Chapter 23 Quiz

Question 1

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?

Answer 1

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?

Question 2

What is another name for a severe allergic reaction?

Answer 2

Anaphylaxis

Question 3

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?

Answer 3

Contact medical control for orders to administer the patient’s epinephrine auto-injector.

Question 4

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. What is the best treatment for the patient?

Answer 4

Administering epinephrine with consent from medical control

Question 5

After activating the EpiPen® auto-injector, how long should it be held in place before removing it from the patient’s thigh?

Answer 5

10 seconds

Question 6

Which of the following is a trade name for an epinephrine auto-injector?

Answer 6

EpiPen®

Question 7

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?

Answer 7

Contact medical control.

Question 8

Which of the following happens to blood vessels during an anaphylactic reaction?

Answer 8

Dilation

Question 9

When documenting the administration of an epinephrine auto-injector, which of the following should be included?
A.
Patient’s response to the medication

B.
Site of medication administration

C.
Time the medication was administered

D.
All of these

Answer 9

D.
All of these

Question 10

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?

Answer 10

You are having an allergic reaction to the latex in the gloves.

Question 11

Your patient is a 7-year-old girl who was prescribed an antibiotic for an ear infection. After 4 days on the antibiotic, the patient is experiencing hives and itching on her face, throat, and neck. Which of the following should you do?

Answer 11

Provide supportive care and monitor the patient’s condition during transport to the hospital.

Question 12

If a patient is having a myocardial infarction–not an allergic reaction–and receives an epinephrine auto-injection, which of the following will most likely occur?

Answer 12

Stronger and faster heartbeat

Question 13

Which of the following statements concerning severe allergic reactions is true?

Answer 13

Severe reactions often occur immediately, but they are occasionally delayed 30 minutes or more.

Question 14

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?

Answer 14

Request orders from medical control to administer epinephrine.

Question 15

At which of the following sites should the EMT administer an epinephrine auto-injector?

Answer 15

Thigh

Question 16

Which of the following does not commonly lead to anaphylaxis?

Answer 16

Cat dander

Question 17

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 severe respiratory distress and is unable to speak. 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?

Answer 17

Administer high-concentration oxygen.

Question 18

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 suddenly 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, and she has hives on her arms and chest. She is most likely suffering from which of the following?

Answer 18

Anaphylaxis

Question 19

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. Which of the following is the best option for the EMT?

Answer 19

Administer the EpiPen® only on the advice of medical control.

Question 20

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?

Answer 20

Assist ventilations with a bag-valve mask.

Question 21

Which of the following is the proper method of disposing of a used epinephrine auto-injector?

Answer 21

Place the device in a rigid biohazardous sharps disposal container.

Question 22

Which of the following explains why a patient may experience difficulty breathing during anaphylaxis?

Answer 22

Swelling of the airway tissues causes difficulty breathing.

Question 23

Which of the following is not a side effect of epinephrine?

Answer 23

Bradycardia

Question 24

You are unsure whether a patient’s condition requires the administration of an epinephrine auto-injector. Which of the following actions is most appropriate?

A.
Ask a family member if this is the type of situation when the patient usually takes his auto-injector.

B.
Administer the epinephrine, just in case.

C.
Consult with a paramedic on your service for advice.

D.
None of these

Answer 24

D.
None of these

Question 25

You are called to the local park on a hot summer day for an 8-year-old child in respiratory distress. The child can barely speak and appears to be getting sleepy. Vital signs are blood pressure 90/60, pulse 120, and respiratory rate 32. Your physical exam reveals a swollen tongue, inspiratory stridor, wheezing, and hives on the neck and chest. What condition do you suspect?

Answer 25

Anaphylaxis

Question 26

Which of the following is not a sign or symptom of an allergic reaction involving the skin? A. Itching B. Flushing C. Hives D. Cyanosis

Answer 26

Cyanosis

Question 27

Which of the following is a general term for a substance to which the body may have an anaphylactic reaction?

Answer 27

Allergen

Question 28

Which of the following is most likely to be a complaint of a patient suffering from anaphylaxis?

Answer 28

"My throat feels like it is closing."

Question 28

A 35-year-old female has just eaten lobster and is now complaining of itchy, watery eyes. Her blood pressure is beginning to fall, but she denies difficulty breathing. Which of the following best describes her condition?

Answer 28

Anaphylaxis

Question 29

Which of the following is not an indication that epinephrine is helping the anaphylaxis patient's condition?

Answer 29

Increased dyspnea

Question 30

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 percent. Her lung sounds are clear and equal bilaterally. Her mother states she put "nox-a-sting" on the bites but the bites only seemed to get worse. What condition is the patient suffering from?

Answer 30

Allergic reaction from the hornets' stings

Question 31

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?

Answer 31

Insert an oral airway and apply oxygen at 15 liters per minute by bag-valve mask.

Question 32

Most epinephrine auto-injectors contain how many doses of epinephrine?

Answer 32

One

Question 33

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 does so in short two- to three-word statements. What condition do you suspect?

Answer 33

Anaphylaxis

Question 34

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?

Answer 34

Ask the nursing facility staff to find synthetic exam gloves to wear for contact with this patient.

Question 35

Which of the following is the result of histamine and other chemicals in the body during anaphylaxis?

Answer 35

Capillaries become leaky, bronchoconstriction occurs, and swelling appears in areas around the vocal cords.

Question 36

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?

Answer 36

Try to find out if the casserole contained seafood.

Question 37

Which of the following does a physician not take into consideration when writing a prescription for a patient to obtain an epinephrine auto-injector?

Answer 37

How far the patient lives from medical attention

Question 38

Which of the following would you expect to hear when auscultating the lungs of a patient having an anaphylactic reaction?

Answer 38

Wheezing

Question 39

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

Answer 39

Vasoconstriction

Question 40

Which of the following is the reason why infants rarely experience anaphylactic reactions?

Answer 40

Infants have not yet developed antibodies to allergens.

Question 41

Which of the following is included in the primary assessment of a conscious patient suffering from anaphylactic shock?

Answer 41

Assessing whether the patient is able to speak without difficulty

Question 42

Which of the following changes commonly occurs in the cardiovascular system during anaphylaxis?

Answer 42

Low blood pressure due to vasodilation

Question 43

You are on the scene of a 40-year-old male patient who is anaphylactic and still unresponsive following a single epinephrine injection. Prior to giving the injection, you inserted an oral airway and administered oxygen at 15 liters per minute by bag-valve mask and your partner found diminished lung sounds. Following 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?

Answer 43

Contact medical control and request to administer another dose of epinephrine.