Chapter 19 Test Questions

Question 1

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.

Answer 1

C. can sting multiple times, because their stinger is not left imbedded in the skin.

Question 2

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.

Answer 2

D. inhaled bronchodilators.

Question 3

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.

Answer 3

A. swelling of the upper airway.

Question 4

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.

Answer 4

D. respiratory system, circulatory system, mental status, and skin

Question 5

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.

Answer 5

C. applying ice to the bites and observing for signs of an allergic reaction.

Question 6

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

Answer 6

A. skin

Question 7

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.

Answer 7

C. works rapidly to raise the BP by constricting the vasculature and improves ventilation by dilating the bronchioles.

Question 8

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.

Answer 8

D. begin CPR and apply the AED.

Question 9

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

Answer 9

B. Desensitized with a vaccination

Question 10

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.

Answer 10

B. administer oxygen as needed and transport promptly.

Question 11

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.

Answer 11

B. assist the patient with her EpiPen in accordance with your protocols.

Question 12

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.

Answer 12

B. an acute response is followed later by a delayed response.

Question 13

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.

Answer 13

A. histamine release that results in an increase in vascular permeability.

Question 14

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

Answer 14

B. Histamines and leukotrienes

Question 15

In addition to widespread urticaria, _____________ is a common response in patients experiencing a severe allergic reaction.

A. cephalgia

B. rhinorrhea

C. bronchospasm

D. vasoconstriction

Answer 15

C. bronchospasm

Question 16

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.

Answer 16

D. exaggerated response of the body’s immune system to a foreign stimulus.

Question 17

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.

Answer 17

B. it can inject venom for up to 20 minutes after the initial sting.

Question 18

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.

Answer 18

A. administer a second dose of epinephrine, if the patient has another auto-injector.

Question 19

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.

Answer 19

D. leaving the stinger in place.

Question 20

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.

Answer 20

C. systemic vasodilation.

Question 21

Potential side effects of epinephrine include:

A. hypotension and lethargy.

B. tachycardia and hypertension.

C. facial flushing and weakness.

D. bronchospasm and hypoxemia.

Answer 21

B. tachycardia and hypertension.

Question 22

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.

Answer 22

A. produces antibodies after being exposed to and experiencing all the symptoms of a disease.

Question 23

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.

Answer 23

A. basophils and mast cells.

Question 24

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.

Answer 24

C. may cause a severe reaction within 30 to 60 minutes of ingestion.

Question 25

The AEMT should transport any patient with an allergic reaction, even if he or she is able to stop the reaction with epinephrine, because:

A. the patient’s symptoms could recur up to 8 hours later.

B. any patient who is given a drug must be transported by law.

C. most patients require a continuous infusion of epinephrine.

D. the effects of epinephrine only last about 10 or 15 minutes.

Answer 25

A. the patient’s symptoms could recur up to 8 hours later.

Question 26

The dose of epinephrine for patients who weigh more than 66 pounds is:

A. 0.15 mg.

B. 1.5 mg.

C. 0.3 mg.

D. 3 mg.

Answer 26

C. 0.3 mg.

Question 27

A 50-year-old male was stung two times by a yellow jacket. He has a history of coronary artery disease and thinks that he is allergic to yellow jackets. Your assessment reveals a fine rash to his trunk and arms. His breath sounds are clear and equal bilaterally, his vital signs are stable, and he denies shortness of breath. Treatment for this patient should include all of the following, EXCEPT:

A. psychological support.

B. oxygen therapy as needed.

C. epinephrine via auto-injector.

D. an IV line set to keep the vein open.

Answer 27

C. epinephrine via auto-injector.

Question 28

A foreign substance that stimulates the body’s immune response is called a(n):

A. antigen.

B. antibody.

C. histamine.

D. leukotriene.

Answer 28

A. antigen.

Question 29

Following exposure to an allergen, an individual will MOST likely experience a severe allergic reaction if he or she:

A. has not been exposed to the same allergen in the past.

B. was previously exposed and sensitized to the allergen.

C. is taking medications that weaken the immune system.

D. develops symptoms within 24 hours following exposure.

Answer 29

B. was previously exposed and sensitized to the allergen.

Question 30

Unlike an epinephrine auto-injector, a Twinject:

A. can only be used in adults.

B. delivers two doses of epinephrine.

C. delivers a maximum of 0.3 mg.

D. is specifically designed for children.

Answer 30

B. delivers two doses of epinephrine.

Question 31

Assuming that previous exposure and sensitization has occurred, which of the following patients will likely experience the MOST severe allergic reaction?

A. A 21-year-old male who applies lotion to his hands

B. A 29-year-old female who ingested a penicillin tablet

C. A 36-year-old male with a surface exposure to dry lime

D. A 40-year-old female who was stung by a yellow jacket

Answer 31

D. A 40-year-old female who was stung by a yellow jacket

Question 32

The presence of _________ should alert you to the presence of upper airway swelling during an allergic reaction.

A. rales

B. dyspnea

C. stridor

D. wheezing

Answer 32

C. stridor

Question 33

The ability of the body to recognize a foreign substance the next time it is encountered is called:

A. sensitivity.

B. immunity.

C. phagocytosis.

D. anaphylaxis.

Answer 33

A. sensitivity.

Question 34

You are assessing a 32-year-old female who was stung by a scorpion. She is unresponsive and has stridorous, severely labored respirations. Your partner, who is assisting the patient’s ventilations with a bag-mask device, tells you that he is meeting significant resistance with each ventilation. You should:

A. administer 3 to 5 mL of epinephrine 1:1,000 SC.

B. request a paramedic crew to perform a cricothyrotomy.

C. apply cricoid pressure to facilitate airflow into the lungs.

D. insert an advanced airway device to protect her airway.

Answer 34

D. insert an advanced airway device to protect her airway.