Chapter 32

Compared to adults, infants and children are at higher risk for hypothermia for all of the following reasons, EXCEPT: A. a smaller amount of body fat. B. a smaller overall muscle mass. C. a decreased ability to shiver. D. a relatively small surface area.

.

High air temperature reduces the body's ability to lose heat by: A. convection. B. evaporation. C. conduction. D. radiation.

.

Signs and symptoms of an air embolism include all of the following, EXCEPT: a. dizziness b. pale skin. C. dysphasia. D. joint pain.

.

Which of the following is an early sign of pit viper envenomation? A. General weakness and diaphoresis B. Local swelling and ecchymosis C. Signs and symptoms of hypoperfusion D. Syncope and bleeding at distal sites

Local swelling and ecchymosis

To assess a patient's general body temperature, pull back on your glove and place the back of your hand on his or her skin at the: A. chest. B. forehead. C. neck. D. abdomen.

abdomen

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. immediately begin CPR on the unresponsive patient, but cease resuscitation efforts if there is no response after 5 minutes of treatment. B. assess the unresponsive patient's pulse, begin CPR starting with chest compressions if he is pulseless, and attach the AED as soon as possible. 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. focus your initial treatment efforts on the patients who are conscious because the unresponsive patient is likely in irreversible cardiac arrest.

assess the unresponsive patient's pulse, begin CPR starting with chest compressions if he is pulseless, and attach the AED as soon as possible.

Patients with generalized hypothermia are at an increased risk of a local cold injury because: A. the major muscles of the body become rigid during hypothermia. B. peripheral vasodilation brings warm blood to the skin's surface. C. the patient is usually unable to escape the cold ambient temperature. D. blood is shunted away from the extremities to the body's core.

blood is shunted away from the extremities to the body's core.

In contrast to Lyme disease, Rocky Mountain spotted fever: A. causes painful joint swelling after a few days or weeks. B. presents with flu-like symptoms and a bull's-eye rash. C. can cause paralysis and cardiorespiratory collapse. D. may be confused with rheumatoid arthritis.

can cause paralysis and cardiorespiratory collapse.

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. convection. C. conduction. D. evaporation.

conduction

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.

death from suffocation after submersion in water.

When the body loses sweat, it also loses: A. plasma. B. nutrients. C. erythrocytes. D. electrolytes.

electrolytes

High humidity reduces the body's ability to lose heat through: A. radiation. B. conduction. C. evaporation. D. convection.

evaporation

The body's natural cooling mechanism, in which sweat is converted to a gas, is called: A. radiation. B. conduction. C. evaporation. D. convection.

evaporation

All of the following terms refer to a body part that is cold but not frozen, EXCEPT: A. frostbite. B. frostnip. C. immersion foot. D. trench foot.

frostbite

The rate and amount of heat loss by the body can be modified by all of the following, EXCEPT: A. wearing insulated clothing. B. moving to an area where heat loss is decreased. C. increasing fluid intake. D. increasing heat production.

increasing fluid intake.

To obtain the MOST accurate reading of a patient's core body temperature, you should place a special hypothermia thermometer: A. under the patient's tongue. B. into the patient's rectum. C. behind the patient's knee. D. under the patient's armpit.

into the patient's rectum.

In order for sweating to be an effective cooling mechanism: A. it must be able to evaporate from the body. B. the relative humidity must be above 90%. C. the body must produce at least 1 L per hour. D. several layers of clothing must be worn.

it must be able to evaporate from the body.

Signs and symptoms of heat exhaustion and associated hypovolemia include all of the following, EXCEPT: A. cold, clammy skin with ashen pallor. B. normal vital signs. C. dizziness, weakness, or faintness. D. normal thirst.

normal thirst.

The EMT must assume that any unwitnessed water-related incident is accompanied by: A. an air embolism. B. possible spinal injury. C. alcohol intoxication. D. cold-water immersion.

possible spinal injury.

You are transporting a 28-year-old man with a frostbitten foot. The patient's vital signs are stable and he denies any other injuries or symptoms. The weather is treacherous and your transport time to the hospital is approximately 45 minutes. During transport, you should: A. administer oxygen via a nonrebreathing mask. B. cover his foot with chemical heat compresses. C. protect the affected part from further injury. D. rewarm his foot in 102°F to 104°F (38.9°C to 40°C) water.

protect the affected part from further injury.

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 feet. On assessment, you note that he has cyanosis around his lips and has pink froth coming from his nose and mouth. You should: A. 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. suction his mouth and nose, apply high-flow oxygen, monitor the patient's breath sounds for a pneumothorax, 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. position him supine with his head elevated 30°, suction his mouth and nose, hyperventilate him with a bag-valve mask, and contact medical control for further guidance.

suction his mouth and nose, apply high-flow oxygen, monitor the patient's breath sounds for a pneumothorax, and contact medical control regarding transport to a recompression facility.

Burns associated with lightning strikes are typically: A. third-degree. B. partial-thickness. C. superficial. D. full-thickness.

superficial

The two MOST efficient ways for the body to eliminate excess heat are: A. sweating and vasodilation. B. perspiration and tachycardia. C. hyperventilation and tachycardia. D. respiration and bradycardia.

sweating and vasodilation.

Most of the serious injuries associated with scuba diving are caused by: A. alcohol consumption. B. too rapid of a descent. C. too rapid of an ascent. D. cold water temperature.

too rapid of an ascent.

Covering a patient's________ will significantly minimize radiation heat loss. A. head B. chest C. extremities D. abdomen

head

Common signs and symptoms of heat exhaustion include all of the following, EXCEPT: A. tachycardia. B. headache. C. hot, dry skin. D. nausea.

hot, dry skin.

In contrast to the brown recluse spider, the black widow spider: A. has a bite that is typically painless until a blister develops. B. is very small and has a violin-shaped marking on its back. C. is large and has a red-orange hourglass mark on its abdomen. D. has a bite that usually produces local pain but no systemic signs or symptoms.

is large and has a red-orange hourglass mark on its abdomen.

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. You should: A. load him into the ambulance and begin rapid cooling interventions. B. place him in a sitting position and have him drink 1 L of water. C. perform a head-to-toe assessment and look for signs of trauma. D. administer one tube of oral glucose and reassess his mental status.

load him into the ambulance and begin rapid cooling interventions.

Treatment of drowning or near drowning begins with: A. ventilation with 100% oxygen via bag-mask device. B. opening the airway. C. suctioning the lungs to remove the water. D. rescue and removal from the water.

rescue and removal from the water.

You are assessing a man with suspected hypothermia. The patient is conscious and alert, and is actively shivering. His respiratory rate is increased, but his breathing is unlabored, and the pulse oximeter reads 72%. The pulse oximetry reading is MOST likely: A. secondary to decreased perfusion in the extremities. B. accurate because shivering affects hemoglobin binding. C. accurate because he has signs of respiratory failure. D. a direct reflection of his increased respiratory rate.

secondary to decreased perfusion in the extremities.

Signs and symptoms of severe systemic hypothermia include all of the following, EXCEPT: A. shivering. B. coma. C. very slow respirations. D. weak pulse.

shivering

Heat stroke occurs when: A. the body's heat-eliminating mechanisms are overwhelmed. B. a person becomes dehydrated secondary to excess water loss. C. a person's core body temperature rises above 103°F (39°C). D. the ambient temperature exceeds 90°F (32°C) and the humidity is high.

the body's heat-eliminating mechanisms are overwhelmed.

An air embolism associated with diving occurs when: A. the diver holds his or her breath during a rapid ascent. B. high water pressure forces air into the mediastinum. C. the alveoli completely collapse due to high pressure. D. the diver hyperventilates prior to entering the water.

the diver holds his or her breath during a rapid ascent.

Heat loss from the body through respiration occurs when: A. cool air is inhaled and displaces warm air. B. the core body temperature is greater than 98°F (37°C). C. warm air is exhaled into the atmosphere. D. air temperature is greater than body temperature.

warm air is exhaled into the atmosphere.

Signs of late heatstroke include: a. a change in behavior b. nausea and vomiting. c. hot, moist skin. d. a weak, rapid pulse.

.

The MOST prominent symptom of decompression sickness is: A. tightness in the chest. B. difficulty with vision. C. abdominal or joint pain. D. dizziness and nausea.

.

The body's natural protective mechanisms against heat loss are: A. shivering and vasodilation. B. vasodilation and respiration. C. vasoconstriction and shivering. D. respiration and vasoconstriction.

.

The venom of a black widow spider is toxic to the: A. cardiovascular system. B. renal system. C. respiratory system. D. nervous system.

.

The venom of a brown recluse spider is cytotoxic, meaning that it: a. destroys the body's red blood cells. b. causes severe local tissue damage. C. weakens the structure of the bones. d. suppresses the respiratory drive.

.

Which of the following statements regarding lightning strikes is correct? a. The tissue damage pathway caused by lightning usually occurs through the skin. b. Victims who are struck by lightning often experience severe full-thickness burns. c. Cervical spine fractures are the most common cause of lightning-related deaths. d. Lightning often results in a brief period of a systole that resolves spontaneously.

.

A person's ability to shiver is lost when his or her body temperature falls below: A. 90°F (32°C). B. 92°F (33°C). C. 94°F (34°C). D. 95°F (35°C).

90°F (32°C).

Hypothermia occurs when the core body temperature falls below: A. 98°F (37°C). B. 95°F (35°C). C. 88°F (31°C). D. 90°F (32°C).

95°F (35°C).

Which of the following medications increases a person's risk of a heat-related emergency? A. Diuretics B. Motrin C. Tylenol D. Aspirin

Diuretics

Which of the following conditions would be the LEAST likely to increase a person's risk of hypothermia? A. Head injury B. Hyperglycemia C. Spinal cord injury D. Severe infection

Hyperglycemia

Which of the following statements regarding the brown recluse spider is NOT true? A. It lives mostly in the southern and central parts of the country. B. It is larger than the black widow spider. C. Bites rarely cause systemic signs and symptoms. D. Its venom is not neurotoxic.

It is larger than the black widow spider.

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. Confusion B. Bradypnea C. Tachycardia D. Stiff muscles

Tachycardia

Which of the following MOST accurately describes hyperthermia? A. Heat evaporates a significant amount of body water. B. The core body temperature exceeds 99.5°F (37°C). C. The body is exposed to more heat than it can lose. D. The body eliminates more heat than it can generate.

The body is exposed to more heat than it can lose.

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 unresponsive, pale, and apneic. You should: A. apply chemical heat packs to his groin and axillae. B. assess for a carotid pulse for up to 60 seconds. C. open his airway and give two rescue breaths. D. apply an AED and assess his cardiac rhythm.

assess for a carotid pulse for up to 60 seconds.

Hypothermia can worsen internal bleeding secondary to: A. blood-clotting abnormalities. B. cardiac arrhythmias. C. a decreased heart rate. D. severe muscular rigidity.

blood-clotting abnormalities.

The organs most severely affected by air embolism are the: A. brain and heart. B. brain and spinal cord. C. brain and Ilungs. D. heart and lungs.

brain and spinal cord.