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JBL Test Prep. Questions 645-690 Questions and Answers 100% Accurate
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JBL Test Prep. Questions 645-690
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JBL Test Prep. Questions 645-690#645: A week after a near-drowning incident, a 6-year-old boy presents with respiratory
distress, tachypnea, and fever. What should you suspect?
A) Asthma
B) Pertussis
C) Pneumonia
D) Bronchiolitis - answerC) Pneumonia
Pneumonia is a general term that refers to an infection of the lungs. Pneumonia is often
a secondary infection; it commonly occurs during or after a pre-existing infection such
as a cold. It can also be caused by direct lung injuries, such as from an accidental
chemical ingestion or a submersion incident (ie, near-drowning). Common signs and
symptoms of pneumonia include rapid breathing (tachypnea), breathing with grunting or
wheezing sounds, nasal flaring, and hypothermia or fever. Given this child's history of a
recent submersion incident, pneumonia should be the suspected cause of his
symptoms. A hallmark of asthma is wheezing; however, fever is usually not present.
Bronchiolitis could also explain the child's symptoms; however, the recent submersion
incident makes pneumonia far more likely. Furthermore, bronchiolitis more commonly
affects infants and toddlers. Pertussis (whooping cough) is not likely because the child
does not have a cough.
#646: Which of the following signs is the MOST ominous in a child with respiratory
distress?
A) Bradypnea
B) Tachycardia
C) Nasal flaring
D) Retractions - answerA) Bradypnea
Retractions, nasal flaring, and tachycardia are all common findings in infants and
children with respiratory distress. As the child begins to tire, however, retractions often
become weak and ineffective and the accessory muscles become less prominent during
breathing. Bradypnea, a decrease in the respiratory rate, is an ominous sign and
indicates impending respiratory arrest. Do NOT mistake bradypnea for a sign of
improvement; it usually indicates that the child's condition has deteriorated. Therefore,
you should be prepared to provide ventilatory assistance.
#647: Which of the following is the definitive sign of imminent delivery of a baby?
A) Crowning
B) Urge to defecate
C) Lengthy contractions
,D) Contractions less than 3 minutes apart - answerA) Crowning
The operative word in this question is definitive. While the urge to defecate, contractions
that are less than 2 to 3 minutes apart, and contractions that are lengthy, are all strong
indicators that delivery is very close, nothing is more definitive than visualization of the
presenting part of the baby at the vaginal opening (crowning).
#648: At what stage during pregnancy does the embryo become a fetus?
A) 2 weeks
B) 6 weeks
C) 8 weeks
D) 10 weeks - answerC
#649: Following delivery of a baby, the newborn has a strong cry and a heart rate of 130
beats/min. What should you do?
A) Suction the baby's mouth and nose
B) Keep the baby warm and transport
C) Ventilate with a bag-mask device
D) Administer free-flow oxygen by mask - answerB) Keep the baby warm and transport
If the newborn has no signs of distress, has pink skin, and a heart rate greater than 100
beats/min, simply keep the baby warm and transport to the hospital. Re-suctioning the
mouth and nose is not necessary if the newborn is breathing adequately. Bag-mask
ventilation is indicated if the newborn is apneic or has gasping respirations, or if the
heart rate is less than 100 beats/min. If the baby has central cyanosis—cyanosis to the
face or trunk—administer free-flow oxygen by face mask or oxygen tubing.
#650: - answer
#651: - answer
#652: A woman is 30 weeks pregnant. During your assessment, she tells you that she
delivered a stillborn baby at 38 weeks and currently has no living children. How should
you document her obstetric history?
A) Gravida 1; para 1
B) Gravida 2; para 1
C) Gravida 1; para 2
D) Gravida 2; para 2 - answerD) Gravida 2; para 2
Gravida refers to the number of times a woman has been pregnant, regardless of the
length of the pregnancy. Para refers to the number of babies carried beyond 28 weeks,
regardless of whether the baby was born dead or alive. The patient in this scenario has
been pregnant twice (including her current pregnancy); therefore, she is a gravida 2.
Since she has surpassed week 28 of her current pregnancy, and delivered her last baby
(albeit, stillborn) past 28 weeks, she is a para 2.
, #653:A 3-year-old girl is unresponsive and has slow, shallow breathing. Her heart rate is
65 beats/min and her skin is cyanotic. Her caregiver advises that the child ingested an
unknown quantity of her narcotic painkillers. What should you do?
A) Administer naloxone via the intranasal route
B) Ventilate with a bag-mask device at 20 breaths/min
C) Begin chest compressions at a rate of 100 to 120/min
D) Administer high-flow oxygen via nonrebreathing mask - answerB) Ventilate with a
bag-mask device at 20 breaths/min
The child's breathing is clearly inadequate and she is significantly hypoxemic. Initial
treatment for an opioid overdose, regardless of the patient's age, is to optimize
ventilation and oxygenation. Opioid-related deaths are the result of respiratory failure;
the most immediate and effective way to prevent this is to ventilate the patient. For the
child, provide 20 to 30 breaths/min (one breath every 2 to 3 seconds). The child is also
significantly bradycardic, which is likely the result of a combination of the opioid and
hypoxemia. After restoring ventilation and oxygenation, administer naloxone (Narcan)
via the intranasal route, if allowed by local protocol, in a dose that is appropriate for the
pediatric patient. If her heart rate falls below 60 beats/min despite adequate ventilation
and oxygenation, begin chest compressions.
#654: Which of the following clinical signs would you MOST likely observe in an infant
or small child with a tension pneumothorax?
A) Tracheal deviation
B) An irregular pulse
C) Distended jugular veins
D) Progressive respiratory distress - answerD) Progressive respiratory distress
Tension pneumothorax can be a rapidly fatal condition unless promptly identified and
treated. Progressive respiratory distress following a chest injury is a critical finding in
any patient and should make you suspect increasing pleural tension with resultant
collapsing of the lung. Due to their short neck, the jugular veins can be very difficult, if
not impossible, to assess in infants and small children. Tracheal deviation, an extremely
late sign, occurs on the lower part of the trachea, near the carina; without a chest x-ray,
one cannot appreciate this finding. An irregular pulse is not a common finding in
patients with a tension pneumothorax, regardless of age.
#655: The process of removing or neutralizing and properly disposing of hazardous
materials from equipment, patients, and rescue personnel is called:
A) autoclaving.
B) sterilization.
C) detoxification.
D) decontamination. - answerD) decontamination.
Decontamination is the process of removing or neutralizing and properly disposing of
hazardous materials from equipment, patients, and rescue personnel. Decontamination
should occur in the warm zone of a hazardous materials incident. The process of
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