Deck 24: Environmental Emergencies

Question 1

You have been called to a football practice field on a very hot day for a heat-related emergency. On scene you find a young male patient panting and lying under a tree. His skin is flushed and teammates are continually wiping the sweat off his face, arms, and chest with towels. Which one of the following statements is most appropriate?

A) "Keep wiping. You are helping him retain water that his body needs."
B) "Good job guys. By wiping him down you are helping him cool down."
C) "Please let him sweat. It is helping his body cool down."
D) "To keep him from sweating, let's put his shirt back on."

Answer 1

C

Question 2

You have been chosen by the medical director to give a 15-minute presentation on cold-related emergencies to a local volunteer fire department. In preparing the talk, which one of the following points should you emphasize?

A) Emergency responders play a critical role in caring for the hypothermic patient since the most important phase of care occurs during the first 30 minutes.
B) Of the two types of cold-related injuries, a local cold injury, or frostbite, is more life-threatening since it can result in the loss of fingers, toes, arms, or legs.
C) Coma or unresponsiveness in the patient suffering a cold-related injury is actually protective since it decreases the body's energy requirements.
D) A cold-related emergency becomes critical when the body temperature falls below 79°F since at this point the body loses ability to regulate its temperature.

Answer 2

A

Question 3

The EMT should recognize which one of the following patients as suffering from generalized hypothermia?

A) 21-year-old female who was trapped in cold water for 10 minutes before being rescued
B) 19-year-old male who is intoxicated and fell asleep under a fan for three hours
C) 34-year-old male whose fingers and toes are blue from exposure to the cold
D) 87-year-old alcoholic with hand pain and numbness after sweeping snow without gloves

Answer 3

A

Question 4

A young male who was angry with friends wandered away from a party and spent the night outside uncovered in 40 to 50 degree temperatures. He is confused, has decreased but adequate breathing, and a weak radial pulse. His skin is cool and capillary refill delayed. When looking to see if he is shivering, you note that he is not. Based on this presentation, which one of the following can the EMT safely conclude?

A) The patient is exhibiting signs that he is compensating and conserving heat.
B) The patient's body temperature is most likely dangerously low.
C) The absence of shivering indicates the body temperature is almost back to normal.
D) The cause of his confusion is related to alcohol and not the overnight temperatures.

Question 5

Which one of the following patients is losing body heat by the mechanism of convection?

A) 41-year-old female who is intoxicated and passed out in the snow
B) 56-year-old male who is confused and perspiring heavily
C) 63-year-old female who took a drug that depressed her brain function
D) 30-year-old male in cool temperature and exposed to a light breeze

Question 6

A young boy complains of pain to his fingers after spending several hours outside riding a sled in cold winter temperatures. After ensuring he has no life-threatening conditions, you turn your attention to his hands and note that the fingers are cold to the touch. Suspecting that he is suffering from early or superficial cold injury, which one of the following signs or symptoms would help confirm this suspicion?

A) Skin on the fingers that is soft but numb
B) History of being exposed to cold temperatures
C) Swelling and blisters noted to the fingers
D) Firm skin that is cold and numb

Question 7

You are treating a male patient who is hypothermic. What should you do to decrease heat loss caused by radiation?

A) Wrap a towel around the patient's head.
B) Turn off the fan in the back of the ambulance.
C) Wipe the patient's skin down with warm water.
D) Apply warm packs to the patient's body.

Question 8

A patient who is conscious and breathing has been pulled from a stream of cold water. To decrease her loss of heat via the mechanism of conduction, the EMT should immediately:

A) cover her with a blanket.
B) remove her wet clothing.
C) provide positive pressure ventilation.
D) encourage her to stop shivering.

Question 9

Which one of the following indicates the most significant mechanism by which the body can lose heat?

A) Conduction
B) Respirations
C) Radiation
D) Evaporation

Question 10

You have been called to a residence for a patient who is sick. On scene the family tells you that the patient is being treated for the "stomach flu" and has had a fever of 102°F for the past two days. She has been taking all of the medications prescribed by her doctor but this evening became very "sweaty." Assessment shows her to be stable with a pulse of 88, respirations 18, adequate blood pressure of 128/68 mmHg, and an oral temperature of 100.2°F. Based on this, the EMT should recognize the:

A) patient's body is attempting to retain heat by covering itself with sweat, which acts as a barrier to heat loss.
B) sweat is causing the loss of body heat since the sweat is warmer than the body, causing heat to move from inside to outside the body.
C) sweat is causing the body to retain heat since sweat is warmer than the temperature of the body, causing the heat in the body to exit and cool the patient.
D) patient's body is cooling itself by transferring heat into the sweat, which is then evaporated into the air.

Question 11

You have been called for a 78-year-old female who slipped while getting out of her bathtub. She is confused and cold to the touch. You learn that she slipped 24 hours ago and has been on the tile bathroom floor ever since. Since it is summer, she also had her air conditioner running on high. The EMT would best categorize this emergency as:

A) external urban hypothermia caused by a medical complaint.
B) generalized hyperthermia caused by convection.
C) internal urban hypothermia with heat loss caused by conduction.
D) localized external hypothermia caused by immobility.

Question 12

Which one of the following signs would present earliest in the hypothermic patient?

A) Confusion
B) Hypotension
C) Shivering
D) Bradycardia

Question 13

The EMT shows she understands the regulation of temperature in the human body when she states:

A) "If the body becomes too hot or too cold, the brain will send instructions out to the body to either retain or lose heat."
B) "If the air outside the body is cold and the body is too hot, the cold air will move into the body to cool it."
C) "Since the cellular activity in the body constantly generates heat, the body must always be cooler than the air that surrounds it."
D) "For the body's cells to function properly, the human body must always be warmer than the air that surrounds it."

Question 14

You are assessing a conscious but confused hunter who became lost in the woods on a cold day. Your assessment shows him to have an open airway, adequate breathing, and a weak radial pulse. His skin is cold to the touch and he is shivering. The EMT should recognize that the:

A) cold has caused the brain to become dysfunctional, as evidenced by the shivering.
B) shivering actually represents a small seizure, indicating that the brain is cold.
C) shivering is a protective means by which the body is attempting to warm itself.
D) shivering indicates that the patient's core body temperature has fallen below 90°F.

Question 15

An Emergency Medical Responder (EMR) quickly checks the breathing and pulse of a patient with Alzheimer's disease who has been sleeping outside in the cold for several hours. The EMR informs you that the patient grimaces to painful stimuli but is not breathing and does not have a pulse. Your best response would be:

A) "Let's get the automated external defibrillator ready and apply it to the patient."
B) "Someone start CPR, but do not insert an oral airway since this can cause ventricular fibrillation."
C) "We need to contact medical direction to see what the doctor wants us to do since she is hypothermic."
D) "Let's re-perform the primary assessment, and this time take longer to assess for breathing and a pulse."

Question 16

Which one of the following best describes a patient suffering an environmental emergency?

A) Young female who slipped on ice and has pain and deformity to her left arm
B) Male patient who fell into a stream and sustained a laceration to the head after hitting a rock
C) Female who is sick and vomiting after eating potato salad at an outdoor church picnic
D) Intoxicated male patient who collapsed in the snow and is complaining that he feels cold

Question 17

A person is in a hot environment and his body is successfully compensating to off-load excess heat. Which one of the following assessment findings best illustrates this process?

A) Cool and clammy skin, normal blood pressure, slow respirations
B) Warm and diaphoretic skin, elevated heart rate, increased respirations
C) Diaphoretic skin, decreased heart rate, decreased blood pressure
D) Warm skin, elevated heart rate, decreased respirations, decreased blood pressure

Question 18

On entering an apartment for a confused elderly female, you note that the air conditioner is running on high and the room is extremely cold. What other clue obtained during the scene size-up would best indicate that the patient may be hypothermic?

A) Patient covered with diaphoresis
B) Fan blowing directly onto the patient
C) Oxygen concentrator next to the patient
D) Medication for hypertension next to the patient

Question 19

Which one of the following statements about immersion hypothermia is false?

A) "When a patient is pulled from cold water, he should be immediately moved to a warm environment."
B) "Immersion hypothermia typically does not occur until the water temperature is below 35°F."
C) "Adults typically can withstand exposure to colder water for a longer period of time than children."
D) "It is important to remove the clothes of a patient who has been exposed to cold water as soon as possible."

Question 20

You are called for an elderly woman who has slipped on the ice. On arrival you find her supine on an icy sidewalk and responsive to painful stimuli with decorticate posturing (flexion). She has blood coming from a laceration on the back of her head and is breathing agonally at 4 times a minute. Which one of the following should you do immediately?

A) Start positive pressure ventilation.
B) Insert a nasal airway.
C) Perform the jaw-thrust airway maneuver.
D) Remove the patient to the warm ambulance.

Question 21

You have been called to a hunting camp for a patient with a severe localized cold injury to his hand and fingers. The patient is suffering no life-threatening conditions and you elect to rewarm the affected areas. Which one of the following would be appropriate for this patient?

A) Immerse the hand and fingers in water no hotter than 120°F.
B) Place the hand lower than the heart after rewarming is complete.
C) Do not stir the water while the hand is submerged to decrease risk for injury.
D) Thaw and rewarm the tissue as quickly as possible.

Question 22

The EMT is correctly assessing the skin temperature of a patient who has been exposed to cold temperatures for an extended period of time when he:

A) feels the patient's forehead with the back of his hand.
B) places the palm of his hand on the patient's neck.
C) feels the skin temperature on the patient's chest.
D) places the back of his hand on the patient's abdomen.

Question 23

Medical direction has ordered you to begin rewarming an unresponsive patient with a core temperature of 93°F. Which one of the following measures would best benefit this patient?

A) Give him warm fluids to drink to increase internal body temperature.
B) Gently massage the patient's arms and legs.
C) Wrap the patient in several warm blankets.
D) Place one extremity at a time in warm water.

Question 24

The EMT shows that he understands the danger of heat stroke when he states:

A) "In heat stroke, the body loses its ability to rid itself of excess heat, causing the core temperature to rise."
B) "Heat stroke is a dire emergency since the body has lost much of its fluid and ability to circulate oxygen."
C) "The EMT can identify heat stroke because the patient will have skin that is warm and dry instead of hot and moist."
D) "Heat stroke occurs when the patient's blood vessels have overdilated, causing a mild state of shock."

Question 25

When moving a patient with severe generalized hypothermia, which one of the following instructions is most appropriate?

A) "I want everyone to take extra care in moving her very gently to the stretcher. We do not want her to go into cardiac arrest."
B) "Be careful when moving her to the stretcher; the cold makes the patient very prone to bone fractures."
C) "Let's place her on her side on the stretcher since her body temperature contraindicates placement of a nasal airway."
D) "Let's secure her with her arms and legs extended since this position promotes the retention of heat in the body."

Question 26

You have initiated the rewarming of a local cold injury to a patient's hand and fingers. On scene the patient had no sensation in his hand or fingers. Which one of the following statements is a cause of concern when made by the patient?

A) "The blisters on my fingers haven't broken yet."
B) "My fingers are really starting to hurt now!"
C) "There is no pain when I rub my fingers with my other hand."
D) "My hand is feeling funny. It seems to be starting to tingle a little bit."

Question 27

You are called to a construction site on a hot and humid day for a male patient suffering a heat emergency. On scene you find a 49-year-old man who is responsive to verbal stimuli. Coworkers state that the patient has been moving concrete blocks all day in the hot weather and has not rested, eaten, or had anything to drink in the past 2 hours. After conducting the primary assessment, you note his airway to be open and breathing rapid but adequate. His radial pulse is rapid and bounding, and his skin is hot and dry. Which one of the following signs makes this patient a priority for immediate and rapid transport?

A) Bounding pulse
B) Altered mental status
C) Hot and dry skin
D) Tachypneic respirations

Question 28

Which one of the following signs or symptoms best indicates that the patient with cold skin is suffering from generalized hypothermia?

A) Blood pressure of 108/60 mmHg
B) Respirations of 24 per minute
C) Heart rate of 48 beats per minute
D) Pulse oximetry reading of 95%

Question 29

After successfully rewarming a foot and frozen toes, the EMT should:

A) cover the foot and toes with dry, sterile dressings.
B) gently massage the foot and toes.
C) ambulate the patient to ensure return of adequate motor function.
D) place the foot below the level of the heart to enhance circulation.

Question 30

The EMT should recognize heat cramps as the probable cause of a patient's problem when the patient states:

A) "I am having a hard time moving my fingers."
B) "I cannot remember what day it is."
C) "I have pain in my belly and legs."
D) "My neck feels as though it is in spasm."

Question 31

You have been called for an alert and oriented male patient whose friends state he spent several hours locked out of his house in the cold temperatures. Since the primary and secondary assessments have ruled out immediate life-threatening conditions, you have decided to rewarm the patient. Which one of the following would be most appropriate for this patient?

A) Placement in a tub of warm water
B) Hot packs to the patient's chest, groin, and armpits
C) Massaging of the arms and legs after applying warm blankets
D) Blowing hot air with a hair dryer over the patient's arms and legs

Question 32

At an in-service, your medical director asks if anyone can tell her the cause of heat cramps. What response would be most appropriate?

A) "They are thought to occur when the patient does not consume enough water and becomes dehydrated."
B) "They are caused when the patient's electrolytes such as salt and calcium are lost and become too low in the body."
C) "They occur when the body can no longer compensate and off-load excess heat."
D) "They occur when blood vessels constrict and decrease blood flow to the affected muscle."

Question 33

Bystanders have called 911 for a female who lives on the street because she has been outside in the cold all night and is muttering incomprehensible words. Her airway is open and her breathing is adequate. Her skin is cold and a radial pulse is present but weak. Oxygen has been applied. Which one of the following should you do next?

A) Perform a secondary assessment.
B) Obtain a blood pressure.
C) Assess breath sounds.
D) Transfer her into the ambulance.

Question 34

When providing oxygen to a patient with a core temperature of 95 degrees and adequate breathing, which one of the following is best?

A) Positive pressure ventilation with warm oxygen
B) Humidified oxygen delivered through a nonrebreather face mask
C) Oxygen that is warmed and humidified via nonrebreather mask
D) Warm but nonhumidified oxygen through a nonrebreather face mask

Question 35

A hypothermic patient is in cardiac arrest. The automated external defibrillator (AED) is applied and delivers one shock. Which one of the following actions would the EMT perform next?

A) Start cardiopulmonary resuscitation.
B) Reanalyze the patient's heart rhythm.
C) Provide ventilations but not compressions.
D) Check for a pulse.

Question 36

You are giving a talk on hunting safety. A hunter asks you when one should attempt to rewarm a hand or foot that is frostbitten. Your best response should be:

A) "You never want to rewarm a frozen body part since that can cause additional damage."
B) "Only attempt to rewarm a frozen body part if the person still has some feeling in it."
C) "It is best to attempt rewarming in any situation because the benefit of rewarming outweighs the risk of not rewarming."
D) "Rewarming should only take place when there is no chance that the tissue will refreeze."

Question 37

A core temperature is most accurately assessed on a patient who has been exposed to cold temperatures by placing a:

A) tympanic thermometer in the patient's ear.
B) medical-grade thermometer in the patient's rectum.
C) household rectal thermometer in the patient's rectum.
D) thermometer into the patient's mouth.

Question 38

Which statement made by an EMT shows that he understands the care of a patient with a localized cold injury to the foot?

A) "While it is best to remove wet clothing from the patient, it is best to leave clothing that is frozen to the skin in place."
B) "If the patient has blisters on his foot, it is beneficial to break them so the fluid inside will not freeze and cause additional injury."
C) "Gentle massage of the foot has been shown to help the patient since this enhances the circulation of warm blood to the cold area."
D) "The EMT should avoid immobilizing the foot since this will further decrease circulation of blood into the cold area."

Question 39

When obtaining a history of a 5-year-old boy with generalized hypothermia, which one of the following questions should be asked first?

A) "Are all of his childhood shots up to date?"
B) "How long was he out in the cold?"
C) "When did he eat or drink last?"
D) "Why was he outside without adult supervision?"

Question 40

Which one of the following patients would be the highest priority for transport?

A) 24-year-old who is intoxicated and is complaining of pain and spasms to his legs
B) 34-year-old with confusion and cool diaphoretic skin along with tachycardia
C) 28-year-old responsive to verbal stimuli with tachycardia and cool, moist skin
D) 19-year-old responsive to verbal stimuli with hot dry skin and tachycardia

Question 41

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?

A) "Mom suffers from a low thyroid."
B) "She takes a daily vitamin every day."
C) "Mom had her gallbladder out last year."
D) "She used to take a blood pressure pill."

Question 42

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?

A) Provide care to the burn injury on the patient's back.
B) Perform the jaw-thrust maneuver.
C) Initiate positive pressure ventilation.
D) Attach the automated external defibrillator.

Question 43

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:

A) apply ice packs to the area of the snake bite.
B) administer the epinephrine auto-injector into the site.
C) have the patient remove her wedding ring from her left hand.
D) attempt to locate the snake for identification.

Question 44

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?

A) "You need to get checked out, but if venom was injected, the signs and symptoms of a generalized reaction typically appear very quickly."
B) "We need to get you to the hospital immediately. Anytime that a snake bites it injects venom from its fangs."
C) "Based on the way the bite looks, I think that you were bitten by a nonpoisonous snake."
D) "Walking all of that distance probably saved you since your body metabolized the poison faster."

Question 45

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?

A) "I am beginning to feel itchy all over and have a hive."
B) "The bites are really beginning to hurt more."
C) "I took some Motrin this morning for a headache."
D) "My hand seems to be more swollen now."

Question 46

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:

A) start positive pressure ventilation.
B) wrap him in a sheet soaked with cool water.
C) administer oxygen through a nonrebreather face mask.
D) obtain a full set of vitals.

Question 47

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?

A) Mix one teaspoon salt in one quart of water and administer half of a glass every 15 minutes.
B) Make and administer a salt water solution by combining Gatorade with one teaspoon of salt.
C) Administer salt tablets every 15 minutes until the cramping subsides.
D) Have the patient drink one quart of cold tap water every 15 minutes until he has to urinate.

Question 48

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:

A) elevating the right hand.
B) applying a cold pack to the site.
C) scrubbing the site with soap and sterile water.
D) massaging the site gently.

Question 49

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?

A) Perform a secondary assessment.
B) Transfer him into the ambulance.
C) Get a medical history.
D) Re-perform the primary assessment.

Question 50

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?

A) Place him supine on the stretcher with feet elevated.
B) Lay the patient down and place in side-lying position.
C) Administer Tylenol tablets by mouth to lower the body temperature.
D) Pour cold water over the patient and fan him aggressively.

Question 51

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?

A) Place a constricting band above the sting sites.
B) Wash the sting sites with sterile water and soap.
C) Attempt removal of any embedded stingers.
D) Apply ice packs to the sting site for pain relief.

Question 52

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:

A) pour a vinegar solution over the bite.
B) keep the hand below the level of the heart.
C) massage the muscles of the back and shoulders.
D) apply hot packs to the bite.

Question 53

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?

A) "Its eyes were round."
B) "It was about two feet long."
C) "Its head was triangular."
D) "It had a stripe down its back."

Question 54

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?

A) Cold packs
B) Cayenne pepper extract
C) Alcohol
D) Vinegar

Question 55

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:

A) wrapping the tick and bite area with roller gauze.
B) administering high-concentration oxygen.
C) removing the tick with tweezers.
D) applying a hot pack over the tick.

Question 56

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?

A) Start cardiopulmonary resuscitation.
B) Attach the automated external defibrillator.
C) Ventilate 10 to 12 breaths per minute.
D) Do a secondary assessment to locate the burn sites.

Question 57

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:

A) "Since the bite of that spider generally causes immediate pain and swelling, you probably can go without additional medical attention."
B) "You should be okay by refusing transport, but make sure to wash the bite site daily with soap and water."
C) "Let us take you to the hospital. They have an antivenom that will allow this to heal and make you resistant to future bites."
D) "You really need to go because the bite of that spider does not heal very well and will put you at risk for infection."

Question 58

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?

A) Be prepared for vomiting by placing him in a prone position.
B) Wrap him in a sheet that has been soaked with cold water.
C) Place cold packs to the patient's groin and armpits.
D) Gently pour cold water over the patient to rapidly cool him down.

Question 59

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?

A) Swelling to the area of the bite
B) Increased pain to the area of the bite
C) Complaint of a headache
D) Hives to the chest and abdomen

Question 60

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

A) Blood pressure increasing to 102/78 mmHg
B) The heart rate going from 140 beats to 120 beats per minute
C) Observing your partner apply a sheet soaked in tepid water to the patient
D) Determining that the patient is shivering after having cold packs applied to the neck

Question 61

A hypothermic patient is alert and confused but complaining of left arm pain. His friends found him outside where he spent the night after he passed out in the cold. It appears as though he has a localized cold injury to the arm in question. In caring for this patient, which of the following would be acceptable?

A) Warm water to raise his internal body temperature
B) Ambulation to get warm blood flowing to all areas of his body
C) Placement in a hot shower to expedite the rewarming process
D) Immobilization of the arm to keep it from moving

Question 62

A patient at a mountain ski resort presents to you with notable shortness of breath. She denies any past medical history and takes no medications. Your assessment reveals crackles to the bases of both lungs. After applying oxygen, you realize that the key to helping this patient improve is to:

A) remove to a lower altitude.
B) administer albuterol by a metered-dose inhaler.
C) position her in a left lateral recumbent position.
D) place her in a supine position with legs elevated.

Question 63

Regarding snakebites, the EMT would recognize which statement as true?

A) Over half of all snake bites involve intoxicated males.
B) The majority of snakebites involve nonpoisonous snakes.
C) Over 75% of all poisonous snakebites involve the injection of venom.
D) The majority of snakebites result in death of the patient.

Question 64

It is the coldest stretch of winter and you just finished up transporting an 86-year-old male who was found severely hypothermic in his apartment with the thermostat set at 50ᵒF. You and your partner are discussing the call and how this situation may have arisen. Which statement would be most appropriate?

A) "Events like this are typically the first sign that a patient has dementia."
B) "I am surprised since as you age you do not need as much heat to keep warm."
C) "As you age, your hormones trick your body into feeling warm, when it is not."
D) "He may have had financial concerns of how he was going to pay for the heat."

Question 65

You are first to arrive at the side of a pond where a boy playing hockey has fallen through the ice. He is holding onto the ice at the edge of the break and has a distressed look on his face. Your immediate action would be to:

A) carefully slide on your abdomen out to the patient.
B) instruct the patient to remain still until the rescue team arrives.
C) tell the patient to keep moving to keep warm.
D) place tarps on the ice and carefully walk out to the patient.

Question 66

You have been summoned to a beach for a young male who has been stung by jellyfish on both forearms. Which one of the following instructions to other EMTs shows proper care of this patient?

A) "Make sure to keep the arms below the heart."
B) "Let's put a constricting band on his wrists."
C) "We need to rinse the sting sites with peroxide."
D) "Let's soak the arms in warm water."

Question 67

What statement would require immediate correction when treating a hypothermic patient with a deep cold injury to his left foot, ankle, and lower leg?

A) "Why don't we rewarm his lower left leg as quickly as possible."
B) "It is important that we keep the left leg elevated."
C) "We will need to gradually rewarm the patient at a rate of 2 to 3 degrees per hour."
D) "Since his SpO₂ is 98%, we may not need to administer any oxygen."

Question 68

You are caring for a patient with an extensive cold injury to his right hand and arm. Which of the following instructions would be appropriate?

A) "Why don't we get that ring off his right ring finger."
B) "We need to move the right arm to promote blood flow into it."
C) "I need someone to apply hot packs to the right hand and arm."
D) "Will someone please carefully cut off the frozen clothing on his arm?"

Question 69

You are accompanying a team of hikers climbing a high mountain. In the morning, you are summoned to a tent and find one of the climbers confused and complaining of a headache. His airway is patent and respirations adequate. He has no medical history and was in good health until found this morning by his friend. Suspicious of high-altitude cerebral edema (HACE), you should do which one of the following?

A) Immobilize the patient.
B) Provide high-concentration oxygen.
C) Insert an oropharyngeal airway.
D) Administer oral glucose.

Question 70

When treating a confused patient who has been exposed to high temperatures, which finding is most concerning?

A) SpO₂ 94%
B) Bounding radial pulse
C) Cramping in arms, legs, and abdomen
D) Hot and dry skin

Question 71

An 18-month-old has a temperature of 105.2ᵒF. Without treatment, which of the following will occur?

A) Fluid overload
B) Cellular dysfunction
C) Hypertension
D) Drying of the skin

Question 72

The EMT recognizes that the primary center for controlling the temperature in the human body is located in the:

A) brainstem.
B) skin.
C) hypothalamus.
D) pons.

Question 73

The EMT would recognize that a hypothermic patient is deteriorating when he observes:

A) slurred speech.
B) vigorous shivering.
C) red-colored skin.
D) painful extremities.

Question 74

You have been summoned to a field where a 32-year-old male patient has been struck by lightning. Emergency Medical Responders are with the patient holding manual in-line spinal stabilization. Once you arrive at the patient's side, which one of the following should you do first?

A) Apply a cervical spine collar.
B) Perform a secondary assessment.
C) Assess the airway and breathing.
D) Place the patient on the stretcher.

Question 75

An intoxicated 24-year-old female has been struck by lightning and is conscious but confused. Which one of the following assessment findings should the EMT investigate first?

A) Burns to both arms
B) Irregular heartbeat
C) Deformity to the left wrist
D) Unequal pupils

Question 76

In what situation will the means of sweating to cool the body be less effective?

A) Relative humidity of 98%
B) Outdoor temperature of 92ᵒF
C) Internal temperature of 102ᵒF
D) Indoor humidity of 68%

Question 77

After ensuring that there are no life-threatening conditions to the airway, breathing, and circulation, the priority in caring for the hypothermic patient is:

A) providing passive rewarming.
B) assessing for complications.
C) preventing additional heat loss.
D) starting active rewarming measures.

Question 78

A patient is confused and combative after playing football in the open sun on an extremely hot day. On the field, you find his airway open, respirations tachypneic, but adequate, and radial pulse rapid. His skin is hot and dry. After applying oxygen, your next action would be to:

A) provide the patient with cold water for rehydration.
B) apply cool compresses to his arms and legs.
C) move patient to the air-conditioned ambulance.
D) ascertain if the patient has any medical problems.

Question 79

You are reassessing a patient you are treating for heat exhaustion. Which of the following indicates that the patient is improving?

A) The skin is now hot and dry.
B) The mental status is now alert and oriented.
C) The patient now exhibits shivering.
D) The core temperature has only increased by 0.5ᵒF.

Question 80

As an EMT working at a mountain resort, you are presented with a 50-year-old female who states that she does not feel well. From your assessment, which one of the following findings would seemingly indicate that the patient is being adversely affected by the high altitude?

A) Vomiting after eating large meals
B) Elevated blood glucose with no history of diabetes
C) Heart rate of 62 beats per minute
D) Complaint of dyspnea on exertion