Module 7 Test

What does the umbilical cord do?

carries oxygen to the infant via the umbilical vein

Which of the following is a sign of imminent birth in the next few minutes?

Crowning

Identify the first stage of labor

Contractions to crowning

Identify the second stage of labor

crowning to delivery of infant

Identify the third stage of labor

delivery of infant to delivery of placenta

You are delivery a newborn and see this (bloody head that is sideways) - you should:

Apply firm downward pressure on the outside of the head with your finger

You are delivering a newborn and see this (cord around neck). You should FIRST:

Attempt to manipulate the cord off the neck

You are delivering a newborn and see this. (head protruding/crowning, facing down) You should FIRST:

Apply gentle pressure to the top of the head to prevent explosive delivery

Which fetal age corresponds to an embryonic fetus that is only a few layers of cells thick and no organs?

5 weeks

Which fetal age corresponds to a uterus that is roughly at the level of the bellybutton?

20 weeks

What fetal age corresponds to an infant that is head-down and a mother that experiences Braxton-Hicks contractions?

36 weeks

What makes women in late-stage pregnancy breathe shallow and often quickly?

Upward pressure on the diaphragm makes large breaths difficult

What does PRIMIGRAVIDA mean?

First pregnancy

When a patient is referred to as Gravida 4 para 2, that means:

She has been pregnant 4 times, but only carried 2 infants to a viable age of birth

What is a typical time for a primigravida to spend in the first stage of labor

16 hours

As the time of birth approaches, the contractions will

Increase in frequency and intensity

After the fetus has descended into the pelvis at the end of the third trimester, many mothers experience:

easier breathing.

Preeclampsia MOST commonly occurs after the ____ week of gestation.

20th

Eclampsia is MOST accurately defined as:

seizures that result from severe hypertension.

What happens causes a late-stage pregnant woman to get diaphoretic and hypotensive when laid supine?

Pressure of the uterus on the inferior vena cava inhibiting blood flow back to the heart

What is it called when the placenta develops over the cervical opening?

Placenta previa

What is it called when a cord is wrapped around a newborn's head?

Nuchal cord

Meconium is material from the fetus' GI tract. The presence of it in the amniotic fluid makes you suspect:

The fetus may have airway obstruction

During delivery of the baby's head, you should suction the mouth before the nose because:

suctioning the nose first may cause the baby to gasp and aspirate fluid.

This age is characterized by no speaking, no stranger anxiety, and a preference for parents or care-givers

Infant

This age is characterized by associating injury with punishment and anxiety over being separated from parents/caregivers

Toddler

This age is characterized by boundry-testing, needing to be interviewed in private, and wanting to not be observed during procedures.

Adolescent

What is are appropriate vitals for newborns?

Breathing 40-60; Heart rate 110-180

What are appropriate vitals for adolescents?

Breathing 12-20; Heart rate 60-100

Compared to an adult, the diaphragm dictates the amount of air that a child inspires because the:

intercostal muscles are not well developed.

The Pediatric Assessment Triange (PAT) allows you to effectively perform a ___________ in a pediatric patient.

General impression

Which is NOT an element of the Pediatric Assessment Triangle (PAT)?

Airway

(options: appearance, work of breathing, circulation)

Capillary refill time is MOST reliable as an indicator of end-organ perfusion in children younger than:

6 years.

Strategies when communicating with older adults include:

Have only one EMT speak to the patient at at time

Stress in elderly patients can often be caused by all of the following except:

Keen understanding of the healthcare system and how it works

In thinking about trauma in the elderly, the EMT should remember that:

Elderly patients often have trauma triggered by medical events such as syncope

Because of the complexity of the older patient and the vagueness of his or her complaint, you should:

attempt to differentiate between chronic and acute problems.

Since older patients often fear being admitted to a hospital, they may:

Understate how severe their symptoms are

An altered mental status is a normal part of aging and should not be considered remarkable during physical exam.

False

An important part of determining altered mental status in the elderly patient is to:

Establish the patient's baseline mental status from family or caretakers

The elderly may not display tachycardia during shock the way an older patient would because

The shock response may be bluntened by anti-hypertensive medication

An older patient with significant dehydration would MOST likely present with:

dizziness or fainting upon standing.

Which of the following patients is at highest risk for a pulmonary embolism?

71-year-old male with recent surgery to a lower extremity

In contrast to younger patients, older patients are more prone to a decrease in blood pressure upon standing because:

the baroreceptors have become less sensitive to blood pressure.

A "silent" heart attack occurs when:

the usual chest pain is not present.

The EMT should suspect left-sided heart failure in the geriatric patient who presents with:

tachypnea and paroxysmal nocturnal dyspnea.

When assessing a 78-year-old female who complains of shortness of breath, the EMT should:

ask her how many pillows she uses when she sleeps.

What is the most important piece of information when treating an ischemic stroke patient?

The best estimate possible of time of the start of symptoms

A 10% to 20% reduction in brain weight and volume would MOST likely increase an older person's risk for:

head trauma

Clouding of the lenses of the eyes is called:

cataracts.

When caring for an elderly patient who is hearing-impaired, you should:

recall that elderly patients have difficulty hearing high-frequency sounds.

Syncope in the older patient is:

caused by an interruption of blood flow to the brain.

Which of the following is a potential cause of aortic aneurysm?

Hypertension

A palpable pulsatile mass in the abdomen is a suspicious finding for what condition?

aortic aneurysm

What is the clinical term for the 'humpback' spinal curvature seen in elderly patients?

Kyphosis

Osteoporosis is MOST accurately defined as:

a decrease in bone mass and density.

Upon arriving at the residence of an elderly female who apparently fainted, you find the patient lying supine on her living room floor. She is not moving and her eyes are closed. A neighbor tells you that she found the patient this way, but did not move her. When you gently tap the patient, she does not respond. You should:

direct your partner to manually stabilize her head while you quickly visualize her chest for signs of breathing

Fractures of the pelvis in older patients often occur as the result of a combination of:

osteoporosis and low-energy trauma.

Which of the following is NOT an anatomical/physiological difference in a child compared to an adult?

A more calcified and rigid bone structure

(options: proportionally larger head and tongue, and faster pulse and breathing rates)

The main reason for using pediatric AED pads is to:

Deliver lower energy amounts

Which of the following appliances is a tube in the neck through which the patient breathes?

Trachiostomy

Which of the following appliances is a tube through which excess cerebrospinal fluid is drained into the abdomen?

Ventricular Peritoneum Shunt

Which of the following is a simple hole in the neck without a tube, often seen after laryngectomy?

Stoma

You are resuscitating an infant and when you place the patient supine this happens - you should:

Place a towel under the back

Which of the following is NOT a symptom of imminent delivery?

Intense headache

(options: sudden discharge of fluid of birth canal, contractions of the uterus, the urge to move one's bowels)

Which is the most characteristic feature of autism?

Impaired social interaction

Which is the most characteristic feature of Down's Syndrome?

"Moon Face" appearance with round head and flat occiput

Which is the most characteristic feature of cerebral palsy?

Brain injury or impaired development affecting muscle movement, tone and control

Which of the most characteristic feature of Attention Deficit Disorder?

Hyperactivity, impulsiveness and inability to focus

What is the most common reason for a patient to receive a Left Ventricular Assist Device (LVAD)?

To assist a failing heart until a transplant can be obtained

Which of the following is a tube inserted into the stomach through which nutrition is provided?

gastrostomy

Which of the following is a tube inserted into the bladder that allows urine to drain into a bag?

Foley catheter

Due to a relatively larger body-surface-area-to-mass ratio, children are more prone to

Hypothermia

An infant appears indifferent to your examination, lying passive and quiet. What does this tell you about the infant?

She is likely to be very ill

Which of the following is an early sign of hypoperfusion in a child?

Delayed capillary refill

Pale skin; vasoconstriction may diminish blood flow to extremities; signs include pulses weak in extremities, bad cap refill and cool hands or feet

What is the number one killer of children over 1 year of age?

Trauma

Infants naturally breathe through their

Nose

In assessing a child's circulation, a capillary refill greater than ______ seconds suggests hypoperfusion

2 seconds

When a child (versus an adult) sustains significant blunt trauma to the chest, the most likely injury is

Underlying lung and pleural injury

Which of the following is much more common in pediatric, rather than adult, head injuries?

vomiting

Seizures in children are most often caused by:

Rapidly rising high body temperatures

A child who is being transported for a fourth fall in 2 weeks, resulting in two broken arms, should be evaluated for:

Child abuse

An EMT is evaluating a child who fell out of bed. She notes numerous bruises of a variety of stages on the child's back and limbs. What should she do about this observation?

Document it & make ER doctor aware of the finding

Which of the following positions would result in extremely difficult breathing for a severely obese patient to be in?

Supine

The use of multiple prescription drugs causing the potential for negative effects such as overdosing or interaction is:

polypharmacy.

A productive cough, fever, and chills in an 80-year-old patient with a compromised immune system should make you MOST su

pneumonia.

Death caused by shaken baby syndrome is usually the result of:

bleeding in the brain.

Greenstick fractures occur in infants and children because:

their bones bend more easily than an adult's.

The pediatric patient should be removed from the car seat and secured to an appropriate spinal immobilization device if:

the car seat is visibly damaged.

When inserting an oropharyngeal airway in an infant or child, you can:

depress the tongue with a tongue depressor.

What is the hallmark sign of epiglottitis?

Drooling

What is the hallmark sign of croup?

Seal-like barking cough

When documenting a case of suspected elder abuse, it is MOST important for the EMT to:

avoid documenting any unsupported opinions.

Many older victims of physical abuse may make false statements or lie about the origin of their injuries because:

they fear retribution from the abuser.

Poor maintenance of home, poor personal care, and poor diet are all possible indicators of elder ___________:

neglect

In contrast to a living will, a "do not resuscitate" (DNR) order becomes valid when:

the patient develops cardiac arrest.

Patients who have experienced even minor-appearing head injuries should be suspected of having a brain injury if:

are taking blood-thinning medications

Fractures of the pelvis in older patients often occur as the result of a combination of:

osteoporosis and low-energy trauma.

When performing your secondary assessment on an older patient who has been injured, it is important to:

recall that it will take a less severe mechanism of injury to cause significant injuries.

Which of the following is the MOST common mechanism of injury in older patients?

falls