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Mod 6

Multiple Choice
Identify the choice that best completes the statement or answers the question.
 

 1. 
You are on scene with a 2-year-old who fell from a window ledge. You notice that he is tachypneic. Which of the following is an appropriate therapy for this child?
a.
 Airway management is important because of the increased size of his tongue.
b.
 The caregiver should hold the patient.
c.
 Supplemental oxygen is optional.
d.
 C-spine precautions are not necessary, because children rarely break bones.
 

 2. 
A 2-year-old has an upper respiratory infection. You notice that he is tachypneic and has retractions. You hear coarse sounds from the airway that resemble gurgling. Which of the following would be most helpful for this child?
a.
 Keep the patient supine.
b.
 Use an oropharyngeal airway.
c.
 Use a jaw thrust maneuver to keep the airway open.
d.
 Suction out secretions.
 

 3. 
You arrive on scene to find a 3-year-old with cool, clammy skin, a decreased number of urine diapers, altered mental status, and irritation. Which of the following best describes his condition?
a.
 End-organ damage has occurred.
b.
 These are signs of compensated shock.
c.
 Perfusion is adequate.
d.
 These signs are normal for an upper respiratory illness.
 

 4. 
Which of the following best describes compensated shock?
a.
 All the vital signs remain unchanged.
b.
 Signs of end-organ damage appear.
c.
 Blood is diverted from the skin and intestines to the heart.
d.
 Blood pressure drops.
 

 5. 
You are on scene with a 4-year-old patient who has a head injury. You notice that he is not breathing adequately. A jaw thrust maneuver does not help this situation. Which of the following would be an appropriate action?
a.
 Insert a nasopharyngeal airway if no gag reflex is present.
b.
 Insert an oropharyngeal airway if no gag reflex is present.
c.
 Perform a head tilt chin lift maneuver.
d.
 Administer oxygen with a nonrebreather mask at a rate of 10 liters per minute.
 

 6. 
You are on scene with an elderly patient. Which of the following is an appropriate statement regarding treatment?
a.
 Position yourself in front of the patient.
b.
 Stand so that you are above the patient.
c.
 Position yourself behind the patient.
d.
 Speak in a loud tone.
 

 7. 
On scene with an elderly patient, you notice that the patient is having trouble breathing. Which of the following is an important consideration with this patient?
a.
 She may have dentures.
b.
 She has increased upper airway muscles, which makes airway management more difficult.
c.
 She has an increased gag reflex.
d.
 Her mouth has increased sensation.
 

 8. 
Which of the following can cause a seizure in the pediatric age group?
a.
 Fracture of an extremity
b.
 Agitation
c.
 Hypoglycemia
d.
 Hyperglycemia
 

 9. 
A 5-year-old patient has a history of epilepsy. You are called because he is having a seizure that has lasted longer than 30 minutes. Which of the following is the best term for this condition?
a.
 Tonic-clonic seizure
b.
 Postictal state
c.
 Status epilepticus
d.
 Epilepsy
 

 10. 
A 7-year-old child has a central venous catheter. You are called because he is not feeling well. You notice that he has cool, clammy skin and delayed capillary refill. Which of the following is the most likely cause of his condition?
a.
 Cardiogenic shock
b.
 Septic shock
c.
 Hemorrhage shock
d.
 Hypovolemic shock
 

 11. 
A call has been placed to the police that children at a nearby home are not being watched during the day. There is concern that they are not eating. Which of the following types of child abuse is this?
a.
 Shaken baby syndrome
b.
 Sexual abuse
c.
 Neglect
d.
 Physical abuse
 

 12. 
You arrive on scene to find a 7-year-old boy who fell from a jungle gym on the playground. He is actively seizing. Which of the following is the most appropriate treatment?
a.
 Administer supplemental oxygen.
b.
 Perform a head tilt chin lift maneuver.
c.
 Restrain the patient.
d.
 Insert an oropharyngeal airway.
 

 13. 
Which of the following is an accurate statement regarding infant development?
a.
 An infant’s neck can support the head at 3 weeks of age.
b.
 The limbs start out relaxed and then flex as they develop.
c.
 Development proceeds from toe to head.
d.
 A 6-month-old baby may be able to sit without support.
 

 14. 
You are assessing an elderly patient whose chief complaint is syncope. You notice that the patient appears weak. You begin to take orthostatic vital signs. Which of the following is indicative of hypovolemia?
a.
 A rise in blood pressure with standing greater than 10 mm Hg
b.
 A decrease in blood pressure of 20 mm Hg with standing
c.
 A decrease in heart rate of 10 beats per minute or more with sitting
d.
 A decrease in heart rate of 20 beats per minute or more with standing
 

 15. 
A pediatric patient has suffered a direct blow to the head by a baseball. You arrive on scene and notice that he is breathing at a rate of 5 times per minute. Which of the following is an appropriate treatment?
a.
 Consider providing CPR.
b.
 Administer supplemental oxygen with a bag-mask device.
c.
 Perform a head–tilt/chin-lift maneuver.
d.
 Do not apply a cervical collar.
 

 16. 
A patient has been playing with toys. You notice that he is not crying or talking. Which of the following airway emergencies is most likely?
a.
 Foreign body obstruction
b.
 Asthma
c.
 Croup
d.
 Epiglottitis
 

 17. 
You arrive on scene to find an elderly patient with an altered mental status. He has a significant medical history. Which of the following may be likely for his altered mental status?
a.
 Hypoglycemia
b.
 Irregularly irregular heartbeat
c.
 Heat intolerance
d.
 Cardiac disease
 

 18. 
You arrive on scene to find a 16-year-old pregnant female. She was eating when she started turning blue and couldn’t speak. Which of the following is the most appropriate action?
a.
 Administer supplemental oxygen.
b.
 Perform chest thrusts.
c.
 Administer back blows.
d.
 Perform abdominal thrusts.
 

 19. 
Which of the following is a physiologic change in the lungs associated with aging?
a.
 Increased tidal volume
b.
 Increased surface area
c.
 Increased elasticity
d.
 Decreased number of alveoli
 

 20. 
You have just finished a call in which you had to provide CPR to an infant. You and your partner are feeling down. Which of the following is the most appropriate intervention?
a.
 Ignore your feelings.
b.
 Consider a career change.
c.
 Cancel the rest of your shift.
d.
 Participate in a debriefing.
 

 21. 
Which of the following is a cause of delirium?
a.
 Genetic factors
b.
 Sensory factors
c.
 Vascular factors
d.
 Infection
 

 22. 
You are assessing breathing in a geriatric patient. Which of the following would you expect to see in this patient?
a.
 Increased depth of breathing
b.
 Decreased rate of breathing
c.
 Increased tidal volume
d.
 Decreased depth of breathing
 

 23. 
Which of the following is appropriate regarding CPR in an infant?
a.
 Place the patient on a soft surface.
b.
 Check the pulse for 30 seconds.
c.
 Start CPR if the pulse is less than 60 beats per minute.
d.
 Use a compression-to-ventilation ratio of 15:2 for infants.
 

 24. 
A 9-month-old has signs of an upper airway obstruction but is responsive. Which of the following is the most appropriate action?
a.
 Deliver five back blows, and then five chest thrusts.
b.
 Tilt the child’s body slightly lower than the head.
c.
 Perform chest thrusts over the upper third of the sternum.
d.
 Hold the infant supine.
 

 25. 
A child has a complaint of a sore throat. You notice that he is drooling and has an abnormal voice. Which of the following illnesses of the respiratory system may this child have?
a.
 Reactive airway disease
b.
 Bronchiolitis
c.
 Croup
d.
 Epiglottitis
 

 26. 
You arrive on scene to find a 55-year-old male patient. The family states that he is confused and is not acting like himself. He normally works as an engineer, but now he cannot handle basic tasks. Which of the following is an accurate statement regarding his condition?
a.
 It is not uncommon for a patient of this age to have an altered mental status.
b.
 Underlying disease should be suspected.
c.
 A general decrease in intelligence occurs at age 50.
d.
 His speed of response is increased.
 

 27. 
You are on scene with a 72-year-old male who complains of dizziness when he stands. Which of the following may explain this?
a.
 The blood vessels are still and inelastic.
b.
 The heart rate is irregularly irregular.
c.
 The conduction system has lost functional cells.
d.
 The heart rate is increased.
 

 28. 
Which of the following is the most common type of dementia?
a.
 Alzheimer’s disease
b.
 Delirium
c.
 Vascular type
d.
 Stroke
 

 29. 
You are on scene with a 92-year-old male who is being taken care of by his grandson. You are concerned that he is being mistreated. Which of the following is the next most appropriate action?
a.
 Contact medical control.
b.
 Ignore the situation and treat the chief complaint.
c.
 Report the abuse per your protocol.
d.
 Confront the grandson.
 

 30. 
Which of the following is the leading cause of death in the elderly?
a.
 Dementia
b.
 Cardiovascular disease
c.
 Chronic obstructive pulmonary disease
d.
 Stroke
 

 31. 
You arrive on scene to find a 91-year-old male. He appears intimidated, fearful, and withdrawn. You notice his daughter yelling at him. Which of the following types of abuse is this?
a.
 Physical abuse
b.
 Emotional abuse
c.
 Sexual abuse
d.
 Financial abuse
 

 32. 
You are on scene with a 90-year-old male who is not acting normally, according to his wife. She states that last night he was fine, and today he is acting “strange.” He does not know where he is or what time it is. It also appears that he is having hallucinations. Which of the following is the most likely cause of his altered mental status?
a.
 Stroke
b.
 Delirium
c.
 Cardiovascular disease
d.
 Dementia
 

 33. 
A patient has increasing shortness of breath. He states that he cannot lie flat, and this has been getting worse over the past few days. Rales are heard on auscultation. Which of the following is the most likely cause?
a.
 Surgical abdomen
b.
 Asthma
c.
 Dementia
d.
 Congestive heart failure
 

 34. 
Which of the following is a correct description of assisted ventilation in the pediatric patient?
a.
 The respiratory rate should be close to 10 breaths per minute.
b.
 The respiratory rate should be close to 30 breaths per minute.
c.
 It is most helpful if done by one EMT.
d.
 Two-person bag-mask ventilation is most helpful.
 

 35. 
You arrive on scene to find a toddler who is having difficulty breathing. He is 18 months old. Which of the following is appropriate for examining this patient?
a.
 Don’t bother to use games; they aren’t helpful.
b.
 Take the child from the caregiver.
c.
 Start the exam at the head.
d.
 Examine the child on the caregiver’s lap.
 

 36. 
Which of the following injuries may indicate child abuse?
a.
 Fracture of the clavicle
b.
 Fracture of the femur
c.
 Elbow pain
d.
 Bruise on the forehead
 

 37. 
Which of the following is a true statement regarding airway obstruction?
a.
 In children, abdominal thrusts may be used.
b.
 Children and infants are treated the same way for airway obstruction.
c.
 Blind finger sweeps are recommended in infants.
d.
 Abdominal thrusts are inward and downward in direction.
 

 38. 
You arrive on scene to find a 6-month-old infant who is apneic. You want to assist ventilations. Which of the following provides the best position for air entry?
a.
 Place a towel underneath the neck.
b.
 Tilt the head in full flexion.
c.
 Place a towel underneath the shoulders.
d.
 Tilt the head in full extension.
 

 39. 
Which of the following injuries would make you suspect child abuse?
a.
 Wrist pain in a gymnast who fell from the parallel bars.
b.
 Bruises on the shins of a 3-year-old.
c.
 Bruises and injuries in different stages of healing.
d.
 Ankle pain in a 6-year-old playing basketball in the park.
 

 40. 
You arrive on scene to find a 5-year-old with leukemia. He has a tracheostomy tube and is having trouble breathing. Which of the following is the most appropriate treatment?
a.
 No supplemental oxygen is necessary.
b.
 Administer supplemental oxygen with a bag-mask device connected to the tracheostomy.
c.
 Administer supplemental oxygen with a bag-mask device applied to the face.
d.
 Suction secretions in the mouth.
 

 41. 
You arrive on scene to find an 86-year-old male who may have been abused. Which of the following statements would be appropriate for your report?
a.
 The patient has cigarette burns on his back.
b.
 The patient has been beaten.
c.
 The patient has been neglected.
d.
 The patient has been abused by the daughter-in-law.
 

 42. 
You are on scene with a 79-year-old female who was in a motor vehicle accident. You are about to transfer the patient to a backboard. Which of the following is an appropriate action?
a.
 The patient most likely will have no injury.
b.
 The patient has a low risk of musculoskeletal injury.
c.
 Additional padding is required.
d.
 A cervical collar is unnecessary.
 

 43. 
Which of the following is the most common cause of cardiac arrest in pediatric patients?
a.
 Cardiac disorder
b.
 Respiratory disorder
c.
 Medical illness
d.
 Trauma
 

 44. 
A geriatric patient calls 911 because he has abdominal pain. Which of the following is a true statement regarding abdominal pain in this age group?
a.
 It most often is a benign condition.
b.
 It typically is caused by dietary changes.
c.
 It can be severe.
d.
 Transport is rarely necessary.
 

 45. 
You are on scene at a motor vehicle accident. A 5-year-old is restrained in a child seat in the back of the car. Which of the following would be considered normal in this patient?
a.
 Heart rate of 160 beats per minute
b.
 Respiratory rate of 40 to 60 breaths per minute
c.
 Heart rate of 60 to 135 beats per minute
d.
 Blood pressure of 60 mm Hg systolic
 

 46. 
You are on scene at a motor vehicle accident. A 76-year-old male who was involved in the accident states that he is not hurt. You notice that he has a respiratory rate of 24. Which of the following might explain why this may be a normal finding in this patient?
a.
 Tidal volume is increased, which increases respirations.
b.
 Residual volume is decreased, which increases respirations.
c.
 Tidal volume is decreased, which increases respirations.
d.
 Minute volume is increased, which decreases respirations.
 

 47. 
Which of the following is the best definition of dementia?
a.
 An increase in the size of brain cells
b.
 A progressive alteration of mental status
c.
 An acute, temporary state of confusion
d.
 The experience of hallucinations
 

 48. 
During a summer heat wave, you are called to an apartment building to treat an unresponsive geriatric patient. Which of the following might explain why he is unable to handle the heat?
a.
 He has decreased vasodilation of the blood vessels.
b.
 He has an increased number of thermoreceptors.
c.
 He has increased muscle mass.
d.
 He has increased sweating.
 

 49. 
A child has had significant diarrhea and vomiting for 2 days. She has an increased respiratory rate and a normal pulse. Which of the following is an important treatment?
a.
 Cool the patient with water.
b.
 Have the AED standing by.
c.
 No immediate treatment is required.
d.
 Administer supplemental oxygen.
 

 50. 
A 3-year-old patient has a decreased level of consciousness. He has poor interaction and is using accessory muscles to breathe. He is demonstrating nasal flaring, tachypnea, and cyanosis. Which of the following is the most appropriate treatment?
a.
 Administer oxygen with a nonrebreather mask at a rate of 10 liters per minute.
b.
 Administer oxygen with a nasal cannula at a rate of 4 liters per minute.
c.
 Assist ventilations with a bag-valve-mask.
d.
 Administer oxygen with a simple mask at a rate of 10 liters per minute.
 



 
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