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EPC 4E TEST ,EPC 4E TEST ,EPC 4E TEST ,EPC 4E TEST, Exams of Medicine

Antillean Adventist University (AAU)Medicine

EPC 4E TEST EPC 4E TEST EPC 4E TEST EPC 4E TEST EPC 4E TEST

Typology: Exams

2025/2026

Available from 06/08/2026

Nurse-Camille 🇺🇸

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EPC 4E TEST

While assessing a 9 year old female, you note she has a fever, stiff

neck, and petechia. You suspect meningitis. Which of the following

steps is appropriate?

-

Avoid touching the child to limit the risk of infection

-

Ensure your entire crew is wearing masks, gloves, and eye

protection

-

Immediately perform your assessment without considering body

substance isolation because of the patient's acuity

-

Administer an IV fluid bolus and diazepam IM - ANSWERS-Ensure

your entire crew is wearing masks, gloves, and eye protection

When treating a preschool-aged child who is suffering from mild to

moderate pain, treatment should include which of the following?

-

IN fentanyl

-

IM ketamine

-

IV opioids

-

PO acetaminophen - ANSWERS-PO acetaminophen

While caring for a 4 year old female, you note numerous unexplained

bruises and injuries in various stages of healing. Her mother refuses to

let you transport the child to the hospital. You are suspicious of child

maltreatment. Which of the following actions should you take?

Discover Exams of Medicine Antillean Adventist University (AAU)

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EPC 4E TEST

While assessing a 9 year old female, you note she has a fever, stiff neck, and petechia. You suspect meningitis. Which of the following steps is appropriate?

Avoid touching the child to limit the risk of infection
Ensure your entire crew is wearing masks, gloves, and eye protection
Immediately perform your assessment without considering body substance isolation because of the patient's acuity
Administer an IV fluid bolus and diazepam IM - ANSWERS-Ensure your entire crew is wearing masks, gloves, and eye protection When treating a preschool-aged child who is suffering from mild to moderate pain, treatment should include which of the following?
IN fentanyl
IM ketamine
IV opioids
PO acetaminophen - ANSWERS-PO acetaminophen While caring for a 4 year old female, you note numerous unexplained bruises and injuries in various stages of healing. Her mother refuses to let you transport the child to the hospital. You are suspicious of child maltreatment. Which of the following actions should you take?

Attempt to talk the mother into allowing you to transport the patient to the hospital, then give up if she continues to refuse
Have mom sign a refusal form
Contact medical control and/or call the police for assistance, per your agency protocols
Directly share your concerns of abuse with the mother - ANSWERS- Contact medical control and/or call the police for assistance, per your agency protocols A 13 year old female was struck by a car while riding her bike. She presents with hypotension, respiratory distress, and decreased breath sounds on the right. Which of the following is the highest priority treatment for this patient?
NG tube placement
Immediate needle decompression of the right chest
Wide-open IV fluids
Elevation of the head of the stretcher - ANSWERS-Immediate needle decompression of the right chest An 8 year old male has had vomiting and diarrhea for 4 days. His general appearance is poor and his interactions are obtunded. The family states this is not usual for him. You note that he has weak peripheral pulses, but his central pulses are strong. What does this tell you?

Children respond to volume-related hypo perfusion by which of the following mechanisms?

Vigorous vasodilation
Increasing cerebral perfusion
Decreasing heart rate
Vigorous vasoconstriction - ANSWERS-Vigorous vasoconstriction You are dispatched to an 11 year old female patient complaining of abdominal pain. Upon your arrival, you find the patient lying on the couch in the fetal position. The PAT reveals the patient is alert and has a patent airway, increased work ob breathing, and pale skin. The patient is crying and says, "my belly hurts." Mom informs you that the patient has been vomiting all day. Your physical exam notes a distended abdomen, but no signs of physical trauma. Vital signs are BP 82/50, HR 138, RR 28, SpO2 94%, GCS 15 (E4, V5, M6), and a blood glucose 112 mg/dL. The patient has a history of asthma and sickle cell disease. In this scenario, which of the following findings is critical with this patient?
Patient age
Respiratory rate
Blood glucose level
Patient is crying in the fetal position - ANSWERS-Patient is crying in the fetal position

When evaluating a child with multiple bruises on their body, which of the following is the best indicator that the injuries are not the result of child maltreatment?

Bruising found on infants who are not yet crawling
An 18 month old with bruising on his head
Bruising on the torso, ears, or neck in a child 4 years of age or younger
Bruises that are located away from bony prominences - ANSWERS- An 18 year old with bruising on his head Which of the following behavioral health disorders is most likely to be a risk factor for suicidal ideation?
Anxiety
Depression
Autism spectrum disorder
Attention-deficit/hyperactivity disorder (ADHD) - ANSWERS- Depression When caring for children with special healthcare needs, it is important to remember which of the following?
The caregivers and even children may be more knowledgeable about the underlying healthcare needs than you

Understanding how children think and communicate - ANSWERS- Enlisting the caregivers as members of the patient care team Accurate documentation of suspected child maltreatment is extremely important. Which of the following is correct when documenting child maltreatment?
Document the subjective information about the situation
All information should be documented verbatim
Document your conclusion about who abused the child
Document the weapon or mechanism you think was the cause of the injuries - ANSWERS-All information should be documented verbatim A 2 year old male is found at the bottom of a swimming pool. He is unresponsive and apnea. After removing him the from water, which of the following would be the proper order of pediatric resuscitation for this patient?
Initiate PAT, abdominal thrusts to force any fluids form his lungs, assess pulses, begin CPR if indicated
Remove his wet clothing and cover him with dry blankets
Assess his cardiac rhythm, initiate PAT, initiate basic airway management, transport
Initiate PAT, primary survey, address clinical interventions that are needed, begin CPR if indicated - ANSWERS-Initiate PAT, primary survey, address clinical interventions that are needed, begin CPR if indicated

Hypothermia increases oxygen demands, and newborns can easily become hypothermic. Which of the following is the recommended way to prevent heat loss in a newborn?

Placing the newborn on a bed alone
Avoiding skin-to-skin contact between the newborn and mother
Warming and drying the newborn and placing on mom for skin-to- skin contact
Placing the newborn directly under a warming lamp without drying - ANSWERS-Warming and drying the newborn and placing on mom for skin-to-skin contact Positive-pressure ventilations should be initiated on a newborn who is apnea, shows signs of inadequate respiratory effort, or has which of the following?
Pulse oximetry less than 95%
Heart rate less than 100 after stimulation and oxygen delivery
Respiratory rate greater than 20 breaths per minute
No available nasal cannula - ANSWERS-Heart rate less than 100 after stimulation and oxygen delivery Which of the following is the most common cause of upper airway obstruction in pediatric patients younger than 6 years?

When obtaining your impression of pediatric patients, which of the following parameters are quickly assessed?

Revised trauma score, blood pressure, heart rate
Glasgow Coma Scale, airway, breathing
General appearance, work of breathing, circulation to the skin
Airway, respiratory rate, pulse, cardiac rhythm - ANSWERS- General appearance, work of breathing, circulation to the skin Intraosseous vascular access in children with a critical condition is:
Contraindicated in most cases
Usually achieved rapidly with a high success rate
Difficult to obtain and has a low success rate
Experimental - ANSWERS-Usually achieved rapidly with a high success rate Helpful practices in treating adolescent patients include which of the following?
Lying about painful procedures so they don't get upset
Asking the patient questions in front of their parents/caregivers
Allowing them to make simple choices about their care
Not questioning them directly about their history - ANSWERS- Allowing them to make simple choices about their care

An 8 year old female is pulseless and apnea after being pulled from a lake on an early fall afternoon. Upon completing 5 minutes of cardiac arrest management, you and your partner achieve return of spontaneous circulation (ROSC). Continued treatment for this patient includes:

Maintaining an ETCO2 of less than 20 mmHg
Continuing positive-pressure ventilation
Discontinuing ventilatory support
Administering a fluid bolus of 10 mL/kg - ANSWERS-Continuing positive-pressure ventilations You are caring for a newborn, and their heart rate remains less than 60 after positive-pressure ventilation. What should be your next action?
Increase oxygen percentage
Oral suctioning
Obtain IV access and administer epinephrine
Begin chest compressions - ANSWERS-Begin chest compressions Which of the following is correct about ingestion of marijuana in food (edibles)?
Naloxone administration is recommended
Airway compromise is a concern

An 8 year old male was struck by a car while riding his bike. He presents with hypotension, respiratory distress, and decreased breath sounds on the right. Which of the following injuries would present the greatest immediate danger to the patient?

Closed head injury
Ruptured diaphragm
Lacerated liver
Tension pneumothorax - ANSWERS-Tension pneumothorax Which of the following best describes respiratory failure?
Inadequate respiratory effort
Patient can no longer maintain oxygenation and ventilation
Patient has asthma
Patient has visible retractions - ANSWERS-Patient can no longer maintain oxygenations and ventilation You respond to a 2 year old male for difficulty breathing. He presents with inspirations stridor, barking cough, and a temperature of 100. °F. Which of the following actions should be your initial treatment?
Administer nebulized epinephrine
Prepare to intubate

Administer nebulized albuterol
Administer IV fluids - ANSWERS-Administer nebulized epinephrine Which of the following is an appropriate technique when suctioning a child with a tracheostomy tube?
Suction the or pharynx with a Yankauer for 15 seconds
Force the suction catheter down the tracheostomy tube and suction while removing the catheter
Cover the suction port and suction for 15 seconds while removing the catheter
Cover the suction port and suction for 3 - 5 seconds while removing the catheter - ANSWERS-Cover the suction port and suction for 3 - 5 seconds while removing the catheter Initial steps for cardiac arrest in a child include which of the following?
Hands-only CPR
Administration of medication prior to CPR
Immediate use of an AED or defibrillator
Immediate high-quality, choreographed CPR with ventilations - ANSWERS-Immediate high-quality, choreographed CPR with ventilations

It follows the XABCDE approach
If three sides of the triangle are compromised, you do not have to consider moving quickly
The PAT does not focus on the ABCs of a pediatric patient - ANSWERS-It is a tool used to obtain your first impression of a pediatric patient A 10 year old male is complaining of thirst, hunger, and excessive urination. He also has vomiting and his breath smells like nail polish remover. His blood glucose level is 358 mg/dL. You suspect he is suffering from:
Inflammatory bowel disease
Meningitis
Diabetic ketoacidosis
Influenza - ANSWERS-Diabetic ketoacidosis Which of the following descriptions is accurate for post-traumatic stress disorder (PTSD)?
It is severe sadness and hopelessness for a period of 2 weeks or greater
It develops in some pediatric patients who experience or witness a traumatic event
It is more common in boys than in girls

It is the most common reason for pediatric behavioral health EMS transports - ANSWERS-It develops in some pediatric patients who experience or witness a traumatic event You and your partner respond to a 5 year old male with special healthcare needs who is on a ventilator at home. Upon arrival, you find him on the ventilator but in clear respiratory distress. What should you attempt first?
Immediately remove the trach tube and replace it with a new, smaller one
Suction the tube to clear any secretions or mucus plugs
Increase the rate, tibial volume, and the percentage of oxygen delivered by the ventilator
Nothing; leave him on the ventilator until you reach the hospital - ANSWERS-Suction the tube to clear any secretions or mucus plugs Which of the following is one of the ways the pediatric airway differs from the adult airway?
The larynx is more posterior
The epiglottis is stiffer
Neutral airway positioning involves hyperextending the neck
The tongue is larger in relation to the size of the mouth - ANSWERS-The tongue is larger in relation to the size of the mouth

Remove the remaining portion of the line and apply a dressing
Have the parents take her to the hospital
Initiate an IV bolus using the central line
Clamp the line if possible and transport to her usual hospital - ANSWERS-Clamp the line if possible and transport to her usual hospital In which of the following situations is endotracheal intubation indicated in a pediatric patient?
A patient is postictal form a seizure with a normal respiratory effort
There is evidence of meconium spirit ion and good general appearance immediately after birth
There are signs of basilar skull fracture
All other airway management resources have been exhausted - ANSWERS-All other airway management resources have been exhausted Which of the following is the correct sequence of initial steps in caring for a newborn?
Dry, elevate the baby above the mother's heart until the cord is up
Dry, warm, position, stimulate gently, suction if needed
Cut the cord, suction, turn upside down to drain secretions
Warm, stimulate if needed, put drops in the eyes - ANSWERS-Dry, warm, position, stimulate gently, suction if needed

A 7 year old male was involved in a bike versus vehicle collision while on a bike ride with his family. He was hit head-on by the vehicle and struck the handlebars. Based on the mechanism of injury, what is the most likely acute, life-threatening injury?

Sternum fracture
Fractured tibia and fibula
Intra-abdominal organ rupture
Orbital fracture - ANSWERS-Intra-abdominal organ rupture A 12 year old male presents with respiratory distress. After assessing his airway, what initial parameters would you evaluate for breathing?
Skin color, respiratory rate, and arterial blood gas
Respiratory rate, depth, effort, and breath sounds
External bleeding and respiratory rate, depth, and effort
Respiratory rate is all that needs to be assessed - ANSWERS- Respiratory rate, depth, effort, and breath sounds When utilizing a tourniquet on a 7 year old, which of the following is correct?
Appropriate to switch to an elastic-style tourniquet when a windlass- style tourniquet is too large
Appropriate to use over joints or cloths with bulky material

EPC 4E TEST ,EPC 4E TEST ,EPC 4E TEST ,EPC 4E TEST, Exams of Medicine

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EPC 4E TEST