Question 1
Question
A viral infection of the pediatric upper airway that results in inflammation of the subglottic region is known as:
Answer
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epiglottitis
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bronchiolitis
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croup
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bronchitis
Question 2
Question
An inflammation of an airway structure that is often due to a bacterial infection in children and is known to be potentially life threatening is:
Question 3
Question
Which of these is the best description of asthma?
Answer
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Viral infection of the lower airways
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Inflammatory disease of the lower airways
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Bacterial infection of the lower airways
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Bacterial or viral disease of the upper airways
Question 4
Question
What type of shock in the pediatric patient occurs when there is a marked decrease in peripheral vascular resistance?
Answer
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Distributive
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Cardiogenic
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Hypovolemic
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Obstructive
Question 5
Question
Which of these terms should be used to convey the preventable nature of childhood trauma?
Answer
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Injury
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Accident
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Misadventure
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Mishap
Question 6
Question
Which of these terms is best applied to the majority of childhood injuries?
Answer
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Unavoidable
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Inevitable
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Preventable
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Unforeseeable
Question 7
Question
Several large emergency medical services (EMS) systems have abandoned the practice of pediatric endotracheal intubation in favor of simple:
Question 8
Question
The less frequently a paramedic uses a skill, the:
Answer
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more likely that it is outside the scope of the paramedic's practice.
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more frequently it should be practiced.
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less time it will take to perform.
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more likely it is never to be necessary.
Question 9
Question
While you are questioning a 4-year-old with abdominal pain, he tells you that his stomach started hurting last week. Which of the following should you do next?
Answer
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Continue your interview with the parents because the child is unreliable.
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Continue questioning the child but verify information with the parents.
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Understand that pain of this duration is always an emergency.
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Ask the parents why they waited so long to seek help.
Question 10
Question
You are caring for a 5-year-old who was injured when his older brother accidentally stabbed him in the thigh with a pocketknife. The patient has lost about 350 mL of blood. He is pale, with cool, diaphoretic skin, and is awake but very still. As part of your treatment, you have applied direct pressure to the wound, stopped the bleeding, and covered the patient with a blanket. The patient's mother is very upset and does not want to let go of the child's hand. How should you go about completing your treatment?
Answer
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Ask the mother why the boys weren't supervised more closely.
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Ask your partner to take the mother to another room so you can work.
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Show the mother where to sit, so she can remain with the child while allowing you to work.
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Tell the mother she needs to stay out of the way so you can do your work.
Question 11
Question
You are caring for a 6-year-old who was struck by a car on the street in front of her home in a very impoverished part of town. Her distraught father yells at you to hurry up and says, "If this was a kid on the other side of the tracks, you would be moving faster!" Which of the following is the most appropriate response?
Answer
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"Sir, I can either pay attention to you and address your concerns or pay attention to your child. Please allow me to do my job."
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"I know this is upsetting. We are moving as fast as we can without making her condition worse. As long as I have your word that you won't yell at us, you can ride in the ambulance, and we will tell you everything we are doing."
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"Sir, if you don't calm down, the police are going to remove you from the scene."
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"Don't yell at us. We were not the ones who were responsible for keeping her out of the street."
Question 12
Question
Generally, adolescents:
Question 13
Question
You are transporting a dehydrated 9-month-old who has had a fever, vomiting, and diarrhea for 12 hours. He is lethargic with pale, cool, mottled skin and capillary refill time of 4 seconds. His respiratory rate is 38, and you have initiated oxygen due to a low pulse oximeter reading and have started an intraosseous (IO) infusion followed by an initial bolus of fluid according to protocol. The patient's perfusion has not improved. Which of the following is the best choice with regard to fluid resuscitation?
Answer
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Maintain the fluid at a keep-open rate.
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Give a second bolus of 20 mL/kg.
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Infuse fluids wide-open.
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Give a larger second bolus of 40 mL/kg.
Question 14
Question
You should consider the heart rate of a 5-year-old patient to be bradycardic beginning at a rate below how many beats per minute?
Question 15
Question
Which of these is the most common cause of cardiac arrest in an infant or a young child?
Question 16
Question
Compared to an adult's, an infant's or a child's:
Answer
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lung tissues are more fragile.
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ribs are harder and stiffer.
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mediastinum is less mobile.
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chest muscles tire less easily.
Question 17
Question
Above what respiratory rate would a 10-year-old child be considered to be breathing abnormally fast?
Answer
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36/min
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24/min
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20/min
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32/min
Question 18
Question
According to the pediatric assessment triangle, which of the following is used to assess the work of breathing when forming a general impression of the patient?
Answer
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Auscultating the lung sounds
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Presence of grunting, stridor, wheezing, and crowing
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Heart rate
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Skin color
Question 19
Question
What age should a pediatric patient be before blood pressures are routinely utilized?
Answer
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3 years
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1 month
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5 years
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1 year
Question 20
Question
According to the pediatric assessment triangle, which of the following is used to assess circulation to the skin?
Answer
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Skin color
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Capillary refill time
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Skin temperature
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Peripheral pulses
Question 21
Question
A 4-year-old male patient presents with stridor, a cough, and hoarseness when speaking. The paramedic should:
Answer
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begin cardiopulmonary resuscitation (CPR).
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place the patient in a position of comfort and transport immediately.
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perform a series back blows followed by a series of chest thrusts.
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perform a series of abdominal thrusts.
Question 22
Question
You are suctioning a 10-year-old female patient's airway following the patient having vomited. The patient has a decreased level of consciousness. You should:
Answer
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suction no deeper than you can see.
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stimulate the vagus nerve.
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use the largest flexible catheter available.
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decrease suction pressure to less than 100 mmHg.
Question 23
Question
An 8-year-old male patient presents with pale, cool, clammy skin; tachycardia and tachypnea; a weak peripheral pulse; and a decreased level of consciousness. The parents say the patient has been sick and vomiting with diarrhea for several days. According to his vitals, he is at the tail end of compensated shock, and his pulse oximeter reading is 90%. Your treatment should include:
Answer
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administration of supplemental oxygen and establishment of IV access for a 20 mL/kg bolus of normal saline.
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establishment of IV access for a 100 mL/kg bolus of lactated Ringer's.
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Blow-by oxygen and rapid transport in a position of comfort.
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intubation, continuous positive airway pressure (CPAP), and establishment of IV access for a wide-open bolus of normal saline.
Question 24
Question
A 7-year-old child is in cardiac arrest after experiencing respiratory arrest. Treatment for this patient should NOT include:
Answer
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epinephrine administration every 10 minutes in the pediatric patient.
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placement of an IV.
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placement of an advanced airway.
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administration of cardiopulmonary resuscitation (CPR).
Question 25
Question
What is the oxygenation goal for a pediatric patient receiving oxygen?
Answer
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SpO2 of 94 percent or greater
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SpO2 of 95 percent or greater except newborns, who should always receive 100% O2 until reaching the emergency department (ED) regardless of SpO2
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SpO2 of 100 percent for pediatric patients without a history of pulmonary disease
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A heart rate of 100 is reached
Question 26
Question
When performing ventilation on an infant receiving cardiopulmonary resuscitation (CPR), it may likely be necessary to:
Answer
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utilize a flow-restricted, oxygen-powered ventilation device.
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perform a needle cricothyrotomy.
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hyperextend the neck to open the airway.
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occlude the pop-off valve.
Question 27
Question
When does respiratory failure occur?
Answer
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The patient experiences an increase in arterial carbon dioxide tension.
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The patient experiences increased work of breathing.
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The cessation of breathing follows a period of bradypnea and agonal respirations.
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The respiratory system is unable to meet the body's demands for oxygen intake and carbon dioxide removal.
Question 28
Question
If present, which of the following findings should alert the paramedic that a child is in respiratory failure?
Answer
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Profound cyanosis
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Head bobbing
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Grunting
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Retractions
Question 29
Question
You are caring for a 2-year-old child who has been sick with a fever, diarrhea, and vomiting for 24 hours. To assess perfusion, which of these would provide you with the least reliable information about dehydration?
Question 30
Question
Which of the following presentations is most consistent with bronchiolitis?
Answer
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Runny nose, sore throat, cough, and low-grade fever that progress to ear pain in 2 to 3 days
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Mild lower respiratory infection signs and symptoms that progressively deteriorate over 1 to 2 days to respiratory distress with fever, cough, tachypnea, crackles in the lungs, and wheezing
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Mild upper respiratory signs and symptoms that progress in 1 to 2 days to inspiratory stridor, hoarseness, and a "seal bark" cough at night
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Rapid onset of high fever, dyspnea, inspiratory stridor, and drooling
Question 31
Question
In the secondary assessment of a 7-year-old child with difficulty breathing and a history of reactive airway disease, which of the following would give the paramedic the least amount of relevant information about the patient's ventilation and oxygenation?
Question 32
Question
A seven-year-old female patient who was drowning in a pond was rescued and resuscitated prior to your arrival. It is a cold day, and the water soaking the patient's clothing is very cold. What can you assume for this patient?
Answer
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The child experienced drowning without morbidity.
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Having been resuscitated, the child will suffer no ill effects from anoxia.
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The child is not in danger of neurological deficits because she only experienced a near drowning.
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The low temperature of the water might have helped protect the child against brain injury.
Question 33
Question
Which of the following actions should you take if you suspect that your pediatric patient is a victim of abuse?
Answer
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Report your findings to the appropriate authorities, including to the receiving hospital personnel.
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Request a social services follow-up visit for after the child is discharged from the hospital.
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Tell the parents that you are obligated by law to contact law enforcement and that they need to stay on the scene until law enforcement arrives.
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Contact medical direction to report your suspicions and request direction about contacting law enforcement.
Question 34
Question
Which of the following findings seems least consistent with child abuse?
Answer
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Bilateral foot burns in a 6-month-old
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Bruises on both knees of a 5-year-old
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Bite marks on the shoulder of a 1-year-old
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Circumoral ecchymosis of a 3-month-old
Question 35
Question
What term is used to describe the situation in which a child is regularly threatened, yelled at, or humiliated but not otherwise harmed?
Answer
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Social abuse
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Psychological abuse
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Physical abuse
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Sexual abuse
Question 36
Question
Which of these statements is true?
Answer
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The victims of sexual abuse typically do not know the perpetrators.
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The paramedic always must report suspected sexual abuse to the appropriate authorities and the medical personnel who will be assuming care of the patient.
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Something is not sexual abuse unless it involves an overt act involving physically touching the victim.
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Sexual abuse typically causes physical harm and so rarely goes unreported for long.
Question 37
Question
Which of these statements best describes why paramedics should be knowledgeable about pediatric patients who are dependent on medical technology?
Answer
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Emergency medical technicians (EMTs) must be able to make emergency repairs or adjustments to life-sustaining equipment.
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Emergency medical services (EMS) may be called when the medical condition worsens or a medical device fails.
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EMS providers are involved in routine home health care of patients with special medical challenges.
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A public health function of EMS is to make routine checks of specialized medical devices.
Question 38
Question
What is a common complication of a tracheostomy tube that a mucus plug may cause?
Answer
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Air embolism
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Obstruction
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Altered mental status
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Air leakage
Question 39
Question
You are on scene with a pediatric patient who is obtunded due to a congenital brain defect. As you are assessing the patient, you note that she has a gastric feeding tube and currently is hooked up to a machine that is delivering a feeding. You have not seen this type of pump before and have little experience with gastric tubes. What action should you take?
Answer
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Take the equipment with the patient.
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Turn off the equipment in preparation for transport.
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Disable any alarms on the equipment in preparation for transport.
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Ask the patient and caregivers about the device.
Question 40
Question
When responding to a report of a patient with difficulty breathing, you find a pediatric male about 3 years old in a hospital bed at home. He is cared for 24 hours a day by his parents. You note a small, round tube that exits from the patient's neck, through which he is breathing. Given this finding, which of these devices does the patient most likely have?
Answer
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Dual lumen catheter
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Tracheostomy tube
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Airway catheter
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Endotracheal tube
Question 41
Question
JumpSTART provides a framework for triage decisions that is:
Answer
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biased
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objective
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emotional
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unjust
Question 42
Question
Which of the following best identifies the age group of patients who should be triaged by using the JumpSTART system?
Answer
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School-age and adolescent children
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Patients who look younger than a young adult
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Toddlers and preschoolers
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Infants, toddlers, and preschoolers
Question 43
Question
Which statement best describes the purpose of the JumpSTART triage method?
Answer
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To find and treat all of a patient's injuries before moving him or her
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To treat all patients as they are discovered
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To do the most good for the greatest number of patients
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To treat the youngest, healthiest patients first
Question 44
Question
High winds blew down a tent at an outdoor high school graduation reception. A fire started from the fuel used for the hot buffet. Several people were injured by the tent collapse, and several patients have burns. The first patient you triage is a 3-year-old girl. She is not breathing. You open her airway, but she does not start breathing. What is the next action?
Answer
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Check the patient's pulse.
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Categorize the patient as black.
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Start cardiopulmonary resuscitation (CPR), beginning with chest compressions.
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Deliver five rescue breaths.
Question 45
Question
You are called to a residence for a 7-year-old child in hypovolemic shock. You note evidence of severe dehydration, hypoxia, and malnutrition. The child is wearing dirty clothes and appears to be unwashed. The child's home is visibly unclean. What is your immediate priority?
Answer
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Treat the child for shock, administering oxygen and establishing IV access for the replacement of fluids.
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Call in law enforcement to take the caregivers into custody for neglect while maintaining a safe distance.
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Immediately call in the case as child abuse.
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Carefully question the child's caregivers about the child's circumstances.
Question 46
Question
You respond to a call for a 10-year-old patient who hit a road sign while traveling at high speed on a bicycle. The child is unconscious with no eye opening or motor or verbal response and has a severe contusion to the head. You note elevated blood pressure but a depressed heart rate with decreasing, deep respirations and an SpO2 of 92 percent. What do you assess as the problem, and how do you manage this patient?
Answer
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Severe traumatic brain injury with increasing intracranial pressure, to be managed with rapid sequence intubation and rapid transport to a pediatric trauma facility
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Mild traumatic brain injury with decreasing intracranial pressure, to be managed with rapid sequence intubation, ventilation, and rapid transport to a pediatric trauma facility
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Moderate traumatic brain injury with increasing intracranial pressure, to be managed with endotracheal intubation, ventilation, and rapid transport to a pediatric trauma facility
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Severe traumatic brain injury with increasing intracranial pressure, to be managed with rapid sequence intubation, ventilation, and rapid transport to a pediatric trauma facility
Question 47
Question
You note gastric distention in a 6-month-old patient experiencing respiratory failure you are attempting to ventilate but for whom you are not able to achieve adequate tidal volume. What do you do?
Answer
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Administer a neuromuscular blocker.
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Place a laryngeal mask airway.
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Insert a 12 French nasogastric tube.
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Insert an 8.0 French nasogastric tube.
Question 48
Question
A 12-year-old patient collided face first with another child while both were riding bikes. The patient bit his tongue when his jaw was struck and received a black right eye and bloody nose. He is alert and oriented, and after you suction some blood from his airway appears to have no respiratory compromise, with respirations clear bilaterally and 20/minute. Your index of suspicion should be high for what other injury?