Get All Weeks Emergency Care: Pregnancy, Infants, and Children Coursera Quiz Answers
Week 01: Emergency Care: Pregnancy, Infants, and Children Coursera Quiz Answers
Quiz 01: Did You Read The Course Info Above?
Q1. Based on what you just read, where can you find additional resources that provide a framework for evaluation of the pediatric patient with a problem like respiratory distress?
- As a link from the required activities
- In the course resources
- As part of the skills video
- In the required reading
Quiz 02 :Pregnancy, Labor, and Delivery Assessment
Q1. Answer questions 1-5 based on the following scenario:
You are dispatched to a patient who is pregnant and having abdominal pain.
It’s been a while since you had a call with a pregnant patient so on the way to the call you review with your partner some of the problems encountered in pregnancy. Which of the following are true? Choose 2 answers
- Bleeding from placenta previa can be encountered in any trimester
- Abruptio placentae most commonly causes bleeding in the third trimester
- Preeclampsia can occur in the first trimester
- Ectopic pregnancy is usually a problem encountered in the second trimester
Q2. The scene is safe and you have put on your BSI. When you arrive to the scene you find an obviously pregnant female. She is alert, appears anxious and is able to introduce herself in complete sentences without problem. Her radial pulse that you check on arrival is strong and regular. ABC’s are intact and you decide to continue with history. She states she has been pregnant 3 times and has two children and she is 32 weeks pregnant.
If you were to describe this woman’s pregnancy history, you would say that she is gravida (G) _____ para (P) ________
Use this G___P___ or Gravida ___ Para ____ formats when answering this question.
Q3. When you go on to your exam, what vital sign differences would you expect to see in any pregnant patient at 32 weeks? Choose 2 answers
- Decreased blood pressure
- Increased respiratory rate
- Normal heart rate
- Increased heart rate
- Increased blood pressure
Q4. On further history and exam you learn the following notable things (complete SAMPLE and OPQRST not included). She has had some mild abdominal pain that is primarily located in the upper abdomen. She reports this hasn’t happened in past pregnancies. The pain started 2 days ago. It is dull and constant. Nothing seems to change it. It is associated with a headache. She has a history of preecclampsia with her past pregnancy and has had normal check ups with this pregnancy. She does not have any other past medical history. She has still been feeling the baby move. On exam she has a uterus that is palpable about 2 inches below the xyphoid. She has edema to her lower legs. Her vitals are as seen: blood pressure 150/90 heart rate 104 respiratory rate 22.
Based on the above information, what is your assessment of this patient?
- Imminent delivery, prepare for delivery on scene
- Active labor but time to transport to the hospital
- Patient is likely not in labor but should be transported
- Braxton Hicks contractions. Provide reassurance
Q5. On the way to the hospital the patient starts to seize. Given the history and exam, the patient likely has ______________
- Protect the person from injury. Keep them from falling if you can, or try to guide the person gently to the floor.
- Do not force anything, including your fingers, into the person’s mouth.
- Do not try to hold down the person.
- Provide a safe area where the person can rest after the seizure.
Q6. Answer questions 6-10 based on the following case
Dispatched to 21 yo female who is pregnant with unknown due date. She is complaining of abdominal pain and back pain. She has not been getting routine prenatal care and reports she might be “6 or 8” months pregnant. She looks uncomfortable and the pain seems to be coming in waves. She is awake and answering questions. Her breath sounds are clear and her radial pulse is strong and regular
What additional symptoms or signs would suggest the patient is probably in the first stage of labor? Choose 2 answer
- Mother is G5P4
- Contractions every 2-3 minutes lasting 60 seconds
- Gush of fluid
- Overwhelming sensation to pus
Q7. As you observe the patient and time her waves of pain, it seems that they are coming every 3 minutes and last about 90 seconds each. Your OPQRST questions on cut short when she yells that she thinks the baby is coming soon.
You decide you need to estimate how far along she is in her pregnancy. To do this you palpate the top (fundus) of the uterus. Which of the following findings would suggest she is actually close to a term pregnancy (38-40 weeks)
- It is palpable at the level of the umbilicus
- It is palpable at the level of the xiphoid
- You cannot palpate the fundus
- It is palpable half way between the umbilicus and xiphoid
Q8. The patient reported she has been pregnant 5 times including this one and has delivered 4 children. She thinks she is about to deliver the baby and when you do a quick visual evaluation of her perineum it appears to bulge with each contraction. You prepare to deliver at the scene and call for ALS back up.
Put the following steps in order for the expected delivery (this is not all the steps)
- Put on PPE and create a clean field around area for delivery with blankets and drapes from OB kit
- Deliver the lower shoulder
- Place a hand on the bony prominence of the head when is seen at the vaginal opening
- Deliver the upper shoulder
- Look for a nuchal cord
Q9. If during the delivery the upper shoulder seems to get stuck. The first maneuver to attempt is?
- Have the mother push harder
- Gently pull the baby from the birth canal
- Have the mother pull her knees apart and toward her chest
- Have the mother get on her hands and knees
Q10. You successfully deliver the baby on scene. The baby is placed on the mothers stomach and dry the baby and stimulate it. You cut the cord after applying clamps and about the time the placenta delivers ALS arrives. Mom and baby seem to be doing well and an external exam of the vagina doesn’t reveal any sites of bleeding. After placental delivery however the mother continues to bleed significantly.
The ALS crew decides to bring you to the hospital with the patient for an extra set of hands. What is the most important intervention for treating postpartum hemorrhage in this patient besides initiating rapid transport
- Pack gauze at the opening of the vagina
- Look for lacerations internally
- Find the fundus of the uterus and massage with firm pressure
- Place the patient in trendelenburg
Week 02: Emergency Care: Pregnancy, Infants, and Children Coursera Quiz Answers
Quiz 01: Neonatal Care and Pediatric Basics Assessment
Q1. You are dispatched to a 23 yo female in labor. You arrive on the corner of 2 residential streets where the dispatcher just talked a father through helping his wife deliver their son. The scene is safe, you put on you PPE and approach the scene to find the father holding the newly born child with the cord still attached. You have your OB and pediatric kits and you quickly get the cord clamps out, a blanket and a baby warmer. The father reports the baby was at 38 weeks today. You notice the baby isn’t crying and looks a little cyanotic but seems to have good tone.
Based on this initial evaluation, what are your initial steps based on the neonatal resuscitation protocol (NRP)? Choose all that apply
- Check a pulse
- Warm and stimulate the baby
- Place the baby with mom and dry him
- Suction the airway if there seem to be secretions there
Q2. As you continue the resuscitation, you find the pulse to be 70. What is the next intervention on the algorithm?
- Begin chest compression
- Provide blow by oxygen
- Provide positive pressure ventilation
- Stimulate the child- flick feet, dry them
Q3. After these interventions, the child starts to cry, becomes more pink and you transition into post resuscitation care.
When you reflect on the case you realize there were a couple of things you wish you had done to take some of the panic out of managing the case. Choose all that apply
- Review NRP on the way to the call
- Review your pediatric equipment routinely
- Just get these kids- especially the small ones- to the hospital faster
- Memorize all the steps so you don’t have to reference anything
Q4. On your next call, you are dispatched to a 12 month old (one year old) with a breathing problem.
You are reviewing your pediatric vitals on the way to the call. What would be a concerning systolic blood pressure to get in this child based on their reported age?
Q5. As you think about your pediatric assessment triangle, which of the following is/are true? Choose all that apply
- If one or more sides of the triangle are abnormal you should start transporting to the hospital before anything else
- The appearance of the child includes an assessment of their alertness, how they track you
- Respiratory distress is demonstrated by retractions, respiratory rate, and sound of breathing
- To check their circulation correctly, you will have to check their pulse
Q6. Based on developmental milestones, what is the most advanced milestone you would expect this child to demonstrate?
- Pincher grasp
- Rolling over
- Sitting up
- Walking with assistance
Q7. On arrival to the scene you make sure the scene is safe and you put on your BSI. As you get closer, you notice the child is sitting on the floor with parents. He is sitting upright and leaning forward a little bit. He looks up at you when you walk in but doesn’t seem very interested. As you watch him, he is breathing 50 times per minute and his head is bobbing a little. He is fully dressed but appears slightly pale. He is not cyanotic. He starts to cry a little as you get closer and you notice stridor and increased work of breathing when you approach and he gets more agitated.
Which of the following are signs of respiratory distress in this scenario? Choose all that apply
- Respiratory rate
- Head bobbing
Q8. Watch the following video and answer questions 8 and 9.
How would you assess this child on the pediatric assessment triangle?
- A: normal B: abnormal C: normal
- A: abnormal B: normal C: abnormal
- A: normal B: normal C: abnormal
- A: abnormal B: abnormal C; abnormal
Q9. From watching the previous video on question 8. What is the patient’s respiratory rate (best estimate since clip is not 1 minute)?
Q10. Which of the following are true regarding the secondary assessment on a child? Choose all that apply
- The exam should be done on a flat surface, seldom in caretaker’s arms
- Explain what you are doing so the parents understand what you are doing next
- Modify the order of your exam to maximize your ability to evaluate the child
- For children under the age of about 18 months, checking the fontanelle should always be included
Week 03: Emergency Care: Pregnancy, Infants, and Children Coursera Quiz Answers
Quiz 01: Pediatric Pathology and Intervention Assessment
Q1. You are dispatched to a 2 year old with trouble breathing.
On your way to the call you review with your partner a few key points for management of the pediatric airway. Which of the following is true? Choose all that apply
- The appropriately sized OPA is estimated by the distance from the corner of the mouth to the earlobe
- A respiratory rate of 40 for a 2 year old would be in the normal range
- The appropriately sized mask should cover from even with the eyebrows to just below the lower lip
- Use the entire volume of a pediatric BVM when bagging a pediatric patient
Q2. When you arrive on scene, the scene is safe and you bring in your pediatric kit. Upon performing your pediatric assessment triangle you notice the following things:
A: Patient looks distressed and anxious, she is looking around and notices when you come in.
B: She is not making any noise, she is sitting forward, looks like she is trying to cough but seems unable. She has retractions at her neck that you can see across the room.
C: She has normal color in her face, you can’t see anything else from the door.
The family states this started suddenly about 3 minutes ago while she was eating grapes for lunch. They state she was initially coughing really hard but just stopped making noise. Your next steps include(s)? Choose all that apply
- Introduce yourself and let the child know what you are about to do
- Perform abdominal thrusts with your fist above the umbilicus and sharp inward and upward movements
- Check the 5 rights and then administer albuterol
- Perform chest compression at a rate of 30:2 compression to breaths, checking for foreign body between each 30 compression
Q3. What if, instead of the story in question 2, the family reports the child developed initial symptoms while eating lunch and having peanut butter for the first time. They report she initially was coughing and when the mom looked in her mouth her tongue looked swollen. The father then lifts her shirt and shows a diffuse rash on her trunk. After placing the child on a non-rebreather at 15 L, based on this presentation you would perform which (one) of the following next?
- Put the patient in the ambulance and transfer to the hospital as quickly as possible
- Contact online medical direction for permission to administer epinephrine IM
- Protocol allows for administration of epinephrine. Check the 5 rights and administer 0.3 mg of epinephrine intramuscular
- Contact online medical direction for permission to administer albuterol inhaled
Q4. Your next call you are dispatched to the scene of a highway speed motor vehicle accident. The patient you are responsible for is a 5 year old male. He was restrained appropriately in his car seat. There is significant damage to the car on the side he was restrained. The driver of the car is unconscious and a rapid transport to the hospital. Your pediatric assessment triangle reveals: A: child is awake and crying, he answers when you ask him what his name is and is able to tell you his is 5, you observe him to move each of his extremities while you approach B: he is breathing about 40 times per minute that persists even when he is not crying. C: he appears slightly pale, there are no signs of external hemorrhage.
Some of the special considerations in children with respect to trauma include which of the following? Choose all that apply
- Since the bones are more flexible and don’t break, there tend to be fewer underlying injuries to the organs
- The proportionally larger head predisposes the child to increased head injuries
- The presence of a normal blood pressure for this child is not necessarily reassuring
- You should place the child into full spinal immobilization even if they really fight it
Q5. On your rapid trauma assessment, the patient’s airway is intact, he is breathing spontaneously. He has delayed capillary refill of about 3-4 seconds. He is moving everything and on exposure he does not have any signs of bruising but does say his stomach hurts. His vitals are as follows: Blood pressure: 88/50, respiratory rate: 30, and pulse: 130.
What is your general impression of this patient?
- Stable for now, continue with secondary survey on scene
- Compensated shock, continue with secondary survey on scene
- Compensated shock, rapid trauma transport
- Decompensated shock, rapid trauma transport
Q6. The next call is to a 3 year old seizing. You arrive on scene and are met by a child who identifies herself as the sister at the door. There are 5 kids in the house and there seems to be general chaos but the scene appears safe. The child is on the floor with a woman who identifies herself as the foster mother in the living room and you can see an adult male in the kitchen talking to another child. Your doorway assessment triangle is as such: A; the child’s eyes are closed, he does not appear to have any ongoing tonic clonic activity. He appears to have slightly decreased tone but moves his arm away when the mother squeezes it. He does not open his eyes. B: He is intermittently crying but he does not appear to have any respiratory distress, breathing is slightly irregular but about 34 times per minute while crying C: he appears pale but not cyanotic, you don’t appreciate any mottling of the extremities.
Using the AVPU assessment tool, what is this patient’s score at most? Using pediatric GCS?
- AVPU= A, GCS= 15
- AVPU = V, GCS = 13
- AVPU= P, GCS= 9
- AVPU=U, GCS=3
Q7. Your impression from your assessment triangle is that this patient is sick and needs rapid transport to the hospital and you call for ALS. The child’s airway is clear. He is breathing spontaneously and has a gag so you administer a 15L/min oxygen via a nonrebreather mask. His pulse is regular at 120. There is normal cap refill. Mother describes the child having a episode where he went unresponsive, had shaking of his upper and lower extremities and lost control of his bladder. She denies he has any other medical problems. Vaccines are up to date and she reports he has been this level of consciousness for about 45 minutes. She states her husband kept telling her he would “snap out of it” so she didn’t call right away.
For this to be considered a simple febrile seizure the following would have to be true? Choose all that apply
- The patient had/has a fever
- The child has a history of febrile seizures
- The child returns to baseline mental status
- The seizure lasted less than 15 minutes
Q8. Which features of this case/social situation also make this potentially suspicious for child abuse/ non accidental trauma as the etiology of the problem? Choose all that apply
- The foster mom left her diabetes medications out
- Age 3 or younger
- Foster child
- Delayed presentation
Q9. You are called a 10 month old infant with the diagnosis of a respiratory illness by the pediatrician 2 days ago who has had progressive trouble breathing since then. Today the child became less responsive to the family and they called 911. When you arrive the patient appears ill and has the following vital signs: 5 second capillary refill with, unable to auscultate a systolic blood pressure, respiratory rate of 70 and shallow, Heart rate of 60.
Based on having two responders present, your next steps should include?
- Deliver 2 positive pressure ventilations with an OPA or NPA and BVM
- Initiate single hand chest compressions at a rate of 100-120/minute
- Initiate chest compressions to a depth of ⅓ the diameter of the thorax using 2 fingers
- Place the patient on a nonrebreather mask for passive oxygenation for the first 2 minutes of compressions
Q10. You discover that you only have adult size AED pads. Which of the following are reasonable solutions?
- All ALS services have pediatric pads, have them bring theirs when they come
- Don’t use the AED, just transport to the hospital
- Place one pad on the anterior chest and one laterally as long as they don’t overlap
- Place one pad on the anterior chest and one on the posterior chest
Week 04: Emergency Care: Pregnancy, Infants, and Children Coursera Quiz Answers
Quiz 01: Other Things To Know As An EMT Assessment
Q1. You are with a paramedic partner and are evaluating a 65 year old male with abdominal pain after what you initially asses to be a moderate mechanism MVC. The patient states he has X insurance so his usual care is at a community hospital with a level IV trauma designation. His initial exam demonstrated mild abdominal tenderness and vitals were 120/80 with a heart rate of 88. (this is a very shortened version of your whole assessment).
When should you reevaluate this patient? Choose all that apply
- He becomes sweaty but denies any changes in his pain
- He reports he notices some right hip pain
- Minimum every 15 minutes given his age, complaint and vitals
- Minimum every 5 minutes given his age, complaint, and vitals
Q2. On routine reevaluation in the ambulance when starting to transport, you note the patient’s blood pressure is 100/60 and his heart rate is 100.
What factors should influence where you decide to transport this patient? Choose all that apply
- Location of the regional trauma centers
- Change in vitals
- What hospitals take the patient’s insurance
- Patient preference to go to his usual hospital
Q3. If you were to document the above the location of the pain you appreciate on palpation is part of the __________ portion of the narrative and the pain the patient describes in his abdomen is part of the __________ portion
- Subjective, Objective
- Subjective, Subjective
- Objective, Subjective
- Objective, Objective
You come across a patient at home with a device in place like the one in this photo. The patient states it was placed during a recent hospital admission to complete 6 weeks of antibiotics. She states they told her it is a long tube that goes through her veins to her heart. This is most likely?
- A Port
- A PICC (peripherally inserted central catheter) line
- A dialysis fistula
- A normal intravenous catheter
A limitation of this device for airway management is?
- There is not a port to suction the stomach
- It requires the use of a laryngoscope
- It does not protect the airway from blood or vomit if present
- It sits over/covers the larynx
Q6. You are dispatched to a motor vehicle collision on the highway. On your arrival you find a tanker has collided with a sports utility vehicle. Both drivers are out of their vehicles and walking around. There is a liquid substance that is draining from the tanker onto the road.
Your responsibility from a HAZMAT standpoint is usually going to be? Choose all that apply
- Recognize this is a potential hazmat situation
- Isolate the surround people from the area of the substance
- Notify the appropriate people according to your system
- Start to direct the clean up
Q7. Which of the following is/are true regarding patient extrication? Choose all that apply
- If it’s safe, You might be stabilize the cspine or providing other interventions in the vehicle before extrication
- Hybrid cars can be approached in the same way as regular cars for extrication
- In a complex extrication, the car is deconstructed around the patient
- If the car is off you don’t have to worry about the airbags
Q8. You go on a call with a patient who has a tracheotomy who has shortness of breath. After a full evaluation you hand the patient off to ALS providers for transport to the hospital. Which of the following would be reflective of an appropriate plan that is documented for that patient?
- The patient was placed on a nonrebreather over the tracheostomy site at 15l/min O2, There was continued significant work of breathing so we transitioned to a BVM to the tracheostomy tube. There was some improvement with that and the patient was handed off to the ALS crew
- The patient reported shortness of breath for the last 3 days, He endorses cough, fevers and some increased mucus production requiring frequent suctioning. He called today because he is starting to feel fatigued
- Patient vitals are blood pressure 100/60, pulse of 120 and respiratory rate of 30. His exam is notable for wheezes in bilateral lung fields, tachypnea with some retractions. He is tachycardic. His abdomen is soft and there is not any lower extremity edema
- This is a 55 year old male with tracheostomy in place due to prior laryngeal cancer with shortness of breath and respiratory distress that could be due to pneumonia, COPD or plugging of his tracheostomy from mucus
Q9. In the video about lifelong learning, you heard about a case where the patient was diagnosed with zoster. Using one of the resources in the required activity, provide the common name for herpes zoster. _____________
Q10. In a situation where you think hazardous material might be involved, the hot zone is/ are? Choose all that apply
- The area that is contaminated
- The area only people with appropriate training and familiarity with PPE should be
- The patient care area
- Where patients are decontaminated