Chapter 19 Test Questions Flashcards
Unlike the honeybee, wasps and hornets:
A. have weaker venom, which is less likely to cause anaphylactic shock.
B. are typically easier to identify as the species that caused an allergic reaction.
C. can sting multiple times, because their stinger is not left imbedded in the skin.
D. have a barbed stinger, which will remain imbedded in the skin.
C. can sting multiple times, because their stinger is not left imbedded in the skin.
In addition to epinephrine, other medications that can be administered to patients with an allergic reaction include:
A. glucagon.
B. atropine sulfate.
C. amiodarone.
D. inhaled bronchodilators.
D. inhaled bronchodilators.
The MOST immediate threat to life that is associated with angioedema is:
A. swelling of the upper airway.
B. decreased circulatory volume.
C. spasm of the lower airways.
D. reduced right atrial preload.
A. swelling of the upper airway.
Your assessment of a patient with an allergic reaction should focus on the:
A. circulatory system, mental status, and respiratory system.
B. mental status, gastrointestinal system, renal system, and skin.
C. respiratory system, renal system, and integumentary system.
D. respiratory system, circulatory system, mental status, and skin.
D. respiratory system, circulatory system, mental status, and skin
A 29-year-old male experienced multiple fire-ant bites to his lower extremities. He is conscious and alert, and denies respiratory distress. His skin is warm, dry, and without urticaria and his breath sounds are clear and equal bilaterally. Appropriate management for this patient includes:
A. assisting the patient with an epinephrine auto-injector if he has one.
B. administering prophylactic epinephrine in a dose of 0.3 to 0.5 mg IM.
C. applying ice to the bites and observing for signs of an allergic reaction.
D. administering 100% oxygen via nonrebreathing mask and starting an IV.
C. applying ice to the bites and observing for signs of an allergic reaction.
Because the ____________ is the body’s first line of defense, signs of anaphylaxis typically manifest there first.
A. skin
B. airway
C. respiratory system
D. cardiovascular system
A. skin
Epinephrine is a critical treatment for patients with severe allergic reactions (anaphylaxis) because it:
A. directly blocks the endogenous chemicals that are responsible for the negative effects of the allergic reaction.
B. markedly increases the patient’s heart rate and improves perfusion to the brain, kidneys, and myocardium.
C. works rapidly to raise the BP by constricting the vasculature and improves ventilation by dilating the bronchioles.
D. does not increase myocardial oxygen demand and consumption as if it were given to patients with other conditions.
C. works rapidly to raise the BP by constricting the vasculature and improves ventilation by dilating the bronchioles.
Shortly after administering epinephrine to a 49-year-old male with anaphylactic shock, he becomes unconscious. Your assessment reveals that he is pulseless and apneic. You should:
A. begin CPR and start an IV line.
B. insert a multilumen airway device.
C. request a paramedic crew to assist.
D. begin CPR and apply the AED.
D. begin CPR and apply the AED.
Which of the following is an example of acquired immunity?
A. Born with specific antigens
B. Desensitized with a vaccination
C. Sensitized to a specific antigen
D. Desensitized following a bite or sting
B. Desensitized with a vaccination
A 30-year-old man presents with widespread urticaria after being bitten numerous times by fire ants. He is conscious and alert and denies respiratory distress. Further assessment reveals that his breath sounds are clear and equal bilaterally. He tells you that his wife has a prescribed epinephrine auto-injector because she is allergic to hornets. However, he does not have a prescribed auto-injector of his own. You should:
A. request a paramedic unit to administer epinephrine.
B. administer oxygen as needed and transport promptly.
C. assist him in self-administering his wife’s epinephrine.
D. refer him to his primary care physician for epinephrine.
B. administer oxygen as needed and transport promptly.
A 46-year-old female presents with respiratory difficulty, facial swelling, and widespread hives after she was stung by an unknown type of insect. Her blood pressure is 88/58 mm Hg; auscultation of her lungs reveals diffuse expiratory wheezing. The patient has a prescribed EpiPen, but has not used it. After administering 100% oxygen, you should:
A. start an IV and administer a 20 mL/kg saline bolus to raise her BP.
B. assist the patient with her EpiPen in accordance with your protocols.
C. administer 0.3 to 0.5 mL of epinephrine 1:1,000 subcutaneously.
D. administer a nebulized beta2 agonist to relieve the bronchospasm.
B. assist the patient with her EpiPen in accordance with your protocols.
A biphasic response to an antigen occurs when:
A. the acute response is sustained despite appropriate care.
B. an acute response is followed later by a delayed response.
C. there is no acute response but a delayed response hours later.
D. the acute response is rapidly corrected by the immune system.
B. an acute response is followed later by a delayed response.
While assessing a patient with signs and symptoms of anaphylactic shock, you notice angioedema of the face and neck. This is caused by:
A. histamine release that results in an increase in vascular permeability.
B. decreased function of the right side of the heart with blood regurgitation.
C. histamine release that causes internal bleeding due to vascular damage.
D. decreased vascular permeability and shifting of fluid into the soft tissues.
A. histamine release that results in an increase in vascular permeability.
Which of the following chemicals that are released by the immune system are responsible for an allergic reaction?
A. Mast cells and histamines
B. Histamines and leukotrienes
C. Leukotrienes and mast cells
D. Adrenaline and lymphocytes
B. Histamines and leukotrienes
In addition to widespread urticaria, _____________ is a common response in patients experiencing a severe allergic reaction.
A. cephalgia
B. rhinorrhea
C. bronchospasm
D. vasoconstriction
C. bronchospasm
An allergic reaction is MOST accurately defined as a(n):
A. abnormal sensitivity of the body to a foreign toxin or substance.
B. autoimmune response of the body to an internal or external stimulus.
C. direct negative effect on the human body as the result of a foreign toxin.
D. exaggerated response of the body’s immune system to a foreign stimulus.
D. exaggerated response of the body’s immune system to a foreign stimulus.
You should attempt to remove an imbedded stinger from a patient who was stung by a bee because:
A. it is likely to cause severe local swelling and intense pain.
B. it can inject venom for up to 20 minutes after the initial sting.
C. the toxicity of the venom increases when it enters the bloodstream.
D. desensitization to the venom will occur following prolonged exposure.
B. it can inject venom for up to 20 minutes after the initial sting.
Five minutes after administering a patient’s epinephrine auto-injector to him, you reassess him and note that his symptoms have not improved. You should:
A. administer a second dose of epinephrine, if the patient has another auto-injector.
B. assist the patient’s ventilations, and begin transport to the hospital without delay.
C. elevate the patient’s lower extremities 12 inches, and reassess him in 5 minutes.
D. conclude that the patient’s epinephrine was probably expired and ineffective.
A. administer a second dose of epinephrine, if the patient has another auto-injector.
Treatment for anaphylactic shock secondary to an insect sting may include all of the following, EXCEPT:
A. rapid transport.
B. assisting ventilations.
C. giving IV fluid boluses.
D. leaving the stinger in place.
D. leaving the stinger in place.
Decreases in cardiac output and blood pressure in a patient with anaphylactic shock are the result of:
A. internal fluid loss.
B. profound tachycardia.
C. systemic vasodilation.
D. increased cardiac preload.
C. systemic vasodilation.
Potential side effects of epinephrine include:
A. hypotension and lethargy.
B. tachycardia and hypertension.
C. facial flushing and weakness.
D. bronchospasm and hypoxemia.
B. tachycardia and hypertension.
Natural immunity occurs when a person’s body:
A. produces antibodies after being exposed to and experiencing all the symptoms of a disease.
B. produces antibodies to a particular disease after he or she is vaccinated against the disease.
C. does not produce antibodies after being exposed to or vaccinated against a particular disease.
D. produces antibodies, even if he or she is not exposed to or vaccinated against a particular disease.
A. produces antibodies after being exposed to and experiencing all the symptoms of a disease.
The chemical mediators that cause an allergic reaction are released by:
A. basophils and mast cells.
B. macrophages and eosinophils.
C. histamines and leukotrienes.
D. lymphocytes and neutrophils.
A. basophils and mast cells.
Allergic reactions to oral medications:
A. usually occur without prior sensitization to the medication.
B. are typically mild to moderate but may last for several days.
C. may cause a severe reaction within 30 to 60 minutes of ingestion.
D. rarely cause anaphylaxis because digestive enzymes destroy the antigen.
C. may cause a severe reaction within 30 to 60 minutes of ingestion.
