Chapter 30 - Environmental Emergencies

The body's natural cooling mechanism, in which sweat is converted to a gas, is called: Select one: A. evaporation. B. conduction. C. convection. D. radiation.

A. evaporation.

The MOST prominent symptom of decompression sickness is: Select one: A. tightness in the chest. B. abdominal or joint pain. C. dizziness and nausea. D. difficulty with vision.

B. abdominal or joint pain.

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

A. 90°F (32°C).

Which of the following MOST accurately describes hyperthermia? Select one: A. The body is exposed to more heat than it can lose. B. Heat evaporates a significant amount of body water. C. The body eliminates more heat than it can generate. D. The core body temperature exceeds 99.5°F (37°C).

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

Breath-holding syncope is caused by a decreased stimulus to breathe and occurs when: Select one: A. a swimmer hyperventilates prior to entering the water. B. a swimmer breathes shallowly before entering the water. C. 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.

A. a swimmer hyperventilates prior to entering the water.

In order for sweating to be an effective cooling mechanism: Select one: A. it must be able to evaporate from the body. B. the relative humidity must be above 90%. C. the body must produce at least 1 L per hour. D. several layers of clothing must be worn.

A. it must be able to evaporate from the body.

While drinking beer with his friends near a creek, 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: Select one: A. supine positioning, splinting the leg, and transporting. B. transporting only with close, continuous monitoring. C. applying ice to the wound and transporting quickly. D. elevating the lower extremities and giving antivenin.

A. supine positioning, splinting the leg, and transporting.

Which of the following statements regarding lightning strikes is correct? Select one: A. Cervical spine fractures are the most common cause of lightning-related deaths. B. Lighting often results in a brief period of asystole that resolves spontaneously. C. The tissue damage pathway caused by lightning usually occurs through the skin. D. Victims who are struck by lightning often experience severe full-thickness burns.

B. Lighting often results in a brief period of asystole that resolves spontaneously.

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 unconscious, pale, and apneic. You should: Select one: A. open his airway and give two rescue breaths. B. assess for a carotid pulse for up to 45 seconds. C. apply chemical heat packs to his groin and axillae. D. apply an AED and assess his cardiac rhythm.

B. assess for a carotid pulse for up to 45 seconds.

The venom of a brown recluse spider is cytotoxic, meaning that it: Select one: A. suppresses the respiratory drive. B. causes severe local tissue damage. C. destroys the body's red blood cells. D. weakens the structure of the bones.

B. causes severe local tissue damage.

Geriatric patients are at a higher risk for heatstroke because: Select one: A. most geriatric patients are obese. B. circulation to the skin is reduced. C. their ability to shiver is reduced. D. their ability to sweat is enhanced.

B. circulation to the skin is reduced.

Shivering is a mechanism in which the body generates heat by: Select one: A. retaining excess carbon dioxide. B. increasing the metabolic rate. C. decreasing the use of oxygen. D. decreasing the metabolic rate.

B. increasing the metabolic rate.

An air embolism associated with diving occurs when: Select one: A. high water pressure forces air into the mediastinum. B. the diver holds his or her breath during a rapid ascent. C. the diver hyperventilates prior to entering the water. D. the alveoli completely collapse due to high pressure.

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

Compared to adults, infants and children are at higher risk for hypothermia for all of the following reasons, EXCEPT: Select one: A. a smaller overall muscle mass. B. a decreased ability to shiver. C. a relatively small surface area. D. a smaller amount of body fat.

C. a relatively small surface area.

To assess a patient's general temperature, pull back on your glove and place the back of your hand on his or her skin at the: Select one: A. forehead. B. chest. C. abdomen. D. neck.

C. abdomen.

The diving reflex may allow a person to survive extended periods of submersion in cold water secondary to: Select one: A. tachycardia and a lowering of the blood pressure. B. increases in the metabolic rate and oxygen demand. C. bradycardia and a slowing of the metabolic rate. D. laryngospasm that protects the lungs from water.

C. bradycardia and a slowing of the metabolic rate.

All of the following snakes are pit vipers, EXCEPT for the: Select one: A. rattlesnake. B. copperhead. C. coral snake. D. cottonmouth.

C. coral snake.

Geriatric patients, newborns, and infants are especially prone to hyperthermia because they: Select one: A. have relatively smaller heads. B. have smaller body surface areas. C. exhibit poor thermoregulation. D. have less body fat.

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 had been mowing the lawn in the heat for the past 3 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. In addition to administering 100% oxygen, you should: Select one: A. perform a rapid assessment and look for signs of trauma. B. administer one tube of oral glucose and reassess his mental status. C. load him into the ambulance and begin rapid cooling interventions. D. 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.

The EMT must assume that any unwitnessed water-related incident is accompanied by: Select one: A. alcohol intoxication. B. cold water immersion. C. possible spinal injury. D. an air embolism.

C. possible spinal injury.

Signs of late heatstroke include: Select one: A. hot, moist skin. B. a change in behavior. C. nausea and vomiting. D. a weak, rapid pulse.

D. a weak, rapid pulse.

In contrast to the brown recluse spider, the black widow spider: Select one: A. has a bite that usually produces local pain but no systemic signs or symptoms. B. has a bite that is typically painless until a blister develops. C. is very small and has a violin-shaped marking on its back. D. is large and has a red-orange hourglass mark on its abdomen.

D. is large and has a red-orange hourglass mark on its abdomen.

The venom of a black widow spider is toxic to the: Select one: A. respiratory system. B. cardiovascular system. C. renal system. D. nervous system.

D. nervous system.

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. In addition to monitoring her ABCs, administering oxygen, and turning up the heat in the back of the ambulance, you should: Select one: A. apply the AED in case she develops cardiopulmonary arrest, cover her with layers of blankets, and transport carefully. B. 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. C. cover her with warm blankets and let her move about on the stretcher in order to generate body heat and increase her temperature. D. place heat packs to her groin, axillae, and behind her neck; cover her with warm blankets; and avoid rough handling.

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

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)? Select one: A. confusion B. stiff muscles C. bradypnea D. tachycardia

D. tachycardia