Pediatrics (Paramedic) Study Center > Diagnostic Tests > Paramedic Diagnostic Tests > Pediatrics (Paramedic) Step 1 of 40 2% A 10 year old female complains of an acute onset of shortness of breath. She states she began wheezing while playing outside in the grass. Her mother notes a long history of asthma. You note moderate respiratory distress and accessory muscle use. Her vital signs are: P 120, R 36, BP 110/80. Her pulse oximeter reads 95%. You should first administer* intramuscular epinephrine. a corticosteroid. high concentration oxygen. a nebulized beta agonist. A 5 year old male fell from a fast-moving ATV. There was no loss of consciousness, but the patient complains of pain in his pelvis. Your assessment reveals no instability and the patient’s vital signs are P 128, BP 102/68, R 38. You should first* administer fentanyl. apply a commercial pelvic binder. secure the patient to a long spine board. administer 20 mL/kg of normal saline. A 14 year old male was hit hard during a hockey game. Following the game, he complains of severe left shoulder pain. Your exam finds no tenderness in the shoulder but does find tenderness in the upper quadrants of the abdomen. You should suspect* an injury to the kidney. an injury to the spleen. a musculoskeletal injury in the shoulder. an injury to the muscles of the flank. The mother of a 4 year old female notes her daughter has developed a cold over the last week but today presents with a fever and a body-wide rash that is characterized by small red raised spots. These findings most likely indicate* mononucleosis. the mumps. varicella. pertussis. A 10 year old male complains of severe upper left quadrant abdominal pain and left shoulder pain. He notes a recent diagnosis of sickle cell disease. Your assessment finds the patient’s abdomen to be tender and you note pale skin. His vital signs are: P 128, R 30, BP 80/58. You should suspect* appendicitis. hepatitis. urinary tract infection. splenic sequestration. A 6 year old female complains of 2 days of fever and a cough. Her mother called today because the child “just wasn’t acting right.” The patient has Duchenne muscular dystrophy, but her mother notes she is otherwise healthy. As you begin your assessment, you should first* contact medical control. initiate transport to a facility capable of caring for a special needs child. speak to the parent to establish baseline normal for the child. discuss whether a “Do Not Resuscitate” order is in place. A 16 year old male was found unconscious by his family today. They note he has no past medical history but he has not been feeling well for days. He has also been complaining of abdominal pain. On assessment, the patient appears dehydrated and has rapid and deep respirations. You note a fruity odor on his breath. You should suspect* hyperglycemia. HHNK. hypoglycemia. stroke. A 9 year old male has been stung multiple times on the foot by fire ants. He is in severe pain and has recently developed a red, raised rash all over his body. He also has vomited once and complains of abdominal cramping. You should first* administer an analgesic. wash the site of the fire ant stings. deploy an epinephrine auto-injector. administer an antiemetic. A 7 year old male complains of pain in his right ear. His mother states that he has become increasingly agitated over the last two hours. She tells you that the patient has autism and has particular trouble communicating. To best assess this patient, you should* speak loudly and clearly. ask questions through the patient’s mother. assess the center of his body first. use therapeutic touch. A 3 year old male is found in severe respiratory distress. He has altered mental status and is breathing at a rate of 60. His heart rate is 58. You should next* apply a cardiac monitor. initiate chest compressions. administer a beta agonist. administer high concentration oxygen. A 10 year old male was involved in a motor vehicle crash yesterday. His mother states that his chest hurt from the seatbelt, but he was evaluated and signed off at the scene. Today the patient complains of difficulty breathing and has been coughing up blood. On examination, you note bilateral lung sounds, but hear rales in the bases. You should suspect* a pulmonary embolism. a pulmonary contusion. pericardial tamponade. a pneumothorax. A six month old male has severe respiratory distress. Your exam found coarse wheezes over all fields and you have had to support his oxygen levels with a non-rebreather mask. You have administered two rounds of albuterol with no effect. You should next* administer ipratropium bromide. administer inhaled epinephrine. administer inhaled hypertonic saline. continue with a third round of albuterol. A 9 year old female is experiencing seizures and respiratory failure after a snake bite. Which of the following poisonous snakes would likely cause these effects?* A copperhead A coral snake A cottonmouth A rattlesnake A 2 year old female has had a three day history of fever, vomiting and diarrhea. Today she presents listless and pale. Her vital signs are P 140, R 50, BP 68/40. You should first* begin a norepinephrine infusion. administer normal saline. administer an antiemetic. begin chest compressions. An 8 year old male is experiencing a severe asthma attack. His mother notes he has been getting worse for 2 hours. You have administered 2 rounds of albuterol and ipratropium without significant improvement. You note that his pulse oximetry is falling and his end tidal carbon dioxide is rising. His vital signs are P 132, R 36, BP 100/60. You should next* initiate positive pressure ventilation with a BVM. administer inhaled magnesium sulfate. prepare rapid sequence intubation. administer intramuscular epinephrine. A 12 year old male has fallen out of a second story window and landed feet first onto the pavement. He complains of pain in his feet and also in his right hip. It does not appear that he landed on his hip. You should suspect* pain referred from his spleen. an indirect fracture. torsion injury. an open fracture of the hip. A 16 month old male is febrile and inconsolable. His mother states that he has been this way “all night.” Upon assessment, you note that the patient is active and crying. He also has a recently placed feeding tube that is obviously dislodged. The site of placement is very red and swollen. You should first* administer an analgesic. cover the site with an occlusive dressing. replace the tube. ask the mother to replace the tube. A 6 year old male has a high fever and lethargy. The patient’s mother called EMS this morning after the patient began to complain of photophobia. She notes each of her three children are ill with similar complaints. On examination you note a small, red dot like, systemic rash common on each child. You should suspect* mumps. pertussis. measles. tetanus. A 4 year old male was struck by a car at moderate speed. Bystanders note that the grill of the car hit the patient in the chest and threw him backward. Given his age, which of the following injuries would be most likely?* Rib fractures Pulmonary contusion Sternal fractures Fractured vertebrae A 9 year old male has fallen from the tree he was climbing. You find the patient crying, but ambulatory. The patient tells you his belly hurts, but he is otherwise ok. You note diffuse tenderness in his abdomen. His vital signs are P 118, R 28 (crying), BP 92/70. You should first* administer a 20 mL/kg bolus of normal saline. await the patient’s mother for permission to treat. administer fentanyl to treat the pain. allow the patient to calm down before initiating care. A 12 year old male has been shot in the abdomen. You find the patient anxious, diaphoretic and in pain. His initial vital signs were P 128, R 36, BP 92/70. After administering 20 mL/kg of normal saline you note his vital signs have not changed. You should next* initiate a norepinephrine drip. adjust the IV drip to TKO. limit the second bolus of normal saline to 10 mL/kg. administer a second bolus 20 mL/kg normal saline. An 8 month old has developed difficulty breathing after having a cough and fever for 24 hours. You note intercostal retractions, hear wheezing and observe that the patient’s nose is obstructed with mucus. You should first* suction the nose. apply CPAP. administer an inhaled beta agonist. administer ipratropium bromide. A 6 year old female has a partial thickness burn on her thigh. You assess that the total area of her burn is about the same as the area of her palm and fingers on her hand. You would conclude therefore that the area of the burn would be roughly ____% of her total body surface area.* 10 1 3 9 A 2 year old female has had a runny nose and fever for 24 hours. Tonight her mother says she is inconsolable and writhing in pain. The patient has a fever and is tugging at her right ear. You should suspect* febrile seizures. meningitis. otitis media. child abuse. A 10 year old female has severely altered mental status and has vomited. Her family states she has been sick for a week. Her vital signs are P 130, R 60, BP 70/30 and her blood glucose is 1150 mg/dL. You should first administer* 1 L of normal saline. dextrose 25%. 10 mL/kg of normal saline. dextrose 10%. A 2 year old female presents with a barking cough and stridor at rest. She is anxious as you enter the room. As you begin your assessment you should* reach in and tickle her to calm her down. begin the physical examination first. ask her mother to leave the room. move your body to her level. A 2 year old is found to be hypoglycemic after accidentally ingesting an aspirin overdose. Which of the following treatments would best address her low blood sugar?* 5-10 mL/kg of dextrose 10% 25 g of dextrose 50% 1 mg of naloxone 1 mg of glucagon A three year old female has fallen out of a high chair at her day care center. She has an obviously fractured right forearm and you determine the need for pain management. You should next* choose an appropriate dose of medication based on the patient’s approximate age. withhold pain medication until a parent arrives. utilize a length based resuscitation tape to estimate the patient’s weight. consult the day care center staff for their estimation of the patient’s weight. A 3 year old female presents with a low grade fever and a severe cough. On examination you find widespread raised red spots and the patient notes they are very itchy. You should suspect* measles. mumps. pertussis. varicella. A 7 year old male with a known peanut allergy recently accidentally ingested peanuts. He complains of GI cramping, diarrhea, and widespread itching. You should first administer* albuterol. an antiemetic. IM epinephrine. IV diphenhydramine. A 6 year old female has developed stridor after ingesting a new antibiotic. She has also rapidly developed widespread urticaria. After an initial dose of IM epinephrine you should next administer* inhaled epinephrine. cimetidine. a corticosteroid. albuterol. A 5 year old female was recently diagnosed with pertussis and despite treatment has experienced worsening coughing fits over the last three days. Today her mother called after noticing “bleeding in her eyes.” This finding would most likely indicate* retinal detachment. hyphema. subconjunctival hematoma. corneal abrasion. A 9 year old male has had 24 hours of nausea and vomiting. His mother contacted EMS because the child has become increasingly ill and lethargic. You find him slightly confused, pale and febrile. His vital signs are P 110, R 22, BP 102/60. Upon examination, you note that the child has a vagus nerve stimulator implanted in his left chest. You should next* administer midazolam. have the mother stop the vagus nerve stimulator. contact medical control to discuss the vagus nerve stimulator. initiate a fluid bolus. A 3 year old male has fallen from a second story window into the parking lot below. Given the patient’s age, which of the following injuries would he most likely sustain?* Rib fractures Head injury Leg fractures Spinal injury A 6 year old female was ejected from the back of a truck during a moderate speed motor vehicle crash. She has an obviously fractured left leg and complains of abdominal pain. Your exam identified tenderness in the right upper quadrant. The patient’s vital signs are: P 130, R 40, BP 90/60. You should first* administer 20 mL/kg normal saline. initiate transport to the trauma center. splint the fractured leg. administer fentanyl to treat the pain. A 4 year old female presents with a new onset of an unstable gait followed by an inability to speak. The patient is currently conscious but does not respond to verbal questions. You should next* assess a blood glucose level. obtain a body temperature. obtain a validated prehospital stroke screen. administer anticonvulsant medications. A 10 year old child was found floating in a local lake. As part of the rescue team, you have entered the water to attend to the child. While in the water, you find the patient apneic, but with a pulse of 50. You should first* initiate rescue breathing. extricate the patient from the water into the rescue boat. immobilize the patient to a long spine board. begin chest compressions. A 12 year old male is having a severe asthma attack. He complains of respiratory distress and you note he has a silent chest. When measuring his end tidal carbon dioxide levels, you should expect* low levels of carbon dioxide. normal levels of carbon dioxide. an inability to obtain this measurement. high levels of exhaled carbon dioxide. A 10 year old female with a known allergy to bee stings was recently stung by a bee. She is visibly upset and complains of severe pain around the sting. You note swelling and erythema on the arm that was stung, but note no skin signs anywhere else on her body. She denies shortness of breath and her vital signs are P 100, R 20, BP 99/64. You should first administer* albuterol. diphenhydramine. epinephrine. a corticosteroid. A two year old female woke from sleep with a barking cough. Her mother says that she has had a cold for two days and that everyone in the house has had it. Upon examination, you note that the patient has stridor at rest. You should next administer* inhaled magnesium sulfate. humidified oxygen. racemic epinephrine. albuterol.