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ANSWERS 2025
How long should assessing for breathing and a pulse take? A) no longer than 20 seconds B) no longer than 10 seconds C) no longer than 15 seconds D) no longer than 5 seconds - correct answers B) no longer than 10 seconds What should you do to check for breathing? A) look for chest rise and fall B) place your hand on the chest C) look at the nose to check for nasal flaring D) listen for lung sounds - correct answers A) look for chest rise and fall Where do you check a pulse on an infant and child? - correct answers Infant: brachial Child: femoral or carotid If the child does not have normal breathing and a pulse of 64 bpm is present, you will need to: A) begin CPR B) monitor C) provide rescue breathing - correct answers C) provide rescue breathing
ANSWERS 2025
For an unwitnessed cardiac arrest, what should you do after determining unresponsiveness and there is no breathing and no pulse? A) shout for help B) perform high quality CPR for 2 minutes C) provide rescue breaths D) activate the emergency response system - correct answers B) perform high quality CPR for 2 minutes The appropriate rate for compressions for children is 100-120/min. What is the correct depth for children? A) approximately 2 inches (one third the AP diameter) B) approximately 3 inches (one half AP diameter) C) approximately 4 inches (two thirds AP diameter) - correct answers A) approximately 2 inches (one third the AP diameter) What is the compression to ventilation ratio for 1- and 2-rescuer CPR for children and infants? A) 15:2 for both B) 30:2 for both C) single rescuer 15:2, 2 rescuers 30: D) single rescuer 30:2, 2 rescuers 15:2 - correct answers D) single rescuer 30:2, 2 rescuers 15:
ANSWERS 2025
B) during the primary assessment C) during the transfer of care D) during the secondary assessment - correct answers A) during the "from the doorway" observation The evaluate-identify-intervene sequence should be continued until: A) the child is stable B) the child is ready for transport C) the child is ready for discharge D) interventions are provided for the child - correct answers A) the child is stable In the primary assessment, how should you open the airway of a child who is not suspected of having a c-spine injury? A) with ET intubation B) with a jaw thrust C) by flexing the neck D) with a head tilt-chin lift - correct answers D) with a head tilt-chin lift Hypotension for children 1-10 years of age is a SBP of less than: A) 50 + (2 x age in years) B) 40 + (2 x age in years) C) 70 + (2 x age in years)
ANSWERS 2025
D) 60 + (2 x age in years) - correct answers C) 70 + (2 x age in years) What does a prolonged capillary refill time indicate? A) low cardiac rate B) increased stroke volume C) increased cardiac output D) low cardiac output - correct answers D) low cardiac output What pulses should be assessed to monitor systemic perfusion in a child? A) carotid and brachial B) pedal and radial C) peripheral and central D) femoral and carotid - correct answers C) peripheral and central What do weak central pulses indicate a need for immediate intervention to prevent? A) hypovolemia B) sepsis C) respiratory arrest D) cardiac arrest - correct answers D) cardiac arrest Which resuscitation strategy will result in an improved chest compression fraction?
ANSWERS 2025
A) lower respiratory rate B) higher HGB C) higher metabolic rate D) lower oxygen demand - correct answers C) higher metabolic rate Which of the following describes laminar or normal airflow? A) low airway resistance and a small driving pressure B) smaller airways need increased airways resistance C) larger airways need increased airway resistance D) high airway resistance and low driving pressure - correct answers A) low airway resistance and a small driving pressure Which of the following is true about airway resistance? A) the smaller the airway, the lower the airway resistance B) impedance to airflow is decreased when the airways constrict C) airway resistance decreases as lung volume remains unchanged D) when airway resistance increases, work of breathing increases - correct answers D) when airway resistance increases, work of breathing increases What do central chemoreceptors respond to? A) CO2 in the CSF B) serum pH
ANSWERS 2025
C) CO2 in the bloodstream D) hydrogen ions in the CSF - correct answers D) hydrogen ions in the CSF What is the function of the nonrebreathing outlet valve of a self-inflating bag? A) keeps exhaled gases contained B) opens when the child exhales C) prevents rebreathing of CO D) allows the child to exhale - correct answers C) prevents rebreathing of CO Which of the following is required to appropriately ventilate a child with a self-inflating bag? A) the oxygen flow rate must remain constant B) face masks do not need to be fitted to the child C) tidal volume needs to be delivered at the correct rate D) the outlet control valve must not be changed - correct answers C) tidal volume needs to be delivered at the correct rate How is sniffing position achieved in an infant or child? A) place the infant in a prone position B) flex the neck behind the level of the shoulder C) hyperextend the neck
ANSWERS 2025
What can happen if the OPA is too large? A) it can push the tongue to the back of the throat B) it can block the airway C) it may cause vomiting D) it will open the airway - correct answers B) it can block the airway Which are appropriate interventions for an apneic child? A) provide a breath every 2-3 seconds B) provide a breath every 2 seconds C) provide a breath every 3-5 seconds D) watch for chest rise - correct answers A and D Which of the following should be included in rescue breathing for an infant? A) provide a breath every 6 seconds B) check for a pulse every 5 minutes C) start chest compressions D) use oxygen as soon as it is available - correct answers D) use oxygen as soon as it is available What should you do before suctioning a child who has an upper airway obstruction?
ANSWERS 2025
A) give nebulized epinephrine B) give corticosteroids C) determine the underlying cause of the obstruction D) determine if there is blood or debris in the airway - correct answers C) determine the underlying cause of the obstruction In a less severe case of upper airway obstruction in a child, what can relieve obstruction caused by the tongue? A) suction B) decide if a surgical airway is needed C) insert an oral airway D) minimize agitation - correct answers C) insert an oral airway Where may padding be required under when properly positioning a child older than 2 years of age to maintain a patent airway? A) the shoulders B) the occiput C) the upper torso D) padding is not required for children older than 2 years of age - correct answers B) the occiput A responsive infant presents with severe foreign body airway obstruction. What is the appropriate management?
ANSWERS 2025
A) bronchiolitis B) asthma C) epiglottitis D) foreign body airway obstruction - correct answers A and B How can small airways be obstructed in lower airway obstruction? A) increased expiratory flow B) decreased volume of gas in the lungs C) smooth muscle bronchial constriction D) decreased intrapleural pressure E) mucus plugging - correct answers C and E How do infants initially respond to lower airway obstruction? A) increased tidal volumes B) increased respiratory rate C) decreased respiratory rate D) decreased intrapleural pressure - correct answers D) decreased intrapleural pressure BVM ventilation has been used on a child with a lower airway obstruction. Which complications may occur? A) increased venous return to the heart
ANSWERS 2025
B) decreased blood supply to the heart C) risk of lung collapse D) increased oxygenation - correct answers B and C Which of the following are typical signs of lung tissue disease? A) bradypnea and hypercarbia B) tachypnea and hypoxemia C) normal respiratory rate and hypoxemia D) tachypnea and hypercarbia - correct answers B) tachypnea and hypoxemia How would you estimate the size of a cuffed or uncuffed ET tube to use for a patient that is 7 kg and 6 months old? - correct answers cuffed: (age in years)/4 + 3. uncuffed: (age in years)/4 + 4 How does the clinical presentation of distributive shock compare to hypovolemic shock? A) distributive shock has completely different presenting characteristics than those of hypovolemic shock B) distributive shock presents with bradycardia while hypovolemic shock presents with tachycardia C) distributive shock has a more variable presentation than that of hypovolemic shock
ANSWERS 2025
You are dispatched to the home of a 7 y/o male who presents with a 1-day history of runny nose and progressive lethargy and fever. He has a decreased LOC and a rash on his trunk and legs. He is hot to the touch. The first responders report that the scene is safe. The patient's vital signs are HR 178 bpm, BP 61/38, RR 32/min, SpO2 95%, and temperature 102.9 degrees. When you arrive at the house, the patient is sitting on the couch in the living room. Given the status of the patient, what immediate steps should you take to stabilize him? A) insert an OPA B) monitor and support ABCs C) establish IV/IO access D) monitor HR, BP, and SpO E) obtain chest XR - correct answers You establish an IV in your 7 y/o patient with septic shock. What is the next most appropriate intervention? A) administer fluid bolus B) consider medical control consult C) initiate and titrate vasoactive drugs D) administer an antipyretic - correct answers A) administer fluid bolus Ongoing assessment of your 7 y/o septic shock patient must be done while administering fluid boluses. What are some of the adverse effects that indicate that you should stop rapid fluid bolus administration? A) increased urinary output
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B) hepatomegaly C) mental status improvement D) rales E) respiratory distress - correct answers B, D, E What is the most appropriate vasoactive drug to use in fluid-refractory septic shock? A) epinephrine or norepinephrine B) vasopressin C) milrinone D) phenylephrine - correct answers A) epinephrine or norepinephrine What is the recommendation for fluid bolus of isotonic crystalloids in cardiogenic shock? A) 40 mL/kg over 20-30 mins B) 10-20 mL/kg over 10 - 15 mins C) 5-10 mL/kg over 10-20 mins D) 20 mL/kg over 5-10 mins - correct answers C) 5-10 mL/kg over 10-20 mins Most patients in cardiogenic shock will need inotropic support with medications. Which of the following could be used? A) vasopressin B) epinephrine
ANSWERS 2025
D) tachycardia - correct answers A, C, D Why do children with cardiac tamponade improve temporarily with fluid administration? A) late-phase symptoms are delayed with fluid administration B) fluids will decrease cardiac output and improve hemodynamic status C) poor myocardial contractility is improved and pulmonary edema is minimized with fluid administration D) fluids augment cardiac and tissue perfusion until pericardial drainage is performed
- correct answers D) fluids augment cardiac and tissue perfusion until pericardial drainage is performed In the setting of actual or impending pulseless arrest when there is strong suspicion of pericardial tamponade, what is the appropriate management? A) PRBCs B) emergency pericardiocentesis C) fluid bolus of 20 mL/kg over 5-20 mins D) consultation with an appropriate specialist - correct answers B) emergency pericardiocentesis What findings help distinguish PE from hypovolemic shock? A) tachycardia and hypotension B) respiratory distress with increased respiratory rate and effort
ANSWERS 2025
C) extremities may be cool and mottled D) systemic venous congestion and right heart failure - correct answers D) systemic venous congestion and right heart failure What is the definitive treatment for most children with PE who are not in shock? A) anticoagulants B) vasodilators C) inotropic agents D) glycoprotein IIb/IIIa inhibitors - correct answers A) anticoagulants In children with severe cardiovascular compromise from PE, what treatment should be considered? A) glycoprotein IIb/IIIa inhibitors B) platelet aggregation inhibitors C) fibrinolytic agents D) low-molecular-weight heparin - correct answers C) fibrinolytic agents You are dispatched to the local elementary school for a 7 yo girl who says she is having chest pain and difficulty breathing. During recess about 3 hours earlier, she fell from a swing and reported right-sided rib pain. When you arrive on scene, you find the child in the nurse's office. The child is awake, responsive, and anxious. Her initial vital signs are HR 168 bpm, BP 61/43, RR 44/min, and SpO2 66%. What is the initial treatment priority for this patient? A) administer O2 (NRB)
