Fundamentals Of Nursing Iii

A 7 y/o child has an altered mental status, high fever, and a generalized rash. You perform your assessment and initiate oxygen therapy. En route to the hospital, you should be most alert for: a. Vomiting b. Seizures c. Combativeness d. Respiratory distress Initial steps in the management of newly newborn include: a. Opening the airway and blowing over the newborn’s nose b. Prevention of heat loss, opening the airway, and evaluation of the infant c. Opening the airway and administering oxygen by bag-valve mask d. Prevention of heat loss, opening the airway, performing chest compression You are dispatched for a sick child with high fever. On arrival, you find a 4 y/o female sitting on the living room couch. She is leaning slightly forward and drooling because she says it “hurts too much to swallow”. Her mother tells you she has a sore throat and fever, which developed relatively quickly. You are concerned because by now you suspect: a. Foreign body airway obstruction b. Meningitis c. Epiglotitis d. Strep throat How much energy is used in initial biphasic defibrillation of a 70kg adult? a. 360 joules b. 150 joules c. Maximum output d. 300 joules The most common cause for seizures in the child is: a. Ventricular fibrillation b. Elevated temperature c. Bronchiolitis d. Inadequate tissue perfusion

Which of the following is true regarding the hazard of oxygen therapy? a. Premature infants may develop eye damage if given too much damage b. High flow oxygen can stimulate hyperactivity in our children c. Patients with COPD may go to respiratory arrest after only a short time on high concentration oxygen d. All of the above What is the percentage of oxygen in inhaled air? a. 17% b. 14% c. 78% d. 21% What is the average total volume of cerebrospinal fluid in and around the brain and spinal cord of an adult? a. 250 ml b. 200 ml c. 150 ml d. 125 ml Which if the following non hemorrhagic cause of acute abdomen? a. Ulcer b. Esophageal Varices c. AAA d. Appendicitis When dealing with hostile aggressive patient you should: a. Place the patient between you and the nearest exit b. Attempt to restrain the patient by yourself with gauge bandages c. Attempt to talk to the patient on a non-threatening manner d. Politely ask the patient if he is having thoughts of destructive behaviour

You are called to a residence for a ‘sick’ 5 y/o child. When you arrive and begin your assessment, you note that the child is unconscious with respiratory rate of 8 breaths/min and a heart rate of 50 beats/min. Management of this child should consist of a. 100% oxygen via NRM and transport b. Positive pressure ventilations with a BVM device and rapid transport c. Chest compression, artificial ventilation and transport

d. Back blows and chest thrust while attempting artificial ventilations A 7 y/o child has an altered mental status, high fever and generalized rash. You perform your assessment and initiate oxygen therapy. En route to the hospital, you should be most alert for a. Vomiting b. Seizures c. Combativeness d. Respiratory distress Which of the following techniques represents the most appropriate method of opening the airway of an infant with no suspected neck injury? a. Lift up the chin and hyperextend the neck b. Tilt the head back without hyper extending the neck c. Gently lift the chin while maintaining slight flexion of the neck d. Perform the techniques as you would for a older child or adult You are called to a local park where a 12 y/o boy was skateboarding and fell. You arrive to find the boy sitting on the sidewalk supporting his left wrist with his right arm. In this situation you should: a. Control medical control for direction b. Immediately perform a detailed physical examination c. Immediately load the patient before any other activity d. After a rapid trauma assessment, perform a focused physical examination Which of the following is not a sign and symptoms of a potential spine injury? a. Numbness, weakness or tingling of the extremities b. Soft tissue injury of the shoulder, back or abdomen c. Unequal pupils or pupils that do not respond to light d. Pain in the lower legs and independent of movement A 34 y/o woman who is 36 weeks AOG is having a seizure. After you protect the airway and ensure adequate ventilation. You should transfer her: a. Supine position b. Knee chest c. Fowler’s position d. On her left side

You are called to a scene of a reported rape. Police officers are on the scene. Which of the following statements is correct regarding this situation? a. Items at the scene should not be moved unless emergency cares requires it b. Allow the patient to wash before transporting to the closest appropriate facility c. Document anything unusual at the scene before initiating contact with the patient d. Instruct the patient to change clothing before transporting to the closest appropriate facility

Which of the following statements regarding consent is true? a. Responsive and unresponsive patients can provide consent b. Use implied consent to treat the unresponsive patient c. Use implied consent to treat children whose parents do not want them to be treated d. The patient cannot withdraw his or her consent once it is given EMT-Bs are best defined as a. Responders who stabilize the patient until advanced help arrives b. Providers of definitive care for trauma patient c. Advanced level of pre-hospital care provider d. Providers of primary care before the patient reach the hospital During the rapid trauma assessment, assess the abdomen for DCAP-BTLS and a. Paradoxical motion b. Crepitation c. Distention d. Instability Which of the following is found in an obstetrical kit? a. Infant BVM b. Bulb syringe c. Magil forceps d. Browselow tape

How should you treat a patient with a impaled object in the cheek that is obstructing the airway? a. Leave the impaled object as found

b. Remove the impaled object c. Stabilize the object from inside the mouth d. Stabilize the object from outside the mouth Prior to delivery, the mother is in supine position she may develop dizziness and drop in blood pressure is called a. Eclampsia b. Pregnancy shock c. Suspine hypotensive syndrome d. Pre-labor syndrome All of the following are signs of spinal cord injury except: a. Loss of bowel or bladder control b. Priapism c. Increasing BP from vessel constriction d. Posturing The major symptoms of chest injury include: a. Surgical emphysema, hemoptysis and cynosis b. Flail chest, contusion and tracheal deviation c. Chest pain, shortness of breath and respiratory distress d. Chest wall contusion, distended neck veins and tracheal deviation Once you have completed your focused physical examination of your patient, you will: a. Splint all injuries b. Package and transport the patient c. Begin your detailed physical examination d. Set baseline vital sign A 17 y/o female was struck y a car while she was crossing the street and is displaying signs of shock. During your assessment, you note a contusion on the left hypochondria. Which of the following organs has most likely been to injured? a. Stomach b. Liver c. Intestines d. Spleen In an asthmatic child which of the following would be considered a bad sign? a. Use of accessory muscle of respiration b. Wheezing c. Inability to speak in few sentences

d. Sleepiness and drowsiness During a soccer game, an 18 y/o man injured his knee. You note that the knee is in the flexed position and obviously deformed. Your action should be to: a. Assess the neurovascular status b. Straighten the knee to facilitate immobilization c. Manually stabilize the leg above and below the joint d. Immobilize the knee in the position in which it was found As you are assessing an elderly man who is complaining of severe chest pain, the patient loses consciousness. Your first step in caring of this patient is: a. Attach AED b. Assess for a pulse c. Assess for breathing d. Open the airway Which of the following is a sign of cardiac compromise? a. Chest pain b. Headache c. Indigestion d. Abnormal pulse rate Which of the following would confirm “flail chest”? a. Pain, especially on respiration b. Slow deep respirations c. Rapid, deep respirations d. Paradoxical chest movement The blood pressure is of limited value and not usually worth taking in children less than: a. 2 years b. 6 years c. 3 years d. 9 years An oropharyngeal airway should be considered in which of the following patients? a. A 37 y/o female who responds to painful stimuli b. A 28 y/o male patient who goes in and out of consciousness c. A 66 y/o diabetic patient with GCS 6 d. A 70 year old male patient who is having a seizure

Which of the following blood vessels carries oxygenated blood? a. Inferior vena cava b. Superior vena cava c. Pulmonary artery d. Pulmonary vein

A woman’s OB history shows she has 3 pregnancies and 2 live births, which of the following would be recorded on your report a. G3 P3 b. G3 P2 c. P3 G2 d. P2 G3 When behavioral changes occur in trauma patients you most likely think it is attributed to a. Psychological disorder b. Hypoxia c. The patient may a violent sociopath d. Suicide tendencies You are called to a scene where a 12 y/o girl fell from her bicycle injuring her left lower extremity. To evaluate the presence of swelling in this extremity you should: a. Ask the patient is she can feel pinch in her toes b. Ask the patient to point her toes upward and downward c. Compare the lower extremity to the uninjured lower extremity d. Compare the lower extremity to the upper extremity on the same side of the body. A large collection of blood beneath the skin is called: a. A contusion b. A laceration c. A hematoma d. An abrasion The most significant problem resulting from hypoglycemia is a. Loss of consciousness b. Damage to pancreas c. Damage to liver d. Hunger

Which the following is true regarding treating behavioral emergency patient? a. Show you are listening by re-phrasing or repeating part of what the patient has said. b. Let the patient know that telling you what is wrong is not important c. In a calm reassuring manner, explain that he or she has a behavioral problem d. Apply physical restraints, then inform the patient you will remove it if he or she cooperates to you To determine if a child has a pulse, you should check the ________ artery a. Brachial b. Radial c. Carotid d. Femoral Life threatening complications of femoral fractures are most often caused by: a. Thigh muscle contractions b. Pressure on the femoral tendons c. Open wounds d. The mechanism of injury APGAR scores should be evaluated: a. At one and five minute after birth b. At the time of birth and again in 5 minutes c. At the time of birth and again in 10 minutes d. Five minutes after birth and again in 10 minutes Select the INCORRECT statement regarding seizures in an infant or child. a. Seizures may be caused by head injury b. Inadequate breathing and/or an altered mental status may occur following a seizure c. The child should be restrained during a seizure to prevent injury to himself or others d. The child should be assessed for the presence of injuries that may have occurred during a seizure Once the baby’s head is delivered, if you see the umbilical cord around the baby’s neck you should: a. Immediately clamp and cut the cord

b. Place the fingers on the cord and remove it from around the baby’s neck c. Continue to support the neck and immediately transport the mother to the hospital d. Allow the delivery to continue and remove the cord after the baby is completely out If you don’t see the patient’s chest rise and fall during ventilation with a BVM, you should: a. Squeeze harder on the bag b. Switch to a different BVM c. Perform chest compressions d. Re-position the head The first step in caring for a unresponsive patient in diabetic emergency is to: a. Begin suctioning the patient mouth b. Provide oxygen by non-rebreathing mask c. Make sure the airway is open d. Place glucose gel under the tongue The term “pulse pressure” refers to: a. Palpation of the radial pulse b. Taking the blood pressure by palpation c. The difference between the systolic and diastolic blood pressure d. The systolic blood pressure You are called to a local park for a 7 y/o boy with respiratory distress. During your assessment, you find that the patient is wheezing and has wide-spread hives and facial edema. What should you suspect has occurred? a. Heat emergencies b. Allergic reaction c. Acute asthma attack d. Exposure to a poisonous plant You are responding to a call for a 2 y/o child who fell from a second-story window. With the mechanism of injury and age of the patient in mind, you should suspect that the primary injury occurred to the child’s a. Head b. Chest c. Abdomen

d. Lower extremities The responsive child who is ill or injured but breathing adequately; a. Should receive O2 cannula at 8 lpm b. Should be ventilated at the rate of 20 times a minute c. Should be ventilated with an oxygen powered ventilation device d. Should receive O2 by NRM at 8 lpm Which of the following statements is true of normal respiratory rates? a. Children breath more quickly than adult b. The oxygen needs of infants and children are less than adult c. Adults normally breath 10 to 30 times per minute d. Children normally breath 15-30 times per minute Which of the following statements concerning the SAMPLE history is correct? a. The “A” in SAMPLE stands for allergies to medications only b. A complete medical history should be assessed c. A symptom is any medical condition that can be observed d. The “E” in SAMPLE stands for events leading to the illness or injury Which of the following is a method of heat loss? a. Shivering b. Condensation c. Conduction d. Conversion Which of the following statements about splinting is true? a. Assess proximal pulse, sensation and motor function before/after splinting b. Splint the bone above and below the injury c. Replace protruding bone ends before splinting d. Leave clothing in place to minimize pain when splinting When treating a patient with an open soft tissue injury your first action should be: a. Assess the patient for spinal injury b. Take body substance isolation precaution c. Assess the adequacy of the patient’s airway d. Obtained a rapid trauma assessment

Which of the following considered a critical burn to a child? a. Any superficial burn involving the chest, abdomen or thigh b. Partial thickness burn covering 10-20% of the body surface area c. Partial thickness burn covering less than 10% of the body surface area d. Any partial thickness burns covering more than 20% of the body surface area During an emergency childbirth, you should suction: a. Immediately after the infant is fully delivered b. The mouth then the nose as soon as the head is delivered c. The nose then the mouth as soon as the head is delivered d. Only is the infant is in respiratory distress Which of the following situation is an example of a priority patient? a. A woman experiencing uncomplicated childbirth b. A patient with a scalp wound that is oozing blood c. A patient who is responsive, but unable to follow your command d. A man complaining of dizziness with a systolic blood pressure of 130 mmhg Bleeding up to _________ is spontaneous delivery (childbirth) a. 250 ml b. 500 ml c. 300 ml d. 750 ml

normal

following

normal

Your patient is a 28 y/o female in her 32 weeks AOG. The husband called because she has been complaining of severe headache and vomiting. As you begin your evaluation you notice her face and hands appears swollen. You took her VS reveals a BP 146/92, PR 90, RR 24. The patient most likely has; a. Abortion b. Abruptio placenta c. Pre-eclampsia d. Supine hypotension syndrome You are called for an 85 y/o woman complaining of generalized weakness and fatigue, you note that she has pale clammy skin and she is diaphoretic. Your best cause of action will be to: a. Perform a rapid head and toe assessment

b. Perform a focused physical examination c. Administer 100% O2 and transport immediately d. Contact medical control for advice about how to proceed Given the formula of estimating the weight of a child, a 5 y/o will be; a. 19 kgs b. 25 kgs c. 20 kgs d. 15 kgs Which pediatric respiratory associated with “seal bark”. a. Broncholitis b. FBAO c. Asthma d. Croup

emergency

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Which of the following is an indication of sever FBAO to a child? a. Stridor b. Wheezing c. Drooling d. Unresponsiveness When caring for a patient with an emotional and behavioral crisis your primary concern should be: a. Obtaining a complete post psychiatric history b. Gathering all patient’s medications c. Providing safe transport to the hospital d. You and your partner’s safety A 3 y/o child had sudden onset of respiratory distress. The mother denies any recent illness and fever. You should expect: a. Croup b. Asthma c. Bronchiolitis d. FBAO Caring for an alert 4 y/o with mild airway obstruction, who has stridor and adequate peripheral perfusion includes a. Abdominal thrust and transport b. Oxygen, avoiding agitation and transport c. Assisting ventilation, backblow and transport d. Backblow, finger sweeps and transport