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

Accepted Answer

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 ```

Accepted Answer

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.

Accepted Answer

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 ```

Accepted Answer

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 ```

Accepted Answer

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. ```

Accepted Answer

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.

Accepted Answer

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.

Accepted Answer

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. ```

Accepted Answer

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. ```

Accepted Answer

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 ```

Accepted Answer

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. ```

Accepted Answer

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.

Accepted Answer

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 ```

Accepted Answer

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 ```

Accepted Answer

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 ```

Accepted Answer

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

Accepted Answer

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.

Accepted Answer

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.

Accepted Answer

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.

Accepted Answer

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.

Accepted Answer

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.

Accepted Answer

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 ```

Accepted Answer

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. ```

Accepted Answer

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 ```

Accepted Answer

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.

Accepted Answer

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.

Accepted Answer

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 ```

Accepted Answer

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.

Accepted Answer

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.

Accepted Answer

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.

Accepted Answer

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

Accepted Answer

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

Accepted Answer

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. ```

Accepted Answer

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.

Accepted Answer

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 ```

Accepted Answer

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

Accepted Answer

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 ```

Accepted Answer

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.

Accepted Answer

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 ```

Accepted Answer

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 ```

Accepted Answer

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.

Accepted Answer

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. ```

Accepted Answer

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

Accepted Answer

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. ```

Accepted Answer

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 ```

Accepted Answer

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.

Accepted Answer

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 ```

Accepted Answer

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 ```

Accepted Answer

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.

Accepted Answer

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.

Accepted Answer

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 ```

Accepted Answer

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

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CH 35 Environmental Emergencies Flashcards

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