NAEMT Pediatric Exam Practice

Scenario 1: Upper Airway Obstruction (Infant) You are called to a daycare for a 6-month-old infant who suddenly began choking while eating small cracker pieces. The infant is conscious, alert, crying weakly, and has an ineffective cough. Which action is the most appropriate initial treatment modification for this age group?

• Perform 5 abdominal thrusts.

• Perform the head-tilt, chin-lift maneuver.

• Deliver 5 back blows followed by 5 chest thrusts.

• Begin chest compressions.

Scenario 2: Lower Airway Reactive Disease (Toddler) A 3-year-old child presents with a 2-day history of wheezing, non-productive cough, and increased work of breathing. The child is tachypneic, using accessory muscles, and has bilateral expiratory wheezes. What is the most appropriate treatment modification for this suspected lower airway reactive disease?

• Apply a non-rebreather mask at 15 L/min.

• Administer nebulized Albuterol.

• Attempt endotracheal intubation.

• Perform needle decompression.

• Normal.

• Compensated.

• Decompensated.

• Increased work of breathing.

Tags

NGSS.HS-LS1-3

Scenario 4: Respiratory Failure (Adolescent) A 16-year-old patient with cystic fibrosis presents with a profoundly altered mental status, minimal chest wall movement, and a heart rate of 55 beats/min. The skin is cyanotic. This patient is most likely progressing from respiratory distress to respiratory arrest. What is the most immediate critical treatment?

• Deliver continuous positive airway pressure (CPAP).

• Initiate positive pressure ventilation via bag-valve mask (BVM).

• Administer nebulized Racemic Epinephrine.

• Transport immediately without intervention.

Scenario 5: Croup (Toddler Assessment) A frantic mother reports her 2-year-old has a sudden onset of a "seal-bark" cough and stridor when crying. The child is visibly distressed but has a normal color and is interactive. According to age-related assessment findings, the stridor indicates:

• Lower airway obstruction.

• Complete foreign body obstruction.

• Significant upper airway obstruction.

• Severe heart failure.

Scenario 6: Upper Airway Foreign Body (Child) A 5-year-old child is eating a piece of candy and suddenly becomes unable to speak. The child is panicking and turning cyanotic. Based on age-related treatment modifications, which intervention is most appropriate?

• Abdominal thrusts (Heimlich maneuver).

• Back blows and chest thrusts.

• Blind finger sweep of the mouth.

• Head-tilt, chin-lift and BVM ventilation.

Scenario 7: Epiglottitis (Adolescent Assessment). A 14-year-old presents with a high fever, sudden sore throat, muffled voice, and is drooling while sitting upright and refuses to lie down. You suspect epiglottitis. The most appropriate modification to your assessment and treatment is to:

• Immediately examine the throat with a tongue depressor to confirm.

• Place the patient in the position of comfort and avoid any action that may agitate them, such as inserting an OPA/NPA.

• Vigorously suction the mouth to manage drooling.

• Administer a nebulized bronchodilator.

Scenario 8: Bronchiolitis (Infant Age Consideration). You are assessing a 9-month-old infant with profuse clear nasal discharge, a temperature of 101.5°F, and diffuse crackles/wheezes. The most common cause of lower airway reactive disease at this age (bronchiolitis) is:

• Bacterial pneumonia.

• Respiratory syncytial virus (RSV).

• Aspirated foreign body.

• Severe allergic reaction.

Scenario 9: Respiratory Distress Management (Neonate). A newborn (neonate) in the delivery room has slow, gasping respirations. The heart rate is 70 beats/min. What is the initial ventilatory intervention modification for this age?

• Deliver positive pressure ventilation (PPV) at a rate of 12–20 breaths/min.

• Deliver PPV at a rate of 40–60 breaths/min.

• Apply a non-rebreather mask and transport.

• Perform endotracheal intubation immediately.

Scenario 10: Respiratory Arrest Confirmation (Assessment). Which of the following assessment findings in a pediatric patient is the most reliable indicator of impending or actual respiratory arrest?

• Mild wheezing and stridor.

• Clear lung sounds and mild tachypnea.

• Bradycardia and a severely decreased level of consciousness.

• Inspiratory retractions and mild restlessness.