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24) You are assessing a 2-year-old child whose mother states she has had a fever for several
hours. Which of the following signs is cause for concern?
A) Crying
B) Absence of nasal flaring with inhalation
C) Grunting at the end of expiration
D) Respiratory rate of 28 breaths per minute
Objective: 33.8
25) A bulging fontanelle in a quietly resting child may be an indication of which of the
following?
A) Fever
B) Dehydration
C) Normal development
D) Increased intracranial pressure
Objective: 33.8
26) Which of the following is NOT a cause of altered mental status in the pediatric patient?
A) Traumatic brain injury
B) Diabetes
C) Dementia
D) Infection
Objective: 33.8
11
27) You respond to a 5-year-old child who has been injured while playing in his backyard. It
appears that he has broken his arm, but you cannot tell how it occurred. You will need to gather
some information regarding what exactly happened. Therefore, you should:
A) speak only to the mother to find out what happened.
B) tell the child that you will not hurt him.
C) get down to the child's eye level to talk to him.
D) tell the child that big boys don't cry.
Objective: 33.8
28) You are dispatched to a 1-year-old child with respiratory distress. En route, you review how
to assess and treat infants with respiratory problems. Which of the following would indicate an
infant with respiratory distress?
A) Wheezing upon inspiration
B) Respiratory rate of 30
C) Capillary refill time of 2 seconds
D) Abdominal movement when breathing
Objective: 33.8
12
29) You are trying to ventilate an 18-month-old baby who has stopped breathing. You have laid
him down on a flat surface to ventilate him, but you are unable to get his chest to rise. You
should:
A) tip his head back farther to open his airway.
B) flex his neck toward his chest.
C) place a folded towel under his shoulders.
D) suction his mouth to clear secretions.
Objective: 33.9
30) Which of the following is a consideration in airway management in the pediatric patient?
A) Keeping the nose clear of secretions
B) The need to hyperextend the head to achieve an open airway
C) Using blind finger sweeps to clear a foreign body from the airway
D) All of the above
Objective: 33.9
13
31) Your patient is a 3-year-old male who developed sudden stridor while playing with some of
his 5-year-old cousin's toys. The patient is alert and anxious, producing stridor when he cries. His
skin is pink and warm, and capillary refill is less than 2 seconds. Which of the following is
appropriate in the management of this child?
A) Perform abdominal thrusts.
B) Perform back blows and chest thrusts.
C) Attempt a finger sweep to remove the foreign body from the child's airway.
D) Transport the child in a restrained car seat with his mother by his side.
Objective: 33.9
32) Your patient is a 11-month-old male who began choking while his babysitter was feeding
him some sliced peaches. The child has retractions of his intercostal muscles, is drowsy, and is
grayish in color. Which of the following is the BEST intervention for this patient?
A) Use of a flow-restricted oxygen-powered ventilation device (FROPVD)
B) Back slaps and chest thrusts
C) Abdominal thrusts
D) Blow-by oxygen at 10 to 15 liters per minute
Objective: 33.9
14
33) Artificial ventilations for a 5-year-old child should be provided at a rate of ________ per
minute.
A) 24/28
B) 28/32
C) 12/20
D) 22/26
Objective: 33.9
34) Which of the following is NOT a common cause of shock in infants and children?
A) Heart failure
B) Blood loss
C) Infection
D) Dehydration
Objective: 33.10
35) Which of the following is an indication of shock in an infant or small child?
A) Capillary refill greater than 2 seconds
B) Absence of tears when crying
C) Not producing wet diapers
D) All of the above
Objective: 33.10
15
36) You are called to a home where a family has been enjoying a Labor Day picnic and swim
party. A 2-year-boy slipped to the bottom of the pool unnoticed. By the time you arrive, the child
has been removed from the water and family members are administering CPR. You assess the
child and note that he has a weak pulse and is trying to breathe on his own. You initiate transport
and continue providing positive pressure ventilations. You are also very concerned about:
A) the safety of the other children at the party.
B) how the parents are handling the situation.
C) the child being hypothermic.
D) the last time the child ate something.
Objective: 33.11
37) You are standing in line waiting to get a prescription filled for your mother. A woman walks
in with a young boy in her arms. As she places him in a nearby chair, he begins to seize. Which
of the following is true regarding childhood seizures?
A) They usually accompany a high fever.
B) Most are due to head injuries.
C) They usually last from 1 to 2 minutes.
D) They are due to a rapid rise in temperature.
Objective: 33.11
16
38) Which of the following is NOT likely to be a cause of respiratory distress in a 2-year-old
child?
A) Epiglottitis
B) A cold
C) Foreign body airway obstruction
D) Emphysema
Objective: 33.12
39) Which of the following is the MOST common cause of cardiac arrest in the pediatric patient?
A) Hypoglycemia
B) Congenital heart defects
C) Ventricular fibrillation
D) Respiratory failure
Objective: 33.12
40) Usually the first sign of respiratory distress in infants is:
A) bradycardia.
B) tachycardia.
C) bradypnea.
D) tachypnea.
Objective: 33.12
17
41) Which of the following signs may signify impending cardiac arrest in a child?
A) Respiratory rate over 60
B) Pulse rate over 120
C) Pulse rate 80 in a 5-year-old
D) Blood pressure of 105 systolic in a school age child
Objective: 33.12
42) You are called for a 6-year-old girl who is not well. Her mother says that the child has been
sick for several days but today she has had trouble keeping her daughter awake. You note that the
girl's capillary refill time is 4 seconds and she has a skin rash. The MOST important part of your
assessment will be to:
A) determine if she has a fever.
B) get a full SAMPLE history.
C) determine her level of consciousness.
D) recognize any respiratory distress.
Objective: 33.12
18
43) Which of the following is an early sign of respiratory distress in an 18-month-old patient?
A) Wheezing
B) Heart rate of 60 beats per minute
C) Drowsiness
D) Respiratory rate of 12 breaths per minute
Objective: 33.12
44) Which of the following is a sign of the MOST severe respiratory distress in a 1-year-old
pediatric patient?
A) Wheezing
B) Decreased muscle tone
C) Respiratory rate greater than 60
D) Grunting
Objective: 33.12
19
45) You have determined that your patient, a 6-year-old boy, most likely has epiglottitis. He has
developed a high fever and appears very ill. You realize that this is a serious illness and you need
to handle your patient carefully. You should:
A) check his temperature regularly.
B) not place anything in his mouth.
C) give him ice chips to suck on.
D) have him lie down with his head elevated.
Objective: 33.12
46) You are responding to a 6-year-old child with a fever and difficulty breathing. His mother
reports that he was playing normally this morning but when he came in for lunch he had spiked a
fever. Now, he is sitting up with his mouth open, drooling. Which of the following signs would
point to epiglottitis?
A) Loud "seal bark" cough
B) Painful swallowing
C) Low grade fever
D) Some hoarseness
Objective: 33.12
20
