Ch. 38-41 Quiz Questions

Front 1

All of the following processes take place in the uterus, EXCEPT?

Back 1

Fertilization

Front 2

Women who have had a cesarean section?

Back 2

Can have a normal vaginal delivery

Front 3

When dispatched to a residence for an injury involving a pregnant woman, you should?

Back 3

Be alert for evidence of abuse

Front 4

Which of the following assessment parameters is MOST difficult to interpret when a pregnant woman is injured?

Back 4

pulse rate

Front 5

The dome-shaped top of the uterus is called the?

Back 5

fundus

Front 6

Complications in a pregnant woman with cystic fibrosis are usually the result of?

Back 6

reduced pulmonary function

Front 7

Which of the following medications would MOST likely be used in the prehospital setting to treat some women with severe premenstrual syndrome?

Back 7

glucose and fentanyl

Front 8

You are assessing a 36-year-old woman who is in the 33rd week of her pregnancy. The patient complains of bright red vaginal bleeding, but denies abdominal pain or cramping. She tells you that she felt her baby move about 5 or 10 minutes ago. Fetal heart tones are audible at a rate of 130 beats/min. Gentle palpation of her abdomen reveals that it is soft and nontender. Which of your assessment findings is MOST suggestive of placenta previa?

Back 8

absence of abdominal pain

Front 9

Mittelschmerz is MOST accurately defined as?

Back 9

unilateral abdominal pain and cramping that occurs during the ovulatory process

Front 10

Gestational diabetes is caused by?

Back 10

increased insulin production and decreased cellular sensitivity to insulin

Front 11

Which of the following conditions is characterized by a lack of progesterone and increased androgen levels, and can lead to hypertension and cardiac problems?

Back 11

polycystic ovaries

Front 12

During normal menstruation, approximately ___ to ___ mL of blood is discharged from the vagina?

Back 12

25, 65

Front 13

Risk factors for pelvic inflammatory disease (PID) include all of the following, EXCEPT?

Back 13

monogamy

Front 14

During third trimester vaginal bleeding?

Back 14

the mother may lose as much as 40% of her blood volume before significant signs of hypovolemia occur

Front 15

There is evidence that a 21-year-old woman was given Rohypnol before being raped. She presents with alcohol on her breath, drowsiness, and memory loss. Her blood pressure is 98/68 mmHg, pulse is 58 beats/min and weak, and her respirations are decreased and shallow. You attempt to administer high-flow oxygen, but she resists. What should you do now?

Back 15

consider administering naloxone in case she was also given a narcotic drug.

Front 16

A 25-year-old woman was involved in a motor vehicle accident in which she struck the rear end of another car at a low rate of speed. When you arrive at the scene and exit the ambulance, you immediately hear the patient screaming, “My baby, my baby!” After calming the patient down, she tells you that she is 10 weeks pregnant and that she is afraid that the car accident injured her child. She confirms that she was properly restrained at the time of impact. She is conscious and alert, denies abdominal pain, and has stable vital signs. She refuses spinal motion restriction precautions, but does consent to EMS transport. You should?

Back 16

administer supplemental oxygen, establish a large-bore IV line and set the rate to keep the vein open, provide emotional support, and transport her to an appropriate hospital.

Front 17

If a pregnant woman is injured and bleeding severly?

Back 17

blood flow will be diverted away from the uterus

Front 18

Reiter syndrome?

Back 18

is a rare complication associated with untreated Chlamydia and is characterized by arthritis and skin lesions

Front 19

Which of the following statements regarding an ectopic pregnancy is MOST correct?

Back 19

in ectopic pregnancy, a fertilized egg implants somewhere other than the uterus

Front 20

The external female genitalia are collectively reffered to as the?

Back 20

pudendum

Front 21

The headache commonly experienced by a women during their menstrual cycle is caused by?

Back 21

hormonal release

Front 22

Pelvic inflammatory disease (PID) commonly affects all of the following organs, EXCEPT the?

Back 22

urinary bladder

Front 23

Which of the following questions is the MOST important to ask when obtaining a patient’s gynecologic history?

Back 23

“When was your last menstrual period?”

Front 24

Which of the following statements regarding the umbilical cord is MOST correct?

Back 24

the umbilical vein carries oxygenated blood from the placenta to the fetus

Front 25

You are caring for a 44-year-old woman who was sexually assaulted by several men. She is conscious but very quiet. Your partner, a female paramedic, quickly examines her and finds no immediate life threatening injuries. The patient tells you that all she wants to do is go home and take a shower. After multiple attempts to convince the patient to consent to transport, you are unsuccessful. Your MOST appropriate action should be to?

Back 25

ask the patient if there is a friend you can call with whom she can stay.

Front 26

Common signs and symptoms of gardnerella vaginitis include?

Back 26

a “fishy” vaginal odor, itching, irritation, and vaginal discharge

Front 27

Postmenopausal women?

Back 27

are more susceptible to atherosclerosis and osteoporosis

Front 28

In addition to meeting the metabolic needs of the developing fetus, the mother’s blood supply increases significantly in order to perfuse her own organs, especially the?

Back 28

uterus and kidneys

Front 29

What event occurs during the third stage of labor?

Back 29

placental delivery

Front 30

The MOST common cause of amenorrhea is?

Back 30

pregnancy

Front 31

If a woman’s prepregnancy resting heart rate is 70 bpm, you would expect her heart rate to range between ___ and ___ at term.

Back 31

85, 90

Front 32

When examining the placenta, you should suspect fetal anemia if?

Back 32

the maternal side of the placenta is pale

Front 33

Which of the following statements regarding endometriosis is MOST correct?

Back 33

untreated endometriosis may result in septic shock

Front 34

During the proliferative phase?

Back 34

estrogen stimulates the endometrium to increase in thickness in preparation for the reception and future growth of a fertilized egg.

Front 35

A woman who does not take prenatal vitamins during the course of her pregnancy is at GREATEST risk for?

Back 35

anemia

Front 36

Dysmenorrhea that occurs before, during, and after menstrual flow?

Back 36

may signal an underlying illness.

Front 37

Which of the following changes occurs in the respiratory system of a pregnant woman?

Back 37

minute ventilation increases by as much as 50%, which causes the PaCO2 to drop by about 5%.

Front 38

A woman who is taking pentosan polysulfate sodium (Elmiron) MOST likely has?

Back 38

interstitial cystitis

Front 39

In the late stage of syphilis?

Back 39

the patient is usually asymptomatic, but damage to the brain, heart, blood vessels, and liver is occurring

Front 40

Which of the following statements regarding the human papillomavirus (HPV) is MOST correct?

Back 40

HPV has been identified as a causative agent in cervical cancer

Front 41

An increase in maternal cardiac output can cause a benign systolic flow murmur, which results from?

Back 41

hypertrophy of the heart and dilation across the tricuspid valve

Front 42

Which of the following statements regarding toxic shock syndrome (TSS) is MOST correct?

Back 42

patients with TSS may show signs of liver failure

Front 43

The MOST common underlying cause of a tubo-ovarian abscess is?

Back 43

gonorrhea

Front 44

Human chorionic gonadotropin (HCG) hormone sends signals to the corpus luteum, which in turn?

Back 44

produces hormones designed to support the pregnancy until the placenta has developed

Front 45

Which of the following conditions poses the LEAST risk for shock due to vaginal bleeding?

Back 45

dysmenorrhea

Front 46

Appropriate care for postpartum bleeding in the prehospital setting includes all of the following, EXCEPT?

Back 46

carefully placing sanitary pads in the vagina

Front 47

Which of the following statements regarding uterine fundus measurement is MOST correct?

Back 47

measurement of the fundus in centimeters corresponds to the number of gestational weeks

Front 48

In pregnancy, magnesium sulfate is used principally for?

Back 48

eclamptic seizures

Front 49

When conduction the scene size-up of a call involving a gynecologic emergency, it is MOST important to?

Back 49

assess for danger because any scene should be considered volatile

Front 50

Initial signs and symptoms of toxic shock syndrome (TSS) include all of the following, EXCEPT?

Back 50

cardiac dysrhythmias

Front 51

In the average female, the menstrual cycle lasts ___ days.

Back 51

28

Front 52

You are dispatched to a grocery store for a woman with severe abdominal pain. When you arrive, you find the patient lying on her side in the manager’s office. She is confused, diaphoretic, and appears to be bleeding from her vagina. Her blood pressure is low, and her pulse and respiratory rates are elevated. You should?

Back 52

apply high-flow oxygen, visually inspect her vagina and cover it with sterile dressings, keep her warm, begin transport, establish at least one large-bore IV en route, and administer enough crystalloid fluid to maintain radial pulses

Front 53

While caring for an unresponsive young woman who was apparently sexually assaulted, you note that her respirations are slow and shallow, her pulse is slow and weak, and her blood pressure is low. There is a small amount of dried blood on her thigh, but no grossly active bleeding. Immediate care for this patient involves?

Back 53

maintaining her airway and providing ventilatory assistance.

Front 54

Which of the following is NOT characteristic of the secondary stage of syphilis?

Back 54

single or multiple chancres

Front 55

A spontaneous abortion?

Back 55

occurs naturally and may or may not have an identifiable cause

Front 56

Uterine rupture MOST commonly occurs?

Back 56

during active labor

Front 57

In contrast to endometritis, endometriosis?

Back 57

may present without abdominal pain

Front 58

A spontaneous abortion?

Back 58

occurs naturally and may or may not have an identifiable cause

Front 59

A 25-year-old woman presents with acute abdominal pain and vaginal bleeding. She tells you that she has soaked 8 high-absorbency tampons in the past 2 hours. Approximately how much blood has she lost externally?

Back 59

160 mL

Front 60

An immature egg is called a/an?

Back 60

oocyte

Front 61

Motor vehicle trauma accounts for nearly 70% of trauma in pregnancy?

Back 61

but only about 20% of maternal deaths

Front 62

In contrast to endometritis, endometriosis?

Back 62

may present without abdominal pain

Front 63

You are caring for a young woman with constant, diffuse abdominal pain, referred pain to both shoulders, and vaginal bleeding. She states that her last menstrual period was 2 months ago, but she adamantly denies being pregnant. Her blood pressure is 86/50 mmHg, pulse rate is 120 beats/min and weak, and respirations are 24 breaths/min and regular. Which of the following interventions is NOT appropriate for this patient?

Back 63

narcotic analgesia

Front 64

Which of the following is NOT characteristic of the secondary stage of syphilis?

Back 64

single or multiple chancres

Front 65

Law enforcement request that you respond to a local apartment complex for a young woman who was sexually assaulted. When you arrive at the scene, you find the patient sitting on her couch, clearly upset. You see a small amount of blood on her shorts, near the groin area. What is your initial priority in the care of this patient?

Back 65

identifying and treating immediate life threats

Front 66

A 25-year-old woman presents with acute abdominal pain and vaginal bleeding. She tells you that she has soaked 8 high-absorbency tampons in the past 2 hours. Approximately how much blood has she lost externally?

Back 66

160 mL

Front 67

If a woman who is 35 weeks pregnant is placed in supine position?

Back 67

atrial preload may be reduced markedly

Front 68

Uterine rupture MOST commonly occurs?

Back 68

during active labor

Front 69

You are dispatched to a residence for a 34-year-old woman who is “sick.” Upon your arrival, the patient greets you at the door. She states that she recently had her menstrual period, which was accompanied by more pain than usual. Her vital signs are stable, she is conscious and alert, and denies vaginal bleeding or fever. This patient MOST likely has?

Back 69

a ruptured ovarian cyst

Front 70

Motor vehicle trauma accounts for nearly 70% of trauma in pregnancy?

Back 70

but only about 20% of maternal deaths

Front 71

If a young female with a known history of gonorrhea presents with abdominal pain, nausea and vomiting, and bleeding between periods?

Back 71

she most likely has pelvic inflammatory disease

Front 72

Law enforcement request that you respond to a local apartment complex for a young woman who was sexually assaulted. When you arrive at the scene, you find the patient sitting on her couch, clearly upset. You see a small amount of blood on her shorts, near the groin area. What is your initial priority in the care of this patient?

Back 72

identifying and treating immediate life threats

Front 73

If a woman who is 35 weeks pregnant is placed in supine position?

Back 73

atrial preload may be reduced markedly

Front 74

If a young female with a known history of gonorrhea presents with abdominal pain, nausea and vomiting, and bleeding between periods?

Back 74

she most likely has pelvic inflammatory disease

Front 75

Gestational hypertension?

Back 75

may be an early sign of preeclampsia

Front 76

The typical upper limit of the fetal heart rate is?

Back 76

160 beats/min

Front 77

The egg is referred to as a blastocyst when?

Back 77

it has been fertilized and enters the uterus and begins absorbing uterine fluid through the cell membrane

Front 78

Which of the following conditions, if it remains undetected until puberty, can result in acute pain, severe constipation, and low back pain at the onset of menses?

Back 78

imperforate hymen

Front 79

If your EMS system protocols permit you to administer oxytocin to the mother following delivery of the placenta, it is MOST important to?

Back 79

ensure that she is not delivering a second baby

Front 80

What part of the female genitalia is homologous to the glans penis of the male?

Back 80

clitoris

Front 81

Common signs of gestational diabetes include?

Back 81

polydipsia

Front 82

Implantation of a fertilized egg within a fallopian tube?

Back 82

can cause severe intra-abdominal hemorrhage

Front 83

All of the following events occur during the prodromal stage of labor, EXCEPT:

Back 83

contractions at 5- to 15- minute intervals

Front 84

Common signs and symptoms of infection with the cytomegalovirus (CMV) include:

Back 84

prolonged high fever

Front 85

By definition, a premature infant:

Back 85

is born before 37 weeks gestation

Front 86

If a 17-year-old woman with a gynecologic problem answers your question, “Is there any possibility that you are pregnant” with a firm “No way!,” you should?

Back 86

ask the patient why she is sure she is not pregnant

Front 87

The MOST important aspect in the care of a woman with severe vaginal bleeding is?

Back 87

treating for shock and transporting rapidly

Front 88

The MOST common type of ovarian cyst is the ____ cyst, which generally develops during the?

Back 88

functional, menstrual cycle

Front 89

The onset of eclampsia is marked by the presence of?

Back 89

grand mal seizures

Front 90

Average blood loss during the third stage of labor is approximately?

Back 90

150 mL

Front 91

Which of the following statements regarding Rh disease during pregnancy is MOST correct?

Back 91

During subsequent pregnancies, the Rh antibody will cross the placental barrier and attack the fetal red blood cells

Front 92

When caring for a prolapsed umbilical cord, you should?

Back 92

Keep the presenting part of the baby off the umbilical cord during rapid transport to the hospital

Front 93

The onset of menses is called ___, and typically occurs between the ages of?

Back 93

Menarche, 11 and 14 years

Front 94

The lesions associated with genital herpes?

Back 94

Initially appear as small red bumps

Front 95

You are in the process of assisting a woman in labor. She is 38 weeks pregnant with her second child and her contractions are 3 minutes apart and are strong and regular. Her first baby was delivered by cesarean section. As you prepare for imminent delivery, the woman tells you that her contractions have decreased significantly, and that she is very dizzy. Assessment of her vaginal area reveals moderate vaginal bleeding. You quickly assess her and note that she is diaphoretic, tachycardic, and hypotensive. You should be MOST suspicious for?

Back 95

Uterine rupture

Front 96

If a woman who is being treated with the antibiotic metronidazole for bacterial vaginosis consumes alcohol during treatment?

Back 96

She may develop severe nausea and vomiting

Front 97

Cervical effacement occurs when?

Back 97

The less muscular lower part of the uterus is pulled upward over the presenting part of the baby

Front 98

If a woman is gravid 3 and para 2?

Back 98

She has delivered two babies

Front 99

A 30-year-old woman complains of an “achy” pain to both lower abdominal quadrants, which she states is made worse by walking. She further tells you that she recently finished her menstrual period. She has a fever of 101.9F. Her blood pressure is 122/62 mmHg, pulse rate is 84 beats/min and strong, and respirations are 14 breaths/min and unlabored. After gathering the rest of her medical history, you should?

Back 99

Provide emotional support, make her as comfortable as possible, and safely transport her to an appropriate hospital.

Front 100

A nulliparous woman?

Back 100

Has never delivered a baby

Front 101

Uterine inversion occurs when?

Back 101

The placenta fails to detach properly and adheres to the uterine wall when it is expelled

Front 102

Which of the following statements regarding the amniotic sac and fluid is MOST correct?

Back 102

In the latter stages of pregnancy, the fetus swallows amniotic fluid and passes wastes out into the fluid

Front 103

Which of the following is a potential complication of pelvic inflammatory disease (PID)?

Back 103

Ectopic pregnancy

Front 104

Fertilization of an egg usually occurs in the?

Back 104

Fallopian tube

Front 105

Pelvic inflammatory disease (PID) MOST commonly affects?

Back 105

Sexually active women

Front 106

Within a few days after having a therapeutic abortion, a 33-year-old woman presents with malaise, fever, constipation, and pelvic pain. Her blood pressure is124/84 mmHg, pulse rate is 104 beats/min and strong, and respirations are 22 breaths/min and regular. You should be MOST suspicious for?

Back 106

Endometritis

Front 107

You are assisting in the delivery of a baby. As the infant’s head begins to emerge from the vagina, you should support the head as it turns and then?

Back 107

Assess for a nuchal cord

Front 108

Which of the following statements regarding abdominal trauma during pregnancy is MOSt correct?

Back 108

Use of a lap belt increases the risk of uterine injury

Front 109

Unlike the prenatal period, the gestational period?

Back 109

Is 38 weeks in gestation

Front 110

Which of the following disorders or conditions is related to decreased glycogen stores in the newborn?

Back 110

small for gestational age

Front 111

Meningococcal meningitis with sepsis is typcially characterized by a/an?

Back 111

purpuric rash

Front 112

Which of the following statements regarding fever in children is MOST correct?

Back 112

fever is generally a sign of underlying illness

Front 113

Unlike sinus tachycardia, reentry supraventricular tachycardia in infants is characterized by?

Back 113

an unvarying pulse rate

Front 114

If the parent or caregiver of a sick or injured child is emotionally distraught:

Back 114

provide support, but remember that your first priority is the child

Front 115

Treatment for pediatric asystole includes:

Back 115

epinephrine

Front 116

A subtle seizure in the newborn is characterized by:

Back 116

eye deviation

Front 117

During transport of a newborn, timely intervention of acute deterioration is most effectively achieved by?

Back 117

ongoing observation and frequent assessment

Front 118

The correct positive-pressure ventilation rate for an apneic newborn is?

Back 118

40 to 60 breaths/min

Front 119

An infant born with a pink body and blue extremities, a pulse rate of 90 beats/min, a strong cry, and active movement, should be assigned an initial Apgar score of?

Back 119

8

Front 120

In addition to an IV dextrose bolus, the MOST important treatment for newborn hypoglycemia is?

Back 120

proper thermal management

Front 121

Failure of a child's SaO2 to increase despite high-flow oxygen is MOST indicative of?

Back 121

congenital heart disease

Front 122

Cardiopulmonary arrest in the pediatric patient?

Back 122

is most often a secondary event

Front 123

How much naloxone should you give to a 6.5-pound newborn with a respiratory depression secondary to maternal narcotic administration?

Back 123

0.3 mg

Front 124

An 8-year-old child:

Back 124

is anatomically and physiologically similar to an adult

Front 125

When a child who is too young to verbalize is in significant pain:

Back 125

your ability to assess accurately for physiologic abnormalities is impaired

Front 126

Common medications used to treat pediatric seizures in the prehospital setting include all of the following, EXCEPT:

Back 126

Dilantin

Front 127

A young child who falls from a significant height would MOST likely experience?

Back 127

a traumatic brain injury

Front 128

Epiglottitis in children:

Back 128

is rare now that children are vaccinated against Haemophilus influenza type B

Front 129

You have just delivered a little girl that was born 4 weeks premature. There is no evidence of meconium in the amniotic fluid. After drying, warming, suctioning, positioning,and stimulating the infant, she remains acrocyanotic and is not crying. You should:

Back 129

open her airway and assess respirations

Front 130

A newborn is at GREATEST risk for meconium aspiration if he or she:

Back 130

is born at more than 42 weeks gestation

Front 131

Which of the following statements regarding acrocyanosis is MOST correct?

Back 131

Acrocyanosis is cyanosis of the hands and feet, and is a normal finding in infants younger than 2 months of age who are cold.

Front 132

In contrast to adults, retractions in children are:

Back 132

more evident in the intercostal area

Front 133

Choanal atresia is MOST accurately defined as a:

Back 133

bony or membranous obstruction of the back of the nose

Front 134

When assessing and caring for a 17-year-old gang member, it is MOST important to remember that he or she:

Back 134

may have a weapon and a reputation to earn

Front 135

Most children begin to experience stranger anxiety at:

Back 135

9 months of age

Front 136

Upon arriving at the scene of a 4-year-old boy with respiratory distress, you enter the residence and see the child, who is conscious, sitting on his father's lap. The father is aware of your presence, but the child is not. Your inital action should be to?

Back 136

visually assess the child from across the room for any signs of increased work of breathing

Front 137

Diffuse rales, rhonchi, and wheezing in an infant:

Back 137

are typical signs of lower airway inflammation

Front 138

A 4-year-old girl presents with a fever of 103.2F. 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:

Back 138

81 mg of aspirin

Front 139

The MOST common reasons for ineffective bag-mask ventilations in the newborn are:

Back 139

inadequate mask-to-face seal and incorrect head position

Front 140

Which of the following statements regarding the Apgar score is MOST correct?

Back 140

If resuscitation is necessary, the Apgar score is completed to determine the result of the resuscitation

Front 141

When dealing with the caregivers of an infant who died suddenly, you should:

Back 141

find out the infant's name and use it

Front 142

You have been providing bag-mask ventilation to a newborn with a sustained heart rate of 75 beats/min for approximately 5 minutes. The infant's abdomen is markedly distended. Although you are properly trained, your protocols do not allow you to intubate newborns. The MOST appropriate intervention involves:

Back 142

inserting an orogastric tube

Front 143

The risk of newborn complications is HIGHEST if the amniotic sac:

Back 143

ruptured more than 24 hours before the time of birth

Front 144

Bradyarrhythmias in children MOST often occur secondary to:

Back 144

severe bradycardia

Front 145

If a newborn does not respond to the initial steps of resuscitation, the need for further intervention is based upon:

Back 145

respiratory effort, pulse rate, and color

Front 146

During the delivery of a post-term baby, you note the presence of particulate meconium in the amniotic fluid. Your post-delivery assessment of the newborn reveals that it is active, has a strong cry, and has a heart rate of 110 beats/min. You should:

Back 146

ensure that the infant is warm and dry, administer free-flow oxygen if needed, and provide continuous monitoring

Front 147

Epinephrine is indicated during newborn resuscitation if:

Back 147

the heart rate remains below 60 beats/min after 30 seconds of effective ventilation and an additional 30 seconds of chest compressions

Front 148

In contrast to a complex febrile seizure, a simple febrile seizure:

Back 148

lasts less than 15 minutes and occurs in children without underlying neurologic abnormalities

Front 149

Appropriate treatment for a conscious child with anaphylaxis includes:

Back 149

0.01 mg/kg epinephrine 1:1,000 IM

Front 150

The single MOST common cause of seizures in both term and preterm infants is:

Back 150

hypoxic ischemic encephalopathy

Front 151

You are assessing a 7-month-old infant who presents with listlessness, pallor, and increased work of breathing. The infant's mother tells you that the child was born 2 months premature and was in the neonatal intensive care unit for 3 weeks. She denies any recent vomiting, diarrhea, or fever. The infant's oxygen saturation is 89% and does not improve with supplemental oxygen. Her heart rate is rapid and weak and does not vary with activity. When you apply the cardiac monitor, you will MOST likely encounter a:

Back 151

narrow QRS complex rhythm with absent P waves and a heart rate greater than 220 beats/min

Front 152

Early hypoxia in a child would MOST likely present with:

Back 152

tachycardia

Front 153

You are assisting in the delivery of a baby. After the baby's bead emerges from the vagina, you should quickly assess for the presence of a nuchal cord and then:

Back 153

suction its mouth and nose

Front 154

A 9-year-old, 55-pould girl presents with generalized hives, marked facial swelling, and loud inspiratory stridor. She is conscious, but appears sleepy. You can MOST rapidly improve the child's condition by:

Back 154

administering 0.25 mg of epinephrine intramuscularly

Front 155

The MOST appropriate vagal maneuver for an infant involves:

Back 155

holding ice packs firmly to the face

Front 156

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:

Back 156

give her 0.5 mg of nebulized ipratropium

Front 157

The recommended IV dose and concentration of epinephrine for the newborn is:

Back 157

0.1 to 0.3 mL/kg; 1:10,000

Front 158

An oropharyngeal airway would MOST likely be indicated for a newborn with:

Back 158

Pierre Robin sequence

Front 159

What type of seizure is MOST common in premature infants?

Back 159

tonic seizure

Front 160

Which of the following is NOT a component of the Apgar score?

Back 160

reflexes

Front 161

Upon arriving at the scene of a 4-year-old girl who is ill, you assess her and note that she is tachypneic and tachycardic. Her skin is warm and moist and there are no signs of increased work of breathing. The child's mother denies any vomiting or diarrhea. This child's tachycardia and tachypnea is MOST likely the the result of:

Back 161

fever and anxiety

Front 162

While preparing equipment for newborn resuscitation, which of the following equipment is NOT considered optional?

Back 162

endotracheal tubes

Front 163

You are dispatched to a daycare center for a 5-year-old girl with trouble breathing. Upon arriving at the scene, you assess the child and note that she is responsive to pain only, has weak intercostal retractions, and is breathing at a slow rate with shallow depth. You should:

Back 163

begin assisting her ventilations with a bag-mask device and assess her pulse rate

Front 164

The MOST common etiology for bradycardia in a neonate is:

Back 164

severe hypoxia

Front 165

You and your partner are caring for a 5-pould distressed newborn. After providing 30 seconds of effective bag-mask ventilations, the newborn's heart rate remains below 60 beats/min. You should:

Back 165

try tactile stimulation as you continue bag-mask ventilations

Front 166

You and your partner are caring for a child with stable supraventricular tachycardia that was refractory to initial treatment. As your partner is preparing to establish vascular access, the child's level of consciousness decreases markedly. You reassess the child and note that his femoral pulse is rapid and weak. You should:

Back 166

perform immediate synchronized cardioversion and reassess

Front 167

A shift of heart tones and severe respiratory distress despite positive-pressure ventilations is MOST indicative of:

Back 167

a pneumothorax

Front 168

When performing chest compressions on a newborn, you should:

Back 168

compress the chest one third the anteroposterior depth of the chest

Front 169

Which of the following statements regarding bronchiolitis is MOST correct?

Back 169

bronchiolitis is a viral infection of the lower airway that commonly affects infants and children younger than 2 years of age

Front 170

Early distributive shock in children is characterized by:

Back 170

warm, flushed skin

Front 171

When evaluating a child's oxygen saturation level with a pulse oximeter:

Back 171

it should be evaluated in the context of the pediatric assessment triangle and remainder of the inital assessment

Front 172

Respiratory distress in a premature infant is MOST often the result of:

Back 172

surfactant deficiency

Front 173

A delay in clamping the umbilical and keeping the baby below the level of the placenta can result in fetal:

Back 173

polycythemia

Front 174

Which of the following statements regarding fever in the newborn is MOST correct?

Back 174

fever may not always be a presenting feature in newborns with an infection

Front 175

You are transporting anewborn who requires ongoing ventilatory support and chest compressions for severe bradycardia. Your estimated time of arrival at the hospital is 45 minutes. Air medical transport was unavailable due to severe weather in the vicinity. A peripheral IV line has been established in the antecubital vein and you are in the process of attempting intubation. Approximately 10 seconds into your intubation attempt, the newborn's heart rate suddenly drops more. You should?

Back 175

abort the intubation attempt and continue ventilations

Front 176

In which of the following situations would a newborn MOST likely experience a seizure?

Back 176

34 weeks' gestation

Front 177

What dose and concentration of glucose would be MOST appropriate for a 6-pound hypoglycemic newborn?

Back 177

5.5 mL of 10% dextrose (D10)

Front 178

To evaluate function of an infant's or child's cerebral cortex, you should:

Back 178

use the AVPU scale

Front 179

Causes of delayed fetal transition include all of the following, EXCEPT:

Back 179

birth at 41 weeks

Front 180

If a newborn requires epinephrine and peripheral venous access is unsuccessful, you should:

Back 180

cannulate the umbilical vein

Front 181

If hypovolemia is suspected or confirmed, you should administer ___ mL of normal saline to a 6-pould newborn over a period of:

Back 181

27, 5 to 10 minutes

Front 182

You receive a call at 11:50 pm for a 3-year-old boy with respiratory distress. As soon as you enter the child's residence, you can hear a lound, barking cough. You find the child sitting on his mother's lap. He is conscious and appears alert to his surroundings. According to the child's moither, he has been sick for the past few days with a low-grade fever, but then began experiencing a high-pitched cough. His skin is warm and dry, his heart rate is 120 beats/min, and his oxygen saturation is 99% on room air. There are no signs of increased work of breathing. You should:

Back 182

allow the child to assume a position of comfort, avoid agitating him, and transport him to the hospital

Front 183

Which of the following factors is associated with the HIGHEST risk of newborn hypoglycemia?

Back 183

morbid obesity in the mother

Front 184

You are assessing a 10-year-old child with apparent ventricular tachycardia, but cannot decide whether electrical or pharmacological therapy is the most appropriate inital treatment approach. Which of the following interventions would pose the GREATEST potential for harm?

Back 184

starting an IV line and administering amiodarone followed by procainamide

Front 185

Chest compressions are indicated in the newborn if its heart rate remains less than ___ beats/min despite effective positive-pressure ventilations for ___ seconds.

Back 185

60, 30

Front 186

In contrast to toxic ingestions in toddlers, toxic ingestions in adolescents:

Back 186

typically involve multiple agents

Front 187

Endotracheal intubation is clearly indicated in the newborn if:

Back 187

meconium is present in the amniotic fluid and the newborn is limp and has a heart rate of 70 beats/min.

Front 188

When suctioning the newborn's oropharynx to clear secretions prior to intubation, it is MOST important to:

Back 188

monitor a newborn's heart rate

Front 189

You are dispatched to a residence for a 17-year-old woman with acute abdominal pain. When you arrive and begin your assessment, it is clear that the patient is uncomfortable with the presence of her parents because she is reluctant to answer your questions. You should:

Back 189

diplomatically ask the parents if their daughter can have some privacy

Front 190

Signs of hypovolemia in the newborn include all of the following, EXCEPT:

Back 190

profound acrocyanosis

Front 191

Which of the following statements regarding a child's chest wall is MOST correct?

Back 191

children are belly breathers because they rely heavily on their diaphragms

Front 192

Cerebrospinal fluid (CSF) shunts are typically placed in children who:

Back 192

have impaired circulation and absorption of CSF, leading to an increased size of the ventricles of the brain and increased intracranial pressure

Front 193

During your assessment of a 30-year-old woman in active labor, she admits to being a chronic heroin abuser and states that she last "shot up" about 6 hours ago. After the baby delivers, you will MOST likely need to:

Back 193

give positive-pressure ventilations

Front 194

A typical finding for a foreign body aspiration is:

Back 194

an afebrile child with a sudden onset of coughing or gagging while playing

Front 195

A child in anaphylactic shock:

Back 195

may require a low-dose epinephrine infusion

Front 196

When caring for a child with a CSF shunt or gastrostomy tube, it is MOST important to:

Back 196

recognize that the caregiver is a key resource and that his or her expertise should be utilized to assist in the care of the child

Front 197

A child who is experiencing a moderate asthma attack would MOST likely present with:

Back 197

wheezing during inspiration and expiration

Front 198

Signs of a diaphragmatic hernia include all of the following, EXCEPT:

Back 198

bilaterally absent breath sounds

Front 199

Common causes of respiratory distress in the newborn include:

Back 199

mucous obstruction of the nose

Front 200

Caput succedaneum is MOST accurately defined as:

Back 200

temporary swelling of the soft tissue of the baby's scalp secondary to pressure from the dilating cervix

Front 201

The approximate total blood volume of a 60-pound child is:

Back 201

2.2 liters

Front 202

The goal in treating a child with epiglottitis is to:

Back 202

transport him or her to the hospital with a maintainable airway

Front 203

A term infant is born between ___ after conception.

Back 203

37 and 42 weeks

Front 204

Newborn hypoglycemia is defined as a blood glucose level lower than:

Back 204

40 mg/dL

Front 205

During your rapid assessment of a newborn's cardiopulmonary status, you not that its respirations are adequate, you feel 8 pulsations in a 6-second time frame, and the newborn is centrally pink but peripherally cyanotic. The MOST appropriate next action should be to:

Back 205

administer positive-pressure ventilations

Front 206

The general area of a child's body that sustains inital trauma after being struck by an automobile depends MAINLY on:

Back 206

the child's height and the height of the bumper upon impact

Front 207

A conscious child who is in the sniffing position:

Back 207

is trying to align the axes of the airway to improve ventilation