After properly measuring a patient’s blood glucose level, the glucometer displays a reading that displays the word "low." This finding would indicate: |
hypoglycemia |
A patient fainted when she tried to stand up, and you discover signs of internal bleeding during your assessment. This patient’s syncope was likely from: |
hypovolemia. |
A 76-year-old male patient has been found with facial droop and paralysis to the left side of his body. His vital signs are P 88, R 20, BP 210/100. His oxygen saturation is 90%. You administer oxygen and initiate transport to the local stroke center. Ten minutes later, you note that he has recovered fully. You should NEXT: |
continue to the stroke center. |
Over which of the following factors that affect the survivability of a stroke patient does the EMT have the MOST influence? |
time to treatment |
The basic primary fuel for the cell is: |
glucose |
Which of the following situations would MOST likely lead to hyperglycemia? |
a patient forgets to self-administer insulin |
A 17-year-old female has been actively seizing for over 5 minutes. The patient’s jaw is clenched, and you note that she is cyanotic around her lips. Her vitals are P 130, R 18, BP 180/92. You should next: |
maintain the airway and administer oxygen as appropriate |
If a patient had a long-standing vascular malformation in her brain that went unrecognized for years but finally resulted in a burst blood vessel, what type of stroke will she likely present with? |
a subarachnoid hemorrhagic stroke |
A 50-year-old female patient has been found unconscious and unresponsive. She is breathing rapidly and is diaphoretic. Her vital signs are P 130, R 30, BP 140/80. Which of the following conditions would most likely explain these findings? |
hypoglycemia |
A sensation experienced by a seizure patient right before the seizure is: |
an aura |
You are taking the history of a 35-year-old male patient who is unresponsive in the postictal phase of a tonic-clonic seizure from the patient’s spouse, who informs you that the patient has been taking a prescribed medication for managing generalized seizures for several months. Based on this information, you suspect it is MOST likely that: |
the patient failed to take his prescribed medication. |
When is administering oral glucose to a hypoglycemic patient the worst thing you could do? |
when the patient can’t protect his airway |
Which of the following would be an appropriate description of the reticular activating system? |
wake and sleep center |
During the primary assessment, what is a sign of shock? |
rapid heart rate |
In the Cincinnati Prehospital Stroke Scale (CPSS) screening method, arm drift is when: |
one arm drifts compared to the other |
A 19-year-old female has lost consciousness while traveling home from a house party. Friends note that she vomited and then she appeared to "pass out" for several minutes. They note this has never happened before. The patient is responsive, has a patent airway, and is breathing adequately. She insists that she did not drink or take any drugs at the party. Which of the following questions would be LEAST appropriate to this situation? |
are you afraid of the consequences of admitting substance abuse? |
A patient presenting with dizziness and a rapid heart rate may be experiencing: |
cardiac dysrhythmia. |
A 16-year-old male athlete suffered a syncopal episode while playing soccer on a hot, humid day. You find him lying supine and complaining of dizziness. He has no apparent injuries. You should: |
keep the patient supine and allow him to slowly recover. Consider ALS and/or transport. |
When a clot or embolism occludes an artery, this causes: |
an ischemic stroke |
Hemorrhagic stroke is frequently the result of long-standing |
high bp |
Under what circumstance can an EMT use a glucometer to determine a patient’s blood glucose level? |
only if allowed by medical direction and local protocols |
Hyperglycemia typically develops: |
over days or even weeks |
To prevent additional injuries during repeated seizures, you should: |
move objects away from the patient |
Which of the following statements about patients with altered mental status is CORRECT? |
One of the most common causes of altered mental status is hypoxia. |
After administering oral glucose to a patient in a diabetic emergency, you should: |
reassess the patient |
Your patient is a 19-year-old male who was reportedly unconscious for a brief time. You learn that he regained consciousness in about 30 seconds. You find no evidence of drowsiness or neurological deficits. Which of the following is MOST likely the cause? |
syncope |
A partial seizure affects: |
one part or one side of the brain |
The family of a 30-year-old male states that the patient recently had a tonic-clonic seizure. The event lasted 5 minutes, and the family notes that the patient has no previous history of seizures. The family also states that the patient has no past medical history of any kind. Until the point he began seizing, he had seemed fine. Which of the following causes MOST likely explain the previous findings? |
recent head trauma |
Sepsis typically refers to: |
a severe, systemwide response to infection. |
What type of convulsion usually lasts for only a few minutes and has three distinct phases? |
Tonic-clonic seizure |
A stoke refers to the death or injury of: |
brain tissue. |
Which patient has LEAST likely suffered a disruption of the reticular activating system? |
A patient has sustained minor lacerations from falling off a bicycle. |
Which of the following is LEAST necessary for a patient to maintain consciousness? |
Medication |
Which of the following statements about altered mental status in pediatric patients is CORRECT? |
Parents are usually the best judges of their child’s mental status. |
Why does diabetic ketoacidosis cause dehydration? |
The lack of insulin creates an excess of glucose, which attracts large amounts of water from the body, potentially causing profound dehydration. |
Hyperglycemia is usually caused by a decrease in insulin, which: |
leaves sugar in the bloodstream rather than helping it enter the cells. |
Which of the following findings are commonly associated with diabetic ketoacidosis (DKA)? |
Rapid and deep breathing |
Which of the following statements about blood glucose meters is TRUE? |
Blood glucose meters are portable and reliable. |
During the primary assessment, one clinical indication that a patient may be experiencing a hypoglycemic emergency is: |
an altered mental status. |
If a patient in a diabetic emergency is not awake enough to swallow, then: |
secure the airway, provide ventilations if necessary, and be prepared to perform CPR if necessary. |
Contraindications to the use of oral glucose in a patient with altered mental status and a history of medication-controlled diabetes include: |
the patient being unable to swallow. |
An 18-year-old male has been found unconscious. Which of the following findings would indicate that his altered mental status has been caused by hyperglycemia? |
Acetone breath |
A 62-year-old female was found confused and diaphoretic. Her blood glucose level was assessed to be 35 mg/dl. After administering a tube of oral glucose, you should NEXT: |
perform a reassessment. |
Your patient has experienced a seizure that involves only one cerebral hemisphere and produces jerky muscular activity in one area of the body, arm, leg, or face. What type of seizure is this? |
simple partial seizure |
A five-year-old male is frequently witnessed simply staring off into space. Several times a day he loses focus, which has been affecting his ability to pay attention to instructions and know what’s going on around him. Today his teacher saw him fall off his chair and strike his head on his desk. He now has a bleeding laceration above his right eye. The patient is now awake and crying. His vital signs are P 100, R 24, BP 100/60. His blood glucose level is 80 mg/dl. Given the patient’s history, you suspect he has been suffering from: |
absence seizures. |
Which of the following is the MOST common cause of seizures in infants? |
Fever |
A seizure that affects the brain and is evidenced by jerking movements of paired muscle groups is often called what type of seizure? |
generalized |
An idiopathic seizure: |
has no known cause. |
A patient in the postictal state will have: |
altered mental status. |
What is the typical mental status of a patient who is actively experiencing a generalized tonic-clonic seizure? |
Unresponsive |
Dizziness: |
means different things to different people. |
If you describe a patient as presyncope, you mean that he: |
is about to faint. |
What is NOT a typical sign of stroke? |
Heightened alertness |
A 52-year-old male complains of not feeling well. Family members state that upon awakening this morning, they noticed that the patient had right-sided facial droop and was slurring his words slightly. The patient states that he is a diabetic, and five minutes ago his blood glucose was 88 mg/dL. After completing the primary assessment, you should NEXT: |
complete a Cincinnati Prehospital stroke assessment. |
You witness an adult patient experiencing a seizure in which a progressive twitching of his right arm leads to his entire body twitching. What can you reasonably say about the seizure’s origin? |
It was a partial seizure that became generalized to the entire body. |
A 24-year-old male has regained consciousness after a tonic-clonic seizure and is now alert. He is fatigued and complains of generalized muscle pain. You note that he is slightly cyanotic and breathing rapidly. His vital signs are P 116, R 28, BP 174/88. You should NEXT: |
administer supplemental oxygen. |
If your patient is actively seizing, it may be necessary to: |
place the patient on the floor or ground. |
Which of the following conditions is MOST likely to lead to a stroke? |
Long-standing high blood pressure |
A stroke patient appears to understand you but can’t find the correct words to express his condition. The words he uses don’t make sense. This is: |
expressive aphasia. |
For a stroke patient, what is the MOST important treatment priority? |
Rapid transport to an appropriate destination. |
A 73-year-old female complains of a new onset of vertigo and states that she almost passed out when she tried to stand. She is alert but weak. Her vital signs are P 70, R 20, BP 100/60. Her pulse oximeter reads 95 percent. An action it is LEAST necessary to take for this patient is to: |
administer oxygen. |
In taking the history of a patient who has had a convulsive seizure, you discover the patient is epileptic, which means that the patient experiences seizures: |
from profound sepsis |
Aphasia is often seen in: |
stroke patients |
A 45-year-old male presents agitated and confused. Your assessment identifies an oxygen saturation of 90%. You should next: |
administer oxygen |
Which of the following findings from the SAMPLE and OPQRST history of a seizure patient is of GREATEST concern to the EMT? |
the patient stopped taking his antiseizure medicine |
A person in a hypoxic state experiences an altered mental status, because in the reticular activating system, oxygen is needed to: |
perfuse the brain tissue |
A 62-year-old male complains of weakness on one side of his body and slurred speech. After you arrive and evaluate the patient, you notice that the symptoms are beginning to subside. What is the likely cause of the patient’s condition? |
transient ischemic attack |
Which of the following is characterized by sudden, temporary loss of consciousness caused by insufficient blood flow to the brain, with return of consciousness almost immediately on becoming supine? |
Vasovagal syncope |
To optimize the care of a stroke patient who is a potential candidate for thrombolytics, an EMT can determine and document the exact time of: |
onset of symptoms |
The postictal phase of a tonic-clonic seizure involves the patient transitioning from full loss of consciousness to: |
full mental status |
To which of the following hypoglycemic seizure patients should the EMT administer oral glucose? |
the postical patient who can manage his or her own airway |
Which of the following readings on the glucometer would be of concern to the EMT? |
150 mg/dl |
After a period of syncope lasting 30 seconds, your patient is now reporting a "fluttering" in his chest and generalized weakness. Which of the following is necessary? |
Requesting ALS to support the patient’s care |
A patient was running a riding lawnmower in a closed garage and experienced dizziness. Immediately after opening the garage door, the patient experienced syncope that lasted for several moments. It is MOST likely that the cause of the patient’s syncope was: |
toxicological |
Occasionally, a patient with only mild hypoglycemia and minor altered mental status can be treated by simply giving that patient: |
something to eat |
A patient with aphasia who seems to understand what you say but cannot form intelligible responses to what you say should be classified as: |
verbal |
For a patient who is hypoxic, hyperglycemic, dehydrated, and with altered mental status, you would expect that what would MOST make this patient prone to a seizure would be the: |
hypoxia. |
Which of the following is MOST likely to cause an altered mental status? |
hypoxia |
In an ischemic stroke, what occludes an artery? |
a clot or embolism |
A 16-year-old female has altered mental status. Her blood glucose is 40 mg/dL. This finding tells you that: |
the patient is hypoglycemic. |
A patient experiencing disorientation and a lowered state of alertness is experiencing a failure of the reticular activating system (RAS), which is responsible for: |
consciousness |
Which of the following substances specifically nourishes the brain to enable consciousness? |
glucose |
Hyperglycemia is often due to: |
a lack of insulin. |
Syncope is: |
fainting |
Your diabetic ketoacidosis patient has rapid breathing and a fruity odor on his breath. This is likely due to: |
the presence of ketones |
A stroke cannot happen without: |
deprivation of oxygen to the brain tissue |
Which of the following are the MOST important treatment elements to consider in transporting a patient with seizures? |
airway and oxygen levels |
Which of the following statements is TRUE about paralysis caused by stroke? |
Typically, paralysis from strokes affects only one side of the body. |
A 26-year-old female complains of six hours of vomiting and diarrhea. She is dizzy and lightheaded but feels better while lying down. What follow-up question would be BEST to ask if the patient answers yes to the question "Have you had any similar episodes in the past?" |
"What cause was found?" |
Your patient is a 19-year-old female who is 7 months pregnant. She just experienced a seizure. She has no previous history of seizures or any other medical condition. Which of the following is the MOST likely cause of the seizure? |
eclampsia |
The Cincinnati Prehospital Stroke Scale assesses for: |
facial droop, arm drift, and abnormal speech |
The typical steps of managing a diabetic emergency are: |
Primary assessment, secondary assessment, prepare to administer oral glucose, assist the patient in accepting glucose, and reassessment. |
You respond to a 32-year-old female who is having a seizure. You arrive on the scene to find the patient drowsy, confused, and complaining of a headache. This patient is demonstrating the: |
postictal phase. |
You have arrived on the scene of a call for a possible stroke. On your arrival, the patient denies signs and symptoms, is alert and oriented, and moves all extremities well. Her husband states that before you arrived, the patient could not move her right arm and the left side of her face seemed to be "slack." Which of the following has most likely occurred? |
the patient suffered a transient ischemic attack |
What statement BEST distinguishes type 1 from type 2 diabetes? |
in type 1 diabetes, the pancreas does not secrete insulin normally, but in type 2 diabetes, the bodys ells fail to use insulin properly |
Most of the diabetic emergencies that you will be called to deal with will be related to hypoglycemia. However, occasionally you will experience an instance of hyperglycemia. In the list below, which item is NOT likely to be a sign or symptom of hyperglycemia? |
reduced rate of breathing |
Normal consciousness is regulated by a series of neurologic circuits in the brain that comprise the reticular activating system (RAS). The RAS has simple requirements to function properly. Which one of the following items is NOT one of those requirements? |
sodium |
Which of the following BEST describes status epilepticus? |
Two or more seizures with tonic-clonic activity without an intervening period of consciousness |
Which of the following is NOT a sign or symptom of stroke? |
chest pain |
Which of the following is the most critical piece of equipment to have immediately available for the seizure patient who has just stopped convulsing? |
Suctioning equipment |
Which of the following is NOT a sign of a hypoglycemic diabetic emergency? |
slow heart rate |
Which of the following blood glucose levels is considered normal for an adult? |
80 mg/dL |
During your primary assessment, you find your patient has an altered mental status. This could indicate which of the following? |
failing respiratory system |
A seizure that occurs spontaneously from an unknown cause is called: |
idiopathic |
The death of brain tissue due to deprivation of oxygen because of a blocked or ruptured artery in the brain is known as which of the following? |
Stroke |
One of the criteria for administering oral glucose is the patient having a history of diabetes. The point at which you would typically ask about whether the patient has a history of diabetes is when: |
taking the sample history |
Some EMS systems allow administration of intranasal glucagon to patients who are |
unable to safely shallow oral glucose |
Treatment of someone with a seizure disorder includes all of the following EXCEPT: |
placing a bite block in the patient’s mouth so he does not bite his tongue. |
Compared to hypoglycemia, which of the following is true of hyperglycemia? |
Its onset is more gradual. |
A dose of oral glucose gel in a toothpaste-type tube is: |
one tube |
Which of the following is the LEAST important question in obtaining the history of a seizure patient in the prehospital setting? |
does the patient have a family history of seizures? |
Which of the items below is NOT part of the Cincinnati Prehospital Stroke Scale? |
test for equal grip strength |
Which statement below is NOT true about seizures? |
Many seizures are followed by an aura. |
Your patient is a 44-year-old male with a history of diabetes. He is lying on the living room floor, unresponsive to all stimuli. He has a respiratory rate of 12 breaths per minute, heart rate of 112 beats per minute, and is pale and sweaty. Which of the following should you do to treat this patient? |
place the patient in the recovery position, administer oxygen, and monitor his airways status |
A patient complains of dizziness followed by brief syncope of several seconds. Regardless of this patient’s history, it is likely that the dizziness and syncope are related to interference with the function of the patient’s: |
brain |
In hyperglycemia, increasing blood sugar levels starve the cells of the body for: |
sugar |
Which of the following is the cause of most strokes? |
blockage of an artery supplying part of the brain |
The medical term for fainting is: |
syncope |
What is a sign of sepsis becoming systemic? |
altered mental status |
A patient with a history of seizures experiences a seizure for no apparent reason. What is the likely cause? |
failure to take prescribed medication |
The signs and symptoms of a transient ischemic attack (TIA) may last up to: |
24 hours |
Your patient is waking up from a seizure; it was the patient’s first seizure ever. When you ask what happened, the patient tells you she had the smell of fresh mown grass just before she seized. This sensation is known as: |
an aura |
Which of the following may result in hypoglycemia in the diabetic patient? |
vomiting after eating a meal |
Looking at the following list, which of the items does NOT correctly compare the signs and symptoms of hypoglycemia and hyperglycemia? |
the hypoglycemic patient is usually complaining of a headache, whereas the hyperglycemic patient is not |
When assessing a patient for a possible stroke, which of the following three functions should be tested by the EMT? |
Control of facial muscles, ability to speak, and ability to hold both arms in an extended position for 10 seconds |
Which is NOT one of the steps in managing a patient experiencing dizziness and syncope? |
applying cold packs to the patients head |
Which of the following is LEAST important for the patient who has stopped seizing before the EMT’s arrival at the scene? |
determining when the patient was last transported to the hospital for seizures |
There are two types of seizures; if your patient is having a seizure that affects only one area of her body and does not cause her to lose consciousness, it is called a: |
partial seizure. |
When someone is experiencing hypoglycemia, the body attempts to compensate by using the fight-or-flight mechanism of the autonomic nervous system. Which one of the statements below is NOT one of the fight-or-flight responses? |
the skin is hot and dry |
Your patient is a 21-year-old female with a history of epilepsy. She is having a convulsion upon your arrival. Which of the following should you do? |
move furniture and other objects away from the patient to prevent injury |
Your patient is a 59-year-old female with a sudden onset of slurred speech and weakness on her right side. Which of the following measures is appropriate? |
immediately transport the patient to a hospital with specialized treatment for stroke patient |
Many stroke patients are candidates for thrombolytic drugs. One of the most important things that an EMT can do to optimize the care of a stroke patient who is a candidate for the drugs is: |
determine the exact time of onset of symptoms. |
Your patient is an unresponsive 30-year-old male wearing a Medic-Alert bracelet indicating that he is a diabetic. The patient’s coworkers came by his house to check on him when he did not show up for work and did not call in sick. Your assessment does not clearly indicate to you whether the patient may be hypoglycemic or hyperglycemic. Which of the following should you do next? |
protect the patients airway, administer oxygen, and consider assessing the patients blood glucose per local protocol |
Patients displaying altered mental status were lost for several hours in a desert area without food and water and temperatures in the high 90s. You would expect their altered mental status to be from: |
dehydration |
A hormone called insulin is secreted by the: |
islets of langerhans in the pancreas |
With advances in clot-busting (thrombolytic) drugs, the patient has a window of ________ hours to receive treatment. |
3 |
You are called to a scene at which multiple patients are seizing at the same time. The likely cause is: |
something environmental at the scene |
Which of the following is characteristic of a patient with hyperglycemia? |
a "fruity" odor of the breath |
Which of the following is one of the most common characteristics of a stroke? |
Weakness on one side of the body |
If the blood sugar level is very high, which of the following may result? |
excessive urination, excessive thirst, and excessive hunger |
The condition in which there is an insufficient amount of sugar in the blood is called: |
hypoglycemia |
A patient who demonstrates any one of the three symptoms from the Cincinnati Prehospital Stroke Scale has a(n) ________% chance of having an acute stroke. |
70 |
The insulin-glucose relationship has been described as a "lock and key" mechanism because: |
without the insulin "key", glucose cannot enter the locked cells |
What is epilepsy? |
a condition in which a person has multiple seizures and that is usually controlled medication |
The most common medical emergency for the diabetic is hypoglycemia, or low blood sugar. Which one of the factors below is NOT a cause of hypoglycemia? |
reduces sugar intake by eating too much |
Which of the following refers to difficulty in speaking or understanding speech as a result of a stroke? |
Aphasia |
For the reticular activating system (RAS) to work correctly, what three substances are needed? |
Oxygen to perfuse brain tissue, glucose to nourish brain tissue, and water to keep the brain hydrated |
Your patient is a 70-year-old man whose wife called EMS because her husband began exhibiting unusual behavior. Upon your arrival, you introduce yourself to the patient, who responds, "Not until nine o’clock," but shows no actual understanding of what you just said. This phenomenon is BEST described as: |
receptive aphasia. |
Which of the following foods is MOST likely to cause a severe allergic reaction? |
Peanuts |
The steps in administering epinephrine by auto-injector include: |
holding the injector in place until all the medication has been injected. |
Which of the following should be assessed FIRST for a patient who is in anaphylactic shock? |
The patient’s airway |
Which of the following is caused by a histamine release during an allergic reaction? |
increased leakage of fluids from blood vessels |
For a hypotensive patient, which of the following effects of epinephrine would be MOST important? |
Vasoconstriction |
A particular antibody combines with: |
only the allergen it was formed in response to or a very similar allergen |
A 10-year-old male was stung by several bees. Shortly after the envenomation, his face became severely swollen. This edema is the result of: |
increased capillary permeability |
Upon examining the patient’s auto-injector, you notice that the contents are yellow and contain particulate matter. What should you do? |
do not administer the auto injector and seek an alternative source for epinephrine |
An allergic reaction is an abnormal response of the: |
immune system |
After administering the epinephrine auto-injector to your patient with anaphylaxis, you should pay particular attention to: |
assessing the patients airway, breathing, and circulation |
What effect does epinephrine have on the blood vessels? |
constriction |
Which of the following findings is the MOST concerning in a patient with a suspected severe allergic reaction? |
swollen face and tongue |
A 50-year-old woman is experiencing an allergic reaction after accidentally ingesting some shrimp. She has hives, complains of diarrhea, and notes that she is beginning to have difficulty breathing. You assess wheezes. Her vital signs are P 118, R 30, BP 100/60. What is the BEST answer for when you may administer epinephrine? |
the patient has a prescription for epinephrine and medical control authorizes you to do so |
Which of the following is MOST likely to cause anaphylaxis? |
Penicillin |
A patient carrying a prescribed epinephrine auto-injector: |
may ask you for assistance with using the device |
The first time someone is exposed to an allergen, the immune system: |
forms antibodies in response |
What is more characteristic of anaphylaxis than a less severe allergic reaction? |
Generalized pallor |
Following an epinephrine injection, reassessment should occur during: |
transport |
In an anaphylactic reaction, hives are: |
generalized |
If a person is allergic to bee stings, the venom from the bee is referred to as a(n): |
allergen |
Which of the following statements about epinephrine is TRUE? |
Epinephrine is a hormone produced by the body. |
What does the immune system use to fight off invasion by foreign substances in the body? |
Antibodies |
A 44-year-old female has anaphylaxis after being injected with a new antibiotic. The patient has stridor. This finding is most likely due to: |
swelling around the vocal cords. |
Asking a patient experiencing an allergic reaction about how the patient was exposed to the allergen involved typically happens during: |
secondary assessment. |
What is an exception to the rule that EMTs may only administer for patients with a prescription for epinephrine? |
The region allows EMTs to carry and administer epinephrine. |
A 15-year-old male has hives and GI distress after ingesting eggs. Medical control has ordered administration of an epinephrine auto-injector: Which of the following findings would be an expected side effect of this drug? |
Nausea |
The recommended single dosage of epinephrine for an infant or child with a severe allergic reaction is how many milligrams? |
0.15 mg |
Which of the following is the MOST reliable indication of improvement in a patient with anaphylaxis who was treated with an epinephrine auto-injector? |
Improvement of breathing difficulty |
When administering epinephrine via auto-injector, you should place the tip of the device against the: |
lateral portion of the patients thigh |
Your patient was experiencing anaphylaxis with severe hypoxia when you administered his epinephrine auto-injector. Within minutes, his oxygen saturation improved. What therapeutic effect of epinephrine would BEST explain this improvement? |
bronchodilation |
Which of the following statements about poison ivy is TRUE? |
it is the oil on the leaves of the poison ivy plant that causes the allergic reaction |
In your management of a patient with true anaphylaxis who has a prescribed epinephrine auto-injector, which of the following interventions is MOST correct? |
contact medical direction for authorization to administer the epi auto injector |
Which of the following is an anticipated side effect of epinephrine administration? |
tachy |
You arrive on scene to back up another EMT unit on a patient with an allergic reaction. As you approach the scene, you see one EMT preparing to administer the patient’s EpiPen®. Which of the following clinical findings would support the use of the EpiPen®? |
signs and symptoms of shock |
Proteins produced by the body that search for invaders and destroy them are called: |
antibodies |
A 35-year-old male is suffering a severe anaphylactic reaction. You have administered one of the patient’s two epinephrine auto-injectors as indicated; however, after 10 minutes, the patient’s condition has not improved. You should NEXT: |
consult with medical control and administer tthe second auto injector |
If a patient reports an allergy to walnuts, what other foods should the patient probably avoid? |
Almonds |
You have just completed administering an EpiPen® to an anaphylactic 22-year-old female. You have successfully injected the medication and withdrawn the syringe. You should NEXT: |
place the EpiPenSuperscript ®® in an appropriate biohazard container. |
Which of the following would prevent the administration of an EpiPen® to a 16-year-old male in a life-threatening anaphylactic situation? |
medical direction has denied permission to administer the drug |
In an allergic reaction, what substance released by mast cells and basophils causes bronchoconstriction, promotion of thick mucus production in the lungs, vasodilation, and increased vascular permeability? |
histamine |
What finding is LEAST likely to make an EMT suspect an allergic reaction? |
the patient has dry eyes and nose |
A 17-year-old male presents with itchy skin after exposure to peanuts. He is allergic to peanuts. The findings at this point indicate: |
an allergic reaction. |
Histamine release increases vascular permeability. What physical sign is associated with this pathophysiology? |
swelling |
Urticaria is another term for: |
hives |
Which of the following would BEST describe a patient who is experiencing shock and respiratory compromise after exposure to a known allergen? |
Anaphylaxis |
You just administered an EpiPen® to your patient. The patient is improved but is now complaining of chest pain. You should: |
notify medical direction |
Why is a patient’s second exposure to an allergen more dangerous than the first? |
On the second exposure, the antibody combines with the allergen, causing histamine release. |
What change in vital signs would typically indicate that patient with an allergic reaction has progressed to anaphylaxis? |
Decreased oxygen saturation |
You are transporting a 41-year-old female suffering from severe anaphylaxis. Her respiratory rate is 42 per minute, she is cyanotic, and she has a decreased level of responsiveness. Which of the following is the highest priority of care for this patient? |
assist ventilations with a bag-valve mask |
Your patient is a 45-year-old female who is allergic to sesame seeds, which she accidentally ingested when she ate a deli sandwich. She is having difficulty breathing, and she has hives, watery eyes, a weak pulse of 120 per minute, and swelling of the face and tongue. Which of the following is the BEST course of immediate action? |
contact medical control for orders to administer the patients epi auto injector |
If medical control authorizes the administration of an epinephrine auto-injector, then you would: |
prepare the auto-injector for use by removing the safety cap. |
You have administered epinephrine via auto-injector to a patient and disposed of the used injector in a portable biohazard container. Now you: |
document the patients response to the medication |
Which of the following does NOT commonly lead to anaphylaxis? |
cat dander |
Which of the following is MOST likely to be a complaint of a patient suffering from anaphylaxis? |
my throat feels like its closing |
You are called to a residence for a 60-year-old male complaining of chest pain. You find the patient seated in bed. His past medical history includes hypertension and high cholesterol. The patient presents with hives over the chest, stridor, a swollen tongue, and wheezing in the upper fields. He denies any shortness of breath or respiratory distress, but speaks only in short two- to three-word statements and complains of a tightness in the chest. What condition do you suspect? |
anaphylaxis |
Which of the following is the result of histamine and other chemicals in the body during anaphylaxis? |
capillaries become leaky, bronchoconstriction occurs, and swelling appears in areas around vocal cords |
As you prepare to enter a patient’s room in a nursing home, you see a sign posted on the door indicating that the patient has a latex allergy. Which of the following is the BEST way to care for the patient? |
ask the nursing facility staff to find nonlatex exam gloves to wear for contact with this patient |
You are called to a farmhouse on a sunny spring afternoon. Upon arrival, a frantic mother tells you that her 3-year-old daughter was playing in the yard, accidentally stepped on a hornets’ nest, and was stung repeatedly. The patient is alert, screaming and crying, and can follow her mother’s commands. Her arms and legs are swollen and show the marks of several stings. Her body is covered in hives. Her vital signs are blood pressure 90/40, pulse 110, respiratory rate 24, and oxygen saturation 99%. Her lung sounds are clear and equal bilaterally. Her mother states she put "nox-a-sting" on the sting sites but the hives only seemed to get worse. What condition is the patient suffering from? |
allergic reaction most likely from the hornets stings |
Which of the following is the reason why infants rarely experience anaphylactic reactions? |
infants have not yet developed antibodies to allergens |
Which of the following is NOT a sign or symptom of an allergic reaction involving the skin? |
stridor |
Your patient has eaten a casserole that may have contained seafood. The patient is worried because he has a seafood allergy. Upon assessment, you find no signs or symptoms of anaphylaxis. The patient’s vital signs are stable and he has an epinephrine auto-injector prescribed to him. Which of the following actions is most appropriate? |
try and find out if the casserole contained seafood |
Which of the following statements concerning severe allergic reactions is true? |
Signs or symptoms of shock indicate a severe allergic reaction. |
Which of the following would you expect to hear when auscultating the lungs of a patient having an anaphylactic reaction? |
wheezing |
A 35-year-old female has just eaten lobster and is now complaining of itchy, watery eyes. She describes a feeling of impending doom, she is sweating profusely, and she has an elevated heart rate and respiratory rate, although she denies difficulty breathing. Which of the following best describes her condition? |
anaphylaxis |
Which of the following does a physician NOT take into consideration when writing a prescription for a patient to obtain an epinephrine auto-injector? |
how far the patient lives from medical attention |
It is characteristic of an allergen to be: |
a substance foreign to the body |
At which of the following sites should the EMT administer an epinephrine auto-injector? |
thigh |
You have responded to a park where you find a 23-year-old female sitting on a bench near a running trail. She states that she has been running for the past 30 minutes, and all of a sudden she cannot catch her breath. She states that this has never happened before and she usually runs 5 miles a day. Your assessment reveals that she is flushed, her pulse is fast and weak, her respirations are fast and she is wheezing with stridor, and she has hives on her arms and chest. She is most likely suffering from which of the following? |
Anaphylaxis |
You are on the scene of a 40-year-old male patient who is anaphylactic and still unresponsive following a single epinephrine injection. You had inserted an oral airway and administered oxygen at 15 liters per minute by bag-valve mask and your partner found diminished lung sounds. After the epinephrine administration, your partner reassesses lung sounds and tells you that the patient is now wheezing loudly in all fields. What is the next action you should perform? |
Contact medical control and request to administer another dose of epinephrine. |
What is another name for a severe allergic reaction? |
anaphylaxis |
You are on the scene of a motor vehicle collision in which a car has driven off the roadway and is resting at the bottom of an embankment. The driver is in mild respiratory distress. His skin is flushed and he has hives. A Medic-Alert bracelet indicates an allergy to peanuts. You notice a candy bar wrapper on the floor of the car. Which of the following should you do first? |
Administer high-concentration oxygen. |
Which of the following is NOT an indication that epinephrine is helping the anaphylaxis patient’s condition? |
Increased dyspnea |
You respond to a local swim park for a 29-year-old male who was stung by a bee and "passed out." Upon arrival, you find the patient unresponsive to all stimuli with agonal respirations at 6 per minute. You insert an oral airway and administer oxygen at 15 liters per minute by bag-valve mask. You notice that it is difficult to bag the patient. Your partner listens to lung sounds and states they are very diminished in the upper fields and absent in the lower fields. What is the best action? |
request orders from medical control to administer epi |
Which of the following is included in the primary assessment of a conscious patient suffering from anaphylactic shock? |
assessing whether the patient is able to speak without difficulty |
After activating the auto-injector, how long should it be held in place before removing it from the patient’s thigh? |
10 sec |
After administering epinephrine per medical control via an auto-injector to an unresponsive anaphylactic adult patient, your partner reassesses the lung sounds. He tells you that the patient is now wheezing loudly in all fields, whereas before the injection, they were diminished in the upper fields and absent in the lower. What is your suspicion regarding the patient’s condition? |
the patients condition is improving |
Which of the following occurs to blood vessels during an anaphylactic reaction? |
Dilation |
You are unsure if a patient’s condition requires the administration of an epinephrine auto-injector. Which of the following actions is most appropriate? |
consult medical direction |
You are on the scene of a 22-year-old female patient who is unresponsive. The patient’s mother states that she is deathly allergic to peanuts and accidentally ate stir fry cooked in peanut oil. The patient is unresponsive with agonal respirations at 6 per minute. What is your first action? |
insert an oral airway and apply oxygen at 15 lpm by bag valve mask |
If a patient was having a myocardial infarction, not an allergic reaction, and received an epinephrine auto-injection, which of the following would most likely occur? |
stronger and faster heartbeat |
Which of the following is NOT a side effect of epinephrine? |
Bradycardia |
Which of the following explains why a patient may experience difficulty breathing during anaphylaxis? |
swelling of the airway tissues causes difficulty breathing |
What is a skin texture sign common to both anaphylaxis and less severe allergic reactions? |
Hives |
Which of the following is an action caused by epinephrine in anaphylaxis? |
Vasoconstriction |
Upon delivering a patient to the emergency department, you remove your gloves and find that your hands are red and itchy. Which of the following is most likely? |
You are having an allergic reaction to the latex in the gloves. |
You have used an Auvi-QSuperscript TMTM device to administer epinephrine to a patient. Now you should: |
put the outer case back on. |
Which of the following changes commonly occurs in the cardiovascular system during anaphylaxis? |
low bp due to vasodilation |
You are treating a 28-year-old female who is 34 weeks pregnant. She has a history of bee sting anaphylaxis and was stung by a bee while in the garden. She is having severe respiratory distress and her blood pressure is 72/50 mmHg. You are in an area that allows EMTs to carry and administer epinephrine, and the patient has a prescribed Epi-Pen®. Which of the following is the BEST option for the EMT? |
Administer the Epi-PenSuperscript ®® only on the advice of medical control. |
Which of the following is the proper method of disposing a used epinephrine auto-injector? |
place the device in a rigid biohazardous sharps disposal container |
Your patient has a history of severe anaphylaxis and carries several auto-injectors. You have administered one of the auto-injectors, but the patient’s condition continues to worsen. Which of the following is the next best course of action? |
contact medical control |
You are called to a residence for a 50-year-old male complaining of difficulty breathing. He is alert and oriented to time, place, and person. The patient presents with hives over the chest, stridor, a swollen tongue, and wheezing in the upper fields. He is breathing 32 times per minute. He is speaking in two- to three-word sentences. You administer oxygen at 15 liters per minute by nonrebreather mask. What action next is the best treatment for the patient? |
administering epi with consent from medical control |
It is characteristic of less severe allergic reactions to: |
exhibit localized swelling hives |
EMT Chapter 19 & 20
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