EMT Practice Test

1. Question Content...

---

Question1: A child with a right pulmonary contusion is intubated and ventilated. When positioned with the affected side down, O# saturation drops. The most likely cause is:

Question2: A family member has not left a child's bedside in 3 days and says, "I would leave, but I don't know where to go." The best nursing response is:

Question3: A patient on peritoneal dialysis has high blood glucose. Most likely cause is:

Question4: For a child with disseminated intravascular coagulation (DIC), administration of fresh frozen plasma (FFP) will replace:

Question5: What is the best method to ensure parents of a child with a new tracheostomy are adequately prepared for home care?

Question6: A child's ABG reveals pH 7.58, PaCO# 40, HCO# 30. What electrolyte change is expected?

Question7: A patient has a large intracranial hemorrhage and loss of brainstem reflexes. Prior to official brain death declaration, which must be ensured?

Question8: Family members have been complaining about limited visiting hours. To facilitate a potential change in practice, a nurse should first:

Question9: A 6-year-old with WPW syndrome and SVT episodes is admitted. What intervention is anticipated?

Question10: After a disaster drill, several issues related to notification of personnel and their role in the disaster were revealed. Which action should be done first?

Question11: What is the most common cause of neurologic dysfunction associated with spinal cord injury?

Question12: A child with sickle cell anemia develops chest pain, SOB, and tachypnea. What is the most likely diagnosis?

Question13: A child with RDS is on mechanical ventilation with PEEP 15 cm H#O and FiO# 50%. What is the most likely initial complication?

Question14: The treatment of choice for diabetes insipidus should be fluid:

Question15: One hour after receiving naloxone, a child becomes lethargic again and has a RR of 6. The nurse should anticipate:

Question16: An 18-month-old child is irritable and restless. Retractions, grunting with crackles, and an S3 gallop are noted. Vital signs:
* BP: 70/56
* HR: 160
* RR: 60
* Temp: 99°F (37.4°C)
Which of the following types of shock is this patient most likely experiencing?

Question17: In an infant with bronchopulmonary dysplasia (BPD), pathophysiologic consequences of chronic hypoxia include:

Question18: A nurse just completed their first-year evaluation and indicates a long-term goal to be a Chief Nursing Officer (CNO). The mentor should recommend the nurse:

Question19: Twenty-four hours after a severe burn and inhalation injury, a child develops increased tachypnea and desaturation. The most likely cause is:

Question20: A nursing practice council is reviewing a protocol for flushing unused IV lines. A team member questions the use of saline vs. dextrose. What should the council do first?

Question21: One day after a spinal fusion, a child is tachycardic and febrile with decreased bilateral breath sounds.
SaO# is 92% on 2 L/min and FVC is 10 mL/kg. These symptoms most likely indicate:

Question22: A 6-year-old patient with ARDS has been mechanically ventilated for 10 days. The patient is being assessed for readiness to wean. The patient will open his eyes spontaneously but not to command. The pupils are equal and reactive but the patient is restless, sleeping only for short intervals. A nurse suspects the patient is demonstrating signs of:

Question23: A child has fever, chills, back pain, elevated WBC and ESR, and abnormal urinalysis. After IV fluids and antibiotics, what procedure should be anticipated?

Question24: A recently deceased patient's family begins arriving to the ICU, visibly distraught and wailing. What is the nurse's first action?

Question25: The primary function of an institutional ethics committee in the critical care area is to:

Question26: A child with ALL presents 1 week after chemo, fatigued and hypothermic. Initial expected nursing intervention?

Question27: A patient has visitors whose loud talking and laughing disrupts other patients and visitors in the ICU.
Which of the following is the most effective way for a nurse to address this situation?

Question28: A patient asks the nurse to join in saying bedtime prayers. The nurse is not comfortable with this practice.
Which of the following is the nurse's most appropriate response?

Question29: A 6-year-old child is admitted following ingestion of an unidentified substance. Assessment reveals:
* BP: 120/84
* HR: 190
* RR: 44
* ECG: Sinus rhythm with occasional PVCs
* Dilated pupils
* Dry mucous membranes
* Disorientation
* Urinary retention
These findings are consistent with ingestion of:

Question30: Multiple blood transfusions have been given to a patient with massive blood loss following a motor vehicle crash. Which of the following electrolyte abnormalities should a nurse anticipate?

Question31: Which of the following defines post-coarctectomy syndrome?

Question32: A nurse preceptor and new nurse are caring for a 16-year-old patient following a crush injury. The lab report is significant for a creatine kinase (CK) level of 150 U/L and the patient's urine is dark yellow.
Vital signs are:
* BP: 95/60
* HR: 115
* RR: 22
* Temp: 100.5°F (38.1°C)
Which of the following statements by the new nurse is most correct?

Question33: Which of the following is a prerenal cause of acute renal failure?

Question34: Early symptoms of carbon monoxide poisoning include:

Question35: An adolescent's sleep is disrupted by alarms and blood draws. What is the nurse's best action?

Question36: A 9-year-old patient with a history of tachycardia and syncope is connected to a monitor that shows a HR of 190, with regular P-P and R-R intervals. The patient is awake, crying, anxious, and has a BP of
94/60. Which of the following is the initial nursing intervention?

Question37: A transgender adolescent requests to be addressed by preferred name/pronouns, different from medical record. What is the best response?

Question38: An 8-year-old patient who sustained intracerebral hemorrhage after a traumatic incident was intubated in the field. Head CT scan showed a 5 mm midline shift. The patient is difficult to arouse but pulls away from noxious stimuli. The most concerning sign of clinical deterioration is:

Question39: A patient has been declared brain dead. A nurse would like the family to consider organ donation but has never requested this from a family before. The best initial action by the nurse is to:

Question40: In diabetic ketoacidosis (DKA), gluconeogenesis is a compensatory mechanism for a perceived deficiency in:

Question41: An infant is 2 hours post median sternotomy closure after cardiac surgery. Assessment:
* BP:82/56
* HR:170
* Temp:101.8°F (38.8°C)
* CVP:3 mmHg
* Cap refill:2 seconds
* Skin color:Bright
Which type of shock is most likely developing?

Question42: In a child with a closed head injury, the presence of which of the following is most commonly associated with significant morbidity or mortality?

Question43: An adolescent patient presents with altered mental status following ingestion of unknown substances at a party. Lab values include an elevated serum ammonia. The nurse should anticipate an order for which of the following?

Question44: A 4-day-old infant presents with lethargy, vomiting, acidosis, and has a seizure upon arrival. What is the most likely diagnosis?

Question45: A stat abdominal x-ray reveals free air and a large loculated fluid collection presumed to be blood. The priority of care should be:

Question46: For a patient with pulmonary aspiration, PEEP is used to:

Question47: Early management of a child in septic shock includes:

Question48: A child presents with new-onset right-sided weakness, slurred speech, and headache. Which chronic condition most likely predisposes the child to this presentation?

Question49: A 15-year-old patient with a history of anxiety is experiencing palpitations, dizziness, nausea, diaphoresis, and tachypnea. This is most likely:

Question50: A 2-month-old with ventricular septal defect (VSD) and CHF should be managed with:

Question51: A 14-year-old post-MVC receives massive transfusion. Later, the abdomen is rigid. Which finding suggests abdominal compartment syndrome?

Question52: An irritable child has an acute fever, conjunctivitis, rash, and a strawberry tongue. A prolonged PR interval is observed on the ECG monitor. These findings are most likely due to:

Question53: A 13-year-old with systemic lupus erythematosus has hypotension, CVP of 15 mm Hg, cool extremities, gallop rhythm, and coarse breath sounds. What treatment is expected?

Question54: An infant with acute exacerbation of bronchopulmonary dysplasia (BPD) is placed on mechanical ventilation. The most appropriate ventilator strategy is:

Question55: An adolescent is admitted with toxic shock syndrome. In addition to blood cultures, which of the following lab orders should a nurse anticipate?

Question56: A 3-year-old near-drowning child who is intubated and mechanically ventilated exhibits increased peak inspiratory pressures and decreased O# saturation. Stat chest x-ray reveals diffuse pulmonary infiltrates. No improvement is exhibited after an increase in FiO#. The nurse should suspect:

Question57: A child with short bowel syndrome presents with fever, dehydration, and weight loss. To ensure nutrition, the nurse should anticipate:

Question58: After arterial switch surgery, an infant shows ST elevation, low oxygen saturation, and frothy secretions. Most likely cause?

Question59: A family member asks permission to visit a patient after work at 12:30 AM. On previous visits, the family member has been disruptive. To address the situation, a nurse should:

Question60: A recently deceased patient's family begins arriving to the ICU, visibly distraught and wailing. What is the nurse's first action?

Question61: A 17-year-old presents with history of progressive exercise intolerance. He is admitted with a diagnosis of hypertrophic cardiomyopathy. The vital signs are as follows:
* BP: 78/55
* HR: 110
* RR: 20
* T: 98.3°F (36.8°C)
* SpO#: 89% on room air
The patient's vital signs reflect:

Question62: Which of the following is a major indication for peritoneal dialysis?

Question63: A patient is admitted with severe anemia requiring urgent intervention. The parents refuse the transfusion due to religious beliefs. The most appropriate action by the nurse is to:

Question64: Which of the following is contraindicated when caring for a child with asthma who is intubated and receiving mechanical ventilation?

Question65: A pediatric patient with a complex, chronic condition has a multidisciplinary care team. The patient's family expresses frustration with receiving conflicting information from different team members.
Which of the following is the most appropriate action for a nurse to take?

Question66: A school-age child is admitted in acute respiratory failure requiring mechanical ventilation.
Endotracheal aspirate Gram staining is positive for an acid-fast bacillus. The nurse's initial action should be to:

Question67: Which of the following interventions is most effective in preventing pulmonary vasospasm in an infant with persistent pulmonary hypertension of the newborn (PPHN)?

Question68: Following placement of a central venous catheter, a mechanically ventilated child develops acute tachycardia, hypotension, and arterial desaturation. A nurse should evaluate the need for:

Question69: A 2-year-old child in septic shock is receiving nitroprusside (Nipride). Which of the following findings indicates the need to increase the nitroprusside dosage?

Question70: High lead levels present a medical emergency because they are associated with the development of:

Question71: A nurse managing a patient with carbon monoxide poisoning should consider the possibility of an inaccurate:

Question72: When preparing a 2-month-old with hypoplastic left heart syndrome for a cardiac transplant, which of the following findings is most alarming?