.

C. Check the mechanical ventilator for malfunction.

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

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

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

C. Children have a larger, rounder occiput compared to adults.

Which of the following statements regarding hearing aids is correct? A. Over time, hearing aids can restore normal hearing. B. In-the-canal hearing aids fit in the outer part of the ear. C. Hearing aids cannot restore hearing to normal levels. D. A whistling sound indicates correct hearing aid placement.

C. Hearing aids cannot restore hearing to normal levels.

Which of the following is NOT a reason why the exact extent and prevalence of elder abuse is unknown? A. It has been largely hidden from society. B. The definitions of abuse and neglect vary. C. Human resource agencies fail to investigate. D. Victims of elder abuse are hesitant to report it.

C. Human resource agencies fail to investigate.

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

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

Which of the following statements regarding sudden infant death syndrome (SIDS) is correct? A. Certain cases of SIDS are predictable and therefore preventable. B. SIDS is most commonly the result of an overwhelming infection. C. Most cases of SIDS occur in infants younger than 6 months. D. The cause of death following SIDS can be established by autopsy.

C. Most cases of SIDS occur in infants younger than 6 months.

Which of the following statements regarding autism is correct? A. Autism affects females four times greater than males. B. The majority of patients with autism do not speak at all. C. Most cases of autism are diagnosed by 3 years of age. D. Impairment of motor activity is a classic sign of autism.

C. Most cases of autism are diagnosed by 3 years of age.

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

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

Which of the following conditions would MOST likely cause a patient to slur words, speak very slowly, or speak in a monotone? A. advanced age B. cerebral palsy C. Parkinson disease D. visual impairment

C. Parkinson disease

Which of the following statements regarding gastrostomy (gastric) tubes is correct? A. Gastrostomy tubes are placed directly into the small intestine. B. Most gastrostomy tubes are temporary and are not sutured in place. C. Patients with a gastrostomy tube may still be at risk for aspiration. D. Gastrostomy tubes are used for patients who cannot digest food.

C. Patients with a gastrostomy tube may still be at risk for aspiration.

Which of the following processes occurs during ovulation? A. Certain female hormone levels decrease significantly in quantity. B. The endometrium sheds its lining and is expelled from the vagina. C. The inner lining of the uterus thickens in preparation for implantation. D. Numerous follicles mature and release eggs into the fallopian tubes.

C. The inner lining of the uterus thickens in preparation for implantation.

Which of the following occurs during true labor? A. Uterine contractions decrease in intensity. B. The uterus becomes very soft and movable. C. Uterine contractions become more regular. D. Uterine contractions last about 10 seconds.

C. Uterine contractions become more regular.

When questioning the parent of a child who ingested a poisonous substance, which of the following questions would be of LEAST pertinence? A. What time did the ingestion occur? B. Have you noticed any signs or symptoms? C. Why did your child ingest the poison? D. Do you know what substance was ingested?

C. Why did your child ingest the poison?

Osteoporosis is MOST accurately defined as: A. increased flexibility of bone mass. B. decreased bone marrow production. C. a decrease in bone mass and density. D. an abnormality near the growth plate.

C. a decrease in bone mass and density.

Down syndrome is a genetic defect that occurs as the result of: A. an extra pair of chromosomes. B. a separation of chromosome 21. C. a triplication of chromosome 21. D. a sperm that contains 24 chromosomes.

C. a triplication of chromosome 21.

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.

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

Common causes of depression in the elderly include all of the following, EXCEPT: A. chronic medical conditions. B. prescription medication use. C. an acute onset of dementia. D. alcohol abuse and dependence.

C. an acute onset of dementia.

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.

C. an ineffective cough.

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

C. an unresponsive 5-year-old male with shallow respirations

When assessing a 78-year-old female who complains of shortness of breath, the EMT should: A. give oxygen only if the patient has labored breathing. B. conclude that the patient is experiencing a heart attack. C. ask her how many pillows she uses when she sleeps. D. place the patient supine to see if the problem worsens.

C. ask her how many pillows she uses when she sleeps.

When interacting with a developmentally disabled patient, the best approach is to: A. speak primarily with the patient's family to establish the degree of disability. B. approach the patient as a team to reassure him or her that you are there to help. C. ask your team members to wait until you can establish a rapport with the patient. D. position yourself slightly above the patient's level to reduce his or her anxiety.

C. ask your team members to wait until you can establish a rapport with the patient.

You are assessing a 25-year-old woman who is 39 weeks pregnant. She is experiencing regular contractions that are approximately 3 minutes apart and states that her amniotic sac broke 2 hours ago. After taking the standard precautions, you should: A. apply 100% oxygen. B. place her on her left side. C. assess her for crowning. D. transport her immediately.

C. assess her for crowning.

Because of the complexity of the older patient and the vagueness of his or her complaint, you should: A. limit your physical examination to the area of pain or injury. B. rely exclusively on family members for the medical history. C. attempt to differentiate between chronic and acute problems. D. perform a rapid assessment on all geriatric patients you treat.

C. attempt to differentiate between chronic and acute problems.

If suctioning of the tracheostomy tube is necessary, the EMT should: A. attach a bag-mask device to the tracheostomy tube and hyperventilate the patient for 2 minutes. B. instill 20 mL of saline into the tracheostomy tube and suction for no longer than 20 seconds. C. attempt to use the patient's suction device first because it is probably already sized correctly. D. insert the suction catheter to a depth of no more than 15-cm and set the suction unit to 140 mm Hg.

C. attempt to use the patient's suction device first because it is probably already sized correctly.

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.

C. blood vessels near the skin are constricted.

Cerebral palsy is characterized by poorly controlled ________ movement. A. eye B. neck C. body D. extremity

C. body

The umbilical cord: A. separates from the placenta shortly after birth. B. carries blood away from the baby via the artery. C. carries oxygen to the baby via the umbilical vein. D. contains two veins and one large umbilical artery.

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

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

C. consistency in the method of injury reported by the caregiver

Upon arriving at the residence of an elderly female who apparently fainted, you find the patient lying supine on her living room floor. She is not moving and her eyes are closed. A neighbor tells you that she found the patient this way, but did not move her. When you gently tap the patient, she does not respond. You should: A. suction her airway, apply a cervical collar, administer high-flow oxygen via a nonrebreathing mask, and perform a rapid assessment. B. open her airway with the head tilt-chin lift maneuver, insert an oral or nasal airway, and assess her blood glucose level to rule out hypoglycemia. C. direct your partner to manually stabilize her head while you quickly visualize her chest for signs of breathing. D. begin assisting her ventilations with a bag-mask device while your partner auscultates her lung sounds to ensure adequate positive-pressure ventilation.

C. direct your partner to manually stabilize her head while you quickly visualize her chest for signs of breathing.

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

C. femoral

General communication techniques with the elderly include: A. using medical terms to ensure patient understanding. B. explaining procedures while you are performing them. C. frequently asking the patient if he or she understands. D. having at least two EMTs talk to the patient at a time.

C. frequently asking the patient if he or she understands.

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.

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

EMS personnel would MOST likely be called to the residence of a patient receiving home health care when the home care provider: A. needs simple assistance in providing patient care. B. must confirm that a specific intervention is required. C. has recognized a change in the patient's health status. D. has a question that is specific to the patient's condition.

C. has recognized a change in the patient's health status.

A precipitous labor and delivery is MOST common in women who: A. have gestational diabetes. B. are younger than 30 years of age. C. have delivered a baby before. D. are pregnant for the first time.

C. have delivered a baby before.

You are assessing a 70-year-old female who complains of intense thirst, frequent urination, and dizziness. She has a history of type 2 diabetes, heart disease, rheumatoid arthritis, and gout. Her blood glucose level is 450 mg/dL. She is conscious, but confused. Her blood pressure is 92/52 mm Hg, her pulse rate is 130 beats/min and weak, and her respirations are 22 breaths/min and shallow. This patient's clinical presentation is MOST consistent with: A. diabetic ketoacidosis. B. hyperglycemia with moderate dehydration. C. hyperosmolar hyperglycemic nonketotic coma (HHNC). D. acute renal failure with associated hyperglycemia.

C. hyperosmolar hyperglycemic nonketotic coma (HHNC).

The leading cause of maternal death during the first trimester of pregnancy is: A. massive brain damage secondary to a prolonged seizure. B. unrecognized or untreated supine hypotensive syndrome. C. internal bleeding caused by a ruptured ectopic pregnancy. D. blunt trauma to the abdomen during a motor vehicle crash.

C. internal bleeding caused by a ruptured ectopic pregnancy.

An abdominal aortic aneurysm: A. is usually not repairable, even if discovered early. B. causes dull pain that often radiates to the shoulders. C. is often the result of hypertension and atherosclerosis. D. can sometimes be palpated as a mass in the groin area.

C. is often the result of hypertension and atherosclerosis.

The term primigravida refers to a woman who: A. has never been pregnant. B. has had only one live birth. C. is pregnant for the first time. D. has had more than one live baby.

C. is pregnant for the first time.

Motor nerve neuropathy is characterized by: A. numbness, tingling, and severe muscle pain. B. loss of bladder control and sensitivity to touch. C. loss of balance, muscle weakness, and spasms. D. constipation, low blood pressure, and bradycardia.

C. loss of balance, muscle weakness, and spasms.

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. speak in a monotone voice. C. lower the pitch of your voice. D. increase the pitch of your voice.

C. lower the pitch of your voice.

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. may not be possible if the child's condition is critical. D. is most appropriate when your transport time is short.

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

Findings during the social assessment of an older patient include all of the following, EXCEPT: A. interaction with others. B. daily activity assistance. C. outdated medications. D. delays in obtaining meals.

C. outdated medications.

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%.

C. palpate the abdomen for rise and fall.

After using the 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.

C. perform a hands-on assessment of the ABCs.

Common interventions used to stimulate spontaneous respirations in the newborn include all of the following, EXCEPT: A. suctioning of the upper airway. B. thorough drying with a towel. C. positive-pressure ventilations. D. some form of tactile stimulation.

C. positive-pressure ventilations.

A pregnant trauma patient may lose a significant amount of blood before showing signs of shock because: A. pregnant patients can dramatically increase their heart rate. B. pregnancy causes vasodilation and a lower blood pressure. C. pregnant patients have an overall increase in blood volume. D. blood is shunted to the uterus and fetus during major trauma.

C. pregnant patients have an overall increase in blood volume.

Following delivery of a pulseless and apneic infant who has a foul odor, skin sloughing, and diffuse blistering, you should: A. begin full resuscitation and transport. B. report the case to the medical examiner. C. provide emotional support to the mother. D. dry the infant off to stimulate breathing.

C. provide emotional support to the mother.

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

C. putting a baby to sleep on his or her back

When performing your secondary assessment on an older patient who has been injured, it is important to: A. routinely perform a focused exam to minimize time at the scene. B. perform an in-depth physical exam prior to initiating any treatment. C. recall that it will take a less severe mechanism of injury to cause significant injuries. D. focus your assessment just on the area(s) of pain or obvious injury.

C. recall that it will take a less severe mechanism of injury to cause significant injuries.

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

C. restlessness.

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

Eclampsia is MOST accurately defined as: A. high levels of protein in the patient's urine. B. hypertension in the 20th week of pregnancy. C. seizures that result from severe hypertension. D. a blood pressure greater than 140/90 mm Hg.

C. seizures that result from severe hypertension.

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.

C. severe hypoxia and bradycardia.

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

C. stimulate the vagus nerve.

When the mother is experiencing a contraction, you should instruct her to: A. hold her breath. B. push for 30 seconds. C. take quick short breaths. D. rest and breathe deeply.

C. take quick short breaths.

In contrast to younger patients, older patients are more prone to a decrease in blood pressure upon standing because: A. their red blood cells are destroyed at a faster than normal rate. B. the aging process results in an overall increase in blood volume. C. the baroreceptors have become less sensitive to blood pressure. D. any change in position causes blood to be shunted to the brain.

C. the baroreceptors have become less sensitive to blood pressure.

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. intrathoracic bleeding and cardiac compression C. the effects of her antihypertensive medication D. failure of the parasympathetic nervous system

C. the effects of her antihypertensive medication

When caring for a geriatric patient with a traumatic injury, it is important to consider that: A. geriatric patients usually present with little to no pain. B. decreased bone density often results in incomplete fractures. C. the injury may have been preceded by a medical condition. D. geriatric patients typically present with classic signs of shock.

C. the injury may have been preceded by a medical condition.

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

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

A 70-year-old male complains of shortness of breath. During your assessment, you note that he has bilateral hearing aids. When you ask him questions related to his chief complaint, he does not answer you. You can hear a whistling sound coming from his hearing aids. You should: A. recognize that the batteries in his hearing aids are probably depleted. B. remove his hearing aids, turn up the volume, and replace them in his ears. C. try repositioning the hearing aid or remove it and turn down the volume. D. remove both of his hearing aids and use pencil and paper to communicate.

C. try repositioning the hearing aid or remove it and turn down the volume.

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.

C. vomiting and diarrhea.

A mother who is pregnant with her first baby is typically in the first stage of labor for approximately: A. 4 hours. B. 8 hours. C. 10 hours. D. 16 hours.

D. 16 hours.

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

D. 18, 6

Preeclampsia MOST commonly occurs after the ____ week of gestation. A. 12th B. 20th C. 24th D. 30th

D. 30th

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.

D. A 3-month-old infant can distinguish a parent from a stranger.

Which of the following statements regarding interaction with the caregiver of a child or adult with special health care needs is correct? A. In most cases, it is more appropriate for the EMT to contact medical control prior to speaking with the patient's primary caregiver. B. Before performing an assessment of the patient's ABCs, the EMT should ask the caregiver about the patient's medical condition. C. In general, the EMT should only speak with a certified home health care provider because he or she is the expert on the patient's illness. D. Communication with the patient's caregiver or family members is important because they are the most familiar with the patient's condition.

D. Communication with the patient's caregiver or family members is important because they are the most familiar with the patient's condition.

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 to be an injury to the ligaments because of rapid movement of the head.

D. If the cervical spine is injured, it is most likely to be an injury to the ligaments because of rapid movement of the head.

Which of the following statements regarding communications with the elderly is correct? A. The majority of elderly patients are hearing or visually impaired. B. Attempt to calm the elderly patient by using his or her first name. C. Explain the justification for a procedure after it has been completed. D. Older patients have difficulty understanding when they are stressed.

D. Older patients have difficulty understanding when they are stressed.

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.

D. They can usually identify painful areas when questioned.

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

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

A significant number of patients with cerebral palsy also have: A. paralysis. B. brain tumors. C. type 2 diabetes. D. a seizure disorder.

D. a seizure disorder.

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.

D. absent urine output.

A specific legal document that directs relatives and caregivers regarding the medical treatment that may be given to patients who cannot speak for themselves is called a(n): A. statute of care. B. power of attorney. C. physician directive. D. advance directive.

D. advance directive.

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.

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

A history of pelvic inflammatory disease or tubal ligations increases a woman's risk for: A. preeclampsia. B. placenta previa. C. gestational diabetes. D. an ectopic pregnancy.

D. an ectopic pregnancy.

You respond to a skate park where a 10-year-old male fell from his skateboard and struck his head on the ground; he was not wearing a helmet. He is responsive to painful stimuli only and has a large hematoma to the back of his head. After your partner stabilizes his head and opens his airway, you assess his breathing and determine that it is slow and irregular. His pulse is slow and bounding. You should: A. apply high-flow oxygen via a nonrebreathing mask, perform an in-depth secondary assessment, apply full spinal precautions, and transport. B. insert an oral airway, hyperventilate him with a bag-mask device, apply full spinal precautions, and transport to the closest trauma center. C. apply high-flow oxygen via a nonrebreathing mask, obtain baseline vital signs, apply full spinal precautions, and perform a secondary assessment. D. assist his ventilations, be prepared to suction his mouth if he vomits, apply full spinal precautions, and prepare for immediate transport to a trauma center.

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.

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 100% oxygen to the mother and transport at once. 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.

When documenting a case of suspected elder abuse, it is MOST important for the EMT to: A. theorize as to why the patient was abused. B. document his or her perceptions of the event. C. list the names of all of the suspected abusers. D. avoid documenting any unsupported opinions.

D. avoid documenting any unsupported opinions.

The third stage of labor begins when the: A. placenta is fully delivered. B. cervix is completely dilated. C. umbilical cord has been clamped. D. baby is expelled from the vagina.

D. baby is expelled from the vagina.

The vagina and the neck of the uterus comprise the: A. womb. B. cervix. C. fundus. D. birth canal.

D. birth canal.

Which of the following is NOT a component of the Apgar score? A. pulse B. activity C. grimace D. body size

D. body size

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

D. bradycardia.

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.

D. caused by the inability of the body to cool itself.

The chief component of connective tissues and bones that deteriorates as people age is called: A. fibrin. B. elastin. C. sebum. D. collagen.

D. collagen.

With age, the spine stiffens as a result of shrinkage of the intervertebral disc spaces, and the vertebrae become brittle. This increases the risk of: A. severe kyphosis. B. distracting injuries. C. spinal cord tearing. D. compression fractures.

D. compression fractures.

Two thirds of children born with Down syndrome have: A. diabetes mellitus. B. intracranial bleeding. C. unilateral paralysis. D. congenital heart disease.

D. congenital heart disease.

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.

The slow onset of progressive disorientation, shortened attention span, and loss of cognitive function is known as: A. delirium. B. delusion. C. paranoia. D. dementia.

D. dementia.

Placenta previa is MOST accurately defined as: A. delivery of a portion of the placenta before the baby. B. premature placental separation from the uterine wall. C. abnormal development and functioning of the placenta. D. development of the placenta over the cervical opening.

D. development of the placenta over the cervical opening.

After the fetus has descended into the pelvis at the end of the third trimester, many mothers experience: A. midback pain. B. a bloated feeling. C. an urge to push. D. easier breathing.

D. easier breathing.

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.

D. entrapment in a structural fire.

When caring for a morbidly obese patient, you should: A. leave him or her in a supine position, as this often facilitates breathing. B. ask the patient if he or she knows what led to his or her obesity problem. C. call for ALS backup because obese patients are at high risk for heart attack. D. establish his or her chief complaint and then communicate your plan to help.

D. establish his or her chief complaint and then communicate your plan to help.

A service dog is easily identified by its: A. size. B. breed. C. color. D. harness.

D. harness.

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 5′. C. has a possible closed fracture of the radius. D. has a history suggestive of a serious illness.

D. has a history suggestive of a serious illness.

An elderly patient may understate or minimize the symptoms of his or her illness because: A. the nervous system has deteriorated. B. of decreased perception of pain. C. of conditions such as dementia. D. he or she fears hospitalization.

D. he or she fears hospitalization.

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.

D. head bobbing.

A 10% to 20% reduction in brain weight and volume would MOST likely increase an older person's risk for: A. stroke. B. delirium. C. dementia. D. head trauma.

D. head trauma.

The leading cause of death in the geriatric patient is: A. hypertension. B. altered mental status. C. arthritis. D. heart disease.

D. heart disease.

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

D. hyperglycemia.

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

D. may indicate a serious underlying illness.

Which of the following is MORE common in children than in adults following a head injury? A. spinal cord injury B. loss of consciousness C. seizures and hypoxia D. nausea and vomiting

D. nausea and vomiting

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

D. observe the chest for adequate rise.

When preparing a pregnant patient for delivery, you should position her: A. in a supine position with her legs spread. B. on her left side with the right leg elevated. C. in a sitting position with her hips elevated 12″. D. on a firm surface with her hips elevated 2″ to 4″.

D. on a firm surface with her hips elevated 2″ to 4″.

Most medical models base a pregnant woman's due date: A. two weeks after her last menstrual cycle. B. on the last day of her last menstrual cycle. C. two weeks before her last menstrual cycle. D. on the first day of her last menstrual cycle.

D. on the first day of her last menstrual cycle.

You respond to a residence for a 9-year-old female with Down syndrome who is sick. When you arrive at the scene and assess the patient, you determine that she is unresponsive and has gurgling respirations. You should: A. insert an oropharyngeal airway and begin assisting her ventilations with a bag-mask device. B. open her airway with the jaw-thrust maneuver and assess the rate and depth of her breathing. C. immediately apply high-flow oxygen via a nonrebreathing mask and then assess her pulse rate. D. open her airway with a manual maneuver, suction her oropharynx, and insert a simple airway adjunct.

D. open her airway with a manual maneuver, suction her oropharynx, and insert a simple airway adjunct.

Autism is MOST accurately defined as a: A. psychiatric condition related to an imbalance of serotonin in the brain. B. mental disability caused by insufficient cognitive development of the brain. C. congenital condition caused by factors such as malnutrition or birth complications. D. pervasive developmental disorder characterized by impairment of social interaction.

D. pervasive developmental disorder characterized by impairment of social interaction.

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.

D. place him or her on a firm surface.

A productive cough, fever, and chills in an 80-year-old patient with a compromised immune system should make you MOST suspicious for: A. heart failure. B. bronchitis. C. emphysema. D. pneumonia.

D. pneumonia.

General techniques for communicating with hearing-impaired patients include: A. exaggerating your lip movements to ensure the patient understands. B. speaking directly into the patient's ear with an increased voice pitch. C. removing any hearing aids and using pen and paper to ask questions. D. positioning yourself approximately 18″ directly in front of the patient.

D. positioning yourself approximately 18″ directly in front of the patient.

Pregnant women are advised to take iron supplements, such as prenatal vitamins, because: A. iron makes the blood clot faster, which protects the mother from excessive bleeding during delivery. B. the blood naturally thins during pregnancy, which predisposes the mother to severe bleeding. C. white blood cells decrease during pregnancy, which increases the mother's risk of an infection. D. pregnancy causes a decreased number of red blood cells, which predisposes the mother to anemia.

D. pregnancy causes a decreased number of red blood cells, which predisposes the mother to anemia.

The purpose of a ventricular peritoneum shunt is to: A. divert excess cerebrospinal fluid to the ventricles of the brain. B. monitor pressure within the skull in patients with a head injury. C. remove fluid from the abdomen of patients with right heart failure. D. prevent excess cerebrospinal fluid from accumulating in the brain.

D. prevent excess cerebrospinal fluid from accumulating in the brain.

If a newborn's heart rate is less than 60 beats/min following delivery, you should: A. flick the soles of its feet. B. begin chest compressions. C. re-suction the mouth only. D. provide ventilations for 30 seconds.

D. provide ventilations for 30 seconds.

When caring for an elderly patient who is hearing-impaired, you should: A. speak directly into his or her ear with an elevated tone. B. remember that most hearing-impaired patients can read lips. C. request that he or she communicates with you by writing on paper. D. recall that elderly patients have difficulty hearing high-frequency sounds.

D. recall that elderly patients have difficulty hearing high-frequency sounds.

Common complications associated with central venous catheters include all of the following, EXCEPT: A. a local infection. B. clotting of the line. C. bleeding around the line. D. rupture of a central vein.

D. rupture of a central vein.

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.

D. secure the torso before the head.

An important aspect in the assessment of a patient who experienced a previous brain injury involves: A. presuming that he or she has cognitive impairment until proven otherwise. B. contacting the patient's physician to determine the extent of the brain injury. C. recalling that most patients with a brain injury have other organ dysfunction. D. speaking with the patient and family to establish what is considered normal for the patient.

D. speaking with the patient and family to establish what is considered normal for the patient.

When determining the frequency of contractions, you should time the contractions from the: A. end of one to the start of the next. B. start of one to the end of the next. C. end of one to the end of the next. D. start of one to the start of the next.

D. start of one to the start of the next.

When caring for a patient who is visually impaired, it is important to: A. allow a service dog to remain with the patient at all times, even if the patient is critically ill. B. stand to the side of the patient when speaking if his or her peripheral vision is impaired. C. leave items such as canes and walkers at the residence if the patient will be carried on a gurney. D. tell him or her what is happening, identify noises, and describe the situation and surroundings.

D. tell him or her what is happening, identify noises, and describe the situation and surroundings.

Many older victims of physical abuse may make false statements or lie about the origin of their injuries because: A. they are protective of the abuser. B. they do not want to be bothersome. C. most elderly patients have dementia. D. they fear retribution from the abuser.

D. they fear retribution from the abuser.

You receive a call to a residence for an apneic 2-month-old male. When you arrive at the scene, the infant's mother tells you that her son was born prematurely and that his apnea monitor has alarmed 4 times in the past 30 minutes. Your assessment of the infant reveals that he is conscious and active. His skin is pink and dry, and he is breathing at an adequate rate and with adequate tidal depth. His oxygen saturation reads 98% on room air. You should: A. request an ALS ambulance to transport the infant to the hospital. B. advise the mother to observe her son and call 9-1-1 again if necessary. C. administer high-flow oxygen and observe for a drop in oxygen saturation. D. transport the infant to the hospital and bring the apnea monitor with you.

D. transport the infant to the hospital and bring the apnea monitor with you.

An infant is considered to be premature if it: A. is born before 38 weeks' gestation or weighs less than 6 lb. B. weighs less than 5.5 lb or is born before 37 weeks' gestation. C. is born before 40 weeks' gestation or weighs less than 7 lb. D. weighs less than 5 lb or is born before 36 weeks' gestation.

D. weighs less than 5 lb or is born before 36 weeks' gestation.

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.

A. 2 seconds.

An abortion occurs when the fetus and placenta deliver before: A. 20 weeks. B. 24 weeks. C. 26 weeks. D. 28 weeks.

A. 20 weeks.

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

A. 3

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

A. 40

A child may begin to show signs of separation anxiety as early as: A. 6 months. B. 12 months. C. 18 months. D. 24 months.

A. 6 months.

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

A. 82 mm Hg

Which of the following statements regarding a breech presentation is MOST correct? A. A breech presentation occurs when the buttocks are the presenting part. B. There is minimal risk of trauma to the infant with a breech presentation. C. It is impossible to deliver a breech presentation in the prehospital setting. D. Breech deliveries occur rapidly, so the EMT should deliver at the scene.

A. A breech presentation occurs when the buttocks are the presenting part.

Which of the following statements regarding a decreased level of consciousness in the elderly patient is correct? A. A decreased level of consciousness is not a normal part of the aging process. B. Most elderly patients have some deterioration in their level of consciousness. C. A decreased level of consciousness is most often the result of chronic dementia. D. The AVPU scale is an ineffective tool when assessing an elderly patient's level of consciousness.

A. A decreased level of consciousness is not a normal part of the aging process.

Which of the following statements regarding the aging process is correct? A. Aging is a linear process; the rate at which a person loses functions does not increase with age. B. Because he or she is younger and healthier, a 35-year-old person ages slower than a 75-year-old person. C. Human growth and development peaks in the late 40s or early 50s, at which point the aging process sets in. D. The older a person gets, the slower the decline in the function of vital organs, such as the kidneys and liver.

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

During your visual inspection of a 19-year-old woman in labor, you see the baby's head crowning at the vaginal opening. What should you do? A. Apply gentle pressure to the baby's head as it delivers. B. Tell the mother not to push and transport her immediately. C. Place your fingers in the vagina to assess for a nuchal cord. D. Maintain firm pressure to the head until it completely delivers.

A. Apply gentle pressure to the baby's head as it delivers.

Which of the following statements regarding cerebral palsy is correct? A. Conditions such as brain injury at birth, postpartum infections, and fetal hypoxia can cause cerebral palsy. B. Most cases of cerebral palsy develop within the first 10 years of life and are typically caused by meningitis. C. Approximately 25% of patients with cerebral palsy possess some varying degrees of developmental delay. D. A key clinical feature of cerebral palsy is paralysis of the respiratory muscles, which confines the patient to a ventilator.

A. Conditions such as brain injury at birth, postpartum infections, and fetal hypoxia can cause cerebral palsy.

Which of the following statements regarding suicide in the older patient is correct? A. Older patients tend to use more lethal means than younger patients. B. Older females have a higher rate of suicide than any other group. C. Depression and hopeless feelings are often not predisposing factors. D. Most suicidal patients readily seek care and do not deny the problem.

A. Older patients tend to use more lethal means than younger patients.

Which of the following statements regarding the placenta is correct? A. 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. B. 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. C. The placenta, also referred to as the afterbirth, provides oxygen and nutrients to the fetus and is expelled from the vagina about 30 minutes before the baby is born. D. 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.

A. 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.

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.

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

During the natural process of aging, the number of functional cilia in the respiratory system decreases, resulting in: A. a decreased ability to cough. B. baseline respiratory distress. C. an increased risk of COPD. D. air-trapping within the alveoli.

A. a decreased ability to cough.

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

A. alcohol.

A 73-year-old female experienced a syncopal episode while watching TV. She is now conscious, but is diaphoretic, tachycardic, and hypotensive. Your assessment reveals abdominal tenderness and a pulsating mass to the left of her umbilicus. You should be MOST suspicious for: A. an aortic aneurysm. B. acute appendicitis. C. a strangulated bowel. D. myocardial infarction.

A. an aortic aneurysm.

The components of the PAT are: A. appearance, work of breathing, and skin circulation. B. mental status, heart rate, and systolic blood pressure. C. skin condition, respiratory rate, and level of alertness. D. activity, respiratory quality, and level of consciousness.

A. appearance, work of breathing, and skin circulation.

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.

A. at the feet.

You are assessing a 440-lb man who complains of shortness of breath and lower back pain. The patient is conscious and alert, his blood pressure is 148/98 mm Hg, and his heart rate is 120 beats/min. Your MOST immediate action should be to: A. avoid placing him in a supine position if possible and administer oxygen. B. notify the receiving facility and advise them of the patient's weight and status. C. perform a secondary assessment, focusing on his respiratory system and back. D. ask a member of your team to locate the best route to move him to the ambulance.

A. avoid placing him in a supine position if possible and administer oxygen.

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 in order to open her bronchioles. D. begin chest compressions if she becomes unresponsive and her heart rate falls below 80 beats/min.

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

By the 20th week of pregnancy, the uterus is typically at or above the level of the mother's: A. belly button. B. pubic bone. C. xiphoid process. D. superior diaphragm.

A. belly button.

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.

A. bleeding in the brain.

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

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

Cerebral palsy is a condition that results from damage or injury to the: A. brain. B. spinal cord. C. voluntary muscles. D. peripheral nervous system.

A. brain.

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

A. breech presentation and prolapsed umbilical cord.

Syncope in the older patient is: A. caused by an interruption of blood flow to the brain. B. generally of no concern unless the patient was injured. C. most commonly caused by a silent myocardial infarction. D. rarely life threatening but should be evaluated by a physician.

A. caused by an interruption of blood flow to the brain.

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.

A. cherry-red spots or a purplish rash.

Vagal nerve stimulators may be an alternative treatment to medication for patients with: A. chronic seizure disorders. B. inherently slow heart rates. C. certain psychiatric conditions. D. chronic muscle pain and fatigue.

A. chronic seizure disorders.

A surgical procedure that creates an opening between the intestine and the surface of the body that allows for elimination of waste products is called a(n): A. colostomy. B. gastrostomy. C. gastric stoma. D. intestinal shunt.

A. colostomy.

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

A. croup.

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

A. cyanosis.

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

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

You are dispatched to a skilled nursing care facility for an 80-year-old female with abnormal behavior. The patient is clearly confused and asks you if you are her husband. As your partner administers oxygen to the patient, you should: A. determine the patient's baseline mental status. B. inquire about a history of Alzheimer disease. C. obtain a complete list of the patient's medications. D. ask an attendant for the patient's medical records.

A. determine the patient's baseline mental status.

After a baby is born, it is important to: A. ensure that it is thoroughly dried and warmed. B. position it so that its head is higher than its body. C. cool the infant to stimulate effective breathing. D. immediately clamp and cut the umbilical cord.

A. ensure that it is thoroughly dried and warmed.

Which of the following is the MOST common mechanism of injury in older patients? A. falls B. burns C. abuse D. suicide

A. falls

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.

A. grunting.

In contrast to a full-term infant, a premature infant: A. has an even proportionately larger head. B. is often covered with excess vernix material. C. is one who is born before 38 weeks' gestation. D. retains heat better because of excess body hair.

A. has an even proportionately larger head.

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

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

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.

A. he or she can compensate for blood loss better than adults.

Signs and symptoms of preeclampsia include: A. headache and edema. B. marked hypoglycemia. C. dyspnea and bradycardia. D. dysuria and constipation.

A. headache and edema.

The purpose of the GEMS diamond is to: A. help EMS personnel remember what is different about elderly patients. B. provide the EMT with a standard format for assessing elderly patients. C. replace the typical ABC approach to patient care when caring for the elderly. D. provide clues about an elderly patient's problem by observing his or her home.

A. help EMS personnel remember what is different about elderly patients.

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.

A. intercostal muscles are not well developed.

In contrast to delirium, dementia: A. is usually considered irreversible. B. is the result of an acute condition. C. is reversible with certain treatment. D. often develops over a period of days.

A. is usually considered irreversible.

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. keep him warm and provide ventilatory assistance. B. begin chest compressions and reassess in 30 seconds. C. clamp and cut the umbilical cord and keep him warm. D. assess his skin color and give free-flow oxygen as needed.

A. keep him warm and provide ventilatory assistance.

The stooped posture of some older people, which gives them a humpback appearance, is called: A. kyphosis. B. arthritis. C. scoliosis. D. miosis.

A. kyphosis.

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.

A. neonatal period.

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. B. complaining of severe back pain. C. immobilized on a long backboard. D. experiencing cardiopulmonary arrest.

A. older than 8 to 10 years.

Fractures of the pelvis in older patients often occur as the result of a combination of: A. osteoporosis and low-energy trauma. B. increased bone density and car crashes. C. arthritic joints and high-energy trauma. D. acetabular separation and severe falls.

A. osteoporosis and low-energy trauma.

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. idiopathic fracture. C. compression fracture. D. comminuted fracture.

A. pathologic fracture.

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

A. perform abdominal thrusts.

Poor maintenance of home, poor personal care, and dietary neglect are all possible indicators of ____________ elder abuse. A. physical B. financial C. emotional D. psychological

A. physical

A 33-year-old woman who is 36 weeks pregnant is experiencing scant vaginal bleeding. During transport, you note that she suddenly becomes diaphoretic, tachycardic, and hypotensive. In addition to administering 100% oxygen, you should: A. place her in a left lateral recumbent position. B. position her supine and elevate her legs 12″. C. carefully place sterile gauze into her vagina. D. assist her ventilations with a bag-mask device.

A. place her in a left lateral recumbent position.

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.

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

Your 22-year-old patient is in active labor. Upon visual inspection, you note that the infant's leg is protruding from the vagina. Appropriate management of this situation includes: A. placing the mother supine with her head down and pelvis elevated. B. gently pulling on the infant's leg in an attempt to facilitate delivery. C. placing the mother in a recumbent position and rapidly transporting. D. carefully attempting to push the infant's leg off of the umbilical cord.

A. placing the mother supine with her head down and pelvis elevated.

Sedentary behavior while healing from a hip fracture would MOST likely predispose the older patient to: A. pneumonia. B. osteoporosis. C. heart failure. D. ischemic stroke.

A. pneumonia.

Compared to adults, the liver and spleen of pediatric patients are more prone to injury and bleeding because they are: A. proportionately larger and situated more anteriorly. B. more vascular despite the fact that they are proportionately smaller. C. spaced further apart, which causes them to shift following trauma. D. lower in the abdominal cavity, where the muscles are not as strong.

A. proportionately larger and situated more anteriorly.

Which of the following does NOT usually contribute to or cause obesity? A. rapid metabolism B. high caloric intake C. low metabolic rate D. genetic predisposition

A. rapid metabolism

When an elderly patient presents you with multiple over-the-counter medications that he or she is taking, it is MOST important to: A. recall that the patient is at risk for negative medication interactions. B. ask the patient to explain what each of the medications is used for. C. look up all of the medications before providing care to the patient. D. contact each of the physicians whose names are on the medications.

A. recall that the patient is at risk for negative medication interactions.

In contrast to an automated implanted cardioverter/defibrillator, an internal cardiac pacemaker: A. regulates the patient's heart rate if it falls below a preset value. B. delivers a shock to the heart if the rate becomes exceedingly fast. C. is implanted under the skin in the left upper abdominal quadrant. D. will only activate if it detects rhythms such as ventricular fibrillation.

A. regulates the patient's heart rate if it falls below a preset value.

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.

Because a tracheostomy tube bypasses the nose and mouth: A. secretions can build up in and around the tube. B. the risk of a local infection is significantly high. C. bleeding or air leakage may occur around the tube. D. severe swelling of the trachea and bronchi can occur.

A. secretions can build up in and around the tube.

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

A. sexual activity

You are dispatched to a residence for an 80-year-old female who fell. When you arrive, you find the patient conscious, lying in a recumbent position on the floor in her living room. In addition to providing the appropriate treatment, you should ask the patient if: A. she became dizzy or fainted before falling. B. she attempted to catch herself before falling. C. a family member regularly checks up on her. D. she takes medications for Alzheimer disease.

A. she became dizzy or fainted before falling.

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

A. shins

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.

During delivery of the baby's head, you should suction the mouth before the nose because: A. suctioning the nose first may cause the baby to gasp and aspirate fluid. B. it is easier to suction larger volumes of fluid from the baby's oropharynx. C. babies are primarily mouth breathers and do not breathe through their nose. D. the mucosa of the nose is fragile and is easily damaged by vigorous suctioning.

A. suctioning the nose first may cause the baby to gasp and aspirate fluid.

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. an altered mental status.

A. sunken fontanelles.

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

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

The pediatric patient should be removed from his or her car seat and secured to an appropriate spinal immobilization device if: A. the car seat is visibly damaged. B. he or she has no visible injuries. C. his or her vital signs are stable. D. he or she even has a minor injury.

A. the car seat is visibly damaged.

During delivery, it is MOST important to position your partner at the mother's head because: A. the mother may become nauseated and vomit. B. the mother needs to be apprised of the situation. C. she may need emotional support during the delivery. D. mothers often need assisted ventilation during delivery.

A. the mother may become nauseated and vomit.

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

A. the placenta prematurely separates from the uterine wall.

The term "bloody show" is defined as: A. the small amount of pink-tinged mucus that is discharged from the vagina after expulsion of the mucous plug. B. mild vaginal bleeding that occurs within the first 30 minutes after the onset of the second stage of the labor process. C. the normal amount of vaginal bleeding that occurs within the first 24 hours following delivery of the baby and placenta. D. any volume of blood that is expelled from the vagina after the amniotic sac has ruptured and contractions have begun.

A. the small amount of pink-tinged mucus that is discharged from the vagina after expulsion of the mucous plug.

Vigorous suctioning of a newborn's airway is indicated if: A. there is meconium in the amniotic fluid. B. positive-pressure ventilations are indicated. C. the newborn presents with labored breathing. D. his or her heart rate is less than 60 beats/min.

A. there is meconium in the amniotic fluid.

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.

A. they usually do not wish to be observed during a procedure.

When explaining the need for a particular procedure to an elderly patient, you should: A. use plain language and simple terms. B. use the appropriate medical terminology. C. be complex so the patient fully understands. D. realize that he or she will not understand you.

A. use plain language and simple terms.

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

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

The tip of a central venous catheter rests in the: A. vena cava. B. left atrium. C. right ventricle. D. pulmonary vein.

A. vena cava.

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

A. wheezing.