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Ch. 33 Assesment

Your patient is a? 11-month-old male who began choking while his babysitter was feeding him some sliced peaches. The child has retractions of his intercostal? muscles, is? drowsy, and is grayish in color. Which of the following is the BEST intervention for this? patient?
A.
?Blow-by oxygen at 10 to 15 liters per minute
B.
Abdominal thrusts
C.
Use of a? flow-restricted oxygen-powered ventilation device? (FROPVD)
D.
Back slaps and chest thrusts
D

Back slaps and chest thrusts

In? general, a child is considered an adolescent when he reaches the age of? ________ years.
A.
9
B.
4
C.
7
D.
12
D
12
Which of the following is characteristic of? preschool-age children?
A.
They have few fears of anything.
B.
They do not mind being separated from their parents.
C.
They are not especially embarrassed or modest about body exposure.
D.
They may believe their injury is a punishment for being bad.
D
They may believe their injury is a punishment for being bad.
Which of the following statements is true regarding? SIDS?
A.
It usually occurs between the ages of 1 and 3 years.
B.
Death usually occurs during sleep.
Your answer is correct.C.
All children are at equal risk.
D.
It is usually caused by external suffocation.
B
Death usually occurs during sleep.
Which of the following is a surgically implanted drainage device that runs from the brain to the? abdomen?
A.
Central intravenous line
B.
Gastrostomy tube
C.
Tracheostomy tube
D.
Shunt
D
Shunt
Capillary refill should be assessed in which of the following age? groups?
A.
Younger than 1 year
B.
Younger than 6 years
Your answer is correct.C.
?2-years-old and younger
D.
Younger than 12 years
B
Younger than 6 years
Which of the following is LEAST common in a pedestrian child versus car? incident?
A.
Abdominal injuries
Your answer is not correct.B.
Head injuries
C.
Spinal injuries
D.
?Upper-extremity injuries
D
Upper-extremity injuries
Which of the following is NOT likely to be a cause of respiratory distress in a? 2-year-old child?
A.
Foreign body airway obstruction
B.
Epiglottitis
C.
A cold
D.
Emphysema
D
Emphysema
Which of the following statements is true regarding the skin and body surface area of children as compared to? adults?
A.
A child is not more prone than an adult to heat loss through the skin.
B.
Children have a larger body? surface-to-weight ratio.
This is the correct answer.C.
The skin of a child is thicker.
Your answer is not correct.D.
Children have more subcutaneous fat.
B
Children have a larger body? surface-to-weight ratio.
Your patient has a tracheostomy and is on a ventilator. He presents in acute respiratory distress. You assess his trach tube and it appears? clear, but there is something wrong with the ventilator. You do not notice any loose fittings or disconnected tubes. The airway is clear and he is sitting upright. What is your next? step?
A.
Try to further troubleshoot the ventilator.
B.
Connect your oxygen tank directly to the tracheostomy tube.
Your answer is not correct.C.
Call the? manufacturer’s service hotline.
D.
Disconnect the patient and ventilate him with a? bag-valve device.
D
Disconnect the patient and ventilate him with a? bag-valve device.
You are dispatched to a? 1-year-old child with respiratory distress. En? route, you review how to assess and treat infants with respiratory problems. Which of the following would indicate an infant with respiratory? distress?
A.
Abdominal movement when breathing
B.
Wheezing upon inspiration
Your answer is correct.C.
Capillary refill time of 2 seconds
D.
Respiratory rate of 30
B
Wheezing upon inspiration
Which of the following would be an appropriate statement in gaining the cooperation of a? 7-year-old pediatric patient during your? assessment?
A.
?”Joey, this is a splint that will help your arm feel better. I promise it? won’t hurt when I put your arm in? it.”
B.
?”Big girls? don’t cry, Emily.? You’re a big? girl, aren’t? you?”
C.
?”Katie, this is my stethoscope. I can use it to hear what your breathing sounds like. Would you like to look at it for a? minute?”
Your answer is correct.D.
?”I’m sorry? Nick, but you? can’t see Mommy and Daddy until you let me take your blood? pressure.”
C
“Katie, this is my stethoscope. I can use it to hear what your breathing sounds like. Would you like to look at it for a? minute?”
Careful assessment and ongoing evaluation of the pediatric patient is critical for which of the following? reasons?
A.
A sick or injured child who initially appeared stable can deteriorate very rapidly.
B.
Childhood injuries and illnesses as a result of abuse or neglect may be missed if the EMT is not thorough.
C.
Signs of significant illness and injury may be subtle and easily overlooked.
D.
All of the above
D
All of the above
Which of the following is NOT a common cause of shock in infants and? children?
A.
Dehydration
B.
Infection
C.
Blood loss
D.
Heart failure
D
Heart failure
Your patient is a? 3-year-old child who is in severe respiratory distress. She is cyanotic and responds only to painful stimuli. According to the? patient’s mother, the child had complained of a sore throat earlier and has had a fever since early in the morning. Which of the following is the BEST course of? action?
A.
Perform abdominal thrusts and finger? sweeps; attempt to ventilate.
B.
Suction the airway.
C.
Begin gentle ventilations with a? bag-valve mask? (BVM) and supplemental oxygen.
Your answer is correct.D.
Insert an oropharyngeal airway? (OPA) and begin? bag-valve-mask ventilations with supplemental oxygen.
C
Begin gentle ventilations with a? bag-valve mask? (BVM) and supplemental oxygen.
You are called for a child that has had a fever for a couple of days. The parents tell you that two of the other children have been home with a stomach virus and fever. As you attempt to assess the? child, he pulls away from you and grabs onto his mother. Which of the following behaviors would be considered? “normal” for a? 4-year-old?
A.
He begins to cry when you try to touch his booboo.
Your answer is correct.B.
He flares his nostrils when he breathes.
C.
He? doesn’t make eye contact as you approach.
D.
He runs up to you when you enter the room.
A
He begins to cry when you try to touch his booboo.
Which of the following is a concern when dealing with an adolescent? patient?
A.
The adolescent patient fears permanent disfigurement from injuries.
Your answer is correct.B.
Adolescents usually lack the sophistication to understand explanations of what you are doing and why.
C.
?Physiologically, adolescents are very different from adults.
D.
The adolescent patient will generally be more truthful about what happened in front of his parents than in front of his peers.
A
The adolescent patient fears permanent disfigurement from injuries.
The most common type of burn injury suffered in the home by children? is:
A.
direct fire.
B.
electrical.
Your answer is not correct.C.
scald.
This is the correct answer.D.
chemical.
C
scald.
Prehospital management of the abused child includes all of the following except?:
A.
allowing parent to drive child to hospital.
This is the correct answer.B.
reporting your findings to the emergency department staff.
C.
treating all injuries.
D.
eliciting a complete history from child and parents.
A
allowing parent to drive child to hospital.
A? 4-year-old child is generally categorized as? a(n):
A.
toddler.
B.
?school-age child.
C.
adolescent.
D.
preschooler.
D
preschooler.
You are called to a home where a family has been enjoying a Labor Day picnic and swim party. A? 2-year-boy slipped to the bottom of the pool unnoticed. By the time you? arrive, the child has been removed from the water and family members are administering CPR. You assess the child and note that he has a weak pulse and is trying to breathe on his own. You initiate transport and continue providing positive pressure ventilations. You are also very concerned? about:
A.
how the parents are handling the situation.
B.
the safety of the other children at the party.
C.
the last time the child ate something.
D.
the child being hypothermic.
D
the child being hypothermic.
Which of the following is a sign of the MOST severe respiratory distress in a? 1-year-old pediatric? patient?
A.
Decreased muscle tone
Your answer is correct.B.
Wheezing
C.
Respiratory rate greater than 60
D.
Grunting
A
Decreased muscle tone
Your patient is a? 3-year-old male who developed sudden stridor while playing with some of his? 5-year-old cousin’s toys. The patient is alert and? anxious, producing stridor when he cries. His skin is pink and? warm, and capillary refill is less than 2 seconds. Which of the following is appropriate in the management of this? child?
A.
Attempt a finger sweep to remove the foreign body from the? child’s airway.
B.
Transport the child in a restrained car seat with his mother by his side.
Your answer is correct.C.
Perform abdominal thrusts.
D.
Perform back blows and chest thrusts.
B
Transport the child in a restrained car seat with his mother by his side.
A bulging fontanelle in a quietly resting child may be an indication of which of the? following?
A.
Increased intracranial pressure
Your answer is correct.B.
Normal development
C.
Fever
D.
Dehydration
A
Increased intracranial pressure
Which of the following is true regarding the? EMT’s approach to the pediatric? patient?
A.
It is not necessary to use Standard Precautions when dealing with pediatric patients.
B.
Scene safety is not an important consideration in the care of pediatric patients.
C.
It is not possible to develop an initial impression of the pediatric patient without a detailed physical examination.
D.
An EMT does not have to attempt to obtain a blood pressure on patients younger than 3 years old.
D
An EMT does not have to attempt to obtain a blood pressure on patients younger than 3 years old.
Which of the following is the MOST common cause of seizures in infants and? children?
A.
Hypoglycemia
B.
Poisoning
C.
Fever
Your answer is correct.D.
Hypoxia
C
Fever
For the EMT who has cared for a pediatric patient in tragic? circumstances, which of the following would be an appropriate way of dealing with stress accompanying the? experience?
A.
Put the incident as your social media status and encourage others talk about it.
B.
Get together with others who participated in the care of the child and unwind with some alcoholic beverages.
C.
Talk to a compassionate coworker who has had similar experiences in the past.
Your answer is correct.D.
Vent your rage in a letter to the person responsible for the? child’s circumstances.
C
Talk to a compassionate coworker who has had similar experiences in the past.
You are called for a sick? 2-year-old boy. When you? arrive, you see the boy sitting quietly on his? mother’s lap. You note that he is not crying and has his head tucked against his? mother’s chest.? However, he does lift his head and look at you when you enter. As you? approach, he withdraws deeper toward his mother. What have you learned about the patient so? far?
A.
His front fontanelle is? sunken, likely from dehydration.
B.
He is alert and probably acting appropriately.
Your answer is correct.C.
He probably does not have a fever.
D.
His skin is warm and dry.
B
He is alert and probably acting appropriately.
You are assessing a child who is having problems breathing. Her mother states that she has been diagnosed with asthma and has recently started using an inhaler. Which of the following would indicate early respiratory? distress?
A.
Respiratory rate of 12
B.
Cyanosis of the nail beds and lips
C.
Nasal flaring
Your answer is correct.D.
Slow heart rate
C
Nasal flaring
Which of the following is NOT a component of the pediatric assessment? triangle?
A.
Circulation
B.
Breathing
C.
Abdomen
Your answer is correct.D.
Appearance
C
Abdomen
Which of the following signs may signify impending cardiac arrest in a? child?
A.
Respiratory rate over 60
Your answer is correct.B.
Pulse rate 80 in a? 5-year-old
C.
Pulse rate over 120
D.
Blood pressure of 105 systolic in a school age child
A
Respiratory rate over 60
Which of the following is the MOST common cause of death in? children?
A.
Infectious disease
Your answer is not correct.B.
Environmental emergencies
C.
Trauma
This is the correct answer.D.
Poisonings
C
Trauma
You have determined that your? patient, a? 6-year-old boy, most likely has epiglottitis. He has developed a high fever and appears very ill. You realize that this is a serious illness and you need to handle your patient carefully. You? should:
A.
have him lie down with his head elevated.
B.
give him ice chips to suck on.
C.
not place anything in his mouth.
Your answer is correct.D.
check his temperature regularly.
C
not place anything in his mouth.
A? 3-year-old child who burns both legs and arms has burned approximately? ________% of his entire body surface area.
A.
45
This is the correct answer.B.
36
Your answer is not correct.C.
72
D.
54
A
45
You respond to a? 5-year-old child who has been injured while playing in his backyard. It appears that he has broken his? arm, but you cannot tell how it occurred. You will need to gather some information regarding what exactly happened.? Therefore, you? should:
A.
tell the child that big boys? don’t cry.
B.
speak only to the mother to find out what happened.
C.
get down to the? child’s eye level to talk to him.
Your answer is correct.D.
tell the child that you will not hurt him.
C
get down to the? child’s eye level to talk to him.
You are standing in line waiting to get a prescription filled for your mother. A woman walks in with a young boy in her arms. As she places him in a nearby? chair, he begins to seize. Which of the following is true regarding childhood? seizures?
A.
They usually last from 1 to 2 minutes.
B.
They are often due to a rapid rise in temperature.
Your answer is correct.C.
They always accompany a high fever.
D.
Most are due to head injuries.
B
They are often due to a rapid rise in temperature.
Which of the following should increase your suspicion of child? abuse?
A.
Improperly healed? fractures, resulting in deformity of extremities
B.
Indications of alcohol? and/or drug abuse in the home
C.
Bruises on the back? and/or buttocks in various stages of healing
D.
All of the above
D
All of the above
Which of the following should be considered by the EMT as a result of the proportionally larger size of a small? child’s head?
A.
Differences in positioning to maintain an open airway
B.
Adaptations in positioning for cervical spine immobilization
C.
Different injury patterns than in adults
D.
All of the above
D
All of the above
Because infants and small children rely more heavily on the diaphragm for? breathing, respiratory distress can be detected by observing which one of the following signs that is not prominent in? adults?
A.
Use of the sternocleidomastoid muscles of the neck
B.
Movement of the abdomen with respiratory effort
Your answer is correct.C.
Bulging of the intercostal spaces
D.
None of the above
B
Movement of the abdomen with respiratory effort
You are at a? friend’s birthday party with people of all ages. There is an? 11-month-old boy, just learning to stand? up, who has fallen. He was holding onto the edge of a table and he toppled over. He is crying hard and his mother is trying to console him. She asks if you would mind checking him? out, and you agree to take a look at him. You notice that his anterior fontanelle is bulging. This is most likely caused? by:
A.
pressure built up because of his crying.
Your answer is correct.B.
fluid loss from dehydration.
C.
an infection causing intracranial pressure.
D.
the bones of the head not fusing properly.
A
pressure built up because of his crying.
The anterior fontanelle should be closed between the ages of? ________ and? ________.
A.
24? months; 36 months
B.
3? months; 6 months
C.
6? months; 10 months
D.
12? months; 18 months
D
12? months; 18 months
Your protocols call for you to use the pediatric assessment triangle when assessing young children. You know that the second leg of the triangle assesses the? “work of? breathing” and the bottom leg of the triangle assesses? “circulation to the? skin.” What does the first leg of the triangle stand? for?
A.
Alteration of mental status
B.
Appearance
Your answer is correct.C.
Airway
D.
Assessment
B
Appearance
Which of the following is the MOST common cause of cardiac arrest in the pediatric? patient?
A.
Respiratory failure
Your answer is correct.B.
Hypoglycemia
C.
Congenital heart defects
D.
Ventricular fibrillation
A
Respiratory failure
Which of the following is NOT a normal response of a small child when approached by the? EMT?
A.
Fear
B.
Anxiety
C.
Indifference
Your answer is correct.D.
None of the above
C
Indifference
All of the following are normal parental reactions to a child suffering from a sudden? life-threatening illness or injury except?:
A.
denial.
B.
indifference.
Your answer is correct.C.
guilt.
D.
anger.
B
indifference.
Your patient is an infant being treated for bronchopulmonary dysplasia. He is being weaned off his respirator by a process called intermittent mandatory ventilation. When you? arrive, you find the infant obviously hypoxic and? sick-looking. Which of the following treatments is? indicated?
A.
Oxygen administration
B.
Prompt transport to a neonatal center
C.
Ventilator support
D.
All of the above
D
All of the above
What is the tendency for a frightened child to act younger than his? age?
A.
Regression
Your answer is correct.B.
Retraction
C.
Retreat
D.
Repression
A
Regression
You have been called for a? 2-year-old female who has fallen and is bleeding from a head laceration. Her mother states that she was running down the hallway when she? fell, striking her head on a side table. You suspect that part of the reason she fell is? that:
A.
her head is proportionately larger and heavier than an? adult’s.
B.
she has low blood? sugar, making her unstable.
C.
she is still new to walking and may be unstable on her feet.
D.
both A and C are contributing factors.
D
both A and C are contributing factors.
Which of the following statements regarding child abuse is? correct?
A.
Children without siblings are at higher risk for abuse.
B.
There is no distinction as to race or economic background.
This is the correct answer.C.
Children with disabilities are rarely victims of abuse.
D.
Economic abuse is a common form of child abuse.
B
There is no distinction as to race or economic background.
Which of the following is an indication of shock in an infant or small? child?
A.
Capillary refill greater than 2 seconds
B.
Absence of tears when crying
C.
Not producing wet diapers
D.
All of the above
D
All of the above
Usually the first sign of respiratory distress in infants? is:
A.
bradycardia.
B.
tachycardia.
C.
tachypnea.
Your answer is correct.D.
bradypnea.
C
tachypnea.
Which of the following is NOT a cause of altered mental status in the pediatric? patient?
A.
Infection
B.
Traumatic brain injury
C.
Diabetes
D.
Dementia
D
Dementia
You are called for a? 6-year-old girl who is not well. Her mother says that the child has been sick for several days but today she has had trouble keeping her daughter awake. You note that the? girl’s capillary refill time is 4 seconds and she has a skin rash. The MOST important part of your assessment will be? to:
A.
recognize any respiratory distress.
Your answer is correct.B.
determine if she has a fever.
C.
get a full SAMPLE history.
D.
determine her level of consciousness.
A
recognize any respiratory distress.
You are trying to ventilate an? 18-month-old baby who has stopped breathing. You have laid him down on a flat surface to ventilate? him, but you are unable to get his chest to rise. You? should:
A.
place a folded towel under his shoulders.
Your answer is correct.B.
suction his mouth to clear secretions.
C.
flex his neck toward his chest.
D.
tip his head back farther to open his airway.
A
place a folded towel under his shoulders.
Which of the following is a consideration in airway management in the pediatric? patient?
A.
Using blind finger sweeps to clear a foreign body from the airway
B.
Keeping the nose clear of secretions
Your answer is correct.C.
The need to hyperextend the head to achieve an open airway
D.
All of the above
B
Keeping the nose clear of secretions
Which of the following is a classic characteristic of a child? abuser?
A.
Parent who spends majority of time with child
B.
Parent who is experiencing financial or marital stress
Your answer is not correct.C.
Parent who was abused as child
D.
All of the above
D
All of the above
You are assessing a? 2-year-old child whose mother states she has had a fever for several hours. Which of the following signs is cause for? concern?
A.
Crying
B.
Respiratory rate of 28 breaths per minute
C.
Absence of nasal flaring with inhalation
D.
Grunting at the end of expiration
D
Grunting at the end of expiration
Artificial ventilations for a? 5-year-old child should be provided at a rate of? ________ per minute.
A.
?12/20
Your answer is correct.B.
?24/28
C.
?22/26
D.
?28/32
A
12/20
Pop-off valves should be functional when ventilating the pediatric? patient:
A.
to avoid barotrauma to the lungs.
B.
to avoid causing a pneumothorax.
Your answer is not correct.C.
to avoid overinflation of the lungs.
D.
None of the above
D
None of the above
You are responding to a? 6-year-old child with a fever and difficulty breathing. His mother reports that he was playing normally this morning but when he came in for lunch he had spiked a fever.? Now, he is sitting up with his mouth? open, drooling. Which of the following signs would point to? epiglottitis?
A.
Painful swallowing
Your answer is correct.B.
Low grade fever
C.
Loud? “seal bark” cough
D.
Some hoarseness
A
Painful swallowing
You are trying to assess? Judy, a? 16-year-old girl, who has abdominal cramps with nausea and vomiting. Her? mother, Mrs.? Smith, is attempting to give you her? daughter’s past medical history. It is important that you get the history of the present illness.? Therefore, you? should:
A.
ignore Mrs. Smith and ask Judy if she is sexually active.
B.
ask Mrs. Smith to go write down their? physician’s name and phone number.
Your answer is correct.C.
skip the history of current illness and suggest that Judy should visit her physician.
D.
ask Mrs. Smith if there is a chance Judy could be pregnant.
B
ask Mrs. Smith to go write down their? physician’s name and phone number.
Your patient is a? 2-year-old female who has suffered a seizure but does not have a previous history of seizures. The? patient’s father states that the child has been pulling at her ear and has had a fever. They were getting ready to leave for a? doctor’s appointment when the child had a brief seizure. The patient is drowsy and has? hot, flushed skin. Which of the following is recommended in the prehospital management of this? patient?
A.
Cover the child with a towel soaked in ice water.
B.
Sponge the? child’s back and arms with rubbing alcohol.
C.
Place ice packs in the? armpits, groin, and around the head.
D.
Remove the? child’s clothing down to her underpants or diaper.
D
Remove the? child’s clothing down to her underpants or diaper.
Which of the following statements is true regarding child abuse? injuries?
A.
Head injuries are usually the first sign in child abuse.
B.
Splash burns indicate child abuse.
C.
Rib fractures in young children suggest child abuse.
Your answer is correct.D.
Shaken baby syndrome never causes death of the infant.
C
Rib fractures in young children suggest child abuse.
As a? rule, as a child gets older the blood? pressure:
A.
rises and the pulse rate falls.
Your answer is correct.B.
rises and the pulse rate rises.
C.
falls and the pulse rate falls.
D.
falls and the pulse rate rises.
A
rises and the pulse rate falls.
Which of the following is an early sign of respiratory distress in an? 18-month-old patient?
A.
Drowsiness
B.
Wheezing
C.
Respiratory rate of 12 breaths per minute
D.
Heart rate of 60 beats per minute
B
Wheezing

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