Pepp Final Exam 2025

PEPP FINAL EXAM 2025 A 7-year-old boy has difficulty breathing and is wheezing. Vital signs are BP 94/62, HR 128, and RR 32. What initial management should be performed? A. Open the airway with the jaw-thrust maneuver. B. Initiate bag-mask ventilation. C. Place the patient in the Trendelenburg position. D. Apply oxygen by non-rebreather mask. - Correct Ans-D. Apply oxygen by non rebreather mask. A 4-month old infant who has had vomiting and diarrhea for the past 36 hours is lethargic, has a weak cry, and has mottled skin color. Vital signs are BP 62/46, HR 172, and RR 48. What do the signs and symptoms suggest? A. Respiratory arrest. B. Bacterial meningitis. C. Cardiogenic abnormality. D. Hypovolemic shock. - Correct Ans-D. Hypovolemic shock. What is the priority treatment for a child who is seizing? A. Open the airway. B. Obtain a history. C. Protect the cervical spine. D. Insert an oropharyngeal airway. - Correct Ans-A. Open the airway. What should be included in the treatment of thermal burns to the chest, abdomen, and legs? A. Apply burn cream to burned areas. B. Administer 100% oxygen. C. Apply wet dressings to the burned areas. D. Place the patient in the shock position. - Correct Ans-B. Administer 100% oxygen. A 2-year-old boy, who is alert and crying, has multiple lacerations and a deformed lower leg after being hit by a car. Additional assessment reveals that he has warm, dry, pink skin and bruising on the lateral right lower chest. What is the significance of the bruising to the right side of his chest? A. The ribs are pliable, which makes organs more susceptible to underlying damage. B. The chest wall muscles absorb the energy of impact and protect underlying organs from injury. C. Rib fractures may be present because the chest wall is thin. PEPP PEPP D. The intercostal muscles may be damaged because they are not well developed. - Correct Ans-A. The ribs are pliable, which makes organs more susceptible to underlying damage. A 9-year-old patient fell down a steep incline after he rolled over the handlebars of his bicycle. He was not wearing a helmet and has begun vomiting. How should you manage this patient? A. Elevate his head to 90 degrees. B. Begin suctioning the airway. C. Insert an oropharyngeal airway. D. Open the airway with a head-tilt/chin-lift maneuver. - Correct Ans-B. Begin suctioning the airway. Which of the following patients may have injuries that suggest maltreatment? A. A 4-year-old with bilateral bruises to the shins. B. A 6-year-old with bruises throughout the back. C. An 8-year-old with a laceration on the face. D. A 10-year-old with several abrasions on the forearm. - Correct Ans-B. A 6-year-old with bruises throughout the back. The history provided by the caregiver of which of the following patients is inconsistent with the injury? A. A 9-month-old infant with a bump on the head from falling out of a highchair reaching for a toy. B. A 2½-year-old girl with a facial laceration from pulling a toaster off a counter. C. A 2-year-old boy with several small, healing circular burns from running into a lit cigarette. D. A 4-year-old boy with a wrist deformity from falling off a swing set at the park. - Correct Ans-C. A 2-year-old boy with several small, healing circular burns from running into a lit cigarette. A newborn who was just delivered at home has cyanosis of the hands and feet, has a strong cry, and is moving her extremities vigorously. Vital signs are HR 164 and RR 52. What is the first step in managing this patient? A. Dry her and then wrap her in a blanket. B. Ventilate her with a bag-mask device. C. Give high-flow oxygen by nonrebreather mask. D. Maintain her airway using the jaw-thrust maneuver. - Correct Ans-A. Dry her and then wrap her in a blanket. What is the best way to obtain information about the medical history of a 6-year-old girl who is on a ventilator and has a tracheostomy? PEPP PEPP A. Ask the caregivers. B. Ask the home health agency. C. Contact the hospital where she is usually admitted. D. Contact her physician. - Correct Ans-B. Ask the home health agency. In what position should the child in mild respiratory distress be placed? A. Left lateral recumbent. B. Position of comfort. C. Supine with feet up. D. On his or her right side. - Correct Ans-B. Position of comfort. An 8-year-old boy has been sick for 3 days. He has been experiencing nausea and diarrhea that has become progressively worse. He is semi-responsive with pale and diaphoretic skin. It is difficult to obtain a BP. Other vital signs are HR 54 and RR 10. What type of shock is this patient experiencing? A. Cardiogenic. B. Hypovolemic. C. Septic. D. Neurogenic. - Correct Ans-B. Hypovolemic. An unrestrained 4-year-old girl was ejected during a two-vehicle motor vehicle collision. She is crying vigorously while moving her upper extremities. Her lower extremities appear deformed. What is the appropriate initial management of this patient? A. Initiate cervical spine immobilization. B. Initiate immobilization of the lower extremities. C. Ventilate her with a bag-mask device. D. Cover her with a blanket to keep her warm. - Correct Ans-A. Initiate cervical spine immobilization. What is the most common cause of pediatric seizures? A. Fever. B. Head trauma. C. Epilepsy. D. Brain cancer. - Correct Ans-A. Fever. When is it appropriate to use an AED in a witnessed pediatric cardiac arrest? A. After 4 minutes of CPR. B. As soon as possible. C. Once the patient is in the ambulance. PEPP PEPP D. When the ambulance is en route to the hospital. - Correct Ans-B. As soon as possible. A 7-year-old boy was having difficulty breathing during his physical education class. He appears tired and has audible wheezing. His vital signs are BP 98/66, HR 124 beats/min, and RR 32 breaths/min. What should the treatment of this patient include? A. Preparing equipment for orotracheal intubation. B. Initiating bag-mask ventilation at 12 breaths per minute. C. Administering a nebulized beta-agonist medication. D. Administering IV epinephrine 1:10,000. - Correct Ans-C. Administering a nebulized beta-agonist medication. What is the first step in caring for a patient with a tracheostomy tube who is having difficulty breathing? A. Suction the tracheostomy tube. B. Remove the tracheostomy tube. C. Administer a nebulizer treatment with a beta-agonist medication. D. Place a mask over the mouth and initiate bag-mask ventilation. - Correct Ans-A. Suction the tracheostomy tube. A 3-month-old infant is found unresponsive in his crib and has cool, mottled skin. His vital signs are HR 50 and RR 6. What is the initial treatment for this patient? A. Establish IV access and administer an IV fluid bolus of 20 mL/kg. B. Establish IV access and administer 0.01 mg/kg IV epinephrine 1:10,000. C. Perform chest compressions and ventilate with a bag-mask device. D. Initiate bag-mask ventilation and then reassess his skin color and heart rate. - Correct Ans-C. Perform chest compressions and ventilate with a bag-mask device. Which of the following is an indication for insertion of an intraosseous needle? A. You are unable to obtain peripheral access within 90 seconds in a 2-year-old child in impending arrest. B. You have just arrived on scene to find a 3-month-old infant who has pink skin color and is lethargic following a seizure. C. You have attempted all peripheral access sites in a 7-year-old child in respiratory failure. D. The transport time is longer than 10 minutes for a 4-year-old boy in hypovolemic shock. - Correct Ans-A. You are unable to obtain peripheral access within 90 seconds in a 2-year-old child in impending arrest. A 4-year-old boy fell down a 15-foot embankment and landed on packed dirt. He is unresponsive and has pale, cool skin and a capillary refill time of 4 seconds. Additional PEPP PEPP assessment reveals a 2 cm laceration on the left side of the forehead with minimal bleeding and a distended abdomen. His vital signs are BP 78/56, HR 146, and RR 48. What are the initial management steps for this patient? A. Administer oxygen by nasal cannula, followed by a detailed physical exam before transport. B. Manage blood loss from the forehead, establish IV access and give a slow infusion of fluids, and prepare for transport. C. Administer oxygen by nonrebreather mask, establish intraosseous access and give a 10 mL/kg bolus, and place him in a high Fowler's position. D. Maintain cervical spine stabilization, establish IV access and give a 20 mL/kg bolus, complete the spinal immobilization, and initiate transport. - Correct Ans-D. Maintain cervical spine stabilization, establish IV access and give a 20 mL/kg bolus, complete the spinal immobilization, and initiate transport. What is the dysrhythmia for a 3-year-old with a heart rate of 180 beats/min, a narrow QRS complex, and a variable R-R interval called? A. Supraventricular tachycardia. B. Sinus tachycardia. C. Ventricular tachycardia. D. Pulseless electrical activity (PEA). - Correct Ans-B. Sinus tachycardia. What is the initial airway management of a child who is seizing and has gurgling respirations? A. Suction the oropharynx. B. Insert an endotracheal tube. C. Insert an oropharyngeal airway. D. Administer bag-mask ventilation. - Correct Ans-A. Suction the oropharynx. A 3-year-old boy reportedly fell down a flight of stairs and has a swollen, deformed right forearm. You also note several small, healing, circular burns on his arms and back. He appears quiet and withdrawn. What is the treatment of this patient? A. Splint the forearm. B. Establish IV access. C. Cover the burns. D. Contact law enforcement. - Correct Ans-A. Splint the forearm. What is the best way to repair a break in a central line catheter? A. Place a piece of silk tape horizontally over the break. B. Remove the catheter. C. Irrigate the catheter. PEPP PEPP D. Clamp the catheter with a hemostat and gauze. - Correct Ans-D. Clamp the catheter with a hemostat and gauze. What is a contraindication to straightening the head and neck of a trauma patient during spinal immobilization? A. Resistance to movement. B. Multiple facial injuries. C. Dilated pupils. D. Severe headache. - Correct Ans-A. Resistance to movement. A 4-year-old semi-responsive boy has had difficulty breathing and a fever for 3 days. Vital signs are BP 60/40, HR 128, and RR 10. What initial management should be performed? A. Open the airway and maintain cervical spine immobilization. B. Open the airway and ventilate with a bag-mask device. C. Place the patient in the Trendelenburg position. D. Apply oxygen by nonrebreather mask at 15 L/min. - Correct Ans-B. Open the airway and ventilate with a bag-mask device. A 12-year-old boy was shot in the abdomen during a hunting accident. He has altered mental status and his skin is cool and clammy. Vital signs are BP 64/46, weak HR 142, and RR 38. What do the signs and symptoms suggest? A. Tension pneumothorax. B. Neurogenic shock. C. Cardiac tamponade. D. Hypovolemic shock. - Correct Ans-D. Hypovolemic shock. What is the priority treatment for a child with altered mental status? A. Open the airway. B. Obtain a history. C. Protect the cervical spine. D. Obtain a blood glucose. - Correct Ans-A. Open the airway. A 4-year-old boy is screaming and crying after he fell into a campfire. He has partial- and full-thickness burns on both arms. Vital signs are HR 140, BP 100/70, and RR 40. What should be done first in the treatment of thermal burns? A. Apply burn cream to burned areas. B. Remove any clothing that is still smoldering. C. Apply moist dressings to all of the burned areas. D. Place the patient in the shock position. - Correct Ans-B. Remove any clothing that is still smoldering. PEPP PEPP A 2-year-old boy, who is alert and crying, has multiple lacerations and a deformed forearm after he was ejected from a vehicle. Additional assessment reveals that he has cool, moist, pale skin and bruising on the lateral right lower chest. What is the significance of the bruising to the right side of his chest? A. The ribs are pliable, which makes organs more susceptible to underlying damage. B. The chest wall muscles absorb the energy of impact and protect underlying organs from injury. C. Rib fractures may be present because the chest wall is thin. D. The intercostal muscles may be damaged because they are not well developed. - Correct Ans-A. The ribs are pliable, which makes organs more susceptible to underlying damage. A 7-year-old semi-conscious patient rolled off of a 4-foot embankment when he fell off of his father's all-terrain vehicle. He was not wearing a helmet a