Pedi Quiz Part 3

Your patient is a 13 year-old male drowning victim. He was initially in cardiac arrest with a pulseless, wide-complex bradycardia. He is intubated and being ventilated with supplemental oxygen. After CPR and intubation, the patient is now in ventricular tachycardia with a weak radial pulse. Which of the following would be an appropriate treatment for this patient?

• Synchronized cardioversion starting at 0.5-1.0 joules/kg

• Lidocaine, 3 mg/kg IV bolus, followed by a 3 mg/minute drip

• Procainamide, 20 mg per minute, up to 800 mg

• Amiodarone, 5 mg/kg IV push

Your patient is a toddler who was burned when he accidentally pulled the cord of a deep fryer sitting on a countertop and spilled hot oil on his head and back. He has burns to the back half of his head, as well as his entire back. What percentage of total body surface area does this account for?

• 36

• 27

• 18

• 40

Which of the following conditions does NOT cause an upper airway obstruction?

• Epiglottitis

• Bacterial tracheitis

• Asthma

• Croup

You have just arrived on the scene where an infant stopped breathing. You find a three-month-old child being held tightly by his mother, who is sobbing uncontrollably. On examination, you find that the child is apneic and pulseless and has dependent lividity and early rigor mortis. There are no obvious signs of injury. Which of the following is the best course of action?

• Begin CPR and continue BLS measures until you are inside the ambulance; notify the hospital that you are transporting a deceased SIDS infant.

• Gently tell the mother that the baby is dead and that there is nothing that can be done for him; allow her to hold him.

• Begin limited resuscitative measures, then contact medical control for orders to terminate resuscitation in the field.

• Tell the mother that the baby is dead but that you cannot allow her to hold him until the police verify that no crime has been committed.

Your patient is a seven-year-old girl with a history of bee-sting anaphylaxis. She was stung by a bee and nearly immediately began having difficulty swallowing and breathing. Her father administered her prescribed 0.15 mg epinephrine auto-injector without result. On your arrival, the patient responds to painful stimuli; has labored, rapid, wheezing respirations; a heart rate of 60; and a blood pressure of 92/60 mmHg. Which of the following is the best sequence of treatment for this patient?

• Administer only diphenhydramine IM

• Administer both epinephrine 1:10,000 and diphenhydramine intravenously

• Administer diphenhydramine IM and epinephrine 1:1,000 IV

• Administer only epinephrine 1:1,000 PO

You are delayed getting to a residence where a 16-month-old boy is actively seizing. The mother reports that he has had a fever for the past two days. A firefighter on scene informs you that the child has been seizing since their arrival approximately 15 minutes ago. You should:

• actively cool the child with ice packs to the groin and axilla.

• actively warm the child with blankets.

• apply oxygen, administer fluids, and transport.

• apply oxygen, administer intranasal midazolam, and transport.

A woman has called 911 after not being able to wake her eight-year-old son. Upon arrival, the mother tells you that her son is a diabetic, and that his diabetic alert dog awoke her in the night indicating the child's blood sugar was low. You perform a blood glucose check and find that your glucometer reads 28 mg/dL. You should:

• administer IV dextrose at 30% concentration.

• administer 1 mg of IV glucagon.

• administer IV dextrose at 25% concentration.

• administer 1 mg of IM glucagon.

Which of the following would constitute child neglect?

• Buying a child clothing only from thrift stores

• Failing to properly bathe a child on a regular basis

• Denying a 9-year-old access to electronics as a form of punishment

• Spanking a 5-year-old as a form of punishment

Which of the following describes the Moro reflex in the infant?

• The infant's hand grasps an object placed in the palm of the hand.

• When the infant's cheek is stroked, he turns his head in that direction.

• When startled, the infant throws his arms out wide, then grasps with the fingers and arms.

• When the infant's lips are touched, he makes sucking motions.

Atropine is used in

• A- Fib

• SVT

• V-Fib

• Bradycardia