1) You have been unsuccessful in your basic airway procedures to remove a foreign body airway obstruction in a 12-month-old child. Which of the following should be the next intervention? A) Surgical cricothyrotomy B) Positive pressure ventilation with a manually triggered, flow-restricted, oxygen-powered ventilation device C) Direct laryngoscopy, removing the object with Magill forceps if it is visualized D) Needle cricothyrotomy 2) Your patient is a 16-year-old female cheerleader who fell while attempting a pyramid formation and struck her forehead on the back of another girl’s head. She has a 2-cm laceration just above her right eyebrow. She is tearful and asks you if you think she is going to have a scar. Which of the following is the best response? A) “It’s a small cut. They’ll do everything they can at the emergency department to minimize scarring.” B) “I really can’t say. You should probably see a plastic surgeon as soon as possible.” C) “You probably won’t even notice it when you grow up.” D) “It’s likely, but it’s not something to get upset about.” 3) Which of the following is NOT part of the pediatric assessment triangle when forming your general impression of the patient’s condition? A) Blood glucose level B) Breathing C) Appearance D) Circulation 4) When selecting an appropriately sized blood pressure cuff for a pediatric patient, which of the following guidelines will help you? A) The width of the cuff should equal the circumference of the arm. B) The width of the cuff should equal the distance from the antecubital fossa to the axilla. C) The width of the cuff should equal the length of the little finger. D) The width of the cuff should be 2/3 the circumference of the arm. 5) Your patient is a two-year-old male who has ingested approximately 30 tablets of children’s chewable acetaminophen tablets anywhere from 15 to 30 minutes before your arrival. He is awake and appears stable, but he is intermittently crying. You have a 20-minute transport time to the hospital. The child weighs 18 pounds. Which of the following would be the best prehospital treatment option for this child? A) Magnesium citrate, po B) Syrup of ipecac followed by 16 ounces of water; if vomiting ensues, follow with activated charcoal in a slurry with sorbitol C) Insertion of an orogastric tube, lavage with tap water until return is clear D) Activated charcoal mixed in a slurry with sorbitol 6) At which of the following ages does the risk of foreign body airway obstruction become a significant concern in the normally developing infant? A) three months B) 18 months C) one month D) six months 7) Your patient is a 14-year-old male who was struck by a vehicle while riding his ATV. He has bilateral open femur fractures and an unstable pelvis. He is lethargic, pale, cool, and diaphoretic. He lacks a palpable radial pulse but has a carotid pulse of 130 and respirations of 28. You estimate he weighs 110 pounds. Which of the following represents the best sequence of treatment for this patient? A) Intubate the trachea with in-line stabilization of the cervical spine, ventilate with 100 percent oxygen at a rate of 20 to 24 per minute, immobilize the patient to a long spine board, start two large-bore IVs of lactated Ringer’s solution, administer a 500-mL bolus, initiate transport, and reassess the patient’s hemodynamic status. B) Administer oxygen by nonrebreather mask, apply bilateral traction splints for the femur fracture, immobilize to a long spine board, initiate transport, start two large-bore IVs of isotonic crystalloid solution, infuse a 2000-mL bolus, and reassess the patient’s hemodynamic status. C) Assist the patient’s ventilations with a bag-valve-mask device and supplemental oxygen; immobilize the patient to a long spine board; initiate transport; start two large-bore IVs, one of normal saline and one of lactated Ringer’s solution, and rapidly infuse 200 mL of each; and reassess the patient’s hemodynamic status. D) Administer oxygen by nonrebreather mask, immobilize the patient to a long spine board, initiate transport, start two large-bore IVs of normal saline solution, infuse a 1,000-mL bolus, and reassess the patient’s hemodynamic status. 8) Your patient is a four-year-old child whom you have intubated due to respiratory failure secondary to asthma. During reassessment of the child, which of the following would indicate increased end-organ perfusion? 1. Pupillary dilation 2. capillary refill less than 2 seconds 3. increase in heart rate 4. Warm skin A) 1, 2, and 4 B) 3 and 4 C) 2 and 4 D) 2, 3, and 4 9) In which of the following ways can paramedics help identify the need for more pediatric services or specialized pediatric services in their areas? A) Transport all ill and injured children to specialized children’s hospitals B) Carefully document pediatric emergency calls C) Write to the editors of their local newspapers D) Participate in fund-raising events for their volunteer fire departments 10) Your patient is a 9-month-old male who was a restrained passenger in a motor vehicle collision. He was properly secured in his child safety seat at the time of the collision, but his mother has since taken him out of the seat and is holding him. Due to the significant mechanism of injury, you are going to provide spinal immobilization for the patient. You have found that you lack a cervical collar that fits him. Which of the following is the best way to immobilize this patient? A) Use the smallest cervical collar available, filling any voids between the collar and the patient with soft dressing material. Place him back in the car seat with padding behind his head. Place a towel roll on each side of his head. Use 2-inch tape across the front of the car seat to secure the towel rolls and the patient’s head. B) Place the child back in his car seat. Pad behind his shoulders and place a folded receiving blanket around the back of his neck like a scarf, crossing the ends in front to limit the range of motion of his neck. Place towel rolls on both sides of his head and tape across the front of the car seat, securing the towel rolls and the patient’s head. C) Secure a medium-length padded board splint to the patient’s spine, using self-adherent roller gauze to secure it to his body and tape to secure it to his head. With the splint in place, the mother can hold him on her lap to comfort him on the way to the hospital. D) Place the child on a long backboard with a folded towel under his shoulders and a 1,000-cc bag of saline on each side of his head. Place pillows on both sides of his body and use 2-inch tape, rather than straps, to secure the patient to the backboard. 1