Pepp Flashcards
A 5-year-old boy is wheezing and complains of chest tightness. He is sitting upright and using accessory muscles to breathe. Vital signs are BP 92/62, HR 128, and RR 36, and
oxygen saturation is 93%. What initial management should be performed?
Initiate bag mask wentlationing mask
Open the airway with the jaw-thrust maneuver.
Insert a nasopharyngeal airway.
Apply oxygen by nonrebreathing mask.
Apply oxygen by nonrebreathing mask
Which of the following is an acceptable means of safe transport for a child in an ambulance?
The child in an age-appropriate car seat secured via two straps to the stretcher
The child transported in his own car seat after a rollover motor vehicle crash
The child held in a parent’s arms with the parent secured to the stretcher via a fivepoint harness
The child belted in the captain’s chair in the ambulance.
The child in an age-appropriate car seat secured via two straps to the stretcher
A 3-year-old boy has been seizing for approximately 2 minutes and has gurgling respirations. Which of the following is the first priority?
Protect the cervical spine.
Suction the airway.
Administer midazolam 0.2 mg/kg by the intranasal route.
Obtain a history.
Suction the airway
A 9-year-old boy is screaming and crying after he fell into a backyard bonfire. He has partialand full-thickness burns on both arms and legs. His hair and eyebrows are singed. Vital signs are HR 140, BP 100/70, and RR 30. What should be done first?
Place the patient in the shock position.
Provide 100% oxygen
Apply a wet sheet dressing to the burned areas.
Apply burn cream to burned areas.
Provide 100% oxygen
A 10-year-old cyclist without a helmet fell from her bicycle while riding down a steep hill. She is confused and has vomited twice. Which of the following is an appropriate step in management?
Insert an oropharyngeal airway.
Open the airway with a head-tilt/chin-lift maneuver
Begin suctioning the airway
Elevate the head to 90 degrees.
Begin suctioning the airway
In which of the following patients should child abuse be suspected?
A 10-month-old infant with a bump on the head from falling while climbing out of his highchair
A 2-year-old boy with a facial laceration from pulling a radio off a shelf
A 3-year-old boy with several small, healing circular burns from running into a lit cigarette
A 5-year-old boy with a wrist deformity from falling off a swing set
A 3 year old boy with several small, healing circular burns from running into a lit cigarette
Which of the following is the correct word to describe a high-pitched respiratory noise that occurs during expiration?
Crackles
Wheeze
Rales.
Rhonchi
Wheeze
Which of the following findings is the first to present when a child is in a state of compensated shock?
Altered mental status
Tachypnea.
Prolonged capillary refilli
Tachycardia
Tachycardia
A 2-year-old boy has moderate respiratory distress. He appears uncomfortable and has respiratory rate of 28 breaths/min with tracheal tugging and stridor.
Which of the following
is the best position for the patient?
Prone
Supine
Position of comfort
Side-lying
Position of comfort
A 12-year-old boy with autism is behaving aggressively at school. He has thrown a chair at his teacher and attempted to bite a classmate. Which of the following is an appropriate initial step in caring for this patient?
Place him in four-point restraints.
Distract the boy and have your partner restrain him from behind.
Ask police to place him in handcuffs before you begin your assessment.
Speak directly to the boy and ask him to cooperate with you.
Speak directly to the boy and ask him to cooperate with you
A baby girl has just been delivered at home. She is crying and breathing, but her hands and feet are blue. After clamping and cutting the cord, what do you do next?
• Ventilate her with a bag-mask device
• Maintain her airway using the jaw-thrust maneuver.
• Give high-flow oxygen by nonrebreathing mask.
• Warm and dry the baby.
NOT SURE • Give high-flow oxygen by nonrebreathing mask.
A 6-year-old child was injured when his right foot was run over by a lawnmower. He has a near amputation of the right foot at the ankle. There is pulsatile bleeding from the wound, which continues to bleed briskly despite the application of direct pressure with gauze. The child is pale and diaphoretic. His vital signs include HR 160, RR 24 (crying), and BP 76/38.
Which of the following is the highest priority?
• Apply a tourniquet to the right calf.
• Splint the injured extremity.
• Provide supplemental oxygen at 10L/min by nonrebreathing mask.
• Transport to the closest hospital.
Apply tourniquet to the right calf
Which of the following is the best description of optimal ventilation volume for a 6-monthold child during CPR?
Ventilate just until the chest begins to rise.
• Ventilate until you see abdominal rise.
• Half squeeze the adult size ambu-bag.
• Ventilate until full chest expansion.
Ventilate until the chest begins to rise
An 8-year-old boy has been sick for 4 days with vomiting and diarrhea.
He has not tolerated any fluids for the past 2 days. He is lethargic and pale. His HR is 162 and RR 12. You are unable to obtain a blood pressure. What type of shock is this?
Neurogenic
Septic
Cardiogenic
Hypovolemic
Hypovolemic
A 4-year-old boy was in a high-speed motor vehicle collision. He is lying on the ground
and moaning but has no obvious injuries. What is the most appropriate hrst step in management?
• Immobilize him on a long spine board.
• Place a cervical collar.
• Provide supplemental oxygen at 4 L/min by nasal cannula.
• Remove his clothing to look for other injuries.
In which of the following situations would activated charcoal be contraindicated in a child with a toxic ingestion?
• Child has altered mental status
• Child is younger than age 1 year
• Ingestion occurred 1 hour ago
• Child with a gastrostomy tube
Child has altered mental status.
Which of the following signs suggests that an intraosseous line is NOT in proper position?
• Fluid requires pressure to flow into the line.
• The needle comes out from the tibia at an angle.
• There is swelling of the soft tissue around the site.
• Bubbles of blood appear when pulling back from the line.
There is swelling of the soft tissue around the site.
A 2-year-old boy who is ventilator dependent and has a tracheostomy has developed difficulty breathing and his ventilator is alarming. What is the first step in caring for this patient?
• Suction the tracheostomy tube.
• Initiate bag-mask ventilation via a face mask over the mouth and nose
• Attempt bag-mask ventilation via the tracheostomy tube.
• Administer nebulized albuterol via the tracheostomy
NOT
Suction the tracheostomy tube.
A 3-month-old infant is found unresponsive in his crib and has cool, mottled skin. His vital signs are HR 50 and RR 6. What is the initial treatment for this patient?
• Establish IV access and administer an IV fluid bolus of 20 mL/kg.
• Perform chest compressions and ventilate with a bag-mask device.
• Establish IV access and administer 0.1 mg/mL IV epinephrine 1:10.000.
• Initiate bag-mask ventilation and then reassess his skin color and heart rate.
Perform chest compressions and ventilate with a bag-mask device.
A 4-year-old boy has a HR that varies between 180 to 188 beats/min with narrow QRS complex. His pulses are strong. Which of the following is the most likely description of this rhythm?
• Ventricular tachycardia
• Supraventricular tachycardia
• Atrial fibrillation
• Sinus tachycardia
Sinus tachycardia.
Which of the following is NOT considered an approved site for intraosseous insertion for a pre-adolescent child?
• Sternum
• Proximal tibia
• Distal femur
• Proximal humerus
Sternum.
Which of the following medications can be given by the intranasal route?
• Morphine
• Epinephrine
• Albuterol
• Midazolam
Midazolam
Which of the following is the initial airway management of a child who is seizing and has gurgling respirations?
• Insert an oropharyngeal airway
• Administer bag-mask ventilation.
• Insert an endotracheal tube.
• Suction the oropharynx
Suction the oropharynx.
Which of the following is a contraindication to straightening the head and neck of a trauma patient during spinal immobilization?
• Attempting to apply a cervical collar worsens the patient’s neck pain
• Multiple facial injuries
• Severe headache.
• Dilated pupils,
Attempting to apply a cervical collar worsens the patient’s neck pain.
A 22-month-old boy was scalded when he pulled a hot cup of coffee from his grandmother’s hands. He has blistering burns to the right face, neck, shoulder, and anterior chest. He is screaming with vital signs HR 162, RR 32, and BP 104/70. Which of the following is the most appropriate action prior to transport?
• Intranasal fentanyl 1 mcg/kg
• Administer oxygen via nasal cannula at 2 L/min
• Endotracheal intubation to secure the airway
• Notify law enforcement of possible child maltreatment
Intranasal fentanyl 1 mcg/kg
