EMT Chapter 19 & 20

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After properly measuring a​ patient’s blood glucose​ level, the glucometer displays a reading that displays the word​ "low." This finding would​ indicate:


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:


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:


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?


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?


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?


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?


A seizure that affects the brain and is evidenced by jerking movements of paired muscle groups is often called what type of​ seizure?


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?



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:


​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:


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:


Which of the following is MOST likely to cause an altered mental​ status?


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:


Which of the following substances specifically nourishes the brain to enable​ consciousness?


Hyperglycemia is often due​ to:

a lack of insulin.

Syncope​ is:


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?


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?


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:


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?


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:


In​ hyperglycemia, increasing blood sugar levels starve the cells of the body​ for:


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:


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:


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.


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:


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.


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?


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?


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?


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?


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?


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:


In an anaphylactic​ reaction, hives​ are:


If a person is allergic to bee​ stings, the venom from the bee is referred to as​ a(n):


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?


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?


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?


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?


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:


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?


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?


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?


Urticaria is another term​ for:


Which of the following would BEST describe a patient who is experiencing shock and respiratory compromise after exposure to a known​ allergen?


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?


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?


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?


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?


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?


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?


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?


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?


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?


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?


Which of the following is an action caused by epinephrine in​ anaphylaxis?


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

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