Ch 44

Question 1

A child with early hypoxia would most likely present with:
- tachycardia.
- bradypnea.
- bradycardia.
- mottled skin.

Answer 1

tachycardia.

Question 2

Which medication used to treat pediatric seizures has a short duration of action and therefore may need repeat dosing for recurrent seizures?
- Dilantin
- Ativan
- Midazolam
- Lorazepam

Answer 2

Midazolam

Question 3

Which of the following statements regarding a child’s chest wall is correct?

• A child’s chest wall has proportionately more subcutaneous fat on the chest.
• Retractions are less obvious in children owing to their noncompliant rib cages.
• Children are belly breathers because they rely heavily on their diaphragms.
• Lung sounds are difficult to hear because of the thick intercostal muscles.

Answer 3

Children are belly breathers because they rely heavily on their diaphragms.

Question 4

When a child who is too young to verbalize is in significant pain:

• pain scales using facial expressions are a valuable tool to assess pain severity.
• benzodiazepine drugs are preferred over opiates to minimize central nervous system depression.
• your ability to assess accurately for physiologic abnormalities is impaired.
• narcotic analgesic drugs should be avoided unless transport will be delayed.

Answer 4

your ability to assess accurately for physiologic abnormalities is impaired.

Question 5

A sick or injured child’s general appearance is most reflective of:

their cardiovascular status.
their central nervous system function.
their ability to be consoled.
the etiology of the problem.

Answer 5

their central nervous system function

Question 6

A 13-year-old, 40-pound girl is experiencing an acute asthma attack that has been unresponsive to three puffs of her albuterol inhaler. She is conscious and alert, but is notably dyspneic and has diffuse wheezing. In addition to administering supplemental oxygen, you should:
give nebulized ipratropium.
administer a dose of albuterol.
ventilate her with a bag-mask device.
give epinephrine 1:1,000 SQ.

Answer 6

give nebulized ipratropium

Question 7

If a child with a functioning central venous line requires emergency drug therapy, you should:

• carefully cleanse the injection port on the central line and administer the drug in the usual fashion.
• avoid using the central line if possible and attempt to establish peripheral IV access elsewhere.
• administer the drug through the central line, but only give half the usual dose of the drug.
• flush the central line with at least 30 mL of normal saline first and then administer the emergency drug.

Answer 7

avoid using the central line if possible and attempt to establish peripheral IV access elsewhere.

Question 8

You are assessing a 10-year-old child with a wide-complex tachycardia, but cannot decide whether electrical or pharmacologic therapy is the most appropriate initial treatment approach. Which of the following interventions would pose the greatest potential for harm?
- Establishing IO access, administering a sedative, and cardioverting at 15 joules
- Administering high-flow oxygen and obtaining a 12-lead ECG tracing
- Establishing vascular access and rapidly administering 3 mg of adenosine
- Starting an IV line and administering amiodarone followed by procainamide

Answer 8

Starting an IV line and administering amiodarone followed by procainamide

Question 9

Prior to administering pharmacologic therapy to an infant or child with pulseless ventricular tachycardia, the paramedic should perform:
CPR for 5 minutes.
defibrillation.
cardioversion.
intubation.

Answer 9

defibrillation.

Question 10

Bradydysrhythmias in children most often occur secondary to:
cardiac irritability.
AV heart block.
severe hypoxia.
drug ingestion.

Answer 10

severe hypoxia.

Question 11

Distributive shock in children is most often the result of:
anaphylaxis.
sepsis.
heart failure.
spinal Injury

Answer 11

sepsis

Question 12

Unlike other types of shock, a child in cardiogenic shock would most likely present with:

an enlarged spleen.
a primary cardiac dysrhythmia.
unlabored tachypnea.
increased work of breathing.

Answer 12

increased work of breathing.

Question 13

Which of the following presentations of bruises is rarely incurred accidentally?
Bruises in a straight line
Bruises on the hands
Bruises on the forehead
Bruises on both shins

Answer 13

Bruises in a straight line

Question 14

When assessing a child’s circulation by looking at their skin, pallor is most indicative of:

• systemic vasodilation with resulting low blood pressure.
• peripheral vasoconstriction and compensated shock.
• vasomotor instability and decompensated shock.
• poor oxygenation and a state of circulatory collapse.

Answer 14

peripheral vasoconstriction and compensated shock.

Question 15

Children between 1 and 2 years of age:

• are capable of basic reasoning.
• generally explore the world exclusively by crawling.
• may have negative associations with health care providers.
• have a well-developed sense of cause and effect.

Answer 15

may have negative associations with health care providers.

Question 16

Which of the following is often not acquired during the SAMPLE history of an adult, but should be routinely acquired when obtaining the history of an infant or child?

Preceding events
Nature of symptoms
Immunizations
Prescribed medications

Answer 16

Immunizations

Question 17

When an infant or child is in respiratory failure:

• they can no longer compensate, which causes hypoxia and hypercarbia.
• tachypnea is usually present despite a marked decrease in heart rate.
• oxygen via nonrebreathing mask should be given if tidal volume is reduced.
• decreased cerebral perfusion leads to restlessness and a weak, rapid pulse.

Answer 17

they can no longer compensate, which causes hypoxia and hypercarbia.

Question 18

The most important initial treatment for a child in respiratory failure due to suspected croup is:
- ventilatory assistance with a bag-mask device.
- continuous administration of a beta-2 agonist.
- a 2.25% concentration of racemic epinephrine.
- prompt intubation before the airway closes.

Answer 18

ventilatory assistance with a bag-mask device.

Question 19

Which of the following statements regarding simple febrile seizures is correct?

• Any child who experiences a simple febrile seizure is at significant risk for developing epilepsy.
• They are unique to children, are common, and typically do not cause any type of permanent deficit.
• More than one simple febrile seizure in a child is highly suggestive of an underlying neurologic problem.
• The overall prognosis for a child with simple febrile seizures worsens with each seizure episode.

Answer 19

They are unique to children, are common, and typically do not cause any type of permanent deficit.

Question 20

Adolescents tend to struggle with which of the following issues?

Limited mobility
Stranger anxiety
peer pressure
Distraction

Answer 20

peer pressure

Question 21

You are dispatched to a residence for a 17-year-old woman with acute abdominal pain. When you arrive and begin your assessment, it is clear that the patient is uncomfortable with the presence of her parents because she is reluctant to answer your questions. You should:

• diplomatically ask the parents if their daughter can have some privacy.
• tell the patient that her parents must legally be present during the exam.
• reassure the patient and tell her that her candor is vital to your treatment.
• recognize that the parents are an invaluable resource for information.

Answer 21

diplomatically ask the parents if their daughter can have some privacy.

Question 22

When mechanically securing an injured child’s head and neck to a backboard, you should:

• place tape or a strap or tape over the chin.
• use towel rolls instead of a cervical collar.
• place padding underneath the occiput.
• manually stabilize the child’s torso first.

Answer 22

Use towel rolls instead of a cervical collar

Question 23

You are dispatched to a daycare center for a 5-year-old girl 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:

• apply oxygen via pediatric nonrebreathing mask and attach a pulse oximeter.
• administer high-flow oxygen, assess her cardiac rhythm, and establish IO access.
• begin assisting her ventilations with a bag-mask device and assess her pulse rate.
• deliver two effective rescue breaths and assess her pulse for at least 5 seconds.

Answer 23

begin assisting her ventilations with a bag-mask device and assess her pulse rate.

Question 24

Ventricular shunts are typically placed in children who:

• are born with an abnormally small brain, which results in a relative increase in the amount of circulating cerebrospinal fluid.
• are born with a congenital condition in which the ventricles of the brain produce excessive amounts of cerebrospinal fluid.
• have impaired circulation and absorption of cerebrospinal fluid, leading to increased size of the ventricles of the brain and increased intracranial pressure.
• have experienced a severe traumatic brain injury that results in chronic cerebral edema and increased intracranial pressure.

Answer 24

have impaired circulation and absorption of cerebrospinal fluid, leading to increased size of the ventricles of the brain and increased intracranial pressure.

Question 25

Once you suspect that a child may have been abused, you should: - transport the child to the hospital at once. - apprise the caregiver of your suspicions. - question the child in front of the caregiver. - carefully document what you see and hear.

Answer 25

carefully document what you see and hear.

Question 26

The first-line treatment of pediatric patients in distributive shock is: continuous positive airway pressure. drug-assisted intubation. volume resuscitation. a vasopressor infusion.

Answer 26

volume resuscitation.

Question 27

If a child who is wearing a helmet strikes a fixed object on their bicycle and flies over the handlebars, you would most likely encounter: - open or closed fractures of the lower extremities. - stretching or tearing injuries to the kidneys. - facial fractures with associated brain injury. - compression injuries to the intra-abdominal organs

Answer 27

compression injuries to the intra-abdominal organs

Question 28

An 8-year-old child: - is anatomically and physiologically similar to an adult. - is capable of analytic but not abstract thought. - generally requires little reassurance and encouragement. - should not be the initial historian regarding an illness.

Answer 28

is anatomically and physiologically similar to an adult

Question 29

You receive a call for a “sick child.” When you arrive at the scene, the child's mother tells you that her 5-year-old son has had vomiting and diarrhea for the past day and will not eat or drink anything. On exam, the child's level of consciousness 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 beats/min. The most appropriate treatment for this child involves: - establishing IV access and administering a 20-mL/kg normal saline bolus, applying high-flow oxygen, administering 25% dextrose, and transporting. - applying high-flow oxygen via pediatric nonrebreathing mask, assessing his blood glucose level, elevating his legs 12 inches, and transporting. - administering supplemental oxygen, keeping the child warm, assessing his blood glucose level, transporting, and establishing vascular access en route. - administering supplemental oxygen, starting an IV line, assessing his blood glucose level, delivering at least two 20-mL/kg normal saline boluses, and transporting.

Answer 29

administering supplemental oxygen, keeping the child warm, assessing his blood glucose level, transporting, and establishing vascular access en route.

Question 30

You are transporting an unresponsive intubated 4-year-old child. An IO catheter is in place, and you are ventilating the child at an age-appropriate rate. Suddenly, the child becomes cyanotic and experiences a significant drop in her heart rate and oxygen saturation, and there is loss of a capnographic waveform. You attempt to auscultate her lung sounds but are unable to hear over the drone of the engine. You should: - increase your ventilation rate and reassess the child's condition. - look for vapor mist in the endotracheal tube and attach a colorimetric device. - administer 0.02 mg/kg of atropine via rapid IO push and reassess. - extubate immediately and ventilate with a bag-mask device.

Answer 30

extubate immediately and ventilate with a bag-mask device.

Question 31

Proficiency in ventilating apneic infants or children with a bag-mask device: - cannot be achieved by practicing on a manikin. - is difficult because their faces are much smaller. - may avert the need for endotracheal intubation. - is more important for paramedics than EMTs.

Answer 31

may avert the need for endotracheal intubation.

Question 32

Immediate treatment for a conscious child with anaphylaxis includes: epinephrine IM. a dopamine infusion. normal saline boluses. diphenhydramine IV.

Answer 32

epinephrine IM.

Question 33

When inserting an oropharyngeal airway in a child, you should: - open the mouth with the tongue-jaw lift. - hyperextend the head to facilitate insertion. - suction the oropharynx for 15 seconds first. - use a tongue blade to depress the tongue.

Answer 33

use a tongue blade to depress the tongue.

Question 34

You are assessing a 7-month-old infant 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 intensive care unit for 3 weeks. She denies any recent vomiting, diarrhea, or fever. The infant's oxygen saturation is 89% and does not improve with supplemental oxygen. Her heart rate is rapid and weak and does not vary with activity. When you apply the cardiac monitor, you will most likely encounter a: - rhythm with QRS complexes greater than 0.08 seconds in duration and a heart rate greater than 180 beats/min. - wide QRS complex rhythm with occasional P waves and a rate greater than 150 beats/min. - rhythm with QRS complexes less than 0.08 seconds in duration and a heart rate less than 220 beats/min. - narrow QRS complex rhythm with absent P waves and a heart rate greater than 220 beats/min.

Answer 34

narrow QRS complex rhythm with absent P waves and a heart rate greater than 220 beats/min.

Question 35

Adenosine may be considered for a hemodynamically stable child with a wide-complex tachycardia if: - the QRS complex is less than 0.12 seconds. - the child has a history of congenital heart disease. - the heart rate is over 180 beats/min. - the ventricular rhythm is regular and monomorphic.

Answer 35

The ventricular rhythm is regular and monomorphic

Question 36

Following significant blunt trauma to the abdomen, a 9-year-old boy presents with diaphoresis and pallor. He is conscious and alert, with a blood pressure of 90/58 mm Hg, a heart rate of 130 beats/min, and a respiratory rate of 28 breaths/min with adequate depth. With an estimated ground transport time of 30 minutes, you should: - administer high-flow oxygen, apply spinal precautions if indicated, provide warmth, begin transport, establish vascular access en route, and administer enough crystalloid solution to maintain adequate perfusion. - apply supplemental oxygen, start two large-bore IV lines with normal saline, administer several crystalloid boluses of 20 mL/kg, apply spinal precautions if indicated, and transport to an appropriate medical facility. - apply warm blankets, elevate his lower extremities 12 inches, administer high-flow oxygen, insert an IO catheter, administer a 250-mL normal saline bolus, and transport expeditiously to an appropriate trauma center. - assist his ventilations to increase tidal volume, cover him with a blanket, establish at least one large-bore IV line, administer a 20-mL/kg normal saline bolus, and transport to a trauma center

Answer 36

administer high-flow oxygen, apply spinal precautions if indicated, provide warmth, begin transport, establish vascular access en route, and administer enough crystalloid solution to maintain adequate perfusion.

Question 37

Ventilating a child too fast with a bag-mask device may cause: cerebral vasodilation. decreased preload. reflex hypertension. severe hypercarbia.

Answer 37

Decreased preload.

Question 38

Hemodynamically stable children with a wide QRS complex tachycardia that persists despite initial treatment: - respond well to adenosine. - should receive amiodarone. - are likely experiencing supraventricular tachycardia. - will usually respond favorably to vagal maneuvers.

Answer 38

should receive amiodarone.

Question 39

Which of the following are signs of pain in an infant? A heart rate that is not variable Tachycardia and inconsolability Diaphoresis and dilated pupils Labored tachypnea and pallor

Answer 39

Tachycardia and inconsolability

Question 40

You receive a call to a residence for a 6-year-old girl with a decreased level of consciousness. The child has hydrocephalus following surgery to remove a brain tumor and has a ventricular shunt in place. The child's level of consciousness 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 vital signs is most indicative of shunt obstruction and increased intracranial pressure? - Blood pressure 130/68 mm Hg; pulse 70 beats/min; respirations 28 breaths/min - Blood pressure 90/50 mm Hg; pulse 110 beats/min; respirations 10 breaths/min - Blood pressure 106/66 mm Hg; pulse 80 beats/min; respirations 14 breaths/min - Blood pressure 140/92 mm Hg; pulse 58 beats/min; respirations 8 breaths/min

Answer 40

Blood pressure 140/92 mm Hg; pulse 58 beats/min; respirations 8 breaths/min

Question 41

The most appropriate vagal maneuver for an infant involves: applying a heat stimulus to the body. blowing into an occluded straw. holding ice packs firmly to the face. firmly massaging the carotid artery.

Answer 41

holding ice packs firmly to the face.

Question 42

In contrast to a complex febrile seizure, a simple febrile seizure: - is focal in nature and tends to occur in children with a baseline developmental abnormality. - lasts less than 15 minutes and occurs in children without underlying neurologic abnormalities. - is of short duration and occurs when the child's body temperature gradually rises above 102.5 degrees Fahrenheit. - is not associated with tonic-clonic body movement and occurs in children older than 6 years of age.

Answer 42

lasts less than 15 minutes and occurs in children without underlying neurologic abnormalities.

Question 43

Sorbitol is not recommended for use in young children because it: - induces vomiting, which increases the risk for pulmonary aspiration. - can cause severe diarrhea and life-threatening electrolyte abnormalities. - has been linked to sudden cardiac death due to ventricular dysrhythmias. - prolongs the QT interval and is associated with ventricular fibrillation.

Answer 43

can cause severe diarrhea and life-threatening electrolyte abnormalities.

Question 44

The most appropriate airway management for an actively seizing child whose airway is not maintainable with positioning involves: - 100% oxygen and a left lateral recumbent position. - nasal airway insertion and suctioning as needed. - immediate endotracheal intubation. - insertion of an oropharyngeal airway adjunct.

Answer 44

nasal airway insertion and suctioning as needed.

Question 45

You are called to a residence for a ventilator-dependent child with respiratory distress. Upon your arrival, the child's mother tells you that the child was doing fine, but then suddenly began experiencing labored breathing. She further tells you that the child's home ventilator was recently replaced with a newer one. Assessment of the child reveals that she is in marked respiratory distress and has intercostal retractions. Your first action should be to: - disconnect the child from the ventilator and begin bag-mask ventilations. - remove the tracheostomy tube and replace it with a similar-sized endotracheal tube. - assess the patency of the tracheostomy tube to determine if it is dislodged. - suction the child's tracheostomy tube to rule out secretions as the problem

Answer 45

disconnect the child from the ventilator and begin bag-mask ventilations.

Question 46

A child who is experiencing a moderate asthma attack would most likely present with: - wheezing during inspiration and expiration. - an oxygen saturation between 80% and 90%. - a markedly prolonged expiratory phase. - an inability to speak in complete sentences.

Answer 46

wheezing during inspiration and expiration.

Question 47

You should be most suspicious for cardiogenic shock in an infant or child if: - perfusion decreases following a fluid bolus. - their heart rate is greater than 150 beats/min. - they appear listless or lethargic. - their heart rate varies with activity.

Answer 47

perfusion decreases following a fluid bolus.

Question 48

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 oxygen saturation is 93% on room air, and his heart rate is rapid. The most appropriate initial treatment for this child involves: - administering oxygen as tolerated, auscultating his lung sounds, and being prepared to assist his ventilations. - recognizing that the child is in respiratory failure and making immediate preparations to perform endotracheal intubation. - assisting his ventilations with a bag-mask device and determining whether his tachycardia is ventricular or supraventricular in origin. - conducting a focused history and physical exam and allowing him to breathe room air to see if his oxygen saturation falls.

Answer 48

administering oxygen as tolerated, auscultating his lung sounds, and being prepared to assist his ventilations.

Question 49

When attempting resuscitation of a child with pulseless electrical activity, you should: - administer epinephrine via the endotracheal tube, if possible. - perform synchronized cardioversion if the rate is fast. - give atropine if the heart rate is less than 60 beats/min. - attempt to identify an underlying cause of the arrest.

Answer 49

Attempt to identify an underlying cause of the arrest

Question 50

When assessing an otherwise healthy child who is injured, you notice that his general appearance is abnormal. This should make you most suspicious for: hypoglycemia. child abuse. internal bleeding. a head injury.

Answer 50

a head injury

Question 51

Which of the following is the most appropriate endotracheal tube for a 6-year-old child? 5.0 mm, uncuffed 4.5 mm, cuffed 5.5 mm, uncuffed 4.0 mm, cuffed

Answer 51

5.5 mm, uncuffed

Question 52

It is important to remember that blood pressure is only one component in the overall assessment of a child because: - blood pressure may remain adequate in compensated shock. - it generally yields a falsely low reading in agitated children. - hypotension is seen much earlier in children than in adults. - it is an unreliable measurement of perfusion in all children.

Answer 52

blood pressure may remain adequate in compensated shock.

Question 53

A 6-month-old child has burns to his head, face, neck, and anterior chest. What percentage of his body surface area has been burned? 45% 21% 36% 27%

Answer 53

36%

Question 54

Beta-blocker ingestion in small children would most likely cause: marked hypertension. agitation or irritability. acute hypoglycemia. ventricular fibrillation.

Answer 54

acute hypoglycemia.

Question 55

Which of the following statements regarding chest trauma in children is correct? - Most cases of fatal chest trauma occur in children who fall more than 10 feet. - Children are more prone to intrathoracic trauma due to compression forces. - The pliability of children's rib cages predisposes them to sternal fractures. - Signs of a pneumothorax are often more obvious in children than in adults.

Answer 55

Children are more prone to intrathoracic trauma due to compression forces.

Question 56

Several cycles of chest compressions have failed to remove a foreign body airway obstruction in an unresponsive infant. Your next action should be to: - perform laryngoscopy and try to visualize the foreign body. - perform back slaps and chest thrusts and then look in the mouth. - open the infant's airway and sweep their mouth with your finger. - continue chest compressions and perform a cricothyrotomy.

Answer 56

perform laryngoscopy and try to visualize the foreign body.

Question 57

A 2-year-old girl fell approximately 12 feet from a second-story window, landing on her head. Your primary survey reveals that she is unresponsive; has slow, irregular respirations; and has blood draining from her mouth and nose. A rapid exam of her body does not reveal any gross injuries or bleeding. You should: - suction her mouth and nose for no longer than 15 seconds, insert an oral airway, and apply high-flow oxygen with a pediatric nonrebreathing mask. - manually stabilize her head and neck in a neutral position, insert a nasal airway, and hyperventilate her at a rate of 35 breaths/min. - open her airway with the jaw-thrust maneuver, suction her mouth and nose, insert an oral airway, and assist her ventilations with a bag-mask device. - insert an oral airway, apply a cervical collar, preoxygenate her with a bag-mask device and 100% oxygen for 30 seconds, and intubate her trachea.

Answer 57

open her airway with the jaw-thrust maneuver, suction her mouth and nose, insert an oral airway, and assist her ventilations with a bag-mask device.

Question 58

When evaluating a child's oxygen saturation level with a pulse oximeter: - a reading of less than 96% on room air indicates respiratory distress and necessitates the administration of supplemental oxygen. - you should provide ventilatory assistance with a bag-mask device if the reading is below 94% and not increasing rapidly. - you should recall that peripheral vasodilation from a warm environment will typically yield a false reading. - it should be evaluated in the context of the Pediatric Assessment Triangle and remainder of the primary assessment.

Answer 58

it should be evaluated in the context of the Pediatric Assessment Triangle and remainder of the primary assessment.

Question 59

Which of the following clinical findings is the most consistent with hypertrophic cardiomyopathy? Unexplained syncope Sustained hypertension Unresolving bradycardia Chest pain with fever

Answer 59

Unexplained syncope

Question 60

Medications used to prevent an asthma attack include: inhaled steroids. beta-2 agonists. oral ibuprofen. inhaled albuterol.

Answer 60

inhaled steroids

Question 61

Dilated cardiomyopathy is a condition in which the heart is: - weakened and enlarged, making it a less efficient pump. - unusually thick and must pump harder to eject blood. - temporarily impaired by an isolated bacterial infection. - deprived of oxygen due to sudden coronary vasospasm.

Answer 61

weakened and enlarged, making it a less efficient pump.

Question 62

When caring for a child with a ventricular shunt or gastrostomy tube, it is important to: - assure the caregiver that you can care for the child effectively and recommend that they follow the ambulance in their own vehicle. - recognize that the caregiver is a key resource and that their expertise should be utilized to assist in the care of the child. - obtain a complete medical history from the caregiver and then develop a treatment plan based on your knowledge of special health care devices. - provide supportive care only and then rapidly transport the child to the most appropriate medical facility.

Answer 62

recognize that the caregiver is a key resource and that their expertise should be utilized to assist in the care of the child.

Question 63

In young children, air bags pose a particular threat for injuries to the: soft tissues of the face. head and neck. thoracic organs. abdominal organs.

Answer 63

head and neck.

Question 64

The length-based resuscitation tape: - is used to estimate a child's weight based on their height. - should not be relied upon for determining pediatric drug doses. - is generally more accurate than the weight given by a caregiver. - is only reliable in children who weigh less than 20 kg.

Answer 64

is used to estimate a child's weight based on their height.

Question 65

Early distributive shock in children is characterized by: weak peripheral pulses. warm, flushed skin. pallor and diaphoresis. gross neurologic deficits.

Answer 65

warm, flushed skin.

Question 66

When assessing a 5-year-old child, you should: - conduct a toe-to-head exam. - first ask a parent where the child is experiencing pain. - ask simple yes or no questions, if possible. - conduct a head-to-toe exam.

Answer 66

conduct a head-to-toe exam.

Question 67

To ensure that an infant's head is in a neutral position during spinal immobilization, you should: - place padding under the infant's shoulders. - use towel rolls for lateral head stabilization. - place a towel roll behind the infant's neck. - slightly extend the infant's head.

Answer 67

place padding under the infant's shoulders.

Question 68

Which of the following statements regarding nasogastric (NG) and orogastric (OG) insertion in children is correct? - Insertion of an orogastric tube is contraindicated in children with severe head trauma or injury to the midface. - Gastric decompression with an NG or OG tube is only appropriate for children older than 10 years of age. - The correct size NG or OG tube for a child should be half the ET tube size that they would need. - Prior to inserting an NG or OG tube in an unresponsive child without a gag reflex, you should intubate their trachea.

Answer 68

Prior to inserting an NG or OG tube in an unresponsive child without a gag reflex, you should intubate their trachea.

Question 69

Unlike sinus tachycardia, supraventricular tachycardia in infants is characterized by: - a pulse rate greater than 180 beats/min. - the presence of P waves. - an unvarying pulse rate. - a history of fever or dehydration

Answer 69

an unvarying pulse rate.

Question 70

Failure of a child's oxygen saturation to increase despite high-flow oxygen is most indicative of: relative hypovolemia. right-sided heart failure. congenital heart disease. decreased vascular tone

Answer 70

congenital heart disease.

Question 71

A conscious child who is in the sniffing position: - assumes a physical position that optimizes accessory muscle use. - will refuse to lie down and leans forward on outstretched arms. - is clearly experiencing an obstruction of the lower airway. - is trying to align the axes of the airway to improve ventilation

Answer 71

is trying to align the axes of the airway to improve ventilation

Question 72

A young child with marked respiratory distress who is agitated and thrashing about should receive oxygen via: - positive-pressure ventilation after they have been properly sedated. - a method that minimizes metabolic demand and oxygen consumption. - the blow-by technique while they sit on the caregiver's lap. - nonrebreathing mask, because agitation indicates cerebral ischemia.

Answer 72

a method that minimizes metabolic demand and oxygen consumption.

Question 73

Rapid IV fluid administration in a child with diabetic ketoacidosis increases the risk of: hyperkalemia. cerebral edema. hemodilution. hypokalemia.

Answer 73

cerebral edema.

Question 74

You and your partner arrive at the scene shortly after a 2-year-old child experienced an apparent seizure. The child's 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, is crying, and has hot, moist skin. His heart rate is 160 beats/min, and his respirations are 40 breaths/min. You should: -cool the child with tepid water, administer high-flow oxygen, and transport. - advise the father to take his son to see a pediatrician the following day. - establish vascular access, give a 20-mL/kg saline bolus, and transport. - keep the child cool and transport him to the hospital for physician evaluation.

Answer 74

keep the child cool and transport him to the hospital for physician evaluation.

Question 75

The Pediatric Assessment Triangle will help answer which of the following questions? “What is the child's level of pain?” “Is the child's pulse elevated?” “Will the child cooperate during my exam?” “Is the child sick or not sick?”

Answer 75

“Is the child sick or not sick?”

Question 76

Which of the following is a common sign or symptom of meningitis in young children? Tachycardia Nuchal rigidity Poor feeding Abdominal pain

Answer 76

Nuchal rigidity

Question 77

Which of the following components is used to distinguish sinus tachycardia from supraventricular tachycardia? Oxygen saturation Respiratory rate QRS complex width P wave presence

Answer 77

P wave presence

Question 78

A child in decompensated shock with hypotension should: - receive initial fluid resuscitation at the scene. - receive volume expansion with 5% dextrose in water. - be intubated to protect the airway. - be given 25% dextrose to prevent hypoglycemia.

Answer 78

receive initial fluid resuscitation at the scene.

Question 79

You should be most suspicious for child abuse when caring for an injured 4-year-old child if: - you can smell alcohol on the caregiver's breath. - the child presents with bruises to both shins. - there was an unusual delay in calling 911. - the caregiver demands that you treat the child.

Answer 79

there was an unusual delay in calling 911.

Question 80

The general area of a child's body that sustains initial trauma after being struck by an automobile depends mainly on: - whether the vehicle ran over the child following impact. - whether the child turns away from or toward the vehicle. - the travel speed of the vehicle and the weight of the child. - the child's height and the height of the bumper upon impact.

Answer 80

the child's height and the height of the bumper upon impact.

Question 81

Counting an infant's respiratory rate for 15 seconds and then quadrupling that number: - is recommended because it is the quickest way to determine if the infant's baseline respiratory rate is abnormally slow or abnormally fast. - may yield a falsely low respiratory rate because infants may have periodic breathing or variable respiratory rates with short periods of apnea. - is appropriate only if you are auscultating the child's respirations with a stethoscope while simultaneously listening to lung sounds. - is impractical because the inherent respiratory rate of an infant is usually rapid and counting for such a short period of time leaves room for error.

Answer 81

may yield a falsely low respiratory rate because infants may have periodic breathing or variable respiratory rates with short periods of apnea.

Question 82

Which of the following represents the correct drug, dose, and delivery route for an 18-kg child experiencing severe respiratory distress due to bronchospasm? Albuterol, 0.25 mg nebulized Albuterol, 1 mg nebulized Ipratropium, 0.5 mg nebulized Epinephrine, 0.1 mg/kg IM

Answer 82

Ipratropium, 0.5 mg nebulized

Question 83

Epiglottitis in children: - should be suspected if the child presents with diffuse wheezing. - presents with a sudden onset of low-grade fever and dyspnea. - is uncommon because children are vaccinated against Haemophilus influenza type b. - should be confirmed by visualizing the larynx and epiglottis with a laryngoscope.

Answer 83

- is uncommon because children are vaccinated against Haemophilus influenza type b.

Question 84

The decision to transport an acutely ill child immediately or to remain at the scene to perform additional interventions is dependent on the: expected benefits of treatment. child's previous illnesses. child's age and fear level. number of EMS staff present.

Answer 84

expected benefits of treatment.

Question 85

Which of the following statements regarding acrocyanosis is correct? - Acrocyanosis is cyanosis of the hands and feet, and is a normal finding in infants younger than 2 months of age who are cold. - Acrocyanosis is a bluish discoloration of the chest, abdomen, and face and is the most extreme visual indicator of poor perfusion. - Acrocyanosis is seen in the skin and mucous membranes and is a late finding if respiratory failure or shock is present. - Acrocyanosis is only considered to be a normal finding in newborns and usually resolves within 12 hours following birth.

Answer 85

Acrocyanosis is cyanosis of the hands and feet, and is a normal finding in infants younger than 2 months of age who are cold.

Question 86

You and your partner are caring for a child with stable supraventricular tachycardia that was refractory to initial treatment. As your partner is preparing to establish vascular access, the child's level of consciousness decreases markedly. You reassess the child and note that her femoral pulse is rapid and weak. You should: - preoxygenate the child and then perform endotracheal intubation. - establish vascular access and administer 0.1 mg/kg of adenosine. - begin chest compressions as your partner establishes the IV line. - immediately perform synchronized cardioversion and reassess.

Answer 86

immediately perform synchronized cardioversion and reassess.

Question 87

You are providing high-flow oxygen to a 3-year-old boy with severe respiratory distress. When you reassess him, you note that he is pale and that his respiratory rate has decreased from 30 breaths/min to 12 breaths/min. You should: - secure his airway with an endotracheal tube. - assist his ventilations with a bag-mask device. - begin treatment with a beta-2 agonist medication. - auscultate his lung sounds and reassess his oxygen saturation.

Answer 87

assist his ventilations with a bag-mask device.

Question 88

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: - insert an oropharyngeal airway and apply high-flow oxygen. - begin bag-mask ventilations to improve her low tidal volume. - manually maneuver her head and reassess her breathing status. - provide free-flow oxygen as you perform nasotracheal intubation.

Answer 88

manually maneuver her head and reassess her breathing status.

Question 89

If a 2-year-old child with a foreign body airway obstruction becomes unresponsive, you should place them in a supine position and then: perform chest compressions. visualize the upper airway. assess for a carotid pulse. perform abdominal thrusts

Answer 89

perform chest compressions.

Question 90

Which of the following is the most appropriate dose of activated charcoal for a 45-pound child? 20 g 10 g 15 g 5 g

Answer 90

20 g

Question 91

Upon arriving at the scene of a 4-year-old girl who is ill, you 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 cardiac problem. fever and anxiety. early hypoxemia. moderate dehydration.

Answer 91

fever and anxiety.

Question 92

In the newborn, hypoglycemia is defined as a blood glucose level of less than: 50 mg/dL. 40 mg/dL. 60 mg/dL. 70 mg/dL.

Answer 92

40 mg/dL.

Question 93

In contrast to upper airway emergencies, lower airway emergencies: - are generally associated with high-grade fever. - involve restriction of airflow during exhalation. - often present with more prominent retractions. - include laryngotracheobronchitis and diphtheria.

Answer 93

involve restriction of airflow during exhalation.

Question 94

Because stimulation of the parasympathetic nervous system can occur during intubation of a child, you should: - closely monitor the child's cardiac rhythm. - limit your intubation attempt to 10 seconds. - use a curved blade instead of a straight blade. - premedicate with 0.04 mg/kg of atropine.

Answer 94

closely monitor the child's cardiac rhythm.

Question 95

Treatment for a child with respiratory distress should include which of the following? - Sniffing position and bag-mask ventilation - Semi-sitting position and bag-mask ventilation - Supine position and drug-assisted intubation - Position of comfort and supplemental oxygen

Answer 95

Position of comfort and supplemental oxygen

Question 96

A 4-year-old girl presents with a fever of 103.2 degrees Fahrenheit. The child's 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 should include: 81 mg of aspirin. 750 mg of acetaminophen. icepacks to the extremities. free-flow oxygen.

Answer 96

free-flow oxygen.

Question 97

Your primary survey of an unresponsive 5-year-old, 40-pound child reveals that he is apneic and pulseless. CPR is initiated and the cardiac monitor is applied, which reveals ventricular fibrillation. You should: - start an IV and administer 0.2 mg of epinephrine 1:10,000. - charge the defibrillator to 80 joules while CPR is ongoing. - defibrillate with 40 joules and immediately resume CPR. - continue high-quality CPR and reassess in 2 minutes.

Answer 97

defibrillate with 40 joules and immediately resume CPR.

Question 98

A 9-year-old who fell off his bike has an isolated deformity to his forearm and is in significant pain. The child is conscious and alert, his vital signs are stable, and his mother is present. Your initial effort to relieve this child's pain should involve: - administering morphine or fentanyl via slow IV push. - not allowing the child to visualize his deformed arm. - encouraging the child to breathe high-flow oxygen. - providing calm reassurance to both mother and child.

Answer 98

providing calm reassurance to both mother and child.

Question 99

Compared to adults, the smaller diameter of a child's airway makes it more vulnerable to: obstruction by the tongue. inhalation injury. oropharyngeal secretions. laryngospasm.

Answer 99

obstruction by the tongue.

Question 100

If you cannot palpate the femoral pulse in an unresponsive infant, you should: palpate the brachial pulse. apply an AED at once. assess for adequate breathing. initiate CPR immediately.

Answer 100

initiate CPR immediately.

Question 101

You are dispatched to a residence at 6:15 AM for an unconscious 3-month-old infant who is not breathing. Upon arrival at the scene, you find the father performing CPR on the infant. The infant's mother is sitting on the couch, crying. Your assessment reveals that the child is apneic and pulseless. Her skin is pale and cold, and there is gross lividity to her chest. You should: - recognize that the infant has been deceased for an extended period of time. - continue CPR and assess the infant's cardiac rhythm to confirm asystole. - pronounce the infant dead if she does not respond to 5 minutes of full ACLS. - tell the parents that the child likely suffocated because she slept on her stomach.

Answer 101

recognize that the infant has been deceased for an extended period of time.

Question 102

A 9-year-old, 55-pound girl presents with generalized hives, marked facial swelling, and loud inspiratory stridor. She is conscious but appears sleepy. You can most rapidly improve this child's condition by: - administering epinephrine IM. - starting an epinephrine infusion. - administering a nebulized bronchodilator. - administering diphenhydramine.

Answer 102

administering epinephrine IM.

Question 103

When treating a child who is seizing with diazepam, the paramedic should remember that: - the half-life is short and breakthrough seizures may occur during long transports. - naloxone should be administered if signs of respiratory depression develop. - it is a long-acting drug and has the greatest potential for respiratory compromise. - a single dose of diazepam usually terminates all seizures, without the need to redose.

Answer 103

the half-life is short and breakthrough seizures may occur during long transports.

Question 104

A normal respiratory rate in a child: - generally ranges between 15 and 20 breaths/min and is influenced easily by factors such as excitement, fear, or fever. - cannot be established accurately because a toddler's respirations generally are grossly irregular and extremely difficult to count. - is a sign of impending respiratory failure if it is observed in conjunction with a room air oxygen saturation reading of less than 96%. - may be observed if the child has been breathing rapidly with increased work of breathing and is becoming fatigued.

Answer 104

may be observed if the child has been breathing rapidly with increased work of breathing and is becoming fatigued.

Question 105

A 10-month-old infant presents with an acute onset of increased work of breathing. According to the infant's mother, the child was crawling around in the living room prior to the event and was fine 10 minutes earlier. Your assessment reveals that the infant appears alert to his surroundings, has loud inspiratory stridor, and pink skin. You should: - deliver five sharp back slaps between the infant's shoulder blades. - apply a pediatric nonrebreathing mask and transport expeditiously. - avoid agitating the infant, offer supplemental oxygen, and transport. - look inside the infant's mouth using a tongue blade and penlight.

Answer 105

avoid agitating the infant, offer supplemental oxygen, and transport.

Question 106

Which of the following statements regarding croup is correct? - Most cases of croup result in severe hypoxia and hypercarbia. - Hallmark signs of croup include high fever and a sore throat. - Croup is a viral upper airway infection that may cause stridor. - Croup is also referred to as acute bacterial subglottic stenosis.

Answer 106

Croup is a viral upper airway infection that may cause stridor.

Question 107

With respect to CPR and foreign body airway obstruction procedures, the child should be treated as an adult once: - their resting vital signs are consistent with those of an adult. - their body weight is 55 pounds. - they have developed secondary sexual characteristics. - they reach 8 to 10 years of age.

Answer 107

they have developed secondary sexual characteristics.

Question 108

To evaluate function of an infant's or child's cerebral cortex, you should: evaluate motor activity. use the AVPU scale. assess for posturing. assess pupil reaction.

Answer 108

use the AVPU scale.

Question 109

A 10-year-old child fell approximately 15 feet from a balcony, landing on a sidewalk. He is conscious and alert, and complains of pain to the right side of his body. After completing your primary survey, you should: - provide any immediately needed care, perform a rapid assessment, apply spinal precautions, and transport. - apply spinal precautions, begin transport, and perform a rapid assessment while en route to the hospital. - correct immediate life threats, perform a detailed head-to-toe exam, apply spinal precautions, and transport. - perform a focused physical exam, obtain baseline vital signs, apply spinal precautions, and transport.

Answer 109

provide any immediately needed care, perform a rapid assessment, apply spinal precautions, and transport.

Question 110

Vasopressor support to improve vascular tone in a child in septic shock should be considered: - as soon as sepsis is suspected as the underlying problem. - only if other causes of distributive shock are ruled out. - if hypotension persists despite 60 mL/kg of isotonic fluid. - if the child's sustained heart rate is greater than 130 beats/min.

Answer 110

If hypotension persists despite 60 ml/kg of isotonic fluid

Question 111

Meningococcal meningitis with sepsis is typically characterized by a(n): low-grade fever. insidious onset. persistent cough. purpuric rash.

Answer 111

purpuric rash.

Question 112

If an initial cardioversion attempt is unsuccessful in a 33-pound child, you should repeat the procedure using: 50 joules. 10 joules. 15 joules. 30 joules.

Answer 112

30 J

Question 113

In children, complex partial seizures would most likely manifest with: - generalized tonic-clonic movement of all extremities. - a brief loss of attention without abnormal body movement. - focal motor jerking with loss of consciousness. - focal motor jerking without loss of consciousness.

Answer 113

Focal motor jerking with loss of consciousness

Question 114

A 12-year-old boy presents with marked respiratory distress; hot, moist skin; and anxiety. He is sitting with his chin thrust forward and has inspiratory stridor. According to the child's grandmother, his symptoms began suddenly about 30 minutes ago. You should be most suspicious for: laryngotracheobronchitis. bacterial epiglottitis. subglottic narrowing. acute viral croup

Answer 114

bacterial epiglottitis.

Question 115

Nasopharyngeal airways are rarely used in children younger than 1 year of age because: - most nasopharyngeal airways are too large and result in an obstruction. - unlike older children, small children often have a more active gag reflex. - nasopharyngeal stimulation commonly results in a tachycardic response. - the diameter of their nares is small and easily obstructed by secretions

Answer 115

the diameter of their nares is small and easily obstructed by secretions.

Question 116

To maintain a neutral airway position in an unresponsive infant, you should: pad underneath the infant's occiput. insert an appropriate-sized oral airway. slightly extend the infant's head. place a towel roll under the shoulders.

Answer 116

place a towel roll under the shoulders.

Question 117

If you have reason to believe that an unresponsive child has a foreign body airway obstruction, you should: - administer abdominal thrusts until the object is expelled. - try to remove it by performing a finger sweep of the mouth. - assess for a pulse and then begin chest compressions. - perform 30 chest compressions and then look in the mouth.

Answer 117

perform 30 chest compressions and then look in the mouth.

Question 118

In contrast to the SAMPLE history of a child with an illness, the SAMPLE history of an injured child should include a specific inquiry regarding: routine medication use. any prior hospitalizations. the date of their last tetanus shot. any known drug allergies.

Answer 118

the date of their last tetanus shot.

Question 119

If the parent or caregiver of a sick or injured child is emotionally distraught: - you should firmly tell them that the situation is under control. - you should remove them from the scene immediately. - provide support, but remember that your first priority is the child. - you should advise them to follow the ambulance in their personal vehicle

Answer 119

provide support, but remember that your first priority is the child.

Question 120

First-degree heart block in children: - is typically asymptomatic and does not require special treatment. - should be suspected when a randomly dropped QRS is observed. - does not respond to atropine and should be treated with dopamine. - should be treated with cardiac pacing, even if the child is stable.

Answer 120

is typically asymptomatic and does not require special treatment

Question 121

In contrast to adults, cardiac arrest in children is usually caused by: a toxic ingestion. congenital anomalies. a dysrhythmia. respiratory failure.

Answer 121

respiratory failure.

Question 122

Appropriate bag-mask ventilation for an apneic 3-year-old child involves: - delivering each breath over 1 second until the chest rises visibly. - ensuring a consistently delivered tidal volume of 400 mL. - providing hyperventilation to ensure carbon dioxide elimination. - hyperextending the head to ensure an adequate mask-to-face seal.

Answer 122

delivering each breath over 1 second until the chest rises visibly.

Question 123

Assessment of a child in a cold environment would most likely yield: delayed capillary refill. a slow, irregular pulse. a rapid, weak pulse. flushing of the skin.

Answer 123

delayed capillary refill.

Question 124

Which of the following is a sign of decompensated shock in the infant or child? Increased peripheral perfusion Prolonged capillary refill Abnormal mentation Hypertension

Answer 124

Prolonged capillary refill

Question 125

In contrast to adults, young children are more prone to liver and spleen injuries because these organs: - are relatively smaller and less protected. - are highly vascular. - extend well below the rib cage. - are more mobile and less supported.

Answer 125

extend well below the rib cage

Question 126

Which of the following statements regarding bronchiolitis is correct? - The pathophysiology of bronchiolitis is acute bronchospasm secondary to a bacterium that enters the lower respiratory tract. - Bronchiolitis is a viral infection of the lower airway that commonly affects infants and children younger than 2 years of age. - Bronchiolitis is usually caused by the metapneumovirus and occurs with greatest frequency during late spring and early summer. - Infants born past 42 weeks are at highest risk for respiratory failure and arrest secondary to bronchiolitis.

Answer 126

Bronchiolitis is a viral infection of the lower airway that commonly affects infants and children younger than 2 years of age.

Question 127

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 mother's lap. He is conscious and appears alert to his surroundings. According to the child's mother, he has been sick for the 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 beats/min, and his oxygen saturation is 99% on room air. There are no signs of increased work of breathing. You should: - administer 0.5 mL of racemic epinephrine via nebulizer, apply the cardiac monitor, and transport. - allow the child to assume a position of comfort, avoid agitating him, and transport. - establish vascular access, give an appropriate dose of methylprednisolone, and transport. - administer high-flow oxygen via pediatric nonrebreathing mask, keep him calm, and transport.

Answer 127

allow the child to assume a position of comfort, avoid agitating him, and transport.

Question 128

An oral or nasal airway in an unresponsive infant or child may: cause gastric distention. avert the need for intubation. stimulate the vagus nerve. replace manual head positioning.

Answer 128

avert the need for intubation.

Question 129

When a child experiences a low cardiac output state, they rely mostly on: an increase in heart rate. increased stroke volume. increased tidal volume. central vasoconstriction

Answer 129

an increase in heart rate

Question 130

What is the approximate total blood volume of a 60-pound child? 3.8 L 2.4 L 3.1 L 1.9 L

Answer 130

1.9 L

Question 131

The use of a straight blade during pediatric intubation: - is associated with a higher risk of bradycardia. - makes it easier to manipulate the epiglottis. - facilitates laryngoscopy by lifting the vallecula. - is generally reserved for neonates only.

Answer 131

makes it easier to manipulate the epiglottis.

Question 132

The work-of-breathing component of the Pediatric Assessment Triangle includes which of the following? - Checking the pulse oximetry reading - Determining the child's respiratory rate - Auscultating the lungs for adventitious sounds - Noting the child's position during breathing

Answer 132

Noting the child's position during breathing

Question 133

Treatment for pediatric asystole includes: epinephrine. cardiac pacing. atropine. hyperventilation.

Answer 133

epinephrine.

Question 134

A 6-year-old girl who has been running a fever for the past 2 days presents with lethargy and tachycardia. Her heart rate is 170 beats/min 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 beats/min. You should: - start an IV line and give adenosine while monitoring her cardiac rhythm. - apply chemical ice packs to the child's face to try to slow her heart rate. - establish vascular access and administer a 20-mL/kg normal saline bolus. - transport immediately and establish vascular access en route to the hospital.

Answer 134

establish vascular access and administer a 20-mL/kg normal saline bolus.

Question 135

Which of the following is the first-line treatment for a hemodynamically unstable child with bradycardia? Transcutaneous pacing Ventilatory support Epinephrine IV or IO Chest compressions

Answer 135

Ventilatory support

Question 136

When preparing to intubate a small child, it is important to remember that: - the small child's epiglottis is very rigid. - you should hyperventilate before intubating. - small children have a relatively large occiput. - prolonged intubation attempts often cause tachycardia.

Answer 136

small children have a relatively large occiput

Question 137

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 antihypertensive medication. The child has poor perfusion and is breathing poorly. As you are assisting the child's ventilations with high-flow oxygen, your partner informs you that the child's heart rate is 50 beats/min and weak and that the cardiac monitor reveals sinus bradycardia. You should: - initiate one-rescuer CPR while your partner attempts to establish vascular access. - ask your partner to insert an IO catheter and administer epinephrine 1:10,000. - establish immediate vascular access and administer 0.02 mg/kg of atropine sulfate. - attempt immediate transcutaneous pacing while continuing ventilation assistance.

Answer 137

initiate one-rescuer CPR while your partner attempts to establish vascular access.

Question 138

If an infant or small child swallowed a rigid foreign body, they would most likely experience respiratory distress because: - when an infant or child is stressed they tend to swallow a lot of air. - the esophageal foreign body can compress the relatively pliable trachea. - the feeling of a foreign body in the throat would cause severe anxiety. - a foreign body in the esophagus would cause reflux and aspiration.

Answer 138

the esophageal foreign body can compress the relatively pliable trachea.

Question 139

Any child with unexplained hyperpnea should be suspected of having which type of toxicity? Opiate Salicylate Beta blocker Organophosphate

Answer 139

Salicylate

Question 140

The goal in treating a child with epiglottitis is to: - administer corticosteroids to reduce edema in the upper airway. - administer oxygen by nonrebreathing mask and transport at once. - transport them to the hospital with a maintainable airway. - intubate them before the epiglottis blocks the upper airway.

Answer 140

transport them to the hospital with a maintainable airway.

Question 141

If you cannot palpate the femoral pulse in an unresponsive infant, you should: - apply an AED at once. - initiate CPR immediately. - assess for adequate breathing. - palpate the brachial pulse.

Answer 141

Initiate CPR immediately

Question 142

Which orogastric or nasogastric tube would be the most appropriate size for a 4-year-old child? - 8-F - 6-F - 10-F - 4-F

Answer 142

10-F

Question 143

Upon arriving at the scene of a 4-year-old boy in respiratory distress, you enter the residence and see the child, who is conscious, sitting on his father's lap. The father is aware of your presence, but the child is not. Your initial action should be to: - allow the father to carry his son to the ambulance, where you can perform an initial assessment. - make physical contact with the child as soon as possible in order to identify any life threats. - quickly build good rapport with the child by picking him up and asking him what his name is. - visually assess the child from across the room for any signs of increased work of breathing.

Answer 143

visually assess the child from across the room for any signs of increased work of breathing.