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You are treating a 5-year-old child who has had severe diarrhea and vomiting for 3 days and is now showing signs of shock. Supplemental oxygen has been given, and you have elevated his lower extremities. En route to the hospital, you note that his work of breathing has increased. You should:
- A. begin positive-pressure ventilations and reassess the child.
- B. lower the extremities and reassess the child.
- C. listen to the lungs with a stethoscope for abnormal breath sounds.
- D. insert a nasopharyngeal airway and increase the oxygen flow.
Correct Answer: B
Rationale: When the work of breathing increases after elevating the legs, it is important to lower the extremities. Elevating the lower extremities in a child with signs of shock can worsen the condition by reducing venous return to the heart. Lowering the extremities can help improve venous return and potentially alleviate the increased work of breathing.
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After an advanced airway device has been inserted in a 6-month-old infant in cardiopulmonary arrest, you should deliver ventilations at a rate of:
- A. 10 to 12 breaths/min.
- B. 12 to 20 breaths/min.
- C. 6 to 8 breaths/min.
- D. 8 to 10 breaths/min.
Correct Answer: D
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
A 9-year-old girl was struck by a car while crossing the street. Your assessment reveals a large contusion over the left upper quadrant of her abdomen and signs of shock. Which of the following organs is MOST likely injured?
- A. Liver
- B. Kidney
- C. Pancreas
- D. Spleen
Correct Answer: D
Rationale: The presence of a large contusion over the left upper quadrant of the abdomen, along with signs of shock, points towards a likely injury to the spleen, especially following trauma. The spleen is located in the left upper quadrant of the abdomen and is susceptible to injury due to its position and vulnerability to blunt trauma.
In which of the following situations would the EMT MOST likely deliver a baby at the scene?
- A. A tornado has struck and blocked the only route to the hospital.
- B. Contractions are 8 to 10 minutes apart and irregular.
- C. The amniotic sac has ruptured, and contractions occur regularly.
- D. The hospital is 15 miles away, and crowning is not present.
Correct Answer: A
Rationale: The EMT may be required to deliver a baby at the scene when external factors like a tornado have blocked the only route to the hospital, making it impossible to reach the medical facility in time for delivery. In such emergencies, the EMT must be prepared to manage the childbirth process until further medical assistance can be obtained.
A 30-year-old woman is 22 weeks pregnant with her first child. She tells you that her rings are not fitting as loosely as they usually do and that her ankles are swollen. Her blood pressure is 150/86 mm Hg. She is MOST likely experiencing:
- A. a condition unrelated to pregnancy.
- B. gestational diabetes.
- C. a hypertensive emergency.
- D. preeclampsia.
Correct Answer: D
Rationale: The symptoms of swollen ankles, tight rings, and elevated blood pressure in a pregnant woman at 22 weeks gestation are concerning for preeclampsia. Preeclampsia is characterized by high blood pressure and signs of organ damage, commonly seen with symptoms such as swelling (edema) and protein in the urine. It is crucial to monitor and manage preeclampsia promptly as it can lead to severe complications for both the mother and the baby.
Why is a prolapsed umbilical cord dangerous?
- A. The cord may be wrapped around the baby's neck, causing strangulation.
- B. The cord might pull the placenta from the uterine wall during delivery.
- C. The baby's head may compress the cord, cutting off its supply of oxygen.
- D. The mother may die of hypoxia due to compromised placental blood flow.
Correct Answer: C
Rationale: A prolapsed umbilical cord is dangerous because the baby's head may compress the cord, cutting off its supply of oxygen. This compression can lead to oxygen deprivation, potentially causing significant harm to the baby. Immediate medical intervention is crucial in such cases to prevent adverse outcomes.