EMT: Chapters 33-34 Review

A 33-year-old woman who is 36 weeks pregnant is experiencing vaginal bleeding. During transport, you note that she suddenly becomes diaphoretic, tachycardic, and hypotensive. You should:Select one:A. position her supine and elevate her legs 12 inches.B. ventilate her with a bag-valve mask.C. place her in a left lateral recumbent position. D. carefully place sterile gauze into her vagina.

C

Which of the following occurs during true labor?Select one:A. Uterine contractions last about 10 seconds.B. Uterine contractions become more regular.C. The uterus becomes very soft and movable.D. Uterine contractions decrease in intensity.

B

The ONLY indications for placing your gloved fingers in the vagina during delivery are:Select one:A. nuchal cord and presentation of an arm or leg.B. vertex presentation and delivery of the placenta.C. breech presentation and prolapsed umbilical cord.D. limb presentation and severe vaginal hemorrhage.

C

In contrast to abruptio placenta, placenta previa:Select one:A. may not present with heavy vaginal bleeding.B. may present without significant abdominal pain.C. is caused by hypertension or abdominal trauma.D. is typically associated with severe abdominal pain.

A

Upon delivery of an infant's head, you note that the umbilical cord is wrapped around its neck. You should:Select one:A. attempt to slip the cord gently over the infant's head.B. provide free-flow oxygen to the infant and transport.C. give high-flow oxygen to the mother and transport.D. immediately clamp and cut the umbilical cord.

A

The vagina and the neck of the uterus comprise the:Select one:A. fundus.B. birth canal.C. womb.D. cervix.

B

Which of the following is NOT generally considered an obstetrical emergency?Select one:A. Significant bleeding after delivery of the placentaB. Failure of the placenta to deliver after 30 minutesC. More than 500 mL of blood loss before placental deliveryD. Return of contractions following delivery of the baby

D

Braxton-Hicks contractions are characterized by:Select one:A. pink or red bloody show in conjunction with the contractions.B. alleviation of pain with movement or changing positions.C. a rupture of the amniotic sac just before the contractions begin.D. regular contractions of progressively increasing intensity.

B

Fetal complications associated with drug- or alcohol-addicted mothers include all of the following, EXCEPT:Select one:A. premature delivery.B. low birth weight.C. respiratory depression.D. profound tachycardia.

D

Abruptio placenta occurs when:Select one:A. a tear in the placenta causes severe internal hemorrhage.B. the placenta prematurely separates from the uterine wall.C. the placenta affixes itself to the outer layer of the uterus.D. the placenta develops over and covers the cervical opening.

B

You have just delivered a baby boy. His body is pink, but his hands and feet are blue. His heart rate is approximately 110 beats/min and his respirations are rapid and irregular. He has a weak cry when stimulated and resists attempts to straighten his legs. His Apgar score is:Select one:A. 8B. 6C. 9D. 7

A

Signs and symptoms of preeclampsia include:Select one:A. headache and edema.B. dyspnea and bradycardia.C. dysuria and constipation.D. marked hypoglycemia.

A

Placenta previa is defined as:Select one:A. abnormal development and functioning of the placenta.B. development of the placenta over the cervical opening.C. delivery of a portion of the placenta before the baby.D. premature placental separation from the uterine wall.

B

Which of the following is NOT a component of the Apgar score?Select one:A. GrimaceB. ActivityC. PulseD. Body size

D

After the fetus has descended into the pelvis at the end of the third trimester, many mothers experience:Select one:A. a bloated feeling.B. easier breathing.C. mid-back pain.D. an urge to push.

B

Following delivery of a pulseless and apneic infant who has a foul odor, skin sloughing, and diffuse blistering, you should:Select one:A. provide emotional support to the mother.B. begin full resuscitation and transport.C. dry the infant off to stimulate breathing.D. report the case to the medical examiner.

A

Which of the following are normal physiologic changes that occur in the mother's respiratory system during pregnancy?Select one:A. Increased respiratory reserve and decreased oxygen demandB. Increased respiratory depth and decreased respiratory rateC. Increased respiratory rate and decreased respiratory reserveD. Decreased respiratory rate and increased minute volume

C

You have just delivered a premature baby. Your assessment reveals that he is breathing adequately; however, his heart rate is 90 beats/min. You should:Select one:A. clamp and cut the umbilical cord and keep him warm.B. assess his skin color and give free-flow oxygen as needed.C. begin chest compressions and reassess in 30 seconds.D. keep him warm and ventilate with a BVM.

A

Which of the following statements regarding the placenta is correct?Select one:A. The placenta allows for the transfer of oxygen and carbon dioxide between the mother and fetus but prevents most medications from passing between the mother and fetus.B. The placental barrier consists of two layers of cells and allows the mother's blood that contains high concentrations of oxygen to directly mix with the blood of the fetus.C. The placenta provides oxygen and nutrients to the fetus and is expelled from the vagina about 30 minutes before the baby is born.D. The placenta allows oxygen, carbon dioxide, and other products to transfer between the mother and fetus but does not allow blood to mix between the mother and fetus.

D

Most medical models base a pregnant woman's due date:Select one:A. two weeks after her last menstrual cycle.B. two weeks before her last menstrual cycle.C. on the first day of her last menstrual cycle.D. on the last day of her last menstrual cycle.

C

An infant is considered to be premature if it:Select one:A. weighs less than 5.5 lb or is born before 37 weeks' gestation.B. is born before 38 weeks' gestation or weighs less than 6 lb.C. weighs less than 5 lb or is born before 36 weeks' gestation.D. is born before 40 weeks' gestation or weighs less than 7 lb.

C

Following delivery of the placenta, the mother is experiencing vaginal bleeding. After massaging the uterine fundus and allowing the mother to breastfeed, the bleeding stops. This occurred because:Select one:A. uterine massage increases blood flow to the uterus.B. a portion of the placenta was retained in the uterus.C. breastfeeding causes uterine blood vessels to dilate.D. these actions simulate the production of oxytocin and cause uterine contraction.

D

When the mother is experiencing a contraction, you should instruct her to:Select one:A. hold her breath.B. take quick short breaths.C. push for 30 seconds.D. rest and breathe deeply.

B

While examining a woman in labor, you see the umbilical cord protruding from the vagina. You should:Select one:A. carefully push the cord back into the vagina.B. gently pull on the cord to facilitate delivery.C. push the infant's head away from the cord.D. cover the umbilical cord with a dry dressing.

C

A precipitous labor and delivery is MOST common in women who:Select one:A. have delivered a baby before.B. are pregnant for the first time.C. have gestational diabetes.D. are younger than 30 years of age.

A

Which of the following statements regarding twins is correct?Select one:A. Twins are typically larger than single infants.B. Most twins are born within 45 minutes of each other.C. Fraternal twins have two cords coming from one placenta.D. Identical twins are typically of different gender.

B

Which of the following statements regarding suctioning of a newborn's mouth and oropharynx is correct?Select one:A. Suctioning is indicated prior to cutting the cord if respiratory distress is present.B. If the head delivers facedown, the mouth and nose should be suctioned at once.C. Suctioning should be performed on all newborns immediately following delivery.D. Newborns rapidly expel fluid from their lungs and do not require suctioning.

A

The umbilical cord:Select one:A. carries oxygen to the baby via the umbilical vein.B. separates from the placenta shortly after birth.C. carries blood away from the baby via the artery.D. contains two veins and one large umbilical artery.

A

If a newborn's heart rate is less than 60 beats/min following delivery, you should:Select one:A. resuction the mouth only.B. flick the soles of his or her feet.C. begin chest compressions.D. provide ventilations for 30 seconds.

D

Spina bifida is a developmental defect in which:Select one:A. a portion of the spinal cord or meninges protrudes outside of the vertebrae.B. nerve fibers that arise from the spinal cord do not function properly.C. an excessive amount of cerebrospinal fluid damages the spinal cord.D. the spinal column is severely deformed, resulting in permanent paralysis.

A

Before assessing the respiratory adequacy of a semiconscious infant or child, you must:Select one:A. ensure that his or her head is in a hyperextended position.B. routinely suction the mouth to remove oral secretions.C. insert a nasopharyngeal or oropharyngeal airway adjunct.D. ensure that the airway is patent and clear of obstructions.

D

A common cause of shock in an infant is:Select one:A. a cardiac dysrhythmia.B. dehydration from vomiting and diarrhea.C. cardiovascular disease.D. excessive tachycardia.

B

An oropharyngeal airway should not be used in children who have ingested a caustic or petroleum-based product because it may:Select one:A. result in airway swelling.B. result in a soft-tissue injury.C. cause the child to vomit.D. depress the gag reflex.

C

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:Select one:A. encourage him to cough, give oxygen as tolerated, and transport.B. deliver a series of five back blows and then reassess his condition.C. carefully look into his mouth and remove the object if you see it.D. place the child in a supine position and perform abdominal thrusts.

A

Which of the following is NOT a known risk factor of SIDS?Select one:A. Mother smoked during pregnancyB. Mother younger than 20 yearsC. Low birth weightD. Putting a baby to sleep on his or her back

D

After determining that an infant or child has strong central pulses, you should:Select one:A. assume the child is hypertensive.B. not rule out compensated shock.C. assess his or her respiratory effort.D. conclude that the child is stable.

B

When assessing the heart rate of a 6-month-old infant, you should palpate the brachial or ________ pulse.Select one:A. femoralB. radialC. poplitealD. carotid

A

Bruising to the _________ is LEAST suggestive of child abuse.Select one:A. shinsB. faceC. buttocksD. back

A

The signs and symptoms of poisoning in children:Select one:A. are most severe if the child ingested a poisonous substance.B. vary widely, depending on the child's age and weight.C. are typically consistent among all age and weight groups.D. usually present within the first 10 minutes of ingestion.

B

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 fontanelle appears to be slightly sunken. You should suspect:Select one:A. severe dehydration.B. moderate dehydration.C. mild dehydration.D. hypovolemic shock.

B

Early signs of respiratory distress in the pediatric patient include all of the following, EXCEPT:Select one:A. retractions.B. cyanosis.C. abnormal airway noise.D. tachypnea.

B

In contrast to adults, deterioration to cardiac arrest in infants and children is usually associated with:Select one:A. a sudden ventricular arrhythmia.B. severe hypoxia and bradycardia.C. irritability of the left ventricle.D. acute hypoxia and tachycardia.

B

Which of the following inquiries should you make in private when obtaining a SAMPLE history from an adolescent patient?Select one:A. Change in bladder habitsB. Duration of symptomsC. Sexual activityD. Past medical history

C

Immediate transport is indicated for a child when he or she:Select one:A. has a possible closed fracture of the radius.B. has a history compatible with a serious illness.C. is experiencing mild to moderate pain.D. is breathing rapidly.

B

Which of the following groups of people is associated with the lowest risk of meningitis?Select one:A. FemalesB. Children with HIV/AIDSC. NewbornsD. Children with shunts

A

Which of the following statements regarding the use of nasopharyngeal airways in children is correct?Select one:A. It is the recommended adjunct for children with head trauma.B. Blanching of the nares after insertion indicates correct placement.C. They are usually not well tolerated in children with a gag reflex.D. They are rarely used in infants younger than 1 year.

D

Which of the following statements regarding spinal injuries in pediatric patients is correct?Select one:A. Most cervical spine fractures in infants and children occur between the first and second cervical vertebrae.B. The majority of cervical spine injuries in children are partial transections of the spinal cord, resulting in partial paralysis.C. If the cervical spine is injured, it is most likely to be an injury to the ligaments because of rapid movement of the head.D. Because of a child's proportionately large head, they are more prone to spinal cord injuries than adults.

C

If the situation allows, a child should be transported in a car seat if he or she weighs less than _____ lb.Select one:A. 70B. 60C. 40D. 50

C

When a child experiences a blunt chest injury:Select one:A. there is usually obvious injury to the external chest wall.B. the flexible ribs can be compressed without breaking.C. the sudden force against the ribs causes them to fracture.D. the flexible rib cage protects the vital thoracic organs.

B

A high-pitched inspiratory sound that indicates a partial upper airway obstruction is called:Select one:A. stridor.B. wheezing.C. grunting.D. rhonchi.

A

Death caused by shaken baby syndrome is usually the result of:Select one:A. multiple open fractures.B. intra-abdominal hemorrhage.C. bleeding in the brain.D. fracture of the cervical spine.

C

After squeezing the end of a child's finger or toe for a few seconds, blood should return to the area within:Select one:A. 5 seconds.B. 2 seconds.C. 4 seconds.D. 3 seconds.

B

Children with N. meningitides would MOST likely present with:Select one:A. hypothermia and an irregular pulse.B. a generalized rash with intense itching.C. cherry-red spots or a purplish rash.D. a low-grade fever and tachycardia.

C

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 unresponsive and there are no signs of breathing. You should:Select one:A. begin immediate rescue breathing.B. perform a head tilt-chin lift maneuver.C. stabilize his head and check for a pulse.D. open his airway and look in his mouth.

C

Compared to an adult, the diaphragm dictates the amount of air that a child inspires because the:Select one:A. upper airway is smaller and easily collapsible.B. rib cage is rigid and provides little flexibility.C. intercostal muscles are not well developed.D. abdominal organs force the diaphragm upward.

C

Hyperthermia differs from fever in that it is an increase in body temperature:Select one:A. of more than 2°F to 3°F per hour.B. caused by inflammation of the spinal cord.C. secondary to a severe bacterial infection.D. caused by the inability of the body to cool itself.

D

The suture of the anterior fontanelle is typically closed by _____ months of age, and the suture of the posterior fontanelle is typically closed by _____ months of age.Select one:A. 18, 6B. 12, 4C. 6, 12D. 2, 4

A

During the attempted resuscitation of an infant with suspected SIDS:Select one:A. give detailed updates to the infant's parents.B. allow the family to observe if they wish.C. a law enforcement officer must be present.D. discourage the family from observing.

B

A normal level of consciousness in an infant or child is characterized by:Select one:A. normal interactiveness, awareness to time, and pink skin color.B. age-appropriate behavior, good muscle tone, and good eye contact.C. crying or combativeness, good muscle tone, and awareness to time.D. awareness to place, pink and dry skin, and consistent eye contact.

B

Early signs of respiratory distress in the child include:Select one:A. restlessness.B. bradycardia.C. decreased LOC.D. cyanosis.

A

Before positioning an infant or child's airway, you should:Select one:A. rule out an injury to the spinal cord.B. thoroughly suction his or her airway.C. put padding behind his or her head.D. place him or her on a firm surface.

D

When immobilizing an injured child in a pediatric immobilization device, you should:Select one:A. secure the torso before the head.B. pad underneath the child's head.C. slide the device under the child.D. secure the head before the torso.

A

An infant or child with respiratory distress will attempt to keep his or her alveoli expanded at the end of inhalation by:Select one:A. wheezing.B. grunting.C. retracting the intercostal muscles.D. assuming a tripod position.

B

Signs of vasoconstriction in the infant or child include:Select one:A. brisk capillary refill.B. weak distal pulses.C. a rapid heart rate.D. warm, dry skin.

B

Capillary refill time is MOST reliable as an indicator of end-organ perfusion in children younger than:Select one:A. 10 years.B. 8 years.C. 6 years.D. 4 years.

C

The normal respiratory rate for a newborn should not exceed ______ breaths/min.Select one:A. 70B. 50C. 60D. 80

C

Drawing in of the muscles between the ribs or of the sternum during inspiration is called:Select one:A. tenting.B. accessory muscle use.C. retracting.D. hyperpnea.

C

The MOST accurate method for determining if you are delivering adequate tidal volume to a child during bag-valve mask ventilations is to:Select one:A. monitor the child's heart rate.B. observe the chest for adequate rise.C. monitor the pulse oximeter reading.D. observe the child's skin color.

B

Greenstick fractures occur in infants and children because:Select one:A. their bones bend more easily than an adult's.B. their bones are more brittle than an adult's.C. twisting injuries are more common in children.D. the growth plate is commonly injured.

A

Signs of an upper airway obstruction in an infant or child include all of the following, EXCEPT:Select one:A. a cough that resembles the bark of a seal.B. a weak cough.C. stridorous breathing.D. wheezing.

D

When inserting an oropharyngeal airway in an infant or child, you should:Select one:A. ensure that his or her neck is hyperextended.B. place padding under the child's head.C. insert it until the flange rests on the teeth.D. depress the tongue with a tongue depressor.

D

Which of the following assessment findings should concern the EMT the MOST when assessing a child who experienced a seizure?Select one:A. Neck stiffnessB. TachycardiaC. High feverD. Short postictal phase

A

A 2-year-old child who has no recent history of illness suddenly appears cyanotic and cannot speak after playing with a small toy. You should:Select one:A. perform abdominal thrusts.B. give oxygen and transport at once.C. visualize the child's airway.D. perform a blind finger sweep.

A

When ventilating a pediatric patient with a bag-valve mask, the EMT should:Select one:A. block the pop-off valve if needed to achieve adequate chest rise.B. squeeze the bag 40 times/min when ventilating an infant.C. ventilate the child with sharp, quick breaths at the appropriate rate.D. use a neonatal device for children younger than 12 months.

A

The EMT should be MOST concerned when a child presents with fever and:Select one:A. a headache.B. chills.C. ear pain.D. a rash.

D

Which of the following an appropriate dose of activated charcoal for a 20-kg child?Select one:A. 12.5 gB. 50 gC. 25 gD. 20 g

D

EMTs are called for an unresponsive infant. When they arrive, they find the mother holding her child. She advises that the child became limp, blue, and stopped breathing. Assessment reveals that the infant is conscious and crying, and has good muscle tone and pink skin color. The mother states that she will take her child to the doctor. The EMTs should:Select one:A. inform that mother that, although the event seems to have resolved, transport via EMS is advisable.B. advise the mother that the danger has past and that she can take the child to the pediatrician.C. allow the mother to take her child to the doctor, but inform her that the risk for SIDS is high.D. contact law enforcement personnel and advise them that they are suspicious for child abuse.

A

Use of a nonrebreathing mask or nasal cannula in a child is appropriate ONLY if:Select one:A. his or her tidal volume is adequate.B. an oral airway has been inserted.C. he or she is breathing inadequately.D. his or her respirations are shallow.

A

In most children, febrile seizures are characterized by:Select one:A. isolated tonic-clonic activity, a duration of greater than 15 minutes, and a short postictal phase.B. a blank stare, a duration of between 15 and 30 minutes, and a prolonged postictal phase.C. generalized tonic-clonic activity, a duration of less than 15 minutes, and a short or absent postictal phase.D. unresponsiveness, complete body relaxation, a fever greater than 105°F, and a short postictal phase.

C

Which of the following is MORE common in children than in adults following a head injury?Select one:A. Loss of consciousnessB. Seizures and hypoxiaC. Nausea and vomitingD. Spinal cord injury

C

Signs of severe dehydration in an infant include all of the following, EXCEPT:Select one:A. profound tachycardia.B. delayed capillary refill.C. bulging fontanelles.D. dry mucous membranes.

C

Effective methods for providing pain relief to a child with an extremity injury include:Select one:A. heat compresses and lowering the injured extremity.B. separating the child from his or her parents.C. avoiding the placement of a splint, if possible.D. positioning, ice packs, and extremity elevation.

D

Padding underneath the torso when immobilizing an injured child is generally not necessary if he or she is:Select one:A. experiencing cardiopulmonary arrest.B. immobilized on a long backboard.C. complaining of severe back pain.D. older than 8 to 10 years of age.

D

The MOST common cause of dehydration in pediatric patients is:Select one:A. vomiting and diarrhea.B. internal blood loss.C. high fever.D. refusal to drink fluids.

A

Causes of infant death that may be mistaken for SIDS include all of the following, EXCEPT:Select one:A. hyperglycemia.B. child abuse.C. meningitis.D. severe infection.

A

All of the following are normal findings in an infant or child, EXCEPT:Select one:A. belly breathing.B. quiet breathing.C. fear or anxiety.D. head bobbing.

D

Which of the following represents a low normal systolic blood pressure for a 6-year-old child?Select one:A. 98 mm HgB. 88 mm HgC. 82 mm HgD. 90 mm Hg

C

Blood pressure is usually not assessed in children younger than _____ years.Select one:A. 5B. 4C. 6D. 3

D

With regard to the legal implications of child abuse:Select one:A. you should document your perceptions on the run form.B. a supervisor can forbid you from reporting possible abuse.C. EMTs must report all suspected cases of child abuse.D. child abuse must be reported only if it can be proven.

C

If a nasopharyngeal airway is too long, it may:Select one:A. become obstructed by mucus.B. stimulate the vagus nerve.C. push the tongue anteriorly.D. result in tachycardia.

B