Free Paramedics Exam Pediatric Emergencies Question and Answers — Questions and Answers

Question 1: How much fluid should be administered to a child with hypovolemic shock over a 10 to 20 minute period?

50 mL/kg
40 mL/kg
20 mL/kg (Correct answer)
30 mL/kg

Correct answer: 20 mL/kg

The standard initial fluid bolus for a child in hypovolemic shock is 20 mL/kg of an isotonic crystalloid solution (e.g., normal saline or lactated Ringer's). This amount should be administered rapidly over 5 to 20 minutes to quickly restore circulating volume and improve perfusion. The child's response should be reassessed, and this bolus can be repeated if necessary.

Question 2: Which condition/injury is NOT typical in children aged 6 to 12?

Drowning
Burns
Fractures
Dehydration (Correct answer)

Correct answer: Dehydration

While dehydration can affect children of any age, it is less typical as a primary 'condition/injury' in the 6 to 12 age group compared to infants and toddlers who are more susceptible to rapid fluid loss. School-aged children are generally more resilient to dehydration unless there is significant illness or extreme environmental exposure, whereas drowning, burns, and fractures are common and significant injury risks for this age group.

Question 3: Which way should a 9-month-examination old's develop?

Front-to-back
Head-to-toe
Toe-to-head (Correct answer)
Back-to-front

Correct answer: Toe-to-head

When examining an infant or young child, a 'toe-to-head' approach is often recommended. This strategy involves starting the examination with less invasive and potentially less distressing areas like the feet and legs, gradually moving upwards to the trunk, and saving more invasive or upsetting procedures (like examining the ears, mouth, or head) for last. This helps to build trust and maintain the child's cooperation for as long as possible during the assessment.

Question 4: Which condition/injury is NOT typical in children aged 6 to 12?

Firearms
Drowning
Motor vehicle accidents (Correct answer)
Burns

Correct answer: Motor vehicle accidents

Motor vehicle accidents are a leading cause of injury and death across all pediatric age groups, including children aged 6 to 12, making them a very typical concern. While all options represent significant risks, the question asks what is 'NOT typical.' In some contexts, the frequency of direct involvement in MVAs might be considered comparatively lower than the daily risks of burns, drowning, or the unfortunate prevalence of firearm incidents in specific communities for this age group, leading to this answer.

Question 5: Which one should NOT raise concerns about child abuse?

Fracture in a 15 year old child (Correct answer)
Injuries in various stages of healing
Child inappropriately dressed
Delay in seeking help for the child

Correct answer: Fracture in a 15 year old child

A fracture in a 15-year-old child is less likely to raise immediate concerns for child abuse compared to injuries in younger children, as adolescents are highly active and prone to accidental trauma. Conversely, injuries in various stages of healing, a child being inappropriately dressed for the weather, or a significant delay in seeking medical help are all classic red flags that strongly suggest potential child abuse or neglect.

Question 6: What does pharmaceutical therapy NOT aim to achieve in pediatric cardiac arrest?

Suppression of ventricular extopy
Correction of hypoxemia
Deceleration of the heart rate (Correct answer)
Correction of metabolic acidosis

Correct answer: Deceleration of the heart rate

In pediatric cardiac arrest, the primary goals of pharmaceutical therapy are to restore a perfusing rhythm, improve cardiac contractility, correct underlying metabolic disturbances like hypoxemia and acidosis, and manage life-threatening dysrhythmias. Decelerating the heart rate is not a goal, as the heart is already absent or critically slow; the aim is to stimulate and restart effective cardiac activity.

Question 7: What type of brain injury DOES NOT frequently occur in a school-aged child?

Auto-pedestrian accidents
Sporting events (Correct answer)
Falls from trees
Bicycle accidents

Correct answer: Sporting events

Sporting events are a very frequent cause of brain injuries, particularly concussions, in school-aged children due to falls, collisions, and impacts. Therefore, stating that brain injuries from sporting events 'DOES NOT frequently occur' is generally incorrect. Auto-pedestrian accidents, falls from trees, and bicycle accidents are also common causes of brain injury in this age group, often leading to more severe traumatic brain injuries.

Question 8: What danger does vomiting in children pose the greatest risk to?

Aspiration
Malnutrition
Dehydration (Correct answer)
Obstruction

Correct answer: Dehydration

Vomiting in children, especially infants and young children, poses the greatest risk of dehydration. Their smaller body size, higher metabolic rate, and limited fluid reserves make them highly susceptible to rapid fluid and electrolyte loss. While aspiration is a concern and malnutrition can occur with chronic vomiting, acute vomiting primarily threatens the child's hydration status.

Question 9: What kind of medication should be given to a youngster who is having seizures?

Dopamine
Diazepam (Correct answer)
Epinephrine
Neurontin

Correct answer: Diazepam

For acute seizures in the prehospital setting, benzodiazepines like diazepam (or lorazepam, midazolam) are the first-line medications. They act quickly to depress the central nervous system and stop seizure activity. Dopamine and epinephrine are used for cardiac support, and Neurontin is an anticonvulsant for long-term management, not acute seizure termination.

Question 10: What is the usual pulse rate of a 6 year old?

100-160
90-120
70-110 (Correct answer)
60-90

Correct answer: 70-110

The normal resting pulse rate for a 6-year-old child typically falls within the range of 70 to 110 beats per minute. Heart rates gradually decrease as children mature, so this range is lower than that of infants and toddlers but generally higher than that of adults.

Question 11: What organ experiences injury the most frequently in children?

Stomach
Liver
Intestine
Spleen (Correct answer)

Correct answer: Spleen

In blunt abdominal trauma in children, the spleen is the most frequently injured solid organ. Its relatively large size, superficial location, and less protected position within the abdominal cavity compared to adults make it particularly vulnerable to injury from forces like falls, bicycle accidents, or motor vehicle collisions.

Question 12: What should be done initially when managing an asthma attack in a child?

Administer an inhaled beta agonist (Correct answer)
Establish an airway
Administer a steroid preparation
Administer supplemental, humidified oxygen

Correct answer: Administer an inhaled beta agonist

The initial and most critical step in managing an acute asthma attack in a child is to administer a rapid-acting inhaled beta agonist, such as albuterol. These medications quickly relax the smooth muscles of the airways, relieving bronchospasm and improving airflow. While oxygen, steroids, and airway management are important, bronchodilator administration is the immediate priority for reversing the primary problem of bronchoconstriction.

Question 13: Which kind of seizure is brought on by an abrupt rise in body temperature?

Hypoxic
Febrile (Correct answer)
Epileptic
Meningitis

Correct answer: Febrile

Febrile seizures are a common type of seizure in young children, typically occurring between 6 months and 5 years of age, that are directly triggered by a rapid rise in body temperature. They are usually generalized and brief, and while frightening for parents, are generally benign and do not indicate an underlying epileptic condition.

Question 14: Which age group should be questioned away from the parents?

1-3 years
3-5 years
6-12 years
12-15 years (Correct answer)

Correct answer: 12-15 years

When there are concerns about child abuse, adolescents in the 12-15 year age group should ideally be questioned away from their parents. At this age, children are typically mature enough to articulate their experiences and feelings, and separating them from parents can provide a safer, more open environment for disclosure without fear of reprisal or influence. This allows for a more accurate and unbiased account.

Question 15: What makes croup distinctive?

Occasional stridor
Drooling
Slow onset (Correct answer)
Child prefers to sit up

Correct answer: Slow onset

Croup (laryngotracheobronchitis) is typically characterized by a slow, gradual onset, often starting with cold-like symptoms that progress over a few days to the classic barking cough, inspiratory stridor, and hoarseness. This distinguishes it from conditions like epiglottitis, which has a rapid onset and is associated with drooling and a preference to sit up.

Question 16: What is a highly dehydrated child's skin condition?

Dry, cool, mottled (Correct answer)
Moist and red
Normal
Dry and ashen

Correct answer: Dry, cool, mottled

A highly dehydrated child will exhibit signs of significant fluid loss and compromised circulation. This often includes dry skin due to lack of hydration, and as hypovolemic shock progresses, peripheral perfusion decreases, leading to cool and mottled extremities. This combination indicates severe fluid depletion and circulatory impairment.

Free Paramedics Exam Pediatric Emergencies Question and Answers

How much fluid should be administered to a child with hypovolemic shock over a 10 to 20 minute period?