Name: __________________________ Date: _____________



1.
The EMT should be MOST concerned when a child presents with fever and:
A.
chills.
B.
a rash.
C.
ear pain.
D.
a headache.


2.
Padding underneath the torso when immobilizing an injured child is generally not necessary if he or she is:
A.
older than 8 to 10 years.
B.
complaining of severe back pain.
C.
immobilized on a long backboard.
D.
experiencing cardiopulmonary arrest.


3.
A high-pitched inspiratory sound that indicates a partial upper airway obstruction is called:
A.
stridor.
B.
rhonchi.
C.
grunting.
D.
wheezing.


4.
After squeezing the end of a child's finger or toe for a few seconds, blood should return to the area within:
A.
2 seconds.
B.
3 seconds.
C.
4 seconds.
D.
5 seconds.


5.
After determining that an infant or child has strong central pulses, you should:
A.
assume the child is hypertensive.
B.
not rule out compensated shock.
C.
conclude that the child is stable.
D.
assess his or her respiratory effort.


6.
Which of the following is NOT a known risk factor of SIDS?
A.
mother younger than 20 years
B.
low birth weight
C.
putting a baby to sleep on his or her back
D.
mother smoked during pregnancy


7.
A child who has no recent history of illness suddenly appears cyanotic and cannot speak after playing with a small toy. You should:
A.
perform abdominal thrusts.
B.
visualize the child's airway.
C.
perform a blind finger sweep.
D.
give oxygen and transport at once.


8.
In most children, febrile seizures are characterized by:
A.
a blank stare, a duration of between 15 and 30 minutes, and a prolonged postictal phase.
B.
unresponsiveness, complete body relaxation, a fever greater than 105°F, and a short postictal phase.
C.
generalized tonic-clonic activity, a duration of less than 15 minutes, and a short or absent postictal phase.
D.
isolated tonic-clonic activity, a duration of greater than 15 minutes, and a short postictal phase.


9.
In contrast to adults, deterioration to cardiac arrest in infants and children is usually associated with:
A.
irritability of the left ventricle.
B.
a sudden ventricular arrhythmia.
C.
severe hypoxia and bradycardia.
D.
acute hypoxia and tachycardia.


10.
A 6-year-old male presents with acute respiratory distress. His mother states that she saw him put a small toy into his mouth shortly before the episode began. The child is conscious, obviously frightened, and is coughing forcefully. You should:
A.
carefully look into his mouth and remove the object if you see it.
B.
encourage him to cough, give oxygen as tolerated, and transport.
C.
deliver a series of five back blows and then reassess his condition.
D.
place the child in a supine position and perform abdominal thrusts.


11.
An 8-year-old female with a history of asthma continues to experience severe respiratory distress despite being given multiple doses of her prescribed albuterol by her mother. She is conscious, but clearly restless. Her heart rate is 130 beats/min and her respiratory rate is 30 breaths/min. She is receiving high-flow oxygen via a nonrebreathing mask. You should:
A.
be prepared to assist her ventilations, transport at once, and request an ALS intercept en route to the hospital.
B.
continue high-flow oxygen therapy, contact medical control, and request permission to administer more albuterol.
C.
begin immediate ventilation assistance and ensure that you squeeze the bag forcefully in order to open her bronchioles.
D.
begin chest compressions if she becomes unresponsive and her heart rate falls below 80 beats/min.


12.
The purpose of the pediatric assessment triangle (PAT) is to:
A.
determine if the child's vital signs are within the age-appropriate limits.
B.
allow you to rapidly and visually form a general impression of the child.
C.
facilitate a rapid head-to-toe assessment of the child by visualization only.
D.
gather critical data by performing a rapid hands-on assessment of the child.


13.
When a child experiences a blunt chest injury:
A.
the flexible rib cage protects the vital thoracic organs.
B.
the flexible ribs can be compressed without breaking.
C.
the sudden force against the ribs causes them to fracture.
D.
there is usually obvious injury to the external chest wall.


14.
Infection should be considered a possible cause of an airway obstruction in an infant or child, especially if he or she presents with:
A.
extreme restlessness.
B.
drooling or congestion.
C.
skin that is cool and dry.
D.
acute respiratory distress.


15.
When assessing or treating an adolescent patient, it is important to remember that:
A.
they usually do not wish to be observed during a procedure.
B.
it is generally not necessary to explain procedures in advance.
C.
they often request medication to help in the relief of severe pain.
D.
they cannot understand complex concepts and treatment options.


16.
To ensure that the airway of an infant or small child is correctly positioned, you may have to:
A.
place bulky padding behind his or her occiput.
B.
place a towel or folded sheet behind the shoulders.
C.
slightly flex the neck to prevent tracheal kinking.
D.
hyperextend the neck to ensure adequate alignment.


17.
When caring for a female child who has possibly been sexually abused, you should:
A.
encourage the child to urinate and take a shower.
B.
have a female EMT remain with her if possible.
C.
carefully examine the genitalia for signs of injury.
D.
immediately report your suspicions to the parents.


18.
Signs of severe dehydration in an infant include all of the following, EXCEPT:
A.
profound tachycardia.
B.
slowed level of activity.
C.
delayed capillary refill.
D.
dry mucous membranes.


19.
Hyperthermia differs from fever in that it is an increase in body temperature:
A.
of more than 2°F to 3°F per hour.
B.
secondary to a severe bacterial infection.
C.
caused by inflammation of the spinal cord.
D.
caused by the inability of the body to cool itself.


20.
When administering oxygen to a frightened child, it would be MOST appropriate to:
A.
place oxygen tubing through a hole in a paper cup.
B.
tightly secure the oxygen mask straps to the face.
C.
have a parent restrain the child as you give oxygen.
D.
use a nasal cannula instead of a nonrebreathing mask.


21.
All of the following are normal findings in an infant or child, EXCEPT:
A.
quiet breathing.
B.
fear or anxiety.
C.
belly breathing.
D.
head bobbing.


22.
Early signs of respiratory distress in the child include:
A.
cyanosis.
B.
bradycardia.
C.
restlessness.
D.
decreased LOC.


23.
Critical burns in children include:
A.
any superficial or partial-thickness burn that involves the legs or arms.
B.
partial-thickness burns covering more than 20% of the body surface.
C.
second-degree burns covering more than 10% of the body surface.
D.
superficial burns covering more than 10% to 15% of the body surface.


24.
Which of the following statements regarding a pediatric patient's anatomy is correct?
A.
The tracheal rings of a child are more rigid than an adult's.
B.
A child's tongue is proportionately smaller than an adult's.
C.
Children have a larger, rounder occiput compared to adults.
D.
The child's epiglottis is less floppy and smaller than an adult's.


25.
Signs of vasoconstriction in the infant or child include:
A.
warm, dry skin.
B.
weak distal pulses.
C.
a rapid heart rate.
D.
brisk capillary refill.


26.
Causes of infant death that may be mistaken for SIDS include all of the following, EXCEPT:
A.
child abuse.
B.
meningitis.
C.
severe infection.
D.
hyperglycemia.


27.
The suture of the anterior fontanelle is typically closed by _____ months of age, and the suture of the posterior fontanelle is typically closed by _____ months of age.
A.
2, 4
B.
6, 12
C.
12, 4
D.
18, 6


28.
Which of the following findings is LEAST suggestive of child abuse?
A.
evidence of alcohol consumption or drug use at the scene
B.
burns to the hands or feet that involve a glove distribution
C.
consistency in the method of injury reported by the caregiver
D.
an unexplained delay in seeking medical care after the injury


29.
Febrile seizures in a child:
A.
typically last less than 30 minutes.
B.
occur after a week of a febrile illness.
C.
are usually caused by viral meningitis.
D.
may indicate a serious underlying illness.


30.
Before assessing the respiratory adequacy of an semiconscious infant or child, you must:
A.
routinely suction the mouth to remove oral secretions.
B.
ensure that the airway is patent and clear of obstructions.
C.
insert a nasopharyngeal or oropharyngeal airway adjunct.
D.
ensure that his or her head is in a hyperextended position.


31.
Greenstick fractures occur in infants and children because:
A.
the growth plate is commonly injured.
B.
their bones are more brittle than an adult's.
C.
their bones bend more easily than an adult's.
D.
twisting injuries are more common in children.


32.
When assessing an 8-year-old child, you should:
A.
refrain from taking a blood pressure.
B.
talk to the child, not just the caregiver.
C.
use a toe-to-head assessment approach.
D.
rely solely on the parent for information.


33.
Which of the following children would benefit the LEAST from a nonrebreathing mask?
A.
a conscious 4-year-old male with adequate tidal volume
B.
a responsive 6-year-old male who responds appropriately
C.
an unresponsive 5-year-old male with shallow respirations
D.
a semiconscious 7-year-old female with normal ventilation


34.
Drawing in of the muscles between the ribs or of the sternum during inspiration is called:
A.
tenting.
B.
retracting.
C.
hyperpnea.
D.
accessory muscle use.


35.
An infant or child with respiratory distress will attempt to keep his or her alveoli expanded at the end of inhalation by:
A.
grunting.
B.
wheezing.
C.
assuming a tripod position.
D.
retracting the intercostal muscles.


36.
Which of the following is the MOST appropriate dose of activated charcoal for a 20-kg child?
A.
12.5 g
B.
20 g
C.
25 g
D.
50 g


37.
Use of a nonrebreathing mask or nasal cannula in a child is appropriate ONLY if:
A.
an oral airway has been inserted.
B.
his or her tidal volume is adequate.
C.
his or her respirations are shallow.
D.
he or she is breathing inadequately.


38.
Which of the following statements regarding pediatric trauma is correct?
A.
Children are less likely than adults to be struck by a car.
B.
A child's head is less frequently injured than an adult's.
C.
Children are more likely to experience diving-related injuries.
D.
Inexperience and poor judgment are rare causes of pediatric trauma.


39.
When questioning the parent of a child who ingested a poisonous substance, which of the following questions would be of LEAST pertinence?
A.
What time did the ingestion occur?
B.
Have you noticed any signs or symptoms?
C.
Why did your child ingest the poison?
D.
Do you know what substance was ingested?


40.
During the attempted resuscitation of an infant with suspected SIDS:
A.
discourage the family from observing.
B.
allow the family to observe if they wish.
C.
a law enforcement officer must be present.
D.
give detailed updates to the infant's parents.


41.
Blood pressure is usually not assessed in children younger than _____ years.
A.
3
B.
4
C.
5
D.
6


42.
The signs and symptoms of poisoning in children:
A.
vary widely, depending on the child's age and weight.
B.
are more obvious than in the adult population.
C.
usually present within the first 10 minutes of ingestion.
D.
are most severe if the child ingested a poisonous substance.


43.
Which of the following is MORE common in children than in adults following a head injury?
A.
spinal cord injury
B.
loss of consciousness
C.
seizures and hypoxia
D.
nausea and vomiting


44.
Which of the following statements regarding a 3-month-old infant is correct?
A.
The infant is unable to turn his or her head and focus.
B.
The infant should be aroused easily from a sleeping state.
C.
At this age, the infant typically sleeps for up to 8 hours a day.
D.
A 3-month-old infant can distinguish a parent from a stranger.


45.
Unless he or she is critically ill or injured, you should generally begin your assessment of a toddler:
A.
at the feet.
B.
at the head.
C.
in the ambulance.
D.
en route to the hospital.


46.
When immobilizing an injured child in a pediatric immobilization device, you should:
A.
secure the head before the torso.
B.
slide the device under the child.
C.
pad underneath the child's head.
D.
secure the torso before the head.


47.
The first month of life after birth is referred to as the:
A.
neonatal period.
B.
toddler period.
C.
start of infancy.
D.
premature phase.


48.
A normal level of consciousness in an infant or child is characterized by:
A.
normal interactiveness, awareness to time, and pink skin color.
B.
awareness to place, pink and dry skin, and consistent eye contact.
C.
crying or combativeness, good muscle tone, and awareness to time.
D.
age-appropriate behavior, good muscle tone, and good eye contact.


49.
Which of the following inquiries should you make in private when obtaining a SAMPLE history from an adolescent patient?
A.
sexual activity
B.
past medical history
C.
change in bladder habits
D.
duration of symptoms


50.
Which of the following is the LEAST reliable assessment parameter to evaluate when determining the presence of shock in infants and children?
A.
heart rate
B.
blood pressure
C.
skin condition
D.
capillary refill


51.
With regard to the legal implications of child abuse:
A.
child abuse must be reported only if it can be proven.
B.
EMTs must report all suspected cases of child abuse.
C.
you should document your perceptions on the run form.
D.
a supervisor can forbid you from reporting possible abuse.


52.
Signs of a severe airway obstruction in an infant or child include:
A.
pink, dry skin.
B.
crying and anxiety.
C.
an ineffective cough.
D.
mild respiratory distress.


53.
When assessing an infant's ventilation status, you should:
A.
observe the chest for rise and fall.
B.
rule out hypoxia if cyanosis is absent.
C.
palpate the abdomen for rise and fall.
D.
give oxygen if the SpO2 is less than 90%.


54.
The MOST common cause of dehydration in pediatric patients is:
A.
high fever.
B.
internal blood loss.
C.
vomiting and diarrhea.
D.
refusal to drink fluids.


55.
Effective methods for providing pain relief to a child with an extremity injury include:
A.
separating the child from his or her parents.
B.
positioning, ice packs, and emotional support.
C.
avoiding the placement of a splint, if possible.
D.
heat compresses and lowering the injured extremity.


56.
Early signs of respiratory distress in the pediatric patient include all of the following, EXCEPT:
A.
cyanosis.
B.
tachypnea.
C.
retractions.
D.
abnormal airway noise.


57.
The MOST ominous sign of impending cardiopulmonary arrest in infants and children is:
A.
pallor.
B.
retractions.
C.
nasal flaring.
D.
bradycardia.


58.
A child may begin to show signs of separation anxiety as early as:
A.
6 months.
B.
12 months.
C.
18 months.
D.
24 months.


59.
Common causes of seizures in children include all of the following, EXCEPT:
A.
infection.
B.
hyperglycemia.
C.
electrolyte imbalances.
D.
poisonings or ingestion.


60.
A 6-month-old male presents with 2 days of vomiting and diarrhea. He is conscious, but his level of activity is decreased. The infant's mother tells you that he has not had a soiled diaper in over 12 hours. The infant's heart rate is 140 beats/min and his anterior fontanelle appears to be slightly sunken. You should suspect:
A.
mild dehydration.
B.
moderate dehydration.
C.
severe dehydration.
D.
hypovolemic shock.


61.
Which of the following statements regarding the use of nasopharyngeal airways in children is correct?
A.
They are rarely used in infants younger than 1 year.
B.
It is the recommended adjunct for children with head trauma.
C.
They are usually not well tolerated in children with a gag reflex.
D.
Blanching of the nares after insertion indicates correct placement.


62.
Signs of an upper airway obstruction in an infant or child include all of the following, EXCEPT:
A.
wheezing.
B.
a weak cough.
C.
a cough that resembles the bark of a seal.
D.
stridorous breathing.


63.
Signs and symptoms of meningitis in the infant or child include all of the following, EXCEPT:
A.
sunken fontanelles.
B.
headache and fever.
C.
a stiff or painful neck.
D.
an altered mental status.


64.
The MOST accurate method for determining if you are delivering adequate tidal volume to a child during bag-mask ventilations is to:
A.
monitor the child's heart rate.
B.
observe the child's skin color.
C.
monitor the pulse oximeter reading.
D.
observe the chest for adequate rise.


65.
Compared to an adult, the diaphragm dictates the amount of air that a child inspires because the:
A.
intercostal muscles are not well developed.
B.
rib cage is rigid and provides little flexibility.
C.
abdominal organs force the diaphragm upward.
D.
upper airway is smaller and easily collapsible.


66.
An infant with severe dehydration would be expected to present with:
A.
excessive tearing.
B.
moist oral mucosa.
C.
bulging fontanelles.
D.
absent urine output.


67.
Febrile seizures are MOST common in children between:
A.
3 months and 4 years.
B.
6 months and 6 years.
C.
8 months and 8 years.
D.
18 months and 10 years.


68.
The pediatric patient should be removed from his or her car seat and secured to an appropriate spinal immobilization device if:
A.
the car seat is visibly damaged.
B.
he or she has no visible injuries.
C.
his or her vital signs are stable.
D.
he or she even has a minor injury.


69.
When ventilating a pediatric patient with a bag-mask device, the EMT should:
A.
block the pop-off valve if needed to achieve adequate chest rise.
B.
squeeze the bag 40 times/min when ventilating an infant.
C.
ensure that he or she uses a neonatal device for children younger than 12 months.
D.
ventilate the child with sharp, quick breaths at the appropriate rate.


70.
The secondary assessment of a sick or injured child:
A.
is a rapid head-to-toe exam to detect life threats.
B.
should be performed, regardless of the circumstances.
C.
may not be possible if the child's condition is critical.
D.
is most appropriate when your transport time is short.


71.
Bruising to the _________ is LEAST suggestive of child abuse.
A.
shins
B.
back
C.
face
D.
buttocks


72.
After using the PAT to form your general impression of a sick or injured child, you should:
A.
evaluate the child's baseline vital signs.
B.
obtain a SAMPLE history from the parents.
C.
perform a hands-on assessment of the ABCs.
D.
assess the child's heart rate and skin condition.


73.
Capillary refill time is MOST reliable as an indicator of end-organ perfusion in children younger than:
A.
4 years.
B.
6 years.
C.
8 years.
D.
10 years.


74.
Which of the following groups of people is associated with the lowest risk of meningitis?
A.
newborns
B.
females
C.
geriatrics
D.
children with shunts


75.
Submersion injuries in the adolescent age group are MOST commonly associated with:
A.
alcohol.
B.
child abuse.
C.
hyperthermia.
D.
swimming pools.


76.
A 2-year-old female has experienced a seizure. When you arrive at the scene, the child is conscious, crying, and clinging to her mother. Her skin is hot and moist. The mother tells you that the seizure lasted approximately 5 minutes. She further tells you that her daughter has no history of seizures, but has had a recent ear infection. You should:
A.
allow the mother to drive her daughter to the hospital.
B.
attempt cooling measures, offer oxygen, and transport.
C.
place the child in cold water to attempt to reduce her fever.
D.
suspect that the child has meningitis and transport at once.


77.
An oropharyngeal airway should not be used in children who have ingested a caustic or petroleum-based product because it may:
A.
depress the gag reflex.
B.
cause the child to vomit.
C.
result in airway swelling.
D.
result in a soft-tissue injury.


78.
You respond to a skate park where a 10-year-old male fell from his skateboard and struck his head on the ground; he was not wearing a helmet. He is responsive to painful stimuli only and has a large hematoma to the back of his head. After your partner stabilizes his head and opens his airway, you assess his breathing and determine that it is slow and irregular. His pulse is slow and bounding. You should:
A.
apply high-flow oxygen via a nonrebreathing mask, perform an in-depth secondary assessment, apply full spinal precautions, and transport.
B.
insert an oral airway, hyperventilate him with a bag-mask device, apply full spinal precautions, and transport to the closest trauma center.
C.
apply high-flow oxygen via a nonrebreathing mask, obtain baseline vital signs, apply full spinal precautions, and perform a secondary assessment.
D.
assist his ventilations, be prepared to suction his mouth if he vomits, apply full spinal precautions, and prepare for immediate transport to a trauma center.


79.
Cardiac arrest in the pediatric population is MOST commonly the result of:
A.
a complete airway obstruction.
B.
respiratory or circulatory failure.
C.
a congenital cardiovascular defect.
D.
lethal cardiac rhythm disturbances.


80.
Blood loss in a child exceeding _____ of his or her total blood volume significantly increases the risk of shock.
A.
5%
B.
15%
C.
25%
D.
35%



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