EMT units 22, 23, 24 Flashcards
1) Which of the following individuals is likely in the incubation period of chickenpox?
A) A patient whose rash and fever went away a week ago
B) A patient who was exposed 6 days ago but does not yet have a fever or rash
C) A patient with a fever and a rash on the abdomen and back that began 3 days ago
D) A patient who was vaccinated last year, exposed 4 weeks ago, and shows no signs
B) A patient who was exposed 6 days ago but does not yet have a fever or rash
2) Which of the following statements about bacteria is false?
A) Some bacteria inside the body are good and necessary to survival.
B) Bacteria need to be inside the body in order to reproduce.
C) Over time, bacteria have developed resistance to some antibiotics.
D) Sepsis is a serious and sometimes deadly complication of bacterial infection.
B) Bacteria need to be inside the body in order to reproduce.
3) Which of the following preventive measures is useful against all communicable diseases?
A) Covering sneezes and coughs B) Hand washing C) Vaccination D) Standard Precautions
D) Standard Precautions
4) Why is Lyme disease not considered a communicable disease?
A) A person can only pass the disease to another via contact with blood.
B) It is spread by an insect, not a bacteria, virus, or microbe.
C) A person with the disease cannot pass it to other people.
D) The condition is not fatal.
C) A person with the disease cannot pass it to other people.
5) Which of the following most accurately describes the pathophysiology of sepsis?
A) The body overreacts to an infection and secretes substances that hurt cells, tissues, and organs.
B) An infectious agent in the body multiplies very rapidly, overwhelming the body’s natural immune response.
C) More than one type of infectious agent invades the body, limiting the immune system’s response to each agent.
D) Vasoconstriction and internal fluid retention lead to shock that does not respond to intravenous fluids.
A) The body overreacts to an infection and secretes substances that hurt cells, tissues, and organs.
6) Which of the following statements about sepsis is true?
A) Infections of the lungs commonly lead to sepsis, but sepsis is not typically associated with cases of pneumonia.
B) Patients who use urinary catheters are at a decreased risk of sepsis because catheter use makes it harder for microbes to enter the urinary tract.
C) The exact pathway for the development of sepsis remains unclear, and most cases do not have a clearly defined source.
D) Treatment of sepsis has changed and improved over time, but the definition of the condition has remained relatively unchanged.
C) The exact pathway for the development of sepsis remains unclear, and most cases do not have a clearly defined source.
7) Which of the following patients is at the lowest risk of developing sepsis?
A) An elderly patient who is recovering from abdominal surgery
B) A pediatric patient who has developed pneumonia in both lungs
C) A patient with a compromised immune system who has a permanent gastrostomy tube
D) A college-aged patient who breaks his arm in a skateboard crash
D) A college-aged patient who breaks his arm in a skateboard crash
8) According to the signs of systemic inflammatory response syndrome (SIRS), which of the following infection patients has an increased risk of sepsis?
A) A patient with respiratory rate of 19 and a heart rate of 112
B) A patient with a systolic blood pressure of 75 mmHg and a respiratory rate of 18
C) A patient with a heart rate of 88 and a temperature of 99.6°
D) A patient with a temperature of 95.4°F and a respiratory rate of 28
D) A patient with a temperature of 95.4°F and a respiratory rate of 28
9) According to the systemic inflammatory response syndrome (SIRS) system, which of the following criteria would not contribute to a patient’s likelihood of developing sepsis?
A) Temperature of 95.3°F B) Respiratory rate of 32 C) Heart rate of 87 D) Systolic blood pressure of 76
C) Heart rate of 87
10) Which of the following best describes a difference between the systemic inflammatory response syndrome (SIRS) and the quick sepsis-related organ failure assessment (qSOFA)?
A) SIRS creates a score based on the number of abnormal findings, whereas qSOFA uses the presence of two or more specific criteria.
B) SIRS is more commonly used in the intensive care setting, whereas qSOFA is more commonly used in field assessments.
C) SIRS is used to predict the likelihood a patient will develop sepsis, whereas qSOFA is used to predict the likelihood of patient death from sepsis.
D) SIRS relies on the measurement of exhaled carbon dioxide to detect sepsis, whereas qSOFA uses a variety of measures.
C) SIRS is used to predict the likelihood a patient will develop sepsis, whereas qSOFA is used to predict the likelihood of patient death from sepsis.
11) What is the most important thing you can do for a stable septic patient?
A) Attempt to lower the patient’s temperature. B) Open and maintain the patient’s airway.
C) Notify the emergency department that the patient is septic. D) Assess the patient using capnography.
C) Notify the emergency department that the patient is septic.
12) You are called to the scene of a 13-year-old male with a fever and cough. Upon assessment, you note a red blotch rash on the face and trunk, and small bluish-white spots on the inside of the cheeks. Based on this presentation, the patient likely has: A) chickenpox. B) measles. C) shingles. D) hepatitis A.
B) measles.
13) Mumps infection is primarily spread through:
A) saliva and droplets. B) blood and saliva. C) airborne droplets and direct contact. D) all body fluids.
A) saliva and droplets
14) While caring for a patient known to have hepatitis B, you are splattered across the face with blood. You were not wearing eye protection at the time and some of the blood got onto your eyeball. You have never received your hepatitis B vaccination. Which of the following postexposure actions would not lower your risk of developing hepatitis B?
A) Washing your eye with water B) Receiving immune globulin
C) Having the vaccination D) Taking antiviral medication
D) Taking antiviral medication
15) You have been called to the scene of a single vehicle crash. The victim lost control of the vehicle on an icy road and hit a tree. He shows signs of facial injury with bleeding, but is conscious and aware of his surroundings. Before you begin providing care to him, he tells you that he has HIV and is currently taking medication that has helped suppress his viral load. Based on this information, which of the following actions should you take?
A) Take Standard Precautions while providing care for the patient.
B) Call medical direction and ask how you should proceed.
C) Avoid direct contact with the patient but provide him with dressings he can apply himself.
D) Provide care without using precautions because his viral load is suppressed.
A) Take Standard Precautions while providing care for the patient.
16) You are called to the scene of a patient with influenza. She tells you her symptoms started about 5 days ago and that she began taking antiviral medication 2 days ago. Her symptoms have not improved since taking the medication. What is the most likely reason the medication has been ineffective?
A) Antiviral medications for the flu work against the strains of the virus that are expected to be prevalent that year, and the medication isn’t effective against the strain this patient has.
B) Antiviral medications for the flu must be started within 2 days of symptom onset to be effective.
C) Antiviral medications are not effective against the flu because it is caused by bacteria rather than a virus.
D) Antiviral medication is often ineffective because the flu virus is capable of rapidly mutating inside the body.
B) Antiviral medications for the flu must be started within 2 days of symptom onset to be effective.
17) You have been called to the scene of an 83-year-old woman with a high fever who reports chills and shortness of breath. She is tachypneic and showing signs of pain upon inspiration. You talk with her a bit and she seems confused and unaware of where she is, who she is, or who you are. Based on this presentation, the patient likely has:
A) pneumonia. B) pertussis. C) croup. D) tuberculosis.
A) pneumonia
18) You have been called to the scene of a 19-year-old college student who is at his parents’ house for the weekend. The patient complains of sensitivity to light and nausea. He also has a headache and is covered in what appears to be a red rash that does not blanch when pressed. Your partner asks the patient to sit up straight and then bring his chin down to his chest. For which of the following diseases is your partner assessing this patient?
A) Tuberculosis B) Meningitis C) Hepatitis C D) Shingles
B) Meningitis
19) What role do health care workers play in handling public crises related to newly recognized infectious diseases?
A) They implement the steps outlined by the CDC and other agencies to reduce the number of people who become infected.
B) They work closely with local health departments to determine the microbes responsible for the disease and how to treat them.
C) They report information about the outbreaks to the public and share information about the prevalence and spread of the conditions.
D) They disseminate information about diseases and their treatment to health care providers and institutions.
A) They implement the steps outlined by the CDC and other agencies to reduce the number of people who become infected.
20) Which of the following is the most important thing you can do when treating patients during a public crisis related to a newly recognized infectious disease?
A) Gather data about patient signs and symptoms and report them to the local health department.
B) Follow the recommendations of the CDC and your local health department.
C) Share information with patients about the prevalence of the disease.
D) Tell patients not to worry because new reports exaggerate the severity of these diseases.
B) Follow the recommendations of the CDC and your local health department.
The medical term for fainting is:
A.
syncope.
B.
vertigo.
C.
altered RAS status.
D.
dehydration.
A.
syncope.
Looking at the following list, which of the items does NOT correctly compare the signs and symptoms of hypoglycemia and hyperglycemia?
A.
Hyperglycemia usually has a slower onset than hypoglycemia.
B.
The hypoglycemic patient usually complains of a headache, whereas the hyperglycemic patient does not.
C.
The hyperglycemic patient often has acetone breath, whereas the hypoglycemic patient does not.
D.
Hyperglycemic patients often have warm, red, dry skin, whereas hypoglycemic patients have cold, pale, moist, or clammy skin.
The hypoglycemic patient usually complains of a headache, whereas the hyperglycemic patient does not.
The condition in which there is an insufficient amount of sugar in the blood is called:
A.
hyperglycemia.
B.
diabetic ketoacidosis.
C.
tachycardia.
D.
hypoglycemia.
D.
hypoglycemia.
When assessing a conscious patient for a possible stroke using the Cincinnati Prehospital Stroke Scale, which of the following three functions should be tested by theEMT?
A.
Ability to walk, control of facial muscles, and balance
B.
Ability to walk, ability to hold both arms in an extended position for 10 seconds, and ability to name common objects
C.
Control of facial muscles, ability to speak, and ability to hold both arms in an extended position for 10 seconds
D.
Memory, ability to speak, and ability to track movement with the eyes
C.
Control of facial muscles, ability to speak, and ability to hold both arms in an extended position for 10 seconds
A hormone called insulin is secreted by the:
A.
islets of Langerhans in the liver.
B.
islets of Langerhans in the pancreas.
C.
gallbladder found in the pancreas.
D.
None of the above.
islets of langerhans in the pancreas
f the blood sugar level is very high, which of the following may result?
A.
Excessive urination, excessive thirst, and excessive hunger
B.
Hyperactivity, excessive thirst, and polyuria
C.
Excessive insulin, excessive glucose, and excessive urination
D.
Polyuria and hyperactivity
excessive urine, excessive thirst, and excessive hunger
For the EMT, which of the following is the most important question to ask of a diabetic patient or his family members?
A.
Do you have a family history of diabetes?
B.
Do you have a fruity taste in your mouth?
C.
When was the last time you had something to eat?
D.
What kind of insulin do you take?
C.
When was the last time you had something to eat?
What is epilepsy?
A.
A condition in which a person has generalized seizures that start in childhood
B.
A condition in which a person has multiple seizures usually controlled by medication
C.
A condition caused by congenital brain abnormalities that causes seizures only twice a year
D.
A condition in which a person has an aura followed by seizure usually caused by infection
B.
A condition in which a person has multiple seizures usually controlled by medication
A patient who demonstrates any one of the three symptoms from the Cincinnati Prehospital Stroke Scale has a(n) ________% chance of having an acute stroke.
A.
60
B.
70
C.
50
D.
80
B.
70
our patient is a 21-year-old female with a history of epilepsy. She is having a convulsion upon your arrival. Which of the following should you do?
A.
Place a tongue depressor or spoon in the back of the mouth to prevent the patient from swallowing her tongue.
B.
Insert a bite block, cloth, wallet, or similar item between the patient’s teeth to prevent her from biting her tongue.
C.
Move furniture and other objects away from the patient to prevent injury.
D.
Restrain the patient’s extremities to prevent injury from flailing of the arms and legs
C.
Move furniture and other objects away from the patient to prevent injury.
Which of the following blood glucose levels is considered normal for an adult?
A.
180 mg/dL
B.
80 mg/dL
C.
150 mg/dL
D.
40 mg/dL
B.
80 mg/dL
Which of the following is NOT a sign of a hypoglycemic diabetic emergency?
A.
Anxiety
B.
Cold, clammy skin
C.
Slow heart rate
D.
Combativeness
C.
Slow heart rate
Which of the following is the LEAST important question in obtaining the history of a seizure patient in the prehospital setting?
A.
What was the patient doing before the seizure?
B.
Did the patient lose control of his bladder?
C.
How did the patient behave during the seizure?
D.
Does the patient have a family history of seizures?
Does the patient have a family history of seizures?
The death of brain tissue due to deprivation of oxygen because of a blocked or ruptured artery in the brain is known as which of the following?
A.
Stroke
B.
Transient ischemic attack
C.
Seizure
D.
Aphasia
A.
Stroke
Compared to hypoglycemia, which of the following is TRUE of hyperglycemia?
A.
Its onset is more sudden.
B.
Its onset is more gradual.
C.
Its onset is preceded by an aura, such as hallucinations or detecting unusual odors.
D.
It is more easily treated in the prehospital environment than hypoglycemia.
Its onset is more gradual
Which of the items below is NOT part of the Cincinnati Prehospital Stroke Scale?
A.
Test the patient for arm droop or lack of movement.
B.
Test for equal grip strength.
C.
Ask the patient to smile.
D.
Have the patient repeat a simple sentence.
B.
Test for equal grip strength.
You respond to a 32-year-old female who is having a seizure. You arrive on the scene to find the patient drowsy, confused, and complaining of a headache. This patient is demonstrating the:
A.
tonic phase.
B.
aura phase.
C.
postictal phase.
D.
clonic phase.
C.
postictal phase.
Your patient is an unresponsive 30-year-old male wearing a Medic-Alert bracelet indicating that he is a diabetic. The patient’s coworkers came by his house to check on him when he did not show up for work and did not call in sick. Your assessment does not clearly indicate to you whether the patient may be hypoglycemic or hyperglycemic. Which of the following should you do next?
A.
Use your glucometer to check his blood sugar level.
B.
Use the patient’s glucometer to check his blood sugar level.
C.
Apply oxygen and begin transport without taking further action.
D.
Administer oral glucose, as it will not cause additional harm in hyperglycemia but may prevent brain damage if the patient is hypoglycemic.
Apply oxygen and begin transport without taking further action
Treatment of someone with a seizure disorder includes all of the following EXCEPT:
A.
removing objects that might harm the patient.
B.
placing the patient on the floor or ground.
C.
loosening restrictive clothing.
D.
placing a bite block in the patient’s mouth so that he does not bite his tongue.
D.
placing a bite block in the patient’s mouth so that he does not bite his tongue.
There are two types of seizures; if your patient is having a seizure that affects only one body part and does not cause her to lose consciousness, it is called a:
A.
partial seizure.
B.
generalized seizure.
C.
postictal seizure.
D.
tonic-clonic seizure.
partial seizure
Your patient is a 44-year-old male with a history of diabetes. He is lying on the living room floor, unresponsive to all stimuli. He has a respiratory rate of 12 breaths per minute and heart rate of 112 beats per minute, and is pale and sweaty. Which of the following should you do to treat this patient?
A.
Apply oral glucose solution to a tongue depressor and insert it between the patient’s cheek and gums.
B.
Place the patient in the recovery position to protect the airway and place oral glucose solution under the patient’s tongue.
C.
Encourage the patient’s family to administer his insulin.
D.
Place the patient in the recovery position, administer oxygen, and monitor his airway status.
D.
Place the patient in the recovery position, administer oxygen, and monitor his airway status.
Which of the following BEST describes status epilepticus?
A.
Two or more seizures with tonic-clonic activity without an intervening period of consciousness
B.
A seizure that occurs without a known cause
C.
A seizure involving convulsions on only one side of the body
D.
A period of drowsiness following tonic-clonic seizures
Two or more seizures with tonic-clonic activity without an intervening period of consciousness
Your patient is waking up from a seizure; it was the patient’s first seizure ever. When you ask what happened, the patient tells you she had the smell of fresh mown grass just before she seized. This sensation is known as a(n):
A.
aura.
B.
tonic phase.
C.
clonic phase.
D.
postictal phase
A.
aura.
Which of the following statements about seizures is NOT true?
A.
The most common seizure that EMTs are likely to be called on is a tonic-clonic seizure.
B.
A generalized seizure affects the entire brain.
C.
Many seizures are followed by an aura.
D.
A partial seizure affects one part, or one side, of the brain.
C.
Many seizures are followed by an aura.
Which of the following is the MOST critical piece of equipment to have immediately available for the seizure patient who has just stopped convulsing?
A.
Cervical collar
B.
Glucometer
C.
Bite block
D.
Suction
D.
Suction
Which of the following refers to difficulty in using words or understanding speech as a result of a stroke?
A.
Hemiparesis
B.
Ischemia
C.
Ataxia
D.
Aphasia
D.
Aphasia
Many diabetics today have an insulin pump. Which of the following statements about insulin pumps is NOT true?
A.
They are usually worn on the belt.
B.
They have a catheter that enters into the abdomen or thigh.
C.
They are about the size of a deck of cards.
D.
They are usually worn around the ankle.
D. They are usually worn around the ankle
When someone is experiencing hypoglycemia, the body attempts to compensate by using the fight-or-flight mechanism of the autonomic nervous system. Which of the following is NOT one of the fight-or-flight responses?
A.
The heart pumps faster.
B.
Breathing accelerates.
C.
Blood vessels constrict.
D.
The skin is hot and dry.
D.
The skin is hot and dry.
The most common medical emergency for the diabetic is hypoglycemia, or low blood sugar. Which of the factors below is NOT a cause of hypoglycemia?
A.
Vomits a meal
B.
Over-exercises or over-exerts himself
C.
Takes too much insulin
D.
Reduces sugar intake by eating too much
D.
Reduces sugar intake by eating too much
You have arrived on the scene of a call for a possible stroke. On your arrival, the patient denies signs and symptoms, is alert and oriented, and moves all extremities well. Her husband states that before you arrived the patient could not move her right arm and the left side of her face seemed to be “slack.” Which of the following has most likely occurred?
A.
The patient suffered a transient ischemic attack.
B.
The patient suffered a stroke.
C.
The patient has had a subarachnoid hemorrhage.
D.
The patient is suffering from aphasia.
A.
The patient suffered a transient ischemic attack.
Which of the following may result in hypoglycemia in the diabetic patient?
A.
Vomiting after eating a meal
B.
Lack of exercise
C.
Failure to take insulin or oral diabetes medications
D.
Overeating
A. Vomiting after a meal
Your patient is a 59-year-old female with a sudden onset of slurred speech and weakness on her right side. Which of the following measures is appropriate?
A.
Keep the patient in a supine position.
B.
Test the patient’s sensation with a series of pinpricks, beginning at the feet and working upward.
C.
Administer oral glucose and then assess the patient’s blood sugar.
D.
Immediately transport the patient to a hospital with specialized treatment for stroke patients.
D.
Immediately transport the patient to a hospital with specialized treatment for stroke patients.
Which of the following is the most common cause of seizures in adults?
A.
Fever
B.
Head trauma
C.
Withdrawal from alcohol
D.
Failure to take prescribed medication
Failure to take prescribed medication
Which of the following is the cause of most strokes?
A.
Blockage of an artery supplying part of the brain
B.
A ruptured cerebral artery due to an aneurysm
C.
A spasm in an artery supplying part of the brain
D.
A ruptured cerebral artery due to hypertension
A.
Blockage of an artery supplying part of the brain
Which of the following is LEAST important for the patient who has stopped seizing before the EMT’s arrival at the scene?
A.
Requesting advanced life support
B.
Checking for mechanism of injury
C.
Suctioning
D.
Administering oxygen
A.
Requesting advanced life support
Which is NOT one of the steps in managing a patient experiencing dizziness and syncope?
A.
Apply cold packs to the patient’s head.
B.
Loosen any tight clothing around the neck.
C.
Lay the patient flat.
D.
Administer oxygen.
A.
Apply cold packs to the patient’s head.
Your patient is a 25-year-old female with a history of diabetes. She is confused, agitated, and verbally abusive to you, and she is very sweaty. Although she refuses to give a history of the present illness, which of the following should you suspect as the likely cause of the patient’s presentation?
A.
Failure to intake sufficient sugar
B.
Excessive intake of foods high in sugar, such as soda or candy
C.
Failure to take her insulin
D.
A nondiabetic-related problem, such as a head injury or mental illness
A.
Failure to intake sufficient sugar
Which of the following is a typical cause of seizures in children 6 months to 3 years of age?
A.
Fever
B.
Chest pain
C.
Administration of glucose to a hyperglycemic patient
D.
Asthma
A.
Fever
The signs and symptoms of a transient ischemic attack (TIA) may last up to:
A.
1 hour.
B.
6 hours.
C.
24 hours.
D.
30 minutes.
C.
24 hours.
During your primary assessment, you find your patient has an altered mental status. This could indicate which of the following?
A.
Problems with the RAS due to hypertension
B.
The need to complete a secondary assessment
C.
Failing respiratory system
D.
The need for suctioning of the airway
C.
Failing respiratory system
Which of the following is NOT a sign or symptom of stroke?
A.
Chest pain
B.
Vomiting
C.
Sudden impairment of vision
D.
Seizure
A.
Chest pain
Which of the following is characteristic of a patient with hyperglycemia?
A.
A “fruity” odor of the breath
B.
Use of excessive amounts of insulin or lack of adequate food intake
C.
Pale and sweaty skin, confusion, and increased heart rate
D.
Sudden onset of altered mental status
A.
A “fruity” odor of the breath
Which of the following is one of the most common characteristics of a stroke?
A.
Sudden, severe headache
B.
Weakness on one side of the body
C.
Projectile vomiting
D.
Sudden onset of violent behavior
B.
Weakness on one side of the body
Many factors that cause dizziness and syncope are generally related to the:
A.
lungs.
B.
kidneys.
C.
brain.
D.
heart.
C.
brain.
Your patient is a 70-year-old man whose wife called EMS because her husband began exhibiting unusual behavior. Upon your arrival you introduce yourself to thepatient, who responds, “Not until nine o’clock.” This phenomenon is BEST described as:
A.
disorientation to time.
B.
expressive aphasia.
C.
receptive aphasia.
D.
unresponsive to verbal stimuli.
C.
receptive aphasia.
Most of the diabetic emergencies that you will be called to deal with will be related to hypoglycemia. However, occasionally you will experience an instance of hyperglycemia. In the list below, which item is NOT likely to be a sign or symptom of hyperglycemia?
A.
Reduced rate of breathing
B.
Nausea
C.
Excessive urination
D.
Chronic thirst
A.
Reduced rate of breathing
Which of the following is the role of glucose in the body?
A.
It provides energy for brain cells and other cells in the body.
B.
It is an essential building block for body tissues, such as muscle and bone.
C.
It allows the body to use insulin.
D.
It assists the pancreas in the manufacture of insulin.
A.
It provides energy for brain cells and other cells in the body.
Which of the following is an action of insulin?
A.
It assists the transfer of sugar from the stomach and small intestine to the bloodstream.
B.
It blocks the uptake of sugar by the body’s cells.
C.
It helps the movement of sugar from the bloodstream to the cell.
D.
It increases the circulating level of glucose in the blood.
C.
It helps the movement of sugar from the bloodstream to the cell.
Which of the following is within the EMT’s scope of practice for the treatment of the diabetic patient?
A.
Assisting the patient with the administration of his insulin
B.
Administration of oral glucose
C.
Rectal administration of glucose
D.
Both A and B
B.
Administration of oral glucose
Your patient is a 19-year-old female who is 7 months pregnant. She just experienced a seizure. Although she has no previous history of seizures or any other medicalcondition, she was just diagnosed with pregnancy-induced hypertension. Which of the following is the most likely cause of the seizure?
A.
Hypoglycemia
B.
Trauma
C.
Eclampsia
D.
Any of the above
C.
Eclampsia
Many stroke patients are candidates for thrombolytic drugs. One of the most important things that an EMT can do to optimize the care of a stroke patient who is a candidate for the drugs is:
A.
transport to the closest hospital because the patient must go to the operating room as soon as possible.
B.
do a thorough physical exam of the patient.
C.
determine the exact time of onset of symptoms.
D.
transport the patient to a Level I trauma center.
C.
determine the exact time of onset of symptoms.
A seizure that occurs spontaneously from an unknown cause is called:
A.
toxinic.
B.
idiopathic.
C.
hypoglycemic.
D.
hypoxic.
B.
idiopathic.
Which of the following conditions may be mimicked by hypoglycemia?
A.
Intoxication
B.
Heart attack
C.
Respiratory distress
D.
All of the above
A.
Intoxication
With advances in clot-busting (thrombolytic) drugs, the patient has a window of ________ hours to receive treatment.
A.
4
B.
6
C.
5
D.
3
D.
3
You are on the scene of a 40-year-old male patient who is anaphylactic and still unresponsive following a single epinephrine injection. Prior to giving the injection, you inserted an oral airway and administered oxygen at 15 liters per minute by bag-valve mask and your partner found diminished lung sounds. Following the epinephrineadministration, your partner reassesses lung sounds and tells you that the patient is now wheezing loudly in all fields. What is the next action you should perform?
A.
Contact medical control and request to administer another dose of epinephrine.
B.
Place the patient on a nonrebreather mask.
C.
Discontinue bagging the patient.
D.
Hyperventilate the patient.
A.
Contact medical control and request to administer another dose of epinephrine.
Which of the following does not commonly lead to anaphylaxis?
A.
Cat dander
B.
Wasp stings
C.
Peanuts
D.
Penicillin
A.
Cat dander
You are treating a 28-year-old female who is 34 weeks pregnant. She has a history of bee sting anaphylaxis and was stung by a bee while in the garden. She is having severe respiratory distress and her blood pressure is 72/50 mmHg. Which of the following is the best option for the EMT?
A.
Administer the EpiPen® only on the advice of medical control.
B.
Immediately administer the patient’s EpiPen®.
C.
Transport rapidly, bypassing the emergency department and taking the patient directly to the obstetrics unit of the hospital.
D.
Do not administer the EpiPen® under any circumstances.
A.
Administer the EpiPen® only on the advice of medical control.
Which of the following is the reason why infants rarely experience anaphylactic reactions?
A.
Allergens do not affect infants.
B.
Infants have not yet developed antibodies to allergens.
C.
Infants have received natural immunity to allergens from their mothers before birth.
D.
None of the above
B.
Infants have not yet developed antibodies to allergens.
Which of the following is not a sign or symptom of an allergic reaction involving the skin?
A.
Cyanosis
B.
Itching
C.
Flushing
D.
Hives
A.
Cyanosis
You respond to a local swim park for a 29-year-old male who was stung by a bee and “passed out.” Upon arrival, you find the patient unresponsive to all stimuli with agonal respirations at 6 per minute. You insert an oral airway and administer oxygen at 15 liters per minute by bag-valve mask. You notice that it is difficult to bag the patient. Your partner listens to lung sounds and states they are very diminished in the upper fields and absent in the lower fields. What is the best action?
A.
Request orders from medical control to administer epinephrine.
B.
Request an ALS unit.
C.
Request orders from medical control for an emergency cricothyroidotomy.
D.
Hyperventilate the patient.
A.
Request orders from medical control to administer epinephrine.
Which of the following statements concerning severe allergic reactions is true?
A.
A severe allergic reaction can be prevented by the use of an epinephrine auto-injector before exposure to the substance.
B.
Severe reactions often occur immediately, but they are occasionally delayed 30 minutes or more.
C.
Allergies do not develop until a person is in his late teens to early 20s.
D.
A severe allergic reaction occurs only when the patient has never been exposed to the substance before.
B.
Severe reactions often occur immediately, but they are occasionally delayed 30 minutes or more.
Which of the following is the result of histamine and other chemicals in the body during anaphylaxis?
A.
Urticaria occurs due to fluid being shunted from the skin, causing dehydration of tissue.
B.
Capillaries become leaky, bronchoconstriction occurs, and swelling appears in areas around the vocal cords.
C.
Blood vessels constrict, capillaries become leaky, and bronchoconstriction occurs.
D.
Bronchodilation occurs, blood vessels dilate, and swelling appears in areas around the vocal cords.
B.
Capillaries become leaky, bronchoconstriction occurs, and swelling appears in areas around the vocal cords.
Which of the following is the proper method of disposing of a used epinephrine auto-injector?
A.
Place the device in a rigid biohazardous sharps disposal container.
B.
Leave it at the scene for the patient or his family to dispose of.
C.
Bend the needle at an angle to prevent accidental punctures and place it in the trash.
D.
Take it to the hospital for disposal in the emergency department.
A.
Place the device in a rigid biohazardous sharps disposal container.
If a patient is having a myocardial infarction-not an allergic reaction-and receives an epinephrine auto-injection, which of the following will most likely occur?
A.
Bradycardia
B.
No reaction if administered inadvertently
C.
Stronger and faster heartbeat
D.
Relief of shortness of breath
C.
Stronger and faster heartbeat
After administering epinephrine per medical control via an auto-injector to an unresponsive anaphylactic adult patient, your partner reassesses the lung sounds. He tells you that the patient is now wheezing loudly in all fields whereas before the injection they were diminished in the upper fields and absent in the lower. What is your suspicion regarding the patient’s condition?
A.
There is no change in the patient’s condition.
B.
The patient’s condition is improving.
C.
The patient is about to go into cardiac arrest.
D.
The patient’s condition is worsening.
B.
The patient’s condition is improving.
Your patient is a 7-year-old girl who was prescribed an antibiotic for an ear infection. After 4 days on the antibiotic, the patient is experiencing hives and itching on herface, throat, and neck. Which of the following should you do?
A.
Advise the parents to call the pediatrician for a different antibiotic.
B.
Immediately administer EpiPen Jr.®
C.
Provide supportive care and monitor the patient’s condition during transport to the hospital.
D.
Advise the parents that these symptoms are related to the ear infection and the antibiotic will take care of these symptoms if taken as directed.
C.
Provide supportive care and monitor the patient’s condition during transport to the hospital.
You have responded to a park where you find a 23-year-old female sitting on a bench near a running trail. She states that she has been running for the past 30 minutes and suddenly cannot catch her breath. She states that this has never happened before and she usually runs 5 miles a day. Your assessment reveals that she isflushed, her pulse is fast and weak, her respirations are fast and she is wheezing, and she has hives on her arms and chest. She is most likely suffering from which of the following?
A.
Hyperventilation syndrome
B.
Heat stroke
C.
Allergic reaction
D.
Anaphylaxis
D.
Anaphylaxis
Which of the following is included in the primary assessment of a conscious patient suffering from anaphylactic shock?
A.
Looking for hives and swelling
B.
Determining whether the patient’s systolic blood pressure is over 100 mmHg
C.
Assessing whether the patient is able to speak without difficulty
D.
Finding out how the patient was exposed to the substance to which she is allergic
C.
Assessing whether the patient is able to speak without difficulty
Your patient is a 45-year-old female who is allergic to sesame seeds, which she accidentally ingested when she ate a deli sandwich. She is having difficulty breathing and she has hives, watery eyes, a weak pulse of 120 per minute, and swelling of the face and tongue. Which of the following is the best course of immediate action?
A.
Contact dispatch to see where the closest ALS unit is.
B.
Contact medical control for orders to administer the patient’s epinephrine auto-injector.
C.
Insert an oropharyngeal airway (OPA).
D.
Transport immediately.
B.
Contact medical control for orders to administer the patient’s epinephrine auto-injector.
You are called to a residence for a 60-year-old male complaining of chest pain. You find the patient seated in bed. His past medical history includes hypertension and high cholesterol. The patient presents with hives over the chest, stridor, a swollen tongue, and wheezing in the upper fields. He denies any shortness of breath or respiratory distress, but does so in short two- to three-word statements. What condition do you suspect?
A.
Asthma
B.
Anaphylaxis
C.
Acute myocardial infarction
D.
Angina pectoris
B.
Anaphylaxis
You are transporting a 41-year-old female suffering from severe anaphylaxis. Her respiratory rate is 42 per minute, she is cyanotic, and she has a decreased level of responsiveness. Which of the following is the highest priority of care for this patient?
A.
Search for an epinephrine auto-injector.
B.
Transport rapidly.
C.
Assist ventilations with a bag-valve mask.
D.
Elevate the patient’s head.
C.
Assist ventilations with a bag-valve mask.
You are called to a residence for a 50-year-old male complaining of difficulty breathing. He is alert and oriented to time, place, and person. The patient presents with hives over the chest, stridor, a swollen tongue, and wheezing in the upper fields. He is breathing 32 times per minute. He is speaking in two- to three-word sentences. What is the best treatment for the patient?
A.
Oxygen at 15 liters per minute by bag-valve mask
B.
Oxygen at 15 liters per minute by nonrebreather mask
C.
Rapid transport to the nearest facility
D.
Administering epinephrine with consent from medical control
D.
Administering epinephrine with consent from medical control
Which of the following is not an indication that epinephrine is helping the anaphylaxis patient’s condition?
A.
Increased blood pressure
B.
Increased heart rate
C.
Increased dyspnea
D.
Both B and C
C.
Increased dyspnea
Which of the following changes commonly occurs in the cardiovascular system during anaphylaxis?
A.
High blood pressure due to tachycardia
B.
Low blood pressure due to vasodilation
C.
High blood pressure due to vasoconstriction
D.
Low blood pressure due to bradycardia
B.
Low blood pressure due to vasodilation
Your patient has eaten a casserole that may have contained seafood. The patient is worried because he has a seafood allergy. Upon assessment, you find no signs or symptoms of anaphylaxis. The patient’s vital signs are stable and he has an epinephrine auto-injector prescribed to him. Which of the following actions is mostappropriate?
A.
Assist him with the administration of his epinephrine auto-injector.
B.
Transport the patient rapidly before the onset of anaphylaxis.
C.
Try to find out if the casserole contained seafood.
D.
Advise the patient that he does not require treatment and transport at this time.
C.
Try to find out if the casserole contained seafood.
You are unsure whether a patient’s condition requires the administration of an epinephrine auto-injector. Which of the following actions is most appropriate?
A.
Administer the epinephrine, just in case.
B.
Consult with a paramedic on your service for advice.
C.
Ask a family member if this is the type of situation when the patient usually takes his auto-injector.
D.
None of the above
D.
None of the above
When documenting the administration of an epinephrine auto-injector, which of the following should be included?
A.
Time the medication was administered
B.
Site of medication administration
C.
Patient’s response to the medication
D.
All of the above
D.
All of the above
After activating the EpiPen® auto-injector, how long should it be held in place before removing it from the patient’s thigh?
A.
10 seconds
B.
It should be removed from the injection site immediately.
C.
1 minute
D.
30 seconds
A.
10 seconds
Which of the following does a physician not take into consideration when writing a prescription for a patient to obtain an epinephrine auto-injector?
A.
Severity of previous allergic reactions
B.
Patient’s medical history
C.
Patient’s known allergies
D.
How far the patient lives from medical attention
D.
How far the patient lives from medical attention
You are called to a farmhouse on a sunny spring afternoon. Upon arrival, a frantic mother tells you that her 3-year-old daughter was playing in the yard, accidentally stepped on a hornets’ nest, and was stung repeatedly. The patient is alert, screaming and crying, and can follow her mother’s commands. Her arms and legs are swollen and show the marks of several stings. Her body is covered in hives. Her vital signs are blood pressure 90/40, pulse 110, respiratory rate 24, and oxygen saturation 99 percent. Her lung sounds are clear and equal bilaterally. Her mother states she put “nox-a-sting” on the bites but the bites only seemed to get worse. What condition is the patient suffering from?
A.
Moderate anaphylactic reaction
B.
Allergic reaction from the hornets’ stings
C.
Anaphylactic reaction from the “nox-a-sting” swabs
D.
Minor anaphylactic reaction
B.
Allergic reaction from the hornets’ stings
You are on the scene of a 22-year-old female patient who is unresponsive. The patient’s mother states that she is deathly allergic to peanuts and accidentally ate stir fry cooked in peanut oil. The patient is unresponsive with agonal respirations at 6 per minute. What is your first action?
A.
Perform a complete assessment and confirm that the patient is actually in anaphylaxis.
B.
Administer epinephrine with medical control consent.
C.
Insert an oral airway and apply oxygen at 15 liters per minute by nonrebreather mask.
D.
Insert an oral airway and apply oxygen at 15 liters per minute by bag-valve mask.
D.
Insert an oral airway and apply oxygen at 15 liters per minute by bag-valve mask.
You are on the scene of a motor vehicle collision in which a car has driven off the roadway and is resting at the bottom of an embankment. The driver is in severe respiratory distress and is unable to speak. His skin is flushed and he has hives. A Medic-Alert bracelet indicates an allergy to peanuts. You notice a candy bar wrapper on the floor of the car. Which of the following should you do first?
A.
Search the patient for an epinephrine auto-injector.
B.
Read the candy wrapper to see if it contains peanuts.
C.
Perform rapid extrication.
D.
Administer high-concentration oxygen.
D.
Administer high-concentration oxygen.
Which of the following would you expect to hear when auscultating the lungs of a patient having an anaphylactic reaction?
A.
Fine, wet crackles or rales
B.
Coarse-sounding rhonchi
C.
Clear, adequate air movement
D.
Wheezing
D.
Wheezing
Which of the following is not a side effect of epinephrine?
A.
Pallor
B.
Vomiting
C.
Bradycardia
D.
Chest pain
C.
Bradycardia
Which of the following explains why a patient may experience difficulty breathing during anaphylaxis?
A.
Allergens clump together and block blood flow through the lungs.
B.
Swelling of the airway tissues causes difficulty breathing.
C.
Swelling in the brain decreases the respiratory drive.
D.
Allergens bind to hemoglobin, preventing it from carrying oxygen.
B.
Swelling of the airway tissues causes difficulty breathing.
Which of the following is an action caused by epinephrine in anaphylaxis?
A.
Bronchoconstriction
B.
Decreased heart rate
C.
Vasoconstriction
D.
All of the above
C.
Vasoconstriction
You are called to the local park on a hot summer day for an 8-year-old child in respiratory distress. The child can barely speak and appears to be getting sleepy. Vital signs are blood pressure 90/60, pulse 120, and respiratory rate 32. Your physical exam reveals a swollen tongue, inspiratory stridor, wheezing, and hives on the neck and chest. What condition do you suspect?
A.
Heat exhaustion
B.
Asthma
C.
Allergic reaction
D.
Anaphylaxis
D.
Anaphylaxis
Which of the following is a general term for a substance to which the body may have an anaphylactic reaction?
A.
Antibody
B.
Pathogen
C.
Pyrogen
D.
Allergen
D.
Allergen
A 35-year-old female has just eaten lobster and is now complaining of itchy, watery eyes. Her blood pressure is beginning to fall, but she denies difficulty breathing. Which of the following best describes her condition?
A.
Shock
B.
Anaphylaxis
C.
Dyspnea
D.
Mild allergy
B.
Anaphylaxis
Most epinephrine auto-injectors contain how many doses of epinephrine?
A.
Two
B.
One
C.
Three
D.
None of the above
B.
One
Your patient has a history of severe anaphylaxis and carries several auto-injectors. You have administered one of the auto-injectors, but the patient’s condition continues to worsen. Which of the following is the next best course of action?
A.
Immediately administer a second auto-injector.
B.
Contact medical control.
C.
Continue supportive care en route to the hospital.
D.
Divert transport to a hospital with critical care capabilities.
B.
Contact medical control.
Which of the following happens to blood vessels during an anaphylactic reaction?
A.
Dilation
B.
No change
C.
Spasm
D.
Constriction
A.
Dilation
