EMT 21

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

​"Anaphylaxis is a severe allergic reaction that will lead to death without emergency​ care."

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 of these statements would be most appropriate for you to​ make? A. ​"We have some​ auto-injectors on the ambulance. I can get one for you to have until you are able to get a new one from your​ doctor." B. ​"Call your doctor to get a new injector and ask him if he wants to change the​ dose." C. ​"Call your doctor as soon as possible for a new injector because this one is out of​ date." D. ​"Make sure to call the doctor since this is out of date. Also ask the doctor if he wants to add a steroid to the​ injector."

​"Call your doctor to get a new injector and ask him if he wants to change the​ dose."

A patient who is severely short of breath and covered with hives states that she is allergic to crab. Despite her​ allergy, she tried some crab dip 10 minutes​ ago, since it had been​ "years and​ years" since she had her last allergic reaction. Which question should the EMT ask​ first? A. ​"Do you have an epinephrine​ auto-injector?" B. ​"Which medications are you currently​ taking?" C. ​"Why did you eat the dip if you are allergic to​ crab?" D. ​"How many allergic reactions have you​ had?"

​"Do you have an epinephrine​ auto-injector?"

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

​"Epinephrine administered through an​ auto-injector can be used for all anaphylactic and anaphylactoid​ reactions, regardless of the​ cause."

A​ 39-year-old female​ patient, who is allergic to​ shellfish, thinks that she may have accidentally ingested some that was mixed into her food at a restaurant. When assessing​ her, which of these statements made by the patient would be suggestive that she is in the early stages of an anaphylactic​ reaction? A. ​"I feel dizzy and​ weak." B. ​"I feel as though I am getting a​ fever." C. ​"My heart suddenly feels as though it is skipping some​ beats." D. ​"I suddenly feel like a have a lump in my​ throat."

​"I suddenly feel like a have a lump in my​ throat."

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 provide antibodies to your body and give you temporary​ immunity." C. ​"It will cause the blood vessels to constrict and your airway structures to relax so that they​ reopen." D. ​"It will quickly destroy the allergen in the​ mold."

​"It will cause the blood vessels to constrict and your airway structures to relax so that they​ reopen."

After you assist a patient with his epinephrine​ auto-injector, which of these 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 getting a little bit of a​ headache." D. ​"I am more relaxed and getting​ sleepy."

​"My breathing feels a lot​ easier."

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 on how the scene and the patient may​ present, which instruction regarding the assessment and treatment of an allergic reaction​ and/or anaphylaxis would be​ correct? A. ​"Our first priority will not be to determine what caused the allergic​ reaction, but to treat the patient according to his or her​ symptoms." B. ​"If the allergic reaction was caused by​ food, we will need to administer activated​ charcoal." C. ​"Epinephrine really should be given to any patient experiencing even a mild allergic reaction to prevent​ anaphylaxis." D. ​"If the allergic reaction was caused by exposure to chocolate or​ eggs, we will not be able to administer​ epinephrine."

​"Our first priority will not be to determine what caused the allergic​ reaction, but to treat the patient according to his or her​ symptoms."

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. Which of these statements by the EMT would be most appropriate given this​ situation? A. ​"Epinephrine can make you very sleepy. You can refuse to be​ transported, but just make sure that someone is here to keep an eye on​ you." B. ​"Once we help you take your​ epinephrine, the law requires that you be transported to a hospital for additional​ care." C. ​"The epinephrine will start to wear off in 10 or so minutes.​ Let's see how you are doing then before thinking about refusing​ transport." D. ​"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."

​"The epinephrine will start to wear off in 10 or so minutes.​ Let's see how you are doing then before thinking about refusing​ transport."

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

​"You may feel a little​ shaky, but that is normal and will​ pass."

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

​On-line or​ off-line medical direction for epinephrine administration exists

You are providing a continuing education session for your EMS department regarding​ anaphylaxis, as you have just returned from a national conference at which current issues related to this pathology were discussed. During your​ session, one of your fellow EMS providers asks you how the body can​ "suddenly" become allergic to something. What is your best​ response? A. ​"After a repeat​ exposure, the newly formed antigens of the body will attack the red blood​ cells, causing them to​ die, as well as causing airway closure and​ bronchoconstriction." B. ​"The body's white blood cells are uniquely sensitive to certain​ allergens, and when they are exposed to these allergens for the first​ time, the body will develop an allergic​ reaction." C. ​"After exposure to a new​ antigen, the body will create antibodies to fight​ it; these antibodies can be the root cause of the anaphylactic response​ later." D. ​"It is actually not true that someone​ 'suddenly' becomes allergic to something. Research shows the person was always allergic to​ it, but incorrectly assumed he was exposed once​ before."

"After exposure to a new​ antigen, the body will create antibodies to fight​ it; these antibodies can be the root cause of the anaphylactic response​ later."

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

"When providing positive pressure​ ventilation, it may be difficult to pass air through the swollen​ tissues."

You have assisted an adult patient with his epinephrine​ auto-injector. When giving a report to the emergency department​ nurse, you should inform her that which dose of epinephrine was​ administered? A. 0.3 mcg B. 0.25 mcg C. 0.1 mg D. 0.3 mg

0.3 mg

For the EMT to achieve the best results when assisting a patient with epinephrine​ treatment, the medication should be properly injected​ into: A. A vein B. The skin C. An artery D. A muscle

A muscle

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

A new container of penicillin on a table with two pills missing

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​ breaths/min; blood​ pressure, 74/58​ mmHg; and​ SpO2, 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. Completely expose the patient and administer the epinephrine into his anterior thigh B. Lift the shirt over the​ patient's abdomen and administer the epinephrine into his abdomen below the umbilicus C. Lift the​ patient's shoulder pads and shirt and administer the epinephrine into his upper arm muscle D. Administer the epinephrine through a​ pad-less area of the​ patient's pants over the side of his thigh

Administer the epinephrine through a​ pad-less area of the​ patient's pants over the side of his thigh

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

An anaphylactoid reaction

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

An anaphylactoid reaction may occur without prior sensitization to the​ antigen; anaphylaxis requires prior sensitization

A patient develops an allergic reaction after taking penicillin. In this​ case, the penicillin would be recognized by the body​ as: A. An antibody B. An antigen C. A mast cell D. A form of immunoglobulin E

An antigen

A patient is covered with hives. He is responsive to painful stimuli but has labored respirations with an inspiratory stridor​ sound, bilateral​ wheezing, and a weak and rapid pulse. His vital signs are​ pulse, 128;​ respirations, 24​ breaths/min; and blood​ pressure, 80/50 mmHg. Given this​ presentation, the EMT should suspect that the patient​ has: A. Hypersensitivity B. Sensitization C. Localized allergic reaction D. Anaphylaxis

Anaphylaxis

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

Anaphylaxis

Within the​ body, the release of histamine causes dilation of​ the: A. Salivary glands B. Small airways C. Blood vessels D. Upper airway

Blood vessels

Which of these statements is true regarding both anaphylactic and anaphylactoid​ reactions? A. Anaphylactoid reactions seldom involve the​ airway; anaphylaxis does B. Anaphylaxis is caused by​ medications; anaphylactoid reactions are not C. Both anaphylactoid and anaphylactic reactions are treated in the same way D. Administering epinephrine in an anaphylactoid reaction can be fatal

Both anaphylactoid and anaphylactic reactions are treated in the same way

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 effect occurred due to​ epinephrine's ability​ to: A. Relax the smooth muscle of the blood vessels B. Increase the number of circulating red blood cells C. Increase the​ oxygen-carrying capacity of the red blood cells D. Constrict blood vessels

Constrict blood vessels

Five minutes after assisting a patient with his epinephrine​ auto-injector, you determine that the patient is getting progressively worse. The patient has a second​ auto-injector available;​ however, written protocols do not address the administration of a second dose. What is the priority action the EMT should take at this​ time? A. Continue to monitor the patient B. Administer the second dose of epinephrine C. Request advanced life support​ (ALS) assistance D. Contact medical direction for further orders

Contact medical direction for further orders

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 of these findings would best indicate that the epinephrine is benefiting the​ patient? A. Increasing heart rate B. Decreasing blood pressure C. Decreasing wheezing D. Complaint of fatigue

Decreasing wheezing

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

Dilation of the bronchioles

Regarding the pathophysiology underlying​ anaphylaxis, which of these statements is​ true? A. Smooth muscle dilation in the lungs impairs the exchange of oxygen B. Immunoglobulin E molecules make antibodies that cause bronchoconstriction and vasodilation C. Histamine causes the capillaries to become leaky and bronchioles to constrict D. High blood pressure forces blood from the blood​ vessels, resulting in airway edema

Histamine causes the capillaries to become leaky and bronchioles to constrict

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

Histamine constricts the bronchioles

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 this​ patient, which of these signs or symptoms would provide the best evidence that the patient is having an​ allergic, and possibly an early​ anaphylactic, reaction? A. Cool and dry skin B. Elevated blood pressure C. Hives on his chest D. Panic and anxiety

Hives on his chest

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

Hives to the face and neck

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

Hypotension

You have been summoned to an apartment for a​ 58-year-old female who complains 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, how would you best classify the cause of the​ patient's reaction? A. Anaphylactic B. Iatrogenic C. Idiopathic D. Anaphylactoid

Idiopathic

You are called to an outpatient surgery center for a patient who developed an allergic reaction while receiving an intravenous​ (IV) antibiotic. How would you would document the route of​ exposure? A. Ingestion B. Topical C. Injection D. Contact

Injection

You have been called to a kindergarten class for a​ 5-year-old boy who is allergic to peanuts. He ate some peanuts 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. The patient also looks unresponsive. As you begin the primary​ assessment, what should be a priority​ action? A. Inspect the inside of the​ patient's mouth and assure an open airway B. Contact the​ patient's parents for permission to treat him C. Check breath sounds for wheezing and assess the vital signs D. Determine how many peanuts the patient ingested

Inspect the inside of the​ patient's mouth and assure an open airway

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 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 this​ patient? A. It helps the​ patient's immune system to deactivate the allergen B. It acts as an allergen to stop the allergic reaction through histamine stimulation C. It inhibits the constriction of the​ patient's small airways by blocking histamine D. It dilates the​ patient's blood vessels and delivers more blood to the brain

It inhibits the constriction of the​ patient's small airways by blocking histamine

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

Lateral thigh

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

Medications

A patient states that he is allergic to poison ivy and was burning it yesterday while clearing brush off his farm when he accidentally inhaled some of the smoke.​ Today, he awoke and found a red rash to the back of his left hand and called 911. Assessment reveals him to be alert and​ oriented, with easy respirations and a blood pressure of​ 128/70 mmHg. Your next action would be​ to: A. Assist the patient with his epinephrine​ auto-injector B. Provide immediate and rapid transport C. Call for advanced life support​ (ALS) assistance D. Obtain a full SAMPLE and OPQRST history

Obtain a full SAMPLE and OPQRST history

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

Occlude the​ pop-off valve on the​ bag-valve mask and continue ventilations

A patient with an allergy to bees and a prescribed EpiPen was working in the garden when she noted swelling to the right side of her face. Assessment reveals swelling that is red and hot to the right cheek area. Her airway is​ patent, respirations easy and​ adequate, and radial pulse strong. Her vital signs are​ pulse, 76;​ respirations, 16​ breaths/min; blood​ pressure, 156/62​ mmHg; and​ SpO2, 99%. What should be the​ EMT's action at this​ time? A. Perform a secondary assessment B. Provide immediate and rapid transport C. Assist the patient with her EpiPen D. Treat the​ patient's condition as an anaphylactoid reaction

Perform a secondary assessment

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

Press the injector onto the lateral​ thigh, and wait for it to automatically inject

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, but your service does not have protocols related to its use.​ Fortunately, in your EMT​ class, you learned about and passed a test on the use of an epinephrine​ auto-injector for allergic reactions. In this​ case, you​ should: A. Assist the patient with his epinephrine using implied consent as justification B. Contact the physician prescribing the medication for permission to use the​ auto-injector C. Provide oxygen and respiratory support as​ needed, followed by immediate transport D. Assist the patient with his epinephrine​ auto-injector and then contact medical control

Provide oxygen and respiratory support as​ needed, followed by immediate transport

A young female​ patient, who is allergic to​ peanuts, was just exposed to peanut butter in a sandwich at a church picnic. 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/min and has a heart rate of 82​ beats/min. Your partner advises you that her blood pressure is​ 118/72 mmHg and​ room-air SpO2 is​ 92%. The patient states that she also has​ asthma, for which she uses an inhaler. What should you do​ first? A. Assist the patient with her inhaler B. Start positive pressure ventilation C. Provide supplemental oxygen D. Determine the amount of peanut butter consumed

Provide supplemental oxygen

When reassessing a patient whom you are treating for an anaphylactic​ reaction, which of these findings would be of the greatest​ concern? A. Pulse oximetry reading of​ 95% via​ high-concentration oxygen B. ​Red, warm, and dry​ skin, with the patient becoming increasingly agitated C. New hives appearing on the chest that were not there upon your arrival D. Respiratory rate change from 28 to 10​ breaths/min with increasing patient lethargy

Respiratory rate change from 28 to 10​ breaths/min with increasing patient lethargy

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 able to speak only a few words with each​ breath, and a quick glance at the pulse oximeter reveals the saturation is in the​ 80-90% range.​ Additionally, the​ patient's tongue is swollen and her respirations are​ rapid, labored, and noisy. Which action is your immediate​ priority? A. Obtain a heart rate and blood pressure B. Start positive pressure ventilation C. Wash the latex powder from the​ patient's hand D. Insert an oropharyngeal airway

Start positive pressure ventilation

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. Constriction of the small airways B. Swelling to the upper airway C. Loss of the gag reflex D. Spasm of the lower airway

Swelling to the upper airway

Which of these assessment findings would indicate that the patient is experiencing an anaphylactic reaction after a bee sting and requires immediate​ intervention? A. Edema to the​ feet, with an SpO2 of​ 93% on room air and mild dyspnea B. Hives to the arm that was stung and a heart rate of 96​ beats/min C. Swollen lips and oral​ mucosa, with a blood pressure of​ 84/50 mmHg D. Localized swelling around the site of the bee sting

Swollen lips and oral​ mucosa, with a blood pressure of​ 84/50 mmHg

In which of these situations would the EMT contact medical direction prior to administering epinephrine to a patient who is experiencing an anaphylactic​ reaction? A. The patient has an allergy to chocolate or eggs B. The​ patient's heart rate is 144​ beats/min C. The patient is not prescribed an​ auto-injector D. The patient is hypotensive and tachycardic

The patient is not prescribed an​ auto-injector

If signs and symptoms of anaphylaxis occur rapidly in a​ patient, the EMT must realize​ that: A. An increased amount of antigens is present in the​ patient's body B. The reaction will likely be severe C. The reaction will likely be localized D. Epinephrine will not be effective

The reaction will likely be severe

A patient informs you that whenever she is exposed to a particular​ soap, she experiences a mild allergic reaction. As a knowledgeable​ EMT, you should recognize​ that: A. She must have been exposed to the soap as an infant 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. The soap contains an antigen

The soap contains an antigen

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​ auto-injector. You​ would: A. Wash the​ patient's hand with soap and water B. Administer the epinephrine into the​ patient's thigh C. Contact medical direction for permission to use the epinephrine​ auto-injector D. Ask the mother to administer the​ auto-injector into the​ patient's thigh

Wash the​ patient's hand with soap and water

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

Weak, rapid radial pulse