EMT Chapter 21 Test

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A patient who is responsive to painful stimuli is covered with hives. He has labored respirations and a weak and rapid pulse. His vital signs​ are: pulse​ 128, respirations​ 24, and blood pressure​ 80/50 mmHg. Given this​ presentation, the EMT should be suspicious of what​ condition? A. Anaphylaxis B. Hypersensitivity C. Localized allergic reaction D. Sensitization

A

A patient informs you that any time she is exposed to a particular​ soap, she experiences a mild allergic reaction. As a knowledgeable​ EMT, you should recognize​ that: A. the soap contains an antigen. B. the​ patient's airway will swell shut if she inhales the soap. C. the soap contains antibodies that react in the​ patient's body. D. she must have been exposed to the soap as an infant.

A

A patient suffers an allergic reaction after taking penicillin. In this​ case, the penicillin would be recognized as​ a(n): A. antigen. B. mast cell. C. antibody. D. IgE immunoglobulin.

A

A patient with an allergy to bees and a prescribed​ Epi-pen was working in the garden when she believed she was stung. You note swelling to the right side of her​ face, with redness and warmth to the skin of her cheek. Her airway is​ patent, respirations easy and​ adequate, and radial pulse strong. Which one of the following should you do​ next? A. Perform a secondary assessment. B. Treat as an anaphylactoid reaction. C. Assist the patient with her​ Epi-pen. D. Place her on the cot immediately and transport.

A

A young female​ patient, who is allergic to​ peanuts, was just exposed to peanut butter. Assessment reveals her to be alert and oriented with swollen lips and hives on her face. She is breathing adequately at a rate of 18 breaths per minute and has a heart rate of 82. Your partner advises you that her blood pressure is​ 118/72 mmHg and room air SpO2​ 92%. She states that she also has asthma for which she uses an inhaler. Of the​ following, what would you do​ first? A. Provide supplemental oxygen. B. Determine the amount of peanut butter consumed. C. Start positive pressure ventilation. D. Assist her with her inhaler.

A

An awake but confused patient experiencing an allergic reaction begins to exhibit stridorous respirations. The EMT knows that the underlying condition responsible for this presentation​ is: A. swelling to the upper airway. B. loss of the gag reflex. C. constriction of the small airways. D. spasm of the lower airway.

A

A​ 23-year-old male has called EMS for swollen lips and hives. As you enter the​ scene, what observation would make the EMT suspicious that the patient is having an allergic​ reaction? A. A new container of penicillin on a table with two pills missing B. Other family members complaining of similar symptoms C. A glucometer on a table in the living room D. A bottle of expired nitroglycerin on the kitchen counter

A

Regarding the pathophysiology underlying​ anaphylaxis, which of the following is​ true? A. Histamine causes the capillaries to become leaky. B. High blood pressure forces blood from the blood vessels. C. IgE immunoglobulins make antibodies that cause bronchoconstriction. D. Smooth muscle dilation on the lungs impairs the exchange of oxygen.

A

Which one of the following assessment findings would indicate that the patient is suffering from an anaphylactic reaction and requires immediate​ intervention? A. Swollen lips with a blood pressure of​ 84/50 mmHg B. Localized swelling around the site of a bee sting C. Hives and a heart rate of 96 beats per minute D. Edema to the feet with an SpO2 of​ 93% on room air

A

Within the​ body, the release of histamine would cause dilation of​ the: A. blood vessels. B. small airways. C. salivary glands. D. upper airway.

A

You are staffing an information booth at the county fair when a mother and her​ 15-year-old son approach. The mother informs you that her son is severely allergic to bee stings and had an epinephrine​ auto-injector prescribed to him when he was 5 years old. She hands you the 0.15 mg​ auto-injector and notes that it expired several years ago. Which one of the following statements would be most appropriate for you to​ make? A. ​"Call your doctor to get a new injector and ask him if he wants to change the​ dose." B. ​"We have some on the ambulance. I can get you one until you are able to get a new one from your​ doctor." C. ​"Make sure to call the doctor since this is out of date. Also ask him if he wants to add a steroid to the​ injector." D. ​"Call your doctor as soon as possible for a new injector because this one is out of​ date."

A

Your patient is experiencing a severe anaphylactic reaction. Which of the following signs is most​ concerning? A. Hypotension. B. Restlessness. C. Flushed skin. D. Tachycardia.

A

A football player in full uniform has been stung by a bee. Your assessment reveals him to be confused with stridorous respirations and weak radial pulses. His skin is warm and flushed and covered with hives. Vital signs​ are: pulse​ 164, respirations​ 28, blood pressure​ 74/58 mmHg, and SpO2 at​ 87%. The coach notifies you that the patient is allergic to bees and hands you the​ patient's epinephrine pen. Your next action would be​ to: A. lift the shoulder pads and shirt and administer the epinephrine into his upper arm muscle. B. administer the epinephrine through a padless area of the pants over the side of his thigh. C. completely expose the patient and administer the epinephrine into his anterior thigh. D. lift the shirt over the abdomen and administer the epinephrine into his abdomen below the umbilicus.

B

A panicked and anxious patient tells you that he is allergic to peanuts and thinks he may have accidentally eaten some. He states that the last time he ate peanuts he almost died and needed to have a​ "tube put in his​ throat." When assessing the​ patient, which of the following signs or symptoms would provide the best evidence that the patient is having an​ allergic, and possibly an​ anaphylactic, reaction? A. Panic and anxiety B. Hives on his chest C. Cool and clammy skin D. Elevated blood pressure

B

A patient informs you that he found out he is allergic to certain molds and was prescribed an epinephrine​ auto-injector. He asks you how the epinephrine will help him the next time he is exposed to mold. Your response would​ be: A. ​"It will reverse the reaction by mimicking the parasympathetic nervous system in your​ body." B. ​"It will cause the blood vessels to constrict and increase your blood​ pressure." C. ​"It will provide antibodies to your body and give you temporary​ immunity." D. ​"It will quickly destroy the allergen in the​ mold."

B

A patient states that he is allergic to poison ivy and was likely in contact with it yesterday as he was clearing some weeds and brush from his property.​ Today, he awoke and found a red rash to the back of his left​ hand, that extended up his arm part way. As a​ precaution, he called 911. Assessment reveals him to be alert and well oriented with easy​ respirations, and a strong peripheral pulse. Your next action would be​ to: A. assist the patient with his epinephrine​ auto?injector. B. obtain a medical history. C. provide immediate and rapid transport. D. call for advanced life​ support? (ALS) assistance.

B

After you assist a patient with his epinephrine​ auto-injector, which one of the following statements made by the patient best indicates that the epinephrine is working and the patient is​ improving? A. ​"My heart feels as though it is​ racing." B. ​"My breathing feels a lot​ easier." C. ​"I am more relaxed and getting​ sleepy." D. ​"I am getting a little bit of a​ headache."

B

Five minutes after you assist a patient with her epinephrine​ auto-injector, the patient states that she feels much better and would like to refuse additional care and transport to the hospital. What statement would be most appropriate given the​ situation? A. ​"Epinephrine can make you very sleepy. You can refuse but just make sure that someone is here to keep an eye on​ you." B. ​"The epinephrine will wear off in 10 to 20 minutes.​ Let's see how you are doing then before thinking about refusing​ transport." C. ​"If you feel better​ now, there is probably no need to go to the hospital. I will get the refusal form for you to​ sign." D. ​"Once we help you take your​ epinephrine, the law requires that you be transported to a hospital for additional​ care."

B

How should an EMT assist a patient in taking his epinephrine​ auto-injector? A. Place the injector against the deltoid muscle in the​ arm, and push the plunger to slowly inject the medication. B. Press the injector onto the lateral​ thigh, and wait for it to automatically inject. C. Pinch the skin on the anterior​ thigh, press the injector against the​ skin, and wait until it activates. D. Pinch the skin on the lateral​ thigh, press the injector against the​ skin, and rapidly push the plunger to inject the medication.

B

When assessing a patient with an anaphylactic​ reaction, which one of the following findings would you​ expect? A. Rapid and strong carotid pulse B. Weak radial pulse C. Slow and bounding radial pulse D. Normal to slightly increased blood pressure

B

Which statement indicates that the EMT understands airway management in a patient suffering from​ anaphylaxis? A. ​"If an oral or nasal airway is​ used, the airway will be opened and positive pressure ventilation will not be​ needed." B. ​"When providing positive pressure​ ventilation, it may be difficult to pass air through the swollen​ tissues." C. ​"Epinephrine will help the​ patient's blood​ pressure, but not the swollen tissue in the​ airway." D. ​"The best way to open the airway in a patient with upper airway edema is to place the patient in an upright​ position."

B

You are responding to a call for an allergic reaction. Your partner is a new EMT and this is his first call. When prepping him for what might lie on​ scene, what instruction regarding the assessment and treatment of an allergic reaction​ and/or anaphylaxis would be​ correct? A. ​"If the allergic reaction was caused by exposure to chocolate or​ eggs, we will not be able to administer​ epinephrine." B. ​"Our first priority will be to treat the patient according to her​ symptoms." C. ​"If the allergic reaction was caused by​ food, we will need to administer activated​ charcoal." D. ​"Epinephrine really should be given to any patient suffering even a mild allergic reaction to prevent​ anaphylaxis."

B

You have been called for a male patient experiencing a severe allergic reaction. The patient is very confused and having great difficulty breathing. He has an epinephrine​ auto-injector; however, your service does not have protocols related to its use. In EMT​ class, you went over and passed a test on the use of an epinephrine​ auto-injector for allergic reactions. In this​ case, you​ should: A. contact the physician prescribing the medication for permission to use the​ auto-injector. B. provide oxygen and respiratory support followed by immediate transport. C. assist the patient with his epinephrine​ auto-injector. D. assist the patient with his epinephrine using implied consent as justification.

B

A patient who is severely short of breath and covered with hives states that she is allergic to crab but tried some crab dip 10 minutes ago. Which one of the following questions would the EMT ask​ first? A. ​"Why did you eat the dip if you are allergic to​ crab?" B. ​"How many allergic reactions have you​ had?" C. ​"Do you have an epinephrine autominus−​injector?" D. ​"What medications are you currently​ taking?"

C

During the primary​ assessment, which finding would most lead the EMT to suspect an allergic​ reaction? A. Blood pressure of​ 100/60 mmHg B. Complaint of dizziness C. Hives to the face and neck D. Heart rate of 112 beats per minute

C

Five minutes after assisting a patient with his epinephrine​ auto-injector, you determine the patient to be getting progressively worse. The patient has a second​ auto-injector available;​ however, written protocols do not address the administration of a second dose. Which one of the following should be your next best​ action? A. Request advanced life support​ (ALS) assistance. B. Continue to monitor the patient. C. Contact medical direction for further orders. D. Administer the second dose of epinephrine.

C

In which situation would the EMT contact medical direction prior to administering epinephrine to a patient suffering an anaphylactic​ reaction? A. She has an allergy to chocolate or eggs. B. Her heart rate is 144 beats per minute. C. The patient is not prescribed an​ auto-injector. D. She is hypotensive and tachycardic.

C

On scene you assisted a patient with his epinephrine​ auto-injector after he was stung multiple times by bees. You are now transporting the patient to the hospital. As you reassess the​ patient, which one of the following signs would best indicate that the epinephrine is benefiting the​ patient? A. Complaint of fatigue B. Increasing heart rate C. Decreasing wheezing D. Decreasing blood pressure

C

Prior to assisting a patient with his epinephrine​ auto-injector, the EMT must ensure​ that: A. the​ patient's heart rate and blood pressure are stable. B. the medication is yellow in color. C. ​on- or​ off-line medical direction exists. D. the patient is improving.

C

The EMT exhibits an understanding of allergic reactions and anaphylaxis when she makes which one of the following​ statements? A. ​"Anaphylaxis describes a severe allergic reaction that occurs the first time a person is exposed to an​ allergen." B. ​"An allergic reaction only occurs when the patient ingests or inhales an​ allergen; anaphylaxis occurs when the allergen is​ injected." C. ​"Anaphylaxis is a severe allergic reaction that will lead to death without emergency​ care." D. ​"Allergic reactions are caused by pollen and​ food; anaphylactic reactions are caused by venoms and​ medications."

C

What is the most severe form of an allergic reaction​ called? A. Hypersensitivity B. Rhinorrhea C. Anaphylaxis D. Antigen response

C

When the signs and symptoms of anaphylaxis are​ rapid, the EMT must realize​ that: A. the reaction tends to be localized. B. epinephrine will not be effective. C. the reaction tends to be severe. D. there is an increased amount of antigens.

C

Which of the following explains why patients experiencing an anaphylactic reaction have difficulty​ breathing? A. Antibodies depress the​ brain's respiratory center. B. Antigens increase the​ body's need for oxygen. C. Histamine constricts the bronchioles. D. Allergens use the available oxygen molecules.

C

You have assisted an adult patient with his epinephrine autominus−injector. When giving a report to the emergency department​ nurse, you should inform her that​ ________ mg of epinephrine was administered. A. 1 B. 0.25 C. 0.30 D. 0.15

C

You have been called to a kindergarten class for a​ 5-year-old boy who is allergic to peanuts. He ate some in the form of a birthday treat brought to school by a classmate who is celebrating a birthday. From the door of the​ classroom, you note the patient to have swollen lips and hives to his face and arms. As you begin the primary​ assessment, which one of the following should you do​ first? A. Contact the​ patient's parents for permission to treat him. B. Check breath sounds for wheezing and assess the vital signs. C. Inspect the inside of his mouth. D. Determine how many peanuts he ingested.

C

You have been called to a residence for a female patient who awoke with swollen lips and a rash to her arms and abdomen. In​ addition, she exhibits a mild expiratory wheeze in all lung fields. She states that she called her doctor who advised her to take some Benadryl and call 911 for emergency care. How will the​ Benadryl, acting as an​ antihistamine, benefit the​ patient? A. It dilates her blood vessels and delivers more blood to the brain. B. It helps her immune system to deactivate the allergen. C. It stops the constriction of the​ patient's small airways. D. It acts as an allergen to stop the allergic reaction.

C

You have just assisted a patient with his epinephrine​ auto-injector. The patient states that he has never taken epinephrine before. You would inform him of which one of the​ following? A. ​"If you pass​ out, that is normal. I will just give you some oxygen if that​ happens." B. ​"The epinephrine may make you​ drowsy, so just close your​ eyes." C. ​"You may feel a little​ shaky, but that is normal and will​ pass." D. ​"Be prepared to feel dizzy and nauseated. These are common when taking​ epinephrine."

C

You have been summoned to an apartment for a​ 58-year-old female complaining of hives on her chest and abdomen. When​ asked, she states that she has had several episodes of the hives over the past six​ months, but allergy testing has not been able to pinpoint a cause. Based on this​ information, which one of the following would best classify the cause of the​ reaction? A. Iatrogenic B. Anaphylactic C. Anaphylactoid D. Idiopathic

D

A mother has called you for her​ 9-year-old daughter who was stung in the right hand by a bee. She states that her older daughter is allergic to bees and she is scared that the patient may also be​ allergic, although she has never been stung before. Assessment of the patient reveals a​ red, painful, and swollen area on the back of the​ girl's right hand. The primary assessment is unremarkable and her vital signs are normal. The mother hands you her older​ daughter's epinephrine pen. You​ would: A. administer the epinephrine into the​ patient's thigh. B. ask the mother to administer the pen into the​ patient's thigh. C. contact medical direction for permission to use the​ Epi-pen. D. Treat the patient for a local sting and transport her to the hospital

D

A patient has been stung by a bee. Which one of the following findings would be present in​ anaphylaxis, but not in a local allergic​ reaction? A. Anxiousness B. Swelling at the site of the sting C. Hives near the site of the sting D. Hypotension

D

A patient has just taken her first dose of Zocor for her high cholesterol. Within​ minutes, she begins to develop​ hives, shortness of​ breath, and low blood pressure. In this​ case, the EMT would recognize​ a(n): A. hypersensitivity reaction. B. anaphylaxis. C. sensitized immune response. D. anaphylactoid reaction.

D

After assisting a patient with the use of an epinephrine​ auto-injector, you note that the​ patient's blood pressure has improved. As a knowledgeable​ EMT, you realize that this has occurred due to​ epinephrine's ability​ to: A. increase the​ oxygen-carrying capacity of the red blood cells. B. relax the smooth muscle of the blood vessels. C. increase the number of circulating red blood cells. D. constrict blood vessels.

D

An awake but confused patient experiencing an allergic reaction begins to exhibit stridorous respirations. The EMT knows that the underlying condition responsible for this presentation​ is: A. loss of the gag reflex. B. constriction of the small airways. C. spasm of the lower airway. D. swelling to the upper airway.

D

A​ 39-year-old female, who is allergic to​ peanuts, thinks that she may have accidentally ingested some. When assessing​ her, which statement would be suggestive that the patient is in the early stages of an anaphylactic​ reaction? A. ​"I can hear my heartbeat in my​ ears." B. ​"My arms and legs are​ cramping." C. ​"I feel as though I am getting a​ fever." D. ​"I suddenly feel like a have a lump in my​ throat."

D

For the EMT to achieve the best results when assisting with​ epinephrine, the medication should be placed​ into: A. the skin. B. an artery. C. a vein. D. a muscle.

D

The EMT shows he understands the use of an epinephrine​ auto-injector for treating a patient with an anaphylactic reaction when he makes which one of the following​ statements? A. ​"It is critical that the EMT identify the cause of the allergic reaction prior to administering epinephrine through the​ auto-injector." B. ​"The epinephrine​ auto-injector is used only when a patient is stung by a bee or suffers an insect​ bite." C. ​"The epinephrine​ auto-injector should never be used if the patient has developed the allergic reaction after eating​ chocolate." D. ​"Epinephrine administered through an​ auto-injector can be used for all anaphylactic and anaphylactoid​ reactions, regardless of the​ cause."

D

What is the most common cause of an allergic​ reaction? A. Food B. Pollen C. Bee stings D. Medications

D

What statement would you agree with regarding both anaphylactic and anaphylactoid​ reactions? A. Administering epinephrine in an anaphylactoid reaction can be fatal. B. Anaphylactoid reactions seldom involve the airway while anaphylaxis does. C. Anaphylaxis is caused by​ medications; anaphylactoid reactions are not. D. Both anaphylactoid and anaphylactic reactions are treated the same.

D

When administering epinephrine to an infant or​ child, the EMT would place the injector at what​ site? A. Hip muscle B. Outer buttock C. Upper arm D. Lateral thigh

D

When reassessing a patient you are treating for an anaphylactic​ reaction, what finding would be of the most concern to the​ EMT? A. New hives appearing on the chest B. Pulse oximetry reading of​ 95% despite​ high-concentration oxygen C. ​Red, warm, and dry skin D. Respiratory rate change from 28 to 10 breaths per minute

D

Which one of the following is the primary difference between an anaphylactic reaction and an anaphylactoid​ reaction? A. Anaphylactoid reactions are less severe than anaphylactic reactions. B. Epinephrine is contraindicated in anaphylactoid​ reactions, but not in anaphylactic reactions. C. Anaphylactoid reactions are commonly caused by environmental​ substances; anaphylactic reactions are most commonly caused by foods. D. An anaphylactoid reaction may occur without prior sensitization to the​ antigen; anaphylaxis requires prior sensitization.

D

Why would the patient experiencing an allergic reaction tell you that it is easier to breathe following administration of​ epinephrine? A. Drying of mucus in the airways B. Decreased blood pressure C. Increased blood flow to the lungs D. Dilation of the bronchioles

D

You are called to an​ out-patient surgery center for a patient who developed an allergic reaction while receiving an intravenous​ (IV) antibiotic. The EMT would document the route of exposure​ as: A. ingestion. B. topical. C. contact. D. injection.

D

You are providing​ bag-valve-mask ventilations to a patient in anaphylactic shock. There is increasing resistance to​ ventilation, despite using proper technique. Which of the following is the best way to address this​ situation? A. Turn the patient to her side and apply manual pressure over the epigastrium. B. Stop ventilations and administer an albuterol​ metered-dose inhaler. C. Increase both the ventilatory rate and force of ventilation. D. Occlude the​ pop-off valve on the​ bag-valve mask and continue ventilations.

D

You have arrived by the side of a lethargic patient who is allergic to latex and was exposed to it when she spilled a​ latex-containing powder on her right hand. She is only able to speak a few words with each breath.​ Additionally, her tongue is swollen and respirations are​ rapid, labored, and noisy. What action is your immediate​ priority? A. Insert an oropharyngeal airway. B. Obtain a heart rate and blood pressure. C. Wash the latex powder from the​ patient's hand. D. Start positive pressure ventilation.

D


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