Paramedics Exam Pediatric Emergencies 3 — Questions and Answers
Question 1: A 9-month-old infant has a respiratory rate of 65 breaths/min, nasal flaring, and subcostal retractions. What is the most likely diagnosis?
- Pneumonia
- Croup
- Bronchiolitis (Correct answer)
- Asthma
Correct answer: Bronchiolitis
Bronchiolitis in infants typically presents with tachypnea, nasal flaring, retractions, and wheezing, most commonly caused by RSV.
Question 2: When inserting a nasopharyngeal airway in a pediatric patient, which measurement determines the correct size?
- Distance from the corner of the mouth to the earlobe
- Distance from the tip of the nose to the earlobe (Correct answer)
- Distance from the mouth to the chin
- The diameter of the patient's little finger
Correct answer: Distance from the tip of the nose to the earlobe
A nasopharyngeal airway is sized by measuring from the tip of the nose to the earlobe to ensure appropriate length.
Question 3: A 5-year-old is found with altered mental status and blood glucose of 38 mg/dL. You establish IV access. What is the appropriate dextrose dose?
- D50W 1 mL/kg IV
- D25W 2 mL/kg IV (0.5 g/kg) (Correct answer)
- D10W 5 mL/kg IV
- D25W 1 mL/kg IV
Correct answer: D25W 2 mL/kg IV (0.5 g/kg)
For pediatric hypoglycemia, D25W at 2 mL/kg (0.5 g/kg) is the standard dose; D50 is avoided due to osmotic injury risk.
Question 4: A 3-year-old has ingested an unknown substance. Parents show you the bottle, which contains a caustic drain cleaner. Which intervention is contraindicated?
- Administering oxygen
- Contacting Poison Control
- Inducing vomiting with syrup of ipecac (Correct answer)
- Establishing IV access
Correct answer: Inducing vomiting with syrup of ipecac
Inducing vomiting after caustic ingestion is contraindicated because re-exposure of the esophagus and airway can worsen burns.
Question 5: A 6-week-old presents with projectile vomiting after every feeding for one week. On exam, you note an olive-shaped mass in the right upper quadrant. What condition does this suggest?
- Intussusception
- Pyloric stenosis (Correct answer)
- Volvulus
- Gastroenteritis
Correct answer: Pyloric stenosis
Pyloric stenosis classically presents in infants 2–8 weeks old with projectile non-bilious vomiting and a palpable 'olive' mass at the pylorus.
Question 6: What is the preferred intraosseous access site in a child under 6 years of age?
- Distal femur
- Proximal tibia, 1-2 cm below the tibial tuberosity (Correct answer)
- Sternum
- Distal tibia
Correct answer: Proximal tibia, 1-2 cm below the tibial tuberosity
The proximal tibia 1–2 cm below the tibial tuberosity is the preferred IO site in young children due to its flat, accessible surface and large marrow cavity.
Question 7: A 12-year-old athlete collapses on the field and has no pulse. AED analysis shows VF. After delivering one shock, what is the immediate next step?
- Check pulse for 10 seconds
- Resume CPR immediately for 2 minutes (Correct answer)
- Deliver a second shock
- Administer epinephrine IV
Correct answer: Resume CPR immediately for 2 minutes
After defibrillation, CPR should be resumed immediately for 2 minutes before rechecking rhythm, as early compressions improve post-shock outcomes.
Paramedics Exam Pediatric Emergencies 3
A 9-month-old infant has a respiratory rate of 65 breaths/min, nasal flaring, and subcostal retractions.
What is the most likely diagnosis?