Chapter 21 - Allergy and Anaphylaxis

Question 1

A 19-year-old female was stung multiple times on the legs by fire ants. She states that she is allergic to fire ants, but does not carry her own epinephrine. The patient is conscious and alert and complains of pain to the area of the bites. Her blood pressure is 122/70 mm Hg, her pulse is 100 beats/min and strong, and her respirations are 18 breaths/min and unlabored. You should:

Select one:

A. administer oxygen and transport her to the hospital.
B. position her legs well above the level of her heart.
C. advise her to see her physician as soon as possible.
D. request a paramedic unit to administer epinephrine.

Answer 1

A. administer oxygen and transport her to the hospital.

Question 2

A 37-year-old male is having a severe allergic reaction to penicillin. He does not have an epinephrine auto-injector and your protocols do not allow you to carry epinephrine on the ambulance. How should you proceed with the treatment of this patient?

Select one:

A. Quickly determine if there are any bystanders who may carry epinephrine.
B. Remain at the scene with the patient and request a paramedic ambulance.
C. Ask the patient if he has any diphenhydramine tablets that you can administer.
D. Administer oxygen, transport at once, and request a paramedic intercept.

Answer 2

D. Administer oxygen, transport at once, and request a paramedic intercept.

Question 3

After administering 0.3 mg of epinephrine via auto-injector to a 22-year-old woman with an allergic reaction, you note improvement in her breathing and dissipation of her hives. However, she is still anxious and tachycardic. You should:

Select one:

A. transport her rapidly, as it is obvious that she is having a severe reaction to the epinephrine.
B. contact medical control and obtain authorization to administer another 0.3 mg of epinephrine.
C. monitor her closely but recall that anxiety and tachycardia are side effects of epinephrine.
D. consider administering 0.15 mg of epinephrine to completely resolve her allergic reaction.

Answer 3

C. monitor her closely but recall that anxiety and tachycardia are side effects of epinephrine.

Question 4

Anaphylaxis caused by stinging insects is typically an allergic reaction to ____________ rather than the bite or sting itself.

Select one:

A. injected poison
B. irritating toxin
C. deadly venom
D. All of these answers are correct.

Answer 4

D. All of these answers are correct.

Question 5

Anaphylaxis is MOST accurately defined as a(n):

Select one:

A. extreme allergic reaction that may affect multiple body systems.
B. severe allergic reaction that typically resolves without treatment.
C. moderate allergic reaction that primarily affects the vasculature.
D. allergic reaction that causes bronchodilation and vasoconstriction.

Answer 5

A. extreme allergic reaction that may affect multiple body systems.

Question 6

At the site of the injury, signs and symptoms of an animal or insect bite or sting may include pain, localized heat, and a wheal, which appears as __________.

Select one:

A. an uncomfortable depression in the skin
B. a series of small, raised pustules
C. a raised, well-defined area of the skin
D. a large area of red, blotchy skin

Answer 6

C. a raised, well-defined area of the skin

Question 7

Care for a victim of an immunologic emergency who is severely hypotensive should include which of the following?

Select one:

A. Routine spinal immobilization due to the potential for traumatic injury
B. Initiate basic life support measures, including the use of an automated external defibrillator, if necessary.
C. Position the patient’s airway and initiate positive-pressure ventilations.
D. Apply high-flow oxygen therapy, place the patient in a shock position, and help maintain the patient’s body temperature.

Answer 7

D. Apply high-flow oxygen therapy, place the patient in a shock position, and help maintain the patient’s body temperature.

Question 8

Epinephrine stimulates the ________ response, increasing blood pressure, and relieving bronchospasm.

Select one:

A. respiratory
B. sympathetic
C. parasympathetic
D. cardiac

Answer 8

B. sympathetic

Question 9

Patients may experience allergic reactions to which of the following substances?

Select one:

a. Food and medications
b. All of these answers are correct.
c.
d. Plant material
e. Insect or animal bites and stings

Answer 9

b. All of these answers are correct.

Question 10

The adult epinephrine auto-injector delivers ______ mg of epinephrine, and the infant-child auto-injector delivers ______ mg.

Select one:

A. 0.3; 0.15
B. 0.1; 0.01
C. 0.03; 0.3
D. 0.01; 0.1

Answer 10

A. 0.3; 0.15

Question 11

The effects of epinephrine are typically observed within _________ following administration.

Select one:

A. 1 hour
B. 30 seconds
C. 30 minutes
D. 1 minute

Answer 11

D. 1 minute

Question 12

The goal of invaders such as bacteria and viruses is to __________.

Select one:

A. cause an immune response
B. spread disease and destruction
C. use a human body as a home
D. kill their human host

Answer 12

C. use a human body as a home

Question 13

The stinger from a honeybee should be:

Select one:

A. left in place and covered.
B. scraped away from the skin.
C. irrigated with copious amounts of water.
D. squeezed with tweezers and removed.

Answer 13

B. scraped away from the skin.

Question 14

Urticaria is the medical term for:

Select one:

A. swelling.
B. hives.
C. a wheal.
D. burning.

Answer 14

B. hives.

Question 15

When a foreign substance invades the body, the body will __________.

Select one:

A. protect itself
B. go on alert
C. attempt to inactivate the foreign substance
D. All of these answers are correct.

Answer 15

D. All of these answers are correct.

Question 16

When an allergic reaction proceeds to life-threatening anaphylaxis, it will usually do so __________.

Select one:

A. slowly, over more than 30 minutes.
B. quickly, within 30 seconds.
C. slowly, over several hours.
D. quickly, within 30 minutes.

Answer 16

D. quickly, within 30 minutes.

Question 17

Which of the following medications blocks the release of histamines?

Select one:

A. Acetaminophen (Tylenol)
B. Epinephrine (Adrenalin)
C. Diphenhydramine (Benadryl)
D. Albuterol (Ventolin)

Answer 17

C. Diphenhydramine (Benadryl

Question 18

Which of the following signs/symptoms are indicative of respiratory involvement of an allergic reaction?

Select one:

A. Flushed, itching, or burning skin
B. A sense of impending doom
C. Tightness in the chest or throat
D. All of these answers are correct.

Answer 18

C. Tightness in the chest or throat

Question 19

Which of the following sounds indicates swelling of the upper airway?

Select one:

A. Rales
B. Rhonchi
C. Stridor
D. Wheezing

Answer 19

C. Stridor

Question 20

Which of the following would MOST likely provide clues regarding the source of a patient’s allergic reaction?

Select one:

A. The time of year in which the exposure occurred
B. The patient’s family history
C. The environment in which the patient is found
D. The patient’s general physical appearance

Answer 20

C. The environment in which the patient is found

Question 21

Glipizide, a non-insulin-type medication, is another name for:

Select one:

A. Glucophage.
B. Glucotrol.
C. Micronase.
D. Diabinese.

Answer 21

B. Glucotrol.

Question 22

Kussmaul respirations are an indication that the body is:

Select one:

A. attempting to eliminate acids from the blood.
B. trying to generate energy by breathing deeply.
C. severely hypoxic and is eliminating excess CO2.
D. compensating for decreased blood glucose levels.

Answer 22

A. attempting to eliminate acids from the blood.

Question 23

Type 1 diabetes:

Select one:

A. is typically treated with medications such as metformin (Glucophage).
B. is a condition in which no insulin is produced by the body.
C. typically occurs in patients between 50 and 70 years of age.
D. is defined as a blood sugar level that is less than 120 mg/dL.

Answer 23

B. is a condition in which no insulin is produced by the body.

Explanation
Type 1 - Body attacks the pancreas, destroying the insulin-producing cells.

A. is typically treated with medications such as metformin (Glucophage). — Used to treat Type 2 Diabetes

C. typically occurs in patients between 50 and 70 years of age — This is normally detected in youth.

D. is defined as a blood sugar level that is less than 120 mg/dL. — This does not indicate Type 1 or Type 2 Diabetes. Normal blood sugar levels are less than 100 mg/dL after not eating (fasting) for at least eight hours. And they’re less than 140 mg/dL two hours after eating. During the day, levels tend to be at their lowest just before meals.

Question 24

The two MOST common signs of anaphylaxis are:

Select one:

A. wheezing and widespread urticaria.
B. watery eyes and localized itching.
C. expiratory stridor and tachycardia.
D. hypertension and swollen hands.

Answer 24

A. wheezing and widespread urticaria.

Question 25

Which of the following physiologic actions does epinephrine produce when given for an allergic reaction?

Select one:

A. bronchodilation and vasodilation
B. vasoconstriction and bronchodilation
C. bronchoconstriction and vasoconstriction
D. blocking of further histamine release

Answer 25

B. vasoconstriction and bronchodilation