Chapter 33 - Environmental Emergencies

Question 1

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:

Select one:

A. apply an AED 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.

Answer 1

B. assess for a carotid pulse for up to 60 seconds.

Question 2

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:

Select one:

A. elevating the lower extremities and giving antivenom.

B. supine positioning, splinting the leg, and transporting.

C. applying ice to the wound and transporting quickly.

D. transporting only with close, continuous monitoring.

Answer 2

B. supine positioning, splinting the leg, and transporting.

Question 3

All of the following terms refer to a body part that is cold but not frozen, EXCEPT:

Select one:

A. immersion foot.

B. trench foot.

C. frostnip.

D. frostbite.

Answer 3

D. frostbite.

Question 4

Burns associated with lightning strikes are typically:

Select one:

A. third-degree.

B. superficial.

C. full-thickness.

D. partial-thickness.

Answer 4

B. superficial.

Question 5

Common signs and symptoms of heat exhaustion include all of the following, EXCEPT:

Select one:

A. nausea.

B. tachycardia.

C. hot, dry skin.

D. headache.

Answer 5

C. hot, dry skin.

Question 6

Drowning is MOST accurately defined as:

Select one:

A. temporary survival after submersion in water.

B. water in the lungs following submersion in water.

C. death beyond 24 hours after submersion in water.

D. death from suffocation after submersion in water.

Answer 6

D. death from suffocation after submersion in water.

Question 7

Hypothermia occurs when the core body temperature falls below:

Select one:

A. 90°F (32°C).

B. 95°F (35°C).

C. 88°F (31°C).

D. 98°F (37°C).

Answer 7

B. 95°F (35°C).

Question 8

In contrast to Lyme disease, Rocky Mountain spotted fever:

Select one:

A. causes painful joint swelling after a few days or weeks.

B. can cause paralysis and cardiorespiratory collapse.

C. may be confused with rheumatoid arthritis.

D. presents with flu-like symptoms and a bull’s-eye rash.

Answer 8

B. can cause paralysis and cardiorespiratory collapse.

Question 9

Most of the serious injuries associated with scuba diving are caused by:

Select one:

A. cold water temperature.

B. alcohol consumption.

C. too rapid of a descent.

D. too rapid of an ascent.

Answer 9

D. too rapid of an ascent.

Question 10

The body’s natural cooling mechanism, in which sweat is converted to a gas, is called:

Select one:

A. convection.

B. conduction.

C. evaporation.

D. radiation.

Answer 10

C. evaporation.

Question 11

The EMT must assume that any unwitnessed water-related incident is accompanied by:

Select one:

A. cold-water immersion.

B. an air embolism.

C. possible spinal injury.

D. alcohol intoxication.

Answer 11

C. possible spinal injury.

Question 12

The MOST prominent symptom of decompression sickness is:

Select one:

A. dizziness and nausea.

B. abdominal or joint pain.

C. difficulty with vision.

D. tightness in the chest.

Answer 12

B. abdominal or joint pain.

Question 13

The venom of a black widow spider is toxic to the:

Select one:

A. nervous system.

B. cardiovascular system.

C. respiratory system.

D. renal system.

Answer 13

A. nervous system.

Question 14

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:

Select one:

A. conduction.

B. evaporation.

C. convection.

D. radiation.

Answer 14

A. conduction.

Question 15

Which of the following is an early sign of pit viper envenomation?

Select one:

A. Syncope and bleeding at distal sites

B. Signs and symptoms of hypoperfusion

C. Local swelling and ecchymosis

D. General weakness and diaphoresis

Answer 15

C. Local swelling and ecchymosis

Question 16

Which of the following MOST accurately describes hyperthermia?

Select one:

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°F (37°C).

Answer 16

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

Question 17

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:

Select one:

A. recognize that the patients who are conscious are at high risk for developing cardiac arrest and quickly assess them for potentially life-threatening injuries.

B. immediately begin CPR on the unresponsive patient, but cease resuscitation efforts if there is no response after 5 minutes of treatment.

C. focus your initial treatment efforts on the patients who are conscious because the unresponsive patient is likely in irreversible cardiac arrest.

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

Answer 17

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

Question 18

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:

Select one:

A. cover his foot with chemical heat compresses.

B. protect the affected part from further injury.

C. rewarm his foot in 102°F to 104°F (38.9°C to 40°C) water.

D. administer oxygen via a nonrebreathing mask.

Answer 18

B. protect the affected part from further injury.

Question 19

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:

Select one:

A. administer one tube of oral glucose and reassess his mental status.

B. load him into the ambulance and begin rapid cooling interventions.

C. perform a head-to-toe assessment and look for signs of trauma.

D. place him in a sitting position and have him drink 1 L of water.

Answer 19

B. load him into the ambulance and begin rapid cooling interventions.

Question 20

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:

Select one:

A. 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.

B. 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.

C. 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.

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.

Answer 20

C. 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.

Question 21

___________ causes body heat to be lost as warm air in the lungs is exhaled into the atmosphere and cooler air is inhaled.

Select One

A. Convection
B. Conduction
C. Radiation
D. Respiration

Answer 21

D. Respiration

Question 22

Evaporation, the conversion of a liquid to a gas, is a process that requires:

Select One

A. Energy
B. Circulation
C. A warmer ambient temperature
D. High humidity

Answer 22

A. Energy

Question 23

The rate and amount of heat loss by the body can be modified by all of the following except:

Select One

A. increasing heat production
B. moving to an area where heat loss is decreased
C. wearing insulated clothing
D. increasing fluid intake

Answer 23

D. increasing fluid intake

Question 24

The characteristic appearance of blue lips and/or fingertips seen in hypothermia is the result of:

Select One

A. lack of oxygen in arterial blood
B. frostbite
C. blood vessels constricting
D. lack of oxygen in venous blood

Answer 24

C. blood vessels constricting

Question 25

Signs and symptoms of severe systemic hypothermia include all of the following except:

Select One

A. weak pulse
B. coma
C. shivering
D. very slow respirations

Answer 25

C. shivering

Question 26

Hypothermia is more common among all of the following except:

Select One

A. older individuals
B. long-distance athletes
C. infants and children
D. those who are already ill

Answer 26

B. long-distance athletes​

Question 27

To assess a patient’s general temperature, pull back your glove and place the back of your hand on the patient’s:

Select One

A. abdomen, underneath clothing
B. forehead
C. forearm, on the inside of the wrist
D. neck, at the area where you check the carotid pulse

Answer 27

A. abdomen, underneath clothing

Question 28

Never assume that a(n) __________, pulseless patient is dead.

Select One

A. apneic
B. cyanotic
C. cold
D. hypothermic

Answer 28

D. hypothermic

Question 29

Management of hypothermia in the field consists of all of the following except:

Select One

A. applying heat packs to the groin, axillary, and cervical regions
B. removing wet clothing
C. preventing further heat loss
D. massaging the cold extremities

Answer 29

D. massaging the cold extremities

Question 30

All of the following conditions refer to when exposed parts of the body become very cold, but not frozen, except:

Select One

A. frostnip
B. trench foot
C. immersion foot
D. frostbite

Answer 30

D. frostbite

Question 31

When the body is exposed to more heat energy than it loses, __________ result(s).

Select One

A. hyperthermia
B. heat cramps
C. heat exhaustion
D. heatstroke

Answer 31

A. hyperthermia

Question 32

Contributing factors to the development of heat illnesses include all of the following except:

Select One

A. high air temperature
B. vigorous exercise
C. high humidity
D. increased fluid intake

Answer 32

D. increased fluid intake

Question 33

It is important to remain hydrated while on duty. Drink at least ________ of water per day, and more when exertion or heat is involved.

Select One

A. 8 glasses
B. 1 liter
C. 2 liters
D. 3 liters

Answer 33

D. 3 liters

Question 34

Which of the following statements about heat cramps is false?

Select One

A. they only occur when it is hot outdoors
B. they may be seen in well-conditioned athletes
C. the exact cause of heat cramps is not well understood
D. dehydration may play a role in the development of heat cramps

Answer 34

A. they only occur when it is hot outdoors

Question 35

Signs and symptoms of heat exhaustion and associated hypovolemia include all of the following except:

Select One

A. cold, clammy skin with ashen pallor
B. dizziness, weakness, or faintness
C. normal vital signs
D. normal thirst

Answer 35

D. normal thirst

Question 36

Most spinal injuries in diving incidents affect the:

Select One

A. cervical spine
B. thoracic spine
C. lumbar spine
D. sacrum/coccyx

Answer 36

A. cervical spine

Question 37

Often, the first sign of heatstroke is:

Select One

A. a change in behavior
B. an increase in pulse rate
C. an increase in respirations
D. hot, dry, flushed skin

Answer 37

A. a change in behavior

Question 38

The least common but most serious illness caused by heat exposure, occurring when the body is subjected to more heat than it can handle and normal mechanisms for getting rid of the excess heat are overwhelmed, is:

Select One

A. hyperthermia
B. heat cramps
C. heat exhaustion
D. heat stroke

Answer 38

D. heat stroke

Question 39

_________ is the body’s reaction to an irritation of water entering the lower respiratory tract.

Select One

A. bronchoconstriction
B. laryngospasm
C. esophageal spasms
D. swelling in the oropharynx

Answer 39

B. laryngospasm

Question 40

Treatment of drowning and/or near drowning begins with:

Select One

A. opening the airway
B. ventilation with 100% oxygen via bag-mask device
C. suctioning the lungs to remove the water
D. rescue and removal from the water

Answer 40

D. rescue and removal from the water

Question 41

In a diving emergency, ___________ occurs when bubbles of gas, especially nitrogen, obstruct the blood vessels.

Select One

A. compression sickness
B. decompression sickness
C. pulmonary sickness
D. nitrogen toxicity

Answer 41

B. decompression sickness

Question 42

If the near drowning victim has evidence of upper airway obstruction by foreign matter, which of the following would not be considered a method for clearing it?

Select One

A. remove the obstruction manually
B. apply suction
C. place the patient in the recovery position to allow drainage
D. use abdominal thrusts

Answer 42

C. place the patient in the recovery position to allow drainage

Question 43

You should never give up on resuscitating a cold-water drowning victim because:

Select One

A. when the patient is submerged in water colder than body temperature, heat is maintained in the body
B. the resulting hypothermia can protect vital organs from the lack of oxygen
C. the resulting hypothermia raises the metabolic rate
D. all of the above

Answer 43

B. the resulting hypothermia can protect vital organs from the lack of oxygen

Question 44

The three phases of a dive, in the order they occur, are:

Select One

A. ascent descent, and bottom
B. descent, bottom, and ascent
C. orientation, bottom and ascent
D. descent, orientation, and ascent

Answer 44

B. descent, bottom, and ascent

Question 45

Areas usually affected by descent problems include:

Select One

A. the lungs
B. the skin
C. the joints
D. vision

Answer 45

A. the lungs

Question 46

Potential problems associated with rupture of the lungs include all of the following except:

Select One

A. air emboli
B. pneumomediastinum
C. pneumothorax
D. hemopneumothorax

Answer 46

D. hemopneumothorax

Question 47

The organs most severely affected by air embolism are the:

Select One

A. brain and spinal cord
B. brain and heart
C. heart and lungs
D. brain and lungs

Answer 47

A. brain and spinal cord

Question 48

Black widow spiders may be found in:

Select One

A. New Hampshire
B. Woodpiles
C. California
D. All of the above

Answer 48

D. All of the above

Question 49

Coral snake venom is a powerful toxin that causes __________ of the nervous system.

Select One

A. paralysis
B. hyperactivity
C. hypoactivity
D. hemiparesis

Answer 49

A. paralysis

Question 50

Rocky Mountain spotted fever and Lyme disease are both spread through the tick’s:

Select One

A. saliva
B. blood
C. hormones
D. excrement

Answer 50

A. saliva

Question 51

Signs of envenomation by a pit viper include all of the following except:

Select One

A. swelling
B. chest pain
C. ecchymosis
D. severe burning pain at the site of the injury

Answer 51

B. chest pain

Question 52

Removal of a tick should be accomplished by:

Select One

A. suffocating it with gasoline
B. burning it with a lighted match to cause it to release its grip
C. using fine tweezers to pull it straight out of the skin
D. suffocating it with Vasoline

Answer 52

C. using fine tweezers to pull it straight out of the skin

Question 53

Which of the following statements regarding the brown recluse spider is false?

Select One

A. it is larger than the black widow spider
B. it lives mostly in the southern and central parts of the country
C. venom is not neurotoxic
D. bites rarely cause systemic signs and symptoms

Answer 53

A. it is larger than the black widow spider

Question 54

Treatment of a snake bite from a pit viper includes:

Select One

A. Calming the patient
B. Providing BLS as needed if the patient shows no sign of envenomation
C. Marking the skin with a pen over the swollen are to note whether swelling is spreading
D. All of the above

Answer 54

D. All of the above

Question 55

At 1400 in July, the weather is 105 degrees F and very humid. You have been called for a “man down” at the park. As you arrive, you recognize him as an alcoholic who has been a “frequent flyer” with your service. It looks like he had been sitting under a tree when he fell over, unconscious. As you assess the patient, he has cold, clammy skin and a dry tongue.

You suspect that:

A. he is well-hydrated
B. he has suffered heat exhaustion
C. he is hypothermic
D. he has heatstroke

Answer 55

B. he has suffered heat exhaustion

Question 56

Small infants have a poor ability to thermoregulate and are unable to shiver to control heat loss until about the age of:

Select One

A. 4-6 months
B. 6-12 months
C. 12-18 months
D. 18-24 months

Answer 56

C. 12-18 months

Question 57

Most heat stroke cases occur when the temperature is around _________ and the humidity is 80%.

Select One

A. 80 degrees F
B. 90 degrees F
C. 100 degrees F
D. 110 degrees F

Answer 57

A. 80 degrees F

Question 58

True or False

Normal body temperature is 98.6 degrees F.

Answer 58

True

Question 59

True or False

To assess the skin temperature in a patient experiencing a generalized cold emergency, you should feel the patient’s skin.

Answer 59

True

Question 60

True or False

Mild hypothermia occurs when the core temperature drops to 85 degrees F.

Answer 60

False

Mild hypothermia occurs when the core temperature drops between

90°F and 95°F ^{(32°C and 35°C)}

Question 61

True or False

The body’s most efficient heat-regulating mechanisms are sweating and dilation of skin blood vessels.

Answer 61

True

Question 62

True or False

People who are at greatest risk for heat illnesses are the elderly and children.

Answer 62

True

Question 63

True or False

The strongest stimulus for breathing is an elevation of oxygen in the blood.

Answer 63

False

The strongest stimulus for breathing is an elevation of Carbon Dioxide in the blood.

(Hypercapnic Drive)

Question 64

True or False

Immediate bradycardia after jumping in cold water is called the diving reflex.

Answer 64

True

Question 65

True or False

Cottonmouths are known for aggressive behavior.

Answer 65

True

(pg 1169)

Question 66

True or False

Ice should be promptly applied to any insect sting or snake bite with swelling.

Answer 66

False

Insect sting - Yes Ice

Snakebite with swelling NO Ice or Tourniquets.

^{Ice does little to treat the bite as the venom is in the bloodstream and potentially leads to increased damage.}

^{Cryotherapy was packing or immersion of the bitten extremity in ice or ice water. It was thought to provide benefit by lowering venom enzyme activity, slowing venom absorption, and thus slowing and attenuating the envenomation syndrome. This intervention has fallen from favor over the past 30 to 40 years as experimental models of envenomation have failed to demonstrate significant benefit. In some case series describing snakebite patients, the only cases of tissue loss, amputations, or permanent disability occurred when patients received cryotherapy. These cases typically involved prolonged packing of the bitten extremity in ice for hours to days. An ice pack placed intermittently on the bite for pain control in a fashion similar to an ankle sprain is unlikely to cause harm; however, more aggressive ice therapy is contraindicated.​}

^{“Out-of-hospital and interhospital management of crotaline snakebite”}

^{McKinney, Patrick E; DOI 10.1067/mem.2001.111574}

Question 67

True or False

The most common type of pit viper is the copperhead.

Answer 67

False

Rattlesnake is the most common (pg 1169)

Question 68

True or False

Cottonmouths are known for aggressive behavior.

Answer 68

True

Question 69

True or False

Ticks should be removed by firmly grasping them with tweezers while rotating them counterclockwise.

Answer 69

False

“Using fine tweezers, grasp the tick by the head and pulled gently but firmly straight up so that the skin is tented. Hold this position until the tick releases.” (Pg 1172)

Question 70

True or False

The pain of coelenterate stings may respond to flushing with cold water.

Answer 70

False

Persistent pain may respond to immersion in hot water (110°F to 115°F [43.3°C to 46.1°C])

(pg 1173)

Question 71

True or False

If you are unsure as to whether a hypothermic patient has a pulse present, palpate the carotid artery for 15 to 20 seconds.

Answer 71

False

Palpate the carotid for 60 seconds. (pg 1147)

Question 72

True or False

The goal with the patient with moderate-to-severe hypothermia is to prevent further heat loss.

Answer 72

True

Question 73

True or False

After a lightning strike you should practice reverse triage.

Answer 73

True

When a person is struck by lightning, respiratory or cardiac arrest, if it occurs, usually occurs immediately. focus your efforts on those who are in respiratory or cardiac arrest. This process, called reverse triage, differs from conventional triage, where such patients would ordinarily be classified as deceased. (pg 1166)

Question 74

True or False

Extremes in temperature and humidity are needed to produce hot or cold injuries.

Answer 74

False

Extremes in temperature and humidity are not needed to produce hot or cold injuries. Many hypothermic cases occur at temperatures between 30°F and 50°F. Most future cases occur when the temperature is 80°F and the humidity is at 80%. (Page 1142)

Question 75

True or False

When approaching a water rescue scene, it is better to drive through moving water than through stagnant water.

Answer 75

False

Never drive your car through moving water-a small amount can cause the vehicle to be swept away. Use extreme caution when driving through standing water. (page 1162)

Question 76

True or False

Potential safety hazards in the environment can include wet grass, mud, or icy streets.

Answer 76

True

Question 77

True or False

Long-sleeved shirts and long pants are considered dangerous for EMS responders in extreme heat and are not necessary because they provide only minimal protection from exposure.

Answer 77

False

Long-sleeve shirts and long pants may be uncomfortable in warm weather; however, they can help you from being splashed by blood or other bodily fluids. (Page 1152)

Question 78

Do not attempt to actively rewarm patients who have _________ to _________ hypothermia, because they are prone to developing arrhythmias unless handled very carefully.

Answer 78

Moderate; Severe

As the body reforms, the sudden redistribution of fluids and the release of built of chemicals can have harmful effects, including cardiac dysrhythmias. (Page 1148)

Always handle the patient gently so you do not cause any pain or further injury to the skin. Rough handling of a patient with moderate to severe hypothermia may cause the heart to go into ventricular fibrillation, which may not respond to defibrillation. (Page 1149)

Question 79

Most significant diving injuries occur during __________.

Answer 79

Ascent

Question 80

When treating a patient with frostbite, never attempt ____________ if there is any chance that the part may freeze again before the patient reaches the hospital.

Answer 80

Rewarming

Question 81

A patient at an altitude above 10,000’ with shortness of breath and cough with pink sputum is likely to be suffering from _____-______ _________ _________.

Answer 81

High-Altitude Pulmonary Edema (HAPE)

Question 82

___________, a common effect of hypothermia, is the body’s attempt to maintain heat. (Micro spasms)

Answer 82

Shivering

Question 83

Whenever a person dives or jumps into very cold water, the _________ _________ may cause immediate bradycardia.

Answer 83

Diving reflex

Question 84

_________ is the transfer of heat by radiant energy.

Answer 84

Radiation

Question 85

Mild hypothermia occurs when the core temperature is between ___________ and __________.

Answer 85

90°F; 95°F

Table 32-1 (page 1144)

Question 86

The ____________ and ___________ systems are the most commonly injured during a lightning strike.

Answer 86

Cardiovascular; Nervous

Question 87

_________ is the third most common cause of death from isolated environmental phenomena.

Answer 87

Lightning

Question 88

_________ is a serum containing antibodies that counteracts venom.

Answer 88

Antivenom

Question 89

__________ (bees, wasps, ants, and yellow jackets) stings are painful but are not medical emergencies unless the patient is allergic to the venom.

Answer 89

Hymenoptera

Question 90

Most snake bites occur between _________ and ___________, when the animals are active.

Answer 90

April; October

Question 91

In the United States, the most common form of pit viper is the __________.

Answer 91

Rattlesnake

Question 92

_________ are eight-legged arachnids with a venom gland and stinger at the end of their tail.

Answer 92

Scorpions

Question 93

Tick bites occur most commonly during the _______ months.

Answer 93

Summer

Question 94

One-third of patients with Lyme disease will have a ________ rash.

Answer 94

Bull’s-eye

Question 95

To treat a sting from a jellyfish, immersion in ________ of the affected area may help alleviate symptoms.

Answer 95

Vinegar

(Page 1173)

Question 96

Coelenterates are responsible for more ________ than any other marine animal.

Answer 96

Envenomations

Question 97

Toxins from the spines of urchins and stingrays are _________ __________.

Answer 97

Heat sensitive

(Page 1173)

Question 98

Most frostbitten parts are:

Select One

A. soft and moist
B. hard and waxy
C. soft and waxy
D. hard and moist

Answer 98

B. hard and waxy

Question 99

If a patient has a cold skin temperature, he or she likely is:

Select One

A. hypothermic
B. hyperthermic
C. hypovolemic
D. hypoglycemic

Answer 99

A. hypothermic​

Question 100

If a patient has a hot skin temperature, he or she likely is:

Select One

A. hypothermic
B. hyperthermic
C. hypoglycemic
D. hypervolemic

Answer 100

B. hyperthermic

Question 101

When treating multiple victims of lightning strikes, who should you concentrate your efforts on first?

Select One

A. conscious patients
B. unconscious patients in respiratory or cardiac arrest
C. all unconscious patients
D. none of the above

Answer 101

B. unconscious patients in respiratory or cardiac arrest

See reverse triage (page 1166)

Question 102

What is the best method of inactivating a jellyfish sting?

Select One

A. urinating on it
B. flushing the site with cold water
C. applying vinegar
D. applying an ice pack

Answer 102

C. applying vinegar

Question 103

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 Bull’s-eye rash 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 two days ago. On the basis of this patient’s presentation, you should suspect:

Answer 103

Lyme disease

S/S (page 1172)

• Flulike Symptoms
• Bull’s-eye rash may spread to several parts of the body
• Painful swelling of joints

Question 104

The diving reflex may allow a person to survive extended periods of submersion in cold water secondary to:

Answer 104

Bradycardia and slowing of the metabolic rate

(Page 116; see “diving reflex”)

Question 105

A dysbarism injury refers to the signs and symptoms related to changes in

Answer 105

Barometric pressure

Question 106

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:

Answer 106

Abdomen

Question 107

The body’s natural cooling mechanism, in which sweat is converted to a gas, is called:

Answer 107

Evaporation

Question 108

Geriatric patients are at a higher risk for Illnesses due to extreme environmental temperatures because:

Answer 108

Poor circulation contributes to increased heat loss.

Loss of subcutaneous tissue as they age reduces the amount of insulation they have.

(Page 1142)

Question 109

The transfer of heat to circulating air, such as when cool air moves across the body’s surface, is called:

Select One

A. radiation.
B. conduction.
C. convection.
D. evaporation.

Answer 109

C. convection.

Question 110

The body’s natural protective mechanisms against heat loss are:

Select One

A. shivering and vasodilation.
B. vasodilation and respiration.
C. respiration and vasoconstriction.
D. vasoconstriction and shivering.

Answer 110

D. vasoconstriction and shivering.

Question 111

Patients with generalized hypothermia are at an increased risk of a local cold injury because:

Select One

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.

Answer 111

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

Question 112

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. envenomation from a pit viper.

B. a black widow spider bite.

C. a brown recluse spider bite.

D. Rocky Mountain spotted fever.

Answer 112

B. a black widow spider bite.

Question 113

Compared to adults, infants and children are at higher risk for hypothermia for all of the following reasons, EXCEPT:

Select One

A. a smaller amount of body fat.
B. a decreased ability to shiver.
C. a relatively small surface area.
D. a smaller overall muscle mass.

Answer 113

C. a relatively small surface area.

Question 114

Which of the following conditions would be the LEAST likely to increase a person’s risk of hypothermia?

Select One

A. Hyperglycemia
B. Spinal cord injury
C. Severe infection
D. Head injury

Answer 114

A. Hyperglycemia

Question 115

Covering a patient’s __________ will significantly minimize radiation heat loss.

Select One

A. head
B. chest
C. extremities
D. abdomen

Answer 115

A. head​

Question 116

An air embolism associated with diving occurs when:

Select One

A. the alveoli completely collapse due to high pressure.
B. high water pressure forces air into the mediastinum.
C. the diver hyperventilates prior to entering the water.
D. the diver holds his or her breath during a rapid ascent.

Answer 116

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

Question 117

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)?

Select One

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

Answer 117

C. Tachycardia

Question 118

Which of the following medications increases a person’s risk of a heat-related emergency?

Select One

A. Tylenol
B. Asprin
C. Motrin
D. Diuretic

Answer 118

D. Diuretics

Question 119

To obtain the MOST accurate reading of a patient’s core body temperature, you should place a special hypothermia thermometer:

Select One

A. into a patient’s rectum
B. under the patient’s armpit
C. behind the patient’s knee
D. under the patient’s tongue

Answer 119

A. into a patient’s rectum