Chapter 32

1. The purpose of the pediatric assessment triangle (PAT) is to:

allow you to rapidly and visually form a general impression of the child.

2. The components of the pediatric assessment triangle (PAT) are:

appearance, work of breathing, and skin circulation.

3. A normal level of consciousness in an infant or child is characterized by:

age-appropriate behavior, good muscle tone, and good eye contact.

4. Early signs of respiratory distress in the pediatric patient include all of the following, EXCEPT:


5. After forming a general impression of a sick or injured child, you should:

perform a hands-on assessment of the ABCs.

6. Before assessing the respiratory adequacy of an unconscious infant or child, you must:

ensure that the airway is patent and clear of obstructions.

7. To ensure that the airway of an infant or small child is correctly positioned, you may have to:

place a towel or folded sheet behind the shoulders.

8. All of the following are normal findings in an infant or child, EXCEPT:

head bobbing.

9. Drawing in of the muscles between the ribs or of the sternum during inspiration is called:


10. A high-pitched inspiratory sound that indicates a partial upper airway obstruction is called:


11. Signs of impending respiratory arrest in the infant or child include all of the following, EXCEPT:

nasal flaring.

12. When assessing the heart rate of a 6-month-old infant, you should palpate the brachial or ________ artery.


13. After determining that an infant or child has strong central pulses, you should:

not rule out compensated shock.

14. Capillary refill time (CRT) is MOST reliable as an indicator of end-organ perfusion in children less than:

6 years of age.

15. After squeezing the end of a child's finger or toe for a few seconds, blood should return to the area within:

2 seconds

16. Immediate transport is indicated for a child when he or she:

has a history suggestive of a serious illness.

17. The purpose of the transition phase is to:

allow the infant or child to become familiar with you and your equipment.

18. Blood pressure is usually not assessed in children younger than ___ years of age.


19. Which of the following inquiries should you make in private when obtaining a SAMPLE history from an adolescent patient?

sexual activity

20. A detailed physical exam should be performed, if possible, when an infant or child:

has experienced a significant MOI.

21. The MOST efficient way to identify the appropriately sized equipment for a pediatric patient is to:

use a length-based resuscitation tape measure.

22. Before positioning an infant or child's airway, you should:

place him or her on a firm surface

23. An oropharyngeal airway should not be used in children who have ingested a caustic or petroleum-based product because it may:

cause the child to vomit.

24. Which of the following statements regarding the use of nasopharyngeal airways in children is correct?

They are rarely used in infants younger than 1 year of age.

25. If a nasopharyngeal airway is too long, it may:

stimulate the vagus nerve.

26. When inserting an oropharyngeal airway in an infant or child, you should:

depress the tongue with a tongue depressor.

27. When assessing an infant's ventilation status, you should:

observe the abdomen for rise and fall.

28. Use of a nonrebreathing mask or nasal cannula in a child is appropriate ONLY if:

his or her tidal volume is adequate.

29. When administering oxygen to a frightened child, it would be MOST appropriate to:

place oxygen tubing through a hole in a paper cup.

30. Which of the following children would benefit the LEAST from a nonrebreathing mask?

Unresponsive 5-year-old male with shallow respirations

31. When ventilating a pediatric patient with a bag-valve mask device, the EMT-B should:

block the pop-off valve if needed to achieve adequate chest rise.

32. The MOST appropriate method for determining if you are delivering adequate tidal volume to a child during BVM ventilations is to:

observe the chest for adequate rise.

33. A viral infection that may cause obstruction of the upper airway in a child is called:


34. Infection should be considered as a possible cause of an airway obstruction in an infant or child, especially if he or she presents with:

drooling or congestion.

35. Signs of an upper airway obstruction in an infant or child include all of the following, EXCEPT:


36. Signs of a severe upper airway obstruction in an infant or child include:

an ineffective cough.

37. Which of the following statements regarding airway obstructions in children is MOST correct?

Finger sweeps are indicated only if you can visualize the foreign body.

38. Common interventions used to stimulate spontaneous respirations in the newborn include all of the following, EXCEPT:

positive-pressure ventilations.

39. Which of the following newborns requires positive-pressure ventilations and chest compressions?

Central cyanosis; respirations, slow; pulse, 50 beats/min

40. Vigorous suctioning of a newborn's airway is indicated if:

there is meconium in the amniotic fluid.

41. Cardiac arrest in the pediatric population is MOST commonly the result of:

respiratory or circulatory failure.

42. The automated external defibrillator (AED) is indicated in children over 1 year of age if:

you have an AED with a pediatric adaptor.

43. In contrast to adults, deterioration to cardiac arrest in infants and children is usually associated with:

severe hypoxia and bradycardia.

44. The MOST common cause of traumatic death in infants and children is:

head trauma.

45. Padding underneath the torso when immobilizing an injured child is generally not necessary if he or she is:

older than 8 to 10 years of age.

46. An infant or child with respiratory distress will attempt to keep his or her alveoli expanded at the end of inhalation by:


47. The MOST ominous sign of impending cardiopulmonary arrest in infants and children is:


48. A common cause of shock in an infant is:

vomiting and diarrhea.

49. Blood loss in a child exceeding _____ of his or her total blood volume significantly increases the risk of shock.


50. The LEAST reliable assessment parameter to evaluate when determining the presence of shock in infants and children is:

blood pressure.

51. Common signs of severe dehydration in an infant include all of the following, EXCEPT:

slowed or decreased level of activity.

52. Most seizures in children:

are due to fever alone.

53. Children younger than ____ year(s) of age should always be in a rear-facing car seat when being transported.


54. When immobilizing an injured child in a pediatric immobilization device, you should:

secure the torso before the head.

55. Early signs of respiratory distress in the child include:


56. A child who has no recent history of illness suddenly appears cyanotic and cannot speak after playing with a small toy. You should:

perform abdominal thrusts.

57. A 6-year-old male presents with acute respiratory distress. His mother states that she saw him put a small toy into his mouth shortly before the episode began. The child is conscious, obviously frightened, and is coughing forcefully. You should:

encourage him to cough, give oxygen as tolerated, and transport.

58. You are dispatched to a local elementary school for an injured child. As you approach the child, you note that he is lying at the base of the monkey bars. He is not moving and does not appear to be conscious or breathing. You should:

stabilize his head and open his airway.

59. A 2-year-old female fell from a second-story window and landed on her head. She is unconscious, has slow and shallow respirations, and a heart rate of 90 beats/min. In addition to spinal immobilization, you should:

insert an oral airway, assist ventilations, and transport rapidly.

60. A 6-month-old male presents with 2 days of vomiting and diarrhea. He is conscious, but his level of activity is decreased. The infant's mother tells you that he has not had a soiled diaper in over 12 hours. The infant's heart rate is 140 beats/min and his anterior fontanel appears to be slightly sunken. You should suspect:

moderate dehydration.

61. You are dispatched to a residence for a child with respiratory distress. The patient, an 18-month-old female, is tachypneic, has sternal retractions, and is clinging to her mother. Her skin is pink and dry and her heart rate is 120 beats/min. The MOST appropriate treatment for this child includes:

administering blow-by oxygen and transporting the child with her mother.

62. A 5-year-old male presents with respiratory distress, a low-grade fever, and a cough that resembles a barking seal. The child's mother tells you that he has had a runny nose for the past few days and then developed a cough that worsened at night. On the basis of this child's presentation, you should suspect:


63. During your treatment of a 4-year-old male with a severe foreign body airway obstruction, he becomes unconscious. You place him supine on the ground and attempt ventilations; however, the child's chest does not rise. You should:

reposition his head and reattempt ventilations.

64. A 9-year-old male was electrocuted when he stuck a pin into an electrical socket. Your initial assessment reveals that he is pulseless and apneic. A second ambulance is dispatched to the scene for backup. As your partner begins CPR, you should:

immediately prepare to attach the AED.

65. A 2-year-old female has experienced a seizure. When you arrive at the scene, the child is conscious, crying, and clinging to her mother. Her skin is hot and moist. The mother tells you that the seizure lasted approximately 5 minutes. She further tells you that her daughter has no history of seizures, but has had a recent ear infection. You should:

attempt cooling measures, offer oxygen, and transport.