Ch. 44

Question 1

You are called for a baby with respiratory distress. The 18-month-old patient has a fever of 104.1°F, has expiratory wheezing, and his lungs sound as if they have mucus in the lower airways. His mother reports the baby has been sick for a couple of days with an upper respiratory infection. You should suspect:

A) croup.
B) pertussis.
C) bronchiolitis.
D) pneumonia.

Answer 1

C) bronchiolitis.

Page Ref: 979

Question 2

Which of the following statements regarding treatment of the pediatric patient in the prehospital setting is CORRECT?

A) “If the primary assessment of a sick pediatric patient shows no deficits to the ABCs, the patient is stable and will not deteriorate.”
B) “Since pediatric patients can deteriorate very quickly, they must all be transported with lights and sirens during the ride to the hospital.”
C) “It is critical that the AEMT be able to determine the respiratory status of the patient as this is most likely the reason for acute deterioration.”
D) “When treating a sick pediatric patient in the prehospital setting, the AEMT must determine the exact illness so as to provide the most appropriate treatment.”

Answer 2

C) “It is critical that the AEMT be able to determine the respiratory status of the patient as this is most likely the reason for acute deterioration.”

Page Ref: 978

Question 3

You are caring for a two-year-old child who has fallen from the second story deck. The child is crying and you are trying to complete an assessment on the baby. The father is worried sick about his son. Which of the following should you do in this situation?

A) Call for law enforcement assistance in case the father becomes violent.
B) Have the father leave the room so you can complete your assessment.
C) Reassure him and have him get the child’s favorite toy to take to the hospital.
D) Tell the father to calm down because the boy will be just fine.

Answer 3

C) Reassure him and have him get the child’s favorite toy to take to the hospital.

Page Ref: 972

Question 4

A six-month-old has been stung on the tongue after putting a bottle in his mouth that had a bee on the nipple. In comparison to the same injury in an adult, why would you be more concerned with this child?

A) A child’s airway has more blood vessels than an adult’s, making bleeding more of a concern.
B) The child’s tongue is proportionally larger, increasing the chance of airway occlusion from swelling.
C) Children tend to be highly allergic to bee stings, whereas the same allergy in an adult is rare.
D) When injured, a child’s mouth produces more saliva, making airway occlusion a major concern.

Answer 4

B) The child’s tongue is proportionally larger, increasing the chance of airway occlusion from swelling.

Page Ref: 971

Question 5

You must assess the pupils of a five-year-old who fell off a bed while playing. Which of the following statements would be MOST appropriate prior to performing this assessment?

A) “Open your eyes so that I can look at your pretty eyes.”
B) “I am going to look at your pupils with my light.”
C) “I am going to use this light to look into your eyes.”
D) “I need to test your visual acuity by shining a light in your eyes.”

Answer 5

A) “Open your eyes so that I can look at your pretty eyes.”

Page Ref: 971

Question 6

What would be the minimally acceptable blood pressure for a nine-year-old girl who is suffering from a significant bleed from broken glass?

A) 96 mmHg
B) 80 mmHg
C) 88 mmHg
D) 100 mmHg

Answer 6

C) 88 mmHg

Page Ref: 976

Question 7

You are called for a seven-year-old boy with difficulty breathing. Using the pediatric assessment triangle, you notice that the boy is sitting upright in the tripod position. This observation is obtained during which part of the assessment triangle?

A) Appearance
B) Work of Breathing
C) Circulation to the skin
D) Respiratory status

Answer 7

B) Work of Breathing

Page Ref: 973

Question 8

When you are assessing a three-year-old who is in respiratory distress, which of the following assessment findings should be MOST concerning to you?

A) Retractions observed above the clavicles
B) Abdominal movement during breathing
C) Heart rate of 110 beats per minute
D) Respiratory rate of 28 breaths per minute

Answer 8

A) Retractions observed above the clavicles

Page Ref: 973-976

Question 9

A concerned parent asks you which vaccine will decrease the risk of her child getting epiglottitis. Which vaccine would you tell her?

A) Influenza
B) MMR
C) Hib
D) Hepatitis

Answer 9

C) Hib

Page Ref: 979

Question 10

You have responded for a five-year-old girl in severe respiratory distress apparently from an allergic reaction. You remember that the treatment for severe anaphylaxis for a child this age is:

A) intravenous epinephrine 1:1000 at a dosage of 0.01 mg/kg.
B) subcutaneous epinephrine 1: 10,000 at a dosage of 0.01 mg/kg.
C) intramuscular epinephrine 1: 1000 at a dosage of 0.1 mg/kg.
D) intramuscular epinephrine 1:1000 at a dosage of 0.01 mg/kg.

Answer 10

D) intramuscular epinephrine 1:1000 at a dosage of 0.01 mg/kg.

Page Ref: 980

Question 11

You respond to an apparent SIDS death where the baby is obviously dead. You should:

A) attempt resuscitation even though the baby has rigor mortis.
B) be careful not to disturb the scene since it could be a crime scene.
C) ask the parents why they placed the baby on his stomach to sleep.
D) tell the parents that it looks like the child suffocated on his blankets.

Answer 11

B) be careful not to disturb the scene since it could be a crime scene.

Page Ref: 981

Question 12

You are performing CPR on a three-month old baby who stopped breathing during his nap. There are no obvious signs of death so you begin resuscitation. The parents are watching you as you perform CPR on the baby. You should:

A) have the parents removed from the room while you treat the baby.
B) call law enforcement to manage the parents in case they get upset.
C) allow the parents to watch and explain to them that you are doing everything possible.
D) have the parents take over CPR while you get ready to transport to the hospital.

Answer 12

C) allow the parents to watch and explain to them that you are doing everything possible.

Page Ref: 981

Question 13

You respond to an apparent SIDS death. There appears to be bruising on the baby’s back and buttocks area. The parents say they put the baby down for a nap and he never woke up. What should you do?

A) Ask the parents what they did to the baby.
B) Question the parents gently to avoid implying blame.
C) Ask if the baby has been abused by someone in the household.
D) Find out if the baby had been placed on his back for his nap.

Answer 13

B) Question the parents gently to avoid implying blame.

Page Ref: 981

Question 14

You are providing care for a three-year-old boy who has fallen down a set of stairs in his home. He is crying as his mother tries to console him. You are concerned about the possibility of internal bleeding. Which of the following is CORRECT regarding this patient?

A) He may not show signs or symptoms of shock until very late.
B) He will not likely go into shock because of his ability to compensate.
C) A blood pressure of 90 mmHg would indicate shock.
D) A capillary refill time of two seconds would rule out shock.

Answer 14

A) He may not show signs or symptoms of shock until very late.

Page Ref: 985-986

Question 15

You are caring for a three-year-old girl who was involved in a serious motor vehicle crash. Which of the following is TRUE regarding care for this child?

A) Transport the child in the car seat with padding around the head and torso.
B) If no sign of spinal injury, remove the child from the car seat and transport normally.
C) You should remove the child from the car seat maintaining spinal stabilization.
D) Have the parent hold the child while both are immobilized on a long spine board.

Answer 15

C) You should remove the child from the car seat maintaining spinal stabilization.

Page Ref: 986

Question 16

Which of the following is TRUE regarding spinal motion restriction in the pediatric patient?

A) Allow the parent or caregiver to hold the child to reduce anxiety and movement.
B) Padding under the shoulders may be necessary to maintain cervical spine alignment.
C) Cervical collars are not required since their necks are so short.
D) If the child is too upset, it is better to not spinal immobilize them.

Answer 16

B) Padding under the shoulders may be necessary to maintain cervical spine alignment.

Page Ref: 986

Question 17

You are caring for a child who has been burned. Which of the following is TRUE regarding burn prevention?

A) Toddlers are unable to reach the stove so kitchen burns are not an issue.
B) Children lack the manual dexterity to light matches or use a lighter.
C) The older a child gets, the less likely he is to suffer a burn injury.
D) Lowering the temperature of the hot water heater can prevent serious burns.

Answer 17

D) Lowering the temperature of the hot water heater can prevent serious burns.

Page Ref: 986

Question 18

Which of the following would be an example of child neglect?

A) Burning a child with a cigarette lighter.
B) Leaving a two-year-old child in the tub alone.
C) Spanking a child repeatedly with a cord.
D) Locking a child in a closet at night.

Answer 18

B) Leaving a two-year-old child in the tub alone.

Page Ref: 972, 987

Question 19

You are treating a young child with “stocking foot” burns. You experience anger related to the suspected child abuse, but you are able to control your anger during the call and provide appropriate care to the child. However, after the call you feel like your anger is going to explode. What step should you take to provide for your own mental health?

A) Call law enforcement and have them take the parents into custody.
B) Vent your anger to the other emergency professionals in your organization.
C) Seek help from a mental health professional.
D) Go home and share a drink with your spouse while you talk about the event.

Answer 19

C) Seek help from a mental health professional.

Page Ref: 988

Question 20

You are caring for a child that has been repeatedly dunked in extremely hot water. He has blisters on his lower body all the way to his waist. How should you handle this situation?

A) Let the abuser know that you have called the police.
B) Keep your anger in check and focus on treating the child.
C) Give the abuser a taste of his own medicine.
D) Ask the neighbor if they have observed any abuse.

Answer 20

B) Keep your anger in check and focus on treating the child.

Page Ref: 987-988

Question 21

You are assessing a three-year-old child for possible injuries after the child fell down a flight of stairs. Which of the following would raise your suspicion that the child may be a victim of physical abuse?

A) Bruises are found on his chest and abdomen.
B) The child cannot be consoled by his mother.
C) The child cries when you palpate his arm.
D) Several bruises are located on his knees and shins.

Answer 21

A) Bruises are found on his chest and abdomen.

Page Ref: 972, 987

Question 22

Which of the following statements is MOST appropriate regarding dealing with caregivers and children during a medical emergency?

A) It is best to separate the caregiver from the child so that a proper assessment and care can be given.
B) Tell the caregiver that everything will be okay so they are more calm and better able to help the child.
C) Try to include the caregiver in all you do with the child so that the child and caregiver are more comfortable.
D) Tell the caregiver to step out of the room so you can assess the child without their interference.

Answer 22

C) Try to include the caregiver in all you do with the child so that the child and caregiver are more comfortable.

Page Ref: 972

Question 23

You have arrived on the scene to help a child who is short of breath. The mother is screaming hysterically that her three-year-old son cannot breathe, making assessment of the patient very difficult. What should be your initial action in managing this situation?

A) Have your partner talk to the mother while you assess the child.
B) Summon the police to the residence to subdue the mother.
C) Quickly remove the child to the ambulance and assess while transporting.
D) Inform the mother that you will call the police if she does not calm down.

Answer 23

A) Have your partner talk to the mother while you assess the child.

Page Ref: 972

Question 24

In relation to an adult’s head, the pediatric patient will have a:

A) relatively larger head.
B) smaller occipital bone.
C) relatively smaller head.
D) larger facial area.

Answer 24

A) relatively larger head.

Page Ref: 970

Question 25

Croup is a:

A) bacterial infection of the upper airway.
B) bacterial infection of the lower airway.
C) viral infection of the lower airway.
D) viral infection of the upper airway.

Answer 25

C) viral infection of the lower airway.

Page Ref: 979

Question 26

In pediatric patients, EXCEPT newborns, cough and fever are common early signs of:

A) bronchiolitis.
B) pertussis.
C) epiglottitis.
D) pneumonia.

Answer 26

D) pneumonia.

Page Ref: 980

Question 27

A direct blow to the chest at a vulnerable point in the cardiac cycle, leading to cardiac arrest, is known as:

A) commotio cordis.
B) ALTE.
C) livor mortis.
D) ventricular hypertrophy.

Answer 27

A) commotio cordis.

Page Ref: 980

Question 28

The typical dose for nebulized albuterol in pediatric patients is:

A) 0.10 mg/kg.
B) 0.15 to 0.3 mg/kg.
C) 1-2 mg/kg.
D) 0.3-0.5 mg/kg.

Answer 28

B) 0.15 to 0.3 mg/kg.

Page Ref: 978

Question 29

You are providing IV fluids to a two-year-old boy who is dehydrated. You should use a ________ gtt/mL drip set.

A) 10
B) 30
C) 60
D) 80

Answer 29

C) 60

Page Ref: 979

Question 30

You are caring for a young boy who is very lethargic, and his mother tells you he has had diarrhea and vomiting for several days. What would be the proper amount of fluids to administer in the initial bolus if the boy weighs 44 pounds?

A) 440 mL
B) 600 mL
C) 400 mL
D) 220 mL

Answer 30

C) 400 mL

Page Ref: 986

Question 31

Which of the following is NOT part of the pediatric assessment triangle when forming your general impression of the patient’s condition?

A) Appearance
B) Work of breathing
C) Breath sounds
D) Circulation to the skin

Answer 31

C) Breath sounds

Page Ref: 972-973

Question 32

Which of the following affects the lower airway?

A) Pharyngitis
B) Croup
C) Pneumonia
D) Laryngitis

Answer 32

B) Croup

Page Ref: 979

Question 33

Which of the following is TRUE regarding febrile seizures?

A) The higher the fever, the more likely to have a seizure.
B) They cause a long postictal state after the seizure.
C) Cool the patient to the shivering state to decrease temperature.
D) They are related to the rate of increase in temperature.

Answer 33

D) They are related to the rate of increase in temperature.

Page Ref: 982

Question 34

Which of the following is TRUE regarding severe burns in very young pediatric patients?

A) One in five burns in children is a result of child abuse or child neglect.
B) Children have thin skin that can be burned at a much lower temperature and shorter duration of exposure to heat than in an adult.
C) Children’s high body-surface-area-to-volume ratio causes them to lose fluids more quickly when the skin is damaged.
D) All of the above are true.

Answer 34

D) All of the above are true.

Page Ref: 970; 986

Question 35

Which of the following would be the BEST treatment for a four-year-old having an acute asthma attack?

A) Deliver humidified oxygen and administer a beta2-agonist by small-volume nebulizer.
B) Provide oxygen and a fluid bolus at 10 mL per kilogram up to 200 ccs.
C) Deliver oxygen via a nasal cannula and administer racemic epinephrine via nebulizer.
D) Provide oxygen and administer SQ epinephrine at a dosage of 0.10 mg/kg.

Answer 35

A) Deliver humidified oxygen and administer a beta2-agonist by small-volume nebulizer.

Page Ref: 978-979

Question 36

Which of the following is CORRECT regarding a patient with cystic fibrosis?

A) Avoid providing IV fluids as it may cause further lung congestion.
B) Humidified oxygen is preferred over non-humidified oxygen.
C) Cysts form in the lungs, inhibiting exchange of oxygen and carbon dioxide.
D) IM epinephrine is used to dilate the bronchioles and alveoli.

Answer 36

B) Humidified oxygen is preferred over non-humidified oxygen.

Page Ref: 980

Question 37

Your patient is a toddler who was burned when he accidentally pulled the cord of a deep fryer sitting on a countertop and spilled hot oil on his head and back. He has burns to the back half of his head, as well as his entire back. What percentage of total body surface area does this account for?

A) 40
B) 36
C) 27
D) 18

Answer 37

C) 27

Page Ref: 987

Question 38

Your patient is an eight-year-old girl. As you approach her, you note that she is holding her right arm against her body, cradling it with the left arm. To find out what happened, which of the following is the BEST approach?

A) Ask the parents to tell you what happened while you examine the child.
B) Sit next to the patient, and ask her what happened.
C) Take the parents aside, and ask them what happened.
D) Ask the parents to leave the room so you can talk to the patient.

Answer 38

B) Sit next to the patient, and ask her what happened.

Page Ref: 971

Question 39

Which of the following conditions does NOT cause an upper airway obstruction?

A) Croup
B) Epiglottitis
C) Asthma
D) Bronchiolitis

Answer 39

C) Asthma

Page Ref: 978-979

Question 40

Your patient is a three-year-old lethargic child whom you have determined to be hypoglycemic. Her mother tells you that the child weighs 44 pounds. Which of the following is the BEST treatment for this patient?

A) Administer 20 mL of 25 percent dextrose IV.
B) Deliver 25 mL of 10 percent dextrose IV.
C) Administer 1 mg of glucagon IM.
D) Give her a sucker to quickly raise her blood sugar.

Answer 40

A) Administer 20 mL of 25 percent dextrose IV.

Page Ref: 983

Question 41

A very young pediatric patient who loses ________ percent of their circulating blood volume can go into compensated shock.

A) 10
B) 15
C) 20
D) 25

Answer 41

B) 15

Page Ref: 975

Question 42

You are in the home of a 17-year-old teenager complaining of abdominal pain. Her mother and father are hovering near her and answering most of the questions you ask her. You sense that the patient is uncomfortable answering questions in front of her parents. Which of the following is the BEST way to handle this situation?

A) Defer the history to the triage nurse at the emergency department so as not to cause undue discomfort to the patient.
B) Tell the parents that their daughter is a big girl and probably doesn’t want to talk about her problems in front of them.
C) Tell the patient you know she might be embarrassed but that it is imperative that she give you the whole story so you know what to do for her.
D) Ask the parents to go to the kitchen with your partner so he can get some information for your paperwork.

Answer 42

D) Ask the parents to go to the kitchen with your partner so he can get some information for your paperwork.

Page Ref: 971-972

Question 43

In which of the following would you MOST likely see a child with eyes that appear to bulge with increased visibility of the superior part of the globe, resulting in “sunset eyes”?

A) Cystic fibrosis
B) Meningitis
C) Hydrocephalus
D) Seizures

Answer 43

C) Hydrocephalus

Page Ref: 982

Question 44

You have been called for an eight-year-old girl who is having seizures. The mother tells you that the child has not been sick and has no fever or vomiting. However, she does have a shunt. You should suspect her seizures are caused by:

A) a seizure disorder.
B) increased intracranial pressure.
C) a recent head injury.
D) an acute increase in temperature.

Answer 44

B) increased intracranial pressure.

Page Ref: 982

Question 45

You are called for a “near” drowning. When you arrive, you find a nine-year-old boy who was pulled from the deep end of the pool just before you arrived. He is conscious and alert, sitting by his mother. He has a cough and his pulse oximetry reading is 98 percent. How should you manage this patient?

A) Advise his mother to watch him closely for the next 24 hours.
B) Recommend that his mother schedule an appointment with his physician.
C) See that he is dried and warmed before sending him home with his mother.
D) Recommend that he be transported to the hospital for evaluation.

Answer 45

D) Recommend that he be transported to the hospital for evaluation.

Page Ref: 987

Question 46

Which of the following is the leading cause of cardiac arrest in pediatric patients?

A) Hypoxia
B) Cardiac dysrhythmias
C) Trauma
D) Congenital defects

Answer 46

A) Hypoxia

Page Ref: 980

Question 47

Which of the following is a respiratory infection that results in coughing fits that can interfere with breathing?

A) Bronchiolitis
B) Croup
C) Pertussis
D) Epiglottitis

Answer 47

C) Pertussis

Page Ref: 979