CH 35 Environmental Emergencies

Question 1

H-1) Keys to effectively managing an environmental emergency are​ _____________ and providing prompt and proper emergency care.
A. assessing scene safety
B. moving the patient to a location of safety
C. identifying any preexisting conditions the patient has
D. recognizing the​ patient’s signs and symptoms

Answer 1

D. recognizing the​ patient’s signs and symptoms

The keys to effective management of an environmental emergency are recognizing the​ patient’s signs and symptoms and providing prompt and proper emergency care.

Question 2

H-2) Which of the following is an example of an environmental​ emergency?
A. Meningitis
B. Myocardial infarction
C. Subdural hematoma
D. Deep local cold injury

Answer 2

D. Deep local cold injury

Environmental emergencies include both heat and cold​ exposure; drownings and other​ water-related injuries; high​ altitudes; and bites and stings from​ insects, spiders,​ snakes, and marine life. Deep local cold injury or frostbite is a form of cold exposure.

Question 3

H-3) Hypothermia​ is:
A. generalized cooling that raises body temperature above normal.
B. localized cooling that reduces body temperature below normal.
C. localized cooling that raises body temperature above normal.
D. generalized cooling that reduces body temperature below normal.

Answer 3

D. generalized cooling that reduces body temperature below normal.

Hypothermia is generalized cooling that reduces body temperature below normal. Extreme hypothermia is a​ life-threatening condition.

Question 4

H-4) Your patient is immersed in cold water. Which of the following will cause the fastest loss of body​ heat?
A. Evaporation
B. Conduction
C. Radiation
D. Respiration

Answer 4

B. Conduction

Although body heat transferred directly into cool air is a​ problem, water chill is an even greater​ problem, because water conducts heat away from the body 25 times faster than still air.

Question 5

H-5) Which of the following factors contributes LEAST to the risk of hypothermia for an elderly​ patient?
A. Lack of exercise
B. Retirement
C. Failing body systems
D. Poor diet

Answer 5

B. Retirement

Failing body​ systems, chronic​ illnesses, poor​ diet, certain​ medications, and a lack of exercise may combine with the cold environment to bring about hypothermia. Simply retiring​ isn’t in itself a risk factor for​ hypothermia, although a retiree on a fixed income might live in inadequate conditions that can present risk factors for the condition.

Question 6

H-6) In extreme cases of a decreased level of​ consciousness, a hypothermic patient may have​ a:
A. clenched jaw.
B. harsh laugh.
C. neutral expression.
D. glassy stare.

Answer 6

D. glassy stare.

In extreme cases of a decreased level of​ consciousness, a hypothermic patient may have a glassy stare.

Question 7

H-7) Which of the following findings would LEAST make you suspect​ frostnip?
A. The patient has fallen in cold water.
B. The patient has touched a cold object.
C. The patient has been outside in cold weather.
D. The patient has drunk something cold.

Answer 7

D. The patient has drunk something cold

A patient who has drunk something cold​ isn’t necessarily at risk for​ frostnip, but the other situations could all present a risk for frostnip if the​ object, water, or weather were sufficiently cold.

Question 8

H-8) A disoriented elderly patient is found in his apartment with inadequate breathing.​ It’s the middle of​ winter, and the temperature outside is below freezing. What other factor involved in this​ patient’s situation may most make you suspect​ hypothermia?
A. You find the patient lying on the floor of his room.
B. The patient might have had one drink in the past 24 hours.
C. The patient has the room heat set to 70F.
D. The patient is wearing a thick sweater and is wrapped in a shawl.

Answer 8

A. You find the patient lying on the floor of his room.

Of these​ factors, the most indicative of potential hypothermia would probably be the​ patient’s lying on the floor of his​ room, which in cold weather could be a hypothermia​ risk, especially if the​ patient’s apartment is kept too cool. Alcohol would increase suspicion for hypothermia if intoxication had led the patient to expose himself to​ cold, but one drink in 24 hours​ doesn’t necessarily indicate a high risk for hypothermia on its own.

Question 9

H-9) The specific term for application of heat to the lateral​ chest, neck,​ armpits, and groin of a hypothermic patient​ is:
A. active rewarming.
B. central rewarming.
C. passive rewarming.
D. conduction.

Answer 9

B. central rewarming

Central rewarming is the application of heat to the lateral​ chest, neck,​ armpits, and groin of a hypothermic patient. It is a type of active​ warming, but the generalized term​ “active warming” does not specify where an external source of heat should be applied.

Question 10

H-10) Active rewarming is used for hypothermic​ patients:
A. who are responding appropriately.
B. with no palpable pulse.
C. with severe bradycardia.
D. who are unresponsive.

Answer 10

A. who are responding appropriately.

Active rewarming is typically used only for patients who are alert and responding appropriately.

Question 11

H-11) Which of the following is a risk of active​ rewarming?
A. Tachycardia
B. Cardiac arrest
C. Hypoglycemia
D. Hypertension

Answer 11

B. Cardiac arrest
(Page 1020 - Central rewarming)
Rapid rewarming may circulate stagnant blood too​ quickly, leading to cardiac arrest.

Question 12

H-12) You have removed an alert hypothermic patient from a cold​ environment, and are now ready to begin actively rewarming. After removing the​ patient's wet​ clothes, you should​ NOT:
A. massage the​ patient's extremities.
B. wrap the patient in dry blankets.
C. dress the patient in dry clothes.
D. keep the patient still.

Answer 12

A. massage the​ patient’s extremities.

Do not massage the​ patient’s extremities. When rewarming an alert hypothermic​ patient, you should remove the​ patient’s wet clothes and dress the patient in dry clothes or wrap the patient in dry blankets. Keep the patient still and handle the patient very gently. Do not allow such patients to walk or exert themselves.

Question 13

H-13) Which of the following is an acceptable method of actively rewarming a hypothermic​ patient?
A. Get the patient​ moving, to walk off the cold.
B. Immerse the patient in a bath of water warmed to about 100*F.
C. Place heat packs on the​ groin, neck,​ armpits, and chest.
D. Give the patient a large cup of coffee.

Answer 13

C. Place heat packs on the​ groin, neck,​ armpits, and chest.
(Page 1020 - central rewarming)

Active rewarming in the prehospital setting should involve central rewarming of the patient by applying heat packs to the​ groin, neck,​ armpits, and chest. A warm bath is helpful for patients when transport is​ delayed, but it should not entail too much heat too quickly. A patient should be kept​ still, and should not be given stimulants.

Question 14

H-14) Which group is LEAST likely to have poor​ thermoregulation?
A. Infants
B. Newborns
C. Teens
D. Elderly people

Answer 14

C. Teens

Teens as a group do not often have poor​ thermoregulation, although​ newborns, infants, and elderly people do often have poor thermoregulation.

Question 15

H-15) What can deceive people into overexertion and​ hyperthermia?
A. Dry heat
B. Moist heat
C. Evaporative heat loss
D. Conductive heat loss

Answer 15

A. Dry heat

Moist heat usually tires people​ quickly, and frequently stops them from harming themselves through overexertion. Dry​ heat, in​ contrast, often deceives people. They continue to work or remain exposed to excess heat far beyond what their bodies can tolerate.

Question 16

H-16) A​ 72-year-old woman lives in an apartment without air conditioning. There is currently a severe heat wave with high humidity. The​ woman's neighbor finds her responsive only to​ pain, and with​ hot, red, dry skin. What assessment finding would you LEAST suspect with this​ patient?
A. Heavy perspiration
B. ​Rapid, shallow breathing
C. Full and rapid pulse
D. Dilated pupils

Answer 16

A. Heavy perspiration

For a patient presenting with low responsiveness and​ hot, red, dry​ skin, you would expect little or no perspiration but would expect a full and rapid​ pulse, dilated​ pupils, and​ rapid, shallow breathing.

Question 17

H-17) Which of the following interventions is NOT appropriate for a patient with hot​ skin?
A. Aggressively fanning the patient
B. Administering oxygen by nonrebreather mask at 15 lpm
C. Giving the patient sips of water
D. Transporting the patient immediately

Answer 17

C. Giving the patient sips of water

For a patient with hot skin dry or moist you would not give the patient sips of​ water, but you would transport the patient​ immediately, administer​ oxygen, and attempt to cool the patient down by such means as aggressively fanning the patient.

Question 18

H-18) One rescuer in deep water​ should, when finding a patient facedown in the​ water, swim to a position beside the​ patient, support the​ patient’s head with one hand and the mandible with the​ other, rotate the patient by ducking under the​ patient, and:
A. lift the patient from the water.
B. release manual​ in-line stabilization.
C. continue to rotate until the patient is faceup.
D. immobilize the​ patient’s spine with a backboard.

Answer 18

C. continue to rotate until the patient is faceup.

One rescuer in deep water​ should, when finding the patient facedown in the​ water, swim to a position beside the​ patient, support the​ patient’s head with one hand and the mandible with the​ other, rotate the patient by ducking under the​ patient, and continue to rotate until the patient is​ faceup, maintaining manual​ in-line stabilization until the patient can be immobilized on a backboard. This should only be done if the rescuer is a very good swimmer and trained in water rescue.

Question 19

H-19) To provide a drowning patient who is conscious and alert but too far away for you to reach with a means of​ flotation, throw:
A. a surfboard that you can see on the beach about 50 yards away.
B. any personal flotation​ device, even if you have to run to get it.
C. a ring buoy that you remember seeing at a pier you drove past 2 minutes ago.
D. any object that will float you have on hand.

Answer 19

D. any object that will float you have on hand
(Page 1037 -Figure 35-9 shows everything from actual flotation devices to foam coolers)

If the person you need to rescue is conscious and alert but too far away for you to reach and pull from the​ water, throw an object that will float. A personal flotation device​ (PFD or​ lifejacket) or ring buoy​ (life preserver) works best. Other buoyant objects include foam​ cushions, logs, plastic picnic​ containers, surfboards,​ flat boards, large beach​ balls, and plastic toys. Two​ empty, capped plastic milk jugs can keep an adult afloat for hours. Inflatable splints can be used if there is nothing at the scene that will float. In this​ case, using any flotation device you have on hand is better than going in search of a more ideal device.

Question 20

H-20) When considering a water rescue of a​ patient, it is most important to​ consider:
A. whether getting into the water might involve swimming against a current.
B. the safest way to rescue the patient for both you and the patient.
C. the weight of the​ patient, as far as you can determine it.
D. whether the patient seems to have become unresponsive.

Answer 20

B. the safest way to rescue the patient for both you and the patient.

When considering a water rescue of a​ patient, it is most important to consider the safest way to rescue the patient for both you and the patient. Specific considerations such as the​ patient’s weight and current conditions are factors that might be part of overall safety​ conditions, but will not always be the most important considerations for every given case. Seeing that the patient has become unresponsive is​ important, but would not be more important than considering the safest method of rescue.

Question 21

H-21) A boating accident may produce a range of​ injuries, such​ as:
A. ​evaporation, conduction,​ radiation, and convection.
B. hypothermia and hyperthermia.
C. heat​ cramps, heat​ exhaustion, and heat stroke.
D. fractured​ bones, bleeding,​ soft-tissue injuries, and airway obstructions.

Answer 21

D. fractured​ bones, bleeding,​ soft-tissue injuries, and airway obstructions.

A boating accident may produce a range of​ injuries, such as fractured​ bones, bleeding,​ soft-tissue injuries, and airway obstructions. The other choices are conditions that may be caused by​ long-term exposure to heat or cold or by processes by which the body loses heat.

Question 22

H-22) Very cold​ water:
A. has no effect on resuscitation.
B. may increase the chance of resuscitation.
C. may decrease the chance of resuscitation.
D. requires that the patient be kept in the water for resuscitation.

Answer 22

B. may increase the chance of resuscitation.

Very cold water may have a protective effect for a short time. Some patients who drown in cold water can be resuscitated after 30 minutes or more in cardiac arrest. Once the water temperature falls below 70*​F, biological death may be delayed. The colder the​ water, the better the​ patient’s chances for​ survival, unless generalized hypothermia produces lethal complications.

Question 23

H-23) What is a sign or symptom common to air emboli and decompression​ sickness?
A. Convulsions
B. Personality changes
C. Chest pains
D. Choking

Answer 23

C. Chest pains

Both a patient with an air embolism and a patient with decompression sickness may present with chest​ pains, but convulsions are more likely with an air​ embolism, and personality changes and choking are more likely with decompression sickness.

Question 24

H-24) You are treating a patient at high altitude who complains of shortness of breath at rest. She has a dry cough and a mild fever. While you are gathering her​ history, she begins coughing up blood. You should​ suspect:
A. ​high-altitude pulmonary edema.
B. ​high-altitude cerebral edema.
C. acute mountain sickness.
D. hypothermia.

Answer 24

A. ​high-altitude pulmonary edema.

Common signs and symptoms of​ high-altitude pulmonary edema include shortness of breath​ (initially just on exertion but later also at​ rest), dry cough that progresses to coughing up​ blood, tachypnea,​ tachycardia, mild​ fever, oxygen saturation lower than asymptomatic people in the same​ environment, and respiratory failure or arrest.

Question 25

H-25) Which of the following symptoms is seen in​ high-altitude cerebral edema but not in acute mountain​ sickness?
A. Altered mental status
B. Nosebleed
C. Fatigue
D. Headache

Answer 25

A. Altered mental status

Altered mental status is seen in​ high-altitude cerebral edema but not in acute mountain sickness. Nosebleed is seen in acute mountain sickness but not in​ high-altitude cerebral edema. Headache and fatigue are common to both conditions.

Question 26

H-26) Which of the following statements about insect bites and stings is​ true?
A. Most insect bites lead to systemic complications.
B. Ant bites often transmit Lyme disease.
C. Black widow bites typically cause delayed reactions after several hours.
D. Brown recluse bites are usually painless.

Answer 26

D. Brown recluse bites are usually painless.

Bites from brown recluse spiders can cause tissue damage but are usually painless.

Question 27

H-27) You are treating a patient for an insect​ sting, and during your assessment you see the stinger. You​ should:
A. roughly scrape at the stinger with a blade or​ card, to break the visible part off.
B. push the stinger into the skin until it is completely beneath the epidermis.
C. avoid pulling out the stinger with​ tweezers, even if you have them on hand.
D. remove the stinger as quickly as possible by the best available means.

Answer 27

D. remove the stinger as quickly as possible by the best available means.

To remove the stinger or venom​ sac, the traditional advice was to scrape the site with a blade or a card and to avoid pulling with tweezers.​ (It was thought using tweezers might squeeze more venom into the​ wound.) However, research indicates that how you remove the stinger or venom sac is far less important than doing so quickly. The venom sac is actually​ hard, not​ floppy, so squeezing venom into the wound is very difficult.

Question 28

PT-1) Which of the following is most likely related to cardiac arrest in a drowning​ victim?
A. Hypoglycemia
B. Respiratory arrest
C. Spinal trauma
D. Cardiac dysrhythmias

Answer 28

B. Respiratory arrest

Question 29

PT-2) When treating patients with environmental​ emergencies, it is important to remember such​ emergencies:
A. may involve preexisting conditions or involve additional injuries.
B. typically represent direct threats to your personal safety.
C. involve few signs or symptoms to help you determine proper care.
D. are highly unlikely to occur in urban or suburban areas.

Answer 29

D. are highly unlikely to occur in urban or suburban areas.

(Page 1015 states that “Environmental Emergencies may involve pre-existing conditions or cause additional medical problems and injuries.

I selected A the first time, however, the test counted me wrong. There is NO mention of the above answer in the book.

Question 30

PT-3) If you are caring for a patient with a bee sting and the stinger is still​ present, what is the best course of​ action?
A. Use a specially designed tweezer device to remove it.
B. Remove it quickly by the best means available.
C. Slowly and carefully remove it by scraping with a blade or card.
D. Leave it in place until arrival at the hospital.

Answer 30

B. Remove it quickly by the best means available.

Question 31

PT-4) For a patient with severe​ hypothermia, you:
A. should avoid both passive and active rewarming until reaching the emergency department.
B. provide both passive and active rewarming to the patient.
C. provide passive rewarming but do not actively rewarm the patient.
D. should actively rewarm the patient as soon as possible.

Answer 31

C. provide passive rewarming but do not actively rewarm the patient.

Question 32

PT-5) You suspect that your patient has a deep local cold injury. Which of the following signs or symptoms would you​ expect?
A. Reddened or lightened skin
B. Skin that remains soft but is cold to the touch
C. Numbness of the affected area
D. ​White, waxy-appearing skin

Answer 32

D. ​White, waxy-appearing skin

Question 33

PT-6) Which of the following statements best describes conductive heat​ loss?
A. The transfer of heat from one material to another through direct contact
B. The transfer of heat from one material to another without physical contact
C. The process of breathing in cold air from the atmosphere
D. The process of a liquid or​ solid’s changing to a vapor

Answer 33

A. The transfer of heat from one material to another through direct contact

Page 1015

Question 34

PT-7) Venom is a​ toxin:
A. manufactured by humans.
B. secreted by plants.
C. produced by certain animals.
D. produced as a byproduct of a chemical process.

Answer 34

C. produced by certain animals.

Question 35

PT-8) Which of the following statements about the​ body’s response to heat loss is​ true?
A. The skin becomes flushed.
B. Shivering stops when the patient becomes severely hypothermic.
C. The first response to a decrease in body temperature is vasodilation.
D. The initial reaction to hypothermia is a drop in heart rate.

Answer 35

B. Shivering stops when the patient becomes severely hypothermic.

Question 36

PT-9) Which of the following is most common after an insect​ bite?
A. Hypotension
B. Hemorrhage
C. Seizures
D. Localized pain or itching

Answer 36

D. Localized pain or itching

Question 37

PT-10) When caring for a patient with​ high-altitude cerebral edema or​ high-altitude pulmonary​ edema, what is your​ priority?
A. Administering​ high-concentration oxygen
B. Minimizing physical activity
C. Ensuring proper hydration
D. Arranging for immediate descent to a lower altitude

Answer 37

D. Arranging for immediate descent to a lower altitude

Question 38

PT-11) Which of the following may be dangerous if done incorrectly or used when not​ indicated?
A. Applying a thermal blanket
B. Removing wet clothing
C. Passive rewarming
D. Active rewarming

Answer 38

D. Active rewarming

Question 39

PT-12) You are treating a patient at​ 6,000 feet altitude. The patient arrived about eight hours​ ago, and reports a diffuse headache that he describes as being similar to a​ hangover, though he has not consumed any alcohol. He also reports feeling nauseous. Assessment of his vital signs reveals tachycardia. Based on these​ symptoms, the patient is most likely​ experiencing:
A. fatigue related to a change in altitude.
B. ​high-altitude cerebral edema.
C. ​high-altitude pulmonary edema.
D. acute mountain sickness.

Answer 39

D. acute mountain sickness.

Question 40

PT-13) Which of the following types of patients typically have an ineffective shivering response to​ cold?
A. Pregnant patients
B. Behavioral patients
C. Pediatric patients
D. Adolescent patients

Answer 40

C. Pediatric patients

Question 41

PT-14) You are caring for a patient with a suspected​ heat-related emergency. The patient is​ confused, and presents with​ cool, moist​ skin; nausea; and vomiting. How should the patient be​ transported?
A. Supine position
B. Trendelenburg position
C. ​Fowler's position
D. On the left side

Answer 41

D. On the left side

Question 42

PT-15) When too little heat is generated to be available to all parts of the​ body, then:
A. muscular activity in the form of shivering increases.
B. exposed tissues are​ damaged, and body functions reduce or cease.
C. the body reduces circulation to compensate.
D. the body reduces perspiration to compensate.

Answer 42

B. exposed tissues are​ damaged, and body functions reduce or cease.

Question 43

PT-16)  You suspect that your patient is suffering from severe hypothermia. When checking for a​ pulse, you should check​ for:
A. at least 60 seconds.
B. no more than 10 seconds.
C. 6 seconds.
D. 3045 seconds.

Answer 43

A. at least 60 seconds.

Question 44

PT-17) Which of the following steps is included in the emergency care of a patient who was bitten by a poisonous​ snake?
A. Applying a tourniquet above and below the injection site
B. Applying a paste of baking soda and water to the sting site
C. Applying an ice pack
D. Keeping any bitten extremities immobilized and still

Answer 44

D. Keeping any bitten extremities immobilized and still

Question 45

PT-18) Rough handling of a hypothermic patient may lead​ to:
A. hypertension.
B. ventricular fibrillation.
C. tachycardia.
D. spontaneous fractures.

Answer 45

B. ventricular fibrillation.

Question 46

PT-19) Which of the following is used to reduce the pain from injection of venom by a marine​ animal?
A. Saline solution
B. Ice
C. Hot water
D. Cold water

Answer 46

C. Hot water

Question 47

PT-20) Which of the following statements is​ true?
A. Only patients who are outdoors are at risk for a heat or cold emergency.
B. Pediatric patients are physiologically well equipped to deal with extreme cold.
C. Pediatric and geriatric patients are especially at risk for hypothermia.
D. Hypothermia is not a risk unless the ambient temperature is at or near freezing.

Answer 47

C. Pediatric and geriatric patients are especially at risk for hypothermia.

Question 48

PT-21) Which of the following is NOT an example of an environmental​ emergency?
A. ​High-altitude cerebral edema
B. Heat exhaustion
C. Peritonitis
D. Jellyfish sting

Answer 48

C. Peritonitis

Question 49

PT-22) Which of the following items is most important to have immediately available in managing a drowning​ victim?
A. Suction
B. Nonrebreather mask
C. A blood pressure cuff
D. Backup AED

Answer 49

A. Suction

Question 50

PT-23) Which of the following statements should you use as a guideline in managing patients with a local cold​ injury?
A. Do not​ re-expose the patient to cold.
B. Immediately thaw the affected​ extremity, even if rescue conditions may lead it to be refrozen.
C. If the patient must walk to get to​ help, first thaw an affected lower extremity.
D. Gently massage the affected part to break down ice crystals in the tissues.

Answer 50

A. Do not​ re-expose the patient to cold.

Question 51

PT-24) In a hot​ environment, the air being​ inhaled:
A. is always the same temperature as exhaled air.
B. is cooled when it is exhaled.
C. is still much colder than the air being exhaled.
D. might be warmer than the air being exhaled.

Answer 51

D. might be warmer than the air being exhaled.

Page 1024

Question 52

PT-25) What is the correct order of procedures for a water​ rescue?
A. ​Reach, throw and​ tow, row, and go
B. ​Go, throw and​ tow, row, and reach
C. Throw and​ tow, reach,​ row, and go
D. Throw and​ tow, reach,​ go, and row

Answer 52

A. ​Reach, throw and​ tow, row, and go

Question 53

PT-26) A patient has​ "the bends" following a deep sea dive. The​ patient's condition is likely due​ to:
A. compression injury.
B. severe hypothermia.
C. decompression sickness.
D. nitrogen narcosis.

Answer 53

C. decompression sickness.

Question 54

PT-27) Your patient is a​ 38-year-old female who was mowing the lawn where the outdoor temperature was 96F with​ 80% humidity. She is sitting outside on the​ porch, complaining of severe cramping in the calves of her legs. Which of the following should be your first step in managing this​ patient?
A. Get the patient out of the hot environment.
B. Assist the patient in gently stretching her calf muscles.
C. Place the patient in a cold water bath.
D. Have the patient drink two​ 16-oz. bottles of cold water.

Answer 54

A. Get the patient out of the hot environment.

Question 55

PT-28) Which of the following best describes heat​ exhaustion?
A. An increase in core body temperature above 104F
B. A condition characterized by fluid and salt loss
C. Loss of electrolytes and buildup of lactic acid in the muscles
D. Swelling in the hands and​ feet, with lightheadedness on standing up too quickly

Answer 55

B. A condition characterized by fluid and salt loss

Question 56

PT-29) What effect does humidity have on the efficiency of evaporative heat​ loss?
A. Heat loss is increased by higher humidity.
B. Heat loss is reduced by higher humidity.
C. The effect of humidity on heat loss is unpredictable.
D. Heat loss is not affected by humidity.

Answer 56

B. Heat loss is reduced by higher humidity.

Question 57

PT-30) A victim is in the​ water, and requires rescue. She is too far out in the water to pull to safety from where you stand. You​ should:
A. instruct her to attempt to float on her back.
B. tell her to control her breathing.
C. throw her something that floats.
D. walk her through a simple swim stroke.

Answer 57

C. throw her something that floats.

Question 58

PT-31) In cold​ weather, which of the following persons is most susceptible to a cold​ emergency?
A. A person dressed in warm athletic clothing who is running
B. A person dressed warmly and walking
C. A warmly dressed person lying flat on the cold ground
D. A warmly dressed person sitting next to a heat source

Answer 58

C. A warmly dressed person lying flat on the cold ground

Question 59

PT-32) Which of the following conditions is associated with a breakdown in the​ body's heat-regulating mechanisms and a dramatic and dangerous increase in core body​ temperature?
A. Heat exhaustion
B. Heat stroke
C. Heat collapse
D. Heat cramps

Answer 59

B. Heat stroke

Question 60

PT-33) Ventilating a drowning victim too quickly or forcefully will likely​ cause:
A. improved BVM compliance.
B. increased cardiac output.
C. anxiety in the patient.
D. significant gastric distention.

Answer 60

D. significant gastric distention.

Question 61

PT-34) During transport of a hypothermic patient who is alert and responding​ appropriately, and whom local protocols dictate you may actively​ rewarm, you​ should:
A. wrap the patient in dry blankets.
B. remove all the​ patient’s wet clothing.
C. gently apply heat to the​ patient’s body.
D. remove the patient from the cold environment.

Answer 61

C. gently apply heat to the​ patient’s body.

Question 62

CT-1) Which of the following best describes a localized cold injury with a clear line of demarcation of its​ limits?
A. Deep frostnip
B. Early frostnip
C. Hypothermia
D. Late frostbite

Answer 62

B. Early frostnip

Question 63

CT-2) To rescue someone who has fallen through the​ ice, which of the following is the safest device to​ use?
A. ​Jet-ski
B. Ladder
C. Ring buoy
D. ​Flat-bottomed aluminum boat

Answer 63

D. ​Flat-bottomed aluminum boat

Question 64

CT-3) Heat stroke is caused by which of the following​ mechanisms?
A. Failure of temperature regulation mechanisms
B. Blockage of blood flow to the brain
C. Extreme dilation of all the blood vessels
D. ​Heat-induced swelling of brain tissue

Answer 64

A. Failure of temperature regulation mechanisms

Question 65

CT-4) To assess skin temperature for a possibly hypothermic​ patient, the EMT should place the back of his hand against which part of the​ patient's body?
A. Cheek
B. Abdomen
C. Forehead
D. Inner wrist

Answer 65

B. Abdomen

Question 66

CT-5) Reducing the pain of a marine animal sting can be accomplished by rinsing the affected area with which of the​ following?
A. Vinegar
B. Cold water
C. Sterile saline solution
D. Gasoline or kerosene

Answer 66

A. Vinegar

Question 67

CT-6) In a patient with extreme hypothermia who appears to be in cardiac​ arrest, you should assess the pulse for how​ long?
A. 15 to 20 seconds
B. at least 60 seconds
C. 20 to 30 seconds
D. at least 10 seconds

Answer 67

B. at least 60 seconds

Question 68

CT-7) Which of the following describes the condition of having an abnormally high body​ temperature?
A. Heat exhaustion
B. Hyperthermia
C. Perspiration
D. Heat shock

Answer 68

B. Hyperthermia

Question 69

CT-8) The technique for central rewarming requires the application of heat to which of the following areas of the​ patient’s body?
A. Lateral​ chest, neck,​ armpits, and groin
B. ​Head, neck,​ chest, and back
C. ​Head, neck,​ chest, and groin
D. ​Chest, back,​ neck, and armpits

Answer 69

A. Lateral​ chest, neck,​ armpits, and groin

Question 70

CT-9) You respond to the scene of a​ 14-year-old patient found outside in a cold environment. He is unresponsive and hypothermic. Emergency Medical Responders have moved the patient inside and secured the airway prior to your arrival. What is your next​ action?
A. Vigorously rub the patient to increase the body temperature.
B. Actively rewarm the patient.
C. Passively rewarm the patient.
D. Assess for signs of frostbite and treat immediately.

Answer 70

C. Passively rewarm the patient.

Question 71

CT-10) You respond to a professional volleyball tournament for a potential heat stroke. Upon arrival you find a​ 28-year-old male patient seated inside the​ air-conditioned first aid trailer. He is alert and in obvious distress. He is complaining of severe cramping of his arms and legs. His vital signs are stable. What is the most likely cause of the​ cramping?
A. Drinking too many sports drinks
B. Heat exhaustion
C. Cooling off too quickly
D. Sweating too much

Answer 71

D. Sweating too much

Question 72

CT-11) Which of the following does not make infants and children more prone to​ hypothermia?
A. Large body surface area
B. Inefficient metabolism
C. Small muscle mass
D. Little body fat

Answer 72

B. Inefficient metabolism

Question 73

CT-12) Allowing a​ patient's body temperature to increase by preventing further heat loss is referred to as which of the​ following?
A. Natural rewarming
B. Active rewarming
C. Passive rewarming
D. Core rewarming

Answer 73

C. Passive rewarming

Question 74

CT-13) You respond to the scene of a local campground. Your patient is a​ 15-year-old female patient who was stung in the arm by a bee. The patient is anxious and hyperventilating at 28 times a minute. The patient is alert and oriented to​ time, place,​ person, and event. Lung sounds are clear bilaterally. The left arm is swollen and the stinger is not present. Blood pressure is​ 118/72 and pulse is 110. The​ patient’s mother states the patient is allergic to bee stings and has an epinephrine​ auto-injector. She called 911 because she was afraid the patient would stop breathing. Which of the following is the best treatment​ plan?
A. Assist the patient in administering her epinephrine​ auto-injector.
B. Place the patient in the Trendelenburg position.
C. Treat the patient for shock and transport.
D. Place a constricting band around the arm to minimize the spread of the venom.

Answer 74

C. Treat the patient for shock and transport.

Question 75

CT-14) When submerged in​ water, biological death may be delayed if the water temperature is below ​\_\_\_\_\_\_\_\_F.
A. 32
B. 70
C. 50
D. 98.6

Answer 75

B. 70

Question 76

CT-15) You arrive on the scene to find a scuba diver on board a boat slumped over in the​ captain's chair with frothy blood in his mouth. The captain states that the diver was down no more than 15 feet when he ascended rapidly and called for help. Which of the following is most​ likely?
A. Air embolism
B. Decompression sickness
C. Pneumothorax
D. The bends

Answer 76

A. Air embolism

Question 77

CT-16) Heat cramps occur due to loss of which of the following​ substances?
A. Water
B. Water and potassium
C. Magnesium
D. Salt

Answer 77

D. Salt

Question 78

CT-17) When the body is in​ water, how many times faster does it lose heat than when it is in still​ air?
A. 2
B. 10
C. 100
D. 25

Answer 78

D. 25

Question 79

CT-18) Which of the following is caused by trapped nitrogen gas in the tissues due to a rapid ascent from a scuba​ dive?
A. Arterial gas embolism
B. Pulmonary embolism
C. Myocardial infarction
D. Decompression sickness

Answer 79

D. Decompression sickness

Question 80

CT-19) Applying an external source of heat to the​ patient's body to rewarm him is called​ \_\_\_\_\_\_\_\_ rewarming.
A. central
B. passive
C. peripheral
D. active

Answer 80

D. active

Question 81

CT-20) Why is it important to keep patients at rest when they are​ hypothermic?
A. Because the blood is coldest in the​ extremities, exercise or unnecessary movement could quickly circulate the cold blood and drop the blood pressure.
B. Because the blood is coldest in the​ extremities, exercise or unnecessary movement could quickly circulate the cold blood and lower the core body temperature.
C. Because the blood is warmest in the​ extremities, exercise or unnecessary movement could quickly circulate the warm blood and raise the core body temperature.
D. None of the above.

Answer 81

B. Because the blood is coldest in the​ extremities, exercise or unnecessary movement could quickly circulate the cold blood and lower the core body temperature.

Question 82

CT-21) In mild​ cases, what may overcome acute mountain​ sickness?
A. Rest and rehydration at altitude
B. Vigorous exercise
C. Moving the patient to a higher altitude
D. ​Positive-pressure ventilations

Answer 82

A. Rest and rehydration at altitude

Question 83

CT-22) Which of the following signs would you least expect to see in a patient suffering from severe​ hypothermia?
A. Numbness
B. Heavy shivering
C. Drowsiness
D. Skin cool to the touch

Answer 83

B. Heavy shivering

Question 84

CT-23) In a hypothermic patient the coldest blood is found in what part of the​ patient's body?
A. Intestines
B. Head
C. Extremities
D. Heart and lungs

Answer 84

C. Extremities

Question 85

CT-24) For which of the following reasons are​ newborns, infants, and the elderly more readily affected by the heat than other age​ groups?
A. Faster metabolism
B. Inadequate salt intake
C. Poor ability to regulate body temperature
D. Increased body mass

Answer 85

C. Poor ability to regulate body temperature

Question 86

CT-25) Your patient is a​ 24-year-old man who smoked a cigarette dipped in formaldehyde and then went outside with no shoes on and walked in the snow for about an hour. He has deep local cold injuries to both feet. Which of the following should be included in your management of this​ patient?
A. Massage the feet briskly.
B. Break blisters before wrapping both feet in sterile dressings.
C. Keep the patient cool to avoid rewarming the feet too quickly.
D. Gradually rewarm both feet.

Answer 86

D. Gradually rewarm both feet.

Question 87

CT-26) Where should constricting bands be placed to reduce lymphatic flow after a venomous snake​ bite?
A. 4 inches above and below the bite
B. 2 inches above and below the bite
C. Directly over the bite
D. None of the above

Answer 87

B. 2 inches above and below the bite

Question 88

CT-27) You respond to a construction site on a very hot summer day for a person​ “not acting​ right.” You find a​ 38-year-old male patient seated in a work vehicle with the air conditioner on maximum. Coworkers state the patient was working for the last 2 hours pouring concrete when he started​ “speaking gibberish” and nearly collapsed. The patient is responsive to verbal stimuli. Your initial vital signs are blood pressure​ 90/60, pulse​ 136, and respiratory rate 24. The​ patient’s skin is hot to the touch and​ dry, but his shirt is wet with visible salt rings. Which is the best treatment for the​ patient?
A. Cool the patient with tepid water.
B. Have the patient drink at least 1 liter of water to replace what he has lost.
C. Apply​ high-concentration oxygen and rapidly transport to the nearest medical facility.
D. Have the patient sip water slowly to replace what he has lost.

Answer 88

C. Apply​ high-concentration oxygen and rapidly transport to the nearest medical facility.

Question 89

CT-28) You respond to a construction site on a very hot summer day for a person​ "not acting​ right." You find a​ 44-year-old male patient seated in a work vehicle with the air conditioner on maximum. Coworkers state the patient was working for the last 2 hours pouring concrete when he started​ "speaking gibberish" and nearly collapsed. The patient is responsive to verbal stimuli. Your initial vital signs are blood pressure​ 90/60, pulse​ 136, and respiratory rate 24. The​ patient's skin is cool to the touch and​ moist, and his shirt is wet with visible salt rings. You​ suspect:
A. heat cramps.
B. heat exhaustion.
C. heat stroke.
D. myocardial infarction.

Answer 89

B. heat exhaustion.

Question 90

CT-29) You respond to a boat dock for a diving injury. You find a​ 24-year-old male patient unresponsive with frothy blood in the mouth and lung sounds absent on the right side. The​ patient's friends state they were diving when he came out of the water complaining of chest pains and then collapsed. What condition do you​ suspect?
A. Decompression sickness
B. Air embolism
C. Near drowning
D. Myocardial infarction

Answer 90

B. Air embolism

Question 91

CT-30) Which of the following increases a scuba​ diver’s risk of decompression​ sickness?
A. Flying within several hours after a dive
B. Diving on a full stomach
C. Breathing​ 100% oxygen before a dive
D. Taking cold or sinus medications before a dive

Answer 91

A. Flying within several hours after a dive

Question 92

CT-31) You have responded to a local pool for a drowning patient. Lifeguards have pulled the patient out of the pool prior to your arrival. You find a​ 22-year-old male patient unresponsive with agonal respirations and a weak carotid pulse. Bystanders state the patient was not using the diving board and was found in the shallow end. Why are cervical spine precautions​ necessary?
A. The patient may have hit his head on the side wall while swimming laps.
B. The patient may have suffered a cervical spine injury when pulled out of the water.
C. The patient may have suffered a spinal injury by jumping in shallow water.
D. The patient may have been using the diving board after all and injured his cervical spine.

Answer 92

C. The patient may have suffered a spinal injury by jumping in shallow water.

Question 93

CT-32) You respond to a boat dock for a diving injury. You find a​ 22-year-old female patient unresponsive with frothy blood in the mouth and lung sounds absent on the right side. The patient is breathing 28 times a minute. The​ patient’s friends state they were diving when she unexpectedly came out of the water complaining of chest pains and then collapsed. The nearest hospital is 25 minutes away and the nearest specialty resource center with a hyperbaric chamber is 30 minutes away. What is the best decision when determining​ transport?
A. Transport the patient by air medical to the nearest facility.
B. Transport the patient to the nearest facility.
C. Transport the patient by ground to the specialty center.
D. Transport the patient by air medical to the specialty center.

Answer 93

C. Transport the patient by ground to the specialty center.

Question 94

CT-33) Of the following venomous​ snakes, which one usually has the highest incidence of a​ "dry bite"?
A. Rattlesnake
B. Water moccasin
C. Coral snake
D. Copperhead

Answer 94

C. Coral snake

Question 95

CT-34) Which of the following occurs when gases leave a damaged lung in a diving accident and enter the​ bloodstream?
A. Arterial gas embolism
B. Hyperbaric arterial injury
C. Arterial blood gases
D. Arterial thrombosis

Answer 95

A. Arterial gas embolism

Question 96

CT-35) A patient who is lying on cold ground is losing the most amount of heat by what​ mechanism?
A. Conduction
B. Convection
C. Shivering
D. Radiation

Answer 96

A. Conduction

Question 97

CT-36) Your patient is a​ 44-year-old female with a history of alcoholism. She has been walking around at an outdoor fair on a​ hot, sunny day. She is disoriented to​ time; has​ hot, dry​ skin; and appears to be generally weak. Which of the following is the appropriate sequence of treatment for this​ patient?
A. Get as much ice as possible from the food vendors at the​ fair, place the patient in a large container of​ ice, and apply oxygen by nonrebreather mask.
B. Give oxygen by nonrebreather​ mask, remove heavy​ clothing, and place cold packs on her​ neck, armpits, and groin.
C. Have the patient stand outside the ambulance and slowly drink an electrolyte solution or sports drink.
D. Give oxygen by nonrebreather mask and have the patient​ rest, monitoring the​ patient’s improvement over time at the scene.

Answer 97

B. Give oxygen by nonrebreather​ mask, remove heavy​ clothing, and place cold packs on her​ neck, armpits, and groin.

Question 98

CT-37) In cases of extreme​ hypothermia, you will find the patient​ unconscious, with no discernible vital​ signs, and skin cold to your touch with stiff joints as if they appear dead. What is the emergency care for these​ patients?
A. Call the coroner as indications are the patient is cold and​ deceased, which is a definitive sign of death.
B. Contact medical control for input into the best treatment for this patient.
C. Assess the carotid pulse for at least 60​ seconds; if there is no​ pulse, start CPR immediately and prepare to apply the AED.
D. Check distal​ CSM, apply warming packs to the​ extremities, and transport the patient.

Answer 98

C. Assess the carotid pulse for at least 60​ seconds; if there is no​ pulse, start CPR immediately and prepare to apply the AED.

Question 99

CT-38) You respond to a farm for a possible snake bite. You find a​ 36-year-old male patient seated against a tree. Bystanders state the patient was bitten on the arm by a rattlesnake and is​ “really sick.” As you​ approach, you notice that the patient appears to be in obvious distress and is diaphoretic and holding his right wrist. Which of the following is your highest​ priority?
A. Confirm the location and status of the snake.
B. Confirm the type of snake and contact medical control for specific instructions.
C. Perform a primary assessment and identify any potential life threats.
D. Immediately apply a constricting band to minimize the spread of the venom.

Answer 99

A. Confirm the location and status of the snake.

Question 100

CT-39) Which of the following is acceptable when actively rewarming a hypothermic​ patient?
A. Avoid rewarming the limbs
B. Warming the patient as quickly as possible
C. Giving the patient hot coffee
D. Encouraging the patient to exercise

Answer 100

A. Avoid rewarming the limbs

Question 101

CT-40) You respond to a boat dock for a diving injury. You find a​ 24-year-old male patient unresponsive with frothy blood in the mouth and lung sounds absent on the right side. The patient is breathing 28 times a minute. The​ patient’s friends state they were diving when he unexpectedly came out of the water complaining of chest pains and then collapsed. What is your first​ action?
A. Insert an oropharyngeal airway.
B. Place the patient on​ high-concentration oxygen by nonrebreather mask.
C. Transport the patient.
D. Suction the airway.

Answer 101

D. Suction the airway.

Question 102

CT-41) Which of the following is not a classification of localized cold​ injury?
A. Hypothermia
B. Frostbite
C. Frostnip
D. All of the above

Answer 102

A. Hypothermia

Question 103

CT-42) The term blanching​, used to describe localized cold​ injury, means the tissue has turned to which of the following​ colors?
A. Blue or purple
B. Red
C. White
D. Black

Answer 103

C. White

Question 104

CT-43) Which of the following should the EMT do during the treatment of localized cold​ injury?
A. Rub the affected area with snow.
B. Massage the affected area.
C. Gradually warm the affected area.
D. Encourage the patient to use the affected part.

Answer 104

C. Gradually warm the affected area.

Question 105

CT-44) Which of the following can cause a wound with a characteristic lesion with a bite that is often​ painless?
A. Scorpion
B. Hornet
C. Black widow spider
D. Brown recluse spider

Answer 105

D. Brown recluse spider

Question 106

CT-45) You are enjoying some time at the beach on your day off when you hear a swimmer crying for help. As you spot the swimmer about 30 feet from​ shore, she cries out again but appears to be getting weaker. Although there is no lifeguard on​ duty, there is a rowboat and a ring buoy available. Assuming you do not know how to swim or consider yourself a poor​ swimmer, which of the following should you do​ first?
A. Row the boat out to the swimmer.
B. Find someone who can swim to try to swim out and save the swimmer.
C. Call for help and try to throw the buoy to the swimmer.
D. Use the buoy to float out to the swimmer.

Answer 106

C. Call for help and try to throw the buoy to the swimmer

Question 107

CT-46) Regarding drowning in​ adults, which of the following statements is true​?
A. The warmer the​ water, the better the chances of survival in saltwater drowning.
B. The colder the​ water, the better the chances of survival in either saltwater or freshwater drowning.
C. Colder water improves survival chances in saltwater drowning but not in freshwater drowning.
D. Water temperature makes no difference in the chances of survival in either saltwater or freshwater drowning.

Answer 107

B. The colder the​ water, the better the chances of survival in either saltwater or freshwater drowning.

Question 108

CT-47) In which of the following ways does the body produce heat in response to being​ cold?
A. Increasing the respiratory rate
B. Burning fewer calories
C. Shivering
D. Excreting more urine

Answer 108

C. Shivering

Question 109

CT-48) What is a common sign or symptom of​ high-altitude cerebral​ edema?
A. Paresthesia
B. Peripheral edema
C. Altered mental status
D. Nosebleed

Answer 109

C. Altered mental status

Question 110

CT-49) You are on a​ stand-by at a local high school football game. One of the football players comes over to the ambulance and complains that his face feels numb and he has a burning sensation in his fingers. You notice that the​ patient’s cheeks and fingers are bright red. How should you treat the​ patient?
A. Allow the patient to warm up inside the ambulance by passive rewarming measures.
B. Warm the affected areas with gentle rubbing.
C. Tell the patient that his condition is superficial and allow him to return to the game.
D. Place the patient inside the ambulance and begin active rewarming measures.

Answer 110

A. Allow the patient to warm up inside the ambulance by passive rewarming measures.

Question 111

CT-50) Which of the following terms describes the temperature of the surrounding​ air?
A. Shell temperature
B. Ambient temperature
C. Core temperature
D. Wind chill

Answer 111

B. Ambient temperature

Question 112

CT-51) Which of the following is often associated with​ water-related emergencies?
A. Cardiac arrest
B. Alcohol use
C. Hypothermia
D. All of the above

Answer 112

D. All of the above

Question 113

CT-52) The purpose of a constricting band after a venomous snake bite is to impede the spread of which of the​ following?
A. Lymph
B. Arterial blood
C. Venom
D. Both A and C

Answer 113

C. Venom

Question 114

CT-53) Which of the following is acceptable in the management of a patient stung by a honey​ bee?
A. Take care not to pull the stinger out using tweezers.
B. Treat for shock if you see signs it is developing.
C. Encourage the patient to move around.
D. Remove jewelry from any affected limbs.

Answer 114

D. Remove jewelry from any affected limbs.

Question 115

CT-54) Localized cold injury occurs due to vasoconstriction​ and:
A. loss of calcium.
B. blood clots.
C. chemical imbalance in the tissues.
D. ice crystal formation in the tissues.

Answer 115

D. ice crystal formation in the tissues.

Question 116

CT-55) In which of the following situations would a person lose heat by​ conduction?
A. Breathing
B. Sitting on cold metal bleachers at a football game
C. Going outside without a coat during a cold but calm day
D. Wearing wet clothing in windy weather

Answer 116

B. Sitting on cold metal bleachers at a football game

Question 117

CT-56) When actively rewarming a frostbitten extremity in warm​ water, you should change the water when the temperature falls below​ \_\_\_\_\_\_\_\_ F.
A. 115
B. 100
C. 85
D. 80

Answer 117

B. 100

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Question 118

CT-57) You respond to a landing zone to pick up a skier who was lost in the woods for 36 hours and found by the​ search-and-rescue helicopter. Your patient is a​ 19-year-old male patient. He is alert and oriented to​ time, person,​ place, and event. He is covered in blankets and shivering. He complains of not being able to feel his fingers. Physical exam reveals that the fingers of both extremities have a waxy appearance and feel​ “frozen” on the surface. After treating the patient for potential hypothermia and rapid​ transport, your next action is​ to:
A. keep the digits frozen on ice until they can be properly rewarmed at the hospital.
B. gently bandage the digits.
C. actively rewarm the digits.
D. gently warm the digits by slowly massaging them.

Answer 118

B. gently bandage the digits.

Question 119

CT-58) Which of the following is the process in which heat is lost from the body as wind passes over​ it?
A. Exposure
B. Hydrodynamic cooling
C. Condensation
D. Convection

Answer 119

D. Convection

Question 120

CT-59) Which of the following is the process in which heat is lost from the body as wind passes over​ it?
A. Exposure
B. Hydrodynamic cooling
C. Condensation
D. Convection

Answer 120

D. Convection

Question 121

CT-60) Which of the following would you expect to see in a patient with severe​ hypothermia?
A. Irrational behavior
B. Rapid respirations
C. Tachycardia
D. Loss of muscle tone

Answer 121

A. Irrational behavior

Question 122

CT-61) Most radiant heat is lost through which​ part(s) of the​ body?
A. Hands and feet
B. Head and neck
C. Buttocks
D. Torso

Answer 122

B. Head and neck

Question 123

CT-62) Why is it important to remove constricting items such as rings before thawing a frozen​ extremity?
A. Because thawing leaves clots behind in the veins
B. To prevent damage to the property such as rings and watches
C. Because thawed areas often swell
D. All of the above

Answer 123

C. Because thawed areas often swell

Question 124

CT-63) Which of the following types of snake is not a pit​ viper?
A. Coral snake
B. Rattlesnake
C. Water moccasin
D. Copperhead

Answer 124

A. Coral snake

Question 125

CT-64) Why are infants and young children more prone to hypothermia than​ adults?
A. Their immune system is not fully developed.
B. They are unable to recognize how cold they are.
C. They have less fat than adults.
D. They shiver more than adults.

Answer 125

C. They have less fat than adults

Question 126

CT-65) Which of the following could worsen the effects of a snake​ bite?
A. Application of ice
B. Having the patient lie still
C. Constricting bands above and below the bite
D. Cutting and suctioning out the venom

Answer 126

A. Application of ice

Question 127

CT-66) You arrive on the scene and find an unresponsive homeless man lying in the alleyway clutching a wine bottle. He is wearing a​ long-sleeved shirt but does not have pants on. His skin feels cold to the touch. The​ week’s temperatures have not been above 50F. Which of the following should you do immediately after ensuring the patient has an adequate​ airway?
A. Apply the AED.
B. Check the carotid pulse.
C. Begin passive rewarming.
D. Provide manual stabilization of the cervical spine.

Answer 127

B. Check the carotid pulse.

Question 128

CT-67) Rough handling of a patient with severe hypothermia may result in which of the​ following?
A. Rewarming shock
B. Heart attack
C. Ventricular fibrillation
D. Seizures

Answer 128

C. Ventricular fibrillation

Question 129

CT-68) The term gangrene means localized​ tissue:
A. infection.
B. discoloration.
C. swelling.
D. death.

Answer 129

D. death.