Nokea
You arrive at a residence shortly after a 4-year-old boy experienced an apparent febrile seizure. The child is alert and crying. His skin is flushed, hot, and moist. His mother tells you that the seizure lasted about 2 minutes. You should:
- A. provide supportive care and transport.
- B. give him acetaminophen or ibuprofen.
- C. begin rapid cooling measures at once.
- D. allow the mother to take her child to the doctor.
Correct Answer: A
Rationale: After a febrile seizure, the recommended course of action is to provide supportive care and transport the child to a medical facility. Supportive care may include ensuring a safe environment, monitoring the child, and seeking medical evaluation to determine the underlying cause of the seizure and appropriate management.
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You have just delivered a baby girl. Your assessment of the newborn reveals that she has a patent airway, is breathing adequately, and has a heart rate of 130 beats/min. Her face and trunk are pink, but her hands and feet are cyanotic. You have clamped and cut the umbilical cord, but the placenta has not yet delivered. You should:
- A. reassess the newborn every 5 minutes and transport after the placenta delivers.
- B. keep the newborn warm, give oxygen to the mother if needed, and transport.
- C. massage the lower part of the mother's uterus until the placenta delivers.
- D. give the newborn high-flow oxygen via a non-rebreathing mask and transport.
Correct Answer: B
Rationale: In this scenario, the appropriate action is to keep the newborn warm, ensure the mother receives oxygen if needed, and prepare for transport. The newborn is showing signs of central cyanosis (hands and feet being cyanotic), which can be due to various reasons, including inadequate oxygenation. Therefore, ensuring warmth and possible oxygen to the mother are important. Additionally, monitoring both the mother and baby during transport is crucial for their well-being.
When you attempt to assess a 22-year-old woman who has been sexually assaulted, she orders you not to touch her. Your MOST appropriate initial action should be to:
- A. obtain a signed refusal and return to service.
- B. transport the patient without performing an assessment.
- C. explain to the patient that she must be examined.
- D. ask a female EMT to attempt to assess the patient.
Correct Answer: D
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
A 7-year-old child has an altered mental status, high fever, and a generalized rash. You perform your assessment and administer supplemental oxygen. En route to the hospital, you should be MOST alert for:
- A. hypotension.
- B. combativeness.
- C. convulsions.
- D. respiratory distress.
Correct Answer: C
Rationale: In a 7-year-old child with altered mental status, high fever, and a generalized rash, the most critical concern is the potential for convulsions. These symptoms could indicate a serious underlying condition, such as a febrile seizure or another type of seizure activity. Monitoring for convulsions is crucial during transport to ensure prompt intervention if they occur, as seizures can lead to additional complications and require immediate management.
Which of the following signs or symptoms is more common in children than adults following an isolated head injury?
- A. Changes in pupillary reaction
- B. Tachycardia and diaphoresis
- C. Nausea and vomiting
- D. Altered mental status
Correct Answer: C
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
What is the most likely cause of a sudden onset of respiratory distress in a 5-year-old child with no fever?
- A. Infection of the lower airways.
- B. A progressive upper airway infection.
- C. Inflammation of the upper airway.
- D. A foreign body airway obstruction.
Correct Answer: D
Rationale: A sudden onset of respiratory distress in a child without fever is most likely due to a foreign body airway obstruction. This obstruction can rapidly lead to difficulty breathing, stridor, and other signs of respiratory distress without necessarily causing a fever. Prompt recognition and intervention are crucial in such cases to prevent further complications and ensure the child's airway remains clear.