Chapter 14

Question 1

A patient tells you that he is allergic to poison ivy and that while burning it yesterday he accidentally inhaled some of the smoke. He awoke today to find a red rash on the back of his left hand and is concerned. Assessment reveals him to be alert and oriented, with easy respirations and a blood pressure of 128/70 mm/Hg. Which of the following actions should you take next?

a. Tell him you are calling an ALS ambulance for him.
b. Assist him with his epinephrine auto-injector.
c. Obtain a medical history using the SAMPLE acronym.
d. tell him the rash probably has nothing to do with inhaling the smoke.

Answer 1

a. Tell him you are calling an ALS ambulance for him.
b. Assist him with his epinephrine auto-injector.
c. Obtain a medical history using the SAMPLE acronym.
d. tell him the rash probably has nothing to do with inhaling the smoke.

Answer: c
Objective: Supplemental
Reference: 443

Question 2

Which of the following statements best suggests that the speaker may be having a mild allergic reaction?

a. “I have had a fever and chills for the past two days.”
b. “My heart feels as though it is skipping some beats.”
c. “I feel dizzy and weak.”
d. “I have a rash on my face and neck.”

Answer 2

a. “I have had a fever and chills for the past two days.”
b. “My heart feels as though it is skipping some beats.”
c. “I feel dizzy and weak.”
d. “I have a rash on my face and neck.”

Answer: d
Objective: 14-4
Reference: 439, 444

Question 3

A patient who is responsive only to painful stimuli is covered with hives. He has labored respirations and a weak and tachycardic pulse. His vital signs are pulse 128, respirations 24, and blood pressure 80/50 mmHg. Given this presentation, you would suspect:

a. hypotension.
b. an anaphylactic reaction.
c. a stroke.
d. a head injury.

Answer 3

a. hypotension.
b. an anaphylactic reaction.
c. a stroke.
d. a head injury.

Answer: b
Objective: 14-4
Reference: 440, 444

Question 4

During a primary assessment, which of the following findings would most lead you to suspect an allergic reaction?

a. Hives on the face and neck
b. Blood pressure of 100/60 mmHg
c. Heart rate of 55 beats per minute
d. A complaint of dizziness

Answer 4

a. Hives on the face and neck
b. Blood pressure of 100/60 mmHg
c. Heart rate of 55 beats per minute
d. A complaint of dizziness

Answer: a
Objective: 14-4
Reference: 444

Question 5

A patient who is severely short of breath and covered with hives states that she is very allergic to crab. She admits to trying some seafood dip about 10 minutes ago. Which of the following questions should you ask her first?

a. “How many allergic reactions have you had?”
b. “Why did you eat the dip if you are allergic to crab?”
c. “What medications are you currently taking?”
d. “Do you have an epinephrine auto-injector?”

Answer 5

a. “How many allergic reactions have you had?”
b. “Why did you eat the dip if you are allergic to crab?”
c. “What medications are you currently taking?”
d. “Do you have an epinephrine auto-injector?”

Answer: d
Objective: Supplemental
Reference: 443

Question 6

The patient has swollen lips and hives. Which of the following scene size-up observations supports your suspicion that the patient is having an allergic reaction?

a. He has a glucometer among his belongings.
b. He has a new container of antibiotics with only two pills missing.
c. He states that several members of his family have the flu.
d. He has a bottle of expired nitroglycerin tablets.

Answer 6

a. He has a glucometer among his belongings.
b. He has a new container of antibiotics with only two pills missing.
c. He states that several members of his family have the flu.
d. He has a bottle of expired nitroglycerin tablets.

Answer: b
Objective: 14-3
Reference: 438

Question 7

The most severe form of an allergic reaction is called:

a. vascular shock.
b. anaphylaxis.
c. an antigen response.
d. rhinorrhea.

Answer 7

a. vascular shock.
b. anaphylaxis.
c. an antigen response.
d. rhinorrhea.

Answer: b
Objective: 14-4
Reference: 437

Question 8

When the respiratory effects of an allergic reaction are obvious within a few seconds to minutes:

a. the reaction tends to be more severe.
b. the reaction tends to be localized.
c. a large amount of allergen is likely involved.
d. epinephrine will not be effective.

Answer 8

a. the reaction tends to be more severe.
b. the reaction tends to be localized.
c. a large amount of allergen is likely involved.
d. epinephrine will not be effective.

Answer: a
Objective: 14-4
Reference: 440

Question 9

On scene you assisted a patient with his epinephrine auto-injector after he was stung multiple times by bees. You are now transporting him to the first aid room. As you reassess him, which of the following signs best indicates that the epinephrine is benefiting him?

a. Increasing heart rate
b. Decreasing mental status
c. Decreasing wheezing
d. Decreasing blood pressure

Answer 9

a. Increasing heart rate
b. Decreasing mental status
c. Decreasing wheezing
d. Decreasing blood pressure

Answer: c
Objective: Supplemental
Reference: 447

Question 10

A patient who is allergic to peanuts was just exposed to peanut butter. Assessment reveals her to be alert and oriented, with swollen lips and hives on her face. She states that she is lightly short of breath; her respiratory rate is 20 per minute. She has a heart rate of 82 and a blood pressure of 118/72 mmHg. She states that she is nauseated and has a headache. Which of the following actions is your immediate treatment for this patient?

a. Insert an oropharyngeal airway.
b. Provide oxygen via nonrebreather mask.
c. Start positive pressure ventilation with BVM.
d. Place the patient in a supine position.

Answer 10

a. Insert an oropharyngeal airway.
b. Provide oxygen via nonrebreather mask.
c. Start positive pressure ventilation with BVM.
d. Place the patient in a supine position.

Answer: b
Objective: Supplemental
Reference: 446–447

Question 11

You have arrived by the side of a patient who is allergic to latex and was exposed to it when she spilled a latex-containing powder on her right hand. Assessment reveals her to be lethargic and panicked. She is able to speak only a few words with each breath. Her tongue is swollen and her respirations are rapid, labored, and noisy. Which of the following actions should be your priority?

a. Insert an oropharyngeal airway.
b. Wash the latex powder off of the hand.
c. Obtain a heart rate and blood pressure.
d. Get a SAMPLE history.

Answer 11

a. Insert an oropharyngeal airway.
b. Wash the latex powder off of the hand.
c. Obtain a heart rate and blood pressure.
d. Get a SAMPLE history.

Answer: b
Objective: Supplemental
Reference: 446

Question 12

You are responding to a call for a patient with an allergic reaction. Your partner is a new OEC Technician, and this is his first call. Which of the following instructions to him about assessment and treatment of an allergic reaction would be correct?

a. “If the allergic reaction was caused by exposure to chocolate or eggs, don’t let the patient use auto-inject epinephrine.”
b. “Epinephrine should be given to any patient suffering an allergic reaction to prevent anaphylaxis.”
c. “Our first priority is to treat the patient’s ABCDs.”
d. “If the allergic reaction was caused by food, we should try to make the patient vomit.”

Answer 12

a. “If the allergic reaction was caused by exposure to chocolate or eggs, don’t let the patient use auto-inject epinephrine.”
b. “Epinephrine should be given to any patient suffering an allergic reaction to prevent anaphylaxis.”
c. “Our first priority is to treat the patient’s ABCDs.”
d. “If the allergic reaction was caused by food, we should try to make the patient vomit.”

Answer: c
Objective: Supplemental
Reference: 446

Question 13

A patient informs you that any time she uses a particular soap, she experiences a mild allergic reaction. You recognize that:

a. the soap contains an allergen.
b. her airway will swell shut if she inhales the soap.
c. the soap contains antibodies that react in her body.
d. she must have been exposed to the soap as an infant.

Answer 13

a. the soap contains an allergen.
b. her airway will swell shut if she inhales the soap.
c. the soap contains antibodies that react in her body.
d. she must have been exposed to the soap as an infant.

Answer: a
Objective: 14-2
Reference: 437

Question 14

Which of the following statements indicates that the speaker understands allergic reactions and anaphylaxis?

a. “An allergic reaction only occurs when the patient ingests or inhales an allergen; anaphylaxis occurs when the allergen is injected.”
b. “Allergic reactions are caused by pollen and food; anaphylactic reactions are caused by venoms and medications.”
c. “Anaphylaxis is a severe allergic reaction that will lead to death without emergency care.”
d. “Anaphylaxis describes a severe allergic reaction that occurs the first time a person is exposed to an allergen.”

Answer 14

a. “An allergic reaction only occurs when the patient ingests or inhales an allergen; anaphylaxis occurs when the allergen is injected.”
b. “Allergic reactions are caused by pollen and food; anaphylactic reactions are caused by venoms and medications.”
c. “Anaphylaxis is a severe allergic reaction that will lead to death without emergency care.”
d. “Anaphylaxis describes a severe allergic reaction that occurs the first time a person is exposed to an allergen.”

Answer: c
Objective: 14-1
Reference: 437

Question 15

Which of the following foods most commonly causes an allergic reaction?

a. Shellfish
b. Chocolate
c. Peanuts
d. Eggs

Answer 15

a. Shellfish
b. Chocolate
c. Peanuts
d. Eggs

Answer: c
Objective: 14-3
Reference: 439

Question 16

You are called to the lodge to help a patient who has developed an allergic reaction after taking an antibiotic medication. You would describe this route of exposure as:

a. injection.
b. contact.
c. ingestion.
d. inhalation.

Answer 16

a. injection.
b. contact.
c. ingestion.
d. inhalation.

Answer: c
Objective: 14-2
Reference: 47

Question 17

Which of the following statements explains why patients experiencing a moderate or severe allergic reaction have difficulty breathing?

a. Oxygen molecules are being used up by allergens.
b. The brain’s respiratory center is being depressed.
c. The bronchioles constrict and are clogged by thick secretions.
d. The workload on the heart has increased.

Answer 17

a. Oxygen molecules are being used up by allergens.
b. The brain’s respiratory center is being depressed.
c. The bronchioles constrict and are clogged by thick secretions.
d. The workload on the heart has increased.

Answer: c
Objective: Supplemental
Reference: 440

Question 18

Which of the following statements made by the patient after you assist him with his epinephrine auto-injector best indicates that the epinephrine is working and that the patient is improving?

a. “My breathing feels a lot easier.”
b. “My heart feels as though it is racing.”
c. “I am getting a little bit of a headache.”
d. “I am more relaxed and getting sleepy.”

Answer 18

a. “My breathing feels a lot easier.”
b. “My heart feels as though it is racing.”
c. “I am getting a little bit of a headache.”
d. “I am more relaxed and getting sleepy.”

Answer: a
Objective: Supplemental
Reference: 449

Question 19

Five minutes after you assist a patient with her epinephrine auto-injector, she states that she feels much better and would like to refuse additional care. What of the following statements would be most appropriate given the situation?

a. “If you feel better now, there is probably no need to go to the hospital. But you should get another auto-injector.”
b. “Now that you have taken your epinephrine, you should to go to the hospital for additional care.”
c. “Epinephrine can make your heart race. But don’t worry, you don’t need more care; just be sure that someone is with you.”
d. “The epinephrine will wear off in 10 to 20 minutes. As long as you have another injector I can watch you and see what happens.”

Answer 19

a. “If you feel better now, there is probably no need to go to the hospital. But you should get another auto-injector.”
b. “Now that you have taken your epinephrine, you should to go to the hospital for additional care.”
c. “Epinephrine can make your heart race. But don’t worry, you don’t need more care; just be sure that someone is with you.”
d. “The epinephrine will wear off in 10 to 20 minutes. As long as you have another injector I can watch you and see what happens.”

Answer: b
Objective: Supplemental
Reference: 449

Question 20

After assisting a patient with his epinephrine auto-injector, you note that his blood pressure has improved. You realize that this finding probably resulted from epinephrine’s ability to:

a. relax the smooth muscle of blood vessels.
b. constrict blood vessels.
c. increase the number of circulating red blood cells.
d. increase the oxygen-carrying capacity of the red blood cells.

Answer 20

a. relax the smooth muscle of blood vessels.
b. constrict blood vessels.
c. increase the number of circulating red blood cells.
d. increase the oxygen-carrying capacity of the red blood cells.

Answer: b
Objective: Supplemental
Reference: 447

Question 21

Your patient is having an allergic reaction and needs to use his epinephrine auto-injector. He is concerned that he does not recall the correct way to do it. Which of the following things would you tell him?

a. “Press the injector onto the outer thigh, push the tip against the thigh until the needle deploys, and wait for it to automatically inject.”
b. “Place the injector against the outer upper arm, push the tip until the needle deploys, and then push the plunger slowly to inject the medication.”
c. “Pinch the skin on the anterior thigh, press the injector tip against the skin, and wait until it activates.”
d. “Pinch the skin on the lateral thigh, press the injector against the skin, and rapidly push the plunger to inject the medication.”

Answer 21

a. “Press the injector onto the outer thigh, push the tip against the thigh until the needle deploys, and wait for it to automatically inject.”
b. “Place the injector against the outer upper arm, push the tip until the needle deploys, and then push the plunger slowly to inject the medication.”
c. “Pinch the skin on the anterior thigh, press the injector tip against the skin, and wait until it activates.”
d. “Pinch the skin on the lateral thigh, press the injector against the skin, and rapidly push the plunger to inject the medication.”

Answer: a
Objective: 14-5
Reference: 448

Question 22

You are staffing a first-aid booth at a mountain bike event. A mother approaches you with her 15-year-old son and informs you that her son is severely allergic to bees. Although he hasn’t been stung, she is concerned about the auto-injector he carries. The mother states that it was prescribed when her son was 13 years old. She shows you the 0.15 mg auto-injector, and you note that it expired about 12 months ago. Which of the following statements would be most appropriate for you to make?

a. “Call your doctor’s office for a new prescription because this auto-injector is out of date.”
b. “If you go to the pharmacy where you got this they will be able to give you a new one.”
c. “Most medications are still good for months after the expiration date. You can use this one for a little while longer.”
d. “This medication is good for today but you should call your doctor as soon as possible to replace this.”

Answer 22

a. “Call your doctor’s office for a new prescription because this auto-injector is out of date.”
b. “If you go to the pharmacy where you got this they will be able to give you a new one.”
c. “Most medications are still good for months after the expiration date. You can use this one for a little while longer.”
d. “This medication is good for today but you should call your doctor as soon as possible to replace this.”

Answer: a
Objective: 14-5
Reference: 448

Question 23

Which of the following findings would be a contraindication to the administration of epinephrine for a patient suffering an anaphylactic reaction?

a. The patient is allergic to eggs.
b. The patient has a heart rate of 120 bpm.
c. The name on the injector is not the patient’s name.
d. The patient has hypertension or bradycardia.

Answer 23

a. The patient is allergic to eggs.
b. The patient has a heart rate of 120 bpm.
c. The name on the injector is not the patient’s name.
d. The patient has hypertension or bradycardia.

Answer: c
Objective: 14-5
Reference: 448

Question 24

When administering epinephrine to an infant or child, the injector should be placed at what location?

a. The outer buttock
b. The anterior thigh
c. The upper arm
d. The lateral thigh

Answer 24

a. The outer buttock
b. The anterior thigh
c. The upper arm
d. The lateral thigh

Answer: d
Objective: 14-5
Reference: 448

Question 25

A patient experiencing an allergic reaction tells you that it is easier to breathe following administration of epinephrine. Which of the following effects is an effect of epinephrine that would be responsible for this improvement?

a. Dilation of the upper airway
b. Dilation of the bronchioles
c. Increased blood flow to the lungs
d. Decreased blood pressure

Answer 25

a. Dilation of the upper airway
b. Dilation of the bronchioles
c. Increased blood flow to the lungs
d. Decreased blood pressure

Answer: b
Objective: Supplemental
Reference: 447

Question 26

Which of the following findings is present in anaphylaxis but occurs much less frequently during a mild allergic reaction?

a. Anxiousness
b. Swelling at the site of a bee sting
c. Hives
d. Hypotension

Answer 26

a. Anxiousness
b. Swelling at the site of a bee sting
c. Hives
d. Hypotension

Answer: d
Objective: 14-4
Reference: 444–445

Question 27

An acquired, abnormal immune response to a substance that does not normally cause a reaction is known as:

a. angioedema.
b. an allergy.
c. an allergen.
d. an antigen.

Answer 27

a. angioedema.
b. an allergy.
c. an allergen.
d. an antigen.

Answer: b
Objective: 14-1
Reference: 435

Question 28

A foreign substance that triggers an allergic response in the body is known as:

a. an antigen.
b. histamine.
c. an antibody.
d. a mast cell.

Answer 28

a. an antigen.
b. histamine.
c. an antibody.
d. a mast cell.

Answer: a
Objective: 14-1
Reference: 436

Question 29

A patient can have an allergic reaction caused by intramuscular administration of a medication. This method by which an allergen enters the body is called:

a. inhalation.
b. injection.
c. ingestion.
d. topical.

Answer 29

a. inhalation.
b. injection.
c. ingestion.
d. topical.

Answer: b
Objective: 14-1
Reference: 437

Question 30

The overreaction of the immune system to a substance that is otherwise harmless is known as:

a. hypersensitivity.
b. hives.
c. anaphylaxis.
d. immunity.

Answer 30

a. hypersensitivity.
b. hives.
c. anaphylaxis.
d. immunity.

Answer: a
Objective: 14-1
Reference: 437

Question 31

Which of the following statements concerning allergies is true?

a. Allergies affect young healthy individuals only.
b. An allergic reaction to a substance can occur minutes, hours, or even days after exposure to the substance.
c. Once hypersensitized to a substance, a given individual will experience allergic reactions to that substance randomly, not consistently.
d. Anaphylaxis is the mildest type of allergic reaction.

Answer 31

a. Allergies affect young healthy individuals only.
b. An allergic reaction to a substance can occur minutes, hours, or even days after exposure to the substance.
c. Once hypersensitized to a substance, a given individual will experience allergic reactions to that substance randomly, not consistently.
d. Anaphylaxis is the mildest type of allergic reaction.

Answer: b
Objective: 14-1
Reference: 437

Question 32

The approach allergists recommend to allergies is called “Triple A,” which refers to:

a. awareness, avoidance, and action.
b. allergy, antigen, and anaphylaxis.
c. antibody, airway, and alveoli.
d. airway, assisted ventilations, and advanced life support.

Answer 32

a. awareness, avoidance, and action.
b. allergy, antigen, and anaphylaxis.
c. antibody, airway, and alveoli.
d. airway, assisted ventilations, and advanced life support.

Answer: a
Objective: Supplemental
Reference: 441