AEMCA Pediatric Emergencies 4

Question 1

A 10-month-old presents with a 3-day history of vomiting and diarrhea. Signs include sunken fontanelle, dry mucous membranes, absent tears, and capillary refill of 4 seconds. What level of dehydration does this represent?

Accepted Answer

Severe (>10% body weight loss)

Answer

Severe dehydration (>10% body weight loss) presents with multiple systemic signs including prolonged capillary refill, sunken fontanelle, and hemodynamic compromise.

Question 2

A 6-year-old is struck by a car. On assessment, you note absent breath sounds on the left, tracheal deviation to the right, distended neck veins, and hypotension. What intervention is immediately required?

Accepted Answer

Needle thoracostomy on the left side at the second intercostal space, midclavicular line

Answer

These findings are classic for tension pneumothorax; immediate needle decompression on the affected (left) side relieves the life-threatening pressure.

Question 3

Which of the following signs is most consistent with increased intracranial pressure (ICP) in a pediatric trauma patient?

Accepted Answer

Hypertension, bradycardia, and irregular respirations (Cushing's triad)

Answer

Cushing's triad (hypertension, bradycardia, irregular respirations) is a late and ominous sign of severely elevated ICP indicating impending herniation.

Question 4

A 4-year-old with a history of asthma presents with severe respiratory distress, diffuse wheezing, accessory muscle use, and SpO2 of 89%. After two albuterol treatments, minimal improvement is noted. What medication should be considered next?

Accepted Answer

Ipratropium bromide nebulized

Answer

Ipratropium bromide (an anticholinergic) is added to albuterol for moderate-to-severe pediatric asthma exacerbations unresponsive to initial beta-agonist therapy.

Question 5

When assessing the AVPU scale in a 2-year-old, the child responds only to painful stimuli by withdrawing. What AVPU level does this represent?

Accepted Answer

Pain (P)

Answer

Response only to painful stimuli places the child at the 'P' (Pain) level on the AVPU scale, indicating significant neurological compromise.

AEMCA - Advanced Emergency Medical Care Assistant Practice Test

AEMCA - Advanced Emergency Medical Care Assistant Practice Test

AEMCA Pediatric Emergencies 4