OB /PEDS PARAMEDIC FISDAP FINAL EXAMS 2024, Exams of Nursing

Download OB /PEDS PARAMEDIC FISDAP FINAL EXAMS 2024 and more Exams Nursing in PDF only on Docsity! 1 | P a g e OB /PEDS PARAMEDIC FISDAP FINAL EXAMS 2024 WITH ACTUAL CORRECT QUESTIONS AND VERIFIED DETAILED ANSWERS BY EXPERTS |FREQUENTLY TESTED QUESTIONS AND SOLUTIONS |ALREADY GRADED A+ |NEWEST |LATEST UPDATE |GUARANTEED PASS A 26 year old female is in labor with her first child . When you assess for crowning you see a foot presenting . You are 15 minutes from the nearest hospital . What should you do ? Reassure the mother and have her breathe during contractions Which patient is experiencing the most normal breathing ? A two week old with belly A 23 year old pregnant woman complains of a headache and blurred vision . She is eight months pregnant and saw her obstetrician last week . Vital signs are BP 150/94 , P 98 , R 18. Her hands appear swollen and her eyes look puffy . You should suspect preeclampsia A 22 year old female is in active labor . The baby's leg is protruding from the vagina . What should you do ? Place the mother in a knee - chest position and transport rapidly A 6 year old boy fell out of a tree . He is now lethargic and complaining of abdominal pain . His belly is rigid and distended . You should suspect lacerated liver How many and what type of blood vessels are in the umbilical cord ? Two arteries and one vein An 18 year old , who is twenty-seven weeks pregnant , experiences visual disturbances , a new onset of hypertension , and grand mal seizures . You should suspect eclampsia A six year old female is lethargic to respond and presents with dyspnea , respirations 34 , rapid palpable peripheral pulses . She has a history of upper respiratory infection ( URI ) . You should 2 | P a g e transport her as a high priority patient During a prolonged transport , you are assisting ventilations to a 4 year old semiconscious female with pneumonia. You see minimal chest rise with each ventilation . Vital signs are P 70 and decreasing , SPO2 86% what should you do Perform endotracheal intubation A 24 year old female primipara , 8 weeks gestation , is describing right lower quadrant abdominal pain , periumbilical pain , and fever . Her knees are drawn to her chest , and her pain increases when she is jarred . Vital signs are BP 120/76 , P 100 , R 20. What is the most likely cause of her symptoms ? Appendicitis 6 year old male states that he tripped and hurt his arm . He has marked edema of the right upper extremity and bruises in various stages of healing on his child's chest and back . What should you do Report detailed findings to the hospital A newborn is unresponsive with gasping respirations and a heart rate of 58. You should begin chest compressions Over - vigorous massaging of the fundus post - delivery can result in explosive delivery of the placenta A three month old infant has had diarrhea for three days . She has a sunken anterior fontanelle , dry eyes , dry mucosa , poor skin turgor and 5 second capillary refill . Her skin is cool , mottled and dry . After administering oxygen , you should administer normal saline 20 mL / kg IV (10 if answer says 10) A two year old male produces a high pitched sound when he inhales . He is sitting forward , has a hoarse voice and is febrile . You should administer nebulized racemic epinephrine 0.5 mL An uncommon but life - threatening respiratory illness characterized by sore throat , high fever , excessive drooling , and inspiratory stridor is epiglottitis A history of pelvic inflammatory disease increases the risk of what pregnancy related complication ? Ectopic pregnancy Because of anatomical differences , which laryngoscope blade is preferred for intubating infants and children ? Straight A newborn has just been delivered . He is limp and apneic . What should you do ? 5 | P a g e PID a 22 year old female complains of general weakness with persistent nausea and vomitting. This is the first trimester and her first pregnancy. Vital signs are BP 94/52 P 104, R 18, blood glucose analysis 64 mg/dL. What should you suspect hyperemesis gravidarum a 25 year old female is gravid 5 para 4. She is sitting in a bathtub and has the urge to push. Her due date is tomorrow. She tells. you that her water broke and the fluid was green. What should you do prepare for delivery when should you suction the infants mouth and nose when they are lethargic and meconium staining is present what is the most important question to ask when obtaining a pt hx from pregnant pt who is having contractions in her 3rd trimester is this your first pregnancy a 29 year old female is 33 weeks pregnant. She complains of strong contractions and a foot is presenting. What should you do place her on her L side, have her breathe through contractions and transport rapidly a 36 year old female attempted to have an at home birth. her midwife called EMS because her has been in labor for 26hrs. the baby buttocks is presenting and the fetus has not descended. what should you do assess for a prolapse cord a 31 year old female is having an eclamptic seizure. What should you administer magnesium sulfate 2 g how does placenta previa typically present painless bright red bleeding A 17 year old female presents with diffuse abdominal pain that has been occurring for the "past three days" the pt also reports a recent hx of fever, nausea and foul smelling vaginal discharge. The pt has shuffling gait and severe pain in the. lower abdomen upon palpation. you should suspect? PID 3 multiple choice options An 8 year old female complains of shortness of breath . She has audible wheezing during exhalation Vital signs are P 128. R 34 with supraclavicular retractions , Sp02 94 % . What should you do ? administer nebuilzed albuterol 3 multiple choice options 6 | P a g e An infant in the fetal position , crying continuously , and refusing to eat . The cry is weak , high - pitched , and louder when held . The infant has a low grade fever and a full fontanel . You should suspect meningitis 3 multiple choice options A three year old female is lying limply in her mother's arms . You open her airway and feel no breathing . She is cyanotic and her pulse is 80. You should suspect this patient is in respiratory arrest 3 multiple choice options An unresponsive two month old infant has had a runny nose , slight fever , diarrhea , and decreased appetite for the past three days . The child whimpers to painful stimuli , is breathing 50 R , has a weak brachial P 180 , and his fontanelle is sunken . You should suspect dehydration 3 multiple choice options A patient is nine months pregnant and entrapped in a vehicle . She is in a tremendous amount of pain from obvious bilateral femur fractures . Vital signs are BP 80/62 , P 130 , R 24. You have minimal access to her . To address her pain , you should administer Valium 2-10 mg 3 multiple choice options A 20 year old female complains of diffuse , lower quadrant abdominal pain . When questioned , she indicates having multiple sex partners . She also complains of fever , chills , nausea and vomiting over the last 12 hours and a foul - smelling vaginal discharge . She is bent over with a shuffling gait when she walks . From what condition is she likely suffering ? Pelvic inflammatory disease 3 multiple choice options An 8 year old male has epiglottitis . He is drooling and his respirations are 24 with stridor . What should your treatment include ? Administer humidified oxygen by NRB @ 15lpm 3 multiple choice options A five year old boy has a barky cough , audible stridor , and difficulty breathing . You should suspect croup 3 multiple choice options The most common cause of cardiac arrest in the pediatric patient is due to 7 | P a g e respiratory arrest 3 multiple choice options A 19 year old female is 28 weeks pregnant . Her initial complaint was a severe headache , blurred vision , and edema . She now presents with tonic - clonic seizure activity . You should administer magnesium sulfate 3 multiple choice options The second stage of labor concludes when the baby is delivered 3 multiple choice options A 22 year old female , primigravida with no prenatal care , has just delivered a healthy baby. Now she begins to have forceful contractions and wants to push. Additional amniotic fluid is expelled . You should prepare for delivery of a second baby 3 multiple choice options During transport of a mother and her recent newborn to the hospital , the mother complains of a sudden onset of difficulty breathing and excruciatingly sharp chest pain . She becomes unresponsive , has noted jugular venous distension , and is hypotensive You should suspect pulmonary embolism 3 multiple choice options A three year old has a tracheostomy tube in place and has had an increased work of breathing with evidence of thick secretions . You are unable to achieve effective chest rise with bag - valve mask ventilations . You should irrigate and suction 3 multiple choice options A five year old child ingested an undetermined amount of Amitriptyline sometime in the last hour . Your treatment should include ECG monitoring with rapid transport 3 multiple choice options A 4 year old male slammed his right hand in a door . His index finger is completely severed , and his middle finger is hanging by a flap of skin . What should you do ? Apply a dressing over the partially amputated finger 3 multiple choice options 10 | P a g e sudden gush of blood 3 multiple choice options Five minutes after delivery , a baby has a strong cry , peripheral mottling , active movement of arms and legs , and pulse of 140 . The APGAR score is 9 3 multiple choice options A one year old patient has a fever and a cough that sounds like a " bark " . He has a temperature of 101 degrees and is experiencing increased shortness of breath and intercostal muscle retractions . You should administer racemic epinephrine 0.5 mg with NS via nebulizer 3 multiple choice options A four year old male complains of rapid onset sore throat and muffled speech Respirations are rapid and non - labored . You should place the child in a position of comfort and provide humidified oxygen 3 multiple choice options A 6 year old female with a history of seizures has been actively seizing for 3 minutes . You have established IV access . What should you do? Administer a benzodiazepine 3 multiple choice options Which of the following are classic signs of preeclampsia? Hypertension, proteinuria , and vision changes 3 multiple choice options What size endotracheal tube is generally used when orally intubating a full term newborn? 3.0-3.5 mm tube 3 multiple choice options What is the most common way a newborn loses heat? Evaporation 3 multiple choice options You are preparing to intubate a two year old. You should estimate the correct tube size by comparing the tube diameter to the outside diameter of the little finger 11 | P a g e 3 multiple choice options What is the appropriate amount of fluid to give to a child in hypovolemic shock ? 20 mL / kg 3 multiple choice options A 27 year old female complains of severe abdominal pain . She is guarding the left side of her abdomen . She indicates that she might be pregnant . Vital signs BP 88/40 , P 124 , R 20. What should you do ? Start an IV and administer an analgesic 3 multiple choice options A 24 year old female in her second trimester is complaining of bright red vaginal bleeding without pain . What should you suspect Placenta previa 3 multiple choice options A 25 year old female is 32 weeks pregnant with profound facial edema . She fell and complains of left hip pain with an externally rotated and shortened left leg . Vital signs are BP 162/104 , P 129 , R 20. What should you do ? Place the patient on her right side and monitor vital signs 3 multiple choice options A 40 year old full - term multipara pregnant female is in labor with crowning . You should deliver the baby on scene and transport before the delivery of the placenta 3 multiple choice options How much fluid bolus should you administer to a two year old ( 12 kg ) hypovolemic patient ? 240 mL 3 multiple choice options A 31 year old female complains of heavy vaginal bleeding BP 88/56 and P 120 weak . After applying 100 % oxygen , you should place absorbent dressings over the vagina and administer isotonic crystalloid fluid to maintain perfusion 3 multiple choice options A four month old presents with lethargy and is poorly responsive . Vital signs are P 195 and R 60 and unlabored . Capillary refill is 5 seconds . This baby is most likely showing signs of shock 3 multiple choice options 12 | P a g e A 41 year old non - English speaking female is in active labor , and it looks as if her water has broken . Interpretation is difficult , but you determine that she has 2 other children . She appears to be full - term . What should you do ? Assess to see if the baby is crowning 3 multiple choice options A ten year old patient stops talking and looks straight ahead . He is unresponsive for about 15 seconds . Which of the following conditions is most likely ? Petit mal seizure 3 multiple choice options A 5 year old female has been sick with a low grade fever for the past 2 days . Her irritability increases with movement , and she had a 30 second seizure prior to EMS arrival . What should you suspect ? febrile seizure 3 multiple choice options 23 year old pregnant female is in her third trimester . She complains of painless , bright red vaginal bleeding . What should you do ? Prepare for rapid transport and obtain IV access A 2 year old female is lethargic to respond. She has dry mucous membranes and a tearless cry. What should you suspect? Hypoxia hypoglycemia hypovolemia hypothermia Dehydration hypovolemia A 2 year old female is lethargic to respond. She has dry mucous membranes and a tearless cry. What should you suspect? Hypoxia hypoglycemia hypovolemia hypothermia Dehydration hypovolemia You have just delivered a baby girl who remains cyanotic and is not responding to stimulation and oxygen therapy. Heart rate is 90. You should 15 | P a g e begin positive pressure ventilations A mother has just delivered a newborn with central cyanosis. The newborns vitals are P 82, R 30. You should? Initiate active warming begin positive pressure ventilations administer blow by O2 suction the airway and stimulate begin positive pressure ventilations A 37 year old female in the later stages of pregnancy has been experiencing abdominal pain and vomiting for the last two days. She responds to verbal stimulus. Vital signs are BP 100/70, P 116 R 24, skin cool and dry, How should you position her? In Fowler's position on the stretcher Semi Fowlers with knees bent Left lateral recumbent with knees bent Supine with a pillow under her knees Left lateral recumbent with knees bent A 37 year old female in the later stages of pregnancy has been experiencing abdominal pain and vomiting for the last two days. She responds to verbal stimulus. Vital signs are BP 100/70, P 116 R 24, skin cool and dry, How should you position her? In Fowler's position on the stretcher Semi Fowlers with knees bent Left lateral recumbent with knees bent Supine with a pillow under her knees Left lateral recumbent with knees bent What is the proper way to size an OPA for a child? Tip of the nose to the corner of the mouth corner of mouth to the angle of the mandible the length of the index finger of the child middle of the mouth to the ear lobe corner of mouth to the angle of the mandible What is the proper way to size an OPA for a child? Tip of the nose to the corner of the mouth corner of mouth to the angle of the mandible 16 | P a g e the length of the index finger of the child middle of the mouth to the ear lobe corner of mouth to the angle of the mandible A 6 year old is shy and withdrawn. He has multiple contusions in various stages of healing. His mother states "he fell on the playground." What should you suspect? Sexual abuse Emotional abuse Neglect Physical abuse Physical abuse A 6 year old is shy and withdrawn. He has multiple contusions in various stages of healing. His mother states "he fell on the playground." What should you suspect? Sexual abuse Emotional abuse Neglect Physical abuse Physical abuse Where should you apply pressure to access for uterine contractions? Left and right upper quadrants abdomen below the navel abdomen above the navel left and right flank abdomen below the navel Where should you apply pressure to access for uterine contractions? Left and right upper quadrants abdomen below the navel abdomen above the navel left and right flank abdomen below the navel A 14 year old jumped off a 4 foot wall, landing on her feet. She is complaining of tingling below waist, lower back pain, and cramping in both feet. Vital signs are BP 106/74, P 112, and R 20. You should Immobilize to a long spine board Transport in a position of comfort 17 | P a g e Apply bilateral soft splints to lower extremities Coach her to slow her breathing Immobilize to a long spine board A 14 year old jumped off a 4 foot wall, landing on her feet. She is complaining of tingling below waist, lower back pain, and cramping in both feet. Vital signs are BP 106/74, P 112, and R 20. You should Immobilize to a long spine board Transport in a position of comfort Apply bilateral soft splints to lower extremities Coach her to slow her breathing Immobilize to a long spine board Which of the following indicates decompensated shock in a pediatric patient? Shallow breathing rapid heart rate pale cool and diaphoretic loss of consciousness loss of consciousness Which of the following indicates decompensated shock in a pediatric patient? Shallow breathing rapid heart rate pale cool and diaphoretic loss of consciousness loss of consciousness A 3 year old is unresponsive and apneic on the floor of a restaurant. He was choking, turned blue, and collapsed. What should you do? Begin chest compressions Perform a blind finger sweep Give 5 abdominal thrusts Give 5 back blows Begin chest compressions A 3 year old is unresponsive and apneic on the floor of a restaurant. He was choking, turned blue, and collapsed. What should you do? Begin chest compressions Perform a blind finger sweep 20 | P a g e Continue to dry and warm the newborn Administer oxygen via blow-by Provide ventilatory assistance Provide ventilatory assistance You have assisted a mother in delivering a premature newborn. Assessment after 5 minutes shows newborn has central cyanosis and heart rate of 90. What should you do? Begin chest compressions Continue to dry and warm the newborn Administer oxygen via blow-by Provide ventilatory assistance Provide ventilatory assistance You are treating a 3 month old, apneic patient with a pulse of 110. In preparing to ventilate this infant, you should? Institute 2 min of CPR and then ventilate place a small towel under their shoulders open the airway with an OPA and bag every 6 seconds attach the AED and wait instructions place a small towel under their shoulders You are treating a 3 month old, apneic patient with a pulse of 110. In preparing to ventilate this infant, you should? Institute 2 min of CPR and then ventilate place a small towel under their shoulders open the airway with an OPA and bag every 6 seconds attach the AED and wait instructions place a small towel under their shoulders Normal response for a healthy 9 month old infant. Gaze follows parents pays no attention to you when entering ribs clearly visible upon inspiration extremities feel cool to the touch Gaze follows parents Normal response for a healthy 9 month old infant. Gaze follows parents pays no attention to you when entering 21 | P a g e ribs clearly visible upon inspiration extremities feel cool to the touch Gaze follows parents 2 year old is restless, irritable, and febrile with a distinct cough. The parent states that the child is calmer in a steam shower. You should suspect? Influenza bronchitis croup epiglottis croup 2 year old is restless, irritable, and febrile with a distinct cough. The parent states that the child is calmer in a steam shower. You should suspect? Influenza bronchitis croup epiglottis croup 13 month old lying supine in crib, crying. Fever of 104.5, rash on body and some spots are purple. You should? Transport put on surgical mask open airway apply high-flow oxygen put on surgical mask 13 month old lying supine in crib, crying. Fever of 104.5, rash on body and some spots are purple. You should? Transport put on surgical mask open airway apply high-flow oxygen put on surgical mask 20 year old female is pregnant for the first time with twins. What is she considered? Gravida I| 22 | P a g e Gravidarum primigravida primigravida 20 year old female is pregnant for the first time with twins. What is she considered? Gravida I| Gravidarum primigravida primigravida Initiate CPR on infant if heart rate is less than? 60 Initiate CPR on infant if heart rate is less than? 60 Neonatal 2 week old female is dyspneic and lethargic to respond. Vitals are P 58, R 4 and irregular. What should you be concerned about? Altered mental status cerebral hypoxia respiratory acidosis cardiac arrest cardiac arrest Neonatal 2 week old female is dyspneic and lethargic to respond. Vitals are P 58, R 4 and irregular. What should you be concerned about? Altered mental status cerebral hypoxia respiratory acidosis cardiac arrest cardiac arrest During assessment of a crying infant, you discover a sunken fontanelle. Your next question should be? Birth defects fallen recently how many wet diapers has the baby produced how many wet diapers has the baby produced 25 | P a g e all structures are smaller and can be more easily obstructed Pediatric airways differ from adult airways in that Trachea is more rigid child's tongue takes up less space oral airways devices cannot be used on children all structures are smaller and can be more easily obstructed all structures are smaller and can be more easily obstructed 10 year old patient was injured while skating, upon assessment you note a visible deformity of the forearm. The fingers are pale and cool without a palpable pulse. You should apply? A rigid splint gentle manual traction a cold pack and rapid transport significant traction until pulse returns gentle manual traction 10 year old patient was injured while skating, upon assessment you note a visible deformity of the forearm. The fingers are pale and cool without a palpable pulse. You should apply? A rigid splint gentle manual traction a cold pack and rapid transport significant traction until pulse returns gentle manual traction 37 week pregnant woman with tearing abdominal pain and weak, vitals are 90/60, 140, and 26 with pale, cool, diaphoretic skin, you should suspect? Supine hypotensive syndrome imminent delivery abruptio placentae placenta previa abruptio placentae 37 week pregnant woman with tearing abdominal pain and weak, vitals are 90/60, 140, and 26 with pale, cool, diaphoretic skin, you should suspect? Supine hypotensive syndrome imminent delivery abruptio placentae placenta previa 26 | P a g e abruptio placentae Which may indicate that a fetus was in distress before delivery? Presence of a greenish material in the amniotic fluid meconium meconium Which may indicate that a fetus was in distress before delivery? Presence of a greenish material in the amniotic fluid meconium meconium A 2 year old child presents with a fever, lethargy, and screaming upon neck flexion. You should suspect? Meningitis Influenza febrile seizure ear infection Meningitis A 2 year old child presents with a fever, lethargy, and screaming upon neck flexion. You should suspect? Meningitis Influenza febrile seizure ear infection Meningitis Shortly after delivery, a mother experiences dyspnea and becomes hypotensive. No excessive bleeding is noted and the uterus seems firm. You should suspect? Abruptio placenta pulmonary embolism post delivery trauma uterine rupture pulmonary embolism Shortly after delivery, a mother experiences dyspnea and becomes hypotensive. No excessive bleeding is noted and the uterus seems firm. You should suspect? Abruptio placenta pulmonary embolism 27 | P a g e post delivery trauma uterine rupture pulmonary embolism 38 year old female reports left sided abdominal pain that radiates to the back. Vitals are 90/64, 118, 20. You should suspect? Pelvic inflammatory disease kidney stones a ruptured ectopic emergency cholecystitis a ruptured ectopic emergency 38 year old female reports left sided abdominal pain that radiates to the back. Vitals are 90/64, 118, 20. You should suspect? Pelvic inflammatory disease kidney stones a ruptured ectopic emergency cholecystitis a ruptured ectopic emergency 33 year old female was in a motor vehicle collision. She is 36 weeks pregnant. First responders have removed the patient from the vehicle and immobilized her and they cannot obtain a blood pressure. You should? Load and go to the nearest trauma center tilt the backboard to the left immediately loosen the backboard straps as soon as possible apply oxygen and call for helicopter transport tilt the backboard to the left immediately 33 year old female was in a motor vehicle collision. She is 36 weeks pregnant. First responders have removed the patient from the vehicle and immobilized her and they cannot obtain a blood pressure. You should? Load and go to the nearest trauma center tilt the backboard to the left immediately loosen the backboard straps as soon as possible apply oxygen and call for helicopter transport tilt the backboard to the left immediately 5 year old is actively seizing, his respirations are slow and skin is pale. His parents say he had seized several times in the last 15 minutes without waking up. You should suspect that the? 30 | P a g e rupture ectopic pregnancy A woman is 36 weeks pregnant and complaining of painless vaginal bleeding. The most likely cause is? Abruptio placenta placenta previa spontaneous abortion bloody show placenta previa A woman is 36 weeks pregnant and complaining of painless vaginal bleeding. The most likely cause is? Abruptio placenta placenta previa spontaneous abortion bloody show placenta previa A 4 year old male is sitting upright and drooling. He has swallowed a marble that is completely blocking his airway. What should you do? Start chest compressions perform abdominal thrusts provide back blows suction the airway perform abdominal thrusts A 4 year old male is sitting upright and drooling. He has swallowed a marble that is completely blocking his airway. What should you do? Start chest compressions perform abdominal thrusts provide back blows suction the airway perform abdominal thrusts A maternal condition that occurs when the placenta separates from the uterine wall and is a cause of pre birth bleeding is? Abruptio placenta uterine rupture placenta previa ectopic pregnancy Abruptio placenta 31 | P a g e A maternal condition that occurs when the placenta separates from the uterine wall and is a cause of pre birth bleeding is? Abruptio placenta uterine rupture placenta previa ectopic pregnancy Abruptio placenta 32 week pregnant female complaining of facial swelling, headache, vomiting, and experiencing visual disturbances last 12 hours. You should suspect? Gestational diabetes eclampsia severe migraine pre eclampsia pre eclampsia 32 week pregnant female complaining of facial swelling, headache, vomiting, and experiencing visual disturbances last 12 hours. You should suspect? Gestational diabetes eclampsia severe migraine pre eclampsia pre eclampsia 35 week pregnant woman. Following scenarios most life threatening? Hypertension and experiencing visual disturbances fever and pain on urination sharp lower abdominal pains contracts with mucous discharge Hypertension and experiencing visual disturbances 35 week pregnant woman. Following scenarios most life threatening? Hypertension and experiencing visual disturbances fever and pain on urination sharp lower abdominal pains contracts with mucous discharge Hypertension and experiencing visual disturbances 32 | P a g e 50 year old fell from her bicycle after hitting a bump in the road. She is now bleeding from her vagina. You should Gently pack the vagina with sterile dressing transport the patient with legs elevated transport patient in the left lateral recumbent apply external sterile bulky dressing apply external sterile bulky dressing 50 year old fell from her bicycle after hitting a bump in the road. She is now bleeding from her vagina. You should Gently pack the vagina with sterile dressing transport the patient with legs elevated transport patient in the left lateral recumbent apply external sterile bulky dressing apply external sterile bulky dressing If a patient presents vaginal bleeding within the first 20 weeks of pregnancy you should suspect? Abruptio placentae ruptured uterus placenta previa Spontaneous abortion Spontaneous abortion If a patient presents vaginal bleeding within the first 20 weeks of pregnancy you should suspect? Abruptio placentae ruptured uterus placenta previa Spontaneous abortion Spontaneous abortion Placenta previa occurs when the placenta.. Separates from the uterus is abnormally positioned separates from umbilical cord disrupted is abnormally positioned Placenta previa occurs when the placenta.. 35 | P a g e A patient is in labor and has a strong urge to push. The baby's head is not yet visible, but the umbilical cord is protruding, you should? Clamp the cord in 2 places and cut between them place her in knee-chest position and transport cover the cord with a dry sterile dressing encourage her to bear down and push place her in knee-chest position and transport A patient is in labor and has a strong urge to push. The baby's head is not yet visible, but the umbilical cord is protruding, you should? Clamp the cord in 2 places and cut between them place her in knee-chest position and transport cover the cord with a dry sterile dressing encourage her to bear down and push place her in knee-chest position and transport A pale 2 year old male turns his face away and hides when you approach. Vital signs are P 150 R 32 with audible wheezing what should you be most concerned about? Heart rate skin color respiratory rate breath sounds skin color A pale 2 year old male turns his face away and hides when you approach. Vital signs are P 150 R 32 with audible wheezing what should you be most concerned about? Heart rate skin color respiratory rate breath sounds skin color Which signs and symptoms most suggest pre eclampsia? Hypertension and excessive water retention inability to sleep supine and acid reflux hypoglycemia and swollen extremities polyuria and postural hypotension Hypertension and excessive water retention 36 | P a g e Which signs and symptoms most suggest pre eclampsia? Hypertension and excessive water retention inability to sleep supine and acid reflux hypoglycemia and swollen extremities polyuria and postural hypotension Hypertension and excessive water retention The period of time during which intrauterine fetal development occurs is called? Gravidity gestation parity primi gravity gestation The period of time during which intrauterine fetal development occurs is called? Gravidity gestation parity primi gravity gestation You are assisting a vaginal delivery and the mom is crowning. The infant's head suddenly disappears and the mother begins to complain of sharp, intense, constant abdominal pain. You should suspect? Placenta previa multiple births uterine rupture transition to phase III of delivery uterine rupture You are assisting a vaginal delivery and the mom is crowning. The infant's head suddenly disappears and the mother begins to complain of sharp, intense, constant abdominal pain. You should suspect? Placenta previa multiple births 37 | P a g e uterine rupture transition to phase III of delivery uterine rupture 2 year old patient has a respiratory rate of 30 breaths per minute. This is considered? Too fast inadequate normal too slow normal 2 year old patient has a respiratory rate of 30 breaths per minute. This is considered? Too fast inadequate normal too slow normal 2 year old patient has a respiratory rate of 30 breaths per minute. This is considered? A) Too fast B) Inadequate C)normal D)too slow C) Normal Reason: Normal 24-40 2 year old patient has a respiratory rate of 30 breaths per minute. This is considered? A) Too fast B) Inadequate C)normal D)too slow C) Normal Reason: Normal 24-40 When assessing distal circulatory function in a 3 year old, a reliable indicator is? A) Pulse ox B) BP 40 | P a g e A) Institute 2 min of CPR and then ventilate B) place a small towel under their shoulders C) open the airway with an OPA and bag every 6 seconds D) attach the AED and wait instructions B) place a small towel under their shoulders\ Reason: Slight elevation for airway to be open, head is bigger than body Scald injuries to a child's lower extremity can be indicative of? A) Abuse B) Radiant heat C) accidents D) chemicals A) Abuse Reason: pg 1269/1270 Scald injuries to a child's lower extremity can be indicative of? A) Abuse B) Radiant heat C) accidents D) chemicals A) Abuse Reason: pg 1269/1270 A 3 year old drank some drain cleaner. It would be most helpful to? A) Administer activated charcoal B) transport immediately C) administer glucagon D) induce vomiting B) transport immediately A 3 year old drank some drain cleaner. It would be most helpful to? A) Administer activated charcoal B) transport immediately C) administer glucagon D) induce vomiting 41 | P a g e B) transport immediately You are assisting a vaginal delivery and the mom is crowning. The infant's head suddenly disappears and the mother begins to complain of sharp, intense, constant abdominal pain. You should suspect? A) Placenta previa B) multiple births C) Uterine Rupture D) transition to phase III of delivery C) Uterine Rupture Reason: Look up definition online, only one that makes sense You are assisting a vaginal delivery and the mom is crowning. The infant's head suddenly disappears and the mother begins to complain of sharp, intense, constant abdominal pain. You should suspect? A) Placenta previa B) multiple births C) Uterine Rupture D) transition to phase III of delivery C) Uterine Rupture Reason: Look up definition online, only one that makes sense In centimeter what is the correct depth of chest compressions for a 7 year old child? A) 1.5 B) 6 C) 5 D) 2 C) 5 In centimeter what is the correct depth of chest compressions for a 7 year old child? A) 1.5 B) 6 C) 5 D) 2 C) 5 Which of the following indicates decompensated shock in a pediatric patient? A) Shallow breathing B) *rapid heart rate 42 | P a g e C) pale cool and diaphoretic D) loss of consciousness D) loss of consciousness Reason: Low blood pressure can knock you out Pg. 1254 Which of the following indicates decompensated shock in a pediatric patient? A) Shallow breathing B) *rapid heart rate C) pale cool and diaphoretic D) loss of consciousness D) loss of consciousness Reason: Low blood pressure can knock you out Pg. 1254 Where should you apply pressure to access for uterine contractions? A) Left and right upper quadrants B) abdomen below the navel C) abdomen above the navel D) left and right flan C) abdomen above the navel Where should you apply pressure to access for uterine contractions? A) Left and right upper quadrants B) abdomen below the navel C) abdomen above the navel D) left and right flan C) abdomen above the navel What is the proper way to size an OPA for a child? A) Tip of the nose to the corner of the mouth B) corner of mouth to the angle of the mandible C) the length of the index finger of the child D) middle of the mouth to the ear lobe B) corner of mouth to the angle of the mandible Reason: Same for all ages What is the proper way to size an OPA for a child? 45 | P a g e C) Parity D) Primi gravity B) Gestation The period of time during which intrauterine fetal development occurs is called? A) Gravidity B) Gestation C) Parity D) Primi gravity B) Gestation Which signs and symptoms most suggest pre eclampsia? A) Hypertension and excessive water retention B) Inability to sleep supine and acid reflux C) Hypoglycemia and swollen extremities D) Polyuria and postural hypotension A) Hypertension and excessive water retention Which signs and symptoms most suggest pre eclampsia? A) Hypertension and excessive water retention B) Inability to sleep supine and acid reflux C) Hypoglycemia and swollen extremities D) Polyuria and postural hypotension A) Hypertension and excessive water retention A pale 2 year old male turns his face away and hides when you approach. Vital signs are P 150 R 32 with audible wheezing what should you be most concerned about? A) Heart rate B) skin color C) respiratory rate D) breath sounds B) skin color 46 | P a g e breath sounds Reason: Pulse is normally 60-140, ABC A pale 2 year old male turns his face away and hides when you approach. Vital signs are P 150 R 32 with audible wheezing what should you be most concerned about? A) Heart rate B) skin color C) respiratory rate D) breath sounds B) skin color breath sounds Reason: Pulse is normally 60-140, ABC A patient is in labor and has a strong urge to push. The baby's head is not yet visible, but the umbilical cord is protruding, you should? A) Clamp the cord in 2 places and cut between them B) place her in knee-chest position and transport C) cover the cord with a dry sterile dressing D) encourage her to bear down and push B) place her in knee-chest position and transport A patient is in labor and has a strong urge to push. The baby's head is not yet visible, but the umbilical cord is protruding, you should? A) Clamp the cord in 2 places and cut between them B) place her in knee-chest position and transport C) cover the cord with a dry sterile dressing D) encourage her to bear down and push B) place her in knee-chest position and transport 24 year old woman presents with vaginal bleeding following sexual assault, controlling bleeding would best be done by A) Packing a vaginal canal with gauze B) Apply direct pressure C) Placing a dressing @ the vaginal opening D) Bending the patient's legs upward C) Placing a dressing @ the vaginal opening 47 | P a g e 24 year old woman presents with vaginal bleeding following sexual assault, controlling bleeding would best be done by A) Packing a vaginal canal with gauze B) Apply direct pressure C) Placing a dressing @ the vaginal opening D) Bending the patient's legs upward C) Placing a dressing @ the vaginal opening Signs or symptoms of a pre delivery emergency? A) Hypertension B) Back pain C) crowning D) gush of amniotic fluid A) Hypertension Signs or symptoms of a pre delivery emergency? A) Hypertension B) Back pain C) crowning D) gush of amniotic fluid A) Hypertension Painless bright red vaginal bleeding late in the third trimester. You should suspect? A) placenta previa B) abruptio placentae C) ectopic pregnancy D) spontaneous abortion A) placenta previa Painless bright red vaginal bleeding late in the third trimester. You should suspect? A) placenta previa B) abruptio placentae C) ectopic pregnancy D) spontaneous abortion A) placenta previa Alert & oriented 4 year old patient has possible head injury from a fall. Vitals are P 120, R 18. How should you transport? 50 | P a g e Assess on infant. Which artery should you take for pulse? Brachial radial carotid femoral Brachial One sign of respiratory distress in a neonate? Grunting increased activity barrel chest tachycardia Grunting One sign of respiratory distress in a neonate? Grunting increased activity barrel chest tachycardia Grunting 35 week pregnant woman. Following scenarios most life threatening? A) Hypertension and experiencing visual disturbances B) fever and pain on urination C) sharp lower abdominal pain D) contracts with mucous discharge A) Hypertension and experiencing visual disturbances 35 week pregnant woman. Following scenarios most life threatening? A) Hypertension and experiencing visual disturbances B) fever and pain on urination C) sharp lower abdominal pain D) contracts with mucous discharge A) Hypertension and experiencing visual disturbances 32 week pregnant female complaining of facial swelling, headache, vomiting, and experiencing visual disturbances last 12 hours. You should suspect? Gestational diabetes 51 | P a g e eclampsia severe migraine pre eclampsia pre eclampsia 32 week pregnant female complaining of facial swelling, headache, vomiting, and experiencing visual disturbances last 12 hours. You should suspect? Gestational diabetes eclampsia severe migraine pre eclampsia pre eclampsia A maternal condition that occurs when the placenta separates from the uterine wall and is a cause of pre birth bleeding is? Abruptio placenta uterine rupture placenta previa ectopic pregnancy Abruptio placenta A maternal condition that occurs when the placenta separates from the uterine wall and is a cause of pre birth bleeding is? Abruptio placenta uterine rupture placenta previa ectopic pregnancy Abruptio placenta To relieve pressure on the vena cava when transporting a pregnant patient, you should? Place on left side place in recovery raise the patient's legs place in semi fowler's Place on left side To relieve pressure on the vena cava when transporting a pregnant patient, you should? Place on left side place in recovery 52 | P a g e raise the patient's legs place in semi fowler's Place on left side A 4 year old male is sitting upright and drooling. He has swallowed a marble that is completely blocking his airway. What should you do? Start chest compressions perform abdominal thrusts provide back blows suction the airway perform abdominal thrustss A 4 year old male is sitting upright and drooling. He has swallowed a marble that is completely blocking his airway. What should you do? Start chest compressions perform abdominal thrusts provide back blows suction the airway perform abdominal thrustss A woman is 36 weeks pregnant and complaining of painless vaginal bleeding. The most likely cause is? Abruptio placenta placenta previa spontaneous abortion bloody show placenta previa A woman is 36 weeks pregnant and complaining of painless vaginal bleeding. The most likely cause is? Abruptio placenta placenta previa spontaneous abortion bloody show placenta previa 20 year old female feels faint and has severe pain between her shoulder blades. Her skin is cool and clammy. Vital signs are BP 82/48, P 134, R 22, and SPO2 92%. What should you suspect? Sexual transmitted infection 55 | P a g e Pelvic inflammatory disease 5 year old is actively seizing, his respirations are slow and skin is pale. His parents say he had seized several times in the last 15 minutes without waking up. You should suspect that the? A) Seizure is about to end and you should wait to treat him B) child will become postictal and will regain consciousness C) child is in status epilepticus and medication is required D) child is in diabetic ketoacidosis and medication is required child is in status epilepticus and medication is required 5 year old is actively seizing, his respirations are slow and skin is pale. His parents say he had seized several times in the last 15 minutes without waking up. You should suspect that the? A) Seizure is about to end and you should wait to treat him B) child will become postictal and will regain consciousness C) child is in status epilepticus and medication is required D) child is in diabetic ketoacidosis and medication is required child is in status epilepticus and medication is required 33 year old female was in a motor vehicle collision. She is 36 weeks pregnant. First responders have removed the patient from the vehicle and immobilized her and they cannot obtain a blood pressure. You should? A) Load and go to the nearest trauma center B) tilt the backboard to the left immediately C) loosen the backboard straps as soon as possible D) apply oxygen and call for helicopter transport tilt the backboard to the left immediately 33 year old female was in a motor vehicle collision. She is 36 weeks pregnant. First responders have removed the patient from the vehicle and immobilized her and they cannot obtain a blood pressure. You should? A) Load and go to the nearest trauma center B) tilt the backboard to the left immediately C) loosen the backboard straps as soon as possible D) apply oxygen and call for helicopter transport tilt the backboard to the left immediately 38 year old female reports left sided abdominal pain that radiates to the back. Vitals are 90/64, 118, 20. You should suspect? 56 | P a g e Pelvic inflammatory disease kidney stones ruptured ectopic emergency cholecystitis a ruptured ectopic emergency 38 year old female reports left sided abdominal pain that radiates to the back. Vitals are 90/64, 118, 20. You should suspect? Pelvic inflammatory disease kidney stones ruptured ectopic emergency cholecystitis a ruptured ectopic emergency Pre- eclampsia becomes eclampsia when A seizure occurs constant hyperten occurs systolic above 170 third trimester begins A seizure occurs Pre- eclampsia becomes eclampsia when A seizure occurs constant hyperten occurs systolic above 170 third trimester begins A seizure occurs Compared to adults in shock, pediatric patients? Stay in compensated shock longer do not require treatment as quickly are less likely to become hypovolemic become hypertensive sooner Stay in compensated shock longer Compared to adults in shock, pediatric patients? Stay in compensated shock longer do not require treatment as quickly 57 | P a g e are less likely to become hypovolemic become hypertensive sooner Stay in compensated shock longer Shortly after delivery, a mother experiences dyspnea and becomes hypotensive. No excessive bleeding is noted and the uterus seems firm. You should suspect? Abruptio placenta pulmonary embolism post delivery trauma uterine rupture pulmonary embolism Shortly after delivery, a mother experiences dyspnea and becomes hypotensive. No excessive bleeding is noted and the uterus seems firm. You should suspect? Abruptio placenta pulmonary embolism post delivery trauma uterine rupture pulmonary embolism A child is postictal. You should? Note length of seizure administer blow by o2 ensure open airway protect patient from injury ensure open airway A child is postictal. You should? Note length of seizure administer blow by o2 ensure open airway protect patient from injury ensure open airway With pediatric patient, your assessment should begin? At first sight after you intro yourself after parents consent at first contact 60 | P a g e 10 year old patient was injured while skating, upon assessment you note a visible deformity of the forearm. The fingers are pale and cool without a palpable pulse. You should apply? A rigid splint gentle manual tractiona cold pack and rapid transport significant traction until pulse returns gentle manual traction 10 year old patient was injured while skating, upon assessment you note a visible deformity of the forearm. The fingers are pale and cool without a palpable pulse. You should apply? A rigid splint gentle manual traction a cold pack and rapid transport significant traction until pulse returns gentle manual traction Pediatric airways differ from adult airways in that Trachea is more rigid child's tongue takes up less space oral airways devices cannot be used on children all structures are smaller and can be more easily obstructed all structures are smaller and can be more easily obstructed Pediatric airways differ from adult airways in that Trachea is more rigid child's tongue takes up less space oral airways devices cannot be used on children all structures are smaller and can be more easily obstructed all structures are smaller and can be more easily obstructed When inserting an OPA in a child you should? Hold the tongue in position Use tongue depressor Hold the tongue in position When inserting an OPA in a child you should? Hold the tongue in position Use tongue depressor 61 | P a g e Hold the tongue in position 3 year old child involved in a motor vehicle collision needs to be secured on an adult backboard. You should? Secure the feet first, then the torso secure the head first, then the torso place padding under the child's head place padding under the child's torso place padding under the child's torso 3 year old child involved in a motor vehicle collision needs to be secured on an adult backboard. You should? Secure the feet first, then the torso secure the head first, then the torso place padding under the child's head place padding under the child's torso place padding under the child's torso 4 year old is having trouble breathing. He is drooling and sitting forward in a chair with his mouth wide open. He has a 103.2 temp. you should suspect? Epiglottitis croup hyperthermia asthma attack Epiglottitis 4 year old is having trouble breathing. He is drooling and sitting forward in a chair with his mouth wide open. He has a 103.2 temp. you should suspect? Epiglottitis croup hyperthermia asthma attack Epiglottitis Your neighbor has asked you to check on her 2 month old baby. The baby is sleeping and vitals are P 130, R 40, and he continues to sleep even when you try to wake him up. What should you do? Call for EMS tell your neighbor that he is sleeping soundly 62 | P a g e check on the baby again in a few hours recommend that your neighbor call the pediatrician Call for EMS Your neighbor has asked you to check on her 2 month old baby. The baby is sleeping and vitals are P 130, R 40, and he continues to sleep even when you try to wake him up. What should you do? Call for EMS tell your neighbor that he is sleeping soundly check on the baby again in a few hours recommend that your neighbor call the pediatrician Call for EMS During assessment of a crying infant, you discover a sunken fontanelle. Your next question should be? Birth defects fallen recently how many wet diapers has the baby produced how many wet diapers has the baby produced During assessment of a crying infant, you discover a sunken fontanelle. Your next question should be? Birth defects fallen recently how many wet diapers has the baby produced how many wet diapers has the baby produced Initiate CPR on infant if heart rate is less than? 60 60 Initiate CPR on infant if heart rate is less than? 60 60 65 | P a g e A 6 year old is shy and withdrawn. He has multiple contusions in various stages of healing. His mother states "he fell on the playground." What should you suspect? a. Sexual abuse b. Emotional abuse c. Neglect d. Physical abuse d. Physical abuse A 6 year old is shy and withdrawn. He has multiple contusions in various stages of healing. His mother states "he fell on the playground." What should you suspect? a. Sexual abuse b. Emotional abuse c. Neglect d. Physical abuse d. Physical abuse What is the proper method for suctioning a newborn's airway with a bulb syringe? a. Squeeze after placing the bulb syringe in the nose b. Squeeze before placing the bulb syringe in the nose c. Squeeze after placing the bulb syringe in the mouth d. Squeeze before placing the bulb syringe in the mouth d. Squeeze before placing the bulb syringe in the mouth What is the proper method for suctioning a newborn's airway with a bulb syringe? a. Squeeze after placing the bulb syringe in the nose b. Squeeze before placing the bulb syringe in the nose c. Squeeze after placing the bulb syringe in the mouth d. Squeeze before placing the bulb syringe in the mouth d. Squeeze before placing the bulb syringe in the mouth You have just delivered a baby girl who remains cyanotic and is not responding to stimulation and oxygen therapy. Heart rate is 90. You should ● Attempt suctioning and contact medical control ● Perform chest compressions at 15:2 ● Continue to provide stimulation by flicking the soles of her feet ● Begin positive pressure ventilations 66 | P a g e Begin positive pressure ventilations Administer oxygen by blow by You have just delivered a baby girl who remains cyanotic and is not responding to stimulation and oxygen therapy. Heart rate is 90. You should ● Attempt suctioning and contact medical control ● Perform chest compressions at 15:2 ● Continue to provide stimulation by flicking the soles of her feet ● Begin positive pressure ventilations Begin positive pressure ventilations Administer oxygen by blow by Before assessing the respiratory adequacy of an unconscious infant or child, you should ● Routinely suction the mouth to remove oral secretions ● Insert and OPA or an NPA ● Ensure that his or her head is in a hyperextended position ● Ensure the airway is patent and clear of obstructions Ensure the airway is patent and clear of obstructions Before assessing the respiratory adequacy of an unconscious infant or child, you should ● Routinely suction the mouth to remove oral secretions ● Insert and OPA or an NPA ● Ensure that his or her head is in a hyperextended position ● Ensure the airway is patent and clear of obstructions Ensure the airway is patent and clear of obstructions A 4 year old patient has sustained blunt trauma to the chest. Based on the MOI you should suspect ● Good chest rise with no diaphragmatic breathing ● Minimal external signs with serious internal injury ● Multi rib fractures due to fragile bone structure ● Dark ecchymosis around the umbilical area Minimal external signs with serious internal injury A 4 year old patient has sustained blunt trauma to the chest. Based on the MOI you should suspect ● Good chest rise with no diaphragmatic breathing ● Minimal external signs with serious internal injury 67 | P a g e ● Multi rib fractures due to fragile bone structure ● Dark ecchymosis around the umbilical area Minimal external signs with serious internal injury A 37 year old female in the later stages of pregnancy has been experiencing abdominal pain and vomiting for the last two days. She responds to verbal stimulus. Vital signs are BP 100/70, P 116 R 24, skin cool and dry, How should you position her? ● In Fowler's position on the stretcher ● Semi Fowlers with knees bent ● Left lateral recumbent with knees bent ● Supine with a pillow under her knees Left lateral recumbent with knees bent A 37 year old female in the later stages of pregnancy has been experiencing abdominal pain and vomiting for the last two days. She responds to verbal stimulus. Vital signs are BP 100/70, P 116 R 24, skin cool and dry, How should you position her? ● In Fowler's position on the stretcher ● Semi Fowlers with knees bent ● Left lateral recumbent with knees bent ● Supine with a pillow under her knees Left lateral recumbent with knees bent . Later preg stage with vomiting, AB pain for 2 days nausea, vomiting, vaginal discharge, irregular period and abdominal pain are signs/symptoms of: Pelvic inflammatory disease Ruptured ectopic pregnancy Endometriosis Cystitis Pelvic inflammatory disease . Later preg stage with vomiting, AB pain for 2 days nausea, vomiting, vaginal discharge, irregular period and abdominal pain are signs/symptoms of: Pelvic inflammatory disease Ruptured ectopic pregnancy Endometriosis Cystitis Pelvic inflammatory disease 70 | P a g e C) pale cool and diaphoretic D) loss of consciousness D) loss of consciousness Where should you apply pressure to access for uterine contractions? A) Left and right upper quadrants B) abdomen below the navel C) abdomen above the navel D) left and right flan C) abdomen above the navel What is the proper way to size an OPA for a child? A) Tip of the nose to the corner of the mouth B) corner of mouth to the angle of the mandible C) the length of the index finger of the child D) middle of the mouth to the ear lobe B) corner of mouth to the angle of the mandible A mother has just delivered a newborn with central cyanosis. The newborns vitals are P 82, R 30. You should? A) Initiate active warming B) begin positive pressure ventilations C) administer blow by O2 D) suction the airway and stimulate B) begin positive pressure ventilations Febrile seizures in children are most often the result of a/an: A) Abrupt rise in body temp B) life threatening infection C) temp greater than 100 fahrenheit D) inflammatory process A) Abrupt rise in body temp A 6 month old is febrile, cyanotic, and grunting with labored breathing. You should? A) *Assist ventilations via bvm B) sponge the infant with tepid water C) apply blow by 02 and trans D) perform a rapid medical assessment 71 | P a g e C) apply blow by 02 and trans A 2 year old female is lethargic to respond. She has dry mucous membranes and a tearless cry. What should you suspect? A) Hypoxia B) hypoglycemia C) morning hypovolemia D) hypothermia C) morning hypovolemia The period of time during which intrauterine fetal development occurs is called? A) Gravidity B) Gestation C) Parity D) Primi gravity B) Gestation Which signs and symptoms most suggest pre eclampsia? A) Hypertension and excessive water retention B) Inability to sleep supine and acid reflux C) Hypoglycemia and swollen extremities D) Polyuria and postural hypotension A) Hypertension and excessive water retention A pale 2 year old male turns his face away and hides when you approach. Vital signs are P 150 R 32 with audible wheezing what should you be most concerned about? A) Heart rate B) skin color C) respiratory rate D) breath sounds B) skin color A patient is in labor and has a strong urge to push. The baby's head is not yet visible, but the umbilical cord is protruding, you should? A) Clamp the cord in 2 places and cut between them B) place her in knee-chest position and transport 72 | P a g e C) cover the cord with a dry sterile dressing D) encourage her to bear down and push B) place her in knee-chest position and transport 24 year old woman presents with vaginal bleeding following sexual assault, controlling bleeding would best be done by A) Packing a vaginal canal with gauze B) Apply direct pressure C) Placing a dressing @ the vaginal opening D) Bending the patient's legs upward C) Placing a dressing @ the vaginal opening Signs or symptoms of a pre delivery emergency? A) Hypertension B) Back pain C) crowning D) gush of amniotic fluid A) Hypertension Painless bright red vaginal bleeding late in the third trimester. You should suspect? A) placenta previa B) abruptio placentae C) ectopic pregnancy D) spontaneous abortion A) placenta previa Alert & oriented 4 year old patient has possible head injury from a fall. Vitals are P 120, R 18. How should you transport? A) Fully immobilize with towel under his scapulae B) fully immobilize in Trendelenburg position C) secure child's safety seat to the stretcher D) allow the patient to sit on his mother's lap A) Fully immobilize with towel under his scapulae Assisting a home birth and baby's head just delivered. You should? A) Examine for nuchal B) guide and rotate C) turn face up and suction 75 | P a g e A woman is 36 weeks pregnant and complaining of painless vaginal bleeding. The most likely cause is? Abruptio placenta placenta previa spontaneous abortion bloody show placenta previa 20 year old female feels faint and has severe pain between her shoulder blades. Her skin is cool and clammy. Vital signs are BP 82/48, P 134, R 22, and SPO2 92%. What should you suspect? Sexual transmitted infection spontaneous abortion pelvic inflammatory disease rupture ectopic pregnancy rupture ectopic pregnancy 24 year old female in her second trimester of pregnancy presents with mild contractions. There is no regular pattern to the contractions, and they have not increased in intensity since they began. She denies vaginal bleeding or any other symptoms. This patient is most likely experiencing? Braxton Hicks contractions premature labor placenta previa threatened abortion Braxton Hicks contractions The cessation of menses with associated decrease of estrogen secretion is called? Menopause menarche myometrium mitted schmerz Menopause What effect can excessive traction have on the umbilical cord during placental delivery? Uterine rupture umbilical bleeding abruptio placentae 76 | P a g e abruptio placentae Nausea, vomiting, vaginal discharge, irregular periods and abdominal pain are signs and symptoms of? Pelvic inflammatory disease ruptured ectopic pregnancy endometriosis cystitis Pelvic inflammatory disease 5 year old is actively seizing, his respirations are slow and skin is pale. His parents say he had seized several times in the last 15 minutes without waking up. You should suspect that the? A) Seizure is about to end and you should wait to treat him B) child will become postictal and will regain consciousness C) child is in status epilepticus and medication is required D) child is in diabetic ketoacidosis and medication is required child is in status epilepticus and medication is required 33 year old female was in a motor vehicle collision. She is 36 weeks pregnant. First responders have removed the patient from the vehicle and immobilized her and they cannot obtain a blood pressure. You should? A) Load and go to the nearest trauma center B) tilt the backboard to the left immediately C) loosen the backboard straps as soon as possible D) apply oxygen and call for helicopter transport tilt the backboard to the left immediately 38 year old female reports left sided abdominal pain that radiates to the back. Vitals are 90/64, 118, 20. You should suspect? Pelvic inflammatory disease kidney stones ruptured ectopic emergency cholecystitis a ruptured ectopic emergency Compared to adults in shock, pediatric patients? Stay in compensated shock longer do not require treatment as quickly 77 | P a g e are less likely to become hypovolemic become hypertensive sooner Stay in compensated shock longer Shortly after delivery, a mother experiences dyspnea and becomes hypotensive. No excessive bleeding is noted and the uterus seems firm. You should suspect? Abruptio placenta pulmonary embolism post delivery trauma uterine rupture pulmonary embolism Pre- eclampsia becomes eclampsia when A seizure occurs constant hyperten occurs systolic above 170 third trimester begins A seizure occurs A child is postictal. You should? Note length of seizure administer blow by o2 ensure open airway protect patient from injury ensure open airway With pediatric patient, your assessment should begin? At first sight after you intro yourself after parents consent at first contact At first sight A conscious child has a significant airway obstruction due to an illness. You should? Insert OPA examine the upper airway for white spots place the child in a supine position give o2 and transport immediately 80 | P a g e how many wet diapers has the baby produced Initiate CPR on infant if heart rate is less than? 60 60 13 month old lying supine in crib, crying. Fever of 104.5, rash on body and some spots are purple. You should? Transport put on surgical mask open airway apply high-flow oxygen put on surgical mask Normal response for a healthy 9 month old infant. Gaze follows parents pays no attention to you when entering ribs clearly visible upon inspiration extremities feel cool to the touch Gaze follows parents You have assisted a mother in delivering a premature newborn. Assessment after 5 minutes shows newborn has central cyanosis and heart rate of 90. What should you do? a. Begin chest compressions b. Continue to dry and warm the newborn c. Administer oxygen via blow-by d. Provide ventilatory assistance d. Provide ventilatory assistance A cord is wrapped around a baby's neck during childbirth. This is called a. Neck cord b. Nuchal cord c. Circumferential cord d. Prolapsed cord 81 | P a g e b. Nuchal cord What is the proper method for suctioning a newborn's airway with a bulb syringe? a. Squeeze after placing the bulb syringe in the nose b. Squeeze before placing the bulb syringe in the nose c. Squeeze after placing the bulb syringe in the mouth d. Squeeze before placing the bulb syringe in the mouth d. Squeeze before placing the bulb syringe in the mouth A 3 year old is unresponsive and apneic on the floor of a restaurant. He was choking, turned blue, and collapsed. What should you do? a. Begin chest compressions b. Perform a blind finger sweep c. Give 5 abdominal thrusts d. Give 5 back blows a. Begin chest compressions A 14 year old jumped off a 4 foot wall, landing on her feet. She is complaining of tingling below waist, lower back pain, and cramping in both feet. Vital signs are BP 106/74, P 112, and R 20. You should a. Immobilize to a long spine board b. Transport in a position of comfort c. Apply bilateral soft splints to lower extremities d. Coach her to slow her breathing a. Immobilize to a long spine board A 6 year old is shy and withdrawn. He has multiple contusions in various stages of healing. His mother states "he fell on the playground." What should you suspect? a. Sexual abuse b. Emotional abuse c. Neglect d. Physical abuse d. Physical abuse You have just delivered a baby girl who remains cyanotic and is not responding to stimulation and oxygen therapy. Heart rate is 90. You should ● Attempt suctioning and contact medical control ● Perform chest compressions at 15:2 ● Continue to provide stimulation by flicking the soles of her feet ● Begin positive pressure ventilations 82 | P a g e ● Begin positive pressure ventilations Before assessing the respiratory adequacy of an unconscious infant or child, you should ● Routinely suction the mouth to remove oral secretions ● Insert and OPA or an NPA ● Ensure that his or her head is in a hyperextended position ● Ensure the airway is patent and clear of obstructions ● Ensure the airway is patent and clear of obstructions A 4 year old patient has sustained blunt trauma to the chest. Based on the MOI you should suspect ● Good chest rise with no diaphragmatic breathing ● Minimal external signs with serious internal injury ● Multi rib fractures due to fragile bone structure ● Dark ecchymosis around the umbilical area ● Minimal external signs with serious internal injury A 37 year old female in the later stages of pregnancy has been experiencing abdominal pain and vomiting for the last two days. She responds to verbal stimulus. Vital signs are BP 100/70, P 116 R 24, skin cool and dry, How should you position her? ● In Fowler's position on the stretcher ● Semi Fowlers with knees bent ● Left lateral recumbent with knees bent ● Supine with a pillow under her knees ● Left lateral recumbent with Where would you apply pressure to assess the mother for contractions? The fundus Placenta Previa Placenta is implanted low in the uterus and covering part of or all of the cervix/ Leads to painless bright red vaginal bleeding in the 2nd or 3rd trimester. Best indicator to assess circulation in children Cap refill. A female that is child bearing age who is complaining of abdominal pain with an abnormally low blood pressure, you should suspect? Ectopic pregnancy A patient with deformity and no pulse to his extremity do to an injury, you should? 85 | P a g e Miller blade Whats the difference between a pediatric airway versus an adult airway Airway is much smaller and more flexible larger tongues Excessive traction on the umbilical cord during placental delivery can cause? Uterine Inversion How should you manage a small child conscious with a complete airway obstruction Back blows/thrusts Why do we assess a newborn APGAR score It helps record the condition of the newborn in the first few minutes of birth When do we assess the APGAR score in newborns 1 and 5 minutes after birth A pediatric patient with different stages of bruises healing may indicate? Child abuse gestational diabetes a form of diabetes mellitus that occurs during some pregnancies/ usually resolves after delivery When do you provide chest compression in a newborn/ at what heart rate 60 and under A female who is term and complaining of tearing abdominal pain, you should suspect? Abruption Placenta What should you do once the infants head has been delivered. Guide the head upward and allow delivery of the shoulders. How do you manage vaginal bleeding in a female who was sexually assaulted comfort patient, apply trauma pade to the exterior of the vagina ectopic pregnancy A pregnancy outside of the womb, usually in a fallopian tube Prolapse cord A situation in which the umbilical cord comes out of the vagina before the infant. How do you manage a prolapse cord 86 | P a g e Position the mother supine with her hips elevated, administer 02 via NRB, have mother breathe/pant through contractions to prevent her from bearing down. Insert two fingers with a gloved hand and gently push the presenting part (not the cord) back into the vagina. Maintain pressure on the part, cover the cord with moist warm saline and transport emergent What do you do for a child who has a delay in cap refill Warm their hands and administer 02 Reasons why you are unable to obtain a blood pressure on a 38 week pregnant female who is lying supine on stretcher Possible supine hypotensive syndrome, have mother lay on left side An unresponsive pediatric patient who is tearless and has dry mucous membranes is more than likely suffering from? Dehydration Whats the normal respiratory rate of an infant 30-60 Whats the normal respiratory rate of a child 18-30 Braxton Hicks contractions false labor contractions preparing the body for labor Why is hypertension a pre-delivery emergency (Pre-eclampsia or eclampsia ) They can lead to seizures for the mother and affect oxygen delivery to the fetus. Also signifies that toxins are building up in the mothers body and baby What indicates fetal distress A low apgar score & meconium staining Vaginal bleeding within the first 20 weeks of her pregnancy, you would suspect? Miscarriage or spontaneous abortion Multiple contusion in different stages of healing on a child may indicate? Abuse What are the signs and symptoms of PID Abdominal pain, fever, fatigue, chills, NVD, Dysuria Injuries from scalding water may indicate? 87 | P a g e Abuse A 40 year old female states her water has broken and is full term, what should you do? Ask if this is her first pregnancy, obtain history, time her contractions, check for crowning, if so prepare for delivery What is the location to assess a pulse on an infant Brachial Whats the difference between eclampsia and pre-eclampsia Eclampsia is accompanied by AMS and seizures Indication of imminent delivery of the placenta Contractions begin again, the umbilical cord lengthens and blood excretes from the vagina. Signs and symptoms of abruptio placenta sudden onset of severe abdominal pain radiating to back, decreased fetal movement, decreased fetal heart tones, patient may report vaginal bleeding. Bright red vaginal bleeding without pain during the second half of pregnancy is the main sign of Placenta previa Female with no prenatal care delivered a baby and now has additional amniotic fluid coming out You should prepare for a second delivery How would you manage an arterial bleed to the extremities Apply direct pressure, if bleeding continues use a tourniquet A young child who is tachycardic with a fever and altered mental status, what should you do 02, iv, fluids, emergent transport What is the fluid dose for children 20ml/kg Which delivery presentation would you put the mother in a knee to chest position breech presentation or limb presentation 1st stage of labor Onset of contractions -> ends with full effacement/dilation 2nd stage of labor starts w/ full dilation / effacement of cervix ends with delivery of baby