Deck 38: Pediatrics

Question 1

A coworker is telling you about a recent run in which he provided care to a preschooler. Based on this description, you know that age of the patient would have been:

A) 1-2 years.
B) 3-6 years.
C) 6-8 years.
D) more than 9 years.

Answer 1

B

Question 2

You are immobilizing a 4-year-old-boy on a long spine board. Which of the following would be appropriate when performing this intervention?

A) Do not apply the chest strap across the thorax.
B) Place padding between his shoulders and the spine board.
C) Secure the chest and legs to the board after the head.
D) Place a pillow under the neck to keep the airway open.

Answer 2

B

Question 3

The increased pliability of the child's ribs makes him more prone to:

A) bruising of the lung.
B) rib fractures.
C) cardiac arrest.
D) overinflation of the lungs.

Answer 3

A

Question 4

You have been called to care for a 21-month-old female who has been bitten by a dog. Given the patient's age, you would appropriately classify the patient as a(n):

A) infant.
B) school-age child.
C) preschooler.
D) toddler.

Question 5

A 6-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 the EMT 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) Children tend to be highly allergic to bee stings while the same allergy in an adult is less common.
C) The child's tongue is proportionally larger, increasing the chance of airway occlusion from minor swelling.
D) When injured, a child's mouth produces more saliva, making airway occlusion a major concern.

Question 6

After a 29-year-old male with chest pain is removed from the house by stretcher, the man's 7-year-old son throws a temper tantrum. His mother is embarrassed and states that he has not done this since he was 2 years old. Given the situation, your response would be:

A) "I would not be concerned. This is a stressful event he doesn't understand, and he may just be having trouble coping with it."
B) "You really need to correct this behavior now so it does not happen in the hospital. They will make you take him home."
C) "It may be wise to contact your pediatrician and let him know about the temper tantrum, it may be controllable with medications."
D) "A 7-year-old is too old for this type of behavior. You may want to talk to his pediatrician."

Question 7

An Emergency Medical Responder asks you why you should not overextend the airway on a pediatric patient when performing a head-tilt, chin-lift. Your reply would be:

A) "The pediatric cervical spine is delicate and can be injured if the neck is hyperextended."
B) "The trachea of the pediatric patient is very short and can be injured by extension."
C) "The cartilage of the trachea is very soft and can 'kink' if the neck is extended too far."
D) "The pediatric esophagus is very thick and will occlude the airway if the neck is hyperextended."

Question 8

Which of the following instructions would you provide to an EMT who is preparing to assess a stable 9-month-old boy who has a rash?

A) "To keep the baby calm, do not touch him during the assessment."
B) "Start at the head and slowly work your way to the feet."
C) "Have the mother hold him as you do the assessment."
D) "It is important not to undress the baby for the assessment."

Question 9

You must assess the pupils of a 5-year-old who fell off a bed while playing. Which of the following statements would be most appropriate prior to performing this assessment?

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

Question 10

Which of the following statements made by the EMT is most appropriate regarding dealing with caregivers and children during a medical emergency?

A) "I try to include the caregiver in all that I do with his or her child so that the child and caregiver are more comfortable."
B) "It is best to separate the caregiver from the child so that a proper assessment and care can be given."
C) "I include the caregiver in the care until I get the information that I need, then I remove the child to continue the assessment in the ambulance."
D) "I tell the caregiver that everything will be okay so they are more calm and better able to help the child."

Question 11

You have been called for a 2-year-old girl who has been sick for two days. In preparing to assess the patient, it is important that you recognize that patients in this age group generally:

A) do not like having clothing removed.
B) tolerate separation from their caregiver.
C) have little fear of strangers.
D) like to be touched.

Question 12

Which of the following assessment findings related to the mental status of a 1-year-old would the EMT consider normal?

A) The patient turns his head to sounds.
B) The patient is curious about your penlight.
C) The patient moans when pressure is applied to his finger.
D) The patient does not keep his eyes open.

Question 13

Which of the following behaviors would the EMT recognize as uncharacteristic of a conscious and stable 2-year-old boy who fell and hurt his hand?

A) Cries any time you or your female partner touch him
B) Does not cry or protest when taken from his mother
C) Becomes upset when you lift his shirt to assess his abdomen
D) Apologizes several times for falling and hurting his hand

Question 14

You are assessing a 5-year-old boy who is complaining of arm pain after falling down three steps. As you physically assess the patient, he tries to bite your hands. His mother is at his side. Which of the following statements is appropriate to make regarding the behavior of biting?

A) "If you bite me, I will not help you feel better."
B) "Do you bite your mother? Why would you try to bite me?"
C) "Mom, you need to stop him from trying to bite me."
D) "I know that you do not feel good, but biting is not okay."

Question 15

You have been called for a 6-year-old girl who has vomited once and is complaining of abdominal pain. When you are performing the secondary assessment and obtaining a medical history, which action by you would be considered most appropriate?

A) Asking mostly questions that can be answered with a "yes" or "no"
B) Standing above the child and smiling while asking questions
C) Allowing the child to play with the stethoscope before listening to her lungs
D) Using "baby talk" when asking the child questions about her pain

Question 16

When assessing a 3-year-old who is in respiratory distress, which assessment finding would be most concerning?

A) Retraction of the muscle between the ribs
B) Abdominal rise and fall during breathing
C) Retractions observed above the clavicles
D) Respiratory rate of 28 breaths per minute

Question 17

The EMT would recognize that pediatric patients range in age from:

A) 1 year to 8 years.
B) birth to 12 years.
C) birth to 18 years.
D) 1 year to 15 years.

Question 18

You are assessing a 2½-year-old who was involved in a minor car accident. She is currently alert and oriented. While you are assessing her for possible injuries, which of the following would be considered appropriate?

A) Assess the child starting at her head and moving to her feet.
B) Allow the child to hold a favorite toy during the assessment.
C) Be firm with the child and provide concrete instructions on what you expect.
D) Touch and hold the child as much as possible.

Question 19

You have been called for a 2-week-old baby who is sick. Assessment reveals him to have a fever and rhonchi in the lungs. Which of the additional assessment findings would be most concerning to you given the age of this patient?

A) Respiratory rate of 30 breaths per minute
B) Wet diaper in need of changing
C) Continual moaning and crying
D) Nasal passages occluded by mucus

Question 20

You have arrived on the scene to help a child who is short of breath. The mother is screaming hysterically that her 3-year-old boy cannot breathe, making assessment of the patient very difficult. Your initial action in the management of this situation would be to:

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

Question 21

Assessment of an alert and oriented 9-year-old child with a history of asthma reveals him to be breathing 20 times a minute with adequate chest rise and fall. You also note that he exhibits nasal flaring and has slight retractions of the intercostal muscles. His heart rate is 100 beats per minute and his blood pressure is 102/64 mmHg. On room air, he has a pulse oximeter reading of 98%. The EMT would recognize:

A) compensated respiratory distress.
B) late respiratory failure.
C) hypoxic respiratory failure.
D) decompensated respiratory failure.

Question 22

An infant is short of breath and has rhonchi in both lungs. He is alert with adequate respirations at a rate of 38 per minute. His skin color is pink but cool to the touch. When EMRs place a pediatric mask on his face, he becomes very upset and physically struggles to remove it. In this situation you would:

A) place a nasal airway and start positive pressure ventilation.
B) secure the mask to his face using tape.
C) allow the mother to hold the infant and provide blow-by oxygen.
D) transport the infant with no further attempt at oxygen therapy.

Question 23

You have been called for a 4-year-old female who is short of breath. Her mother informs you that she has had a fever and runny nose for two days and today began to have difficulty breathing. Furthermore, she is having a difficult time waking her up. Your assessment reveals her to be responsive to painful stimuli and breathing at 12 times a minute with minimal chest and abdominal rise and fall. Her skin is warm to the touch with cyanosis around the lips. Your partner informs you that her heart rate is 124 beats per minute. You find the girl lying in bed with snoring respirations despite use of the head tilt,-chin lift airway maneuver. Your immediate action in caring for this child next is:

A) positive pressure ventilation.
B) suctioning the airway.
C) application of a nonrebreather face mask and oxygen.
D) insertion of a nasal airway.

Question 24

You have been called to a preschool for a child in seizure activity. On your arrival, staff direct you to a bed in which a 4-year-old boy is lying. Staff state that the child began making "funny" noises in his sleep then began to seize for approximately 60 seconds. Your assessment indicates that the boy is responsive to painful stimuli and is breathing, but has gurgling sounds coming from the upper airway. His radial pulse is rapid and strong and his skin is cool and diaphoretic. Your immediate action in caring for this child would be to:

A) apply oxygen.
B) place a cervical collar.
C) suction the airway.
D) start positive pressure ventilation.

Question 25

The mother of a 2-year-old has called EMS because her son has an axillary temperature of 103.2°F. On scene, your assessment reveals the boy to be confused and lethargic with a rectal temperature of 104.1°F. When caring for this child, you would:

A) remove the child's clothes and sponge with tepid water.
B) apply washcloths soaked in cold water until the child begins to shiver.
C) administer oxygen and cool the child by sponging with alcohol.
D) have the mother administer Tylenol and cool the child by sponging with cold water.

Question 26

On scene at a school cafeteria, you are presented with a 9-year-old boy who attempted to eat a small plum whole. He is conscious with stridorous respirations and unable to cough when instructed to do so. His skin color is gray and cyanotic. Your immediate action would be to:

A) deliver five abdominal thrusts.
B) provide positive pressure ventilation.
C) place an oral pharyngeal airway.
D) check for a radial and carotid pulse.

Question 27

When you are assessing a 9-month-old boy who had a fever for the past two days, which of the following assessment findings would most strongly suggest that the fever has caused dehydration?

A) Palpation of the anterior fontanelle reveals it to be bulging.
B) The heart rate is at the high end of the normal range.
C) Respirations are labored and rapid.
D) The mother informs you that the baby is wetting very few diapers.

Question 28

You have been asked to speak to a group of new mothers regarding the emergency treatment of a fever. During your presentation, one of the mothers asks you what temperature would cause a child to seize. Your response would be:

A) "When a child's temperature rises above 105°F, seizure activity will occur."
B) "It is not the specific temperature that is of concern, but the rate at which the body temperature rises."
C) "If the temperature of a child's fever rises slowly over several hours, she is at greater risk for seizures."
D) "For a child to seize when she has a fever, she must also have a history of seizures or a cardiac condition."

Question 29

Your partner informs you that the 3-year-old boy you have been called to care for is breathing 28 times per minute. As a knowledgeable EMT, you would recognize:

A) a rapid rate.
B) adequate breathing.
C) a normal rate.
D) inadequate breathing.

Question 30

You have been called to a local day care for a sick child. On scene, panicked day care workers inform you that the 4-year-old child was lethargic all morning and wanted to sleep. After resting for several minutes, she began to "shake all over." This lasted for approximately 30 seconds. Your assessment reveals her to be responsive to painful stimuli and breathing adequately. Her airway is open and her radial pulse is strong and bounding. Her skin is hot and moist to the touch with no signs of cyanosis. You are told that she has no medical history. En route to the hospital, the patient's mental status improves. Based on this presentation and information, you assume that the seizure occurred secondary to:

A) hypoxia.
B) fever.
C) hypoglycemia.
D) altered mental status.

Question 31

Which of the following statements made by another EMT regarding treatment of the pediatric patient in the prehospital setting would you agree with?

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

Question 32

You have been called to a lower-income housing complex for a 4-year-old who is short of breath and has a fever. When assessing this patient, what technique would be best?

A) Determining the respiratory rate before laying hands on the child
B) Auscultating breath sounds over the anterior chest
C) Checking capillary refill by pressing on the skin of the fingers
D) Performing the primary assessment after the secondary assessment

Question 33

You are assessing a 6-year-old girl with possible pneumonia. She has labored breathing and a fever of 102°F. When you are assessing and classifying her respiratory status, which of the following signs would provide the strongest evidence that she is in decompensated or late respiratory failure?

A) Respiratory rate of 36
B) Altered mental status
C) Fever of 102°F
D) Nasal flaring

Question 34

On the scene of a medical emergency, you are directed to a 5-month-old baby in his crib. He responds to painful stimuli by whimpering and he is breathing at a rate of 50 breaths per minute. His airway is open and his brachial pulse is fast, weak, and difficult to locate. Assessment of his skin reveals it to be cool and pale in color. According to the mother, he has had vomiting and diarrhea for four days. She also reports that the father of the baby is a diabetic. Based on this information, the EMT would recognize what condition?

A) Shock
B) Hypoglycemia
C) Cardiac arrest
D) Heart failure

Question 35

You have been summoned to a grocery store for a 6-year-old girl who has collapsed. On scene, you find the girl lying unresponsive on the floor. Quickly you open the airway and determine that she is not breathing. When you try to ventilate her with the bag-valve mask, you are unable to do so. Repositioning the head and reattempting ventilation is not successful in passing air into the lungs. Your next action would be to:

A) perform a blind finger sweep.
B) administer 30 chest compressions.
C) ventilate with greater force.
D) place an oral airway.

Question 36

When providing care to the pediatric patient who has been injured or ill, the EMT must recognize that the most important aspect of care normally revolves around:

A) airway and respiratory support.
B) assessment and support of circulation.
C) ability to provide rapid transport.
D) knowledge of illnesses that affect children.

Question 37

An 8-year-old boy is unresponsive following the accidental ingestion of his father's high blood pressure medications. His airway is open and his breathing is labored and inadequate. The pulse rate is 56 beats per minute and his skin is cool and diaphoretic. Your partner states that his lungs have crackles in them and the blood pressure is 62/40 mmHg. Which of the following represents the most important care that you will provide to the patient?

A) Determination of the exact medication taken
B) Oral airway and high-concentration oxygen
C) Administration of activated charcoal
D) Positive pressure ventilation

Question 38

You are caring for an 8-month-old boy who is unresponsive after choking on a piece of hard candy he managed to find. As you look into his mouth, you can see the candy in the back of his oropharynx. Your next action would be to:

A) provide five abdominal thrusts.
B) attempt to retrieve and remove it.
C) check the brachial pulse.
D) perform a blind finger sweep.

Question 39

Which of the following would be the most appropriate instructions to give to another EMT concerning the ventilation of an unresponsive and apneic 3-year-old boy?

A) "Let's ventilate him at a rate of 24 breaths a minute."
B) "Make sure to give each ventilation over 2 seconds."
C) "Deliver one breath every 3 seconds."
D) "Do not administer cricoid pressure since it is contraindicated."

Question 40

After placing a small rock in her mouth, a 7-month-old girl begins to choke. You are on scene within minutes and find her unresponsive in her mother's arms. You attempt to provide ventilation with the bag-valve mask, but are unsuccessful. Your next action would be to:

A) attempt ventilation with a pocket mask.
B) administer five chest thrusts.
C) provide five abdominal thrusts.
D) start cardiopulmonary resuscitation.

Question 41

A 6-year-old male has a decreased level of consciousness. His mother states that they do not have health insurance so they did not take him to the hospital last week when he started vomiting and had copious amounts of diarrhea. She continues by stating that he has not had anything to eat or drink since then. He has snoring respirations that are rapid and inadequate. His radial pulse cannot be located, and his carotid pulse is rapid and weak. His capillary refill is 5 seconds and his skin is cool to the touch. Your first intervention in caring for this child would be:

A) taking manual in-line spinal immobilization.
B) opening the airway using the head-tilt, chin-lift.
C) providing positive pressure ventilation.
D) attaching the automated external defibrillator.

Question 42

While performing the reassessment of a 2-year-old male who is severely dyspneic, you note that he is now unresponsive and not breathing. He has a heart rate of 32 beats per minute and his skin is cool and diaphoretic. What instruction would you provide to another EMT who is helping you transport the patient?

A) "We need to get a blood pressure and then I will call medical direction."
B) "Please increase the oxygen in the nonrebreather face mask to 15 liters per minute."
C) "Let's start chest compressions and positive pressure ventilations."
D) "We need to try humidified oxygen to see if he will improve with that."

Question 43

You have arrived at a residence to find a 6-month-old girl in her crib in cardiac arrest. Quick assessment reveals no rigor mortis or lividity. The mother states that she put the baby to bed at 9 p.m. last night and awoke at 3 a.m. to find her in her present state. Your first action would be to:

A) ask if the baby has any medical conditions.
B) open the airway and provide 2 ventilations.
C) inquire if the mother wants resuscitation started.
D) apply oxygen and move the baby to the ambulance.

Question 44

While in an apartment to provide care for a 52-year-old female with shortness of breath, you note a baby sleeping in a nearby crib. Which of the following observations related to the baby would prompt you to intervene and speak to the family?

A) The baby is sleeping on a hard mattress.
B) The crib is near a closed window.
C) The baby is sleeping on her abdomen.
D) The baby is sleeping in the afternoon.

Question 45

While attempting resuscitation on a baby with a probable case of SIDS, which of the following questions would be appropriate for the EMT to ask the mother?

A) "Why did you have the baby in bed with you and not in a crib?"
B) "Were there any problems with the pregnancy or his birth?"
C) "Do you think that you may have rolled on him and smothered him?"
D) "Why do you have it so cold in this bedroom?"

Question 46

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

A) Hepatitis
B) Influenza
C) Haemophilus influenza
D) Hib vaccine

Question 47

An 8-year-old child was chasing his dog when he ran out into the street and was struck by a car. He is responsive to verbal stimuli and has an unstable pelvis and a bruise to the side of his face. His airway is open and his breathing is rapid and shallow. His radial pulse is rapid and weak and his skin is cool, moist, and diaphoretic. He also has burns and abrasions to his back after being thrown by the car onto the hot pavement. Based on these assessment findings, the EMT would treat the patient for what condition?

A) Hypoxia
B) Head injury
C) Shock
D) Burn injuries

Question 48

When he is assessing a 3-year-old child for possible injuries after the child fell down a flight of stairs, which of the following would raise the EMT's suspicion that the child may be a victim of physical abuse?

A) The child cries when you palpate his arm.
B) Several bruises are located on his knees and shins.
C) The child is fearful and appears malnourished.
D) Bruises are found on his chest and abdomen.

Question 49

A 7-year-old child was riding a bike downhill and struck a parked car. He was thrown from the bike, impacting his head and back on the roadway. Presently, he is alert, oriented, and complaining of a headache. His airway is open and his breathing is adequate. A radial pulse is easily palpated and his skin is warm and dry. After taking manual in-line spinal immobilization, the EMT would:

A) immobilize the patient to the long spine board.
B) consider the need for supplemental oxygen.
C) perform a rapid trauma exam and obtain vital signs.
D) apply a cervical collar and check the mental status.

Question 50

You are suspicious that a child is being physically abused and neglected. Which of the following best describes your best course of action in such a situation?

A) Confrontation of the alleged abuser
B) Documentation of the situation
C) Notification of other family members
D) Placement of the child in a safe home

Question 51

The mother of a 3-year-old boy has called 911 because her son has a low-grade fever and difficulty breathing. On scene, you are suspicious that the boy is suffering from croup. Which of the following statements made by the mother would reinforce this suspicion?

A) "At night, he seems to get a barking-like cough."
B) "When he is short of breath, his heart rate increases."
C) "There are times when he continually drools."
D) "When I turn the air conditioner on, he becomes more short of breath."

Question 52

You are treating a 6-month-old patient who was accidently dropped down a flight of steps, when her mother stumbled at the top of the stairway. The infant will only open her eyes and moan to deep painful stimuli, and tries to withdraw from the pain. Given these findings, you calculate her Glasgow Coma Score to be:

A) 4.
B) 6.
C) 8.
D) 10.

Question 53

You have been called to a home by neighbors because they are concerned for the welfare of the children inside. On scene, you find two children left by themselves. They are playing in a filthy room with no light or heat. They are dirty and have insect bites all over their bodies. One is in a soiled diaper and has hard stool caked to the buttocks. The EMT would best recognize this situation as one of:

A) physical neglect.
B) parental negligence.
C) physical abuse.
D) felonious care.

Question 54

What is the best location for assessing breath sounds in the pediatric patient?

A) Midaxillary region of the lungs
B) Anteriorly at the apex of the lung
C) Anteriorly at the base of the lung
D) Posteriorly just below the scapula

Question 55

After the unsuccessful resuscitation of a 3-year-old boy who was shot by his mother's boyfriend, you find yourself extremely stressed and anxious over the call. You are having trouble sleeping and the resultant anxiety is affecting your home life. Which of the following should be your initial action, given this situation?

A) Make a conscious effort to focus on the positive, and the event.
B) Talk to a close friend about your feelings.
C) Use the tragedy as incentive to learn more about pediatric trauma.
D) Consider finding a profession outside of medicine.

Question 56

A 2-month-old presents with labored breathing, fever, and coughing. Auscultation of the lungs reveals significant wheezing bilaterally. Based on this presentation, an EMT would recognize that the patient is most likely suffering from:

A) asthma.
B) epiglottitis.
C) bronchiolitis.
D) croup.

Question 57

After you obtain a refusal at a residence in a neighborhood, a couple approaches the ambulance and inform you that they have concerns that a 6-year-old child may be being physically abused in a home two doors away. They state that they heard the child crying and what sounded like physical abuse occurring. In this situation, you would:

A) contact the police and wait in the ambulance until they arrive.
B) attempt entry into the home to determine if the child is injured.
C) inform the couple that they must contact a child welfare agency.
D) knock on the door and confront the parents about the complaint.

Question 58

You have been called to an apartment for a child who is sick. As you approach the 4-year-old boy, you note that he is sitting upright in his mother's arms with his chin thrust forward. He has a sickly appearance and is drooling. His airway appears open and his breathing is adequate. His radial pulse is strong and his skin is hot to the touch. Which of the following interventions would be most appropriate in the care of this patient?

A) Suctioning secretions from the back of the airway
B) Provision of blow-by oxygen
C) Placement of an oropharyngeal airway
D) Placing the boy supine for transport

Question 59

You have arrived at the emergency department with a young child whom you believe is the victim of child abuse. To which person would it be best to report your suspicion?

A) Registered nurse
B) Security guard
C) Emergency physician
D) Hospital administrator

Question 60

The mother of a 4-month-old boy awoke to find him in his crib and not breathing. On scene, you are providing resuscitative care while the parents watch on in disbelief. Which of the following would be most appropriate regarding their presence in the room?

A) Allow them to observe the resuscitation if they wish.
B) Escort them to another part of the house despite them wanting to stay.
C) Move to the ambulance for continued resuscitation en route.
D) Ask the parents to wait in the ambulance for transport.

Question 61

An extremely high fever in a 2-month-old infant should be considered what medical emergency until known otherwise?

A) Bacterial pneumonia
B) Cerebral abscess
C) Viral bronchitis
D) Meningitis

Question 62

You are assessing a 12-year-old female in respiratory distress and a history of asthma. What statement, made by her mother, would be most concerning?

A) "The doctor stopped her prescription for steroids."
B) "Two years ago she needed to have a breathing tube in her throat."
C) "Her asthma started bothering her last night."
D) "There is a history of asthma on her father's side of the family."

Question 63

You are treating a short of breath 9-year-old male with a history of asthma. On scene he presents in severe respiratory distress with noted intercostal retraction, lethargy, and expiratory wheezing. His pulse is 136, respirations 32, and SpO₂ 95%. You have assisted him with his albuterol MDI and are transporting emergently to the hospital. As you reassess the patient, what finding is most concerning?

A) SpO₂ 94%
B) Increased wheezing
C) Heart rate 88
D) Blood pressure 100/64

Question 64

You are by the side of a 2-year-old whose mother states he has had a cough for the past three days. His airway is patent and respirations labored. Intercostal retractions are accompanied by stridorous respirations. His skin is warm to hot and vital signs are as follows: pulse 152, respirations 28, SpO₂ 97%, and temperature 100.3°F. Breath sounds are clear and equal. Based on this presentation, you would suspect and treat the patient for:

A) asthma.
B) bronchiolitis.
C) foreign body airway obstruction.
D) croup.

Question 65

A 6-year-old female is in severe respiratory distress with inspiratory stridor and pale moist skin with cyanosis noted around his mouth. He is very lethargic and cannot hold his head up. His mother is panicked and reports that he has a history of asthma. Breath sounds are diminished and his vital signs are: pulse 162, respirations 40, blood pressure 122/66, and SpO₂ 81%. Your immediate action would be to:

A) apply a nonrebreather with 15 lpm oxygen.
B) insert an oral airway and ventilate with a bag-valve mask.
C) start positive pressure ventilation.
D) administer patient's albuterol MDI and provide immediate transport.

Question 66

A 2-year-old is awake and in respiratory distress with stridorous respirations. His airway is patent and pulses rapid. Vital signs are pulse 144, respirations 28, SpO₂ 93% on room air, and temperature 101°F. The patient has no medical history, although diabetes runs in the family. Appropriate care for this patient would include:

A) high-concentration oxygen by mask.
B) checking blood sugar.
C) blow-by oxygen that is humidified.
D) providing aspirin for fever.

Question 67

What would be the minimally acceptable blood pressure for a 9-year-old girl who is suffering from a significant bleed from broken glass?

A) 96 mmHg
B) 79 mmHg
C) 100 mmHg
D) 88 mmHg

Question 68

When preparing to provide positive pressure ventilation to a child, what will be an acceptable tidal volume if the child weighs 22 kg?

A) 200 mL
B) 154 mL
C) 246 mL
D) 104 mL

Question 69

When assessing the central pulse of a young child, the EMT would palpate the:

A) radial pulse.
B) brachial pulse.
C) pedal pulse.
D) femoral pulse.

Question 70

A mother asks you what causes her son to get bronchiolitis. You would inform her that it is caused by:

A) an unknown bacteria.
B) the same bacterium that causes strep throat.
C) a pneumonia-type virus.
D) the respiratory syncytial virus.

Question 71

Which of the following would be a primary concern for an 11-year-old female with a prolonged asthmatic episode and low-grade temperature?

A) Laryngeal edema
B) Croup
C) Febrile seizure
D) Dehydration

Question 72

The EMT is properly assessing the breathing of a 3-year-old when he:

A) counts the respiratory rate for 15 seconds and multiplies by 4.
B) counts the respiratory rate for 30 seconds and multiplies by 2.
C) counts the respiratory rate for 15 seconds and observes chest rise and fall.
D) counts the respiratory rate for 10 seconds and multiplies by 6.

Question 73

When involved with a pediatric patient, the EMT recognizes that patient assessment begins when:

A) you are dispatched to the call.
B) you physically touch the patient.
C) you first lay eyes on the patient.
D) you arrive by the side of the patient.

Question 74

On scene, a 6-year-old male who is short of breath will not allow EMRs to place a nonrebreather face mask on his face. Assessment indicates moderate respiratory distress with the following vital signs: pulse 124, respirations 24, blood pressure 98/56, and SpO₂ 93%. At this time, you:

A) use a nasal cannula with 2 liters oxygen.
B) hold the nonrebreather mask to his face.
C) start positive pressure ventilation.
D) place a nasal airway and nasal cannula with 6 liters oxygen.

Question 75

Croup is recognized as an illness that involves:

A) edema beneath the glottis.
B) bronchiolar constriction.
C) swelling of the epiglottis.
D) infection within the lungs.

Question 76

When evaluating capillary refill time in a pediatric patient, the EMT must remember that:

A) it is considered very reliable.
B) it should be less than 5 seconds.
C) it is not a good test of perfusion.
D) it is not affected by environmental conditions.

Question 77

A 5-year-old boy who is drooling has suspected epiglottitis. His pulse rate is 144, respirations 156, and blood pressure 110/52. He is noncompliant with the pulse oximeter, but his skin is normal colored. Which statement indicates proper care of this patient?

A) "Let's give him high-concentration oxygen through a mask."
B) "I need to depress his tongue with the tongue blade to see the swelling."
C) "Let's suction his airway to remove the secretions."
D) "We need to place him on his side to drain secretions and transport immediately!"

Question 78

A 7-year-old with a fever of 101.3°F and shortness of breath has a patent airway, but tachypneic respirations. His heart rate is 132, respirations 28, and blood pressure 94/60 with an SpO₂ of 96% on room air. Crackles and wheezes are noted in the base of the right lung. Based on this presentation, you would suspect and treat the patient for:

A) bronchiolitis.
B) pneumonia.
C) asthma.
D) upper respiratory infection.

Question 79

What disease or illness would you suspect when confronted with a pediatric patient exhibiting respiratory distress and audible inspiratory stridor but no cough?

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

Question 80

A 5-year-old male is drooling with stridorous respirations and has a fever of 104°F. What statement would concern the EMT most?

A) "I am not hungry at all."
B) "It hurts to swallow."
C) "I have a headache."
D) "My nose will not stop running."