Q&A Hero

Q: You are trying to ventilate an 18-month-old baby who has stopped breathing. You have laid him down on a flat surface to ventilate him, but you are unable to get his chest to rise. You should: A) tip his head back farther to open his airway. B) flex his neck toward his chest. C) place a folded towel under his shoulders. D) suction his mouth to clear secretions.

Q: You are dispatched to a 1-year-old child with respiratory distress. En route, you review how to assess and treat infants with respiratory problems. Which of the following would indicate an infant with respiratory distress? A) Wheezing upon inspiration B) Respiratory rate of 30 C) Capillary refill time of 2 seconds D) Abdominal movement when breathing

Q: You respond to a 5-year-old child who has been injured while playing in his backyard. It appears that he has broken his arm, but you cannot tell how it occurred. You will need to gather some information regarding what exactly happened. Therefore, you should: A) speak only to the mother to find out what happened. B) tell the child that you will not hurt him. C) get down to the child's eye level to talk to him. D) tell the child that big boys don't cry.

Q: Which of the following is NOT a cause of altered mental status in the pediatric patient? A) Traumatic brain injury B) Diabetes C) Dementia D) Infection

Q: A bulging fontanelle in a quietly resting child may be an indication of which of the following? A) Fever B) Dehydration C) Normal development D) Increased intracranial pressure

Q: You are assessing a 2-year-old child whose mother states she has had a fever for several hours. Which of the following signs is cause for concern? A) Crying B) Absence of nasal flaring with inhalation C) Grunting at the end of expiration D) Respiratory rate of 28 breaths per minute

Q: Your protocols call for you to use the pediatric assessment triangle when assessing young children. You know that the second leg of the triangle assesses the "work of breathing" and the bottom leg of the triangle assesses "circulation to the skin." What does the first leg of the triangle stand for? A) Appearance B) Airway C) Alteration of mental status D) Assessment

Q: You are called for a sick 2-year-old boy. When you arrive, you see the boy sitting quietly on his mother's lap. You note that he is not crying and has his head tucked against his mother's chest. However, he does lift his head and look at you when you enter. As you approach, he withdraws deeper toward his mother. What have you learned about the patient so far? A) He probably does not have a fever. B) He is alert and probably acting appropriately. C) His front fontanelle is sunken, likely from dehydration. D) His skin is warm and dry.

Q: Which of the following is NOT a component of the pediatric assessment triangle? A) Appearance B) Breathing C) Circulation D) Abdomen

Q: Careful assessment and ongoing evaluation of the pediatric patient is critical for which of the following reasons? A) Childhood injuries and illnesses as a result of abuse or neglect may be missed if the EMT is not thorough. B) Signs of significant illness and injury may be subtle and easily overlooked. C) A sick or injured child who initially appeared stable can deteriorate very rapidly. D) All of the above

Q: All of the following are normal parental reactions to a child suffering from a sudden life-threatening illness or injury except: A) anger. B) denial. C) indifference. D) guilt.

Q: You are trying to assess Judy, a 16-year-old girl, who has abdominal cramps with nausea and vomiting. Her mother, Mrs. Smith, is attempting to give you her daughter's past medical history. It is important that you get the history of the present illness. Therefore, you should: A) ask Mrs. Smith to go write down their physician's name and phone number. B) ignore Mrs. Smith and ask Judy if she is sexually active. C) ask Mrs. Smith if there is a chance Judy could be pregnant. D) skip the history of current illness and suggest that Judy should visit her physician.

Q: Which of the following is a concern when dealing with an adolescent patient? A) The adolescent patient will generally be more truthful about what happened in front of his parents than in front of his peers. B) Physiologically, adolescents are very different from adults. C) The adolescent patient fears permanent disfigurement from injuries. D) Adolescents usually lack the sophistication to understand explanations of what you are doing and why.

Q: Which of the following would be an appropriate statement in gaining the cooperation of a 7-year-old pediatric patient during your assessment? A) "Joey, this is a splint that will help your arm feel better. I promise it won't hurt when I put your arm in it." B) "Big girls don't cry, Emily. You're a big girl, aren't you?" C) "I'm sorry Nick, but you can't see Mommy and Daddy until you let me take your blood pressure." D) "Katie, this is my stethoscope. I can use it to hear what your breathing sounds like. Would you like to look at it for a minute?"

Q: Which of the following is NOT a normal response of a small child when approached by the EMT? A) Anxiety B) Indifference C) Fear D) None of the above

Q: What is the tendency for a frightened child to act younger than his age? A) Repression B) Regression C) Retreat D) Retraction

Q: A 4-year-old child is generally categorized as a(n): A) preschooler. B) toddler. C) school-age child. D) adolescent.

Q: You are called for a child that has had a fever for a couple of days. The parents tell you that two of the other children have been home with a stomach virus and fever. As you attempt to assess the child, he pulls away from you and grabs onto his mother. Which of the following behaviors would be considered "normal" for a 4-year-old? A) He doesn't make eye contact as you approach. B) He begins to cry when you try to touch his booboo. C) He runs up to you when you enter the room. D) He flares his nostrils when he breathes.

Q: As a rule, as a child gets older the blood pressure: A) falls and the pulse rate rises. B) rises and the pulse rate falls. C) falls and the pulse rate falls. D) rises and the pulse rate rises.

Q: Capillary refill should be assessed in which of the following age groups? A) Younger than 6 years B) Younger than 1 year C) 2-years-old and younger D) Younger than 12 years

Q: Which of the following is true regarding the EMT's approach to the pediatric patient? A) An EMT does not have to attempt to obtain a blood pressure on patients younger than 3 years old. B) It is not necessary to use Standard Precautions when dealing with pediatric patients. C) Scene safety is not an important consideration in the care of pediatric patients. D) It is not possible to develop an initial impression of the pediatric patient without a detailed physical examination.

Q: Because infants and small children rely more heavily on the diaphragm for breathing, respiratory distress can be detected by observing which one of the following signs that is not prominent in adults? A) Bulging of the intercostal spaces B) Use of the sternocleidomastoid muscles of the neck C) Movement of the abdomen with respiratory effort D) None of the above

Q: You are assessing a child who is having problems breathing. Her mother states that she has been diagnosed with asthma and has recently started using an inhaler. Which of the following would indicate early respiratory distress? A) Cyanosis of the nail beds and lips B) Slow heart rate C) Respiratory rate of 12 D) Nasal flaring

Q: You have been called for a 2-year-old female who has fallen and is bleeding from a head laceration. Her mother states that she was running down the hallway when she fell, striking her head on a side table. You suspect that part of the reason she fell is that: A) her head is proportionately larger and heavier than an adult's. B) she has low blood sugar, making her unstable. C) she is still new to walking and may be unstable on her feet. D) both A and C are contributing factors.

Q: Which of the following is characteristic of preschool-age children? A) They may believe their injury is a punishment for being bad. B) They do not mind being separated from their parents. C) They have few fears of anything. D) They are not especially embarrassed or modest about body exposure.

Q: Which of the following should be considered by the EMT as a result of the proportionally larger size of a small child's head? A) Adaptations in positioning for cervical spine immobilization B) Different injury patterns than in adults C) Differences in positioning to maintain an open airway D) All of the above

Q: In general, a child is considered an adolescent when he reaches the age of ________ years. A) 9 B) 7 C) 12 D) 4

Q: You are at a friend's birthday party with people of all ages. There is an 11-month-old boy, just learning to stand up, who has fallen. He was holding onto the edge of a table and he toppled over. He is crying hard and his mother is trying to console him. She asks if you would mind checking him out, and you agree to take a look at him. You notice that his anterior fontanelle is bulging. This is most likely caused by: A) pressure built up because of his crying. B) an infection causing intracranial pressure. C) fluid loss from dehydration. D) the bones of the head not fusing properly.

Q: The anterior fontanelle should be closed between the ages of ________ and ________. A) 3 months; 6 months B) 24 months; 36 months C) 6 months; 10 months D) 12 months; 18 months

Q: While treating a patient of sexual assault, your treatment should follow which of the following sequences? A) Treat immediate life threats, treat psychological needs, and protect criminal evidence. B) Maintain scene safety, treat immediate life threats, and treat only the secondary injuries that may become life threats to protect criminal evidence. C) Maintain scene safety, treat immediate life threats, treat medical and psychological needs, and protect criminal evidence. D) Maintain scene safety, treat immediate life threats, allow the patient to shower if the patient is capable to help treat psychological needs, and transport.

Q: While treating a pregnant trauma patient, which of the following is the BEST way to keep the fetus alive? A) Transport the patient to the closest pediatric center. B) Treat the patient as any other trauma patient. C) Do not put the patient on a spine board to prevent supine hypotensive syndrome. D) Do an emergency cesarean section of the fetus.

Q: Which of the following is a cause of gynecological emergencies? A) Soft-tissue trauma to the external genitalia B) Sexual assault C) Disorders of the female reproductive organs D) All of the above

Q: When performing chest compressions on a pregnant patient that has gone into cardiac arrest, what change do you need to make in the placement of your hands? A) 0.5 to 1 inch lower on the sternum B) 0.5 to 1 inch higher on the sternum C) 1 to 2 inches lower on the sternum D) 1 to 2 inches higher on the sternum

Q: Which of the following is true concerning a stillborn baby? A) Infants born in cardiopulmonary arrest should not be resuscitated. B) The parents should never be allowed to see the baby, especially if it has begun to deteriorate. C) The death may occur weeks before delivery. D) Resuscitation must always be attempted.

Q: The greatest danger to the pregnant woman and her fetus involved in trauma is which of the following? A) Neurogenic shock B) Distributive shock C) Hemorrhagic shock D) Supine hypotensive shock

Q: Which of the following is true concerning trauma in the pregnant woman? A) The mother's body will preferentially protect the life of the fetus over that of the mother. B) She may lose up to 35% of her blood volume before exhibiting signs of shock. C) The increase in blood volume during pregnancy makes shock an unlikely cause of death. D) She may lose up to 15% of her blood volume before exhibiting signs of shock.

Q: What is the term for when the fetus and placenta deliver before the 28th week of pregnancy? A) Spontaneous abortion B) Induced abortion C) Stillbirth D) Eclampsia

Q: Seizures due to complications of pregnancy generally occur during which of the following time periods? A) In the first trimester B) In the second trimester C) Before the mother even knows she is pregnant D) Late in pregnancy

Q: Your patient is a 26-year-old female with a history of ectopic pregnancies. She has called 911 for extreme abdominal pain and she is concerned that she has another ectopic pregnancy. Her vital signs are pulse 118, respirations 20, and blood pressure 100/76. Which of the following is true regarding ectopic pregnancies? A) The fallopian tubes cannot stretch to accommodate a fetus. B) The fertilized egg usually implants in the wall of the uterus. C) It usually occurs during the second trimester. D) It may cause painless bright red bleeding.

Q: You are called for a woman with severe abdominal pain. During your assessment and interview, she tells you that she is sexually active and there is a chance she could be pregnant. Her vital signs are pulse 122, respirations 22, blood pressure 96/62, and skin cool and pale. You should immediately suspect: A) placenta previa. B) ectopic pregnancy. C) appendicitis. D) internal bleeding.

Q: Which of the following is a common sign of a pre-delivery emergency? A) Contractions become more intense and closer together. B) The amniotic sac ruptures. C) The placenta fails to deliver within 20 minutes of the infant's birth. D) There is profuse vaginal bleeding.

Q: Which of the following is the highest priority to the EMT in delivery of an infant with meconium-stained amniotic fluid? A) Checking for fever B) Vigorously rubbing the infant's back immediately upon delivery to stimulate breathing C) Being prepared to suction the infant immediately before he takes a breath D) None of the above

Q: Which of the following is true of premature infants? A) They are at risk for respiratory difficulty. B) They are more susceptible to infection. C) They can easily develop hypothermia. D) All of the above

Q: An infant's birth weight is considered low if it is less than ________ pounds. A) 4.5 B) 2.5 C) 5.5 D) 3.5

Q: Which of the following is appropriate when caring for a premature baby? A) Wrapping the infant in a blanket, covering his head, and keeping the temperature in the ambulance between 90F and 100F B) Deeply suctioning the airway with a rigid tonsil-tip C) Applying high-concentration oxygen with a neonatal nonrebreather mask D) Encouraging family members to hold the infant

Q: By definition, a premature infant is one who is born before how many weeks of the pregnancy? A) 40 B) 37 C) 34 D) 28

Q: Which of the following is true concerning prehospital delivery of twins? A) There are always two placentas. B) The umbilical cord of the first infant must not be cut until the second infant is born. C) This is a true emergency and cannot be managed outside the hospital setting without additional help. D) The infants will probably be smaller than a single infant and need attention in keeping them warm.

Q: Which of the following is indicated in the prehospital management of a prolapsed umbilical cord? A) Immediately clamp the cord in two places and cut it between the clamps. B) Encourage the mother to push forcefully in order to speed delivery. C) Use your gloved hand to push the umbilical cord back up through the cervix. D) Place the mother in a head-down position with pillows under her hips.

Q: If the baby's umbilical cord is noted to be wrapped around his neck after the head is delivered, which of the following should be done? A) Clamp the cord in two places, but do not cut it until the baby is delivered. B) Try to slip the cord over the baby's head and shoulder. C) Transport emergently without further intervention. D) Immediately cut the cord before delivering the baby.

Q: In which of the following situations should the mother be transported immediately? A) The mother experiences a severe, tearing sensation in her abdomen during labor and the outline of the fetus can be felt through the abdominal wall. B) The infant's arm is the presenting part. C) Delivery is not imminent and there is about 500 cc of painless, bright red bleeding. D) All of the above

Q: You respond for an imminent delivery of a baby in the breech position. As you examine the mother, you see that the umbilical cord is protruding from the opening of the cervix. You realize that the most important care you can provide for this baby is to: A) keep the baby off of the cord. B) provide oxygen to the mother. C) gently push the cord back into the vaginal space. D) wrap the cord to prevent heat loss.

Q: You have delivered a newborn and wrapped the baby in a dry blanket. During your reassessment of the mother, you note continued moderate vaginal bleeding. Care for this bleeding may involve all of the following except: A) applying firm pressure with a sanitary napkin over the vaginal opening. B) massaging the uterus to control bleeding. C) having the mother squeeze her legs together to provide direct pressure. D) elevating the mother's feet.

Q: Which of the following should the EMT do to control maternal bleeding after delivery of the baby? A) Apply direct pressure with a sanitary napkin over any perineal lacerations. B) Allow the infant to nurse, if possible. C) Massage the uterus until it is firm and grapefruit-sized. D) All of the above

Q: Normal maternal blood loss during delivery of an infant usually does not exceed how much? A) 100 cc B) 250 cc C) 1,000 cc D) 500 cc

Q: Traditionally an APGAR score is taken at what time intervals after birth? A) 5 and 10 minutes B) 2 and 7 minutes C) 1 and 5 minutes D) 1 and 6 minutes

Q: You are assessing a newborn patient 1 minute after delivery. You notice the patient has blue extremities with a pink trunk, a pulse of 120, and strong crying with good movement of all extremities. What is the newborn's APGAR score? A) 7 B) 10 C) 9 D) 8

Q: Your patient is an infant who has just been delivered 3 weeks before her due date. She is breathing adequately, has a heart rate of 140 beats per minute, and has cyanosis of her face and chest. Which of the following interventions should be done first? A) Perform ventilations with a bag-valve-mask device and supplemental oxygen. B) Place oxygen tubing near the infant's face at a flow rate of 10 to 12 liters per minute. C) Begin CPR with a compression rate of 120/minute. D) Place a neonatal nonrebreather mask on the infant's face.

Q: Which of the following conditions should be present before the umbilical cord is cut? A) The infant is breathing on his or her own. B) The cord is no longer pulsating. C) The cord is clamped in two places. D) All of the above

Q: When clamping the umbilical cord, the clamp closest to the baby should be approximately ________ inch(es) from the infant's body. A) 3 B) 12 C) 1 D) 7

Q: You have assisted in the delivery of a full-term infant by suctioning the mouth and nose as the head was delivered and again following complete delivery. The infant is not yet breathing. Which of the following is the correct sequence of interventions? A) Perform a series of back blows and chest thrusts interposed with mouth-to-mouth ventilation. B) Transport without further intervention. C) Rub the infant's back, tap the bottom of his foot, begin bag-valve-mask ventilations, and check the pulse. D) Begin bag-valve-mask ventilations, suction the airway with a rigid tonsil tip, and begin CPR.

Q: All of the following are signs of adequate breathing and circulation in the newborn except: A) heart rate greater than 100. B) relaxation of the extremities. C) cyanosis of only the hands and feet. D) vigorous crying.

Q: Which of the following should be done when the infant's head has been delivered? A) Check to see if the umbilical cord is around the neck. B) Suction the mouth. C) Suction the nose. D) All of the above

Q: Which of the following is NOT advisable following complete birth of the infant? A) Dry the infant and wrap him in a blanket. B) Keep the infant at the level of the mother's vagina until the cord is clamped and cut. C) Place the infant on his side with his head slightly lower than his body. D) Hold the infant by the ankles to allow the airway to drain.

Q: If the baby's head is delivered with the amniotic sac still intact, which of the following should be done first? A) Use your fingers to tear the sac away from the baby's face. B) Leave the sac intact until the entire body is delivered. C) Use the scissors in the obstetrics kit to cut the sac away from the baby's head. D) Call medical control before taking action.

Q: When assisting with a delivery in the field, which of the following should be done as the head begins to emerge from the vagina? A) Check for crowning. B) Advise the mother not to push or strain. C) Apply gentle pressure to the head with your gloved hand. D) Pull on the baby.

Q: Which of the following is the correct technique to check for crowning in the assessment of a woman in labor? A) Ask the woman to "push" or "bear down" as you inspect the vaginal opening. B) Place your hand on the woman's abdomen, just above the umbilicus, and check for the firmness of the uterus during contractions. C) Cover her with a sheet, have her remove her underwear, wait for a contraction, and then visualize the vaginal opening. D) None of the above

Q: If assisting in a prehospital delivery while off-duty, which of the following would be the BEST choice for tying or clamping the umbilical cord? A) Section of wire coat hanger B) Pair of shoelaces C) White cotton thread D) Clothespin

Q: Which of the following is NOT part of a basic obstetrics kit? A) Umbilical cord clamps B) Surgical scissors C) Baby blanket D) Packet of suture material

Q: You have just delivered a full-term baby girl and she is doing well. You have dried her off and wrapped her in a warm blanket. You are preparing to cut the umbilical cord. Which of the following is normally true regarding cutting the umbilical cord? A) The cord should be cut immediately following delivery. B) The infant must be breathing on his or her own before you cut the cord. C) You must try to cut the cord before it stops pulsating. D) You should hold the baby above the level of the mother when cutting the cord.

Q: You are called for a possible imminent delivery. Your patient is a 15-year-old girl who is in your estimation about 8 months pregnant. She tells you that she has been hiding her pregnancy. You are especially concerned about problems she might have during the delivery. Which of the following are findings that may indicate the need for neonatal resuscitation? A) Patient with a blood pressure of 130/82 B) Mother who has had five previous births C) Young mother who has not had prenatal care D) Patient whose water has already broken

Q: Which of the following is the correct way to time the frequency of contractions in the pregnant woman? A) From the beginning of a contraction to the end of the same contraction B) From the end of one contraction to the beginning of the next C) From the beginning of one contraction to the beginning of the next D) After counting the number of contractions in a 15-minute period, multiply by 4

Q: You have responded to a woman who has possible premature labor. She is 8 months pregnant and is experiencing labor pains. During your assessment, you note that the baby is not yet crowning. You need to determine whether delivery is imminent or not. You should next: A) time her contractions. B) complete a set of vital signs. C) check for cervix dilation. D) check the level of the fundus.

Q: You respond to a call for a patient in active labor with her second child. Your interview with the patient shows that she is 40 weeks pregnant and has been in active labor for several hours. You determine that her vital signs are all within normal limits. After your physical exam, you determine the baby is crowning. You should next: A) begin transport and plan to deliver in the ambulance. B) prepare to deliver the baby on-scene. C) delay delivery until arrival at the hospital. D) contact medical direction for orders.

Q: You have been called for a 32-year-old female who is in active labor. During your assessment and interview, you note that she is 37 weeks along, this is her first child, and her contractions are 5 minutes apart. She also tells you that her pregnancy is considered "high risk." Your first concern should be: A) assembling your delivery kit. B) calling for a back-up unit. C) getting to the hospital. D) preparing for the delivery.

Q: When delivering a baby, you should do all of the following except: A) have someone stay at the mother's head if possible. B) suction the mouth first, then the nose. C) place your fingers in the armpit to assist with delivery of the shoulders. D) position your gloved hands at the vaginal opening.

Q: Your pregnant patient is in active labor. She has been lying on her back throughout her labor and is experiencing signs and symptoms of shock. Her vital signs are pulse rate 118, respirations 22, blood pressure 96/62, and skin cool and diaphoretic. The BEST way to treat her is to: A) give her some fluids to drink to help elevate her blood pressure. B) elevate her legs to increase the blood return to the heart. C) place a rolled blanket under her left hip to displace the uterus. D) cover her up with a blanket to maintain body heat.

Q: Which of the following is an appropriate question to ask while evaluating a woman in labor? A) Do you know who the father is and what is his medical history? B) When was the last time you were sexually active? C) Is this your first pregnancy? D) None of the above

Q: Which of the following is NOT relevant in determining whether or not delivery is imminent for a woman in labor? A) Determining if the patient feels as if she needs to move her bowels B) Finding out how many pregnancies the patient has had C) Phoning the patient's obstetrician for advice D) Asking how long ago the contractions began

Q: You are assessing a 27-year-old female who is 9 months pregnant with her first child. She has been having contractions for the past 6 hours. As you are about to assist her to your cot, she asks you to wait because she feels the need to use the bathroom first. Which of the following is the BEST course of action? A) Tell the patient she needs to be transported immediately and using the bathroom will have to wait until she arrives at the hospital. B) Advise the patient that this could be a sign of a serious complication, have her lie on her left side, apply high-concentration oxygen, and transport immediately. C) Allow the patient to use the bathroom as it will make transport, and also delivery, more comfortable. D) Advise the patient that this could be an indication that the baby is ready to be born and you need to check to see if the baby's head is visible.

Q: You are assessing a patient in labor. Her contractions are 2 minutes apart lasting 30 seconds with increasing pain. The patient states that she feels the urge to push. These signs indicate which stage of delivery? A) Third stage B) Second stage C) Fourth stage D) First and second stage