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Emergency Care, 13e (Limmer et al.)
Chapter 33 Pediatric Emergencies
1) The anterior fontanelle should be closed between the ages of ________ and ________.
A) 3 months; 6 months
B) 24 months; 36 months
C) 6 months; 10 months
D) 12 months; 18 months
Objective: 33.1
2) You are at a friend's birthday party with people of all ages. There is an 11-month-old boy, just
learning to stand up, who has fallen. He was holding onto the edge of a table and he toppled over.
He is crying hard and his mother is trying to console him. She asks if you would mind checking
him out, and you agree to take a look at him. You notice that his anterior fontanelle is bulging.
This is most likely caused by:
A) pressure built up because of his crying.
B) an infection causing intracranial pressure.
C) fluid loss from dehydration.
D) the bones of the head not fusing properly.
Objective: 33.2
1
3) In general, a child is considered an adolescent when he reaches the age of ________ years.
A) 9
B) 7
C) 12
D) 4
Objective: 33.2
4) Which of the following should be considered by the EMT as a result of the proportionally
larger size of a small child's head?
A) Adaptations in positioning for cervical spine immobilization
B) Different injury patterns than in adults
C) Differences in positioning to maintain an open airway
D) All of the above
Objective: 33.2
5) Which of the following is characteristic of preschool-age children?
A) They may believe their injury is a punishment for being bad.
B) They do not mind being separated from their parents.
C) They have few fears of anything.
D) They are not especially embarrassed or modest about body exposure.
Objective: 33.2
2
6) You have been called for a 2-year-old female who has fallen and is bleeding from a head
laceration. Her mother states that she was running down the hallway when she fell, striking her
head on a side table. You suspect that part of the reason she fell is that:
A) her head is proportionately larger and heavier than an adult's.
B) she has low blood sugar, making her unstable.
C) she is still new to walking and may be unstable on her feet.
D) both A and C are contributing factors.
Objective: 33.2
7) You are assessing a child who is having problems breathing. Her mother states that she has
been diagnosed with asthma and has recently started using an inhaler. Which of the following
would indicate early respiratory distress?
A) Cyanosis of the nail beds and lips
B) Slow heart rate
C) Respiratory rate of 12
D) Nasal flaring
Objective: 33.2
3
8) Because infants and small children rely more heavily on the diaphragm for breathing,
respiratory distress can be detected by observing which one of the following signs that is not
prominent in adults?
A) Bulging of the intercostal spaces
B) Use of the sternocleidomastoid muscles of the neck
C) Movement of the abdomen with respiratory effort
D) None of the above
Objective: 33.2
9) Which of the following is true regarding the EMT's approach to the pediatric patient?
A) An EMT does not have to attempt to obtain a blood pressure on patients younger than 3 years
old.
B) It is not necessary to use Standard Precautions when dealing with pediatric patients.
C) Scene safety is not an important consideration in the care of pediatric patients.
D) It is not possible to develop an initial impression of the pediatric patient without a detailed
physical examination.
Objective: 33.3
4
10) Capillary refill should be assessed in which of the following age groups?
A) Younger than 6 years
B) Younger than 1 year
C) 2-years-old and younger
D) Younger than 12 years
Objective: 33.3
11) As a rule, as a child gets older the blood pressure:
A) falls and the pulse rate rises.
B) rises and the pulse rate falls.
C) falls and the pulse rate falls.
D) rises and the pulse rate rises.
Objective: 33.3
12) You are called for a child that has had a fever for a couple of days. The parents tell you that
two of the other children have been home with a stomach virus and fever. As you attempt to
assess the child, he pulls away from you and grabs onto his mother. Which of the following
behaviors would be considered "normal" for a 4-year-old?
A) He doesn't make eye contact as you approach.
B) He begins to cry when you try to touch his booboo.
C) He runs up to you when you enter the room.
D) He flares his nostrils when he breathes.
Objective: 33.4
5
13) A 4-year-old child is generally categorized as a(n):
A) preschooler.
B) toddler.
C) school-age child.
D) adolescent.
Objective: 33.4
14) What is the tendency for a frightened child to act younger than his age?
A) Repression
B) Regression
C) Retreat
D) Retraction
Objective: 33.4
15) Which of the following is NOT a normal response of a small child when approached by the
EMT?
A) Anxiety
B) Indifference
C) Fear
D) None of the above
Objective: 33.4
6
16) Which of the following would be an appropriate statement in gaining the cooperation of a 7-
year-old pediatric patient during your assessment?
A) "Joey, this is a splint that will help your arm feel better. I promise it won't hurt when I put
your arm in it."
B) "Big girls don't cry, Emily. You're a big girl, aren't you?"
C) "I'm sorry Nick, but you can't see Mommy and Daddy until you let me take your blood
pressure."
D) "Katie, this is my stethoscope. I can use it to hear what your breathing sounds like. Would you
like to look at it for a minute?"
Objective: 33.4
17) Which of the following is a concern when dealing with an adolescent patient?
A) The adolescent patient will generally be more truthful about what happened in front of his
parents than in front of his peers.
B) Physiologically, adolescents are very different from adults.
C) The adolescent patient fears permanent disfigurement from injuries.
D) Adolescents usually lack the sophistication to understand explanations of what you are doing
and why.
Objective: 33.5
7
18) You are trying to assess Judy, a 16-year-old girl, who has abdominal cramps with nausea and
vomiting. Her mother, Mrs. Smith, is attempting to give you her daughter's past medical history.
It is important that you get the history of the present illness. Therefore, you should:
A) ask Mrs. Smith to go write down their physician's name and phone number.
B) ignore Mrs. Smith and ask Judy if she is sexually active.
C) ask Mrs. Smith if there is a chance Judy could be pregnant.
D) skip the history of current illness and suggest that Judy should visit her physician.
Objective: 33.5
19) All of the following are normal parental reactions to a child suffering from a sudden life-
threatening illness or injury except:
A) anger.
B) denial.
C) indifference.
D) guilt.
Objective: 33.6
8
20) Careful assessment and ongoing evaluation of the pediatric patient is critical for which of the
following reasons?
A) Childhood injuries and illnesses as a result of abuse or neglect may be missed if the EMT is
not thorough.
B) Signs of significant illness and injury may be subtle and easily overlooked.
C) A sick or injured child who initially appeared stable can deteriorate very rapidly.
D) All of the above
Objective: 33.7
21) Which of the following is NOT a component of the pediatric assessment triangle?
A) Appearance
B) Breathing
C) Circulation
D) Abdomen
Objective: 33.7
9
22) You are called for a sick 2-year-old boy. When you arrive, you see the boy sitting quietly on
his mother's lap. You note that he is not crying and has his head tucked against his mother's chest.
However, he does lift his head and look at you when you enter. As you approach, he withdraws
deeper toward his mother. What have you learned about the patient so far?
A) He probably does not have a fever.
B) He is alert and probably acting appropriately.
C) His front fontanelle is sunken, likely from dehydration.
D) His skin is warm and dry.
Objective: 33.7
23) Your protocols call for you to use the pediatric assessment triangle when assessing young
children. You know that the second leg of the triangle assesses the "work of breathing" and the
bottom leg of the triangle assesses "circulation to the skin." What does the first leg of the triangle
stand for?
A) Appearance
B) Airway
C) Alteration of mental status
D) Assessment
Objective: 33.7
10
