homework week 12 Flashcards
A 20-year-old woman complains of difficulty breathing and the feeling of a lump in her throat approximately 10 minutes after being stung by a wasp. Your assessment reveals that she is anxious, is in obvious respiratory distress, and has hives covering her arms and legs. Further assessment reveals diffuse wheezing, a blood pressure of 80/50 mm Hg, and a heart rate of 120 beats/min. You should:
Select one:
a. immediately sedate and intubate her to protect her airway, administer Benadryl IM, and consider an epinephrine infusion.
b. administer albuterol via an inline nebulizer attached to a bag-mask device, assist ventilations, and consider administering epinephrine.
c. apply high-flow oxygen via nonrebreathing mask, administer epinephrine via the IM route, and establish vascular access.
d. administer high-flow oxygen, start a large-bore IV, infuse up to 2 liters of normal saline, and administer epinephrine SQ.
c. apply high-flow oxygen via nonrebreathing mask, administer epinephrine via the IM route, and establish vascular access.
A middle-aged male who received a kidney transplant called EMS because he was not feeling well. Which of the following assessment findings is MOST suggestive of organ rejection?
Select one:
a. Excessive urine output, shortness of breath, and a diffuse rash
b. Blood in the urine, diffuse abdominal pain, and hypothermia
c. Fever with swelling and tenderness over the implanted kidney
d. Bilateral flank pain that radiates to both shoulders and scapulae
c. Fever with swelling and tenderness over the implanted kidney
Chest pain in patients with a heart transplant is uncommon because:
Select one:
a. the denervated heart cannot generate angina-like pain.
b. most patients with heart transplants have diabetes.
c. the newly-implanted heart is without atherosclerosis.
d. a ventricular assist device keeps the heart oxygenated.
a. the denervated heart cannot generate angina-like pain.
Patients with ______________ are at an increased risk for anaphylaxis.
Select one:
a. strep infection
b. acute pharyngitis
c. immunosuppression
d. atopic dermatitis
d. atopic dermatitis
Anaphylaxis is classified as a response mediated by ____ antibodies.
Select one:
a. IgD
b. IgE
c. IgG
d. IgA
b. IgE
An abnormal immune response that the body develops when it is re-exposed to an allergen is called:
Select one:
a. anaphylaxis.
b. secondary response.
c. hypersensitivity
d. an allergic reaction.
d. an allergic reaction.
A 31-year-old man presents with diffuse hives, intense itching, and watery eyes that began acutely about an hour ago. He is conscious and alert, is breathing without difficulty, and tells you that he does not have any allergies or significant medical problems. His blood pressure is 126/76 mm Hg, pulse is 80 beats/min and strong, and respirations are 16 breaths/min and unlabored. What drug should you administer?
Select one:
a. Oxygen
b. Albuterol
c. Epinephrine
d. Diphenhydramine
d. Diphenhydramine
A 49-year-old male who had a heart transplant presents with a heart rate of 40 beats/min. He is weak, dizzy, lightheaded, and hypotensive. Which of the following medications would be the LEAST beneficial?
Select one:
a. Atropine
b. Epinephrine
c. Isoproterenol
d. Norepinephrine
a. Atropine
For which of the following reasons would a corticosteroid be administered to a patient who is experiencing an allergic reaction?
Select one:
a. Prevention of idiopathic reactions or recurrent anaphylaxis
b. To block H1 receptors and terminate the allergic reaction
c. To cause vasoconstriction and improve the patient’s blood pressure
d. To cause bronchodilation and restore adequate breathing
d. To cause bronchodilation and restore adequate breathing
What is the MOST common cardiac disorder associated with lupus?
Select one:
a. Endocarditis
b. Pericarditis
c. Pericardial effusion
d. Valvular heart disease
b. Pericarditis
You have administered the appropriate dose of epinephrine to a patient with a severe allergic reaction. Reassessment reveals that the patient’s condition has improved markedly. The patient, who has a history of coronary artery disease, is receiving high-flow oxygen and is on a cardiac monitor. You should next:
Select one:
a. start an epinephrine infusion, administer Benadryl IV or IM, and transport without delay.
b. transport immediately, monitor airway and breathing en route, and administer Benadryl IV or IM.
c. administer a half dose of epinephrine, begin transport, and give the patient Solu-Medrol en route.
d. transport immediately, monitor the patient’s blood pressure en route, and give IV fluid boluses if symptoms recur.
b. transport immediately, monitor airway and breathing en route, and administer Benadryl IV or IM.
An antigen is MOST accurately defined as a:
Select one:
a. chemical the immune system produces to destroy an allergen.
b. substance that causes the immune system to produce antibodies.
c. chemical mediator that deactivates foreign substances in the body.
d. harmless substance that the body does not recognize as being foreign.
b. substance that causes the immune system to produce antibodies.
A 26-year-old female presents with a fever, rash, and joint pain. What should you suspect?
Select one:
a. Lupus
b. Anaphylaxis
c. Scleroderma
d. Allergic reaction
a. Lupus
The longer the time between exposure to a substance:
Select one:
a. the greater the chance of massive IgE antibody production.
b. the less likely a severe anaphylactic reaction will occur.
c. the greater the chance that severe anaphylaxis will occur.
d. the less likely that any kind of allergic reaction will occur.
b. the less likely a severe anaphylactic reaction will occur.
You are caring for a 40-year-old man in obvious anaphylactic shock after being stung by a scorpion. The patient is responsive to pain only, has poor respiratory effort, and is hypotensive and tachycardic. Which of the following represents the MOST appropriate treatment sequence for this patient?
Select one:
a. Immediate intubation, epinephrine SQ, two large-bore IV lines with normal saline, a 250-mL normal saline bolus, and Benadryl IM
b. Assisted ventilation, intubation if necessary, at least one large-bore IV with normal saline, epinephrine IM or IV, and Benadryl IV or IM
c. High-flow oxygen via nonrebreathing mask, Solu-Medrol IV, two large-bore IV lines with normal saline, and 20-mL/kg boluses of normal saline
d. Assisted ventilation, i-gel insertion, Benadryl IM followed immediately by epinephrine SQ, and a large-bore IV with normal saline
b. Assisted ventilation, intubation if necessary, at least one large-bore IV with normal saline, epinephrine IM or IV, and Benadryl IV or IM
