PMED CH43 EXAM QUESTIONS WITH COMPLETE
SOLUTIONS
A 10-month-old infant presents with an acute onset of increased
work of breathing. According to the infant's mother, the child
was crawling around in the living room prior to the event and
was fine 10 minutes earlier. Your assessment reveals that the
infant appears alert to his surroundings, has loud inspiratory
stridor, and pink skin. You should:
A) look inside the infant's mouth using a tongue blade and
penlight.
B) avoid agitating the infant, offer supplemental oxygen, and
transport.
C) deliver five sharp back slaps between the infant's shoulder
blades.
D) apply a pediatric nonrebreathing mask and transport
expeditiously. Correct Answers B
A 10-year-old child fell approximately 15 feet from a balcony,
landing on a sidewalk. He is conscious and alert, and complains
of pain to the right side of his body. After completing your
primary assessment, you should:
A) apply spinal precautions, begin transport, and perform a rapid
assessment while en route to the hospital.
B) provide any immediately needed care, perform a rapid
assessment, apply spinal precautions, and transport.
C) perform a focused physical exam, obtain baseline vital signs,
apply spinal precautions, and transport.
D) correct immediate life threats, perform a detailed head-to-toe
exam, apply spinal precautions, and transport. Correct Answers
B
,A 12-year-old boy presents with marked respiratory distress;
hot, moist skin; and anxiety. He is sitting with his chin thrust
forward and has inspiratory stridor. According to the child's
grandmother, his symptoms began suddenly about 30 minutes
ago. You should be MOST suspicious for:
A) acute viral croup.
B) bacterial epiglottitis.
C) subglottic narrowing.
D) laryngotracheobronchitis. Correct Answers B
A 13-year-old, 40-pound girl is experiencing an acute asthma
attack that has been unresponsive to 3 puffs of her albuterol
inhaler. She is conscious and alert, but is notably dyspneic and
has diffuse wheezing. In addition to administering supplemental
oxygen, you should:
A) give 0.35 mg of epinephrine 1:1,000 SQ.
B) give 0.5 mg of nebulized ipratropium.
C) administer another 2.5-mg dose of albuterol.
D) assist her ventilations with a bag-mask device. Correct
Answers B
A 15-year-old child can be difficult to treat for all of the
following reasons, EXCEPT:
A) peer pressure.
B) stranger anxiety.
C) independence issues.
D) cognizance of body image. Correct Answers B
A 2-year-old girl fell approximately 12 feet from a second-story
window, landing on her head. Your primary assessment reveals
,that she is unresponsive; has slow, irregular respirations; and has
blood draining from her mouth and nose. A rapid scan of her
body does not reveal any gross injuries or bleeding. You should:
A) manually stabilize her head and neck in a neutral position,
insert a nasal airway, and hyperventilate her at a rate of 35
breaths/min.
B) suction her mouth and nose for no longer than 15 seconds,
insert an oral airway, and apply high-flow oxygen with a
pediatric nonrebreathing mask.
C) open her airway with the jaw-thrust maneuver, suction her
mouth and nose, insert an oral airway, and assist her ventilations
with a bag-mask device.
D) insert an oral airway, apply a cervical collar, preoxygenate
her with a bag-mask device and 100% oxygen for 30 seconds,
and intubate her trachea. Correct Answers C
A 4-year-old boy is found unresponsive by his mother. When
you begin your assessment, the child's mother tells you that her
son apparently ingested some of her antihypertensive
medication. The child has poor perfusion and is breathing
poorly. As you are assisting the child's ventilations with high-
flow oxygen, your partner informs you that the child's heart rate
is 50 beats/min and weak and that the cardiac monitor reveals
sinus bradycardia. You should:
A) ask your partner to insert an IO catheter and administer
epinephrine 1:10,000.
B) attempt immediate transcutaneous pacing while continuing
ventilation assistance.
C) establish immediate vascular access and administer 0.02
mg/kg of atropine sulfate.
, D) initiate one-rescuer CPR while your partner attempts to
establish vascular access. Correct Answers D
A 4-year-old girl presents with a fever of 103.2°F. The child's
mother states that the fever came on suddenly and was not
preceded by any symptoms. The child is conscious and alert
with unlabored tachypnea, tachycardia, and a blood pressure that
is consistent with her age. Prehospital treatment for this child
includes all of the following, EXCEPT:
A) 81 mg of aspirin.
B) free-flow oxygen.
C) 250 mg of acetaminophen.
D) simple cooling measures. Correct Answers A
A 6-year-old child has burns to his head, face, neck, and anterior
chest. What percentage of his body surface area has been
burned?
A) 21%
B) 27%
C) 30%
D) 36% Correct Answers A
A 6-year-old girl who has been running a fever for the past 2
days presents with lethargy and tachycardia. Her heart rate is
170 beats/min and varies with activity. Her skin is cool and
clammy, and her capillary refill time is 4 seconds. The cardiac
monitor reveals a narrow complex tachycardia with a rate that
varies between 150 and 170 beats/min. After applying high-flow
oxygen, you should:
A) apply chemical ice packs to the child's face to try to slow her
heart rate.
SOLUTIONS
A 10-month-old infant presents with an acute onset of increased
work of breathing. According to the infant's mother, the child
was crawling around in the living room prior to the event and
was fine 10 minutes earlier. Your assessment reveals that the
infant appears alert to his surroundings, has loud inspiratory
stridor, and pink skin. You should:
A) look inside the infant's mouth using a tongue blade and
penlight.
B) avoid agitating the infant, offer supplemental oxygen, and
transport.
C) deliver five sharp back slaps between the infant's shoulder
blades.
D) apply a pediatric nonrebreathing mask and transport
expeditiously. Correct Answers B
A 10-year-old child fell approximately 15 feet from a balcony,
landing on a sidewalk. He is conscious and alert, and complains
of pain to the right side of his body. After completing your
primary assessment, you should:
A) apply spinal precautions, begin transport, and perform a rapid
assessment while en route to the hospital.
B) provide any immediately needed care, perform a rapid
assessment, apply spinal precautions, and transport.
C) perform a focused physical exam, obtain baseline vital signs,
apply spinal precautions, and transport.
D) correct immediate life threats, perform a detailed head-to-toe
exam, apply spinal precautions, and transport. Correct Answers
B
,A 12-year-old boy presents with marked respiratory distress;
hot, moist skin; and anxiety. He is sitting with his chin thrust
forward and has inspiratory stridor. According to the child's
grandmother, his symptoms began suddenly about 30 minutes
ago. You should be MOST suspicious for:
A) acute viral croup.
B) bacterial epiglottitis.
C) subglottic narrowing.
D) laryngotracheobronchitis. Correct Answers B
A 13-year-old, 40-pound girl is experiencing an acute asthma
attack that has been unresponsive to 3 puffs of her albuterol
inhaler. She is conscious and alert, but is notably dyspneic and
has diffuse wheezing. In addition to administering supplemental
oxygen, you should:
A) give 0.35 mg of epinephrine 1:1,000 SQ.
B) give 0.5 mg of nebulized ipratropium.
C) administer another 2.5-mg dose of albuterol.
D) assist her ventilations with a bag-mask device. Correct
Answers B
A 15-year-old child can be difficult to treat for all of the
following reasons, EXCEPT:
A) peer pressure.
B) stranger anxiety.
C) independence issues.
D) cognizance of body image. Correct Answers B
A 2-year-old girl fell approximately 12 feet from a second-story
window, landing on her head. Your primary assessment reveals
,that she is unresponsive; has slow, irregular respirations; and has
blood draining from her mouth and nose. A rapid scan of her
body does not reveal any gross injuries or bleeding. You should:
A) manually stabilize her head and neck in a neutral position,
insert a nasal airway, and hyperventilate her at a rate of 35
breaths/min.
B) suction her mouth and nose for no longer than 15 seconds,
insert an oral airway, and apply high-flow oxygen with a
pediatric nonrebreathing mask.
C) open her airway with the jaw-thrust maneuver, suction her
mouth and nose, insert an oral airway, and assist her ventilations
with a bag-mask device.
D) insert an oral airway, apply a cervical collar, preoxygenate
her with a bag-mask device and 100% oxygen for 30 seconds,
and intubate her trachea. Correct Answers C
A 4-year-old boy is found unresponsive by his mother. When
you begin your assessment, the child's mother tells you that her
son apparently ingested some of her antihypertensive
medication. The child has poor perfusion and is breathing
poorly. As you are assisting the child's ventilations with high-
flow oxygen, your partner informs you that the child's heart rate
is 50 beats/min and weak and that the cardiac monitor reveals
sinus bradycardia. You should:
A) ask your partner to insert an IO catheter and administer
epinephrine 1:10,000.
B) attempt immediate transcutaneous pacing while continuing
ventilation assistance.
C) establish immediate vascular access and administer 0.02
mg/kg of atropine sulfate.
, D) initiate one-rescuer CPR while your partner attempts to
establish vascular access. Correct Answers D
A 4-year-old girl presents with a fever of 103.2°F. The child's
mother states that the fever came on suddenly and was not
preceded by any symptoms. The child is conscious and alert
with unlabored tachypnea, tachycardia, and a blood pressure that
is consistent with her age. Prehospital treatment for this child
includes all of the following, EXCEPT:
A) 81 mg of aspirin.
B) free-flow oxygen.
C) 250 mg of acetaminophen.
D) simple cooling measures. Correct Answers A
A 6-year-old child has burns to his head, face, neck, and anterior
chest. What percentage of his body surface area has been
burned?
A) 21%
B) 27%
C) 30%
D) 36% Correct Answers A
A 6-year-old girl who has been running a fever for the past 2
days presents with lethargy and tachycardia. Her heart rate is
170 beats/min and varies with activity. Her skin is cool and
clammy, and her capillary refill time is 4 seconds. The cardiac
monitor reveals a narrow complex tachycardia with a rate that
varies between 150 and 170 beats/min. After applying high-flow
oxygen, you should:
A) apply chemical ice packs to the child's face to try to slow her
heart rate.
