Question 1

You have been called by a family for their mother, who is "not acting right." On scene you find the 69-year-old woman to be confused and seemingly slow in talking. Her airway is open and respirations are 12 per minute. Her pulse is 58 beats per minute and her skin is cool to the touch, despite the thermostat keeping the house at normal room temperature. Family also states that she has been this way for about three days and before then seemed to be doing just fine. Your partner obtains a blood pressure that is 104/52 mmHg. When getting a medical history from the family, which piece of information would make sense, given the presentation of the patient?

Accepted Answer

The patient's symptoms, including confusion, slow speech, and low blood pressure, are consistent with hypothyroidism, a condition caused by a low thyroid hormone level. This information would help confirm the diagnosis and guide appropriate treatment.

Question 2

A patient has been struck by lightning at a picnic. A doctor on scene states that the patient was in cardiac arrest after the strike, but with 1 minute of CPR, has a heartbeat and weak respirations. The patient remains unresponsive. Which one of the following should you do immediately?

Accepted Answer

Given the patient remains unresponsive but has a heartbeat and weak respirations, maintaining an open airway is critical. The jaw-thrust maneuver is appropriate for unresponsive patients, especially if a spinal injury is suspected, which is a possibility with lightning strikes.

Question 3

A young female was weeding her garden when she was bitten on her left hand by an unidentified snake. The primary assessment does not reveal any life threats and vital signs are stable. In caring for this patient, it is critical that the EMT:

Accepted Answer

Removing any constricting items, such as rings, is important in the case of a snake bite due to the potential for swelling. Applying ice, administering epinephrine directly into the bite site, or attempting to capture the snake are not recommended actions in the initial care of a snake bite.

Question 4

A 44-year-old female was hiking in a state park when she was bitten by a snake in her left calf. To get help, she had to hike 4 miles to the first-aid station where you are located. The hike took her 1½ hours. Your assessment reveals a red and swollen area to her leg, and she complains of discomfort to that area. Closer inspection reveals two puncture wounds in the center of the affected area. She asks you if she is going to die from the snake bite. Which one of the following is the best reply?

Accepted Answer

Choice A provides clear and accurate information about snake bites and potential venom reactions. It also encourages the patient to seek medical attention without causing unnecessary alarm or panic.

Question 5

You are transporting a 44-year-old male who was stung multiple times by fire ants. Which one of the following patient statements should concern you most?

Accepted Answer

An allergic reaction to fire ant stings can result in symptoms such as hives, itching, and difficulty breathing. The development of hives is a sign of a systemic reaction, which can progress rapidly and become life-threatening. Therefore, an EMT should be most concerned about the patient's statement of developing hives.

Question 6

A landscaper who has been working in 105 degree weather is responsive to painful stimuli and has an open airway. His breathing is shallow and his radial pulse is weak. His skin is hot and dry and appears to be sunburned. The EMT should immediately:

Accepted Answer

The answer of A landscaper who has been working in...

Question 7

You are treating a patient with suspected heat cramps. Your medical director has issued standing orders for such treatment given the high number of heat-related emergencies to which your service routinely responds. Which one of the following would be appropriate?

Accepted Answer

Administering a salt solution made by mixing one teaspoon of salt in one quart of water and giving half a glass every 15 minutes is an appropriate method to treat heat cramps. This approach helps replace lost fluids and electrolytes, particularly sodium, which is crucial for muscle function and can be depleted during excessive sweating.

Question 8

You are providing a "stand-by" service at the county fair. About midmorning, a 50-year-old male patient approaches your tent and states that he was bitten in the right shoulder by some sort of insect and the pain is tremendous. Assessment reveals his shoulder to have a large reddened area with a bite mark in the middle. The skin is warm to the touch. Your care of this patient should include:

Accepted Answer

Applying a cold pack to the site will help reduce swelling and pain associated with insect bites. Elevating the right hand, scrubbing the site, and massaging the site are all inappropriate interventions for an insect bite.

Question 9

The primary assessment on a teenage male patient who is unresponsive with skin that is hot, moist, and flushed reveals his airway to be open, breathing shallow, and radial pulse weak. You are providing positive pressure ventilation. Which one of the following should you do next?

Accepted Answer

After ensuring the patient is receiving adequate ventilation, the next step is to transfer him to the ambulance for further treatment and transport to a medical facility.

Question 10

You have been called to a park for a teenage boy who is "sick." On scene you find a 16-year-old male who knows his name but is confused about place and time. Friends state that they have been playing basketball most of the morning and afternoon. The temperature is in the 90s and the humidity is high. His airway is patent and his breathing is fast but adequate. His pulse is weak and rapid. Observation of his skin reveals it to be pale, cool, and moist. Oxygen is being administered via nonrebreather face mask. Which one of the following would be appropriate care for this patient?

Accepted Answer

The patient is showing signs of heat exhaustion, characterized by confusion, rapid but weak pulse, and cool, moist skin, especially after physical activity in high temperatures. Placing him supine with feet elevated helps improve circulation to vital organs. Options B, C, and D are not appropriate for his condition. Tylenol is not indicated for heat-related illnesses, and aggressive cooling methods could cause shock.

Question 11

A 31-year-old groundskeeper has been stung by wasps three times in his right arm and left ankle. After performing the primary and secondary assessments, what should you do next?

Accepted Answer

Attempt removal of any embedded stingers.

Question 12

A patient has been bitten by what appears to be a black widow spider. The bite to her left hand is dull and achy and she states that the muscles in her shoulders and back are starting to hurt. After ensuring that no life-threatening conditions are present and administering oxygen, the EMT should:

Accepted Answer

For black widow spider bites, it is important to keep the affected limb below the level of the heart to slow the spread of venom. Massaging the muscles can worsen the symptoms, and applying a hot pack can speed up the spread of venom. Vinegar is also not recommended as it has not been proven to be effective against black widow spider venom.

Question 13

A patient has been bitten by an unidentified snake. Which one of the following statements made by the patient would lead the EMT to believe that the snake was poisonous?

Accepted Answer

Snake species with triangular heads are typically venomous, whereas non-venomous snakes have more rounded heads. The other statements are not necessarily indicative of a poisonous snake.

Question 14

You have been asked by your medical director to put together an emergency kit specifically for patients who have been stung or bitten by small marine life animals. Which one of the following should you place in that kit?

Accepted Answer

Vinegar is the best choice to include in an emergency kit for patients who have been stung or bitten by small marine life animals. Vinegar can help neutralize the toxins from jellyfish, sea anemones, and some types of fish. Cold packs may provide some relief from pain and swelling, but vinegar is the most effective first aid measure for marine animal stings and bites. Cayenne pepper extract and alcohol are not effective treatments for marine animal stings and may actually make the symptoms worse.

Question 15

A 24-year-old female who was hiking in shorts informs you that she has been bitten by an insect on her leg. She states no other complaints. Assessment reveals a tick embedded in her leg. As an EMT, you should provide care to this patient by:

Accepted Answer

The best choice is to remove the tick with tweezers. It is important to grasp the tick as close to the skin as possible and pull it straight out with a steady, even pressure. Avoid twisting or crushing the tick, as this may cause its head and mouth parts to remain embedded in the skin. After the tick is removed, clean the bite site with soap and water and monitor for any signs of infection or illness. It is not appropriate to wrap the tick or apply a hot pack, and administering oxygen is not indicated in this situation.

Question 16

A young man has been struck by lightning on a golf course and is in cardiac arrest. Other golfers say that he was struck about 10 minutes ago. Which one of the following should you do immediately?

Accepted Answer

Immediate cardiopulmonary resuscitation (CPR) is crucial in cases of cardiac arrest to maintain blood flow to vital organs until advanced care can be provided.

Question 17

You have been called to a residence for a spider bite. On scene the homeowner states that he was moving some boxes in his garage when he accidentally grabbed a spider and it bit him. He killed the spider and shows you a brown-colored spider with a "violin shape" on its back. He then states that the bite does not hurt and he sees no need to go to the hospital. As a knowledgeable EMT, you should state:

Accepted Answer

The spider described is likely a brown recluse spider, which has a venomous bite that can cause tissue death and long-term scarring if not treated properly. While the homeowner may not be experiencing pain or swelling at the time, it is important for them to receive medical attention to prevent further complications and possible infection. Therefore, the EMT should strongly encourage the individual to seek medical attention at a hospital.

Question 18

You are en route to the hospital with a patient who is unresponsive and has hot, dry skin. His friends state that he has been drinking and passed out in the hot sun for several hours before 911 was called. An Emergency Medical Responder is ventilating the patient with a bag-valve mask attached to high-concentration oxygen. Which one of the following actions would be most beneficial to the patient at this time?

Accepted Answer

Placing cold packs to the patient's groin and armpits is the most beneficial action in this scenario. This is because the patient is exhibiting signs of heat exhaustion or heat stroke, which can lead to organ damage and even death. Cooling the patient down is crucial, and applying cold packs to these areas can help reduce their core body temperature. The other options, such as inducing vomiting or pouring cold water over the patient, may cause further harm or discomfort.

Question 19

You are transporting a patient who was bitten on her hand by a spider about 20 minutes ago. On scene the primary assessment revealed no life threats and vital signs were stable. While conducting your reassessment, which one of the following would be of most concern to the EMT?

Accepted Answer

The presence of hives on the chest and abdomen may indicate an allergic reaction to the spider bite and could lead to anaphylaxis, a life-threatening condition. Swelling and increased pain to the area of the bite are expected symptoms and may be managed with supportive care. A headache may be a symptom of anaphylaxis, but the hives are a more concerning sign.

Question 20

When cooling a patient with possible heat stroke, which one of the following would be of most concern to the EMT?

Accepted Answer

Shivering after applying cold packs to the neck indicates that the patient may not be responding appropriately to cooling measures and may still be suffering from heat stroke. The other options suggest positive interventions or changes in vital signs.

Quiz 24: Environmental Emergencies