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Pediatric Nursing Exam 1 (PM)
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Question 1
Which of the following substances can be infused via an intraosseous needle?
A
Fluids or medications that are not acidic
B
All medications except sodium bicarbonate and dextrose
C
All medications and intravenous fluids
D
Only medications and fluids that have a neutral pH
Question 2
A 2-year-old girl who is having difficulty breathing and a barky cough has had a fever and runny nose for the past 3 days. She is alert and sitting on her mother s lap. Assessment reveals that she has warm, flushed skin, is using her abdominal muscles to breathe, and has increased work of breathing. She has a blood pressure of 88/66 mm Hg, a pulse of 128 beats/min, and respirations of 48 breaths/min. You should immediately determine whether the patient has:
A
stridor.
B
the ability to tolerate oral feedings.
C
delayed capillary refill time.
D
weak pulses.
Question 3
An 8-year-old boy fell 7 feet out of a tree, landing on his right arm and falling to his right side. He is crying and appears agitated. Assessment reveals that he has pale, warm skin, multiple abrasions on his right shoulder and hip, and a deformed right forearm. He has a blood pressure of 92/74 mm Hg, a pulse of 128 beats/min, and respirations of 32 breaths/min. What is the best approach to conducting the assessment of this patient?
A
Asking him if it is okay to listen to his lungs and touch his chest and stomach
B
Telling him he must lie still or he may become paralyzed
C
Asking him what hurts the most and begin by assessing that area of the body
D
Exposing only those areas currently being assessed and then covering them
Question 4
A 10-year-old girl is unresponsive when she surfaces after diving into a quarry. Bystanders report that she was shaking all over as they pulled her out of the water. The first step in caring for this patient is to:
A
turn her on her side to allow any water to drain from her mouth.
B
open her mouth and insert an oropharyngeal airway to maintain a patent airway.
C
stabilize her cervical spine to reduce the risk of further spinal injury.
D
elevate her head to reduce the risk of aspiration.
Question 5
When should the child s head be secured to the spine board during the immobilization procedure?
A
If the child is quiet the head does not need to be secured once lateral stabilization devices are applied
B
After the body straps and lateral stabilization devices have been applied
C
After the body straps have been applied, but before the lateral stabilization devices to ensure that the tape is applied tightly
D
Before any straps or lateral stabilization devices have been applied
Question 6
A 3-year-old boy who has a tracheostomy has had difficulty breathing and coughing for 2 days because of increased secretions. He is on continuous oxygen. His mother states that his breathing is getting much worse. Assessment reveals that he is lethargic, has cool, mottled skin, and has copious secretions in the tracheostomy tube. Which of the following signs suggests significant obstruction of the tracheostomy tube?
A
A slow heart rate and poor air exchange
B
Irregular respirations and wheezing
C
Unequal chest rise and wheezing
D
Crackles and decreased breath sounds
Question 7
An 18-month-old boy who reportedly fell down the stairs earlier in the day just isn t acting right, according to his caregivers. Assessment reveals multiple bruises on his thighs and back and a deformity of his right thigh. He is alert and crying. What is the best way to interact with the caregivers?
A
Contact the local law enforcement agency to request that the caregiver be arrested while you transport the child.
B
Ask them why they waited so long to call for help; the delay has made the child very sick; therefore, you will need to administer oxygen and establish an IV.
C
Confront them by telling them you know that this injury could not have occurred from a fall; therefore, you are obligated to take him to the hospital.
D
Explain that you are very concerned about the child s condition and that he needs to be examined at the hospital for a possible a broken leg.
Question 8
A 3-month-old infant who is extremely lethargic has had a cough, vomiting, and diarrhea for the past 3 days. Assessment reveals that he responds to pain, has mottled skin color, and a capillary refill time of 4 seconds. He has a blood pressure of 74/60 mm Hg, a pulse of 190 beats/min, and rapid, respirations without increased work of breathing at 60 breaths/min. The appropriate initial treatment is to:
A
administer 100% oxygen by mask.
B
administer epinephrine via an intraosseous needle.
C
perform endotracheal intubation.
D
administer dopamine intravenously.
Question 9
What is the danger of using a mask that is too large on a child who requires ventilatory assistance?
A
It will be more difficult to obtain a seal for ventilation
B
Eye injuries may occur from the mask touching the globe
C
More pressure will need to be applied to obtain a mask seal, which may cause dislocation of the mandible
D
If the mask extends across the eyes, it may exert pressure and stimulate the vagus nerve
Question 10
During transport, what is the correct way to manage the respiratory status of a boy who is on a ventilator but also breathes on his own?
A
Allow the patient to remain on the ventilator if he is not in respiratory distress
B
Decrease the flow rate as the oxygen in the ambulance is more potent and requires a lower flow rate
C
Immediately deliver bag-valve-mask ventilations because you may not be familiar with the ventilator
D
Switch the patient to oxygen by blow-by method because the ventilator will not work in the ambulance
Question 11
A 2-year-old girl who is having difficulty breathing and a barky cough has had a fever and runny nose for the past 3 days. She is alert and sitting on her mother s lap. Assessment reveals that she has warm, flushed skin, is using her abdominal muscles to breathe, and has increased work of breathing. She has a blood pressure of 88/66 mm Hg, a pulse of 128 beats/min, and respirations of 48 breaths/min. The first step in treatment is to:
A
suction the oropharynx for secretion.
B
administer a nebulizer treatment with a beta-agonist medication.
C
administer humidified oxygen via blow-by method.
D
deliver bag-valve-mask ventilations.
Question 12
A 6-month-old infant who is being cared for by a babysitter is unresponsive and has warm, pink skin and respirations without increased work of breathing.. The babysitter appears anxious and frustrated and explains that the infant had been crying for hours and would not stop. The babysitter states, “I couldn t get her to stop crying. I tried everything. All of a sudden she got really quiet, and I couldn’t wake her up. Please help her. I can’t take her crying any more.” The babysitter states that she does not think that the infant has been sick recently. The infant s altered level of consciousness is most likely due to:
A
seizures.
B
respiratory failure.
C
toxic exposure.
D
shaken baby syndrome.
Question 13
An 8-year-old boy fell 7 feet out of a tree, landing on his right arm and falling to his right side. He is crying and appears agitated. Assessment reveals that he has pale, warm skin, multiple abrasions on his right shoulder and hip, and a deformed right forearm. He has a blood pressure of 92/74 mm Hg, a pulse of 128 beats/min, and respirations of 32 breaths/min. What is the most likely cause for the abnormal appearance of this patient?
A
Hypothermia
B
Secondary brain injury
C
Hypoxia
D
Pain
Question 14
An 8-year-old boy fell 7 feet out of a tree, landing on his right arm and falling to his right side. He is crying and appears agitated. Assessment reveals that he has pale, warm skin, multiple abrasions on his right shoulder and hip, and a deformed right forearm. He has a blood pressure of 92/74 mm Hg, a pulse of 128 beats/min, and respirations of 32 breaths/min. After completing your initial assessment, the first step in caring for this patient is to:
A
manually stabilize the cervical spine to reduce the risk of spinal injury.
B
initiate hyperventilation to reduce the accumulation of acids in the body.
C
place him in a position of comfort to decrease anxiety.
D
cover him with blankets to prevent heat loss.
Question 15
Which of the following findings in a 2-year-old child assists in identifying the cause of a grand mal seizure?
A
Crackles in the lungs
B
Fever
C
Abdominal tenderness
D
Cardiac dysrhythmia
Question 16
A 3-month-old infant who is extremely lethargic has had a cough, vomiting, and diarrhea for the past 3 days. Assessment reveals that he responds to pain, has mottled skin color, and a capillary refill time of 4 seconds. He has a blood pressure of 74/60 mm Hg, a pulse of 190 beats/min, and rapid, respirations without increased work of breathing at 60 breaths/min. The tachycardia in this infant is most likely due to:
A
swelling of the brain.
B
anxiety.
C
hypovolemia.
D
pneumothorax.
Question 17
What is the correct method to confirm proper placement of an endotracheal tube?
A
Observe for gastric distention which indicates leakage of air around the tube in the trachea
B
Auscultate for bubbling or gurgling sounds over the epigastrium and breath sounds at the midaxillary regions
C
Palpate for chest rise and fall over the anterior chest and abdomen
D
Auscultate the anterior chest and mid-abdominal area for the presence of bubbling or gurgling sounds
Question 18
A 2-year-old girl who is having difficulty breathing and a barky cough has had a fever and runny nose for the past 3 days. She is alert and sitting on her mother s lap. Assessment reveals that she has warm, flushed skin, is using her abdominal muscles to breathe, and has increased work of breathing. She has a blood pressure of 88/66 mm Hg, a pulse of 128 beats/min, and respirations of 48 breaths/min. Abdominal breathing in this patient should be viewed as a:
A
normal finding for a toddler.
B
sign of impending respiratory failure.
C
sign of decreased perfusion to the respiratory center.
D
compensatory mechanism to increase the volume of air inhaled and respiratory rate.
Question 19
Assessment of a newborn five minutes after delivery reveals cyanosis of the hands, feet, trunk, and face. Vital signs are pulse 160 beats/min and respirations 44 breaths/min. Treatment of this newborn includes:
A
applying free flow oxygen by mask at 5 L/min.
B
reassessing the skin color in five minutes and then initiating oxygen therapy if needed.
C
performing intubation and positive pressure ventilation.
D
initiating bag-valve-mask ventilations.
Question 20
An infant should be immediately evaluated by a physician if which of the following signs or symptoms are present?
A
Refuses a pacifier
B
Use of abdominal muscles to breathe
C
Acting fussier than normal
D
Temperature of 37 degrees (98.6 F)
Question 21
Ascertaining the due date of a newborn during an impending delivery helps you to:
A
decide if an on-scene delivery is needed, particularly if the infant is premature, as the labor is often shorter for these infants.
B
determine if meconium aspiration may have occurred.
C
decide whether the baby will be delivered at the scene or if there is time to transport the mother to the hospital.
D
assemble the correct size of equipment to care for the baby.
Question 22
A woman who is about to deliver a baby at home reports that the fluid was thick green when her bag of waters broke. The most important treatment of the newborn is to:
A
vigorously dry and warm the baby.
B
copiously suction the mouth and nose.
C
administer oxygen by nasal cannula at 4 L/min.
D
calculate the APGAR score.
Question 23
A 6-year-old boy who was struck by a car while he was riding his bicycle is unresponsive and has pale, cool skin. Assessment reveals abrasions to his left shoulder and back and a swollen, deformed left thigh. He has a blood pressure of 74/62 mm Hg, a pulse of 152 beats/min, and respirations of 44 breaths/min. without increased work of breathing. What do these findings tell you about the patient s condition?
A
His heart rate is fast because of pain in his shoulder and leg
B
His blood pressure is low because compensatory mechanisms for blood loss are failing
C
He is unresponsive and his skin is cool because of a low body temperature from being outside
D
His respirations are fast because the impact affected the respiratory center in his brain
Question 24
Activated charcoal is contraindicated in a patient who has ingested a toxic substance if:
A
there is a history of diarrhea or vomiting.
B
the substance was ingested approximately one hour ago.
C
the substance was corrosive.
D
there is a history of abdominal surgery.
Question 25
What information is important to obtain about a child with smoke inhalation?
A
Position of the patient when found
B
Location in the room where the patient was found
C
Presence of windows or ventilation in the room
D
History of recent cold symptoms
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Exam Mode – Questions and choices are randomly arranged, time limit of 1min per question, answers and grade will be revealed after finishing the exam.
Pediatric Nursing Exam 1 (EM)
Choose the letter of the correct answer. You got 25 minutes to finish the exam .Good luck!
Start
Congratulations - you have completed Pediatric Nursing Exam 1 (EM).
You scored %%SCORE%% out of %%TOTAL%%.
Your performance has been rated as %%RATING%%
Your answers are highlighted below.
Question 1
Which of the following findings in a 2-year-old child assists in identifying the cause of a grand mal seizure?
A
Abdominal tenderness
B
Cardiac dysrhythmia
C
Crackles in the lungs
D
Fever
Question 2
Which of the following substances can be infused via an intraosseous needle?
A
Only medications and fluids that have a neutral pH
B
All medications except sodium bicarbonate and dextrose
C
Fluids or medications that are not acidic
D
All medications and intravenous fluids
Question 3
A woman who is about to deliver a baby at home reports that the fluid was thick green when her bag of waters broke. The most important treatment of the newborn is to:
A
calculate the APGAR score.
B
administer oxygen by nasal cannula at 4 L/min.
C
copiously suction the mouth and nose.
D
vigorously dry and warm the baby.
Question 4
When should the child s head be secured to the spine board during the immobilization procedure?
A
After the body straps and lateral stabilization devices have been applied
B
Before any straps or lateral stabilization devices have been applied
C
If the child is quiet the head does not need to be secured once lateral stabilization devices are applied
D
After the body straps have been applied, but before the lateral stabilization devices to ensure that the tape is applied tightly
Question 5
A 3-year-old boy who has a tracheostomy has had difficulty breathing and coughing for 2 days because of increased secretions. He is on continuous oxygen. His mother states that his breathing is getting much worse. Assessment reveals that he is lethargic, has cool, mottled skin, and has copious secretions in the tracheostomy tube. Which of the following signs suggests significant obstruction of the tracheostomy tube?
A
Unequal chest rise and wheezing
B
Crackles and decreased breath sounds
C
Irregular respirations and wheezing
D
A slow heart rate and poor air exchange
Question 6
An 18-month-old boy who reportedly fell down the stairs earlier in the day just isn t acting right, according to his caregivers. Assessment reveals multiple bruises on his thighs and back and a deformity of his right thigh. He is alert and crying. What is the best way to interact with the caregivers?
A
Ask them why they waited so long to call for help; the delay has made the child very sick; therefore, you will need to administer oxygen and establish an IV.
B
Contact the local law enforcement agency to request that the caregiver be arrested while you transport the child.
C
Explain that you are very concerned about the child s condition and that he needs to be examined at the hospital for a possible a broken leg.
D
Confront them by telling them you know that this injury could not have occurred from a fall; therefore, you are obligated to take him to the hospital.
Question 7
A 2-year-old girl who is having difficulty breathing and a barky cough has had a fever and runny nose for the past 3 days. She is alert and sitting on her mother s lap. Assessment reveals that she has warm, flushed skin, is using her abdominal muscles to breathe, and has increased work of breathing. She has a blood pressure of 88/66 mm Hg, a pulse of 128 beats/min, and respirations of 48 breaths/min. You should immediately determine whether the patient has:
A
stridor.
B
weak pulses.
C
delayed capillary refill time.
D
the ability to tolerate oral feedings.
Question 8
A 10-year-old girl is unresponsive when she surfaces after diving into a quarry. Bystanders report that she was shaking all over as they pulled her out of the water. The first step in caring for this patient is to:
A
stabilize her cervical spine to reduce the risk of further spinal injury.
B
turn her on her side to allow any water to drain from her mouth.
C
open her mouth and insert an oropharyngeal airway to maintain a patent airway.
D
elevate her head to reduce the risk of aspiration.
Question 9
An 8-year-old boy fell 7 feet out of a tree, landing on his right arm and falling to his right side. He is crying and appears agitated. Assessment reveals that he has pale, warm skin, multiple abrasions on his right shoulder and hip, and a deformed right forearm. He has a blood pressure of 92/74 mm Hg, a pulse of 128 beats/min, and respirations of 32 breaths/min. After completing your initial assessment, the first step in caring for this patient is to:
A
place him in a position of comfort to decrease anxiety.
B
manually stabilize the cervical spine to reduce the risk of spinal injury.
C
cover him with blankets to prevent heat loss.
D
initiate hyperventilation to reduce the accumulation of acids in the body.
Question 10
A 3-month-old infant who is extremely lethargic has had a cough, vomiting, and diarrhea for the past 3 days. Assessment reveals that he responds to pain, has mottled skin color, and a capillary refill time of 4 seconds. He has a blood pressure of 74/60 mm Hg, a pulse of 190 beats/min, and rapid, respirations without increased work of breathing at 60 breaths/min. The appropriate initial treatment is to:
A
administer 100% oxygen by mask.
B
administer dopamine intravenously.
C
administer epinephrine via an intraosseous needle.
D
perform endotracheal intubation.
Question 11
A 6-month-old infant who is being cared for by a babysitter is unresponsive and has warm, pink skin and respirations without increased work of breathing.. The babysitter appears anxious and frustrated and explains that the infant had been crying for hours and would not stop. The babysitter states, “I couldn t get her to stop crying. I tried everything. All of a sudden she got really quiet, and I couldn’t wake her up. Please help her. I can’t take her crying any more.” The babysitter states that she does not think that the infant has been sick recently. The infant s altered level of consciousness is most likely due to:
A
toxic exposure.
B
respiratory failure.
C
shaken baby syndrome.
D
seizures.
Question 12
An 8-year-old boy fell 7 feet out of a tree, landing on his right arm and falling to his right side. He is crying and appears agitated. Assessment reveals that he has pale, warm skin, multiple abrasions on his right shoulder and hip, and a deformed right forearm. He has a blood pressure of 92/74 mm Hg, a pulse of 128 beats/min, and respirations of 32 breaths/min. What is the most likely cause for the abnormal appearance of this patient?
A
Pain
B
Secondary brain injury
C
Hypoxia
D
Hypothermia
Question 13
Assessment of a newborn five minutes after delivery reveals cyanosis of the hands, feet, trunk, and face. Vital signs are pulse 160 beats/min and respirations 44 breaths/min. Treatment of this newborn includes:
A
applying free flow oxygen by mask at 5 L/min.
B
initiating bag-valve-mask ventilations.
C
performing intubation and positive pressure ventilation.
D
reassessing the skin color in five minutes and then initiating oxygen therapy if needed.
Question 14
A 6-year-old boy who was struck by a car while he was riding his bicycle is unresponsive and has pale, cool skin. Assessment reveals abrasions to his left shoulder and back and a swollen, deformed left thigh. He has a blood pressure of 74/62 mm Hg, a pulse of 152 beats/min, and respirations of 44 breaths/min. without increased work of breathing. What do these findings tell you about the patient s condition?
A
His blood pressure is low because compensatory mechanisms for blood loss are failing
B
His heart rate is fast because of pain in his shoulder and leg
C
His respirations are fast because the impact affected the respiratory center in his brain
D
He is unresponsive and his skin is cool because of a low body temperature from being outside
Question 15
Ascertaining the due date of a newborn during an impending delivery helps you to:
A
determine if meconium aspiration may have occurred.
B
decide if an on-scene delivery is needed, particularly if the infant is premature, as the labor is often shorter for these infants.
C
assemble the correct size of equipment to care for the baby.
D
decide whether the baby will be delivered at the scene or if there is time to transport the mother to the hospital.
Question 16
During transport, what is the correct way to manage the respiratory status of a boy who is on a ventilator but also breathes on his own?
A
Immediately deliver bag-valve-mask ventilations because you may not be familiar with the ventilator
B
Allow the patient to remain on the ventilator if he is not in respiratory distress
C
Decrease the flow rate as the oxygen in the ambulance is more potent and requires a lower flow rate
D
Switch the patient to oxygen by blow-by method because the ventilator will not work in the ambulance
Question 17
An infant should be immediately evaluated by a physician if which of the following signs or symptoms are present?
A
Acting fussier than normal
B
Temperature of 37 degrees (98.6 F)
C
Refuses a pacifier
D
Use of abdominal muscles to breathe
Question 18
What is the correct method to confirm proper placement of an endotracheal tube?
A
Auscultate the anterior chest and mid-abdominal area for the presence of bubbling or gurgling sounds
B
Auscultate for bubbling or gurgling sounds over the epigastrium and breath sounds at the midaxillary regions
C
Observe for gastric distention which indicates leakage of air around the tube in the trachea
D
Palpate for chest rise and fall over the anterior chest and abdomen
Question 19
An 8-year-old boy fell 7 feet out of a tree, landing on his right arm and falling to his right side. He is crying and appears agitated. Assessment reveals that he has pale, warm skin, multiple abrasions on his right shoulder and hip, and a deformed right forearm. He has a blood pressure of 92/74 mm Hg, a pulse of 128 beats/min, and respirations of 32 breaths/min. What is the best approach to conducting the assessment of this patient?
A
Telling him he must lie still or he may become paralyzed
B
Asking him if it is okay to listen to his lungs and touch his chest and stomach
C
Exposing only those areas currently being assessed and then covering them
D
Asking him what hurts the most and begin by assessing that area of the body
Question 20
Activated charcoal is contraindicated in a patient who has ingested a toxic substance if:
A
there is a history of diarrhea or vomiting.
B
there is a history of abdominal surgery.
C
the substance was corrosive.
D
the substance was ingested approximately one hour ago.
Question 21
A 2-year-old girl who is having difficulty breathing and a barky cough has had a fever and runny nose for the past 3 days. She is alert and sitting on her mother s lap. Assessment reveals that she has warm, flushed skin, is using her abdominal muscles to breathe, and has increased work of breathing. She has a blood pressure of 88/66 mm Hg, a pulse of 128 beats/min, and respirations of 48 breaths/min. The first step in treatment is to:
A
administer a nebulizer treatment with a beta-agonist medication.
B
administer humidified oxygen via blow-by method.
C
suction the oropharynx for secretion.
D
deliver bag-valve-mask ventilations.
Question 22
What information is important to obtain about a child with smoke inhalation?
A
Position of the patient when found
B
Location in the room where the patient was found
C
History of recent cold symptoms
D
Presence of windows or ventilation in the room
Question 23
A 2-year-old girl who is having difficulty breathing and a barky cough has had a fever and runny nose for the past 3 days. She is alert and sitting on her mother s lap. Assessment reveals that she has warm, flushed skin, is using her abdominal muscles to breathe, and has increased work of breathing. She has a blood pressure of 88/66 mm Hg, a pulse of 128 beats/min, and respirations of 48 breaths/min. Abdominal breathing in this patient should be viewed as a:
A
sign of impending respiratory failure.
B
sign of decreased perfusion to the respiratory center.
C
normal finding for a toddler.
D
compensatory mechanism to increase the volume of air inhaled and respiratory rate.
Question 24
What is the danger of using a mask that is too large on a child who requires ventilatory assistance?
A
It will be more difficult to obtain a seal for ventilation
B
Eye injuries may occur from the mask touching the globe
C
More pressure will need to be applied to obtain a mask seal, which may cause dislocation of the mandible
D
If the mask extends across the eyes, it may exert pressure and stimulate the vagus nerve
Question 25
A 3-month-old infant who is extremely lethargic has had a cough, vomiting, and diarrhea for the past 3 days. Assessment reveals that he responds to pain, has mottled skin color, and a capillary refill time of 4 seconds. He has a blood pressure of 74/60 mm Hg, a pulse of 190 beats/min, and rapid, respirations without increased work of breathing at 60 breaths/min. The tachycardia in this infant is most likely due to:
A
anxiety.
B
swelling of the brain.
C
hypovolemia.
D
pneumothorax.
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1.A 2-year-old girl who is having difficulty breathing and a barky cough has had a fever and runny nose for the past 3 days. She is alert and sitting on her mother s lap. Assessment reveals that she has warm, flushed skin, is using her abdominal muscles to breathe, and has increased work of breathing. She has a blood pressure of 88/66 mm Hg, a pulse of 128 beats/min, and respirations of 48 breaths/min. You should immediately determine whether the patient has:
stridor.
delayed capillary refill time.
weak pulses.
the ability to tolerate oral feedings.
2.A 2-year-old girl who is having difficulty breathing and a barky cough has had a fever and runny nose for the past 3 days. She is alert and sitting on her mother s lap. Assessment reveals that she has warm, flushed skin, is using her abdominal muscles to breathe, and has increased work of breathing. She has a blood pressure of 88/66 mm Hg, a pulse of 128 beats/min, and respirations of 48 breaths/min. Abdominal breathing in this patient should be viewed as a:
normal finding for a toddler.
sign of impending respiratory failure.
sign of decreased perfusion to the respiratory center.
compensatory mechanism to increase the volume of air inhaled and respiratory rate.
3.A 2-year-old girl who is having difficulty breathing and a barky cough has had a fever and runny nose for the past 3 days. She is alert and sitting on her mother s lap. Assessment reveals that she has warm, flushed skin, is using her abdominal muscles to breathe, and has increased work of breathing. She has a blood pressure of 88/66 mm Hg, a pulse of 128 beats/min, and respirations of 48 breaths/min. The first step in treatment is to:
administer a nebulizer treatment with a beta-agonist medication.
administer humidified oxygen via blow-by method.
suction the oropharynx for secretion.
deliver bag-valve-mask ventilations.
4.A 6-year-old boy who was struck by a car while he was riding his bicycle is unresponsive and has pale, cool skin. Assessment reveals abrasions to his left shoulder and back and a swollen, deformed left thigh. He has a blood pressure of 74/62 mm Hg, a pulse of 152 beats/min, and respirations of 44 breaths/min. without increased work of breathing. What do these findings tell you about the patient s condition?
He is unresponsive and his skin is cool because of a low body temperature from being outside
His heart rate is fast because of pain in his shoulder and leg
His respirations are fast because the impact affected the respiratory center in his brain
His blood pressure is low because compensatory mechanisms for blood loss are failing
5.A 3-month-old infant who is extremely lethargic has had a cough, vomiting, and diarrhea for the past 3 days. Assessment reveals that he responds to pain, has mottled skin color, and a capillary refill time of 4 seconds. He has a blood pressure of 74/60 mm Hg, a pulse of 190 beats/min, and rapid, respirations without increased work of breathing at 60 breaths/min. The tachycardia in this infant is most likely due to:
anxiety.
hypovolemia.
pneumothorax.
swelling of the brain.
6.A 3-month-old infant who is extremely lethargic has had a cough, vomiting, and diarrhea for the past 3 days. Assessment reveals that he responds to pain, has mottled skin color, and a capillary refill time of 4 seconds. He has a blood pressure of 74/60 mm Hg, a pulse of 190 beats/min, and rapid, respirations without increased work of breathing at 60 breaths/min. The appropriate initial treatment is to:
administer 100% oxygen by mask.
administer dopamine intravenously.
administer epinephrine via an intraosseous needle.
perform endotracheal intubation.
7.Which of the following findings in a 2-year-old child assists in identifying the cause of a grand mal seizure?
Fever
Crackles in the lungs
Abdominal tenderness
Cardiac dysrhythmia
8.Activated charcoal is contraindicated in a patient who has ingested a toxic substance if:
there is a history of abdominal surgery.
there is a history of diarrhea or vomiting.
the substance was corrosive.
the substance was ingested approximately one hour ago.
9.A 10-year-old girl is unresponsive when she surfaces after diving into a quarry. Bystanders report that she was shaking all over as they pulled her out of the water. The first step in caring for this patient is to:
stabilize her cervical spine to reduce the risk of further spinal injury.
elevate her head to reduce the risk of aspiration.
turn her on her side to allow any water to drain from her mouth.
open her mouth and insert an oropharyngeal airway to maintain a patent airway.
10.An 8-year-old boy fell 7 feet out of a tree, landing on his right arm and falling to his right side. He is crying and appears agitated. Assessment reveals that he has pale, warm skin, multiple abrasions on his right shoulder and hip, and a deformed right forearm. He has a blood pressure of 92/74 mm Hg, a pulse of 128 beats/min, and respirations of 32 breaths/min. What is the best approach to conducting the assessment of this patient?
Telling him he must lie still or he may become paralyzed
Exposing only those areas currently being assessed and then covering them
Asking him if it is okay to listen to his lungs and touch his chest and stomach
Asking him what hurts the most and begin by assessing that area of the body
11.An 8-year-old boy fell 7 feet out of a tree, landing on his right arm and falling to his right side. He is crying and appears agitated. Assessment reveals that he has pale, warm skin, multiple abrasions on his right shoulder and hip, and a deformed right forearm. He has a blood pressure of 92/74 mm Hg, a pulse of 128 beats/min, and respirations of 32 breaths/min. After completing your initial assessment, the first step in caring for this patient is to:
manually stabilize the cervical spine to reduce the risk of spinal injury.
initiate hyperventilation to reduce the accumulation of acids in the body.
cover him with blankets to prevent heat loss.
place him in a position of comfort to decrease anxiety.
12.An 8-year-old boy fell 7 feet out of a tree, landing on his right arm and falling to his right side. He is crying and appears agitated. Assessment reveals that he has pale, warm skin, multiple abrasions on his right shoulder and hip, and a deformed right forearm. He has a blood pressure of 92/74 mm Hg, a pulse of 128 beats/min, and respirations of 32 breaths/min. What is the most likely cause for the abnormal appearance of this patient?
Secondary brain injury
Hypoxia
Pain
Hypothermia
13.What information is important to obtain about a child with smoke inhalation?
Presence of windows or ventilation in the room
Position of the patient when found
History of recent cold symptoms
Location in the room where the patient was found
14.A 6-month-old infant who is being cared for by a babysitter is unresponsive and has warm, pink skin and respirations without increased work of breathing.. The babysitter appears anxious and frustrated and explains that the infant had been crying for hours and would not stop. The babysitter states, “I couldn t get her to stop crying. I tried everything. All of a sudden she got really quiet, and I couldn’t wake her up. Please help her. I can’t take her crying any more.” The babysitter states that she does not think that the infant has been sick recently. The infant s altered level of consciousness is most likely due to:
toxic exposure.
shaken baby syndrome.
seizures.
respiratory failure.
15.An 18-month-old boy who reportedly fell down the stairs earlier in the day just isn t acting right, according to his caregivers. Assessment reveals multiple bruises on his thighs and back and a deformity of his right thigh. He is alert and crying. What is the best way to interact with the caregivers?
Confront them by telling them you know that this injury could not have occurred from a fall; therefore, you are obligated to take him to the hospital.
Ask them why they waited so long to call for help; the delay has made the child very sick; therefore, you will need to administer oxygen and establish an IV.
Contact the local law enforcement agency to request that the caregiver be arrested while you transport the child.
Explain that you are very concerned about the child s condition and that he needs to be examined at the hospital for a possible a broken leg.
16.A woman who is about to deliver a baby at home reports that the fluid was thick green when her bag of waters broke. The most important treatment of the newborn is to:
vigorously dry and warm the baby.
copiously suction the mouth and nose.
administer oxygen by nasal cannula at 4 L/min.
calculate the APGAR score.
17.Ascertaining the due date of a newborn during an impending delivery helps you to:
assemble the correct size of equipment to care for the baby.
decide whether the baby will be delivered at the scene or if there is time to transport the mother to the hospital.
decide if an on-scene delivery is needed, particularly if the infant is premature, as the labor is often shorter for these infants.
determine if meconium aspiration may have occurred.
18.Assessment of a newborn five minutes after delivery reveals cyanosis of the hands, feet, trunk, and face. Vital signs are pulse 160 beats/min and respirations 44 breaths/min. Treatment of this newborn includes:
initiating bag-valve-mask ventilations.
performing intubation and positive pressure ventilation.
applying free flow oxygen by mask at 5 L/min.
reassessing the skin color in five minutes and then initiating oxygen therapy if needed.
19.An infant should be immediately evaluated by a physician if which of the following signs or symptoms are present?
Use of abdominal muscles to breathe
Temperature of 37 degrees (98.6 F)
Acting fussier than normal
Refuses a pacifier
20.A 3-year-old boy who has a tracheostomy has had difficulty breathing and coughing for 2 days because of increased secretions. He is on continuous oxygen. His mother states that his breathing is getting much worse. Assessment reveals that he is lethargic, has cool, mottled skin, and has copious secretions in the tracheostomy tube. Which of the following signs suggests significant obstruction of the tracheostomy tube?
A slow heart rate and poor air exchange
Irregular respirations and wheezing
Crackles and decreased breath sounds
Unequal chest rise and wheezing
21.During transport, what is the correct way to manage the respiratory status of a boy who is on a ventilator but also breathes on his own?
Allow the patient to remain on the ventilator if he is not in respiratory distress
Immediately deliver bag-valve-mask ventilations because you may not be familiar with the ventilator
Switch the patient to oxygen by blow-by method because the ventilator will not work in the ambulance
Decrease the flow rate as the oxygen in the ambulance is more potent and requires a lower flow rate
22.What is the danger of using a mask that is too large on a child who requires ventilatory assistance?
Eye injuries may occur from the mask touching the globe
It will be more difficult to obtain a seal for ventilation
More pressure will need to be applied to obtain a mask seal, which may cause dislocation of the mandible
If the mask extends across the eyes, it may exert pressure and stimulate the vagus nerve
23.What is the correct method to confirm proper placement of an endotracheal tube?
Palpate for chest rise and fall over the anterior chest and abdomen
Observe for gastric distention which indicates leakage of air around the tube in the trachea
Auscultate the anterior chest and mid-abdominal area for the presence of bubbling or gurgling sounds
Auscultate for bubbling or gurgling sounds over the epigastrium and breath sounds at the midaxillary regions
24.When should the child s head be secured to the spine board during the immobilization procedure?
After the body straps and lateral stabilization devices have been applied
After the body straps have been applied, but before the lateral stabilization devices to ensure that the tape is applied tightly
Before any straps or lateral stabilization devices have been applied
If the child is quiet the head does not need to be secured once lateral stabilization devices are applied
25.Which of the following substances can be infused via an intraosseous needle?
All medications and intravenous fluids
All medications except sodium bicarbonate and dextrose
Fluids or medications that are not acidic
Only medications and fluids that have a neutral pH
Answers
A. stridor.
A. normal finding for a toddler.
B. administer humidified oxygen via blow-by method.
D. His blood pressure is low because compensatory mechanisms for blood loss are failing
B. hypovolemia.
A. administer 100% oxygen by mask.
A. Fever
C. the substance was corrosive.
A. stabilize her cervical spine to reduce the risk of further spinal injury.
B. Exposing only those areas currently being assessed and then covering them
A. manually stabilize the cervical spine to reduce the risk of spinal injury.
C. Pain
A. Presence of windows or ventilation in the room
B. shaken baby syndrome.
D. Explain that you are very concerned about the child s condition and that he needs to be examined at the hospital for a possible a broken leg.
B. copiously suction the mouth and nose.
A. assemble the correct size of equipment to care for the baby.
C. applying free flow oxygen by mask at 5 L/min.
C. Acting fussier than normal
A. A slow heart rate and poor air exchange
A. Allow the patient to remain on the ventilator if he is not in respiratory distress
B. It will be more difficult to obtain a seal for ventilation
D. Auscultate for bubbling or gurgling sounds over the epigastrium and breath sounds at the midaxillary regions
A. After the body straps and lateral stabilization devices have been applied