Free Paediatric Emergencies MCQs with Answers

• A. Give intramuscular adrenaline into the anterolateral thigh
• B. Give oral antihistamine and observe the child closely
• C. Place the child flat and start rapid oral fluid replacement
• D. Administer nebulized salbutamol before calling for help

Explanation: These findings indicate anaphylaxis with airway and circulation compromise.

• A. Keep the child calm and upright while calling the airway team
• B. Inspect the throat with a tongue depressor for swelling
• C. Lay the child flat and obtain a throat swab immediately
• D. Encourage oral fluids to soothe the inflamed throat

Explanation: The presentation suggests acute epiglottitis, which can cause sudden complete airway obstruction.

• A. Remove the child from the source and give high-concentration oxygen
• B. Give oral rehydration solution and reassess the headache
• C. Place the child in a warm room and encourage deep breathing
• D. Administer intravenous antibiotics for possible chest infection

Explanation: Confusion and headache after exposure to a faulty heater suggest carbon monoxide poisoning, which may occur without visible burns.

• A. Arrange urgent assessment for possible N-acetylcysteine treatment
• B. Induce vomiting before the medicine is absorbed
• C. Give activated charcoal at home without further assessment
• D. Wait for abdominal pain before starting any treatment

Explanation: Paracetamol toxicity may cause serious liver injury before symptoms appear.

• A. Give high-concentration oxygen and monitor breathing continuously
• B. Encourage the child to walk around to clear the lungs
• C. Give large amounts of oral water to replace swallowed fluid
• D. Perform abdominal thrusts to remove water from the lungs

Explanation: Hypoxaemia is the immediate threat after submersion, so breathing support takes priority.

• A. Place the child in the recovery position and observe the airway
• B. Restrain the child tightly to prevent another seizure
• C. Give oral medicine while the child is still drowsy
• D. Place a spoon between the teeth to protect the tongue

Explanation: After a seizure, airway protection and breathing assessment remain the priority.

• A. The unequal pupils with worsening level of consciousness
• B. A small bruise over the child’s elbow
• C. Mild thirst after several hours without food
• D. A pulse rate within the child’s usual resting range

Explanation: Unequal pupils and deteriorating consciousness are danger signs of possible raised intracranial pressure or expanding intracranial…

• A. Apply firm direct pressure around the wound and call for help
• B. Push the exposed bone back under the skin before dressing it
• C. Straighten the leg fully before applying a splint
• D. Wash the wound vigorously with antiseptic solution

Explanation: Active haemorrhage threatens circulation and must be controlled promptly with direct pressure around the wound.

• A. Give high-concentration oxygen and summon the emergency team
• B. Place the child flat and wait for a routine chest radiograph
• C. Encourage coughing to remove fluid from the injured side
• D. Apply a tight bandage around the entire chest

Explanation: The findings suggest a life-threatening tension pneumothorax, in which impaired breathing can rapidly reduce circulation.

• A. Begin chest compressions and continue coordinated ventilation
• B. Stop ventilation and observe the heart rate for five minutes
• C. Give oral glucose and reassess the pulse after feeding
• D. Place the child in a sitting position to improve circulation

Explanation: In paediatric resuscitation, severe bradycardia with poor perfusion that persists despite effective oxygenation and ventilation requires…

• A. Keep the child calm in an upright position and provide prescribed oxygen
• B. Place the child flat and inspect the throat with a tongue depressor
• C. Encourage the child to drink cold fluids while lying in bed
• D. Use vigorous chest percussion to remove the upper airway obstruction

Explanation: Keeping the child calm and upright reduces airway obstruction and work of breathing, while oxygen supports breathing.

• A. Clear the nasal secretions and give prescribed oxygen
• B. Offer a large bottle feed to improve hydration quickly
• C. Place the infant prone and leave the airway undisturbed
• D. Administer an oral antibiotic before reassessing breathing

Explanation: Nasal blockage greatly increases breathing difficulty in infants, so gentle suction followed by oxygen addresses airway and breathing…

• A. Remove the hot clothing and cool the burn with clean running water
• B. Apply ice directly to the burn and cover it with cotton wool
• C. Break blisters and apply an antiseptic cream over the burned area
• D. Rub the burned skin firmly to remove soot and loose tissue

Explanation: Removing hot clothing stops further injury, and clean running water cools the tissue and limits burn progression.

• A. Oral rehydration solution given in frequent small amounts
• B. Plain water given rapidly until the thirst disappears
• C. Undiluted fruit juice given freely to replace lost fluid
• D. Intramuscular normal saline given before any oral fluid

Explanation: Oral rehydration solution replaces water and electrolytes through glucose-sodium transport in the intestine and is suitable when the child…

• A. Assess breathing, give oxygen if needed, and arrange urgent medical review
• B. Induce vomiting to remove the kerosene from the stomach
• C. Give milk immediately to neutralise the swallowed hydrocarbon
• D. Insert a nasogastric tube and perform gastric lavage

Explanation: Kerosene can be aspirated into the lungs and cause chemical pneumonitis, so breathing assessment and respiratory support take priority.

• A. A benzodiazepine through an appropriate emergency route
• B. An oral antipyretic while waiting for the seizure to stop
• C. A large oral drink to prevent dehydration during the seizure
• D. A physical restraint to prevent injury to the arms and legs

Explanation: A seizure lasting five minutes or longer requires emergency treatment with a benzodiazepine according to the local protocol, while airway…

• A. Report possible neurovascular compromise urgently and elevate the limb
• B. Apply a warmer blanket and reassess the fingers after four hours
• C. Encourage active finger exercises against the painful cast
• D. Give another analgesic dose and document the finding routinely

Explanation: Increasing pain with pallor, coldness, and reduced movement suggests impaired circulation or compartment syndrome, which threatens the…

• A. Begin CPR and attach the AED as soon as it is available
• B. Check the child repeatedly for a pulse before starting compressions
• C. Give two large glasses of water before assessing the rhythm
• D. Place the child in the recovery position and observe breathing

Explanation: An unresponsive child with abnormal breathing needs immediate basic life support, with the AED used as soon as possible.

• A. Start CPR and look for a foreign body only when it is visible
• B. Perform repeated blind finger sweeps inside the mouth
• C. Hang the child upside down and shake the body firmly
• D. Give oral fluids to help move the object into the stomach

Explanation: Once the child becomes unresponsive, CPR is started because oxygen delivery and circulation are immediately threatened.

• A. The delayed capillary refill with cool peripheral skin
• B. The normal blood pressure during the assessment
• C. The child asking for a drink after the examination
• D. The heart rate decreasing slightly after reassurance

Explanation: Delayed capillary refill and cool peripheral skin indicate poor peripheral perfusion and may occur before hypotension in compensated…