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.
18, 6
A normal level of consciousness in an infant or child is characterized by:
D. age-appropriate behavior, good muscle tone, and good eye contact.
The MOST ominous sign of impending cardiopulmonary arrest in infants and children is:
bradycardia
Common causes of seizures in children include all of the following, EXCEPT:
hyperglycemia
When inserting an oropharyngeal airway in an infant or child, you should:
depress the tongue with a tongue depressor.
A child may begin to show signs of separation anxiety as early as:
6 months.
Febrile seizures are MOST common in children between:
6 months and 6 years.
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.
Signs of vasoconstriction in the infant or child include:
weak distal pulses.
Which of the following findings is LEAST suggestive of child abuse?
consistency in the method of injury reported by the caregiver
Signs of an upper airway obstruction in an infant or child include all of the following, EXCEPT:
wheezing
Bruising to the _________ is LEAST suggestive of child abuse.
shins
Compared to an adult, the diaphragm dictates the amount of air that a child inspires because the:
intercostal muscles are not well developed.
During the attempted resuscitation of an infant with suspected SIDS:
allow the family to observe if they wish.
The MOST common cause of dehydration in pediatric patients is:
vomiting and diarrhea.
Immediate transport is indicated for a child when he or she:
has a history suggestive of a serious illness.
If a nasopharyngeal airway is too long, it may:
stimulate the vagus nerve.
Which of the following is NOT a known risk factor of SIDS?
putting a baby to sleep on his or her back
Which of the following statements regarding spinal injuries in pediatric patients is correct?
If the cervical spine is injured, it is most likely to be an injury to the ligaments because of rapid movement of the head.
After using the PAT to form your general impression of a sick or injured child, you should:
perform a hands-on assessment of the ABCs.
Which of the following inquiries should you make in private when obtaining a SAMPLE history from an adolescent patient?
sexual activity
The pediatric patient should be removed from his or her car seat and secured to an appropriate spinal immobilization device if:
the car seat is visibly damaged.
Early signs of respiratory distress in the pediatric patient include all of the following, EXCEPT:
cyanosis
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
moderate dehydration.
You respond to a skate park where a 10-year-old male fell from his skateboard and struck his head on the ground; he was not wearing a helmet. He is responsive to painful stimuli only and has a large hematoma to the back of his head. After your partner sta
B. assist his ventilations, be prepared to suction his mouth if he vomits, apply full spinal precautions, and prepare for immediate transport to a trauma center.
A common cause of shock in an infant is:
dehydration from vomiting and diarrhea.
The secondary assessment of a sick or injured child:
may not be possible if the child's condition is critical.
Greenstick fractures occur in infants and children because:
their bones bend more easily than an adult's.
Padding underneath the torso when immobilizing an injured child is generally not necessary if he or she is:
older than 8 to 10 years.
Unless he or she is critically ill or injured, you should generally begin your assessment of a toddler:
at the feet.
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
attempt cooling measures, offer oxygen, and transport.
Which of the following is the MOST appropriate dose of activated charcoal for a 20-kg child?
20 g
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.
Death caused by shaken baby syndrome is usually the result of:
bleeding in the brain.
When assessing or treating an adolescent patient, it is important to remember that:
they usually do not wish to be observed during a procedure
When assessing or treating an adolescent patient, it is important to remember that:
they usually do not wish to be observed during a procedure.
Which of the following statements regarding pediatric trauma is correct?
Children are more likely to experience diving-related injuries.
When ventilating a pediatric patient with a bag-mask device, the EMT should:
block the pop-off valve if needed to achieve adequate chest rise.
When a child experiences a blunt chest injury:
the flexible ribs can be compressed without breaking.
Blood loss in a child exceeding _____ of his or her total blood volume significantly increases the risk of shock.
. 25%
An infant with severe dehydration would be expected to present with:
absent urine output.
When assessing an 8-year-old child, you should:
talk to the child, not just the caregiver.
An 8-year-old female with a history of asthma continues to experience severe respiratory distress despite being given multiple doses of her prescribed albuterol by her mother. She is conscious, but clearly restless. Her heart rate is 130 beats/min and her
B. be prepared to assist her ventilations, transport at once, and request an ALS intercept en route to the hospital.
When caring for a female child who has possibly been sexually abused, you should:
have a female EMT remain with her if possible.
Before assessing the respiratory adequacy of an unconscious infant or child, you must:
ensure that the airway is patent and clear of obstructions.
Which of the following statements regarding a 3-month-old infant is correct?
A 3-month-old infant can distinguish a parent from a stranger.
Causes of infant death that may be mistaken for SIDS include all of the following, EXCEPT:
hyperglycemia
After determining that an infant or child has strong central pulses, you should:
not rule out compensated shock.
When a child is struck by a car, the area of greatest injury depends MOSTLY on the:
size of the child and the height of the bumper upon impact.
Capillary refill time is MOST reliable as an indicator of end-organ perfusion in children younger than:
6 years.
The components of the PAT are:
appearance, work of breathing, and skin circulation.
Signs and symptoms of meningitis in the infant or child include all of the following, EXCEPT:
sunken fontanelles.
In most children, febrile seizures are characterized by:
generalized tonic-clonic activity, a duration of less than 15 minutes, and a short or absent postictal phase.
The first month of life after birth is referred to as the:
neonatal period.
Osteoporosis is MOST accurately defined as:
a decrease in bone mass and density.
With age, the spine stiffens as a result of shrinkage of the intervertebral disc spaces, and the vertebrae become brittle. This increases the risk of:
compression fractures.
You receive a call for a sick person. When you arrive, you find the patient, a 75-year-old male, lying unresponsive in his bed. His respirations are slow and irregular and his pulse is slow and weak. His daughter tells you that he fell the day before, but
a subdural hematoma.
Which of the following observations or statements represents the "E" in the GEMS diamond?
The patient's residence is cold due to a malfunctioning heater.
Poor maintenance of home, poor personal care, and dietary neglect are all possible indications of ____________ elder abuse.
physical
Upon arriving at the residence of an elderly female who apparently fainted, you find the patient lying supine on her living room floor. She is not moving and her eyes are closed. A neighbor tells you that she found the patient this way, but did not move h
direct your partner to manually stabilize her head while you open her airway and ensure that her oropharynx is clear of secretions or blood.
In contrast to delirium, dementia:
is usually considered irreversible.
A 77-year-old female presents with an acute onset of altered mental status. Her son is present and advises that she has a history of hypertension, atrial fibrillation, type 2 diabetes, and glaucoma. He further advises that she takes numerous medications a
the patient is experiencing delirious behavior, which suggests a new health problem.
An older woman with osteoporosis presents with pain and deformity to her left hip after she shifted her weight onto her other foot. She has MOST likely experienced a:
pathologic fracture.
An elderly patient may understate or minimize the symptoms of his or her illness because:
he or she fears hospitalization.
Clouding of the lenses of the eyes is called:
. cataracts
A 69-year-old female was involved in a motor vehicle crash. She is semiconscious with a blood pressure of 80/50 mm Hg and a heart rate of 74 beats/min that is weak. Her daughter, who was uninjured in the crash, tells you that her mother has a history of h
the effects of her antihypertensive medication
A specific legal document that directs relatives and caregivers regarding the medical treatment that may be given to patients who cannot speak for themselves is called a:
advance directive.
Blood levels of medications may rise in the elderly, sometimes to toxic levels. This is MOST likely due to:
renal insufficiency.
The slow onset of progressive disorientation, shortened attention span, and loss of cognitive function is known as:
dementia
The leading cause of death in the geriatric patient is:
heart disease.
Which of the following statements regarding a decreased level of consciousness in the elderly patient is correct?
A decreased level of consciousness is not a normal part of the aging process.
The chief component of connective tissues and bones that deteriorates as people age is called:
collagen
A "silent" heart attack occurs when:
the usual chest pain is not present.
The use of multiple prescription drugs by a single patient, causing the potential for negative effects such as overdosing or drug interaction, is called:
polypharmacy.
When documenting a case of suspected elder abuse, it is MOST important for the EMT to:
avoid documenting any unsupported opinions.
When assessing a geriatric patient who has possibly experienced an acute ischemic stroke, it is MOST important to:
determine the onset of the patient's symptoms.
Which of the following statements regarding suicide in the older patient is correct?
Older patients tend to use more lethal means than younger patients.
Findings during the social assessment of an older patient include all of the following, EXCEPT:
outdated medications.
Many older victims of physical abuse may make false statements or lie about the origin of their injuries because:
they fear retribution from the abuser.
Syncope in the older patient is:
. caused by an interruption of blood flow to the brain.
When caring for a geriatric patient with a traumatic injury, it is important to consider that:
the injury may have been preceded by a medical condition.
When an elderly patient presents you with multiple over-the-counter medications that he or she is taking, it is MOST important to:
recall that the patient is at risk for negative medication interactions.
When faced with a situation in which an older patient with a terminal illness is in cardiac arrest, but written documentation regarding the patient's wishes cannot be located, the EMT should:
attempt to resuscitate the patient.
Which of the following is NOT a reason why the exact extent and prevalence of elder abuse is unknown?
Human resource agencies fail to investigate.
General communication techniques with the elderly include:
frequently asking the patient if he or she understands.
You are dispatched to a residence for an 80-year-old female who fell. When you arrive, you find the patient conscious, lying in a recumbent position on the floor in her living room. In addition to providing the appropriate treatment, you should ask the pa
she became dizzy or fainted before falling.
Common causes of syncope in older patients include all of the following, EXCEPT:
vasoconstriction.
When performing your secondary assessment on an older patient who has been injured, it is important to:
recall that it will take a less severe mechanism of injury to cause significant injuries.
While examining a woman in labor, you see the umbilical cord protruding from the vagina. You should:
C. push the infant's head away from the cord.
Upon delivery of the baby's head, you note that its face is encased in the unruptured amniotic sac. You should:
puncture the sac and suction the baby's mouth and nose.
If a pregnant patient requires spinal immobilization, you should secure her to the backboard and then:
elevate the right side of the board with rolled towels or blankets.
An abortion occurs when the fetus and placenta deliver before:
20 weeks.
A 33-year-old woman who is 36 weeks pregnant is experiencing scant vaginal bleeding. During transport, you note that she suddenly becomes diaphoretic, tachycardic, and hypotensive. In addition to administering 100% oxygen, you should:
place her in a left lateral recumbent position.
A nuchal cord is defined as an umbilical cord that:
is wrapped around the baby's neck.
Supine hypotensive syndrome occurs when:
the pregnant uterus compresses the inferior vena cava.
Braxton-Hicks contractions are characterized by:
alleviation of pain with movement or changing positions.
Preeclampsia MOST commonly occurs after the ____ week of gestation.
30th
When determining the frequency of contractions, you should time the contractions from the:
. start of one to the start of the next.
Which of the following statements regarding a breech presentation is MOST correct?
A breech presentation occurs when the buttocks are the presenting part.
After a baby is born, it is important to:
ensure that it is thoroughly dried and warmed.
When the mother is experiencing a contraction, you should instruct her to:
take quick short breaths.
Which of the following is NOT generally considered an obstetrical emergency?
return of contractions following delivery of the baby
From what internal female organ is the fetus expelled during delivery?
uterus
A mother who is pregnant with her first baby is typically in the first stage of labor for approximately:
16 hours
The onset of labor begins with:
contractions of the uterus.
Which of the following statements regarding the placenta is correct?
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.
Signs and symptoms of preeclampsia include:
headache and edema.
Which of the following is an indication of imminent birth?
crowning of the baby's head
If a baby is born at 7:52, the second Apgar score should be calculated at:
7:57.
Following delivery of a full-term baby, you have properly cared for the baby and have clamped and cut the umbilical cord. During transport, you note that the mother is experiencing moderate vaginal bleeding. You should:
firmly massage the uterine fundus with a circular motion.
Most medical models base a pregnant woman's due date:
on the first day of her last menstrual cycle.
The vagina and the neck of the uterus comprise the:
birth canal.
The third stage of labor begins when the:
baby is expelled from the vagina.
Eclampsia is MOST accurately defined as:
seizures that result from severe hypertension.
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:
keep him warm and provide ventilatory assistance.
The leading cause of maternal death during the first trimester of pregnancy is:
internal bleeding caused by a ruptured ectopic pregnancy.
Common interventions used to stimulate spontaneous respirations in the newborn include all of the following, EXCEPT:
positive-pressure ventilations
The term "bloody show" is defined as:
the small amount of pink-tinged mucus that is discharged from the vagina after expulsion of the mucous plug.
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 leg
8
A pregnant trauma patient may lose a significant amount of blood before showing signs of shock because:
pregnant patients have an overall increase in blood volume
Which of the following processes occurs during ovulation?
The inner lining of the uterus thickens in preparation for implantation.
During delivery, it is MOST important to position your partner at the mother's head because:
. the mother may become nauseated and vomit.
The female reproductive system includes:
1. Ovaries
2. Fallopian tubes
3. Uterus
4. Cervix
5. Vagina
6. Breasts
The sac contains about
500 to 1,000 mL of amniotic fluid, which helps insulate and protect the floating fetus.
primigravida is
a woman experiencing her first pregnancy.
multigravida is
a woman who has experienced previous pregnancies.
Spina bifida is
a developmental defect in which a portion of the spinal cord or meninges may protrude outside of the vertebrae and possibly outside of the body.
At birth, a pulse rate
90 to 180 beats/min
respiratory rate At birth,
30 to 60 breaths/min are considered normal.
Toddlers
ages 1 to 3 years
Toddlers pulse rate is
90 to 150 beats/min.
Toddlers The respiratory rate is
20 to 30 breaths/min.
Preschoolers
ages 3 to 6 years
Preschoolers The pulse rate is
80 to 140 beats/min.
Preschoolers The respiratory rate is
20 to 25 breaths/min.
Preschoolers The systolic blood pressure is
80 to 100 mm Hg.
School-Age Children
6 to 12 years,
School-Age Children The pulse rate is
70 to 120 beats/min.
School-Age Children The respiratory rate is
15 to 20 breaths/min.
School-Age Children The blood pressure is
80 to 110 mm Hg.
Adolescents (Teenagers)
ages 12 to 18 years
Adolescents (Teenagers) The pulse rate is
60 to 100 beats/min.
Adolescents (Teenagers) The respiratory rate is
12 to 20 breaths/min.
Adolescents (Teenagers) The systolic blood pressure is between
90 and 110 mm Hg.
TICLS mnemonic
(1) Tone
(2) Interactiveness
(3) Consolability
(4) Look or gaze
(5) Speech or cry
Febrile seizures are common in children between the ages of
6 months and 6 years.
The most frequently occurring conditions in older persons are:
1. Hypertension
2. Respiratory diseases
3. Diagnosed arthritis
4. Heart disease
The leading causes of death in the geriatric population include:
1. Heart disease
2. Cancer
3. Stroke
4. Chronic obstructive pulmonary disease and other respiratory illnesses
5. Diabetes
6. Trauma
G stands for
Geriatric patient.
E stands for
Environmental assessment.
M stands for
Medical assessment.
S stands for
Social assessment.
Pulmonary embolism is a
condition that causes a sudden blockage of an artery by a venous clot.
Dementia is the
slow onset of progressive disorientation, shortened attention span, and loss of cognitive function.
Dementia is the result of
many neurologic diseases and may be caused by:
i. Alzheimer disease
ii. Cerebrovascular accidents
iii. Genetic factors
Delirium is a
sudden change in mental status, consciousness, or cognitive processes.
An important aspect in the assessment of a patient who experienced a previous brain injury involves:
speaking with the patient and family to establish what is considered normal for the patient.
Down syndrome is a genetic defect that occurs as the result of:
a triplication of chromosome 21
According to the Emergency Medical Treatment and Active Labor Act (EMTALA):
all health care facilities must provide a medical assessment and required treatment, regardless of the patient's ability to pay.
A 13-year-old child is on a home ventilator. The parents called because the ventilator is malfunctioning and the child has increasing respiratory distress. You should:
disconnect the ventilator and use a bag-mask device.
When caring for patients with cerebral palsy, it is important to remember that:
their limbs are often underdeveloped and are prone to injury.
A person is said to be obese when he or she is ________ over his or her ideal weight.
20% to 30%
When interacting with a developmentally disabled patient, the best approach is to:
ask your team members to wait until you can establish a rapport with the patient.
The purpose of a ventricular peritoneum shunt is to:
prevent excess cerebrospinal fluid from accumulating in the brain.
Cerebral palsy is characterized by poorly controlled ________ movement.
body
For which of the following conditions would you MOST likely encounter a ventricular peritoneum shunt?
hydrocephalus
When caring for a morbidly obese patient, you should:
establish his or her chief complaint and then communicate your plan to help.
Which of the following statements regarding patients with developmental disabilities is correct?
Patients with developmental disabilities are susceptible to the same disease processes as other patients.
Which of the following statements regarding hearing aids is correct?
Hearing aids cannot restore hearing to normal levels.
You are assessing a 440-lb man who complains of shortness of breath and lower back pain. The patient is conscious and alert, his blood pressure is 148/98 mm Hg, and his heart rate is 120 beats/min. Your MOST immediate action should be to:
avoid placing him in a supine position if possible and administer oxygen.
Because a tracheostomy tube bypasses the nose and mouth:
secretions can build up in and around the tube.
Because a tracheostomy tube bypasses the nose and mouth:
secretions can build up in and around the tube.
Two thirds of children born with Down syndrome have:
congenital heart disease.
General techniques for communicating with hearing-impaired patients include:
positioning yourself approximately 18? directly in front of the patient.
By placing one hand on top of your head and the other hand over your abdomen, you are asking a hearing-impaired patient if he or she:
is sick.
Patients with autism:
have extreme difficulty with complex tasks that require many steps.
You respond to a residence for a 9-year-old female with Down syndrome who is sick. When you arrive at the scene and assess the patient, you determine that she is unresponsive and has gurgling respirations. You should:
open her airway with a manual maneuver, suction her oropharynx, and insert a simple airway adjunct.
A tube from the brain to the abdomen that drains excessive cerebrospinal fluid is called a:
shunt
A significant number of patients with cerebral palsy also have:
a seizure disorder.
Which of the following statements regarding cerebral palsy is correct?
Conditions such as brain injury at birth, postpartum infections, and fetal hypoxia can cause cerebral palsy.
Correct
In contrast to an automated implanted cardioverter/defibrillator, an internal cardiac pacemaker:
regulates the patient's heart rate if it falls below a preset value.
Which of the following does NOT usually contribute to or cause obesity?
rapid metabolism
Vagal nerve stimulators may be an alternative treatment to medication for patients with:
chronic seizure disorders.
Common associated conditions in patients with spina bifida include all of the following, EXCEPT:
spastic limb movement.
EARLY SIGNS FOR RESPIRATORY DISTRESS IN PEDS
ACCESSORY MUSCLE USE, RETRACTIONS, HEAD BOBBING, NASAL FLARING AND TACHYPNEA.
WHEN IS IT REQ FOR THE USE OF A CAR SEAT DURING TRANSPORT?
PEDS PATIENTS WEIGHING LESS THAN 40 LBS SHOULD BE TRANSPORTED IN A CAR SEAT AS LONG AS THE SITUATION ALLOWS.
USE OF NPA WITH PEDS
NPA IS TYPICALLY USED IN ASSOCIATION WITH POSSIBLE RESPIRATORY FAILURE. IT IS RARELY USED IN INFANTS YOUNGER THAN 1 YEAR. A NPA SHOULD NOTBE USED IN PED PTS WITH NASAL OBSTRUCTION OR HEAD TRAUMA OR IN PED PTS WITH MODERATE TO SEVERE HEAD TRAUMA BECAUSE TH
COMMON RISK FACTORS OF SIDS. (1196)
MOTHERS YOUNGER THAN 20 Y/O
MOTHERS WHO SMOKED DURING PREGNANCY
LOW BIRTH WEIGHT
Significance of 10-20% reduction in brain weight and volume:
Increased risk of damage to the intracranial vasculature because of increased movement of the brain due to decreased size
Cataracts
clouding of the lenses or their surrounding membranes
Interferes with vision, makes it difficult to distinguish colors and see clearly, increases likelihood of falls
Causes of abdominal aortic aneurysm:
Patients often have a history of hypertension and atherosclerosis; walls of the aorta weaken, and blood begins to leak into the layers of the vessel, causing the aorta to bulge like a bubble on a tire
Signs and symptoms of AAA:
Abdominal pain radiating through to the back with occasional flank pain; if it is large enough it can be felt as a pulsating mass just above the slightly to the left of the navel; decrease in flow to one of the legs, diminished or absent pulses in the ext