General Medical - 45 Mins - EMT-p
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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:
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Stridor.
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Delayed capillary refill time.
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Weak pulses.
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The ability to tolerate oral feedings.
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Please place your FD or EMS Agency Name and your complete name in the name box.
Quiz Preview
- 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:
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Normal finding for a toddler.
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Sign of impending respiratory failure.
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Sign of decreased perfusion to the respiratory center.
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Compensatory mechanism to increase the volume of air inhaled and respiratory rate.
Correct Answer
A. Normal finding for a toddler.Explanation
Abdominal breathing in a toddler is considered a normal finding. Toddlers have a more horizontal diaphragm, which causes them to primarily use their abdominal muscles for breathing. This is different from adults who primarily use their chest muscles for breathing. In this case, the 2-year-old girl is alert and sitting on her mother's lap, which indicates that she is able to maintain her airway and is not in respiratory distress. The increased work of breathing is likely due to the inflammation and congestion caused by the fever and runny nose. Therefore, abdominal breathing in this patient is a normal compensatory mechanism to increase the volume of air inhaled and respiratory rate.Rate this question:
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- 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:
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Administer a nebulizer treatment with a beta-agonist medication.
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Administer humidified oxygen via blow-by method.
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Suction the oropharynx for secretion.
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Deliver bag-valve-mask ventilations.
Correct Answer
A. Administer humidified oxygen via blow-by method.Explanation
The correct answer is to administer humidified oxygen via blow-by method. This is the first step in the treatment because the patient is experiencing difficulty breathing and increased work of breathing. Humidified oxygen can help improve oxygenation and relieve respiratory distress. Nebulizer treatment with a beta-agonist medication may be considered later if the patient's symptoms worsen or if there is evidence of bronchospasm. Suctioning the oropharynx for secretion may be necessary if there is significant airway obstruction, but it is not the first step in treatment. Bag-valve-mask ventilations may be required if the patient's condition deteriorates, but it is not the initial step.Rate this question:
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- 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?
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He is unresponsive and his skin is cool because of a low body temperature from being outside
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His heart rate is fast because of pain in his shoulder and leg
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His respirations are fast because the impact affected the respiratory center in his brain
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His blood pressure is low because compensatory mechanisms for blood loss are failing
Correct Answer
A. His blood pressure is low because compensatory mechanisms for blood loss are failingExplanation
The correct answer is that the patient's blood pressure is low because compensatory mechanisms for blood loss are failing. This is indicated by the low blood pressure reading of 74/62 mm Hg, which suggests hypotension. The patient's pale, cool skin is also a sign of decreased perfusion and blood loss. Additionally, the elevated heart rate of 152 beats/min is a compensatory response to maintain cardiac output in the face of decreased blood volume. These findings collectively indicate that the patient is experiencing hypovolemic shock due to significant blood loss from his injuries.Rate this question:
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- 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:
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Anxiety.
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Hypovolemia.
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Pneumothorax.
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Swelling of the brain.
Correct Answer
A. Hypovolemia.Explanation
The correct answer is hypovolemia. In this scenario, the infant is presenting with symptoms of lethargy, cough, vomiting, and diarrhea, which are indicative of a potential fluid loss. The mottled skin color, capillary refill time of 4 seconds, low blood pressure, and tachycardia (high pulse rate) further support the diagnosis of hypovolemia, which refers to a decrease in blood volume. Hypovolemia can lead to inadequate perfusion of vital organs, causing the body to compensate by increasing heart rate in an attempt to maintain blood flow.Rate this question:
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- 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:
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Administer 100% oxygen by mask.
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Administer dopamine intravenously.
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Administer epinephrine via an intraosseous needle.
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Perform endotracheal intubation.
Correct Answer
A. Administer 100% oxygen by mask.Explanation
The correct answer is to administer 100% oxygen by mask. This is the appropriate initial treatment because the infant is showing signs of poor oxygenation, such as mottled skin color and a capillary refill time of 4 seconds. Administering 100% oxygen by mask will help improve oxygenation and support the infant's respiratory function. It is important to address the underlying cause of the symptoms, such as a possible infection, but providing oxygen is the immediate priority in this case.Rate this question:
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- 7.
Which of the following findings in a 2-year-old child assists in identifying the cause of a grand mal seizure?
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Fever
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Crackles in the lungs
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Abdominal tenderness
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Cardiac dysrhythmia
Correct Answer
A. FeverExplanation
A grand mal seizure is a type of seizure that involves loss of consciousness and violent muscle contractions. In a 2-year-old child, the presence of a fever can be a helpful finding in identifying the cause of the seizure. Fevers can be caused by infections, such as meningitis or encephalitis, which can trigger seizures. Therefore, the presence of a fever suggests that an infection may be the underlying cause of the seizure in this child.Rate this question:
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- 8.
Activated charcoal is contraindicated in a patient who has ingested a toxic substance if:
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There is a history of abdominal surgery.
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There is a history of diarrhea or vomiting.
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The substance was corrosive.
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The substance was ingested approximately one hour ago.
Correct Answer
A. The substance was corrosive.Explanation
Activated charcoal is contraindicated in a patient who has ingested a toxic substance if the substance was corrosive. Activated charcoal is commonly used to treat poisonings by adsorbing the toxic substance in the gastrointestinal tract and preventing its absorption into the bloodstream. However, if the substance ingested is corrosive, such as a strong acid or alkali, administering activated charcoal can actually worsen the damage to the tissues in the gastrointestinal tract. In these cases, other treatment options should be considered.Rate this question:
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- 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:
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Stabilize her cervical spine to reduce the risk of further spinal injury.
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Elevate her head to reduce the risk of aspiration.
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Turn her on her side to allow any water to drain from her mouth.
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Open her mouth and insert an oropharyngeal airway to maintain a patent airway.
Correct Answer
A. Stabilize her cervical spine to reduce the risk of further spinal injury.Explanation
The correct answer is to stabilize her cervical spine to reduce the risk of further spinal injury. This is the first step in caring for a patient who has experienced a diving accident and is unresponsive. By stabilizing the cervical spine, it helps to prevent any movement that could potentially worsen a spinal injury. This is crucial in order to minimize further damage and protect the patient's neurological function. The other options, such as elevating her head, turning her on her side, or inserting an oropharyngeal airway, may be important steps in caring for the patient, but stabilizing the cervical spine takes priority in this situation.Rate this question:
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- 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?
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Telling him he must lie still or he may become paralyzed
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Exposing only those areas currently being assessed and then covering them
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Asking him if it is okay to listen to his lungs and touch his chest and stomach
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Asking him what hurts the most and begin by assessing that area of the body
Correct Answer
A. Exposing only those areas currently being assessed and then covering themExplanation
The best approach to conducting the assessment of this patient is to expose only those areas currently being assessed and then cover them. This approach ensures that the patient's privacy and dignity are maintained while allowing the healthcare provider to thoroughly assess the patient's injuries. By exposing and covering one area at a time, the healthcare provider can focus on each specific injury, such as the deformed right forearm, and assess it without causing unnecessary discomfort or distress to the patient.Rate this question:
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- 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:
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Manually stabilize the cervical spine to reduce the risk of spinal injury.
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Initiate hyperventilation to reduce the accumulation of acids in the body.
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Cover him with blankets to prevent heat loss.
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Place him in a position of comfort to decrease anxiety.
Correct Answer
A. Manually stabilize the cervical spine to reduce the risk of spinal injury.Explanation
The correct answer is to manually stabilize the cervical spine to reduce the risk of spinal injury. This is the first step in caring for a patient who has fallen from a height and has potential trauma to the spine. Stabilizing the cervical spine is crucial to prevent further damage and potential paralysis. The patient's symptoms, such as the deformed forearm and multiple abrasions, suggest that there may be additional injuries, and it is important to prioritize the stabilization of the spine before addressing other injuries or providing comfort measures.Rate this question:
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- 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?
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Secondary brain injury
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Hypoxia
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Pain
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Hypothermia
Correct Answer
A. PainExplanation
The most likely cause for the abnormal appearance of this patient is pain. The boy fell from a significant height and landed on his right arm and side, resulting in a deformed forearm and multiple abrasions. The presence of pale, warm skin, along with an increased heart rate and respiratory rate, suggests that the patient is experiencing pain and distress. Pain can cause physiological changes in the body, such as increased heart rate and blood pressure, which can contribute to the abnormal appearance of the patient.Rate this question:
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- 13.
What information is important to obtain about a child with smoke inhalation?
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Presence of windows or ventilation in the room
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Position of the patient when found
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History of recent cold symptoms
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Location in the room where the patient was found
Correct Answer
A. Presence of windows or ventilation in the roomExplanation
When a child has smoke inhalation, it is important to obtain information about the presence of windows or ventilation in the room. This information is crucial because it can help determine the extent of smoke exposure and the potential for carbon monoxide poisoning. Windows or ventilation can provide an escape route for smoke and allow fresh air to enter the room, reducing the child's exposure to toxic gases. Therefore, knowing whether there were windows or ventilation in the room can aid in assessing the severity of the child's condition and guide appropriate treatment measures.Rate this question:
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- 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:
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Toxic exposure.
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Shaken baby syndrome.
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Seizures.
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Respiratory failure.
Correct Answer
A. Shaken baby syndrome.Explanation
The correct answer is shaken baby syndrome. Shaken baby syndrome occurs when a caregiver violently shakes an infant, causing the brain to move back and forth within the skull. This can result in serious brain injury, leading to altered level of consciousness and other symptoms. In this scenario, the babysitter's description of the infant suddenly becoming quiet and unresponsive after hours of crying is consistent with shaken baby syndrome. Additionally, the babysitter's frustration and inability to calm the infant suggests a potential abusive situation.Rate this question:
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- 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?
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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.
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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.
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Contact the local law enforcement agency to request that the caregiver be arrested while you transport the child.
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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.
Correct Answer
A. 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.Explanation
The best way to interact with the caregivers is to explain that you are very concerned about the child's condition and that he needs to be examined at the hospital for a possible broken leg. This approach shows empathy towards the caregivers while also prioritizing the child's health and safety. It allows for open communication and encourages the caregivers to seek appropriate medical attention for the child's injuries.Rate this question:
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- 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:
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Vigorously dry and warm the baby.
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Copiously suction the mouth and nose.
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Administer oxygen by nasal cannula at 4 L/min.
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Calculate the APGAR score.
Correct Answer
A. Copiously suction the mouth and nose.Explanation
When the bag of waters breaks and the fluid is thick green, it indicates the presence of meconium, which is the baby's first stool. Meconium-stained fluid can be a sign of fetal distress and can potentially obstruct the baby's airway if aspirated. Therefore, the most important treatment for the newborn in this situation is to copiously suction the mouth and nose to remove any meconium and ensure clear airway passage. This intervention helps prevent respiratory complications and ensures the baby can breathe properly after delivery.Rate this question:
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- 17.
Ascertaining the due date of a newborn during an impending delivery helps you to:
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Assemble the correct size of equipment to care for the baby.
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Decide whether the baby will be delivered at the scene or if there is time to transport the mother to the hospital.
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Decide if an on-scene delivery is needed, particularly if the infant is premature, as the labor is often shorter for these infants.
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Determine if meconium aspiration may have occurred.
Correct Answer
A. Assemble the correct size of equipment to care for the baby.Explanation
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. This is because knowing the due date allows you to estimate the size of the baby and prepare the necessary equipment such as diapers, clothing, and other supplies that are appropriate for their age and size. This ensures that you are well-prepared to provide the necessary care and support for the newborn.Rate this question:
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- 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:
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Initiating bag-valve-mask ventilations.
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Performing intubation and positive pressure ventilation.
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Applying free flow oxygen by mask at 5 L/min.
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Reassessing the skin color in five minutes and then initiating oxygen therapy if needed.
Correct Answer
A. Applying free flow oxygen by mask at 5 L/min.Explanation
The newborn in this scenario is exhibiting cyanosis, which indicates a lack of oxygen in the blood. The initial treatment for cyanosis in a newborn is to provide oxygen therapy. Applying free flow oxygen by mask at 5 L/min is the appropriate intervention in this case. This will help increase the oxygen levels in the baby's blood and alleviate the cyanosis. Reassessing the skin color in five minutes and then initiating oxygen therapy if needed is not the correct approach, as immediate intervention is required in the presence of cyanosis. Bag-valve-mask ventilations and intubation with positive pressure ventilation are more invasive measures that are not necessary at this point.Rate this question:
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- 19.
An infant should be immediately evaluated by a physician if which of the following signs or symptoms are present?
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Use of abdominal muscles to breathe
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Temperature of 37 degrees (98.6 F)
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Acting fussier than normal
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Refuses a pacifier
Correct Answer
A. Acting fussier than normalExplanation
If an infant is acting fussier than normal, it may indicate that something is wrong or bothering them. Infants are not able to communicate their discomfort or pain verbally, so fussiness can be a sign of various underlying issues such as illness, discomfort, hunger, or tiredness. Therefore, it is important to have the infant evaluated by a physician to determine the cause of the fussiness and provide appropriate medical attention if needed.Rate this question:
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- 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?
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A slow heart rate and poor air exchange
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Irregular respirations and wheezing
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Crackles and decreased breath sounds
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Unequal chest rise and wheezing
Correct Answer
A. A slow heart rate and poor air exchangeExplanation
A slow heart rate and poor air exchange suggest significant obstruction of the tracheostomy tube. The slow heart rate indicates decreased oxygen supply to the body, while poor air exchange indicates difficulty in breathing. These signs together indicate that the tracheostomy tube is not allowing adequate airflow, leading to respiratory distress and compromised oxygenation.Rate this question:
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- 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?
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Allow the patient to remain on the ventilator if he is not in respiratory distress
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Immediately deliver bag-valve-mask ventilations because you may not be familiar with the ventilator
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Switch the patient to oxygen by blow-by method because the ventilator will not work in the ambulance
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Decrease the flow rate as the oxygen in the ambulance is more potent and requires a lower flow rate
Correct Answer
A. Allow the patient to remain on the ventilator if he is not in respiratory distressExplanation
If the boy is not in respiratory distress, it is best to allow him to remain on the ventilator. This is because the ventilator is providing the necessary support for his breathing, and it is important to maintain continuity of care during transport. Switching to other methods such as bag-valve-mask ventilation or blow-by oxygen may not be necessary if the patient is stable on the ventilator. It is important to monitor the boy's respiratory status closely during transport and make adjustments if needed.Rate this question:
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- 22.
What is the danger of using a mask that is too large on a child who requires ventilatory assistance?
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Eye injuries may occur from the mask touching the globe
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It will be more difficult to obtain a seal for ventilation
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More pressure will need to be applied to obtain a mask seal, which may cause dislocation of the mandible
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If the mask extends across the eyes, it may exert pressure and stimulate the vagus nerve
Correct Answer
A. It will be more difficult to obtain a seal for ventilationExplanation
Using a mask that is too large on a child who requires ventilatory assistance will make it more difficult to obtain a seal for ventilation. This means that the mask will not fit properly on the child's face, leading to air leakage. As a result, the child may not receive the necessary amount of oxygen, which can be dangerous and potentially life-threatening.Rate this question:
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- 23.
What is the correct method to confirm proper placement of an endotracheal tube?
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Palpate for chest rise and fall over the anterior chest and abdomen
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Observe for gastric distention which indicates leakage of air around the tube in the trachea
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Auscultate the anterior chest and mid-abdominal area for the presence of bubbling or gurgling sounds
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Auscultate for bubbling or gurgling sounds over the epigastrium and breath sounds at the midaxillary regions
Correct Answer
A. Auscultate for bubbling or gurgling sounds over the epigastrium and breath sounds at the midaxillary regionsExplanation
The correct method to confirm proper placement of an endotracheal tube is to auscultate for bubbling or gurgling sounds over the epigastrium and breath sounds at the midaxillary regions. This is because the presence of these sounds indicates that the tube is correctly placed in the trachea and not in the esophagus or bronchus. Palpating for chest rise and fall over the anterior chest and abdomen may not be reliable as it can be influenced by other factors. Observing for gastric distention may indicate leakage of air but does not confirm proper tube placement. Auscultating the anterior chest and mid-abdominal area for sounds is not a recommended method for confirming tube placement.Rate this question:
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- 24.
When should the child s head be secured to the spine board during the immobilization procedure?
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After the body straps and lateral stabilization devices have been applied
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After the body straps have been applied, but before the lateral stabilization devices to ensure that the tape is applied tightly
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Before any straps or lateral stabilization devices have been applied
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If the child is quiet the head does not need to be secured once lateral stabilization devices are applied
Correct Answer
A. After the body straps and lateral stabilization devices have been appliedExplanation
The child's head should be secured to the spine board after the body straps and lateral stabilization devices have been applied. This ensures that the head is properly immobilized and aligned with the rest of the body, providing maximum support and minimizing the risk of further injury. Securing the head last also allows for proper adjustment and tightening of the straps and devices to ensure a secure fit.Rate this question:
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- 25.
Which of the following substances can be infused via an intraosseous needle?
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All medications and intravenous fluids
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All medications except sodium bicarbonate and dextrose
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Fluids or medications that are not acidic
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Only medications and fluids that have a neutral pH
Correct Answer
A. All medications and intravenous fluidsExplanation
An intraosseous needle is a needle that is inserted into the bone marrow cavity, allowing for the infusion of fluids and medications directly into the bloodstream. This method is used when intravenous access is difficult or not possible. The correct answer states that all medications and intravenous fluids can be infused via an intraosseous needle, indicating that this method is versatile and can be used for a wide range of substances.Rate this question:
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Aug 16, 2023Quiz Edited by
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Jun 03, 2008Quiz Created by
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