Paramedic PEDS

  1. 19 y.o diabetic woman who is 22 weeks pregnant presents with occipital headache, blurred vision, and edema to her hands and feet. Her blood pressure is 152/94, PR 108 bpm, and respiration are 20 breaths/min. The patient is conscious and alert and states that she is "retaining a lot of water". Your MOST immediate concern should be: 

    A: The risk of fetal compromise
    B: The possibility of a seizure 
    C: Lowering her BP
    D: Her current blood sugar level
    B: The possibility of a seizure
  2. During "True Labor"

    A: Analgesics often abolish the pain from contractions
    B: The interval between contractions gradually shortens 
    C: The intensity of uterine contractions remain constant 
    D:Contractions are irregularly spaced from one to the next
    B: The interval between contractions gradually shortens
  3. The MOST appropriate vagal maneuver for an infant involves

    A: Blowing into an occluded straw 
    B: Holding ice packs firmly to the face
    C: Firmly massaging the carotid artery
    D: Applying a heat stimulus to the body
    B: Holding ice packs firmly to the face
  4. Which of the following statements regarding group is correct?

    A: Croup is also referred to as acute bacterial subglottic stenosis 
    B: Hallmark signs of croup include high fever and a sore throat
    C: Mst cases of group result in severe hypoxia and hypercarbia 
    D: Croup is a viral upper airway infection that may cause stridor
    D: Croup is a viral upper airway infection that may cause stridor
  5. If a woman is gravida:3 and para:2 

    A: She has been pregnant two times
    B: She has delivered three babies 
    C: She has been pregnant five times
    D: She has delivered two babies
    D: She has delivered two babies
  6. You are caring for a young woman with constant, diffuse abdominal pain, referred pain to both shoulders and vaginal bleeding. She statesthat her last menstrual period was 2 months ago, but she adamantly denies being pregnant. Her blood pressure is 86/50, Pulse 120 bpm and weak. RR 24 breaths/min and regular. Which of the following interventions is NOT appropriate for this patient 

    A: IV fluid boluses 
    B: Thermal Management 
    C: Cardiac Monitoring 
    D: Narcotic Analgesia
    D: Narcotic Analgesia
  7. The dome shaped top of the uterus is called the 
    A: OS
    B: Body 
    C: Fundus 
    D: Cervix
    C: Fundus
  8. Which of the following statements regarding the umbilical cord is correct?

    A: The placenta receives arteriovenous blood from the umbilical arteries 
    B: The umbilical cord is composed of two large veins and one small artery 
    C: The umbilical vein carries oxygenated blood from the placenta to the fetus 
    D: The fetus receives the majority of its oxygen supply from the umbilical arteries
    C: The umbilical vein carries oxygenated blood from the placenta to the fetus
  9. Gestational diabetes is caused by: 
    A: A decreased production of insulin secondary to excess estrogen levels 
    B: Increased insulin production and decreased cellular sensitivity to insulin
    C: Decreased cellular utilization of insulin secondary to increased estrogen 
    D: Ketones that are excreted in the urine during the course of the pregnancy
    B: Increased insulin production and decreased cellular sensitivity to insulin
  10. Common signs of gestational diabetes include

    A: Confusion
    B: Diaphoresis 
    C: Polydipsia 
    D: Tachycardia
    C: Polydipsia
  11. The onset of eclampsia is marked by the presence of 
    A: Hypertension 
    B: Protein in the urine
    C: Thrombocytopenia 
    D: Generalized seizures
    D: Generalized Seizures
  12. Treatmen for pediatric asystole includes:
    A: Atropine 
    B: Epinephrine
    C: Cardiac Pacing 
    D: Hyperventilation
    B: Epinephrine
  13. Prior to administering pharmacologic therapy to an infant or child with pulseless ventricular tachycardia, the paramedic should preform:

    A: Intubation 
    B: Cardioversion 
    C: Defibrillation
    D: CPR for 5 minutes
    C: Defibrillation
  14. Which of the following is the MOST easily correctable problem in a child with an altered mental status?
    A: Ingestion of aspirin 2 hours ago
    B: High fever with a widespread rash 
    C: Blood glucose reading of 40mg/dL
    D: Dehydration associated with hypokalemia
    C: Blood glucose reading of 40mg/dL
  15. Seizures during pregnancy should be treated with 
    A: Diazepam 
    B: Valproic Acid
    C: Phenobarbital
    D: Magnesium Sulfate
    D: Magnesium Sulfate
  16. In contrast to adults, young children are more prone to liver and spleen injuries because the organs
    A: Extend well below the rib cage
    B: Are both highly vascular 
    C: Are more mobile and less supported
    D: Are relatively smaller and less protected
    A: Extend well below the rib cage
  17. A spontaneous abortion 

    A: Affects one out of every three pregnancies and is typically idiopathic
    B: Occurs naturally and may or may not have an identifiable cause 
    C: Is generally performed by a physician to prevent maternal death 
    D: Is most often the result of a congenital abnormality of the placenta
    B: Occurs naturally and may or may not have an identifiable cause
  18. What forms of child maltreatment are often difficult to identify and may go unreported
    A: Sexual and emotional abuse
    B: Emotional abuse and neglect
    C: Neglect and physical abuse
    D: Physical and emotional abuse
    B: Emotional abuse and neglect
  19. When caring for a woman with an inevitable or incomplete abortion, you should be MOST concerned with: 

    A: Bleeding and shock 
    B: Severe maternal infection 
    C: Maternal emotional trauma
    D: the risk of airway compromise
    A: Bleeding and Shock
  20. In contrast to an abruptio placenta, a placenta previa 

    A: Typically presents with tearing abdominal pain 
    B: Is usually caused by maternal abdominal trauma
    C: Is associated with an absence of fetal heart tones
    D: Usually presents with painless vaginal bleeding
    D: Usually presents with painless vaginal bleeding
  21. You are dispatched to a daycare center for a 5 year old with trouble breathing. Upon arriving at the scene, you assess the child and note that she is responsive to pain only has weak intercostal retractions, and is breathing at a slow rate with shallow depth. you should 
    A: Apply oxygen via pediatric nonrebreathing mask and attach a pulse ox 
    B: Deliver two effective rescue breaths and assess her pulse for at least 5 seconds
    C: Administer high- flow O2, assess her cardiac rhythm and establish IO access
    D: Begin assisting her ventilations with a bag mask device and assess her pulse rate
    D: Begin assisting her ventilations with a bag-mask device and assess her pulse rate
  22. Which of the following clinical presentations is MOST consistent with cocaine ingestion in a child:
    A: Diaphoresis, miosis, tachycardia, and bronchospasm 
    B: Miosis, Bradycardia, Hypoventilation, and Hypotension 
    C: Mydriasis, Diarrhea, Hypothermia, and Hallucinations
    D: Hypertension, Tachycardia, Diaphoresis, and Mydriasis
    D: Hypertension, Tachycardia, Diaphoresis, and Mydriasis
  23. First-Degree heart block in children:
    A: Is typically asymptomatic and does not require special treatment 
    B: Should be suspected when a randomly dropped QRS is observed 
    C: Should be treated with cardiac pacing, even if the child is stable 
    D: Does not respond to atropine and should be treated with dopamine
    A: Is typically asymptomatic and does not require special treatment
  24. The incidence of sudden infant death syndrome peaks between the ages of 

    A: 2 and 4 months
    B: 3 and 6 months
    C: 4 and 8 months
    D: 8 and 12 months
    A: 2 and 4 months
  25. While assessing the airway of a 3 year old girl who is unresponsive, you hear a snoring sound during each of her slow, shallow breaths; You should: 

    A: Insert an OPA and apply high-flow O2
    B: Begin bag-mask ventilations to improve her low tidal volume 
    C: Provide free-flow o2 as you nasotracheally intubate her
    D: Manually maneuver her head and reassess her breathing status
    D: Manually maneuver her head and reassess her breathing status
  26. With respect to CPR and foreign body airway obstruction procedures, the child should be treated as an adult once

    A: He or she reaches the age of 8 to 10 years
    B: Resting vital signs are consistent with an adult 
    C: His or her body weight is estimated at 55lbs 
    D: Secondary sexual characteristics have developed
    D: Secondary sexual characteristics have developed
  27. To ensure that an infants head is in neutral position during spinal immobilization, you should:

    A: Provide slight extension of his or her head
    B: Place padding under the infants shoulders
    C: Place Towel roll behind the infants neck 
    D: Use towel rolls for lateral head stabilization
    B: Place padding under the infants shoulders
  28. Abruptio Placenta is MOST accurately defined as:
    A: Separation of the placenta secondary to blunt maternal abdominal trauma 
    B: Premature separation of a normally implanted placenta from the uterine wall 
    C: A condition in which the placenta progressively detaches from the uterine wall 
    D: A placenta that implants low in the uterus and partially or fully covers the cervix
    B: Premature separation of a normally implanted placenta from the uterine wall
  29. Upon arriving at the scene of a 4 year old boy with respiratory distress, you enter the residence and see the child, who is conscious, sitting on the fathers lap. The father is aware of your presence but the child is not. Your initial action should be to:

    A: Make physical contact with the child as soon as possible in order to identify any life threats 
    B: Allow the father to carry his son to the ambulance, where you can perform an initial assessment
    C: Quickly build good rapport with the child by picking him up and asking him what his name is 
    D: Visually assess the child from across the room for any signs of increased work of breathing
    D: Visually assess the child from across the room for any signs of increased work of breathing
  30. Crowning is MOST accurately defined as:

    A: Bulging of the baby's head from the vaginal opening
    B: Passage of the baby through the fully dilated cervix 
    C: The presenting of the baby at the vaginal opening
    D: The thinning and shortening of the cervix during labor
    C: The presenting of the baby at the vaginal opening
  31. A 9 year old, 55lb girl presents with generalized hives, marked facial swelling, and loud inspiratory stridor. She is conscious but appears sleepy. You can MOST rapidly improve this childs condition by:
    A: Starting an infusion of epinephrine at 5ug/min
    B: Administering up to 59 mg of diphendydramine
    C: Administering 0.25mg of EPI IM
    D: Intubating her and administering albuterol via ET tube.
    C: Administering 0.25mg of EPI IM
  32. Law enforcement request that you respond to a local apartment complex for a young woman who was sexually assaulted. When you arrive at the scene you find the patient sitting on her couch, clearly upset. You see a small amount of blood on her shorts near her groin area. What is your initial priority in the care of this patient?

    A: Asking her if she recognized the perpetrator 
    B: Identifying and treating immediate life threats
    C: Not allowing her to shower or use the restroom 
    D: Quickly assessing her blood pressure and pulse
    B: Identifying and treating immediate life threats
  33. Ventricular shunts are typically placed in children who:

    A: Are born with a congenital condition in which the ventricles of the brain produce excessive amounts of CSF
    B: Have experienced a severe traumatic brain injury that results in chronic cerebral edema and increased intracranial pressure 
    C: Are born with an abnormally small brain. Which results in a relative increase in the amount of circulating CSF
    D: Have impaired circulation and absorption of CSF, leading to increased size of the ventricles of the brain and increased intracranial pressure
    D: Have impaired circulation and absorption of CSF, leading to increased size of the ventricles of the brain and increased intracranial pressure
  34. A 4 year old boy is found unresponsive by his mother. When you begin your assessment, the child's mother tells you that her son apparently ingested some of her anti-hypertensive medication. The child has poor perfusion and is breathing poorly. As you are assisting the child's ventilation's with high flow O2, you partner informs you that the child's heart rate is 50 bpm and weak. The Cardiac monitor reveals sinus bradycardia. You should: 

    A: Ask your partner to insert an IO catheter and administer EPI 1:10,000
    B: Attempt immediate transcutaneous pacing while continuing ventilation assistance
    C: Establish immediate vascular access and administer 0.02 mg/kg of atropine sulfate 
    D: Initiate one-rescuer CPR while your partner attempts to establish vascular access
    D: Initiate one-rescuer CPR while your partner attempts to establish vascular access
  35. When attempting resuscitation of a child with PEA, you should 

    A: Administer Epi via the ET tube if possible
    B: Attempt to identify an underlying cause of the arrest
    C: Perform synchronized cardioversion if the rate is fast 
    D: Give atropine if the heart rate is less than 60bpm
    B: Attempt to identify an underlying cause of the arrest
  36. Which of the following statements regarding a breech presentation is correct 

    A: Breech presentations are more common with premature births 
    B: A breech birth is characterized by a vertex position of the baby 
    C: Breech presentations are frequently accompanied by a nuchal cord 
    D: Most breech presentations are associated with a legs-first delivery
    A: Breech presentations are more common with premature births
  37. The length-based resuscitation tape

    A: is only reliable in children who weigh less than 20kg
    B: Should not be relied upon for determining pediatric drug doses 
    C: Is used to estimate a child's weight based on his or her height 
    D: Is generally more accurate than the weight given by the caretaker
    C: Is used to estimate a child's weight based on his or her height
  38. You are transporting an unresponsive intubated 4 year old child. An IO catheter is in place and you are vventilating the child at an age appropriate rate. Suddenly, the child becomes cyanotic and experiences a significant drop in her heart rate and O2 saturation, and loss of capnographic waveform. You attempt to auscultate her lung sounds but are unable to hear over the drone of the engine. You should:

    A: Extubate immediately and ventilate with a bag-mask device 
    B: Increase your ventilation rate and reassess the childs condition 
    C: Administer 0.02mg/kg of atropine via raid IO push and reassess
    D: Look for vapor mist in the ET tube and attach a colorimetric device
    A: Extubate immediately and ventilate with a bag-mask device
  39. You are providing high-flow O2 to a 3 year old boy with severe respiratory distress. When you reassess him you note that he is pale and his respiratory rate has decreased from 30 breath/min to 12 breaths/min. You should:

    A: Assist his ventilations with a bag-mask device 
    B: Secure his airway with an ET tube 
    C: Begin treatment with a beta-2 agonist medication 
    D: Auscultate his lung sounds and reassess his SpO2
    A: Assist his ventilations with a bag-mask device
  40. You should be MOST suspicious for child abuse when caring for an injured 4 year old child if 

    A: There was an unusual delay in calling 911
    B: The child presents with bruises to both shins
    C: The caregiver demands that you treat the child 
    D: You can smell alcohol on the caregivers breath
    A: There was an unusual delay in calling 911
  41. The most appropriate airway management for an actively seizing child whose airway is not maintainable with positioning involves 

    A: Immediate endotracheal intubation 
    B: Insertion of OPA 
    C: Nasal airway insertion and suctioning as needed
    D: 100% O2 and a left lateral recumbent position
    C: Nasal airway insertion and suctioning as needed
  42. You are dispatched to a grocery store for a woman with severe abdominal pain. When you arrive, you find the patient lying on her side in the managers office. She is confused, is diaphoretic, and appears to be bleeding from her vagina. Her blood pressure is low and her pulse, respiratory rates are elevated. You should:

    A: Administer 100% O2, elevate her legs 12-18 inches, keep her warm, establish IV, give 500-mL fluid bolus, reassess her BP and transport at once with continuous monitoring en-route to the hospital 

    B: Immediately place her in a supine position, firmly massage her uterine fundus to control the bleeding, establish 2 large bore IV, run them wide open, transport at once and apply high-flow O2 en-route to the hospital 

    D: Assist her ventilations with a bag-mask device, carefully place a trauma dressing inside her vagina to control the bleeding, begin rapid transport, establish two large-bore IV lines en-route and administer 20mL/Kg fluid boluses as needed
    C: Apply high-flow O2, visually inspect her vagina and cover it with sterile dressings. Keep her warm, begin transport, establish at least 1 large bore IV en-route, and administer enough crystalloid fluid to maintain radial pulses
  43. If you feel 13 pulsations in a 6 second time frame, the newborns heart rate is approximately 

    A: 20bpm
    B: 60bpm
    C: 90bpm
    D: 130bpm
    D: 130bpm
  44. You and your partner are caring for a child with stable SVT that was refractory to initial treatment. As your partner is preparing to establish vascular access, the childs LOC decreases markedly. You reassess the child and note that his femoral pulse is rapid and weak. You should:

    A: Perform immediate synchronized cardioversion and reassess
    B: Begin chest compression as your partner establishes the IV line
    C: Preoxygenate the child and then perform an ET
    D: Establish IV and administer 0.1mg/kg adenosine
    A: Perform immediate synchronized cardioversion and reassess
  45. You and your partner arrive at the scene shortly after a 2 y.o child experience an apparent seizure. The childs father tells you that his son's entire body began shaking and that the episode lasted less than 5 minutes. Your assessment of the child reveals that he is conscious, crying, with hot moist skin. His HR: 160bpm, and RR: 40 breaths/min. You should 

    A: Advise the father to take his son to see a pediatrician the following day 
    B: Cool the child with tepid water, administer high-flow O2 and transport 
    C: Establish vascular access, give a 20mL/Kg saline bolus, and transport him 
    D: Keep the child cool and transport him to the hospital for physician evaluation
    D: Keep the child cool and transport him to the hospital for physician evaluation
  46. In addition to an IV dextrose bolus, the MOST important treatment for newborn hypoglycemia is 

    A: IV fluid boluses 
    B: Assisted ventilation 
    C: A 25% dextrose infusion 
    D: Proper thermal management
    D: Proper thermal management
  47. You are dispatched to a residence at 6:15AM for an unconscious 3mos who is not breathing. Upon arrival at the scene, you find the father performing CPR on the infant. The infants mother is sitting on the couch, crying. Your assessment reveals that the child is apneic and pulseless. His skin is pale and cold, and there is gross lividity to his chest. You should 

    A: Continue CPR and assess the infants cardiac rhythm to confirm asystole
    B: Recognize the infant has been deceased for an extended period of time 
    C: Pronounce the infant dead if he does not respond to 4 minutes of full ACLS
    D: Tell the parents that the child is likely suffocated because he slept on his stomach
    B: Recognize the infant has been deceased for an extended period of time
  48. When assessing a 5y.o you should:

    A: Be able to conduct a head-to-toe exam 
    B: Ask simple yes or no questions if possible 
    C: Generally use a toe-to-head approach 
    D: First ask a parent where the child is hurting
    A: Be able to conduct a head-to-toe exam
  49. Upon arriving at the scene of a 4 y.o girl who is ill, you assess her and note that she is tachypneic and tachycardic. Her skin is warm and moist, and there are no signs of increased work of breathing. The child's mother denies any vomiting or diarrhea. This child's tachycardia and tachypnea are MOST likely the result of 

    A: Fever and Anxiety 
    B: Early hypoxemia 
    C: A cardiac problem 
    D: Moderate dehydration
    A: Fever and Anixety
  50. While caring for an unresponsive young woman who was apparently sexually assaulted, you note that her respitations are slow and shallow. Her pulse is slow and weak, and her BP is low. There is a small amount of dried blood on her thigh, but no grossly active bleeding. Immediate care for this patient involves:

    A: Establishing an IV line and administering 0.5mg of atropine 
    B: Visualizing her vaginal area to assess for external bleeding 
    C: Maintaining her airway and providing ventilatory assistance
    D: Elevating her lower extremities to improve her BP
    C: Maintaining her airway and providing ventilatory assistance
  51. Several cycles of chest compressions have failed to remove a foreign body airway obstruction in an unresponsive infant. Your next action is to 

    A: Perform laryngoscopy and try to visualize the foreign body 
    B: Continue chest compressions and perform a cricothyrotomy 
    C: Open the infants airway and sweep the infants mouth with your finger
    D: Perform back slaps and chest thrusts and then look in the mouth
    A: Perform laryngoscopy and try to visualize the foreign body
  52. A newborn with a pulse rate of 80bpm

    A: Requires ventilation's and chest compressions 

    B: Should be treated with 0.02 mg/kg of atropine 
    C: Is likely under the influence of maternal opiates 
    D: Requires immediate positive-pressure ventilation
    D: Requires immediate positive-pressure ventilation
  53. Your primary assessment of an unresponsive 5 y.o, 40lb child reveals, that he is apneic and pulseless. CPR is initiated and the cardiac monitor is applied, which reveals V-fib. You should: 

    A: Continue high-quality CPR and reassess in 2 minutes
    B: Defibrillate with 40 joules and immediately resume CPR
    C: Start an IV and administer 0.2mg of Epi 1: 10,000 
    D: Charge the defibrillator to 80 joules while CPR is ongoing
    B: Defibrillate with 40 joules and immediately resume CPR
  54. A 4 y.o girl presents with a fever of 103.2. The childs mother states that the fever came on suddenly and was not preceded by any symptoms. The child is conscious and alert with unlabored tachypnea, tachycardia and a blood pressure that is consistent with her age. Prehospital treatment for this child includes all of the following EXCEPT

    A: 81mg of aspirin 
    B: Free-flow O2
    C: 250mg of acetaminophen 
    D: Simple cooling measures
    A: 81mg of aspirin
  55. In young children, airbags pose a particular threat for injuries to the 

    A: Thoracic organs
    B: Abdominal organs 
    C: head and neck 
    D: Soft Tissues of the face
    C: Head and Neck
  56. You receive a call to a residence for a 6 y.o girl with a decreased LOC. The child has hydrocephalus following surgery to remove a brain tumor and has a ventricular shunt in place. The child's LOC is markedly decreased from its baseline, and the child's caregiver tells you that she thinks the shunt is obstructed. Which of the following sets of vitals are MOST indicative of shunt obstruction and increased intracranial pressure. 

    A: BP: 140/92, HR: 58 bpm, RR: 8 breaths/min
    B: BP: 106/66, HR 80 bpm, RR: 14 breaths/min
    C: BP: 90/50, HR 110 bpm, RR: 10
    D: BP: 130/68, HR 70 bpm, RR: 28
    A: BP: 140/92, HR: 58 bpm, RR: 8 breaths/min
  57. When caring for a prolapsed umbilical cord, you should:

    A: Position the mother in a left lateral recumbent position with her knees flexed into her abdomen 

    B: Keep the presenting part of the baby off the umbilical cord during rapid transport to the hospital 

    C: Have your partner cover the exposed portion of the umbilical cord with dry, sterile dressings 

    D: Instruct the mother to push during each contraction to facilitate passage of the baby past the cord
    B: Keep the presenting part of the baby off the umbilical cord during rapid transport to the hospital
  58. If a newborn requires epinephrine and peripheral venous access is unsuccessful, you should:

    A: Cannulate the umbilical vein 
    B: Insert an IO catheter 
    C: Perform intubation immediately 
    D: Inject the drug directly into a vein
    A: Cannulate the umbilical vein
  59. While preparing equipment for newborn resuscitation, which of the following items is/are NOT considered optional?

    A: Pulse Oximeter
    B: Cardiac Monitor 
    C: May be an early sign of preeclampsia 
    D: Is benign in the vast majority of cases
    C: May be an early sign of preeclampsia
  60. Gestational hypertension:

    A: Often requires an antihypertensive 
    B: Is common in underweight women 
    C: May be an early sign of preeclampsia 
    D: Is benign in the vast majority of cases
    C: May be an early sign of preeclampsia
  61. The general area of a child's body that sustains initial trauma after being struck by an automobile depends MAINLY on:

    A: The child's height and the height of the bumper upon impact
    B: The travel speed of the vehicle and the weight of the child 
    C: Whether the child turns away from or toward the vehicle
    D: Whether the vehicle ran over the child following impact
    A: The child's height and the height of the bumper upon impact
  62. When delivering multiple babies, you should clamp and cut the umbilical cord:

    A: After the placenta has delivered 
    B: Only after the first baby delivers 
    C: Following delivery of each baby 
    D: After all the babies have delivered
    C: Following delivery of each baby
  63. In pregnancy, magnesium sulfate is used principally for:

    A: Eclamptic seizures
    B: Tocolytic therapy 
    C: Ventricular dysrhythmias 
    D: Hyperemesis gravidarum
    A: Eclamptic seizures
  64. You receive a call for a "sick child" When you arrive at the scene, the child's mother tells you that her 5 y.o son has had vomiting and diarrhea for the past day and will not eat or drink anything. On exam, the child's LOC appears consistent with his age. His skin is cool and pale, he is tachypneic, his capillary refill time is 4 seconds and his heart rate is 150 bpm. The MOST appropriate treatment for this child involves:

    A: Apply high-flow O2 via pediatric nonrebreathing mask, assessing his blood glucose level, elevating his legs 12 inches and transporting at once. 
    B: Establishing IV access and administering a 20 mL/Kg NS bolus, applying high-flow O2, administering 25% dextrose, and transporting 
    C: Administering supplemental O2, keeping the child warm, assessing his blood glucose level, transporting and establishing vascular access en route 
    D: Administering supplemental O2, starting an IV line, assessing his blood glucose level, delivering at least two 20mL/kg NS boluses, and transporting
    C: Administering supplemental O2, keeping the child warm, assessing his blood glucose level, transporting and establishing vascular access en route
  65. A 7 year old conscious boy presents with marked respiratory distress. Your assessment reveals the presence of intercostal and supraclavicular retractions and nasal flaring. His O2 saturation is 93% on room air, and his heart rate is rapid. The MOST appropriate initial treatment for this child involves:

    A: Administering high-flow O2 as tolerated, auscultating his lung sounds, and being prepared to assist his ventilation's 

    B: Conducting a focused history and physical exam and allowing him to breathe room air to see if his oxygen saturation falls. 

    C: Recognizing that the child is in respiratory failure and amking immediate preparations to perform endotracheal intubation 

    D: Assisting his ventilation's with a bag-mask device and determining if his Tachycardia is ventricular or supraventricular in origin
    A: Administering high-flow O2 as tolerated, auscultating his lung sounds, and being prepared to assist his ventilation's
  66. The MOST important prehospital intervention for a footling breech tor transverse presentation of the baby is 

    A: Maternal vascular access
    B: Keeping the mother warm 
    C: Delivery of high-flow O2
    D: Rapid transport to the hospital
    D: Rapid transport to the hospital
  67. A 15 year old child can be difficult to treat for all of the following reasons; EXCEPT

    A: Peer pressure 
    B: Stranger Anxiety 
    C: Independence issues 
    D: Cognizance of body image
    B: Stranger Anxiety
  68. During transport of a newborn, timely intervention of acute deterioration is MOST effectively achieved by:

    A: Ensuring placement of at least one IV line 
    B: Reassessing vital signs every 5 to 10 minutes
    C: Cardiac monitoring and the use of capnography 
    D: Ongoing observation and frequent reassessment
    D: Ongoing observation and frequent reassessment
  69. Women who have had a C-section 

    A: Can have a normal vaginal delivery 
    B: Most likely delivered two or more babies
    C: Usually have a vertical scar on the abdomen 
    D: Are precluded from having a vaginal delivery
    A: Can have a normal vaginal delivery
  70. Epinephrine is indicated during newborn resuscitation if:

    A: The heart rate does not increase above 80bpm after 30 to 60 seconds of effective positive-pressure ventilation

    B: The newborn is bradycardic and thick secretions are hindering your ability to provide effective positive-pressure ventilations

    C: The heart rate remains below 60 bpm after 30 seconds of effective ventilation and an additional 30 seconds of chest compression's 

    D: Profound central cyanosis persists despite 30 seconds of effective positive-pressure ventilation with 100% supplemental O2
    C: The heart rate remains below 60 bpm after 30 seconds of effective ventilation and an additional 30 seconds of chest compression's
  71. Chest compression's are indicated in the newborn if its heart rate remains less than ___ beats/min despite effective positive-pressure ventilation's for _____ seconds 

    A: 80, 30
    B: 60, 30
    C: 60, 60
    D: 80, 60
    B: 60, 30
  72. Infants and children in shock:

    A: Typically become hypotensive sooner than adults because of a relative decrease in total blood volume 

    B: Generally remain alert for longer periods than adults despite a significant decrease in cerebral perfusion 

    C: Compensate more efficiently than adults by increasing heart rate and peripheral vascular resistance 

    D: Maintain end-organ perfusion longer than adults, making capillary refill time a less reliable perfusion indicator
    C: Compensate more efficiently than adults by increasing heart rate and peripheral vascular resistance
  73. a 6 year old who has been running a fever for the past 2 days presents with lethargy and tachycardia. Her heart rate is 170 bpm and varies with activity. Her skin is cool and clammy, and her capillary refill time is 4 seconds. The cardiac monitor reveals a narrow complex tachycardia with a rate that varies between 150 and 170 bpm. After applying high-flow O2, you should:

    A: Apply chemical ice packs to the child's face to try to slow her heart rate
    B: Establish vascular access and administer a 20mL/Kg normal saline bolus 
    C: Start an IV line and give adenosine while monitoring her cardiac rhythm
    D: Transport immediately and establish vascular access en route to the hospital
    B: Establish vascular access and administer a 20mL/Kg normal saline bolus
  74. Children between 1 and 3 years of age 

    A: are capable of basic reasoning
    B: Have a well-developed sense of cause and effect
    C: Generally explore the world exclusively by crawling 
    D: May have negative associations with health care providers
    D: May have negative associations with health care providers
  75. The presence of Tachycardia in children

    A: Commonly reflects an underlying cardiac pathology that requires emergent intervention 

    B: Often causes hypotension and is usually associated with a QRS complex greater than 0.08 seconds

    C: Should be interpreted in the context of the pediatric assessment triangle and the primary assessment 

    D: Necessitates a 20mL/Kg bolus of an isotonic crystalloid solution until the cardiac rhythm is assessed
    C: Should be interpreted in the context of the pediatric assessment triangle and the primary assessment
  76. Signs of hypovolemia in the newborn include all of the following except:

    A: persistent pallor
    B: weak central pulses 
    C: persistent acrocyanosis 
    D: persistent bradycard
    C: persistent acrocyanosis
  77. Cardiopulmonary arrest in the pediatric patient 

    A: usually presents with PEA 
    B: requires high epi doses 
    C: typically requires defibrillation 
    D: is most often a secondary event
    D: is most often a secondary event
  78. The MOST common device used to provide positive-pressure ventilation to a newborn in the pre hospital setting is a:

    A: T- piece resuscitator 
    B: Self-inflating bag-mask device
    C: Flow-inflating bag-mask device 
    D: Manually triggered ventilator
    B: Self-inflating bag-mask device
  79. A 29 year old woman complains of abdominal cramping and vaginal bleeding. The patient is 22weeks pregnant and tells you that she passed sever large clots of blood while using the toilet. Your partner confirms that she can clearly recognize a small fetus in the toilet the patient is conscious and alert. but her skin is diaphoretic. Her blood pressure is 98/58. Pulse 108bpm and regular and RR: 22 breaths/min with adequate depth. In addition to bringing the fetus to the hospital for inspection, the MOST appropriate treatment for this patient involves:

    A: O2 via NC @ 2lpm, two large bore IV's, 20mL/Kg NS bolus, emotional support, and rapid transport to the hospital. 

    B: O2, careful packing of the vagina to control the bleeding, an IV line set to KVO, emotional support as needed, and transport to the hospital 

    C: O2 by NRB @ 8LPM, placing her in the left lateral recumbent position, a sanitary pad over her vagina, emotional support and transport to the hospital 

    D: High flow O2, sanitary pad over the vagina, a large-bore IV, cystalloid boluses as needed to maintain adequate perfusion, emotional support, and prompt transport
    D: High flow O2, sanitary pad over the vagina, a large-bore IV, cystalloid boluses as needed to maintain adequate perfusion, emotional support, and prompt transport
  80. You are caring for a 33 year old woman who is 35 weeks pregnant and fell down a flight of stairs. Full spinal precautions have been taken, the patient is receiving high flow O2, and a patent IV line is in place. During transport , you reassess her and note that she has become diaphoretic, tachycardic, and tachypneic. You should:

    A: Reassess her blood pressure
    B: Administer a rapid fluid bolus
    C: Cover her with warm blankets
    D: Tilt the backboard to the left side
    D: Tilt the backboard to the left side
  81. You are delivering a baby who was in a breech presentation. The baby's body has delivered, and you are attempting to deliver its head by lifting its body upward. After about 3 minutes, the baby's head has not delivered. You should:

    A: Elevate the mothers hips with pillows, administer high-flow O2, and transport immediately 

    B: Support the baby's body, carefully turn the mother on her left side, and transport expeditiously 

    C: Place your gloved hand in the vagina and gently lift the baby's face away from the vaginal wall 

    D: Elevate the mother's hips and apply gentle traction to the baby's body until the head has delivered
    C: Place your gloved hand in the vagina and gently lift the baby's face away from the vaginal wall
  82. You receive a call at 11:50 pm for a 3 year old boy with respiratory distress. As soon as you enter the child's residence, you can hear a loud, barking cough. You find the child sitting on his mothers lap. He is conscious and appears alert to his surroundings. According to the child's mother he has been sick for he past few days with a low-grade fever, but then began experiencing, a high-pitched cough. His skin is warm and dry. His heart rate is 120 bpm, O2 99% on RA. There are no signs of increased work of breathing. You should: 

    A: Administer high flow O2 via NRB, keep him calm and transport 

    B: Establish vascular access, give an appropriate dose of methylprednisolone, and transport 

    C: Administer 0.5mL of racemic epinephrine via nebulizer, apply the cardiac monitor and transport 

    D: Allow the child to assume a position of comfort, avoid agitating him and transport him to the hospital
    D: Allow the child to assume a position of comfort, avoid agitating him and transport him to the hospital
  83. Most injuries in pediatric patients:

    A: Can be totally eliminated with training
    B: involve trauma to the chest and spine
    C: Are predictable and preventable events 
    D: Occur due to gross caregiver negligence
    C: Are predictable and preventable events
  84. The MOST common etiology for Bradycardia in a newborn is

    A: Severe hypoxia 
    B: Untreated acidosis 
    C: Occult hypovolemia 
    D: Increased vagal tone
    A: Severe hypoxia
  85. Common causes of respiratory distress in the newborn include 

    A: Mucous obstruction of the nose
    B: Unrecognized metabolic alkalosis 
    C: Persistent pulmonary hypotension 
    D:Maternal use of narcotic analgesic
    A: Mucous obstruction of the nose
  86. The goal in treating a child with epiglottitis is to 

    A: transport him or her to the hospital with a maintainable airway
    B: Administer corticosteroids to reduce edema in the upper airway 
    C: Intubate him or her before the epiglottis blocks the upper airway 
    D: Administer O2 by NRB and transport at once
    A: transport him or her to the hospital with a maintainable airway
  87. The MOST common reasons for ineffective bag-mask ventilations in the newborn are:

    A: Equipment malfunction and a ventilation rate that is too rapid 
    B: Inadequate mask-to-face seal and incorrect head position 
    C: Hyperflexion of the newborn's head and thick mucous plugs 
    D: Pneumothorax and a face mask that is too large for the infant
    B: Inadequate mask-to-face seal and incorrect head position
  88. The correct positive-pressure ventilation rate for an apneic newborn is:

    A: 12-20
    B: 20-30
    C: 30-40
    D: 40-60
    C: 30-40
  89. When suctioning the newborn's oropharynx to clear secretions prior to intubation it is MOST important to

    A: Limit suctioning to 15sec 
    B: Use a flexible suction catheter 
    C: Monitor the newborns heart rate 
    D: Administering warmed, humidified O2
    C: Monitor the newborns heart rate
  90. The quickest way to prevent newborn hypothermia involves 

    A: Administering warmed IV fluids 
    B: Thoroughly drying the newborn after birth 
    C: Applying a hot water bottle to the groin area
    D: Administering warmed, humidified O2
    B: Thoroughly drying the newborn after birth
  91. You are assessing a 7mos old who presents with listlessness, pallor and increased work of breathing. The infant's mother tells you that the child was born 2 months premature and was in the neonatal ICU for 3 weeks. She denies any recent vomiting, diarrhea or fever. The infants O2 is 89% and not improve with supplemental O2. Her HR is rapid and weak and does not vary with activity. When you apply the cardiac monitor, you will MOST likely encounter a: 

    A: A wide QRS complex rhythm with occasional P waves and a rate greater than 150 bpm

    B: Rhythm with QRS complexes greater than 0.08 seconds in duration and a heart rate greater than 180 bpm 

    C: Narrow QRS complex rhythm with absent P waves and a heart rate greater than 220 bpm 

    D: Rhythm with QRS complexes less than 0.08 seconds in duration and a heart rate less than 220 bpm
    C: Narrow QRS complex rhythm with absent P waves and a heart rate greater than 220 bpm
  92. The MOST important aspect in the care of a woman with severe vaginal bleeding is :

    A: Controlling the vaginal bleeding
    B: Administering Crystalloid fluid boluses 
    C: Giving O2 via NRB 
    D: Treating for shock and transporting rapidly
    D: Treating for shock and transporting rapidly
  93. When performing chest compressions on a newborn, you should 

    A: Compress the chest one third the anteroposterior depth of the chest 
    B: Use two-finger compression technique if two rescuers are present 
    C: Reassess the newborns heart rate after every 60 seconds of compression's 
    D: Deliver 120 compression's and 40 ventilation's during an 60 second period
    A: Compress the chest one third the anteroposterior depth of the chest
  94. You and your partner are caring for a 5lb distressed newborn. After providing 30 seconds of effective bag-mask ventilations, the newborns heart rate remains below 60bpm. You should:

    A: Cannulate the umbilical vein and give 0.5mL of Epi
    B: Try tactile stimulation as you continue bag-mask ventilations 
    C: Start peripheral IV line and give 4mEq of sodium bicarbonate 
    D: Continue bag-mask ventilations and initiate chest compression's
    D: Continue bag-mask ventilation's and initiate chest compression's
  95. You are transporting a newborn who requires ongoing ventilatory support and chest compression's for severe bradycardia. Your estimate time of arrival at the hospital is 45 minutes. Air medical transport was unavailable due to severe weather in the vicinity. A Peripheral IV line has been established in the AC vein. You are in the process of attempting intubation. Approximately 10 seconds into your intubation attempt, the newborns heart rate suddenly drops move. You should:

    A: Abort the intubation attempt and continue ventilations 

    B: Continue the intubation attempt and administer atropine 

    C: Administer 0.1 to 0.3 mL/Kg of Epi IVP 
    D: Ensure that chest compressions are of adequate rate and depth
    A: Abort the intubation attempt and continue ventilations
  96. There is evidence that a 21 year old woman was given Rohypnol before being raped. She presents with alcohol on her breath, drowsiness and memory loss. Her BP: 98/68, HR: 58bpm and weak RR: Decreased and shallow

    You attempt to administer high-flow O2 but she resists. What should you do now 

    A: Administer a sedative medication to facilitate her acceptance of the O2 
    B: Consider administering naloxone in case she was also given a narcotic drug 
    C: Start an IV and administer 1 to 2 liters of an isotonic crystalloid solution 
    D: Recognize that because the patient is of legal age, she can refuse EMS treatment
    B: Consider administering naloxone in case she was also given a narcotic drug
  97. After performing the initial steps of resuscitation, you assess a newborn and note that its respiration's are poor and its pulse rate is 50bpm. You Should:

    A: Immediately begin positive-pressure ventilation's and chest compression's and then reassess the newborn's pulse rate in 30 seconds

    B: Begin chest compression's, if the heart rate remains below 60bpm after 30 seconds of effective positive-pressure ventilation. 

    C: Begin chest compression's, insert an ET tube, and administer 0.1 to 0.3 mL/Kg of Epi 1:10,000 down the ET Tube

    D: Perform tactile stimulation for 30 seconds, reassess the infants respiration's and pulse rate, and being positive-pressure ventilation's if there is no improvement.
    B: Begin chest compression's, if the heart rate remains below 60bpm after 30 seconds of effective positive-pressure ventilation.
  98. A 30 year old woman complains of an "achy" pain to both lower abdominal quadrants which she states is made worse by walking. She further tells you that she recently finished her menstrual period. She has a fever of 101.9F. Her BP 122/62, HR: 84bpm and strong. RR: 14 and unlabored. After gathering the rest of her medical history you should:

    A: Provide emotional support, make her as comfortable as possible and saftely transport her to an appropriate medical hospital 
    B: Advise her that she can probably go to the hospital VIA personal vehicle since she is not showing signs of shock 
    C: Visually inspect her vagina for bleeding or discharge, start an IV line and set it to KVO, and transport 
    D: Establish IV, give her 250mL NS bolus, consider analgesia for her pain and transport
    A
  99. During your assessment of a 30 year old woman in active labor, she admits to being a chronic heroin abuser and states that she last "shot up" about 6 hours ago. After the baby delivers you will MOST likely need to 

    A: Give positive-pressure ventilation's 
    B: Administer 0.1mg/kg of naloxone 
    C: Suction meconium from its airway
    D: Administer free-flow O2 by mask
    A
  100. You are assisting in the delivery of a baby. After the baby's head emerges from the vagina you should quickly assess for the presence of nuchal cord and then: 

    A: Assess for facial cyanosis 
    B: Administer free-flow O2
    C: Suction its mouth and nose
    D: Dry it's face to stimulate breathing
    C
  101. Which of the following questions is the MOST important to ask when obtaining the patients gynecologic history 
    A: Do you have abdominal pain
    B: When was your last sexual encounter 
    C: When was your last menstrual period 
    D: Is there a chance you can be pregnant
    C
Author
gnomestyle82
ID
320669
Card Set
Paramedic PEDS
Description
Paramedic end of chapter and review tests
Updated