Vol. 5 Ch. 4 - Questions
70
You should consider the heart rate of a 5-year-old patient to be bradycardic beginning at a rate below how many beats per minute?
Dental
A 12-year-old patient collided face first with another child while both were riding bikes. The patient bit his tongue when his jaw was struck and received a black right eye and bloody nose. He is alert and oriented, and after you suction some blood from his airway appears to have no respiratory compromise, with respirations clear bilaterally and 20/minute. Your index of suspicion should be high for what other injury?
Hydrocarbon
A 2-year-old child ingested some lamp oil intended for use in an old-fashioned kerosene lamp. The patient presents with a depressed respiratory rate, gastrointestinal irritation, and a diminished level of consciousness. What type of poisoning do you suspect?
epinephrine administration every 5 to 15 minutes.
A 7-year-old child following a drowning incident in a swimming pool is pulseless and apneic. Treatment for this patient should not include:
croup.
A viral infection of the pediatric upper airway that results in inflammation of the subglottic region is known as:
place the patient in a position of comfort and transport immediately.
A four-year-old male patient presents with stridor, a cough, and hoarseness when speaking. The paramedic should:
The low temperature of the water might have helped protect the child against brain injury.
A seven-year-old female patient who was drowning in a pond was rescued and resuscitated prior to your arrival. It is a cold day and the water soaking the patient's clothing is very cold. What can you assume for this patient?
30/min
Above what respiratory rate would a 10-year-old child be considered to be breathing abnormally fast?
Skin color
According to the pediatric assessment triangle, which of the following is used to assess circulation to the skin?
Presence of grunting, stridor, wheezing, crowing
According to the pediatric assessment triangle, which of the following is used to assess the work of breathing when forming a general impression of the patient?
administration of supplemental oxygen and establishment of IV access for a 20 mL/kg bolus of normal saline.
An 8-year-old male patient presents with pale, cool, clammy skin; tachycardia and tachypnea; a weak peripheral pulse; and a decreased level of consciousness. The parents say the patient has been sick and vomiting with diarrhea for several days. You respond with:
epiglottitis.
An inflammation of an airway structure that is often due to a bacterial infection in children and is known to be potentially life threatening is:
lung tissues are more fragile.
Compared to an adult's, an infant's or child's:
follow a discussion with legal counsel regarding what you are allowed to document.
Documenting a suspected child abuse case in your patient care report should:
are good historians.
Generally, adolescents:
Check the patient's pulse.
High winds blew down a tent at an outdoor high school graduation reception. A fire started from the fuel used for the hot buffet. Several people were injured by the tent collapse, and several patients have burns. The first patient you triage is a 3-year-old girl. She is not breathing. You open her airway, but she does not start breathing. What is the next action?
Profound cyanosis
If present, which of the following findings should alert the paramedic that a child is in respiratory failure?
Palpating the abdomen
In the secondary assessment of a 7-year-old child with difficulty breathing and a history of reactive airway disease, which of the following would give the paramedic the least amount of relevant information about the patient's ventilation and oxygenation?
objective.
JumpSTART provides a framework for triage decisions that is:
Tracheostomy tube
When responding to a report of a patient with difficulty breathing, you find a pediatric male about 3 years old in a hospital bed at home. He is cared for 24 hours a day by his parents. You note a small, round tube that exits from the patient's neck, through which he is breathing. Given this finding, which of these devices does the patient most likely have?
CPAP.
Several large EMS systems have abandoned the practice of pediatric endotracheal intubation in favor of simple:
Blood pressure
You are caring for a 2-year-old child who has been sick with a fever, diarrhea, and vomiting for 24 hours. To assess perfusion, which of these would provide you with the least reliable information about dehydration?
more likely that it is outside the scope of the paramedic's practice.
The less frequently a paramedic uses a skill, the:
The respiratory system is unable to meet the body's demands for oxygen intake and carbon dioxide removal.
When does respiratory failure occur?
occlude the pop-off valve.
When performing ventilation on an infant receiving CPR, it may likely be necessary to:
3 years
What age should a pediatric patient be before blood pressures are routinely utilized?
Obstruction
What is a common complication of a tracheostomy tube that a mucus plug may cause?
SpO2 of 94 percent or greater
What is the oxygenation goal for a pediatric patient receiving oxygen?
Psychological abuse
What term is used to describe the situation in which a child is regularly threatened, yelled at, or humiliated but not otherwise harmed?
Distributive
What type of shock in the pediatric patient occurs when there is a marked decrease in peripheral vascular resistance?
Parents of a child with multiple bruises and burns offer inconsistent explanations that are not consistent with the types of injuries.
Which information should raise the index of suspicion for abuse?
Report your findings to the appropriate authorities, including to the receiving hospital personnel.
Which of the following actions should you take if you suspect that your pediatric patient is a victim of abuse?
Patients who look younger than a young adult
Which of the following best identifies the age group of patients who should be triaged by using the JumpSTART system?
Recent onset of fever or cold symptoms
Which of the following characterizes febrile seizures?
on both knees of a 5-year-old
Which of the following findings seems least consistent with child abuse?
Airway and respiratory problems
Which of the following is the most common cause of cardiac arrest in an infant or young child?
Mild upper respiratory infection signs and symptoms that progressively deteriorate over 1 to 2 days to respiratory distress with fever, cough, tachypnea, crackles in the lungs, and wheezing
Which of the following presentations is most consistent with bronchiolitis?
The cause of SIDS is not yet known; SIDS is a diagnosis that is given when other potential causes of death have been ruled out.
Which of the following statements is accurate regarding sudden infant death syndrome (SIDS)?
Malnutrition
Which of the following would arouse your suspicions of child neglect?
Inflammatory disease of the lower airways
Which of these is the best description of asthma?
EMS may be called when the medical condition worsens or a medical device fails.
Which of these statements best describes why paramedics should be knowledgeable about pediatric patients who are dependent on medical technology?
The paramedic always must report suspected sexual abuse to the appropriate authorities and the medical personnel who will be assuming care of the patient.
Which of these statements is true?
SIDS is defined as the sudden and unexpected death of an infant in which an autopsy fails to identify the cause of death.
Which of these statements regarding SIDS is correct?
Preventable
Which of these terms is best applied to the majority of childhood injuries?
Injury
Which of these terms should be used to convey the preventable nature of childhood trauma?
To do the most good for the greatest number of patients
Which statement best describes the purpose of the JumpSTART triage method?
Cross-examining the parents
While gathering information to document in your PCR report regarding a case of suspected abuse, which of the following activities should you avoid?
Continue questioning the child but verify information with the parents.
While you are questioning a 4-year-old with abdominal pain, he tells you that his stomach started hurting last week. Which of the following should you do next?
If the child becomes distressed during the examination, then the respiratory rate will be impossible to determine.
Why is it important for the paramedic to observe the child's respiratory rate before beginning the examination?
Treat the child for shock, administering oxygen and establishing IV access for the replacement of fluids.
You are called to a residence for a 7-year-old child in hypovolemic shock. You note evidence of severe dehydration as well as malnutrition. The child is wearing dirty clothes and appears to be unwashed. The child's home is visibly unclean. What is your immediate priority?
Show the mother where to sit so she can remain with the child while allowing you to work.
You are caring for a 5-year-old who was injured when his older brother accidentally stabbed him in the thigh with a pocketknife. The patient has lost about 350 mL of blood. He is pale, with cool, diaphoretic skin, and is awake but very still. As part of your treatment, you have applied direct pressure to the wound, applied oxygen, and covered the patient with a blanket. The patient's mother is very upset and does not want to let go of the child's hand. How should you go about completing your treatment?
"I know this is upsetting. We are moving as fast as we can without making her condition worse. As long as I have your word that you won't yell at us, you can ride in the ambulance, and we will tell you everything we are doing."
You are caring for a 6-year-old who was struck by a car on the street in front of her home in a very impoverished part of town. Her distraught father yells at you to hurry up and says, "If this was a kid on the other side of the tracks, you would be moving faster!" Which of the following is the most appropriate response?
Ask the patient and caregivers about the device.
You are on scene with a pediatric patient who is obtunded due to a congenital brain defect. As you are assessing the patient, you note that she has a gastric feeding tube and currently is hooked up to a machine that is delivering a feeding. You have not seen this type of pump before and have little experience with gastric tubes. What action should you take?
suction no deeper than you can see.
You are suctioning a 10-year-old female patient's airway following the patient having vomited. The patient has a decreased level of consciousness. You should:
Give a second bolus of 20 mL/kg
You are transporting a dehydrated 9-month-old who has had a fever, vomiting, and diarrhea for 12 hours. He is lethargic with pale, cool, mottled skin and capillary refill time of 4 seconds. His respiratory rate is 38, and you have initiated oxygen administration and have started an IO infusion followed by an initial bolus of fluid according to protocol. The patient's perfusion has not improved. Which of the following is the best choice with regard to fluid resuscitation?
Insert an 8.0 French nasogastric tube.
You note gastric distention in a 6-month-old patient experiencing respiratory failure you are attempting to ventilate but for whom you are not able to achieve adequate tidal volume. What do you do?
Severe traumatic brain injury with increasing intracranial pressure, to be managed with rapid sequence intubation, ventilation, supplemental oxygen, and rapid transport to a pediatric trauma facility
You respond to a call for a 10-year-old patient who hit a road sign while traveling at high speed on a bicycle. The child is unconscious with no eye opening or motor or verbal response and has a severe contusion to the head. You note elevated blood pressure but a depressed heart rate with decreasing, deep respirations and an SpO2 of 92 percent. What do you assess as the problem and how do you manage this patient?
internal bleeding and possible organ damage should be suspected.
You respond to a shooting at a high school; the shooter has been apprehended, and law enforcement has certified the scene as safe. A 16-year-old patient presents with a small-caliber gunshot wound in the lower middle abdomen. The gunshot wound is small and not bleeding much, and there is no exit wound. This presentation suggests that:
