Chapter 28 Flashcards
You are working at a mountain resort and are presented with a 50-year-old woman who states that she does not feel well. From your assessment, which of the following findings would seemingly indicate that the patient is being adversely affected by the high altitude?
a. Vomiting after eating large meals
b. An elevated blood glucose level with no history of diabetes
c. A heart rate of 62 beats per minute
d. A complaint of dyspnea on exertion
a. Vomiting after eating large meals
b. An elevated blood glucose level with no history of diabetes
c. A heart rate of 62 beats per minute
d. A complaint of dyspnea on exertion
Answer: d
Objective: 28-5
Reference: 903–904
A patient at a mountain ski resort has notable shortness of breath. She denies any past medical history and takes no medications. After applying oxygen, you realize that the key to helping this patient improve is to:
a. descend to a lower altitude.
b. administer a respiratory medication by a metered-dose inhaler.
c. position her in a left lateral recumbent position.
d. place her in a supine position with her legs elevated.
a. descend to a lower altitude.
b. administer a respiratory medication by a metered-dose inhaler.
c. position her in a left lateral recumbent position.
d. place her in a supine position with her legs elevated.
Answer: a
Objective: 28-7
Reference: 912
You are accompanying a team of hikers up a high mountain. The next morning you are summoned to a tent and find one of the climbers confused and complaining of a headache. His airway is patent and his respirations are adequate. He has no medical history and was in good health until found ill this morning by his friend. Suspicious of high-altitude cerebral edema (HACE), which of the following actions should you take?
a. Immobilize the patient.
b. Provide high-flow oxygen.
c. Insert an oropharyngeal airway.
d. Administer oral glucose.
a. Immobilize the patient.
b. Provide high-flow oxygen.
c. Insert an oropharyngeal airway.
d. Administer oral glucose.
Answer: b
Objective: 28-7
Reference: 912
The height or vertical elevation above a fixed point is known as:
a. ascent.
b. elevation.
c. altitude.
d. ataxia.
a. ascent.
b. elevation.
c. altitude.
d. ataxia.
Answer: c
Objective: 28-1
Reference: 898
As altitude increases:
a. barometric pressure increases.
b. the partial pressure of oxygen decreases.
c. the concentration of oxygen decreases.
d. air density becomes greater.
a. barometric pressure increases.
b. the partial pressure of oxygen decreases.
c. the concentration of oxygen decreases.
d. air density becomes greater.
Answer: b
Objective: 28-2
Reference: 900
The concentration of oxygen at sea level is approximately:
a. 35 percent.
b. 43 percent.
c. 40 percent.
d. 21 percent.
a. 35 percent.
b. 43 percent.
c. 40 percent.
d. 21 percent.
Answer: d
Objective: 28-2
Reference: 900
Your family is planning a ski trip to a resort that is at about 10,000 feet of elevation. You suggest that you spend the first two nights of the trip at a hotel where the elevation is about 6,500 feet. When your children protest that they are in good shape and want to go immediately to the resort, you explain that you are concerned about altitude sickness and that:
a. “physical fitness does not necessarily prevent altitude sickness.”
b. “just because you children are fit and don’t need the gradual change doesn’t mean your mom and I don’t need it.”
c. “your mom and I will exercise more before the trip so that maybe we can reduce the delay to one night.”
d. “I’ll see if I can get some medication so that we don’t need to stop over at the lower elevation.”
a. “physical fitness does not necessarily prevent altitude sickness.”
b. “just because you children are fit and don’t need the gradual change doesn’t mean your mom and I don’t need it.”
c. “your mom and I will exercise more before the trip so that maybe we can reduce the delay to one night.”
d. “I’ll see if I can get some medication so that we don’t need to stop over at the lower elevation.”
Answer: a
Objective: 28-4
Reference: 903
You are teaching a class on acute mountain sickness. When one of your students asks you to explain the term acclimatization in relation to AMS, your best response would be which of the following statements?
a. “Physiologic changes that increase the body’s ability to adjust to extreme changes in temperature.”
b. “Physiologic changes that decrease the body’s need for oxygen at high altitudes.”
c. “Physiologic changes that decrease the body’s need for slow ascents.”
d. “Physiologic adjustments that increase the delivery of oxygen to cells.”
a. “Physiologic changes that increase the body’s ability to adjust to extreme changes in temperature.”
b. “Physiologic changes that decrease the body’s need for oxygen at high altitudes.”
c. “Physiologic changes that decrease the body’s need for slow ascents.”
d. “Physiologic adjustments that increase the delivery of oxygen to cells.”
Answer: d
Objective: 28-4
Reference: 902
Which of the following processes does not occur during acclimatization?
a. An increase in respiratory rate and depth
b. Dilation of pulmonary blood vessels
c. An increase in red blood cell production
d. An increase in heart rate
a. An increase in respiratory rate and depth
b. Dilation of pulmonary blood vessels
c. An increase in red blood cell production
d. An increase in heart rate
Answer: b
Objective: 28-2
Reference: 902
In an otherwise healthy individual, the presence of a headache and feelings of sickness at high altitude is known as:
a. a high-altitude migraine.
b. acute mountain encephalitis.
c. acute mountain sickness.
d. high-altitude pulmonary edema.
a. a high-altitude migraine.
b. acute mountain encephalitis.
c. acute mountain sickness.
d. high-altitude pulmonary edema.
Answer: c
Objective: 28-5
Reference: 903
The most common cause of death related to high altitude is:
a. HAPE.
b. chilblains.
c. AMS.
d. HACE.
a. HAPE.
b. chilblains.
c. AMS.
d. HACE.
Answer: a
Objective: Supplemental
Reference: 904
You are with a group of hikers on the third day of an 11,000-foot mountain ascent. One of the hikers has not been feeling well for a couple of days. Today, members of the group notice that he is having difficulty getting dressed and speaking. From your training in outdoor emergency care, you recognize that these signs and symptoms are most often associated with:
a. acute mountain sickness.
b. peripheral neuropathy.
c. frostbite.
d. HACE.
a. acute mountain sickness.
b. peripheral neuropathy.
c. frostbite.
d. HACE.
Answer: d
Objective: 28-5
Reference: 905
You are teaching a class to OEC candidates and explain that a pre-existing illness may be complicated by the effects of high altitude. In teaching this concept to your class, you explain that the reason for this effect is that:
a. the increased barometric pressure at high altitude makes the heart work harder.
b. less oxygen is available to vital organs at high altitude.
c. dehydration can limit circulating blood volume.
d. nausea makes it difficult for people to take their medications.
a. the increased barometric pressure at high altitude makes the heart work harder.
b. less oxygen is available to vital organs at high altitude.
c. dehydration can limit circulating blood volume.
d. nausea makes it difficult for people to take their medications.
Answer: b
Objective: Supplemental
Reference: 906
High-altitude pulmonary edema most commonly affects:
a. young healthy individuals.
b. individuals with a history of COPD.
c. middle-aged, out-of-shape hikers.
d. individuals who ascend higher than 7,500 feet.
a. young healthy individuals.
b. individuals with a history of COPD.
c. middle-aged, out-of-shape hikers.
d. individuals who ascend higher than 7,500 feet.
Answer: a
Objective: Supplemental
Reference: 904
Labored breathing at rest and audible chest congestion herald the development of a serious, potentially life-threatening stage of what altitude-related condition?
a. Acute mountain sickness
b. Peripheral edema
c. HAPE
d. Khumbu cough
a. Acute mountain sickness
b. Peripheral edema
c. HAPE
d. Khumbu cough
Answer: c
Objective: 28-5
Reference: 904–905
