Chapter 32 questions

As an EMT working in a cold environment, your ______ must also be properly maintained and equipped for a cold environment. A. vehicle B. peers C. none of these D. supplies

A

All of the following terms refer to a body part that is cold but not frozen, EXCEPT:Select one: A. frostnip. B. frostbite. C. trench foot. D. immersion foot.

B

You are assessing a 30-year-old woman with a heat-related emergency. Her skin is flushed, hot, and moist, and her level of consciousness is decreased. After moving her to a cool environment, managing her airway, and administering oxygen, you should A. give her ice water to drink B. check the blood glucose level if the patient has altered mental status C. place her in the recovery position D. take her temperature with an axillary probe

B

A lightning injury characterized by dysrhythmias that spontaneously resolve and superficial burns would be classified as being A. moderate B. lightning injuries are not classified in this way C. mild D. severe

A

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: A. administer oxygen and epinephrine and prepare for rapid transport. B. remove the stingers from his leg by scraping them with a stiff object. C. begin transport and immerse his leg in hot water to help reduce pain. D. apply warmth to the sting area and cover it with a dry, sterile dressing.

A

At what age does an infant have the ability to generate heat when needed? A. 12 to 18 months B. 24 months C. 9 to 12 months D. 4 months

A

Burns associated with lightning strikes are typically:Select one: A. superficial. B. third-degree. C. full-thickness. D. partial-thickness.

A

Cardiorespiratory response when core body temperature falls into the range of 89ºF to 92ºF (31.7ºC to 33.3ºC) involves __________ . A. Slowing respirations and a slow pulse B. Weak pulse, dysrhythmias, very slow respirations C. Cardiac arrest D. Constricted blood vessels and rapid breathing

A

During the coldest month of the winter, you are called to the home of an elderly woman. When you arrive, you immediately note that the house is extremely cold. The patient is lethargic. Her blood pressure is 90/60 mm Hg, her pulse is 48 beats/min, and her respirations are 8 breaths/min and shallow. Suspecting hypothermia, what would you estimate her core body temperature to be? A. 89ºF to 92ºF B. 80ºF to 88ºF C. Less than 80ºF D. 90ºF to 95ºF

A

In a cold emergency, if you cannot feel a radial pulse, gently palpate for a carotid pulse and wait for up to _____ before you decide whether the patient is pulseless A. 60 seconds B. 90 seconds C. 30 seconds D. 2 minutes

A

In the context of an environment that is 90°F with 85% humidity, what does moist, pale, cool skin indicate? A. There has been excessive fluid and salt loss. B. The body can no longer regulate core temperature. C. Core body temperature and ambient temperature are equal. D. The patient is hypothermic.

A

Rough handling of a patient with severe hypothermia may cause which of the following dysrhythmias? A. Ventricular fibrillation B. Asystole C. Sinus tachycardia D. Sinus bradycardia

A

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

A

Shortly after ascending rapidly to the surface of the water while holding his breath, a 29-year-old diver begins coughing up pink, frothy sputum and complains of dyspnea and chest pain. You should suspect and treat this patient for A. an air embolism B. a pneumothorax C. decompression sickness D. pneumomediastinum

A

Should you commence CPR on a patient with hypothermia who has no pulse? A. Yes, there is evidence that CPR, when correctly done, will increase blood flow to critical parts of the body B. No, many of the body's systems are in too fragile a state C. No, cardiac activity may spontaneously recover once the body is warmed D. No, the patient is in a "metabolic icebox" and has achieved a balance that CPR can disrupt

A

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

A

What is often the first sign of heat stroke? A. change in behavior B. profuse sweating C. low pulse rate and blood pressure D. muscle cramps

A

What is the term that encompasses the fire coral, sea wasp, and sea anemones? A. coelenterates B. nematocysts C. tursiops truncatus D. jellyfish

A

Which of the following is NOT a basic rule of water rescue? A. If you must swim to the person, turn around so your back is to them B. if you cannot reach the person from shore, wade closer C. if an object that floats is available, throw it to the person D. use a boat if one is available

A

Which of the following is NOT a predisposing factor in hypothermia? A. sex of the patient B. environment C. age of the patient D. ingestion of drugs

A

Which of the following is an early sign of pit viper envenomation?Select one A. Local swelling and ecchymosis B. General weakness and diaphoresis C. Syncope and bleeding at distal sites D. Signs and symptoms of hypoperfusion

A

Which of the following is an example of altitude sickness? A. all of these answers are correct B. mountain sickness C. high-altitude pulmonary edema (HAPE) D. high-altitude cerebral edema (HACE)

A

Which of the following should you NOT do when treating a patient who has a cold emergency? A. have the patient walk, if possible. B. remove any wet clothing C. move the patient from the cold environment D. give the patient warm, humidified oxygen

A

Which of the following statements regarding lightning strikes is correct? A. Lightning strikes may cause cardiac dysrhythmias that spontaneously resolve. 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

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: A. move him as a unit to a supine position. B. begin ventilations with a barrier device. C. immediately secure him to a longboard. D. open his airway with the jaw-thrust maneuver.

A

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

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 2 days ago. On the basis of this patient's presentation, you should suspect: A. Lyme disease. B. an allergic reaction. C. exposure to poison ivy. D. Rocky Mountain spotted fever.

A

You are treating a patient who was climbing a 10,000-foot mountain when he began to experience a severe, constant, throbbing headache; ataxia; and extreme fatigue. He is nauseated and, as you assess him, he loses consciousness. Which of the following should you suspect? A. HACE B. HAPE C. Mountain sickness D. Rocky Mountain spotted fever

A

You arrive at the scene and find the patient sitting under a tree in his garden; he is conscious, but confused. His wife tells you that he has been working outside all day. She further states that he refused to take a break and drink some water. Your assessment finds a flushed appearance; weak and rapid radial pulses; and hot, moist skin. Based on this, you suspect that your patient is suffering from __________ . A. Heat stroke B. Heat asphyxia C. Heat cramps D. Heat exhaustion

A

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 has pink froth coming from his nose and mouth. You should: 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. B. 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. 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. D. 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.

A

your body needs calories for your metabolism to function. What is the catalyst for much of this metabolism? A. water B. simple sugars C. electrolytes D. carbohydrates

A

A 13-year-old girl is found floating face down in a swimming pool. Witnesses tell you that the girl had been practicing diving. After you and your partner safely enter the water, you should A. rotate her entire body as a unit and carefully remove her from the pool B. rotate the entire upper half of her body as a unit, supporting her head and neck C. turn her head tot he side and begin rescue breathing D. turn her head to the side and give five back slaps

B

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:Select one: A. apply an AED and assess his cardiac rhythm. B. assess for a carotid pulse for up to 60 seconds. C. open his airway and give two rescue breaths. D. apply chemical heat packs to his groin and axillae.

B

A patient with a core body temperature of 95°F (35°C) will MOST likely experience: A. a slow pulse. B. rapid breathing. C. muscle stiffness. D. loss of consciousness.

B

A person who stands outside in windy, wintry weather and wears only lightweight clothing is experiencing heat loss mainly by what method? A. Conduction B. Convection C. Respiration D. Evaporation

B

A woman has frostbite in both feet after walking several miles in a frozen field. Her feet are white, hard, and cold to the touch. Treatment at the scene should include A. trying to restore circulation by helping her to walk around B. removing her wet clothing and covering her feet with dry, sterile dressings C. rubbing her feet gently with your own warm hands D. removing her wet clothing and rubbing her feet with a warm cloth

B

Drowning is MOST accurately defined as: A. Temporary survival after submersion in water. B. Death from suffocation after submersion in water. C. Water in the lungs following submersion in water. D. Death beyond 24 hours after submersion in water.

B

Heat emergencies commonly occur at athletic events and practices. If the patient is in a cold-water immersion bath upon your arrival, do NOT remove the patient unless the temperature has normalized to between A. 103ºF and 104ºF B. 101ºF and 102ºF C. 99ºF and 100ºF D. 97ºF and 98ºF

B

Hypothermia is diagnosed when the core body temperature falls below what temperature? A. 98°F (36.7°C) B. 95°F (35°C) C. 92°F (33.3°C) D. 90°F (32.2°C)

B

Hypothermia occurs when the core body temperature falls below:Select one: A. 98°F (37°C). B. 95°F (35°C). C. 90°F (32°C). D. 88°F (31°C).

B

In contrast to Lyme disease, Rocky Mountain spotted fever:Select one: A. may be confused with rheumatoid arthritis. B. can cause paralysis and cardiorespiratory collapse. C. presents with flu-like symptoms and a bull's-eye rash. D. causes painful joint swelling after a few days or weeks.

B

Patients with decompression sickness and air embolism must be treated in a(n) A. low-oxygen facility B. recompression chamber C. ice-cold water bath D. decompression chamber

B

Signs and symptoms of an air embolism include all of the following, EXCEPT: A. dysphasia. B. pale skin. C. dizziness. D. joint pain.

B

Soaking the affected extremity in hot water for 30 minutes would work for injuries from all of the following marine animals, EXCEPT A. urchins B. sea anemones C. lionfish D. stonefish

B

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

B

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

B

What is the definitive treatment for a patient suffering from air embolism or decompression sickness? A. oxygen B. hyperbaric chamber C. IV fluids D. none of these answers are correct

B

What is the most dangerous, and most common, emergency in scuba diving? A. diving reflex B. air embolism C. decompression sickness D. drowning

B

What would a 25-year-old, relatively healthy patient who received a bite from a black widow spider most likely receive as treatment? A. low-flow oxygen B. pain relief C. BLS D. antivenin

B

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:Select one: A. radiation. B. conduction. C. convection D. evaporation.

B

When a warm hand touches metal or ice, the heat transfer is called A. convection B. conduction C. radiation D. evaporation

B

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

B

You respond to a female jogger who was jogging in the park. The ambient temperature is 100ºF. She is complaining of dizziness, dry tongue, rapid pulse, and thirst. Which heat emergency is she MOST likely suffering from? A. Heat cramps B. Heat exhaustion C. Heat stroke D. Hyperkalemia

B

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: A. apply the AED 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. 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. 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.

B

A frostbitten foot can be identified by the presence of: A. gross deformity B. soft, smooth skin. C. mottling and blisters. D. yellowish skin.

C

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

C

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. C. a swimmer hyperventilates prior to entering the water. D. a diver holds his or her breath for a long period of time.

C

Consider a rendezvous with ALS for more aggressive treatment if A. the symptoms do not clear up promptly B. the body temperature remains elevated C. All of these answers are correct D. the person is very young, older, or has an underlying condition

C

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

C

How could alcohol place a patient at greater risk for temperature-related emergencies? A. by discouraging good judgment B. By slowing down metabolism C. by increasing fluid loss D. by depleting serotonin levels

C

In which of the following environmental emergencies are you most likely to encounter laryngospasm? A. a tick bite B. after being bitten by coral snake C. drowning D. hyperthermia

C

Regardless of the severity of the exposure, management of hypothermia in the field consists of stabilizing ABCs and A. assessing the patient's mental status using the AVPU scale B. assessing the patient's skin condition carefully C. preventing further heat loss D. administering high-flow oxygen

C

Shivering stops and muscle activity ceases once the body's core temperature reaches what? A. 80°F (26.7°C) B. 85°F (29.4°C) C. 90°F (32.2°C) D. 95°F (35°C)

C

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

C

The transfer of heat to circulating air, such as when cool air moves across the body's surface, is called: A. radiation. B. conduction. C. convection. D. evaporation.

C

Three ambulances respond to a golf course where six golfers were struck by lightning. Two of the golfers are conscious and alert with superficial skin burns (group 1). The next two golfers have minor fractures and appear confused (group 2). The last two golfers are in cardiac arrest (group 3). According to reverse triage, which group of golfers should be treated FIRST? A. group 1 B. groups 1 and 2; group 3 should be tagged as deceased C. group 3 D. group 2

C

What is the most common problem surrounding drowning deaths by young children in residential pools? A. fences surrounding pools are often under 6 feet B. gates are often not self-locking and self-closing C. lack of adult supervision D. children are not given swimming lessons

C

When a person is exposed to cold temperatures and strong winds for an extended period of time, he or she will lose heat mostly by: A. radiation B. evaporation C. convection D. conduction

C

Which of the following conditions show symptoms of headache, loss of appetite, difficulty sleeping, shortness of breath during physical exertion, and a swollen face? A. High-altitude pulmonary edema (HAPE) B. High-altitude cerebral edema (HACE) C. mountain sickness D. none of these answers are correct

C

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:Select one: A. immediately begin CPR on the unresponsive patient, but cease resuscitation efforts if there is no response after 5 minutes of treatment. 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 AED as soon as possible 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

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. You should:Select one: A. perform a head-to-toe assessment and look for signs of trauma. 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. D. administer one tube of oral glucose and reassess his mental status.

C

You respond to a male patient who has been exercising in a very hot environment. As you check his vital signs, his pulse is becoming weaker. You are perspiring, but he is not. From what could your patient be suffering? A. heat cramps B. hyperkalemia C. heat stroke D. heat exhaustion

C

You suspect that the patient you are treating was bitten by a rattlesnake. What should you do first? A. Catch the snake so you can take it to the ED B. apply suction to the wound to suck out the venom C. place the patient in a supine position D. apply ice to the wound

C

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. applying ice to the wound and transporting quickly. B. transporting only with close, continuous monitoring C. elevating the lower extremities and giving antivenin. D. supine positioning, splinting the leg, and transporting.

D

A dysbarism injury refers to the signs and symptoms related to changes in: A. rapid ascent. B. rapid descent. C. decompression. D. barometric pressure.

D

A swimmer who breathes in and out rapidly and deeply before entering the water in an effort to expand their capacity to stay underwater may experience which of the following problems? A. none of these answers are correct B. a near-drowning experience C. hyperventilation syndrome D. breath-holding syncope

D

Common signs and symptoms of heat exhaustion include all of the following, EXCEPT:Select one: A. nausea. B. headache. C. tachycardia. D. hot, dry skin.

D

Gently pinching the skin on the patient's forehead or the back of the hand will test the skin's A. level of moisture B. temperature C. color D. turgor

D

If there is a possibility that you are assigned to cold weather search-and-rescue, you should receive survival training and A. be familiar with local conditions B. be aware of existing and potential weather conditions C. stay on top of changes that are forecast for the area D. all of these answers are correct

D

Most of the serious injuries associated to diving are related to which of the following emergencies? A. emergencies at the bottom B. emergencies at the surface C. descent emergencies D. ascent emergencies

D

Most of the serious injuries associated with scuba diving are caused by:Select one: A. cold water temperature. B. too rapid of a descent. C. alcohol consumption. D. too rapid of an ascent.

D

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

D

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

D

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

D

What is the MOST obvious way to decrease heat loss from radiation and convection? A. help the patient increase his or her level of activity B. add layers of clothing to provide good insulation C. all of these answers are correct D. move the patient out of a cold environment

D

Which of the following might be difficult to palpate with a patient who experienced a water emergency? A. heartbeat B. respiratory rate C. peripheral pulses D. blood pressure

D

Which of the following statements regarding drowning is correct? A. Hypoxia in the drowning victim initially occurs due to water in the lungs. B. Artificial ventilations can easily be performed in patients with a laryngospasm. C. Large amounts of water enter the lungs in a small number of drowning victims. D. Laryngospasm following submersion in water makes rescue breathing difficult.

D

You are called to a well-kept home for an 8-year-old girl. She presents with vomiting, headache, and partial paralysis. During the history-taking stage, her mother reports that about 8 days ago they were hiking in the mountains and when they arrived home, the child found a tick on her leg, which the mother removed. What could be affecting this patient? A. lyme disease B. allergic reaction C. none of these answers are correct D. rocky Mountain spotted fever

D

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: A. give him a liquid salt solution to drink. B. administer 100% supplemental oxygen. C. apply chemical ice packs to his axillae. D. move him into the cooled ambulance.

D

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:Select one: A. rewarm his foot in 102°F to 104°F (38.9°C to 40°C) water. B. administer oxygen via a nonrebreathing mask. C. cover his foot with chemical heat compresses. D. protect the affected part from further injury.

D

In an air embolism, the air pressure in the lungs remains constant while the external pressure on the chest increases. True False

False

Symptoms of air embolism may not occur for several hours. True False

False

It is difficult to find a pulse in a drowning victim. True False

True

The diving reflex may cause immediate bradycardia. True False

True