Pediatrics (6th edition)

Descripción

paramedic Pediatrics Test sobre Pediatrics (6th edition), creado por Jake Anderson el 04/09/2023.
Jake Anderson
Test por Jake Anderson, actualizado hace 8 meses
Jake Anderson
Creado por Jake Anderson hace 9 meses
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Resumen del Recurso

Pregunta 1

Pregunta
A viral infection of the pediatric upper airway that results in inflammation of the subglottic region is known​ as:
Respuesta
  • epiglottitis
  • bronchiolitis
  • croup
  • bronchitis

Pregunta 2

Pregunta
An inflammation of an airway structure that is often due to a bacterial infection in children and is known to be potentially life threatening​ is:
Respuesta
  • epiglottitis.
  • nasopharyngealitis.
  • laryngotracheobronchitis.
  • glottitis

Pregunta 3

Pregunta
Which of these is the best description of​ asthma?
Respuesta
  • Viral infection of the lower airways
  • Inflammatory disease of the lower airways
  • Bacterial infection of the lower airways
  • Bacterial or viral disease of the upper airways

Pregunta 4

Pregunta
What type of shock in the pediatric patient occurs when there is a marked decrease in peripheral vascular​ resistance?
Respuesta
  • Distributive
  • Cardiogenic
  • Hypovolemic
  • Obstructive

Pregunta 5

Pregunta
Which of these terms should be used to convey the preventable nature of childhood​ trauma?
Respuesta
  • Injury
  • Accident
  • Misadventure
  • Mishap

Pregunta 6

Pregunta
Which of these terms is best applied to the majority of childhood​ injuries?
Respuesta
  • Unavoidable
  • Inevitable
  • Preventable
  • Unforeseeable

Pregunta 7

Pregunta
Several large emergency medical services​ (EMS) systems have abandoned the practice of pediatric endotracheal intubation in favor of​ simple:
Respuesta
  • bag-valve mask​ (BVM) ventilation
  • rapid transport.
  • tracheotomy.
  • continuous positive airway pressure​ (CPAP).

Pregunta 8

Pregunta
The less frequently a paramedic uses a​ skill, the:
Respuesta
  • more likely that it is outside the scope of the​ paramedic's practice.
  • more frequently it should be practiced.
  • less time it will take to perform.
  • more likely it is never to be necessary.

Pregunta 9

Pregunta
While you are questioning a​ 4-year-old with abdominal​ pain, he tells you that his stomach started hurting last week. Which of the following should you do​ next?
Respuesta
  • Continue your interview with the parents because the child is unreliable.
  • Continue questioning the child but verify information with the parents.
  • Understand that pain of this duration is always an emergency.
  • Ask the parents why they waited so long to seek help.

Pregunta 10

Pregunta
You are caring for a​ 5-year-old who was injured when his older brother accidentally stabbed him in the thigh with a pocketknife. The patient has lost about 350 mL of blood. He is​ pale, with​ cool, diaphoretic​ skin, and is awake but very still. As part of your​ treatment, you have applied direct pressure to the​ wound, stopped the​ bleeding, and covered the patient with a blanket. The​ patient's mother is very upset and does not want to let go of the​ child's hand. How should you go about completing your​ treatment?
Respuesta
  • Ask the mother why the boys​ weren't supervised more closely.
  • Ask your partner to take the mother to another room so you can work.
  • Show the mother where to​ sit, so she can remain with the child while allowing you to work.
  • Tell the mother she needs to stay out of the way so you can do your work.

Pregunta 11

Pregunta
You are caring for a​ 6-year-old who was struck by a car on the street in front of her home in a very impoverished part of town. Her distraught father yells at you to hurry up and​ says, "If this was a kid on the other side of the​ tracks, you would be moving​ faster!" Which of the following is the most appropriate​ response?
Respuesta
  • "Sir, I can either pay attention to you and address your concerns or pay attention to your child. Please allow me to do my​ job."
  • ​"I know this is upsetting. We are moving as fast as we can without making her condition worse. As long as I have your word that you​ won't yell at​ us, you can ride in the​ ambulance, and we will tell you everything we are​ doing."
  • "Sir, if you​ don't calm​ down, the police are going to remove you from the​ scene."
  • "Don't yell at us. We were not the ones who were responsible for keeping her out of the​ street."

Pregunta 12

Pregunta
Generally, adolescents:
Respuesta
  • are unreliable witnesses.
  • are good historians.
  • defer to authority.
  • follow their​ parents' lead.

Pregunta 13

Pregunta
You are transporting a dehydrated​ 9-month-old who has had a​ fever, vomiting, and diarrhea for 12 hours. He is lethargic with​ pale, cool, mottled skin and capillary refill time of 4 seconds. His respiratory rate is​ 38, and you have initiated oxygen due to a low pulse oximeter reading and have started an intraosseous​ (IO) infusion followed by an initial bolus of fluid according to protocol. The​ patient's perfusion has not improved. Which of the following is the best choice with regard to fluid​ resuscitation?
Respuesta
  • Maintain the fluid at a​ keep-open rate.
  • Give a second bolus of 20​ mL/kg.
  • Infuse fluids​ wide-open.
  • Give a larger second bolus of 40​ mL/kg.

Pregunta 14

Pregunta
You should consider the heart rate of a​ 5-year-old patient to be bradycardic beginning at a rate below how many beats per​ minute?
Respuesta
  • 70
  • 60
  • 80
  • 90

Pregunta 15

Pregunta
Which of these is the most common cause of cardiac arrest in an infant or a young​ child?
Respuesta
  • Congenital heart disease
  • Airway and respiratory problems
  • Commotio cordis
  • Acute myocardial infarction

Pregunta 16

Pregunta
Compared to an​ adult's, an​ infant's or a​ child's:
Respuesta
  • lung tissues are more fragile.
  • ribs are harder and stiffer.
  • mediastinum is less mobile.
  • chest muscles tire less easily.

Pregunta 17

Pregunta
Above what respiratory rate would a​ 10-year-old child be considered to be breathing abnormally​ fast?
Respuesta
  • 36/min
  • 24/min
  • 20/min
  • 32/min

Pregunta 18

Pregunta
According to the pediatric assessment​ triangle, which of the following is used to assess the work of breathing when forming a general impression of the​ patient?
Respuesta
  • Auscultating the lung sounds
  • Presence of​ grunting, stridor,​ wheezing, and crowing
  • Heart rate
  • Skin color

Pregunta 19

Pregunta
What age should a pediatric patient be before blood pressures are routinely​ utilized?
Respuesta
  • 3 years
  • 1 month
  • 5 years
  • 1 year

Pregunta 20

Pregunta
According to the pediatric assessment​ triangle, which of the following is used to assess circulation to the​ skin?
Respuesta
  • Skin color
  • Capillary refill time
  • Skin temperature
  • Peripheral pulses

Pregunta 21

Pregunta
A​ 4-year-old male patient presents with​ stridor, a​ cough, and hoarseness when speaking. The paramedic​ should:
Respuesta
  • begin cardiopulmonary resuscitation​ (CPR).
  • place the patient in a position of comfort and transport immediately.
  • perform a series back blows followed by a series of chest thrusts.
  • perform a series of abdominal thrusts.

Pregunta 22

Pregunta
You are suctioning a​ 10-year-old female​ patient's airway following the patient having vomited. The patient has a decreased level of consciousness. You​ should:
Respuesta
  • suction no deeper than you can see.
  • stimulate the vagus nerve.
  • use the largest flexible catheter available.
  • decrease suction pressure to less than 100 mmHg.

Pregunta 23

Pregunta
An​ 8-year-old male patient presents with​ pale, cool, clammy​ skin; tachycardia and​ tachypnea; a weak peripheral​ pulse; and a decreased level of consciousness. The parents say the patient has been sick and vomiting with diarrhea for several days. According to his​ vitals, he is at the tail end of compensated​ shock, and his pulse oximeter reading is​ 90%. Your treatment should​ include:
Respuesta
  • administration of supplemental oxygen and establishment of IV access for a 20​ mL/kg bolus of normal saline.
  • establishment of IV access for a 100​ mL/kg bolus of lactated​ Ringer's.
  • Blow-by oxygen and rapid transport in a position of comfort.
  • ​intubation, continuous positive airway pressure​ (CPAP), and establishment of IV access for a​ wide-open bolus of normal saline.

Pregunta 24

Pregunta
A​ 7-year-old child is in cardiac arrest after experiencing respiratory arrest. Treatment for this patient should NOT​ include:
Respuesta
  • epinephrine administration every 10 minutes in the pediatric patient.
  • placement of an IV.
  • placement of an advanced airway.
  • administration of cardiopulmonary resuscitation​ (CPR).

Pregunta 25

Pregunta
What is the oxygenation goal for a pediatric patient receiving​ oxygen?
Respuesta
  • SpO2 of 94 percent or greater
  • SpO2 of 95 percent or greater except​ newborns, who should always receive​ 100% O2 until reaching the emergency department​ (ED) regardless of SpO2
  • SpO2 of 100 percent for pediatric patients without a history of pulmonary disease
  • A heart rate of 100 is reached

Pregunta 26

Pregunta
When performing ventilation on an infant receiving cardiopulmonary resuscitation​ (CPR), it may likely be necessary​ to:
Respuesta
  • utilize a​ flow-restricted, oxygen-powered ventilation device.
  • perform a needle cricothyrotomy.
  • hyperextend the neck to open the airway.
  • occlude the​ pop-off valve.

Pregunta 27

Pregunta
When does respiratory failure​ occur?
Respuesta
  • The patient experiences an increase in arterial carbon dioxide tension.
  • The patient experiences increased work of breathing.
  • The cessation of breathing follows a period of bradypnea and agonal respirations.
  • The respiratory system is unable to meet the​ body's demands for oxygen intake and carbon dioxide removal.

Pregunta 28

Pregunta
If​ present, which of the following findings should alert the paramedic that a child is in respiratory​ failure?
Respuesta
  • Profound cyanosis
  • Head bobbing
  • Grunting
  • Retractions

Pregunta 29

Pregunta
You are caring for a​ 2-year-old child who has been sick with a​ fever, diarrhea, and vomiting for 24 hours. To assess​ perfusion, which of these would provide you with the least reliable information about​ dehydration?
Respuesta
  • Dryness of mucous membranes
  • Warmth and color of skin
  • Mental status
  • Blood pressure​ (BP)

Pregunta 30

Pregunta
Which of the following presentations is most consistent with​ bronchiolitis?
Respuesta
  • Runny​ nose, sore​ throat, cough, and​ low-grade fever that progress to ear pain in 2 to 3 days
  • Mild lower respiratory infection signs and symptoms that progressively deteriorate over 1 to 2 days to respiratory distress with​ fever, cough,​ tachypnea, crackles in the​ lungs, and wheezing
  • Mild upper respiratory signs and symptoms that progress in 1 to 2 days to inspiratory​ stridor, hoarseness, and a​ "seal bark" cough at night
  • Rapid onset of high​ fever, dyspnea, inspiratory​ stridor, and drooling

Pregunta 31

Pregunta
In the secondary assessment of a​ 7-year-old child with difficulty breathing and a history of reactive airway​ disease, which of the following would give the paramedic the least amount of relevant information about the​ patient's ventilation and​ oxygenation?
Respuesta
  • Listening to the breath sounds
  • Pediatric Glasgow Coma Scale​ (GCS) score
  • Palpating the abdomen
  • Pulse oximetry reading

Pregunta 32

Pregunta
A​ seven-year-old female patient who was drowning in a pond was rescued and resuscitated prior to your arrival. It is a cold​ day, and the water soaking the​ patient's clothing is very cold. What can you assume for this​ patient?
Respuesta
  • The child experienced drowning without morbidity.
  • Having been​ resuscitated, the child will suffer no ill effects from anoxia.
  • The child is not in danger of neurological deficits because she only experienced a near drowning.
  • The low temperature of the water might have helped protect the child against brain injury.

Pregunta 33

Pregunta
Which of the following actions should you take if you suspect that your pediatric patient is a victim of​ abuse?
Respuesta
  • Report your findings to the appropriate​ authorities, including to the receiving hospital personnel.
  • Request a social services​ follow-up visit for after the child is discharged from the hospital.
  • Tell the parents that you are obligated by law to contact law enforcement and that they need to stay on the scene until law enforcement arrives.
  • Contact medical direction to report your suspicions and request direction about contacting law enforcement.

Pregunta 34

Pregunta
Which of the following findings seems least consistent with child​ abuse?
Respuesta
  • Bilateral foot burns in a​ 6-month-old
  • Bruises on both knees of a​ 5-year-old
  • Bite marks on the shoulder of a​ 1-year-old
  • Circumoral ecchymosis of a​ 3-month-old

Pregunta 35

Pregunta
What term is used to describe the situation in which a child is regularly​ threatened, yelled​ at, or humiliated but not otherwise​ harmed?
Respuesta
  • Social abuse
  • Psychological abuse
  • Physical abuse
  • Sexual abuse

Pregunta 36

Pregunta
Which of these statements is​ true?
Respuesta
  • The victims of sexual abuse typically do not know the perpetrators.
  • The paramedic always must report suspected sexual abuse to the appropriate authorities and the medical personnel who will be assuming care of the patient.
  • Something is not sexual abuse unless it involves an overt act involving physically touching the victim.
  • Sexual abuse typically causes physical harm and so rarely goes unreported for long.

Pregunta 37

Pregunta
Which of these statements best describes why paramedics should be knowledgeable about pediatric patients who are dependent on medical​ technology?
Respuesta
  • Emergency medical technicians​ (EMTs) must be able to make emergency repairs or adjustments to​ life-sustaining equipment.
  • Emergency medical services​ (EMS) may be called when the medical condition worsens or a medical device fails.
  • EMS providers are involved in routine home health care of patients with special medical challenges.
  • A public health function of EMS is to make routine checks of specialized medical devices.

Pregunta 38

Pregunta
What is a common complication of a tracheostomy tube that a mucus plug may​ cause?
Respuesta
  • Air embolism
  • Obstruction
  • Altered mental status
  • Air leakage

Pregunta 39

Pregunta
You are on scene with a pediatric patient who is obtunded due to a congenital brain defect. As you are assessing the​ patient, you note that she has a gastric feeding tube and currently is hooked up to a machine that is delivering a feeding. You have not seen this type of pump before and have little experience with gastric tubes. What action should you​ take?
Respuesta
  • Take the equipment with the patient.
  • Turn off the equipment in preparation for transport.
  • Disable any alarms on the equipment in preparation for transport.
  • Ask the patient and caregivers about the device.

Pregunta 40

Pregunta
When responding to a report of a patient with difficulty​ breathing, you find a pediatric male about 3 years old in a hospital bed at home. He is cared for 24 hours a day by his parents. You note a​ small, round tube that exits from the​ patient's neck, through which he is breathing. Given this​ finding, which of these devices does the patient most likely​ have?
Respuesta
  • Dual lumen catheter
  • Tracheostomy tube
  • Airway catheter
  • Endotracheal tube

Pregunta 41

Pregunta
JumpSTART provides a framework for triage decisions that​ is:
Respuesta
  • biased
  • objective
  • emotional
  • unjust

Pregunta 42

Pregunta
Which of the following best identifies the age group of patients who should be triaged by using the JumpSTART​ system?
Respuesta
  • School-age and adolescent children
  • Patients who look younger than a young adult
  • Toddlers and preschoolers
  • Infants, toddlers, and preschoolers

Pregunta 43

Pregunta
Which statement best describes the purpose of the JumpSTART triage​ method?
Respuesta
  • To find and treat all of a​ patient's injuries before moving him or her
  • To treat all patients as they are discovered
  • To do the most good for the greatest number of patients
  • To treat the​ youngest, healthiest patients first

Pregunta 44

Pregunta
High winds blew down a tent at an outdoor high school graduation reception. A fire started from the fuel used for the hot buffet. Several people were injured by the tent​ collapse, and several patients have burns. The first patient you triage is a​ 3-year-old girl. She is not breathing. You open her​ airway, but she does not start breathing. What is the next​ action?
Respuesta
  • Check the​ patient's pulse.
  • Categorize the patient as black.
  • Start cardiopulmonary resuscitation​ (CPR), beginning with chest compressions.
  • Deliver five rescue breaths.

Pregunta 45

Pregunta
You are called to a residence for a​ 7-year-old child in hypovolemic shock. You note evidence of severe​ dehydration, hypoxia, and malnutrition. The child is wearing dirty clothes and appears to be unwashed. The​ child's home is visibly unclean. What is your immediate​ priority?
Respuesta
  • Treat the child for​ shock, administering oxygen and establishing IV access for the replacement of fluids.
  • Call in law enforcement to take the caregivers into custody for neglect while maintaining a safe distance.
  • Immediately call in the case as child abuse.
  • Carefully question the​ child's caregivers about the​ child's circumstances.

Pregunta 46

Pregunta
You respond to a call for a​ 10-year-old patient who hit a road sign while traveling at high speed on a bicycle. The child is unconscious with no eye opening or motor or verbal response and has a severe contusion to the head. You note elevated blood pressure but a depressed heart rate with​ decreasing, deep respirations and an SpO2 of 92 percent. What do you assess as the​ problem, and how do you manage this​ patient?
Respuesta
  • Severe traumatic brain injury with increasing intracranial​ pressure, to be managed with rapid sequence intubation and rapid transport to a pediatric trauma facility
  • Mild traumatic brain injury with decreasing intracranial​ pressure, to be managed with rapid sequence​ intubation, ventilation, and rapid transport to a pediatric trauma facility
  • Moderate traumatic brain injury with increasing intracranial​ pressure, to be managed with endotracheal​ intubation, ventilation, and rapid transport to a pediatric trauma facility
  • Severe traumatic brain injury with increasing intracranial​ pressure, to be managed with rapid sequence​ intubation, ventilation, and rapid transport to a pediatric trauma facility

Pregunta 47

Pregunta
You note gastric distention in a​ 6-month-old patient experiencing respiratory failure you are attempting to ventilate but for whom you are not able to achieve adequate tidal volume. What do you​ do?
Respuesta
  • Administer a neuromuscular blocker.
  • Place a laryngeal mask airway.
  • Insert a 12 French nasogastric tube.
  • Insert an 8.0 French nasogastric tube.

Pregunta 48

Pregunta
A​ 12-year-old patient collided face first with another child while both were riding bikes. The patient bit his tongue when his jaw was struck and received a black right eye and bloody nose. He is alert and​ oriented, and after you suction some blood from his airway appears to have no respiratory​ compromise, with respirations clear bilaterally and​ 20/minute. Your index of suspicion should be high for what other​ injury?
Respuesta
  • Severe traumatic brain injury
  • Dental
  • Chest
  • Cervical spine
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