Paramedics Exam Special Patient Populations 4 — Questions and Answers
Question 1: When calculating pediatric drug doses in the field, the MOST reliable method is to:
- Estimate weight based on the child's apparent age
- Use a length-based resuscitation tape (e.g., Broselow tape) (Correct answer)
- Ask the caregiver for the child's last recorded weight
- Use the formula: weight (kg) = age × 4
Correct answer: Use a length-based resuscitation tape (e.g., Broselow tape)
The Broselow tape provides weight-based dosing and equipment sizing directly correlated to the child's measured length, minimizing dosing errors.
Question 2: A 34-week pregnant patient develops generalized tonic-clonic seizures. After securing the airway, your next priority is:
- Administer IV dextrose to rule out hypoglycemia
- Administer IV or IM magnesium sulfate (Correct answer)
- Perform rapid delivery in the field
- Administer IV lorazepam for seizure control
Correct answer: Administer IV or IM magnesium sulfate
Magnesium sulfate is the first-line treatment for eclamptic seizures in pregnancy because it addresses the underlying pathophysiology.
Question 3: Which pediatric age group is at GREATEST risk for submersion injury due to their developmental stage?
- Newborns (0–1 month)
- Toddlers (1–4 years) (Correct answer)
- School-age children (6–12 years)
- Adolescents (13–17 years)
Correct answer: Toddlers (1–4 years)
Toddlers are at highest risk for drowning because they are mobile, curious, and lack the judgment to avoid water hazards.
Question 4: An older adult patient tells you she 'falls a lot lately.' Beyond the current injury, what assessment finding would MOST concern you for elder abuse?
- Osteoporotic compression fractures on prior imaging
- Multiple bruises in various stages of healing on the torso (Correct answer)
- Mild lower extremity edema bilaterally
- Pupillary asymmetry from a remote traumatic brain injury
Correct answer: Multiple bruises in various stages of healing on the torso
Multiple bruises in various stages of healing, especially on protected body areas, are a red flag for elder abuse rather than accidental falls.
Question 5: When managing an obese patient requiring IV access, which site should be considered if peripheral access fails?
- External jugular vein or intraosseous route (Correct answer)
- Femoral vein via blind landmark technique
- Subclavian vein using standard landmarks
- Central venous access via internal jugular
Correct answer: External jugular vein or intraosseous route
The external jugular vein or intraosseous route are appropriate prehospital alternatives when peripheral IV access fails in obese patients.
Question 6: A 3-year-old ingested an unknown number of iron tablets. Which finding would indicate systemic iron toxicity?
- Vomiting with bloody diarrhea progressing to lethargy and shock (Correct answer)
- Bradycardia with hyperthermia and dry skin
- Miosis with excessive secretions and bronchospasm
- Agitation with hyperthermia and hallucinations
Correct answer: Vomiting with bloody diarrhea progressing to lethargy and shock
Iron toxicity classically progresses through GI hemorrhage followed by a latent phase, then systemic toxicity with metabolic acidosis, shock, and multiorgan failure.
Question 7: During delivery, after the head delivers, you note the cord is wrapped tightly around the neck and cannot be slipped over. The correct action is:
- Apply gentle downward traction to complete delivery quickly
- Clamp and cut the cord before delivering the shoulders (Correct answer)
- Have the mother stop pushing and wait for the next contraction
- Attempt to somersault the baby under the cord
Correct answer: Clamp and cut the cord before delivering the shoulders
A tight nuchal cord that cannot be reduced should be double-clamped and cut to allow safe delivery of the shoulders.
Paramedics Exam Special Patient Populations 4
When calculating pediatric drug doses in the field, the MOST reliable method is to: