AEMT Ch. 31 Environmental Emergencies

Which of the following patients is LEAST prone to a local cold injury? Select one: A. A 45-year-old male with hypertension B. A 49-year-old female with fatigue C. A 52-year-old male with alcoholism D. A 60-year-old female with diabetes

A. A 45-year-old male with hypertension

An individual is considered to be hypothermic when his or her core body temperature falls below: Select one: A. 95°F. B. 97°F. C. 85°F. D. 90°F.

A. 95°F.

When transporting a moderately hypothermic patient, you must avoid unnecessary bumps in the road. Not doing so may result in: Select one: A. a cardiac arrhythmia. B. respiratory failure. C. increased patient discomfort. D. fractures of frozen extremities.

A. a cardiac arrhythmia.

When the core body temperature falls below 95°F, the patient's: Select one: A. ability to regulate body temperature is lost. B. heart rate slows in order to produce body heat. C. shivering mechanism is markedly diminished. D. blood vessels dilate in order to conserve heat.

A. ability to regulate body temperature is lost.

Prior to initiating CPR on an apneic, hypothermic patient, you should: Select one: A. assess the carotid pulse for up to 45 seconds. B. administer a 20 mL/kg bolus of isotonic crystalloid. C. analyze the patient's cardiac rhythm with an AED. D. provide two minutes of rescue breathing.

A. assess the carotid pulse for up to 45 seconds.

Heatstroke occurs when the: Select one: A. body is subjected to more heat than it can remove. B. hypothalamus produces excessive body heat. C. patient's core body temperature gradually rises. D. process of thermogenesis is rendered ineffective.

A. body is subjected to more heat than it can remove.

You are treating a 55-year-old male with heatstroke when he suddenly becomes unresponsive and stops breathing. Assessment of his carotid pulse reveals that it is weak and rapid. You should: Select one: A. continue cooling measures, maintain his airway, ventilate him with a bag-mask device, transport, and request a paramedic intercept. B. cease cooling measures, insert an oral airway, hyperventilate him with a bag-mask device, transport, and give a 2 liter IV fluid bolus. C. ventilate him with a bag-mask device, continue cooling measures, apply the AED in case he develops cardiac arrest, and transport. D. insert an oral airway, ventilate him with a bag-mask device, cease rapid cooling measures, and transport to the closest hospital.

A. continue cooling measures, maintain his airway, ventilate him with a bag-mask device, transport, and request a paramedic intercept.

A young male is wearing lightweight clothing and is standing outside in windy winter weather. He is losing heat to the environment mostly by: Select one: A. convection. B. radiation. C. conduction. D. evaporation.

A. convection.

Treatment for a patient with a pit viper bite to an extremity and no signs of envenomation includes oxygen, as well as: Select one: A. covering the area with a sterile dressing, splinting the extremity, and transporting. B. covering the area with a sterile dressing and requesting immediate paramedic backup. C. splinting the extremity, keeping it above the level of the heart, and transporting. D. starting an IV and administering at least one 20 mL/kg normal saline bolus.

A. covering the area with a sterile dressing, splinting the extremity, and transporting.

Severe, persistent pain caused by a jellyfish sting should be treated by: Select one: A. immersing the affected area in hot water for 30 minutes. B. washing the affected area with rubbing alcohol. C. removing the nematocysts with a pair of tweezers. D. irrigating the affected area with fresh water for 15 minutes.

A. immersing the affected area in hot water for 30 minutes.

Gangrene and subsequent amputation of a frostbitten extremity will MOST likely occur if it: Select one: A. is rewarmed and then refreezes. B. is immersed in hot water. C. shows signs of blistering. D. is not covered with a sterile dressing.

A. is rewarmed and then refreezes.

A patient with a core body temperature of 85°F would be expected to present with: Select one: A. profoundly slow respirations. B. confusion or lethargy. C. deep, rapid respirations. D. uncontrolled shivering.

A. profoundly slow respirations.

Because heat always travels from a warm object to a cooler one, a person standing in a cold room will lose heat by: Select one: A. radiation. B. evaporation. C. constriction. D. conduction.

A. radiation.

Shortly after returning to the surface of the water, a scuba diver experiences an acute onset of pleuritic chest pain and difficulty breathing. He is tachycardic and his pulse is irregular. You should suspect: Select one: A. decompression sickness. B. spontaneous pneumothorax. C. air embolism. D. acute nitrogen narcosis.

C. air embolism.

A young female is found floating face-down in a lake. There were no witnesses to the event. Prior to removing her from the water, you must first: Select one: A. rotate the patient into a supine position and protect her spine. B. open her airway and begin rescue breathing while in the water. C. assess for a pulse and begin full CPR if she is in cardiac arrest. D. fully immobilize her to a long spineboard or similar device.

A. rotate the patient into a supine position and protect her spine.

You are treating a 40-year-old female, who is experiencing severe heat cramps. You have moved her to a cooler environment, applied oxygen, and are giving her Gatorade to drink. When you reassess her, you find that her condition has not improved. You should: Select one: A. start an IV of normal saline and transport her. B. advise her to discontinue her activity for the day. C. give her more Gatorade and continue monitoring. D. give her a salt-containing solution to drink.

A. start an IV of normal saline and transport her.

A 24-year-old male was pulled from the water following submersion for an unknown length of time. There were no witnesses to the patient's submersion. When you arrive at the scene, you determine that he is in cardiac arrest. Routine management for this patient should include all of the following, EXCEPT: Select one: A. subdiaphragmatic thrusts. B. full spinal precautions. C. defibrillation as needed. D. oropharyngeal suctioning.

A. subdiaphragmatic thrusts.

Patients who are struck by lightning rarely sustain full-thickness burns because: Select one: A. the duration of the lightning strike is short. B. the skin is an effective barrier to electricity. C. most lightning strikes are caused by indirect injury. D. damage occurs through the skin and not across it.

A. the duration of the lightning strike is short.

You are dispatched to a local golf course, where 3 people were struck by lightning. After ensuring your own safety, you begin triaging the patients. The first patient is conscious and has an apparent closed femur fracture. The second patient is conscious, confused, and complaining of hearing loss. The third patient is unconscious, pulseless, and apneic. You should focus your resuscitative efforts on the cardiac arrest patient because: Select one: A. the other patients are less likely to develop cardiac arrest. B. the other patients have clearly sustained minor injuries. C. the conventional method of triage requires that you do so. D. he is likely in asystole and requires prompt defibrillation.

A. the other patients are less likely to develop cardiac arrest.

Which of the following would be the LEAST reliable assessment parameter or treatment tool for a patient with significant hypothermia? Select one: A. AED B. Pulse oximetry C. Respiratory rate D. Pulse rate

B. Pulse oximetry

Which of the following statements regarding decompression sickness is MOST correct? Select one: A. Intubation should be avoided as it may cause laryngospasm. B. Treatment at a recompression facility is a crucial treatment. C. Hyperbaric oxygen is only beneficial if the patient is unconscious. D. Cardiac arrhythmias are a relatively uncommon finding.

B. Treatment at a recompression facility is a crucial treatment.

"Breath-holding syncope" commonly occurs when a swimmer: Select one: A. rapidly ascends while holding his or her breath. B. breathes deeply and rapidly before entering the water. C. holds his or her breath too long while under water. D. holds his or her breath before entering the water.

B. breathes deeply and rapidly before entering the water.

A 30-year-old female presents with signs of dehydration, generalized weakness, and cool, clammy skin. She is conscious and alert and has an oral temperature of 101.5°F. This clinical presentation is MOST consistent with: Select one: A. thermolytic failure. B. heat exhaustion. C. heat cramps. D. heatstroke.

B. heat exhaustion.

A 19-year-old male who was struck by lightning. He is unresponsive and apneic, but has a pulse. He also has widespread superficial burns. You should: Select one: A. ventilate him with a bag-mask device, call for a paramedic unit to intubate him, cover his burns, and start an IV. B. manually stabilize his head, ventilate him with a bag-mask device, and establish at least one-large bore IV. C. provide mouth-to-mask rescue breathing, apply dry dressings to his burns, and transport without delay. D. quickly insert a multilumen airway device, provide mild hyperventilation, and administer 2 liters of IV fluid.

B. manually stabilize his head, ventilate him with a bag-mask device, and establish at least one-large bore IV.

When rapidly cooling a semiconscious patient with heatstroke, you must stop the cooling process if the patient: Select one: A. develops tachycardia. B. becomes unresponsive. C. begins to shiver. D. becomes more alert.

C. begins to shiver.

Signs of an impending lightning strike include all of the following, EXCEPT: Select one: A. parasthesia in the feet. B. sudden tachycardia. C. tingling in the hands. D. hair standing on end.

B. sudden tachycardia.

Palpating for a pulse in a near-drowning victim may be difficult to assess because: Select one: A. accompanying hypoxia causes a profound, thready tachycardia. B. the peripheral vessels are constricted and cardiac output is low. C. peripheral vascular dilation shunts blood to the body's core. D. the majority of near-drowning victims are in cardiac arrest.

B. the peripheral vessels are constricted and cardiac output is low.

Internal heat production is called: Select one: A. thermolysis. B. thermogenesis. C. thermogenolysis. D. thermostasis.

B. thermogenesis.

Which of the following patients has signs and symptoms that are MOST indicative of heatstroke? Select one: A. A 40-year-old female with severe cramps in her legs, tachycardia, and nausea B. A 44-year-old male with weakness, cool and clammy skin, and a syncopal episode C. A 31-year-old male with hot and moist skin, tachycardia, and confusion D. A 50-year-old female with an axillary temperature of 100.5°F and warm, dry skin

C. A 31-year-old male with hot and moist skin, tachycardia, and confusion

Which of the following is a physiologic abnormality that occurs as a result of hypothermia? Select one: A. Decreased cardiac irritability B. Increased metabolic rate C. Abnormal blood clotting D. Increased thermogenesis

C. Abnormal blood clotting

Which of the following statements regarding hypothermia is correct? Select one: A. Infants and children shiver vigorously in response to hypothermia. B. The ambient temperature must be below 32°F for hypothermia to occur. C. Decreased thyroid gland function predisposes a person to hypothermia. D. Hypothermia progresses gradually when a person falls in cold water.

C. Decreased thyroid gland function predisposes a person to hypothermia.

You are assessing a 24-year-old male who was bitten by a rattlesnake while hiking in the woods. Which of the following clinical signs would be MOST indicative of envenomation? Select one: A. Redness surrounding the bite B. Severe patient anxiety C. Progressive tissue swelling D. Moderate pain at the site

C. Progressive tissue swelling

Which of the following statements regarding scorpion stings is correct? Select one: A. There is currently no antivenin to reverse the effects of any scorpion sting, regardless of the species. B. All species of scorpion secrete venom, which produces a severe systemic reaction that causes cardiopulmonary collapse. C. With the exception of one particular species of scorpion, most scorpion stings cause severe pain and swelling, but are not dangerous. D. The Centruroides sculpturatus is the most common species of scorpion, although its sting does not cause life-threatening symptoms.

C. With the exception of one particular species of scorpion, most scorpion stings cause severe pain and swelling, but are not dangerous.

When treating a diver who complains of severe pain to his joints and abdomen after returning to the surface of the water, you should manage his airway accordingly and position him: Select one: A. in a supine position with his legs elevated. B. in a semi-Fowler's position. C. on his left side with his head down. D. on his right side with his head elevated.

C. on his left side with his head down.

A frostbitten extremity should never be rewarmed if: Select one: A. it is developing signs of gangrene. B. transport to the hospital is delayed. C. there is a chance that it may refreeze. D. blisters have already began to form.

C. there is a chance that it may refreeze.

Which of the following statements regarding the brown recluse spider is correct? Select one: A. The brown recluse spider has a brown hourglass shape on its back. B. Its venom is neurotoxic and causes nervous system depression. C. The bite from a brown recluse spider produces immediate pain. D. Its venom is cytotoxic and causes severe local tissue destruction.

D. Its venom is cytotoxic and causes severe local tissue destruction.

Patients with diabetes are especially prone to heat illnesses because: Select one: A. they cannot readily produce large amounts of glucose. B. diabetes is associated with hypothalamic deterioration. C. they usually have concomitant heart disease. D. autonomic neuropathy interferes with vasodilation.

D. autonomic neuropathy interferes with vasodilation.

While stacking wood on a woodpile, a 60-year-old male experienced immediate, severe pain on the back of his hand. He complains of abdominal pain, nausea, and dizziness. Your assessment reveals that he is conscious and alert, but has an extremely rigid abdomen. You should suspect a/an: Select one: A. severe acute peritonitis. B. brown recluse spider bite. C. envenomated pit viper bite. D. black widow spider bite.

D. black widow spider bite.

You should assess a patient with systemic hypothermia for local cold injuries to the extremities because: Select one: A. cold blood is shunted to the body's periphery. B. hypothermia causes peripheral vasodilation. C. lactic acid tends to accumulate in the periphery. D. blood is shunted away from the extremities.

D. blood is shunted away from the extremities.

Shivering, which is a natural response of the body to cold temperatures, serves to: Select one: A. decrease the basal metabolic rate. B. inhibit the process of thermogenesis. C. facilitate the process of thermolysis. D. increase the rate of cellular metabolism.

D. increase the rate of cellular metabolism.

Lethal cardiac dysrhythmias, such as ventricular fibrillation, may occur in the hypothermic patient if he or she: Select one: A. takes anticoagulant medications. B. is passively rewarmed. C. has an elevated blood pressure. D. is rewarmed too quickly.

D. is rewarmed too quickly.

Compared to classic heatstroke, exertional heatstroke commonly presents with: Select one: A. hot, dry skin. B. altered behavior. C. a weak, rapid pulse. D. moist, pale skin.

D. moist, pale skin.

You are dispatched to the residence of an 80-year-old female with a possible heat-related emergency. Your assessment reveals that she is semiconscious, has hot and dry skin, and signs of severe dehydration. You should: Select one: A. begin to assist her ventilations. B. begin measures to rapidly cool her. C. start an IV and give a 20 mL/kg bolus. D. move her to a cooler environment.

D. move her to a cooler environment.

The signs and symptoms of Lyme disease resulting from a tick bite are MOST commonly confused with: Select one: A. acute peritonitis. B. an allergic reaction. C. acute ischemic stroke. D. rheumatoid arthritis.

D. rheumatoid arthritis.

Mild hypothermia is characterized by: Select one: A. bradycardia, bradypnea, and loss of muscle coordination. B. bradycardia, loss of muscle coordination, and confusion. C. unresponsiveness, a weak pulse, and cardiac arrhythmias. D. shivering, tachypnea, and peripheral vascular constriction.

D. shivering, tachypnea, and peripheral vascular constriction.

When assessing the skin temperature of a patient with a cold-related emergency, you should feel the skin closest to the core of the body because: Select one: A. the body shunts blood from the core to the extremities as a compensatory response. B. hypothermia develops internally and manifests with external clinical signs. C. a warm trunk and cold extremities indicate that the patient is clinically unstable. D. the patient may be hemodynamically stable even if his or her extremities are cold.

D. the patient may be hemodynamically stable even if his or her extremities are cold.