Special Populations - EMR
Which of the following questions should be asked to the caregiver of an injured child during scene size-up?
All of the above
Why might an elderly patient feel fearful and anxious?
All of the above
What are the three sides of the pediatric assessment triangle?
Appearance, breathing, circulation
When forming a general impression about a pediatric patient, which of the following is true of a "sick" child?
Unaware of your presence
To inspect for crowning, what should you do?
Visually inspect the vagina
At what point during assessment should the pediatric assessment triangle be used?
When forming the general impression
The CPCT is caring for a patient who is unable to void her bladder and is crying in pain. Her attending physician has not yet made rounds and her primary nurse is unavailable. Which of the following actions should the CPCT take?
Report the patient's pain to the charge nurse.
When the afterbirth appears, it should be pulled from the mother's vagina.
False
What is the cause of a febrile seizure in pediatric patients?
Fever
A child's head is proportionally larger in relation to the body than an adult's head.
True
An infant's tongue is proportionally larger than an adult's tongue.
True
Elderly patients may not exhibit the signs and symptoms you would expect of an injury or illness.
True
Following a SIDS incident, EMS providers should offer support to the family and caregivers.
True
Pediatric patients have an increased risk of airway obstruction
True
Respiratory arrest often leads to cardiac arrest in pediatric patients.
True
Under what circumstances can a foreign body airway obstruction be removed from a pediatric patient's airway with the finger sweep method?
When the object is visible
When can you expose, examine, and touch a woman's vaginal area?
When your partner is present
Is the patient in labor?
Yes
Which of the following EKG findings differentiates accelerated idioventricular rhythm from junctional rhythm?
accelerated idioventricular rhythm has wide QRS complexes
A CPCT is performing ostomy care for a patient. Which of the following findings should the CPCT report to the nurse?
the stoma is leaking around wafer
What can cause people to lose strength as they age?
Muscle atrophy
What is the leaking of amniotic fluid known as?
Rupture of membranes
The patient is experiencing bloody show.
True
A CPCT is assisting with the care of a patient who has diabetes mellitus. The CPCT should know that which of the following is a sign of hyperglycemia?
frequent urination
A CPCT is preparing to draw blood from a patient in a hospital. The patient extends his arm and turns his head away. Which of the following froms of consent does this indicate?
implied consent
When should the umbilical cord be cut?
All of the above
Which of the following conditions are considered unstable in a child and require rapid transportation?
All of the above
Which of the following is a way in which a child might be exposed to a toxic substance?
All of the above
A CPCT is caring for an adult patient who has a new prescription for albuterol sulfate (Albuterol) to be administered via an inhaler. Which of the following statements by the patient indicates a need for further teaching?
"As an adult, I don't need to use spacers with my inhaler."
When does primary assessment for a pediatric patient begin?
"At the door"
A CPCT is preparing a patient for hospital discharge. The patient states, "I'm afraid to go back home to my husband." Which of the following responses by the CPCT is appropriate?
"Can you tell me if something happened that made you feel unsafe"
Which of the following may be used to determine a child's level of consciousness?
AVPU check
Which of the following is the correct response to a suspected SIDS infant who shows no signs of rigor mortis or lividity?
Aggressively attempt to resuscitate the infant through CPR
Based on the scenario, what emergency medical care should be provided?
All of the above
During your assessment of an elderly patient, you notice that the patient seems confused. How can you determine the patient's baseline mental status?
Ask a caregiver about the patient's baseline mental status
A CPCT is in the cafeteria during lunch. A visitor appears to be in respiratory distress. The visitor's lips and tongue are swollen. Which of the following actions should the CPCT take?
Ask the person if she has any allergies
Which two pulse points should be checked and compared when assessing the circulation of infant patients?
Brachial and femoral
Why is a child's brain more prone to bleeding from an injury than an adult's brain?
Because a child's brain has less cushioning.
Why is it important for EMS providers to be able to recognize signs of respiratory distress in pediatric patients?
Because children with respiratory emergencies deteriorate quickly
Why are children able to compensate for shock for a long period of time?
Because their blood vessels constrict efficiently
A CPCT is collecting a stool specimen from a newly admitted patient. The CPCT should recognize that which of the following findings could be a sing of an upper gastrointestinal disorder?
Black, tarry stool
Which vital sign is likely to increase in late adulthood?
Blood pressure
A patient loses consciousness. The EKG tracing reveals ventricular fibrillation. Which of the following should the CPCT do first?
Call for help and begin CPR
What does respiratory arrest often lead to in pediatric patients?
Cardiac arrest
What is the leading cause of death in elderly people?
Cardiovascular disease
A CPCT is caring for a patient who had a CVA and is non ambulatory. Which of the following findings should the CPCT report to the nurse immediately?
Change in size and shape of pressure ulcer
Who are the most common targets of abuse?
Children and the elderly
You are treating a child who you suspect has been abused. The child's parent is reluctant to allow the child to be transported. What should you do?
Convince the parent that the child needs to go to the hospital for proper assessment and care
What happens to the endocrine system as it ages?
Decrease in production of hormones
Which of the following actions should a CPCT take when discharging a patient?
Escort the patient using a wheelchair
What considerations should an emergency medical provider make when assessing an elderly patient?
Explain ahead of time what you are going to do
A CPCT is caring for a patient who has anxiety during venipuncture. Which of the following should the CPCT recognize as an appropriate response?
Explain the procedure before beginning the venipuncture
Children who are in respiratory distress because of an airway disease are given the same emergency care as those with airway obstructions.
False
Children's skin is generally tougher and thicker than adults' skin
False
EMS providers should communicate with pediatric patients in the same way that they communicate with adult patients.
False
Elderly patients are less likely to experience airway obstructions.
False
Forms of abuse never occur in combination.
False
If an elderly patient does not exhibit typical signs and symptoms, EMS providers should assume that the situation is not an emergency.
False
If contractions last 60 seconds or more and occur less than five minutes apart, the mother has time to be transported to the hospital
False
What should you do if you suspect that a patient may have been abused?
Follow laws and protocols for reporting your suspicions to the proper authorities
A CPCT is transferring a patient using a Hoyer lift from a bed to a wheelchair. As the patient is being transferred, the CPCT should place the him into which of the following positions?
Fowler's
You are assessing an elderly patient who is pale, has a fever, and complains of abdominal pain. What might you suspect is wrong this patient?
Gastrointestinal bleeding
Which type of fracture is common in the extremities of children?
Greenstick fractures
What should an emergency medical provider do when assessing an elderly patient?
Handle the patient gently
Why are the liver and spleen more prone to injury in children than in adults?
In children, these organs are not fully protected by the rib cage.
What happens to an elderly person as the urinary system ages?
Incontinence and nocturia
Why might abuse in the form of shaken baby syndrome be difficult to identify during a call?
It causes internal trauma that may not exhibit as an external injury
An EKG has a 2mm ST elevation in leads I, AVL, V5, and V6. What type of infarction would this represent?
Lateral infarction
You and your partner respond to an elderly man who lives alone. The patient is unable to share any information about his medical history. How might you obtain information about his history?
Observe his environment for clues
Which of the following is true about shock in children?
Once signs of shock appear, the child will deteriorate rapidly.
What causes the bones to become brittle and increases the risk of musculoskeletal injury?
Osteoporosis
If a newborn baby has central cyanosis with adequate breathing and heart rate, what should first be done?
Oxygen should be administered
Which of the following is most likely to be a possible indication of abuse?
Pattern of injury that does not match the reported mechanism of injury
What should suspicions of abuse be based on?
Patterns of injury and behavior
Which of the following is true about pediatric vital signs?
Pediatric vital signs are different, according to the age of a child.
The aging of the nervous system results in slower nerve conductions. These changes in nerve conductions lead to which of the following?
Slower reaction times and decreases in motor and sensory abilities
A CPCT is caring for a patient who has hepatitis B. Which of the following precautions should the CPCT take?
Standard
A technician is performing an EKG in a hospital setting. The patient becomes unresponsive, stops breathing, and does not have a pulse. Which of the following would be the first appropriate step?
Start chest compressions
After the scene of an incident involving a child has been secured, which of the following is an appropriate manner for an EMS provider to enter the scene?
Take a moment to observe the big picture and look for clues.
During assessment and transport, how can you reassure a patient who may have been abused?
Tell the patient that there are people who can help
A CPCT is caring for a patient who is undergo a blood transfusion. The CPCT should recognize that which of the following vital signs should be reported to the nurse immediately?
Temperature is 102 F (38.8 C)
You and your partner respond to a call at the home of an elderly man. Inside the home, you notice dirty dishes and food wrappers scattered around the kitchen. The living room is cluttered with magazines and medication bottles. The home feels cold. What could this scene suggest about the patient?
The patient is having difficulty taking care of himself.
Which of the following is true of decompensated respiratory failure?
The patient is no longer able to compensate for insufficient oxygen.
What is true of a pediatric patient who demonstrates stridor while in respiratory distress?
The patient probably has an upper airway obstruction.
What is the afterbirth?
The placenta
What are contractions the tightening and relaxing of?
The uterus
What is the cause of sudden infant death syndrome (SIDS)?
There is no known cause.
Which of the following is always true about the role of an EMR or EMT during a pediatric poisoning incident?
They must treat the effects of the poisoning in the patient.
Why should the head-tilt, chin-lift maneuver be used with caution in small children?
Tilting back the head may pinch and block the child's airway
Why should a child suspected of being sexually abused be encouraged not to defecate, urinate, or ingest anything?
To preserve evidence
Why should a newborn baby be wrapped in a blanket?
To protect the baby from heat loss
A CPCT should recognize that a patient must avoid deep-breathing and coughing exercises after which of the following surgeries?
eye surgery
Most infants breathe through their mouths.
False
A CPCT enters a patient's room and is approached by visitors requesting test results. Which of the following responses by the CPCT is appropriate?
"I'm sorry, but i can't give you that information
Approximately how many weeks pregnant is the patient?
38
A child in middle childhood or adolescence will have an average body temperature of ____.
98.6°F
When does the fetal stage of prenatal development occur?
9th week to birth
It is important for EMS providers to diagnose SIDS on the field.
False
It is safe to assume that the scene of a call involving a geriatric patient will not pose any danger to you or your partner.
False
Only unstable pediatric patients should be given ABC management.
False
Signs of abuse are always obvious.
False
What effect does the aging of the digestive system have on the elderly patient?
All of the above
What emergency medical care should be provided to a pregnant patient with vaginal bleeding?
All of the above
What is a sign or symptom of gastrointestinal bleeding in a geriatric patient?
All of the above
What reduces vaginal bleeding after delivery?
All of the above
When evaluating contractions, what should be determined?
All of the above
When should you inspect for crowning?
All of the above
Which of the following is a form of abuse?
All of the above
Which of the following is a possible sign of abuse?
All of the above
Which of the following is an example of a lower airway disease that may result in respiratory distress in children?
All of the above
Which of the following items is important during management of pediatric shock?
All of the above
Which vital sign condition is common in elderly patients and is not necessarily a significant finding?
All of the above
If a newborn baby's heart rate is less than 100 beats/minute but greater than 60 beats/minute, what should first be done?
Artificial ventilations should be provided
How does aging affect the reproductive system?
Atrophic changes in sexual organs
How is the heart affected by aging?
Blood pumping is less efficient
Which method may be used to administer oxygen to children who do not tolerate a face mask?
Blow by method
The CPCT is to perform a venous blood draw on a 91-year-old patient. The CPCT should use which of the following methods?
Butterfly needle and syringe
A CPCT is caring for a patient who has an oder for tobramycin (Tobrex) level to be drawn 1 hr after dose. The medication has been ordered for 1100. Which of the following actions should the CPCT take?
Check with the nurse
Children generally have faster metabolisms than adults. What is one result of this faster metabolic rate?
Children use oxygen and glucose faster than adults.
Which of the following is true about children's rib cages?
Children's rib cages are more pliable than adults'
Dementia results in the loss of what?
Cognitive and social function
Which of the following procedural steps for a finger stick should the CPCT do first?
Confirm the correct identity of the patient
As the digestive system ages, peristalsis decreases and leads to which of the following?
Constipation
What happens to the respiratory system as it ages?
Decrease in the exchange of oxygen and carbon dioxide
which of the following abnormalities is associated with large U waves on the EKG?
Decreased potassium level
What is a state of temporary mental confusion?
Delirium
Some older-adult or obese patients may not have accessible antecubital veins. In this situation, the CPCT may use which of the following?
Dorsal veins
Which predelivery emergency in the first trimester causes internal bleeding?
Ectopic pregnancy
Why is it important to reassess elderly patients at regular intervals?
Elderly patients' conditions often decline slowly, which can give the false illusion that everything is fine.
Which statement about the emotional effects of aging is correct?
Emotional changes may lead elderly patients to feel frustrated, insecure, or depressed.
Infants typically have a lower body temperature than all other pediatric age groups.
False
While performing an assessment on an elderly patient, you observe that the patient's blood pressure is high. What should you do?
Find out if your findings are typical for the patient
While performing an assessment on an elderly patient, you observe that the patient's pupils are slow to react and are not round in shape. What should you do?
Find out if your findings are typical for the patient
What might a bulging fontanelle on an infant's head indicate?
Increased intracranial pressure
Which statement about obtaining a focused history for a geriatric patient is correct?
It typically takes more time than normal to obtain a history for a geriatric patient.
In what position should a pregnant woman in the third trimester of pregnancy be placed?
Left lateral
A CPCT is providing palliative care to a patient. The patient's family expresses feelings of anger and hopelessness. Which of the following actions should the CPCT take?
Listen when the family is ready to talk
A CPCT is preparing to transfer a nonambulatory patient from a bed to a wheelchair. Which of the following steps should the CPCT take?
Locking the wheels of the wheelchair and the bed
What effect does an aging immune system have on the elderly?
Makes them more vulnerable to infectious diseases
What is the process of the shedding of the uterine lining and the unfertilized ovum from the body?
Menstruation
Which of the following is an appropriate response to a child who is having a seizure?
Move unsafe items out of the child's way.
A CPCT receives orders to draw an infant screening card, O2 levels, bilirubin, and DNA. Which of the following should be drawn first?
O2 levels
A CPCT should recognize that which of the following agencies ensures safe work environments?
OSHA
How does aging affect the sensory system?
Perception of pain diminishes
What predelivery emergency in the third trimester of pregnancy causes vaginal bleeding with no pain?
Placenta previa
Elderly patients with chronic diseases or compromised immune systems have a greater risk of which respiratory emergency?
Pneumonia
What may occur if too much force is used when ventilating a child?
Pneumothorax
A pregnant woman's contractions last 75 seconds and occur 4 minutes apart. What should be done?
Prepare for delivery on site
Based on the scenario, what should you do?
Prepare for delivery on site
How should your suspicion of abuse affect patient assessment and care?
Provide assessment and care as you would any other patient
If the amniotic sac is not broken when a baby's head delivers, what should you do?
Puncture or tear the amniotic sac
Age-related changes in the respiratory system put geriatric patients at a greater risk for which of the following?
Respiratory disease
Hyperosmolar Hyperglycemic Nonketotic Syndrome is a diabetic complication in the elderly that can result in which of the following?
Severe dehydration
What is the most visible sign of aging?
Skin
When delivering a baby, what should be suctioned first?
The baby's mouth
Why is a "trunk to head" evaluation sometimes recommended when performing a detailed physical exam on a small child who is not in critical condition?
The child may have less anxiety if the trunk of the body is examined before the head.
You are called to the scene of a bicycle accident involving a 10-year-old girl. She is alert and responsive. Her mother and several bystanders are also at the scene. To whom should you first direct your questions?
The girl
You respond to a call at the home of an elderly woman. Inside the home, you notice medication bottles neatly lined up next to the kitchen sink. The living room is clean and free of clutter. The temperature inside the home feels comfortable. What could this scene suggest about the patient?
The patient appears to be able to take care of herself.
In early respiratory distress, an increased respiratory rate is usually able to compensate for insufficient oxygen levels.
True
Knowing the normal vital sign ranges for adults can help emergency medical providers determine if an adult has a medical emergency.
True
Most children rely on their diaphragms for breathing.
True
Neglect is a form of abuse.
True
If vaginal bleeding continues or is excessive after delivery, what should you do?
Treat the mother for shock
A newborn's respiratory rate is normally faster than any other pediatric age group
True
Children have a larger body surface area than adults in relation to their body mass.
True
Elderly patients may be reluctant to report abuse out of shame or fear of losing their caregiver or living situation.
True
If crowning is present, delivery is imminent.
True
If vaginal bleeding continues or is excessive after delivery, the mother should be treated for shock.
True
What action should the CPCT take to verify the quality of venipuncture supplies before beginning a blood draw?
inspect the integrity of the needles's seal
When observing a patient's skin integrity, a CPCT should recognize that the first sign of breakdown is
redness
A CPCT observes a hematoma developing at the site of a venous blood draw. The CPCT should
release the tourniquet and stop the draw
