Ch 33

Most of the serious injuries associated with scuba diving are caused by: a) cold water temperature. b) too rapid of a descent. c) alcohol consumption. d) too rapid of an ascent.

d) too rapid of an ascent.

A person's ability to shiver is lost when his or her body temperature falls below: c) 94°F (34°C). b) 92°F (33°C). d) 95°F (35°C). a) 90°F (32°C).

a) 90°F (32°C).

Which of the following statements regarding lightning strikes is correct? b) The tissue damage pathway caused by lightning usually occurs through the skin. c) Victims who are struck by lightning often experience severe full-thickness burns. d) Cervical spine fractures are the most common cause of lightning-related deaths. a) Lightning strikes might cause cardiac dysrhythmias that spontaneously resolve.

a) Lightning strikes might cause cardiac dysrhythmias that spontaneously resolve.

Which of the following statements regarding lightning strikes is correct? d) Cervical spine fractures are the most common cause of lightning-related deaths. c) Victims who are struck by lightning often experience severe full-thickness burns. a) Lightning strikes might cause cardiac dysrhythmias that spontaneously resolve. b) The tissue damage pathway caused by lightning usually occurs through the skin.

a) Lightning strikes might cause cardiac dysrhythmias that spontaneously resolve.

Which of the following is an early sign of pit viper envenomation? b) General weakness and diaphoresis d) Signs and symptoms of hypoperfusion c) Syncope and bleeding at distal sites a) Local swelling and ecchymosis

a) Local swelling and ecchymosis

Which of the following is an early sign of pit viper envenomation? c) Syncope and bleeding at distal sites d) Signs and symptoms of hypoperfusion a) Local swelling and ecchymosis b) General weakness and diaphoresis

a) Local swelling and ecchymosis

You are dispatched to a residence for a young female who is sick. The patient complains of a rash to her lower extremities and truncal area. Your assessment reveals a small, painful blister on her inner thigh. As your partner is taking the patient's vital signs, she states that she and her family returned from a camping trip two days ago. On the basis of this patient's presentation, you should suspect: c) exposure to poison ivy. b) an allergic reaction. a) Lyme disease. d) Rocky Mountain spotted fever.

a) Lyme disease.

Which of the following would be the least likely to occur in a patient with a core body temperature of between 89°F (32°C) and 92°F (33°C)? a) Muscle activity increases b) Shivering stops c) Finger motion ceases d) Mental status decreases

a) Muscle activity increases

You are assessing a 33-year-old male who complains of severe abdominal pain, weakness, and nausea. He tells you that he was gathering wood to build a fire when he felt a sudden, sharp pain on the back of his hand. Your assessment reveals that the patient's abdomen is rigid and painful to palpation. You should suspect: a) a black widow spider bite. b) envenomation from a pit viper. c) a brown recluse spider bite. d) Rocky Mountain spotted fever.

a) a black widow spider bite.

After being stung on the leg by a jellyfish, a man complains of severe pain to his leg, dizziness, and difficulty breathing. He has a red rash covering his trunk, and his blood pressure is 90/50 mm Hg. The EMT should: b) remove the stingers from his leg by scraping them with a stiff object. d) apply warmth to the sting area and cover it with a dry sterile dressing. a) administer oxygen and epinephrine and prepare for rapid transport. c) begin transport and immerse his leg in hot water to help reduce pain.

a) administer oxygen and epinephrine and prepare for rapid transport.

The diving reflex might allow a person to survive extended periods of submersion in cold water secondary to: c) tachycardia and a lowering of the blood pressure. b) laryngospasm that protects the lungs from water. d) increases in the metabolic rate and oxygen demand. a) bradycardia and a slowing of the metabolic rate.

a) bradycardia and a slowing of the metabolic rate.

The diving reflex might allow a person to survive extended periods of submersion in cold water secondary to: d) increases in the metabolic rate and oxygen demand. c) tachycardia and a lowering of the blood pressure. a) bradycardia and a slowing of the metabolic rate. b) laryngospasm that protects the lungs from water.

a) bradycardia and a slowing of the metabolic rate.

Covering a patient's _________ will significantly minimize radiation heat loss. c) abdomen a) head b) chest d) extremities

a) head

Shivering is a mechanism in which the body generates heat by: d) retaining excess carbon dioxide. c) decreasing the metabolic rate. b) decreasing the use of oxygen. a) increasing the metabolic rate.

a) increasing the metabolic rate.

To obtain the most accurate reading of a patient's core body temperature, you should place a special hypothermia thermometer: a) into the patient's rectum. d) under the patient's armpit. b) under the patient's tongue. c) behind the patient's knee.

a) into the patient's rectum.

You and your partner are standing by at a large social event at a river resort when a frantic woman tells you that she found a young male floating face-down in the water. Nobody claims to have witnessed the event. After you and your partner enter the water and reach the patient, you should: d) open his airway with the jaw-thrust maneuver. a) move him as a unit to a supine position. c) immediately secure him to a longboard. b) begin ventilations with a barrier device.

a) move him as a unit to a supine position.

High air temperature reduces the body's ability to lose heat by: d) evaporation. b) convection. a) radiation. c) conduction.

a) radiation.

You respond to a local lake where a diver complains of difficulty breathing that occurred immediately after rapidly ascending from a depth of approximately 30 feet. On assessment, you note that he has cyanosis around his lips and pink froth coming from his nose and mouth. You should: c) suction his mouth and nose, keep him supine and elevate his legs to prevent air bubbles from entering his brain, administer high-flow oxygen, and transport to a hyperbaric chamber. b) place him in a semi-sitting position, suction his mouth and nose, apply a continuous positive airway pressure (CPAP) device, and transport to the closest emergency department. d) position him supine with his head elevated 30°, suction his mouth and nose, hyperventilate him with a bag-valve mask, and contact medical control for further guidance. a) suction his mouth and nose, apply high-flow oxygen, monitor the patient's breath sounds for a pneumothorax, and contact medical control regarding transport to a recompression facility.

a) suction his mouth and nose, apply high-flow oxygen, monitor the patient's breath sounds for a pneumothorax, and contact medical control regarding transport to a recompression facility.

Burns associated with lightning strikes are typically: d) partial-thickness. a) superficial. c) full-thickness. b) third-degree.

a) superficial.

Heat loss from the body through respiration occurs when: b) the core body temperature is greater than 98°F (37°C). a) warm air is exhaled into the atmosphere. d) air temperature is greater than body temperature. c) cool air is inhaled and displaces warm air.

a) warm air is exhaled into the atmosphere.

Heat loss from the body through respiration occurs when: c) cool air is inhaled and displaces warm air. d) air temperature is greater than body temperature. b) the core body temperature is greater than 98°F (37°C). a) warm air is exhaled into the atmosphere.

a) warm air is exhaled into the atmosphere.

Hypothermia occurs when the core body temperature falls below: c) 90°F (32°C). a) 98°F (37°C). b) 95°F (35°C). d) 88°F (31°C).

b) 95°F (35°C).

Hypothermia occurs when the core body temperature falls below: c) 90°F (32°C). d) 88°F (31°C). a) 98°F (37°C). b) 95°F (35°C).

b) 95°F (35°C).

Which of the following most accurately describes hyperthermia? a) The core body temperature exceeds 99.5°F (37°C). c) Heat evaporates a significant amount of body water. b) The body is exposed to more heat than it can lose. d) The body eliminates more heat than it can generate.

b) The body is exposed to more heat than it can lose.

Which of the following most accurately describes hyperthermia? b) The body is exposed to more heat than it can lose. a) The core body temperature exceeds 99.5°F (37°C). c) Heat evaporates a significant amount of body water. d) The body eliminates more heat than it can generate.

b) The body is exposed to more heat than it can lose.

Compared to adults, infants and children are at higher risk for hypothermia for all of the following reasons, except: b) a relatively small surface area. c) a smaller amount of body fat. d) a smaller overall muscle mass. a) a decreased ability to shiver.

b) a relatively small surface area.

Compared to adults, infants and children are at higher risk for hypothermia for all of the following reasons, except: b) a relatively small surface area. d) a smaller overall muscle mass. c) a smaller amount of body fat. a) a decreased ability to shiver.

b) a relatively small surface area.

A 30-year-old male was rescued after being lost in the woods for approximately 18 hours. The outside temperature is 30°F (−1°C). He is immediately placed in the warmed ambulance, where you perform a primary assessment. He is unresponsive, pale, and apneic. You should: a) apply an automated external defibrillator and assess his cardiac rhythm. c) open his airway and give two rescue breaths. b) assess for a carotid pulse for up to 60 seconds. d) apply chemical heat packs to his groin and axillae.

b) assess for a carotid pulse for up to 60 seconds.

When a warm hand is immersed in water that is 70°F (21°C), heat is transferred from the hand to the water through a process called: c) convection. b) conduction. d) evaporation. a) radiation.

b) conduction.

All of the following terms refer to a body part that is cold but not frozen, except: b) frostbite. a) frostnip. c) trench foot. d) immersion foot.

b) frostbite.

For sweating to be an effective cooling mechanism: d) the body must produce at least 1 L per hour. a) several layers of clothing must be worn. b) it must evaporate from the body. c) the relative humidity must be above 90%.

b) it must evaporate from the body.

The venom of a black widow spider is toxic to the: b) nervous system. c) respiratory system. a) renal system. d) cardiovascular system.

b) nervous system.

Signs and symptoms of an air embolism include all of the following, except: a) dysphasia. c) dizziness. d) joint pain. b) pale skin.

b) pale skin.

Your assessment of a 23-year-old female reveals a core body temperature of 93.4°F (34°C). She is conscious, answers your questions appropriately, is shivering, and complains of nausea. Her skin is cold and pale, her muscles appear rigid, and her respirations are rapid. You should: c) cover her with warm blankets and let her move about on the stretcher to generate body heat and increase her temperature. d) sit her up and give her small sips of warm water to drink, place heat packs to her axillae and groin, and cover her with blankets. a) apply the automated external defibrillator in case she develops cardiopulmonary arrest, cover her with layers of blankets, and transport carefully. b) place heat packs to her groin, axillae, and behind her neck; cover her with warm blankets; and avoid rough handling.

b) place heat packs to her groin, axillae, and behind her neck; cover her with warm blankets; and avoid rough handling.

Heatstroke occurs when: d) the ambient temperature exceeds 90°F (32°C) and the humidity is high. c) a person becomes dehydrated secondary to excess water loss. a) a person's core body temperature rises above 103°F (39°C). b) the body's heat-eliminating mechanisms are overwhelmed.

b) the body's heat-eliminating mechanisms are overwhelmed.

Heatstroke occurs when: d) the ambient temperature exceeds 90°F (32°C) and the humidity is high. c) a person becomes dehydrated secondary to excess water loss. b) the body's heat-eliminating mechanisms are overwhelmed. a) a person's core body temperature rises above 103°F (39°C).

b) the body's heat-eliminating mechanisms are overwhelmed.

An air embolism associated with diving occurs when: c) the alveoli completely collapse due to high pressure. b) the diver holds his or her breath during a rapid ascent. a) the diver hyperventilates prior to entering the water. d) high water pressure forces air into the mediastinum.

b) the diver holds his or her breath during a rapid ascent.

An air embolism associated with diving occurs when: d) high water pressure forces air into the mediastinum. c) the alveoli completely collapse due to high pressure. b) the diver holds his or her breath during a rapid ascent. a) the diver hyperventilates prior to entering the water.

b) the diver holds his or her breath during a rapid ascent.

Rough handling of a hypothermic patient with a pulse might cause: b) ventricular fibrillation. a) profound bradycardia. d) pulseless electrical activity. c) ventricular tachycardia.

b) ventricular fibrillation.

Rough handling of a hypothermic patient with a pulse might cause: b) ventricular fibrillation. d) pulseless electrical activity. c) ventricular tachycardia. a) profound bradycardia.

b) ventricular fibrillation.

Breath-holding syncope is caused by a decreased stimulus to breathe and occurs when: a) a swimmer breathes shallowly before entering the water. b) a diver holds his or her breath during a staged ascent. d) a diver holds his or her breath for a long period of time. c) a swimmer hyperventilates prior to entering the water.

c) a swimmer hyperventilates prior to entering the water.

To assess a patient's general body temperature, pull back on your glove and place the back of your hand on his or her skin at the: d) forehead. b) chest. c) abdomen. a) neck.

c) abdomen.

You and your partner respond to a park where several people were reportedly struck by lightning. When you arrive, you find three patients. The first patient is lying supine on the ground; he is unresponsive and does not appear to be breathing. The second patient is ambulatory, appears confused, and is holding his arm against his chest. The third patient is sitting on the ground holding the sides of his head. After calling for backup, you should: c) assess the unresponsive patient's pulse, begin CPR starting with chest compressions if he is pulseless, and attach the automated external defibrillator as soon as possible. a) immediately begin CPR on the unresponsive patient, but cease resuscitation efforts if there is no response after five minutes of treatment. d) recognize that the patients who are conscious are at high risk for developing cardiac arrest and quickly assess them for potentially life-threatening injuries. b) focus your initial treatment efforts on the patients who are conscious because the unresponsive patient is likely in irreversible cardiac arrest.

c) assess the unresponsive patient's pulse, begin CPR starting with chest compressions if he is pulseless, and attach the automated external defibrillator as soon as possible.

You and your partner respond to a park where several people were reportedly struck by lightning. When you arrive, you find three patients. The first patient is lying supine on the ground; he is unresponsive and does not appear to be breathing. The second patient is ambulatory, appears confused, and is holding his arm against his chest. The third patient is sitting on the ground holding the sides of his head. After calling for backup, you should: c) assess the unresponsive patient's pulse, begin CPR starting with chest compressions if he is pulseless, and attach the automated external defibrillator as soon as possible. b) focus your initial treatment efforts on the patients who are conscious because the unresponsive patient is likely in irreversible cardiac arrest. a) immediately begin CPR on the unresponsive patient, but cease resuscitation efforts if there is no response after five minutes of treatment. d) recognize that the patients who are conscious are at high risk for developing cardiac arrest and quickly assess them for potentially life-threatening injuries.

c) assess the unresponsive patient's pulse, begin CPR starting with chest compressions if he is pulseless, and attach the automated external defibrillator as soon as possible.

The transfer of heat to circulating air, such as when cool air moves across the body's surface, is called: a) radiation. b) conduction. d) evaporation. c) convection.

c) convection.

All of the following snakes are pit vipers, except for the: c) coral snake. d) cottonmouth. a) copperhead. b) rattlesnake.

c) coral snake.

Geriatric patients, newborns, and infants are especially prone to hyperthermia because they: a) have relatively smaller heads. b) have less body fat. d) have smaller body surface areas. c) exhibit poor thermoregulation.

c) exhibit poor thermoregulation.

You receive a call to a residence for a sick patient. Upon your arrival, you find the patient, a 53-year-old diabetic male, lying down on his front porch. His wife tells you that he was mowing the lawn in the heat for the past three hours. The patient is confused and has hot, moist skin. His pulse is weak and thready, and his blood pressure is 90/50 mm Hg. You should: a) perform a head-to-toe assessment and look for signs of trauma. d) administer one tube of oral glucose and reassess his mental status. b) place him in a sitting position and have him drink 1 L of water. c) load him into the ambulance and begin rapid cooling interventions.

c) load him into the ambulance and begin rapid cooling interventions.

You receive a call to a residence for a sick patient. Upon your arrival, you find the patient, a 53-year-old diabetic male, lying down on his front porch. His wife tells you that he was mowing the lawn in the heat for the past three hours. The patient is confused and has hot, moist skin. His pulse is weak and thready, and his blood pressure is 90/50 mm Hg. You should: c) load him into the ambulance and begin rapid cooling interventions. a) perform a head-to-toe assessment and look for signs of trauma. d) administer one tube of oral glucose and reassess his mental status. b) place him in a sitting position and have him drink 1 L of water.

c) load him into the ambulance and begin rapid cooling interventions.

A frostbitten foot can be identified by the presence of: b) soft, smooth skin. a) gross deformity. d) blanching of the skin. c) mottling and blisters.

c) mottling and blisters.

A frostbitten foot can be identified by the presence of: d) blanching of the skin. c) mottling and blisters. a) gross deformity. b) soft, smooth skin.

c) mottling and blisters.

The EMT must assume that any unwitnessed water-related incident is accompanied by: b) alcohol intoxication. d) cold-water immersion. a) an air embolism. c) possible spinal injury.

c) possible spinal injury.

The two most efficient ways for the body to eliminate excess heat are: d) hyperventilation and tachycardia. c) sweating and vasodilation. b) perspiration and tachycardia. a) respiration and bradycardia.

c) sweating and vasodilation.

Which of the following statements regarding drowning is correct? a) Hypoxia in the drowning victim initially occurs due to water in the lungs. d) Patients with a submersion injury might deteriorate rap¬idly because of pulmonary injury and cerebral hypoxia. c) Large amounts of water enter the lungs in a small number of drowning victims. b) Artificial ventilations can easily be performed in patients with a laryngospasm.

d) Patients with a submersion injury might deteriorate rap¬idly because of pulmonary injury and cerebral hypoxia.

The most prominent symptom of decompression sickness is: a) tightness in the chest. d) abdominal or joint pain. c) dizziness and nausea. b) difficulty with vision.

d) abdominal or joint pain.

A dysbarism injury refers to the signs and symptoms related to changes in: b) rapid descent. c) decompression. d) barometric pressure. a) rapid ascent.

d) barometric pressure.

Hypothermia can worsen internal bleeding secondary to: a) cardiac arrhythmias. b) a decreased heart rate. d) blood-clotting abnormalities. c) severe muscular rigidity.

d) blood-clotting abnormalities.

Hypothermia can worsen internal bleeding secondary to: d) blood-clotting abnormalities. b) a decreased heart rate. c) severe muscular rigidity. a) cardiac arrhythmias.

d) blood-clotting abnormalities.

The venom of a brown recluse spider is cytotoxic, meaning that it: b) destroys the body's red blood cells. a) suppresses the respiratory drive. c) weakens the structure of the bones. d) causes severe local tissue damage.

d) causes severe local tissue damage.

The body's natural protective mechanisms against heat loss are: c) respiration and constriction of blood vessels in the skin. d) constriction of blood vessels in the skin and shivering. a) shivering and vasodilation. b) vasodilation and respiration.

d) constriction of blood vessels in the skin and shivering.

High humidity reduces the body's ability to lose heat through: c) conduction. b) convection. d) evaporation. a) radiation.

d) evaporation.

The body's natural cooling mechanism, in which sweat is converted to a gas, is called: c) conduction. b) convection. a) radiation. d) evaporation.

d) evaporation.

Common signs and symptoms of heat exhaustion include all of the following, except: b) dry tongue and thirst. c) tachycardia. a) nausea. d) hot, dry skin.

d) hot, dry skin.

You are dispatched to a local high school track and field event for a 16-year-old male who fainted. The outside temperature is approximately 95°F (35°C) with high humidity. Upon your arrival, the patient is conscious, alert, and complains of nausea and a headache. His skin is cool, clammy, and pale. You should: d) move him into the cooled ambulance. c) apply chemical ice packs to his axillae. a) give him a liquid salt solution to drink. b) administer 100% supplemental oxygen.

d) move him into the cooled ambulance.

You are transporting a 28-year-old man with a frostbitten foot. The patient's vital signs are stable, and he denies any other injuries or symptoms. The weather is treacherous, and your transport time to the hospital is approximately 45 minutes. During transport, you should: a) rewarm his foot in 102°F to 104°F (38.9°C to 40°C) water. c) cover his foot with chemical heat compresses. d) protect the affected part from further injury. b) administer oxygen via a nonrebreathing mask.

d) protect the affected part from further injury.

A 31-year-old male was bitten on the leg by an unidentified snake. The patient is conscious and alert and in no apparent distress. Your assessment of his leg reveals two small puncture marks with minimal pain and swelling. In addition to administering oxygen and providing reassurance, further care for this patient should include: a) applying ice to the wound and transporting quickly. b) transporting only with close, continuous monitoring. d) supine positioning, splinting the leg, and transporting. c) elevating the lower extremities and giving antivenin.

d) supine positioning, splinting the leg, and transporting.