Paramedics Exam Pediatric Emergencies 4 — Questions and Answers
Question 1: A 2-year-old presents with a barking cough and inspiratory stridor that worsens when crying. Symptoms began at night. What is the most likely diagnosis?
- Epiglottitis
- Foreign body aspiration
- Croup (laryngotracheobronchitis) (Correct answer)
- Pertussis
Correct answer: Croup (laryngotracheobronchitis)
Croup is characterized by a seal-like barking cough, inspiratory stridor, and symptom onset that is typically worse at night and aggravated by agitation.
Question 2: A 4-year-old is found choking and becomes unconscious. After opening the airway, you see a foreign object clearly visible in the mouth. What is the correct action?
- Perform a blind finger sweep
- Attempt to remove only if clearly visible (Correct answer)
- Deliver 5 back blows immediately
- Proceed directly to CPR without looking
Correct answer: Attempt to remove only if clearly visible
In a child, remove a foreign body only if it is clearly visible; blind finger sweeps are contraindicated as they may push the object deeper.
Question 3: A 7-year-old with type 1 diabetes is found unresponsive. You cannot establish IV access. What is the appropriate alternative treatment for hypoglycemia?
- Oral glucose gel rubbed on the gums
- Glucagon 1 mg IM (Correct answer)
- Dextrose 10% via nasogastric tube
- Normal saline 20 mL/kg bolus
Correct answer: Glucagon 1 mg IM
When IV access is unavailable in an unresponsive hypoglycemic patient, glucagon 1 mg IM is the alternative treatment to raise blood glucose.
Question 4: When assessing a pediatric patient, the Pediatric Assessment Triangle (PAT) evaluates which three components?
- Airway, Breathing, Circulation
- Appearance, Work of breathing, Circulation to skin (Correct answer)
- Mental status, Pulse, Respirations
- AVPU, Skin color, Capillary refill
Correct answer: Appearance, Work of breathing, Circulation to skin
The PAT rapidly assesses Appearance (tone, interactability), Work of breathing (effort, sounds), and Circulation to the skin (color, mottling) from across the room.
Question 5: A 5-year-old weighing 18 kg requires adenosine for SVT. What is the correct initial IV dose?
- 6 mg rapid IV push
- 0.1 mg/kg rapid IV push (max 6 mg) (Correct answer)
- 0.2 mg/kg slow IV push
- 1 mg/kg IV over 2 minutes
Correct answer: 0.1 mg/kg rapid IV push (max 6 mg)
Pediatric adenosine is dosed at 0.1 mg/kg (max 6 mg) for the first dose, given as a rapid IV push followed immediately by a saline flush.
Question 6: A 3-month-old infant is brought in by parents who report the baby 'stopped breathing' for 20 seconds before resuming on its own. This event is classified as:
- Sudden Infant Death Syndrome (SIDS)
- Brief Resolved Unexplained Event (BRUE) (Correct answer)
- Respiratory syncytial virus apnea
- Infantile seizure disorder
Correct answer: Brief Resolved Unexplained Event (BRUE)
A Brief Resolved Unexplained Event (BRUE) is defined as an episode in infants under 1 year involving apnea, color change, tone change, or altered responsiveness that resolves spontaneously.
Question 7: A 16-year-old presents with altered mental status, fever of 104°F, severe headache, and a petechial rash spreading across the trunk. What is the priority concern?
- Rocky Mountain spotted fever
- Meningococcal meningitis with septicemia (Correct answer)
- Toxic shock syndrome
- Dengue fever
Correct answer: Meningococcal meningitis with septicemia
Petechial or purpuric rash with fever, headache, and altered mental status is a classic presentation of meningococcal septicemia, a rapidly fatal emergency.
Paramedics Exam Pediatric Emergencies 4
A 2-year-old presents with a barking cough and inspiratory stridor that worsens when crying.
Symptoms began at night.
What is the most likely diagnosis?