Environmental Emergencies (Multiple Choice)
The venom of a brown recluse spider is cytotoxic, meaning that it: -Suppresses the respiratory drive -Destroys the body's red blood cells -Weakens the structure of the bones -Causes severe local tissue damage
Causes severe local tissue damage
What is often the first sign of heat stroke? -Change in behavior -Profuse sweating -Muscle cramps -Low pulse rate and blood pressure
Change in behavior
True or False In an air embolism, the air pressure in the lungs remains constant while the external pressure on the chest increases.
False
True or False Symptoms of air embolism may not occur for several hours.
False
A 30-year-old male, who has been playing softball all day in a hot environment, complains of weakness and nausea shortly after experiencing a syncopal episode. Appropriate treatment for this patient includes all of the following, EXCEPT: -Giving a salt-containing solution by mouth -Moving him to a cooler environment at once -Administering oxygen via nonrebreathing mask -Placing him in a supine position and elevating his legs
Giving a salt-containing solution by mouth
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 __________ . -Heat asphyxia -Heat cramps -Heat stroke -Heat exhaustion
Heat stroke
Common signs and symptoms of heat exhaustion include all of the following EXCEPT: -Nausea -Headache -Hot, dry skin -Tachycardia
Hot, dry skin
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: -Move him as a unit to a supine position -Begin ventilations with a barrier device -Immediately secure him to a longboard -Open his airway with the jaw-thrust maneuver
Move him as a unit to a supine position
Hypothermia is diagnosed when the core body temperature falls below what temperature? 90°F (32.2°C) 95°F (35°C) 92°F (33.3°C) 98°F (36.7°C)
95°F (35°C)
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 black widow spider bite -Envenomation from a pit viper -A brown recluse spider bite -Rocky Mountain spotted fever
A black widow spider bite
Burns associated with lightning strikes are typically: -Third-degree -Partial-thickness -Full-thickness -Superficial
Superficial
True or False It is difficult to find a pulse in a drowning victim.
True
True or False The diving reflex may cause immediate bradycardia.
True
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: -Radiation -Convection -Conduction -Evaporation
Convection
All of the following snakes are pit vipers, EXCEPT for the: -Copperhead -Rattlesnake -Coral snake -Cottonmouth
Coral snake
In which of the following environmental emergencies are you most likely to encounter laryngospasm? -Drowning -A tick bite -Hyperthermia -After being bitten by a coral snake
Drowning
The body's natural cooling mechanism, in which sweat is converted to a gas, is called: -Conduction -Evaporation -Convection -Radiation
Evaporation
Which of the following statements regarding lightning strikes is correct? -Lightning strikes may cause cardiac dysrhythmias that spontaneously resolve -The tissue damage pathway caused by lightning usually occurs through the skin -Victims who are struck by lightning often experience severe full-thickness burns -Cervical spine fractures are the most common cause of lightning-related deaths
Lightning strikes may cause cardiac dysrhythmias that spontaneously resolve
Signs and symptoms of an air embolism include all of the following, EXCEPT: -Dysphasia -Pale skin -Dizziness -Joint pain
Pale skin
The two MOST effective ways for the body to eliminate excess heat are: -Hyperventilation and tachycardia -Perspiration and tachycardia -Sweating and vasodilation -Respiration and bradycardia
Sweating and vasodilation
Shivering is a mechanism in which the body generates heat by: -Increasing the metabolic rate -Decreasing the use of oxygen -Decreasing the metabolic rate -Retaining excess carbon dioxide
Increasing the metabolic rate
Shivering stops and muscle activity ceases once the body's core temperature reaches what? 85°F (29.4°C) 90°F (32.2°C) 80°F (26.7°C) 95°F (35°C)
90°F (32.2°C)
Breath-holding syncope is caused by a decreased stimulus to breathe and occurs when: -A swimmer breathes shallowly before entering the water -A diver holds his or her breath during a staged ascent -A swimmer hyperventilates prior to entering the water -A diver holds his or her breath for a long period of time
A swimmer hyperventilates prior to entering the water
Signs of late heat stroke include: -Hot, moist skin -Nausea and vomiting -A weak, rapid pulse -A change in behavior
A weak, rapid pulse
The MOST prominent symptom of decompression sickness is: -Tightness in the chest -Difficulty with vision -Dizziness and nausea -Abdominal or joint pain
Abdominal or joint pain
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: -Administer oxygen and epinephrine and prepare for rapid transport -Remove the stingers from his leg by scraping them with a stiff object -Begin transport and immerse his leg in hot water to help reduce pain -Apply warmth to the sting area and cover it with a dry, sterile dressing
Administer oxygen and epinephrine and prepare for rapid transport
All of the following are examples of passive rewarming techniques, EXCEPT: -Removing cold, wet clothing -Administering warm fluids by mouth -Turning up the heat inside the ambulance -Covering the patient with warm blankets
Administering warm fluids by mouth
What is the most dangerous, and most common, emergency in scuba diving? -Air embolism -Drowning -Decompression sickness -Diving reflex
Air embolism
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: -An air embolism -A pneumothorax =Pneumomediastinum -Decompression sickness
An air embolism
A dysbarism injury refers to the signs and symptoms related to changes in: -Rapid ascent -Rapid descent -Decompression -Barometric pressure
Barometric pressure
Patients with generalized hypothermia are at an increased risk of a local cold injury because: -Blood is shunted away from the extremities to the body's core -Peripheral vasodilation brings warm blood to the skin's surface -The major muscles of the body become rigid during hypothermia -The patient is usually unable to escape the cold ambient temperature
Blood is shunted away from the extremities to the body's core
Shivering in the presence of hypothermia indicates that the: -Musculoskeletal system is damaged -Nerve endings are damaged, causing loss of muscle control -Body is trying to generate more heat through muscular activity -Thermoregulatory system has failed and body temperature is falling
Body is trying to generate more heat through muscular activity
The diving reflex may allow a person to survive extended periods of submersion in cold water secondary to: -Bradycardia and a slowing of the metabolic rate -Laryngospasm that protects the lungs from water -Tachycardia and a lowering of the blood pressure -Increases in the metabolic rate and oxygen demand
Bradycardia and a slowing of the metabolic rate
A person who stands outside in windy, wintry weather and wears only lightweight clothing is experiencing heat loss mainly by what method? -Respiration -Evaporation -Convection -Conduction
Convection
The transfer of heat to circulating air, such as when cool air moves across the body's surface, is called: -Radiation -Conduction -Convection -Evaporation
Convection
You are assessing a 27-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: -Give her ice water to drink -Place her in the recovery position -Cover her with wet sheets and fan her -Take her temperature with an axillary probe
Cover her with wet sheets and fan her
Drowning is MOST accurately defined as: -Death beyond 24 hours after submersion in water -Temporary survival after submersion in water -Water in the lungs following submersion in water -Death from suffocation after submersion in water
Death from suffocation after submersion in water
Geriatric patients, newborns, and infants are especially prone to hyperthermia because they: -Have relatively smaller heads -Have less body fat -Exhibit poor thermoregulation -Have smaller body surface areas
Exhibit poor thermoregulation
Three ambulances respond to a golf course where a group of six golfers were struck by lighting. 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? -Group 1 -Group 2 -Group 3 -Groups 1 and 2; Group 3 should be tagged as deceased
Group 3
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? -Mountain sickness -HACE -HAPE -Rocky Mountain spotted fever
HACE
Which of the following statements regarding drowning is correct? -Hypoxia in the drowning victim initially occurs due to water in the lungs -Artificial ventilations can easily be performed in patients with a laryngospasm -Large amounts of water enter the lungs in a small number of drowning victims -Laryngospasm following submersion in water makes rescue breathing difficult
Laryngospasm following submersion in water makes rescue breathing difficult
It is important to remove a drowning victim from the water before laryngospasm relaxes because: -The patient will suffer less airway trauma -The risk of severe hypothermia is lessened -Less water will have entered the patient's lungs -You can ventilate the patient with laryngospasm
Less water will have entered the patient's lungs
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: -Lyme disease -An allergic reaction -Exposure to poison ivy -Rocky Mountain spotted fever
Lyme disease
A frostbitten foot can be identified by the presence of: -Gross deformity -Soft, smooth skin -Mottling and blisters -Yellowish skin
Mottling and blisters
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: -Give him a liquid salt solution to drink -Administer 100% supplemental oxygen -Apply chemical ice packs to his axillae -Move him into the cooled ambulance
Move him into the cooled ambulance
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: -Apply the AED in case she develops cardiopulmonary arrest, cover her with layers of blankets, and transport carefully -Place heat packs to her groin, axillae, and behind her neck; cover her with warm blankets; and avoid rough handling -Cover her with warm blankets and let her move about on the stretcher in order to generate body heat and increase her temperature -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
Place heat packs to her groin, axillae, and behind her neck; cover her with warm blankets; and avoid rough handling
You suspect that the patient you are treating was bitten by a rattlesnake. What should you do first? -Apply suction to the wound to suck out the venom -Catch the snake so you can take it to the ED -Apply ice to the wound -Place the patient in a supine position
Place the patient in a supine position
The EMT must assume that any unwitnessed water-related incident is accompanied by: -An air embolism -Alcohol intoxication -Possible spinal injury -Cold-water immersion
Possible spinal injury
A patient with a core body temperature of 95°F (35°C) will MOST likely experience: -A slow pulse -Rapid breathing -Muscle stiffness -Loss of consciousness
Rapid breathing
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: -Rubbing her feet gently with your own warm hands -Trying to restore circulation by helping her to walk around -Removing her wet clothing and rubbing her feet briskly with a warm, wet cloth -Removing her wet clothing and covering her feet with dry, sterile dressings
Removing her wet clothing and covering her feet with dry, sterile dressings
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: -Turn her head to the side and give five back slaps -Turn her head to the side and begin rescue breathing -Rotate her entire body as a unit and carefully remove her from the pool -Rotate the entire upper half of her body as a unit, supporting her head and neck
Rotate the entire upper half of her body as a unit, supporting her head and neck
You are assessing a man with suspected hypothermia, The patient is conscious and alert, and is actively shivering. His respiratory rate is increased, but his breathing is unlabored and the pulse oximeter reads 72%. The pulse oximetry reading is MOST likely: -Accurate b/c shivering affects the hemoglobin binding -A direct reflection of his increased respiratory rate -Accurate b/c he has signs of respiratory failure -Secondary to decreased perfusion in the extremities
Secondary to decreased perfusion in the extremities
Cardiorespiratory response when core body temperature falls into the range of 89ºF to 92ºF (31.7ºC to 33.3ºC) involves __________ . -Slowing respirations and a slow pulse -Cardiac arrest -Constricted blood vessels and rapid breathing -Weak pulse, dysrhythmias, very slow respirations
Slowing respirations and a slow pulse
Heat stroke occurs when: -A person's core body temperature rises above 103°F (39°C) -The body's heat-eliminating mechanisms are overwhelmed -The ambient temperature exceeds 90°F (32°C) & the humidity is high -A person becomes dehydrated secondary to excess water loss
The body's heat-eliminating mechanisms are overwhelmed
An air embolism associated with diving occurs when: -The diver holds his or her breath during a rapid ascent -The diver hyperventilates prior to entering the water -High water pressure forces air into the mediastinum -The alveoli completely collapse due to high pressure
The diver holds his or her breath during a rapid ascent
In the context of an environment that is 90°F with 85% humidity, what does moist, pale, cool skin indicate? -The patient is hypothermic -The body can no longer regulate core temperature -Core body temperature and ambient temperature are equal -There has been excessive fluid and salt loss
There has been excessive fluid and salt loss
Rough handling of a hypothermic patient with a pulse may cause: -Profound bradycardia -Ventricular fibrillation -Ventricular tachycardia -Pulseless electrical activity
Ventricular fibrillation
Rough handling of a patient with severe hypothermia may cause which of the following dysrhythmias? -Sinus bradycardia -Ventricular fibrillation -Asystole -Sinus tachycardia
Ventricular fibrillation