Chapter 20 - Q/A

When administering epinephrine via auto-injector, you should hold the injector in place for:

10 seconds

Most patients who die of anaphylaxis do so within the first __________ following exposure.

30 minutes

Urticaria is the medical term for:

hives.

B. administer oxygen and transport her to the hospital.

A 19-year-old female was stung multiple times on the legs by fire ants. She states that she is allergic to fire ants, but does not carry her own epinephrine. The patient is conscious and alert and complains of pain to the area of the bites. Her blood pressure is 122/70 mm Hg, her pulse is 100 beats/min and strong, and her respirations are 18 breaths/min and unlabored. You should: Select one: A. position her legs well above the level of her heart. B. administer oxygen and transport her to the hospital. C. request a paramedic unit to administer epinephrine. D. advise her to see her physician as soon as possible.

B. Administer oxygen, transport at once, and request a paramedic intercept.

A 37-year-old male is having a severe allergic reaction to penicillin. He does not have an epinephrine auto-injector and your protocols do not allow you to carry epinephrine on the ambulance. How should you proceed with the treatment of this patient? Select one: A. Ask the patient if he has any diphenhydramine tablets that you can administer. B. Administer oxygen, transport at once, and request a paramedic intercept. C. Remain at the scene with the patient and request a paramedic ambulance. D. Quickly determine if there are any bystanders who may carry epinephrine.

A 37-year-old male is having a severe allergic reaction to penicillin. He does not have an epinephrine auto-injector and your protocols do not allow you to carry epinephrine on the ambulance. How should you proceed with the treatment of this patient?

Administer oxygen, transport at once, and request a paramedic intercept.

B. extreme allergic reaction that may affect multiple body systems.

Anaphylaxis is MOST accurately defined as a(n): Select one: A. moderate allergic reaction that primarily affects the vasculature. B. extreme allergic reaction that may affect multiple body systems. C. severe allergic reaction that typically resolves without treatment. D. allergic reaction that causes bronchodilation and vasoconstriction.

A. multiple organ systems

Anaphylaxis is not always life threatening, but it typically involves: Select one: A. multiple organ systems. B. wheezing. C. urticaria. D. wheals.

C. a raised, well-defined area of the skin

At the site of the injury, signs and symptoms of an animal or insect bite or sting may include pain, localized heat, and a wheal, which appears as __________. Select one: A. an uncomfortable depression in the skin B. a series of small, raised pustules C. a raised, well-defined area of the skin D. a large area of red, blotchy skin

C. Apply high-flow oxygen therapy, place the patient in a shock position, and help maintain the patient's body temperature

Care for a victim of an immunologic emergency who is severely hypotensive should include which of the following? Select one: A. Position the patient's airway and initiate positive-pressure ventilations. B. Initiate basic life support measures, including the use of an automated external defibrillator, if necessary. C. Apply high-flow oxygen therapy, place the patient in a shock position, and help maintain the patient's body temperature. D. Routine spinal immobilization due to the potential for traumatic injury

A. sympathetic

Epinephrine stimulates the ________ response, increasing blood pressure and relieving bronchospasm. Select one: A. sympathetic B. parasympathetic C. cardiac D. respiratory

D. All of these answers are correct

Epinephrine, whether made by the body or by a drug manufacturer, works rapidly to: Select one: A. raise the pulse rate and blood pressure. B. inhibit an allergic reaction. C. relieve bronchospasm. D. All of these answers are correct.

Which of the following statements regarding fire ants is correct?

Fire ants often bite a person repeatedly.

D. 0.3; 0.15

The adult epinephrine auto-injector delivers ______ mg of epinephrine, and the infant-child auto-injector delivers ______ mg. Select one: A. 0.1; 0.01 B. 0.01; 0.1 C. 0.03; 0.3 D. 0.3; 0.15

B. 1 minute

The effects of epinephrine are typically observed within _________ following administration. Select one: A. 30 seconds B. 1 minute C. 30 minutes D. 1 hour

B. use a human body as a home

The goal of invaders such as bacteria and viruses is to __________. Select one: A. kill their human host B. use a human body as a home C. spread disease and destruction D. cause an immune response

B. scraped away from the skin

The stinger from a honeybee should be: Select one: A. left in place and covered. B. scraped away from the skin. C. squeezed with tweezers and removed. D. irrigated with copious amounts of water.

A. hives

Urticaria is the medical term for: Select one: A. hives. B. burning. C. swelling. D. a wheal.

D. All of these answers are correct.

When a foreign substance invades the body, the body will __________. Select one: A. protect itself B. go on alert C. attempt to inactivate the foreign substance D. All of these answers are correct.

B. quickly, within 30 minutes.

When an allergic reaction proceeds to life-threatening anaphylaxis, it will usually do so __________. Select one: A. quickly, within 30 seconds. B. quickly, within 30 minutes. C. slowly, over more than 30 minutes. D. slowly, over several hours.

D. Diphenhydramine (Benadryl)

Which of the following medications blocks the release of histamines? Select one: A. Albuterol (Ventolin) B. Epinephrine (Adrenalin) C. Acetaminophen (Tylenol) D. Diphenhydramine (Benadryl)

B. Stridor

Which of the following sounds indicates swelling of the upper airway? Select one: A. Rales B. Stridor C. Rhonchi D. Wheezing

C. The environment in which the patient is found

Which of the following would MOST likely provide clues regarding the source of a patient's allergic reaction? Select one: A. The patient's family history B. The patient's general physical appearance C. The environment in which the patient is found D. The time of year in which the exposure occurred

D. 0.15 mg

You have been called to a park where a local church is holding a potluck dinner. As you exit your ambulance, a woman approaches you holding her 7-year-old son who is wheezing and having difficulty breathing. She informs you that he inadvertently ate a brownie with nuts, and he is allergic to nuts. The child's mother has an EpiPen that contains the appropriate dose of epinephrine for a child. What dose would that be? Select one: A. 0.8 mg B. 0.5 mg C. 0.4 mg D. 0.15 mg

A. squeezing may cause the stinger to inject more venom into the wound.

You should not use tweezers or forceps to remove an embedded stinger because: Select one: A. squeezing may cause the stinger to inject more venom into the wound. B. the stinger may break off in the wound. C. the tweezers are not sterile and may cause infection. D. removing the stinger may cause bleeding.

Which of the following patients would MOST likely have a delayed onset of an allergic reaction?

a 45-year-old male who ingested penicillin

A raised, swollen, well-defined area on the skin that is the result of an insect bite or sting is called:

a wheal.

Which of the following MOST accurately defines an allergic reaction?

an exaggerated immune system response to any substance

A 19-year-old female was stung multiple times on the legs by fire ants. She states that she is allergic to fire ants, but does not carry her own epinephrine. The patient is conscious and alert and complains of pain to the area of the bites. Her blood pressure is 122/70 mm Hg, her pulse is 100 beats/min and strong, and her respirations are 18 breaths/min and unlabored. You should:

administer oxygen and transport her to the hospital.

The foreign substance responsible for causing an allergic reaction is called a(n):

allergen.

You are assessing a young male who was stung on the leg by a scorpion. He is conscious and alert, his breathing is regular and unlabored, and his blood pressure is 122/64 mm Hg. Assessment of his leg reveals a wheal surrounded by an area of redness. He states that he had a "bad reaction" the last time he was stung by a scorpion, and carries his own epinephrine auto-injector. You should:

apply oxygen as needed, clean the area with soap and water or a mild antiseptic, and transport him to the hospital.

You respond to the residence of a 55-year-old female with a possible allergic reaction to peanuts that she ate approximately 30 minutes ago. The patient is conscious and alert, but has diffuse urticaria and the feeling that she has a lump in her throat. As your partner applies oxygen to the patient, you should:

ask her if she has prescribed epinephrine.

A 38-year-old female was bitten by fire ants while at the park with her kids. Your primary assessment reveals that she is semiconscious, has profoundly labored breathing, and has a rapid, thready pulse. She has a red rash on her entire body and her face is very swollen. You should:

assist her ventilations with 100% oxygen.

A 73-year-old man presents with a generalized rash, which he thinks may have been caused by an antibiotic that he recently began taking. He has a history of coronary artery disease, hypertension, and emphysema. He is conscious and alert, his blood pressure is 144/94 mm Hg, and his pulse is 64 beats/min and regular. You auscultate his breath sounds and hear scattered wheezing, although he is not experiencing respiratory distress. In addition to administering oxygen, you should:

contact medical control if needed, transport the patient, and monitor him for signs of deterioration.

Which of the following medications blocks the release of histamines?

diphenhydramine (Benadryl)

Common side effects of epinephrine include all of the following, EXCEPT:

drowsiness.

Common signs and symptoms of an allergic reaction include all of the following, EXCEPT:

drying of the eyes.

Anaphylaxis is MOST accurately defined as a(n):

extreme allergic reaction that may affect multiple body systems.

Chemicals that are responsible for the signs and symptoms of an allergic reaction to a bee sting include:

histamines and leukotrienes.

When using an auto-injector to give epinephrine, the primary injection site is the:

lateral portion of the thigh.

A 48-year-old male is found unconscious in the garden by his wife. When you arrive at the scene and assess the man, you find that he is unresponsive, has severely labored breathing, and has hives over his entire trunk. You should:

maintain his airway and assist his ventilations.

After administering 0.3 mg of epinephrine via auto-injector to a 22-year-old female with an allergic reaction, you note improvement in her breathing and dissipation of her hives. However, she is still anxious and tachycardic. You should:

monitor her closely but recall that anxiety and tachycardia are side effects of epinephrine.

Immediately after giving an epinephrine injection, you should:

properly dispose of the syringe.

A 50-year-old male was stung by a honeybee approximately 15 minutes ago. He presents with respiratory distress, facial swelling, and hypotension. After placing him on oxygen and administering his epinephrine via auto-injector, you note that his breathing has improved. Additionally, his facial swelling is resolving and his blood pressure is stable. Your next action should be to:

record the time and dose of the injection, and transport promptly.

You have administered one dose of epinephrine to a 40-year-old female to treat an allergic reaction that she developed after being stung by a scorpion. Your reassessment reveals that she is still having difficulty breathing, has a decreasing mental status, and has a blood pressure of 80/50 mm Hg. You should:

request permission from medical control to give another dose of epinephrine.

The stinger from a honeybee should be:

scraped away from the skin.

Which of the following sounds indicates swelling of the upper airway?

stridor

Which of the following negative effects of anaphylaxis will be the MOST rapidly fatal if not treated immediately?

upper airway swelling

Which of the following physiologic actions does epinephrine produce when given for an allergic reaction?

vasoconstriction and bronchodilation

The two MOST common signs of anaphylaxis are:

wheezing and widespread urticaria.