APEx – Special Populations

You are transporting a pediatric oncology patient that has a centrally developing rash. What PPE should be worn for this patient?

A 3-hour-old neonate is found to be polycythemic. What is the likely cause?

A 30-week gestation neonate with a hypoplastic left heart is on FiO₂ of 18% with a corresponding pre-ductal SpO₂ of 71%. The team is currently at 2,000 feet, and the patient has an increase in SpO₂ to 73%.  What is the initial intervention for this patient?

A 30-week gestation, 1.5kg, neonate delivered three hours prior is being transferred. The most recent chest x-ray demonstrates a ground-glass appearance. Current vent settings: SIMV 26, PRVC, Vte 8, f 48, FiO₂ 0.21 and PEEP 5. Current ABG: pH 7.24, PaCO₂ 38, PaO₂ 40, HCO3^– 24.  What condition do you suspect?

A 32-week gestation patient is being transferred and has received a 4 g bolus of magnesium sulfate and is currently on an infusion of 5 g/hr. You assess the patient’s deep tendon reflexes (DTRs) and note they are absent. After discontinuing the infusion, what would the next best treatment option be?

A 32-week premature neonate is experiencing respiratory distress.  Which drug may be administered in preparation for transport?

A 48-week post-conceptual age infant with a respiratory syncytial virus (RSV) is being transported. This infant is at increased risk of which of the following?

A 6-year-old is complaining of increasing dyspnea, nonproductive cough, and fever. The mother states the patient has a loud “barking cough.” Current vitals: BP 78/38, HR 146, RR 36, SpO₂ 92% on room air.  Based on your assessment, what would your initial diagnosis be for this patient?

A neonate has sudden decompensation two days after going home with parents. The infant was full-term and seemingly healthy. On assessment, the pre-ductal SpO₂ on the right hand is 90%, and lower extremity SpO₂ is 70%. No femoral pulses are noted, and there is a distended abdomen. What is the suspected clinical diagnosis?

A neonate is reported to have transposition of the great vessels.  It is essential to the survival of the neonate to maintain:

A neonate who is experiencing repetitive motion of a bicycling type action with lip-smacking is presenting with what type of seizure?

A neonate with choanal atresia would most likely have difficulty with all of the following EXCEPT:

A patient is presenting in active delivery with a breech presentation. Delivery progression halts upon delivery of the head.  What would be the next best action?

A patient who is 30-weeks gestation is being transferred for premature labor. She is having contractions every five minutes for the last hour and has received one liter of Normal Saline. You should prepare to:

A 3-year-old patient has sustained traumatic injuries after being involved in a motor vehicle collision (MVC). They have become hypovolemic and is demonstrating signs of shock. Which of the following would also be anticipated along with this?

A neonate has an order for continuous prostaglandin administration. What is the starting dose?

A patient is having complications with postpartum hemorrhage. Vigorous fundal massage has been attempted without improvement in bleeding. What should be considered next?

A patient that is PDA dependent would likely require the administration of which of the following drugs?

All of the following contribute to poor variability EXCEPT:

An obstetrics patient requires large amounts of magnesium sulfate to prevent seizures, and the team is concerned about toxicity. What assessment finding would indicate toxic levels in this patient?

Disseminated intravascular coagulation (DIC) is a common complication of?

During the treatment of diabetic ketoacidosis (DKA) in a pediatric patient, at what glucose level would you start a dextrose maintenance infusion?

During transport of a neonate, which of the following findings would indicate that the neonate is in stress?

For an infant with a respiratory syncytial virus (RSV), the best treatment combination is which of the following?

HELLP syndrome is characterized by what?

How much circulating blood volume does your pediatric patient have?

Identify the following chest x-ray of a 4-day old infant presenting with decompensation:

Identify the following chest x-ray of a premature infant:

Identify the following chest x-ray:

Identify the following chest x-ray:

Identify the following x-ray:

Immediately following rapid sequence intubation (RSI) and the use of succinylcholine, a 3-year-old patient develops a widened QRS complex and then a sinusoidal rhythm on the monitor. Subsequently, the patient goes into cardiac arrest. What condition do you suspect?

In evaluating fetal heart characteristics, which finding is most important in determining neurological maturity?

Increased irritability, increased heart rate and blood pressure, eye fluttering and decreased SpO₂ may be subtle signs of what?

Infants are born with ____________ axis deviation?

Intraosseous (IO) access is contraindicated with which of the following?

Late decelerations may indicate which of the following?

Left axis deviation is noted on the EKG for a 1-hour-old neonate. This would indicate?

Minimum urine output for the pediatric burn patient with non-suspected rhabdomyolysis would be?

Pediatric patients will not demonstrate hypotension secondary to hemorrhage, until approximately ________ loss of blood volume.

Temperature regulation in the neonate is limited by an immature hypothalamus and __________?

The drug of choice for treating seizures in the pediatric population is:

The equation for determining the endotracheal tube (ETT) size in a pediatric patient > 1-year-old is?

The fetal heart monitor strip indicates what?

The high vascular resistance in the fetal lung is due to which of the following physiologic mechanisms?

The most common congenital heart defect in neonates is which of the following?

The primary stimulus which causes closure of the patent ductus arteriosus (PDA) is?

The second stage of labor ends with:

The team is called to transfer a 5-month-old infant with Tetralogy of Fallot with DiGeorge syndrome. Enroute, the patient begins to have seizures which are most likely secondary to what?

The team is caring for a 36-week pregnant patient who experienced an eight-foot fall, landing on the right side.  Due to physiologic changes during pregnancy, this patient will present with:

The team is transporting a 5-day-old neonate.  On arrival, the report states that the baby is suffering from Tetralogy of Fallot (TOF). What is the long-term treatment to correct this heart defect?

The team is caring for a neonate with limited prenatal care.  Which of the following signs would cause them to start immediate resuscitation?

The transport team is assisting in the resuscitation of a 32-week-old neonate. Maternal history includes polyhydramnios. After an attempt at feeding, the neonate is distressed, choking, with drooling noted and secondary cyanosis. You attempt to clear the airway and place a nasogastric (NG) tube.  However, the NG tube cannot be passed. What is the suspected diagnosis?

Treatment for pregnancy-induced hypertension (PIH) may include all of the following EXCEPT:

What does the term effacement refer to?

What is a potential complication with surfactant replacement?

What is the leading cause of neonatal sepsis?

What is the most common cyanotic congenital heart defect in the neonate population?

What would be the best position for a neonate with myelomeningocele?

Which fetal heart tracing is an ominous sign?

Which of the following are potential signs and symptoms of pregnancy-induced hypertension (PIH)?

Which of the following congenital disorders results in a right-to-left shunt?

Which of the following is a potential side effect complicating the transport of a neonate receiving prostaglandin therapy?

Which of the following maneuvers may be used to help deliver an infant with shoulder dystocia?

Which type of cricothyrotomy is best performed in children that are less than eight years old?

While transferring a patient out of the pediatric ICU, the following hemodynamic parameters are noted: CI 1.6, CVP 17, PAP 44/22 mmHg, and PCWP 18 with a current BP of 78/60 and HR of 120. These hemodynamic parameters would suggest what diagnosis?

You arrive on the scene of a single rollover accident with a patient who is 28-weeks gestation. The patient is gravida 2, para 1.  Assessment reveals palpation of fetal parts over the abdomen. What is your diagnosis?