Chapter 35 (EMT)

A 4-year-old child is generally categorized as a(n):
Preschooler
In general, a child is considered an adolescent when he reaches the age of ________ years.
12
The anterior fontanelle should be closed between the ages of ________ and ________.
12 months; 18 months
A bulging fontanelle in a quietly resting child may be an indication of which of the following?
Increased intracranial pressure
Which of the following should be considered by the EMT as a result of the proportionally larger size of a small child’s head?
All of the above
Which of the following is a consideration in airway management in the pediatric patient?
Keeping the nose clear of secretions
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?
Movement of the abdomen with respiratory effort
What is the tendency for a frightened child to act younger than his age?
Regression
Which of the following would be an appropriate statement in gaining the cooperation of a 7-year-old pediatric patient during your assessment?
“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?”
Which of the following is a concern when dealing with an adolescent patient?
The adolescent patient fears permanent disfigurement from injuries.
All of the following are normal parental reactions to a child suffering from a sudden life-threatening illness or injury EXCEPT:
Indifference.
Careful assessment and ongoing evaluation of the pediatric patient is critical for which of the following reasons?
All of the above
Which of the following is NOT a component of the Pediatric Assessment Triangle?
Abdomen
Which of the following is true regarding the EMT’s approach to the pediatric patient?
An EMT does not have to attempt to obtain a blood pressure on patients younger than 3 years old.
Which of the following is NOT a normal response of a small child when approached by the EMT?
Indifference
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?
Grunting at the end of expiration
Capillary refill should be assessed in which of the following age groups?
Younger than 6 years
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?
Transport the child in a restrained car seat with his mother by his side.
Your patient is a 6-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?
Back slaps and chest thrusts
Artificial ventilations for a 5-year-old chi ld should be provided at a rate of ________ per minute.
12/20
Which of the following is NOT a common cause of shock in infants and children?
Heart failure
Which of the following is an indication of shock in an infant or small child?
All of the above
Which of the following is the most common cause of cardiac arrest in the pediatric patient
Respiratory failure
Your patient is a 3-year-old chi ld who is in severe respiratory distress. She is cyanotic and responds only to painful stimuli. According to the patient’s mother, the chi ld 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?
Begin gentle ventilations with a bag-valve mask and supplemental oxygen.
Which of the following is a sign of the most severe respiratory distress in a 1-year-old pediatric patient?
Decreased muscle tone
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 chi ld 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?
Remove the child’s clothing down to her underpants or diaper.
Which of the following is the MOST common cause of seizures in infants and chi ldren?
Fever
Which of the following is NOT a cause of altered mental status in the pediatric patient?
Dementia
Which of the following is the MOST common cause of death in children?
Trauma
Which of the following should increase your suspicion of child abuse?
All of the above
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?
Talk to a compassionate coworker who has had similar experiences in the past.
Which of the following is characteristic of preschool-age children?
They may believe their injury is a punishment for being bad.
Which of the following is NOT likely to be a cause of respiratory distress in a 2-year-old child?
Emphysema
Which of the following is an early sign of respiratory distress in an 18-month-old patient?
Wheezing
Which of the following is LEAST common in a child struck by a vehicle?
Upper-extremity injuries
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 toddling down the hallway when she fell, striking her head on a side table. You suspect that part of the reason she fell is that:
Both A and C are contributing factors.
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 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:
Pressure built up because of his crying.
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:
Place a folded towel under his shoulders.
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:
Ask Mrs. Smith to go write down their physician’s name and phone number.
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?
He is alert and probably acting appropriately.
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?
Appearance
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?
He begins to cry when you try to touch his booboo.
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 can’t tell how it occurred. You will need to gather some information regarding what exactly happened. Therefore, you should:
Get down to the child’s eye level to talk to him.
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?
Wheezing upon inspiration
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:
He child being hypothermic.
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:
Recognize any respiratory distress.
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?
Nasal flaring
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?
Painful swallowing
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:
Not place anything in his mouth.
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?
They are due to a rapid rise in temperature.