EMT Chapter 18
7. Covering a patient's ________ will significantly minimize radiation heat loss. A. head B. chest C. abdomen D. extremities
A. head
11. A person's ability to shiver is lost when his or her body temperature falls below: A. 90°F. B. 92°F. C. 95°F. D. 97°F.
A. 90°F.
45. Which of the following statements regarding lightning strikes is MOST correct? A. Lighting often results in a brief period of asystole that resolves spontaneously. 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. Lighting often results in a brief period of asystole that resolves spontaneously.
50. Which of the following is an early sign of pit viper envenomation? A. Local swelling and ecchymosis B. General weakness and diaphoresis C. Syncope and bleeding at distal sites D. Signs and symptoms of hypoperfusion
A. Local swelling and ecchymosis
59. 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. Lyme disease.
55. 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. a black widow spider bite.
28. Heat cramps are MOST likely the result of: A. a loss of water and electrolytes. B. complete thermoregulatory failure. C. carbon dioxide buildup in the muscles. D. stress on the muscles from excess exertion.
A. a loss of water and electrolytes.
20. 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 major muscles of the body become rigid during hypothermia. D. the patient is usually unable to escape the cold ambient temperature.
A. blood is shunted away from the extremities to the body's core.
38. 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. bradycardia and a slowing of the metabolic rate.
33. Geriatric patients are at a higher risk for heatstroke because: A. circulation to the skin is reduced. B. most geriatric patients are obese. C. their ability to sweat is enhanced. D. their ability to shiver is reduced.
A. circulation to the skin is reduced.
6. 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. increasing the metabolic rate.
18. To obtain the MOST accurate reading of a patient's core body temperature, you should place a special hypothermia thermometer: A. into the patient's rectum. B. under the patient's tongue. C. behind the patient's knee. D. under the patient's armpit
A. into the patient's rectum.
60. A 48-year-old male was stung on the leg by a jellyfish while swimming in the ocean. He is conscious and alert, but complains of intense pain at the wound site. Specific treatment for this patient includes: A. irrigating the wound with vinegar and immersing his leg in hot water. B. pulling the nematocysts out with tweezers and bandaging the wound. C. immersing his leg in fresh cold water and scraping away the stingers. D. applying a chemical ice pack to the wound and encouraging movement.
A. irrigating the wound with vinegar and immersing his leg in hot water.
54. 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. perform a jaw-thrust to open his airway.
A. move him as a unit to a supine position.
23. High air temperature reduces the body's ability to lose heat by: A. radiation. B. convection. C. conduction. D. evaporation.
A. radiation.
44. Burns associated with lightning strikes are typically: A. superficial. B. third-degree. C. full-thickness. D. partial-thickness.
A. superficial.
3. Heat loss from the body through respiration occurs when: A. warm air is exhaled into the atmosphere. B. the core body temperature is above 98°F. C. cool air is inhaled and displaces warm air. D. air temperature is above body temperature.
A. warm air is exhaled into the atmosphere.
4. Hypothermia occurs when the core body temperature falls below: A. 98°F. B. 95°F. C. 90°F. D. 88°F.
B. 95°F.
12. 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. a relatively small surface area.
51. A 30-year-old male was rescued after being lost in the woods for approximately 18 hours. The outside temperature is 30°F. He is immediately placed in the warmed ambulance, where you perform an initial assessment. He is unconscious, pale, and apneic. After initiating artificial ventilations, you should: A. apply an AED and assess his cardiac rhythm. B. assess for a carotid pulse for up to 45 seconds. C. begin chest compressions and transport at once. D. apply chemical heat packs to his groin and axillae.
B. assess for a carotid pulse for up to 45 seconds.
1. When a warm hand is immersed in water that is 70°F, heat is transferred from the hand to the water through a process called: A. radiation. B. conduction. C. convection. D. evaporation
B. conduction.
35. 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. death from suffocation after submersion in water.
19. All of the following terms are used to describe a cold body part that is not frozen, EXCEPT: A. frostnip. B. frostbite. C. chilblains. D. trench foot.
B. frostbite.
48. In contrast to the brown recluse spider, the black widow spider: A. is very small and has a violin-shaped marking on its back. B. is large and has a red-orange hourglass mark on its abdomen. C. produces a bite that is typically painless until a blister develops. D. usually produces local pain but no systemic signs or symptoms.
B. is large and has a red-orange hourglass mark on its abdomen.
30. In order for sweating to be an effective cooling mechanism: A. several layers of clothing must be worn. B. it must be able to evaporate from the body. C. the relative humidity must be above 90%. D. the body must produce at least 1L per hour.
B. it must be able to evaporate from the body.
46. The venom of a black widow spider is toxic to the: A. renal system. B. nervous system. C. respiratory system. D. cardiovascular system.
B. nervous system.
41. Signs and symptoms of an air embolism include all of the following, EXCEPT: A. dysphasia. B. pale skin. C. dizziness. D. joint pain.
B. pale skin.
56. Approximately 12 hours after scuba diving with her friends, a 29-year-old female presents with pain in her elbows and knees. She is conscious and alert and is breathing with adequate tidal volume. When asked, she states that she may have ascended too rapidly during her dive, but didn't experience any symptoms until now. When treating this patient, you should: A. position her supine with her legs elevated 6" and her head down. B. place her in a left lateral recumbent position with her head down. C. administer supplemental oxygen via a nasal cannula at 2 to 4 L/min. D. provide ventilatory assistance with a BVM device and 100% oxygen.
B. place her in a left lateral recumbent position with her head down.
10. A patient with a core body temperature of 92°F will MOST likely experience: A. bradycardia. B. rapid breathing. C. muscle stiffness. D. loss of consciousness.
B. rapid breathing.
25. Hyperthermia is MOST accurately defined as a condition in which: A. the core body temperature exceeds 98.6°F. 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. the body is exposed to more heat than it can lose.
31. Heatstroke occurs when: A. a person's core body temperature rises above 103°F. B. the body's heat-eliminating mechanisms are overwhelmed. C. a person becomes dehydrated secondary to excess water loss. D. the ambient temperature exceeds 90°F and the humidity is high.
B. the body's heat-eliminating mechanisms are overwhelmed.
40. An air embolism associated with diving occurs when: A. the diver hyperventilates prior to entering the water. B. the diver holds his or her breath during a rapid ascent. C. the alveoli completely collapse due to high pressure. D. high water pressure forces air into the mediastinum.
B. the diver holds his or her breath during a rapid ascent.
17. Rough handling of a hypothermic patient with a pulse may cause: A. profound bradycardia. B. ventricular fibrillation. C. ventricular tachycardia. D. pulseless electrical activity
B. ventricular fibrillation.
15. When assessing a hypothermic patient, you should palpate for a carotid pulse for approximately __________ seconds before determining that he or she is pulseless. A. 10 to 20 B. 20 to 30 C. 30 to 45 D. 60 to 90
C. 30 to 45
9. Which of the following conditions would be the LEAST likely to increase a person's risk of hypothermia? A. Hypoperfusion B. Severe infection C. Hyperglycemia D. Spinal cord injury
C. Hyperglycemia
43. 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. a swimmer hyperventilates prior to entering the water.
32. Signs of late heatstroke include: A. hot, moist skin. B. nausea and vomiting. C. a weak, rapid pulse. D. a change in behavior.
C. a weak, rapid pulse
14. 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. neck. B. chest. C. abdomen. D. forehead.
C. abdomen
5. 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. convection.
49. All of the following snakes are pit vipers, EXCEPT for the: A. copperhead. B. rattlesnake. C. coral snake. D. cottonmouth.
C. coral snake
27. 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. exhibit poor thermoregulation.
53. 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 BP is 90/50 mm Hg. In addition to administering 100% oxygen, you should: A. perform a rapid medical assessment and look for signs of trauma. B. place him in a sitting position and have him drink 1 liter 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. load him into the ambulance and begin rapid cooling interventions.
21. A frostbitten foot can be identified by the presence of: A. gross deformity. B. soft, smooth skin. C. mottling and blisters. D. blanching of the skin.
C. mottling and blisters.
37. The EMT-B must assume that any unwitnessed water-related incident is accompanied by: A. an air embolism. B. alcohol intoxication. C. possible spinal injury. D. cold water immersion.
C. possible spinal injury.
58. 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 an initial 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. ventilate with a BVM device, apply a cervical collar, remove his wet clothing, and transport rapidly. C. provide rescue breathing, remove wet clothing, immobilize his spine, keep him warm, and transport carefully. D. apply 100% oxygen via a nonrebreathing mask, immobilize his spine, keep him warm, and transport rapidly.
C. provide rescue breathing, remove wet clothing, immobilize his spine, keep him warm, and transport carefully
22. The two MOST efficient ways for the body to eliminate excess heat are: A. respiration and bradycardia. B. perspiration and tachycardia. C. sweating and vessel dilation. D. hyperventilation and tachycardia.
C. sweating and vessel dilation.
34. Which of the following medications increases a person's risk of a heat-related emergency? A. Motrin B. Tylenol C. Aspirin D. Diuretics
D. Diuretics
36. Which of the following statements regarding drowning is MOST 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. Laryngospasm following submersion in water makes rescue breathing difficult.
13. Which of the following would be the LEAST likely to occur in a patient with a core body temperature of between 89°F and 92°F? A. Bradypnea B. Confusion C. Stiff muscles D. Tachycardia
D. Tachycardia
42. The MOST prominent symptom of decompression sickness is: A. tightness in the chest. B. difficulty with vision. C. dizziness and nausea. D. abdominal or joint pain
D. abdominal or joint pain
16. Hypothermia can worsen internal bleeding secondary to: A. cardiac arrhythmias. B. a decreased heart rate. C. severe muscular rigidity. D. blood-clotting abnormalities.
D. blood-clotting abnormalities.
47. 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. causes severe local tissue damage
26. When the body loses sweat, it also loses: A. plasma. B. nutrients. C. erythrocytes. D. electrolytes.
D. electrolytes.
2. The body's natural cooling mechanism, in which sweat is converted to a gas, is called: A. radiation. B. convection. C. conduction. D. evaporation.
D. evaporation.
24. High humidity reduces the body's ability to lose heat through: A. radiation. B. convection. C. conduction. D. evaporation.
D. evaporation.
29. Common signs and symptoms of heat exhaustion include all of the following, EXCEPT: A. nausea. B. headache. C. tachycardia. D. hot, dry skin.
D. hot, dry skin.
52. 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 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. move him into the cooled ambulance.
57. While drinking beer with his friends near a creek, 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: 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. supine positioning, splinting the leg, and transporting.
39. Most of the serious injuries associated with scuba diving are caused by: A. water less than 70°F. B. too rapid of a descent. C. alcohol consumption. D. too rapid of an ascent.
D. too rapid of an ascent.
8. The body's natural protective mechanisms against heat loss are: A. shivering and vasodilation. B. vasodilation and respiration. C. respiration and vasoconstriction. D. vasoconstriction and shivering.
D. vasoconstriction and shivering.