Chapter 30: Environmental Emergencies (Questions)
Which of the following is an early sign of pit viper envenomation? a) signs and symptoms of hypoperfusion b) general weakness and diaphoresis c) local swelling and ecchymosis d) syncope and bleeding at distal sites
C
All of the following snakes are pit vipers, EXCEPT for the: a) rattlesnake. b) cottonmouth. c) coral snake. d) copperhead.
A
Drowning is MOST accurately defined as: a) death from suffocation after submersion in water. b) temporary survival after submersion in water. c) water in the lungs following submersion in water. d) death beyond 24 hours after submersion in water.
A
Patients with generalized hypothermia are at an increased risk of a local cold injury because: a) blood is shunted away from the extremities to the body's core. b) peripheral vasodilation brings warm blood to the skin's surface. c) the patient is usually unable to escape the cold ambient temperature. d) the major muscles of the body become rigid during hypothermia.
A
Signs of late heatstroke include: a) a weak, rapid pulse. b) nausea and vomiting. c) a change in behavior. d) hot, moist skin.
A
The EMT must assume that any unwitnessed water-related incident is accompanied by: a) possible spinal injury. b) an air embolism. c) alcohol intoxication. d) cold water immersion.
A
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: a) abdomen. b) forehead. c) neck. d) chest.
A
When the body loses sweat, it also loses: a) electrolytes. b) nutrients. c) erythrocytes. d) plasma.
A
Which of the following MOST accurately describes hyperthermia? a) The body is exposed to more heat than it can lose. b) The body eliminates more heat than it can generate. c) Heat evaporates a significant amount of body water. d) The core body temperature exceeds 99.5°F (37°C).
A
Which of the following conditions would be the LEAST likely to increase a person's risk of hypothermia? A. hyperglycemia B. severe infection C. hypoperfusion D. spinal cord injury
A
Which of the following medications increases a person's risk of a heat-related emergency? a) diuretics b) Motrin c) Tylenol d) Aspirin
A
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: a) assess the unresponsive patient's pulse, begin CPR starting with chest compressions if he is pulseless, and attach the AED 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. C) recognize that the patients who are conscious are at high risk for developing cardiac arrest and quickly assess them for potentially life-threatening injuries. D) immediately begin CPR on the unresponsive patient, but cease resuscitation efforts if there is no response after 5 minutes of treatment.
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) a brown recluse spider bite. c) envenomation from a pit viper. d) Rocky Mountain spotted fever.
A
A 20-year-old male was pulled from cold water by his friends. The length of his submersion is not known and was not witnessed. You perform a primary assessment and determine that the patient is apneic and has a slow, weak pulse. You should: a) suction his airway for 30 seconds, provide rescue breathing, keep him warm, and transport at once. b) provide rescue breathing, remove wet clothing, immobilize his spine, keep him warm, and transport carefully. c) ventilate with a bag-mask device, apply a cervical collar, remove his wet clothing, and transport rapidly. d) apply 100% oxygen via a nonrebreathing mask, immobilize his spine, keep him warm, and transport rapidly.
B
Compared to adults, infants and children are at higher risk for hypothermia for all of the following reasons, EXCEPT: A. a decreased ability to shiver. B. a relatively small surface area. C. a smaller amount of body fat. D. a smaller overall muscle mass.
B
Covering a patient's _________ will significantly minimize radiation heat loss. a) head b) chest c) extremities d) abdomen
B
Geriatric patients, newborns, and infants are especially prone to hyperthermia because they: a) have relatively smaller heads. b) exhibit poor thermoregulation. c) have smaller body surface areas. d) have less body fat.
B
Hypothermia can worsen internal bleeding secondary to: a) a decreased heart rate. b) blood clotting abnormalities. c) cardiac arrhythmias. d) severe muscular rigidity.
B
Hypothermia occurs when the core body temperature falls below: a) 98°F (37°C). b) 95°F (35°C). c) 90°F (32°C). d) 88°F (31°C).
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: a) radiation. b) conduction. c) convection. d) evaporation.
B
Which of the following statements regarding drowning is correct? A. Hypoxia in the drowning victim initially occurs due to water in the lungs. B. Laryngospasm following submersion in water makes rescue breathing difficult. C. Artificial ventilations can easily be performed in patients with a laryngospasm. D. Large amounts of water enter the lungs in a small number of drowning victims.
B
Which of the following statements regarding lightning strikes is correct? a) The tissue damage pathway caused by lightning usually occurs through the skin. b) Lighting often results in a brief period of asystole that resolves spontaneously. 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.
B
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: a) perform a rapid assessment and look for signs of trauma. b) load him into the ambulance and begin rapid cooling interventions. c) administer one tube of oral glucose and reassess his mental status. d) place him in a sitting position and have him drink 1 L of water.
B
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′. On assessment, you note that he has cyanosis around his lips and has pink froth coming from his nose and mouth. You should: a) position him supine with his head elevated 30°, suction his mouth and nose, hyperventilate him with a bag-mask device, and contact medical control for further guidance. b) suction his mouth and nose, apply high-flow oxygen, position him on his left side with his head down, and contact medical control regarding transport to a recompression facility. c) 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) 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
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: 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) 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. d) cover her with warm blankets and let her move about on the stretcher in order to generate body heat and increase her temperature.
B
All of the following terms are used to describe a cold body part that is not frozen, EXCEPT: A. chilblains. B. frostnip. C. frostbite. D. trench foot.
C
The two MOST efficient ways for the body to eliminate excess heat are: a) perspiration and tachycardia. b) respiration and bradycardia. c) sweating and dilation of skin blood vessels. d) hyperventilation and tachycardia.
C
The venom of a black widow spider is toxic to the: a) respiratory system. b) cardiovascular system. c) nervous system. d) renal system.
C
A dysbarism injury refers to the signs and symptoms related to changes in: a) decompression. b) rapid ascent. c) rapid descent. d) barometric pressure.
D
A patient with a core body temperature of 95°F (35°C) will MOST likely experience: a) loss of consciousness. b) a slow pulse. c) muscle stiffness. d) rapid breathing.
D
A person's ability to shiver is lost when his or her body temperature falls below: a) 92°F (33°C). b) 94°F (34°C). c) 95°F (35°C). d) 90°F (32°C).
D
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 diver holds his or her breath for a long period of time. d) a swimmer hyperventilates prior to entering the water.
D
Heat loss from the body through respiration occurs when: a) air temperature is greater than body temperature. b) cool air is inhaled and displaces warm air. c) the core body temperature is greater than 98°F (37°C). d) warm air is exhaled into the atmosphere.
D
High air temperature reduces the body's ability to lose heat by: a) convection. b) conduction. c) evaporation. d) radiation.
D
Rough handling of a hypothermic patient with a pulse may cause: a) ventricular tachycardia. b) pulseless electrical activity. c) profound bradycardia. d) ventricular fibrillation.
D
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) evaporation. d) convection.
D
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) bradypnea b) stiff muscles c) confusion d) tachycardia
D
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) begin ventilations with a barrier device. b) immediately secure him to a longboard. c) perform a jaw-thrust maneuver to open his airway. d) move him as a unit to a supine position.
D
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: a) Rocky Mountain spotted fever. b) exposure to poison ivy. c) an allergic reaction. d) Lyme disease.
D
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. After initiating artificial ventilations, you should:
assess for a carotid pulse for up to 45 seconds
Geriatric patients are at a higher risk for heatstroke because:
circulation to the skin is reduced
Shivering is a mechanism in which the body generates heat by:
increasing the metabolic rate.
In order for sweating to be an effective cooling mechanism:
it must be able to evaporate from the body
Burns associated with lightning strikes are typically:
superficial.
Heatstroke occurs when:
the body's heat-eliminating mechanisms are overwhelmed.
The body's natural protective mechanisms against heat loss are:
vasoconstriction and shivering.
