Chapter 33 Environmental Emergencies
When the body loses sweat, it also loses: A) nutrients B) electrolytes C) plasma D) erythrocytes
B
Which of the following most accurately describes hyperthermia? A) heat evaporates a significant amount of body water B) the body eliminates more heat than it can generate C) the body is exposed to more heat than it can lose D) the core body temperature exceeds 99.5 degrees
C
A patient with a core body temperature of 95°F (35°C) will MOST likely experience: A) rapid breathing B) muscle stiffness C) loss of consciousness D) a slow pulse
A
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 diver hyperventilates prior to entering the water D) the alveoli completely collapse due to high pressure
A
Burns associated with lightning strikes are typically: A) superficial B) partial-thickness C) third-degree D) full-thickness
A
Heat loss from the body through respiration occurs when: A) warm air is exhaled into the atmosphere B) the core body temperature is greater than 98 degrees C) air temperature is greater than body temperature D) cool air is inhaled and displaces warm air
A
The diving reflex might allow a person to survive extended periods of submersion in cold water secondary to: A) bradycardia and a slowing of the metabolic rate B) increases in the metabolic rate and oxygen demand C) tachycardia and a lowering of the blood pressure D) laryngospas that protects the lungs from water
A
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) under the patient's armpit D) behind the patient's knee
A
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 degrees 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) move him into the cooled ambulance B) give him a liquid salt solution to drink C) apply chemical ice packs to his axillae D) administer 100% supplemental oxygen
A
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 overall muscle mass D) a smaller amount of body fat
B
Covering a patient's _________ will significantly minimize radiation heat loss. A) extremities B) head C) chest D) abdomen
B
For sweating to be an effective cooling mechanism: A) several layers of clothing must be worn B) it must evaporate from the body C) the body must produce at least 1L per hour D) the relative humidity must be above 90%
B
Geriatric patients, newborns, and infants are especially prone to hyperthermia because they: A) have smaller body surface areas B) exhibit poor thermoregulation C) have relatively smaller heads D) have less body fat
B
Heatstroke occurs when: A. a person's core body temperature rises above 103°F (39°C). 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 (32°C) and the humidity is high.
B
High air temperature reduces the body's ability to lose heat by: A) evaporation B) radiation C) convection D) conduction
B
High humidity reduces the body's ability to lose heat through: A) radiation B) evaporation C) conduction D) convection
B
In contrast to Lyme disease, Rocky Mountain spotted fever: A) causes painful joint swelling after a few days or weeks B) can cause paralysis and cardiorespiratory collapse C) might be confused with rheumatoid arthritis D) presents with flu like symptoms and a bullseye rash
B
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 large and has a red-orange hourglass mark on its abdomen C) has a bite that usually produces local pain but no systemic signs or symptoms D) is very small and has a violin-shaped marking on its back
B
Rough handling of a hypothermic patient with a pulse may cause: A) pulseless electrical activity B) ventricular fibrillation C) ventricular tachycardia D) profound bradycardia
B
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
B
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) forehead B) abdomen C) neck D) chest
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 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) position him supine with his head elevated 30 degrees, suction his mouth and nose, hyperventilate him with a bag valve mask, and contact medical control for further guidance 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) 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
a 30-year-old male was rescued after being lost in the woods for approximately 18 hours. The outside temperature is 30 degrees. He is immediately placed in the warmed ambulance, where you perform a primary assessment. He is unresponsive, pale, and apnea. You should: A) apply an automated external defibrillator and assess his cardiac rhythm B) assess for a carotid pulse for up to 60 seconds C) apply chemical heat packs to his groin and axillae D) open his airway and give two rescue breaths
B
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) transporting only with close, continuous monitoring B) supine positioning, splinting the leg, and transporting C) elevating the lower extremities and giving antivenin D) applying ice to the wound and transporting quickly
B
a dysbarism injury refers to the signs and symptoms related to changes in: A) rapid descent B) barometric pressure C) rapid ascent D) decompression
B
a frostbitten foot can be identified by the presence of: A) blanching of the skin B) mottling and blisters C) gross deformity D) soft, smooth skin
B
which of the following conditions would be the least likely to increase a person's risk of hypothermia? A) severe infection B) hyperglycemia C) spinal cord injury D) head injury
B
Which of the following statements regarding drowning is correct? A) patients with submersion injury might deteriorate rapidly because of pulmonary injury and cerebral hypoxia B) hypoxia in the drowning victim initially occurs due to water in the lungs C) large amounts of water enter the lungs in a small number of drowning victims D) artificial ventilations can easily be performed in patients with a laryngospasm
B??????
All of the following terms refer to a body part that is cold but not frozen, EXCEPT: A) immersion foot B) frostnip C) frostbite D) trench foot
C
Breath-holding syncope is caused by a decreased stimulus to breathe and occurs when: A) a diver holds his or her breath during a staged ascent B) a swimmer breathes shallowly before entering the water C) a swimmer hyperventilates prior to entering the water D) a diver holds his or her breath for a long period of time
C
Hypothermia can worsen internal bleeding secondary to: A) severe muscle rigidity B) a decreased heart rate C) blood clotting abnormalities D) cardiac arrhythmias
C
Signs of late heatstroke include: A. hot, moist skin. B. nausea and vomiting. C. a weak, rapid pulse. D. a change in behavior.
C
The two MOST efficient ways for the body to eliminate excess heat are: A) perspiration and tachycardia B) hyperventilation and tachycardia C) sweating and vasodilation D) respiration and bradycardia
C
Which of the following statements regarding lightning strikes is correct? A) cervical spine fractures are the most common cause of lightning-related deaths B) victims who are struck by lightning often experience severe full-thickness burns C) lightning strikes might cause cardiac dysrhythmias that spontaneously resolve D) the tissue damage pathway caused by lightning usually occurs through the skin
C
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) ventilate with a bag valve mask, apply a rigid cervical collar, remove his wet clothing, and transport rapidly. B) suction his airway for 30 seconds, provide rescue breathing, keep him warm, and transport at once. C) provide rescue breathing, remove his wet clothing, immobilize his entire spine, keep him warm, and transport carefully. D) apply high flow oxygen via a nonrebreathing mask, immobilize his spine, keep him warm, and transport rapidly
C
the EMT must assume that any unwitnessed water-related incident is accompanied by: A) cold-water immersion B) alcohol intoxication C) possible spinal injury D) an air embolism
C
the venom of a black widow spider is toxic to the: A) renal system B) cardiovascular system C) nervous system D) respiratory system
C
After being stung on the leg by a jellyfish, a man complains of severe pain to his leg, dizziness, and difficulty breathing. He has a red rash covering his trunk, and his blood pressure is 90/50mm Hg. The EMT should: A) begin transport and immerse his leg in hot water to help reduce pain B) apply warmth to the sting area and cover it with a dry sterile dressing C) remove the stingers from his leg by scraping them with a stiff object D) administer oxygen and epinephrine and prepare for rapid transport
D
Common signs and symptoms of heat exhaustion include all of the following, EXCEPT: A) tachycardia B) nausea C) dry tongue and thirst D) hot, dry skin
D
Drowning is MOST accurately defined as: A) water in the lungs following submersion in water B) temporary survival after submersion in water C) death beyond 24 hours after submersion in water D) death from suffocation after submersion in water
D
Hypothermia occurs when the core body temperature falls below: A) 88 degrees B) 90 degrees C) 98 degrees D) 95 degrees
D
The MOST prominent symptom of decompression sickness is: A) dizziness and nausea B) difficulty with vision C) tightness in the chest D) abdominal or joint pain
D
The body's natural cooling mechanism, in which sweat is converted to a gas, is called: A) convection B) conduction C) radiation D) evaporation
D
The transfer of heat to circulating air, such as when cool air moves across the body's surface, is called: A) conduction B) radiation C) evaporation D) convection
D
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) convection B) evaporation C) radiation D) conduction
D
Which of the following is a sign of pit viper envenomation? A) signs and symptoms of hypoperfusion B) syncope and bleeding at distal sites C) general weakness and diaphoresis D) local swelling and ecchymosis
D
Which of the following medications increases a person's risk of a heat-related emergency? A) Aspirin B) Motrin C) Tylenol D) Diuretics
D
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) Rocky Mountain spotted fever B) a brown recluse spider bite C) envenomation from a pit viper D) a black widow spider bite
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 patients 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) exposure to poison ivy B) an allergic reaction C) Rocking Mountain spotted fever D) Lyme disease
D
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 was mowing the lawn in the heat for the past three hours. The patient is confused and has hot, moist skin. His pulse is weak and thready, and his blood pressure is 90/50mm Hg. You should: A) place him in a sitting position and have him drink 1 L of water B) perform a head to toe assessment and look for signs of trauma C) administer one tube of oral glucose and reassess his mental status D) load him into the ambulance and begin rapid cooling interventions
D
