When treating patients with environmental emergencies, it is important to remember such emergencies:

H-1) Keys to effectively managing an environmental emergency are _____________ and providing prompt and proper emergency care.A. assessing scene safetyB. moving the patient to a location of safetyC. identifying any preexisting conditions the patient has

D. recognizing the patient's signs and symptoms

The keys to effective management of an environmental emergency are recognizing the patient's signs and symptoms and providing prompt and proper emergency care.

H-2) Which of the following is an example of an environmental emergency?A. MeningitisB. Myocardial infarctionC. Subdural hematoma

D. Deep local cold injury

Environmental emergencies include both heat and cold exposure; drownings and other water-related injuries; high altitudes; and bites and stings from insects, spiders, snakes, and marine life. Deep local cold injury or frostbite is a form of cold exposure.

H-3) Hypothermia is:A. generalized cooling that raises body temperature above normal.B. localized cooling that reduces body temperature below normal.C. localized cooling that raises body temperature above normal.

D. generalized cooling that reduces body temperature below normal.

Hypothermia is generalized cooling that reduces body temperature below normal. Extreme hypothermia is a life-threatening condition.

H-4) Your patient is immersed in cold water. Which of the following will cause the fastest loss of body heat?A. EvaporationB. ConductionC. Radiation

D. Respiration

B. Conduction

Although body heat transferred directly into cool air is a problem, water chill is an even greater problem, because water conducts heat away from the body 25 times faster than still air.

H-5) Which of the following factors contributes LEAST to the risk of hypothermia for an elderly patient?A. Lack of exerciseB. RetirementC. Failing body systems

D. Poor diet

B. Retirement

Failing body systems, chronic illnesses, poor diet, certain medications, and a lack of exercise may combine with the cold environment to bring about hypothermia. Simply retiring isn't in itself a risk factor for hypothermia, although a retiree on a fixed income might live in inadequate conditions that can present risk factors for the condition.

H-6) In extreme cases of a decreased level of consciousness, a hypothermic patient may have a:A. clenched jaw.B. harsh laugh.C. neutral expression.

D. glassy stare.

In extreme cases of a decreased level of consciousness, a hypothermic patient may have a glassy stare.

H-7) Which of the following findings would LEAST make you suspect frostnip?A. The patient has fallen in cold water.B. The patient has touched a cold object.C. The patient has been outside in cold weather.

D. The patient has drunk something cold.

D. The patient has drunk something cold

A patient who has drunk something cold isn't necessarily at risk for frostnip, but the other situations could all present a risk for frostnip if the object, water, or weather were sufficiently cold.

H-8) A disoriented elderly patient is found in his apartment with inadequate breathing. It's the middle of winter, and the temperature outside is below freezing. What other factor involved in this patient's situation may most make you suspect hypothermia?A. You find the patient lying on the floor of his room.B. The patient might have had one drink in the past 24 hours.C. The patient has the room heat set to 70F.

D. The patient is wearing a thick sweater and is wrapped in a shawl.

A. You find the patient lying on the floor of his room.

Of these factors, the most indicative of potential hypothermia would probably be the patient's lying on the floor of his room, which in cold weather could be a hypothermia risk, especially if the patient's apartment is kept too cool. Alcohol would increase suspicion for hypothermia if intoxication had led the patient to expose himself to cold, but one drink in 24 hours doesn't necessarily indicate a high risk for hypothermia on its own.

H-9) The specific term for application of heat to the lateral chest, neck, armpits, and groin of a hypothermic patient is:A. active rewarming.B. central rewarming.C. passive rewarming.

D. conduction.

B. central rewarming

Central rewarming is the application of heat to the lateral chest, neck, armpits, and groin of a hypothermic patient. It is a type of active warming, but the generalized term "active warming" does not specify where an external source of heat should be applied.

H-10) Active rewarming is used for hypothermic patients:A. who are responding appropriately.B. with no palpable pulse.C. with severe bradycardia.

D. who are unresponsive.

A. who are responding appropriately.

Active rewarming is typically used only for patients who are alert and responding appropriately.

H-11) Which of the following is a risk of active rewarming?A. TachycardiaB. Cardiac arrestC. Hypoglycemia

D. Hypertension

B. Cardiac arrest(Page 1020 - Central rewarming)

Rapid rewarming may circulate stagnant blood too quickly, leading to cardiac arrest.

H-12) You have removed an alert hypothermic patient from a cold environment, and are now ready to begin actively rewarming. After removing the patient's wet clothes, you should NOT:A. massage the patient's extremities.B. wrap the patient in dry blankets.C. dress the patient in dry clothes.

D. keep the patient still.

A. massage the patient's extremities.

Do not massage the patient's extremities. When rewarming an alert hypothermic patient, you should remove the patient's wet clothes and dress the patient in dry clothes or wrap the patient in dry blankets. Keep the patient still and handle the patient very gently. Do not allow such patients to walk or exert themselves.

H-13) Which of the following is an acceptable method of actively rewarming a hypothermic patient?A. Get the patient moving, to walk off the cold.B. Immerse the patient in a bath of water warmed to about 100*F.C. Place heat packs on the groin, neck, armpits, and chest.

D. Give the patient a large cup of coffee.

C. Place heat packs on the groin, neck, armpits, and chest.(Page 1020 - central rewarming)

Active rewarming in the prehospital setting should involve central rewarming of the patient by applying heat packs to the groin, neck, armpits, and chest. A warm bath is helpful for patients when transport is delayed, but it should not entail too much heat too quickly. A patient should be kept still, and should not be given stimulants.

H-14) Which group is LEAST likely to have poor thermoregulation?A. InfantsB. NewbornsC. Teens

D. Elderly people

C. Teens

Teens as a group do not often have poor thermoregulation, although newborns, infants, and elderly people do often have poor thermoregulation.

H-15) What can deceive people into overexertion and hyperthermia?A. Dry heatB. Moist heatC. Evaporative heat loss

D. Conductive heat loss

A. Dry heat

Moist heat usually tires people quickly, and frequently stops them from harming themselves through overexertion. Dry heat, in contrast, often deceives people. They continue to work or remain exposed to excess heat far beyond what their bodies can tolerate.

H-16) A 72-year-old woman lives in an apartment without air conditioning. There is currently a severe heat wave with high humidity. The woman's neighbor finds her responsive only to pain, and with hot, red, dry skin. What assessment finding would you LEAST suspect with this patient?A. Heavy perspirationB. Rapid, shallow breathingC. Full and rapid pulse

D. Dilated pupils

A. Heavy perspiration

For a patient presenting with low responsiveness and hot, red, dry skin, you would expect little or no perspiration but would expect a full and rapid pulse, dilated pupils, and rapid, shallow breathing.

H-17) Which of the following interventions is NOT appropriate for a patient with hot skin?A. Aggressively fanning the patientB. Administering oxygen by nonrebreather mask at 15 lpmC. Giving the patient sips of water

D. Transporting the patient immediately

C. Giving the patient sips of water

For a patient with hot skin dry or moist you would not give the patient sips of water, but you would transport the patient immediately, administer oxygen, and attempt to cool the patient down by such means as aggressively fanning the patient.

H-18) One rescuer in deep water should, when finding a patient facedown in the water, swim to a position beside the patient, support the patient's head with one hand and the mandible with the other, rotate the patient by ducking under the patient, and:A. lift the patient from the water.B. release manual in-line stabilization.C. continue to rotate until the patient is faceup.

D. immobilize the patient's spine with a backboard.

C. continue to rotate until the patient is faceup.

One rescuer in deep water should, when finding the patient facedown in the water, swim to a position beside the patient, support the patient's head with one hand and the mandible with the other, rotate the patient by ducking under the patient, and continue to rotate until the patient is faceup, maintaining manual in-line stabilization until the patient can be immobilized on a backboard. This should only be done if the rescuer is a very good swimmer and trained in water rescue.

H-19) To provide a drowning patient who is conscious and alert but too far away for you to reach with a means of flotation, throw:A. a surfboard that you can see on the beach about 50 yards away.B. any personal flotation device, even if you have to run to get it.C. a ring buoy that you remember seeing at a pier you drove past 2 minutes ago.

D. any object that will float you have on hand.

D. any object that will float you have on hand(Page 1037 -Figure 35-9 shows everything from actual flotation devices to foam coolers)

If the person you need to rescue is conscious and alert but too far away for you to reach and pull from the water, throw an object that will float. A personal flotation device (PFD or lifejacket) or ring buoy (life preserver) works best. Other buoyant objects include foam cushions, logs, plastic picnic containers, surfboards, flat boards, large beach balls, and plastic toys. Two empty, capped plastic milk jugs can keep an adult afloat for hours. Inflatable splints can be used if there is nothing at the scene that will float. In this case, using any flotation device you have on hand is better than going in search of a more ideal device.

H-20) When considering a water rescue of a patient, it is most important to consider:A. whether getting into the water might involve swimming against a current.B. the safest way to rescue the patient for both you and the patient.C. the weight of the patient, as far as you can determine it.

D. whether the patient seems to have become unresponsive.

B. the safest way to rescue the patient for both you and the patient.

When considering a water rescue of a patient, it is most important to consider the safest way to rescue the patient for both you and the patient. Specific considerations such as the patient's weight and current conditions are factors that might be part of overall safety conditions, but will not always be the most important considerations for every given case. Seeing that the patient has become unresponsive is important, but would not be more important than considering the safest method of rescue.

H-21) A boating accident may produce a range of injuries, such as:A. evaporation, conduction, radiation, and convection.B. hypothermia and hyperthermia.C. heat cramps, heat exhaustion, and heat stroke.

D. fractured bones, bleeding, soft-tissue injuries, and airway obstructions.

A boating accident may produce a range of injuries, such as fractured bones, bleeding, soft-tissue injuries, and airway obstructions. The other choices are conditions that may be caused by long-term exposure to heat or cold or by processes by which the body loses heat.

H-22) Very cold water:A. has no effect on resuscitation.B. may increase the chance of resuscitation.C. may decrease the chance of resuscitation.

D. requires that the patient be kept in the water for resuscitation.

B. may increase the chance of resuscitation.

Very cold water may have a protective effect for a short time. Some patients who drown in cold water can be resuscitated after 30 minutes or more in cardiac arrest. Once the water temperature falls below 70*F, biological death may be delayed. The colder the water, the better the patient's chances for survival, unless generalized hypothermia produces lethal complications.

H-23) What is a sign or symptom common to air emboli and decompression sickness?A. ConvulsionsB. Personality changesC. Chest pains

D. Choking

C. Chest pains

Both a patient with an air embolism and a patient with decompression sickness may present with chest pains, but convulsions are more likely with an air embolism, and personality changes and choking are more likely with decompression sickness.

H-24) You are treating a patient at high altitude who complains of shortness of breath at rest. She has a dry cough and a mild fever. While you are gathering her history, she begins coughing up blood. You should suspect:A. high-altitude pulmonary edema.B. high-altitude cerebral edema.C. acute mountain sickness.

D. hypothermia.

A. high-altitude pulmonary edema.

Common signs and symptoms of high-altitude pulmonary edema include shortness of breath (initially just on exertion but later also at rest), dry cough that progresses to coughing up blood, tachypnea, tachycardia, mild fever, oxygen saturation lower than asymptomatic people in the same environment, and respiratory failure or arrest.

H-25) Which of the following symptoms is seen in high-altitude cerebral edema but not in acute mountain sickness?A. Altered mental statusB. NosebleedC. Fatigue

D. Headache

A. Altered mental status

Altered mental status is seen in high-altitude cerebral edema but not in acute mountain sickness. Nosebleed is seen in acute mountain sickness but not in high-altitude cerebral edema. Headache and fatigue are common to both conditions.

H-26) Which of the following statements about insect bites and stings is true?A. Most insect bites lead to systemic complications.B. Ant bites often transmit Lyme disease.C. Black widow bites typically cause delayed reactions after several hours.

D. Brown recluse bites are usually painless.

Bites from brown recluse spiders can cause tissue damage but are usually painless.

H-27) You are treating a patient for an insect sting, and during your assessment you see the stinger. You should:A. roughly scrape at the stinger with a blade or card, to break the visible part off.B. push the stinger into the skin until it is completely beneath the epidermis.C. avoid pulling out the stinger with tweezers, even if you have them on hand.

D. remove the stinger as quickly as possible by the best available means.

To remove the stinger or venom sac, the traditional advice was to scrape the site with a blade or a card and to avoid pulling with tweezers. (It was thought using tweezers might squeeze more venom into the wound.) However, research indicates that how you remove the stinger or venom sac is far less important than doing so quickly. The venom sac is actually hard, not floppy, so squeezing venom into the wound is very difficult.

PT-1) Which of the following is most likely related to cardiac arrest in a drowning victim?A. HypoglycemiaB. Respiratory arrestC. Spinal trauma

D. Cardiac dysrhythmias

PT-2) When treating patients with environmental emergencies, it is important to remember such emergencies:A. may involve preexisting conditions or involve additional injuries.B. typically represent direct threats to your personal safety.C. involve few signs or symptoms to help you determine proper care.

D. are highly unlikely to occur in urban or suburban areas.

D. are highly unlikely to occur in urban or suburban areas.(Page 1015 states that "Environmental Emergencies may involve pre-existing conditions or cause additional medical problems and injuries.

I selected A the first time, however, the test counted me wrong. There is NO mention of the above answer in the book.

PT-3) If you are caring for a patient with a bee sting and the stinger is still present, what is the best course of action?A. Use a specially designed tweezer device to remove it. B. Remove it quickly by the best means available.C. Slowly and carefully remove it by scraping with a blade or card.

D. Leave it in place until arrival at the hospital.

B. Remove it quickly by the best means available.

PT-4) For a patient with severe hypothermia, you:A. should avoid both passive and active rewarming until reaching the emergency department.B. provide both passive and active rewarming to the patient.C. provide passive rewarming but do not actively rewarm the patient.

D. should actively rewarm the patient as soon as possible.

C. provide passive rewarming but do not actively rewarm the patient.

PT-5) You suspect that your patient has a deep local cold injury. Which of the following signs or symptoms would you expect?A. Reddened or lightened skinB. Skin that remains soft but is cold to the touchC. Numbness of the affected area

D. White, waxy-appearing skin

PT-6) Which of the following statements best describes conductive heat loss?A. The transfer of heat from one material to another through direct contactB. The transfer of heat from one material to another without physical contactC. The process of breathing in cold air from the atmosphere

D. The process of a liquid or solid's changing to a vapor

A. The transfer of heat from one material to another through direct contact

Page 1015

PT-7) Venom is a toxin:A. manufactured by humans.B. secreted by plants.C. produced by certain animals.

D. produced as a byproduct of a chemical process.

C. produced by certain animals.

PT-8) Which of the following statements about the body's response to heat loss is true?A. The skin becomes flushed.B. Shivering stops when the patient becomes severely hypothermic.C. The first response to a decrease in body temperature is vasodilation.

D. The initial reaction to hypothermia is a drop in heart rate.

B. Shivering stops when the patient becomes severely hypothermic.

PT-9) Which of the following is most common after an insect bite?A. HypotensionB. HemorrhageC. Seizures

D. Localized pain or itching

PT-10) When caring for a patient with high-altitude cerebral edema or high-altitude pulmonary edema, what is your priority?A. Administering high-concentration oxygenB. Minimizing physical activityC. Ensuring proper hydration

D. Arranging for immediate descent to a lower altitude

PT-11) Which of the following may be dangerous if done incorrectly or used when not indicated?A. Applying a thermal blanketB. Removing wet clothingC. Passive rewarming

D. Active rewarming

PT-12) You are treating a patient at 6,000 feet altitude. The patient arrived about eight hours ago, and reports a diffuse headache that he describes as being similar to a hangover, though he has not consumed any alcohol. He also reports feeling nauseous. Assessment of his vital signs reveals tachycardia. Based on these symptoms, the patient is most likely experiencing:A. fatigue related to a change in altitude.B. high-altitude cerebral edema.C. high-altitude pulmonary edema.

D. acute mountain sickness.

PT-13) Which of the following types of patients typically have an ineffective shivering response to cold?A. Pregnant patientsB. Behavioral patientsC. Pediatric patients

D. Adolescent patients

PT-14) You are caring for a patient with a suspected heat-related emergency. The patient is confused, and presents with cool, moist skin; nausea; and vomiting. How should the patient be transported?A. Supine positionB. Trendelenburg positionC. Fowler's position

D. On the left side

PT-15) When too little heat is generated to be available to all parts of the body, then:A. muscular activity in the form of shivering increases.B. exposed tissues are damaged, and body functions reduce or cease.C. the body reduces circulation to compensate.

D. the body reduces perspiration to compensate.

B. exposed tissues are damaged, and body functions reduce or cease.

PT-16) You suspect that your patient is suffering from severe hypothermia. When checking for a pulse, you should check for:A. at least 60 seconds.B. no more than 10 seconds.C. 6 seconds.

D. 3045 seconds.

PT-17) Which of the following steps is included in the emergency care of a patient who was bitten by a poisonous snake?A. Applying a tourniquet above and below the injection siteB. Applying a paste of baking soda and water to the sting siteC. Applying an ice pack

D. Keeping any bitten extremities immobilized and still

PT-18) Rough handling of a hypothermic patient may lead to:A. hypertension.B. ventricular fibrillation.C. tachycardia.

D. spontaneous fractures.

B. ventricular fibrillation.

PT-19) Which of the following is used to reduce the pain from injection of venom by a marine animal?A. Saline solutionB. IceC. Hot water

D. Cold water

PT-20) Which of the following statements is true?A. Only patients who are outdoors are at risk for a heat or cold emergency.B. Pediatric patients are physiologically well equipped to deal with extreme cold.C. Pediatric and geriatric patients are especially at risk for hypothermia.

D. Hypothermia is not a risk unless the ambient temperature is at or near freezing.

C. Pediatric and geriatric patients are especially at risk for hypothermia.

PT-21) Which of the following is NOT an example of an environmental emergency?A. High-altitude cerebral edemaB. Heat exhaustionC. Peritonitis

D. Jellyfish sting

PT-22) Which of the following items is most important to have immediately available in managing a drowning victim?A. SuctionB. Nonrebreather maskC. A blood pressure cuff

D. Backup AED

PT-23) Which of the following statements should you use as a guideline in managing patients with a local cold injury?A. Do not re-expose the patient to cold.B. Immediately thaw the affected extremity, even if rescue conditions may lead it to be refrozen.C. If the patient must walk to get to help, first thaw an affected lower extremity.

D. Gently massage the affected part to break down ice crystals in the tissues.

A. Do not re-expose the patient to cold.

PT-24) In a hot environment, the air being inhaled:A. is always the same temperature as exhaled air.B. is cooled when it is exhaled.C. is still much colder than the air being exhaled.

D. might be warmer than the air being exhaled.

Page 1024

PT-25) What is the correct order of procedures for a water rescue?A. Reach, throw and tow, row, and goB. Go, throw and tow, row, and reachC. Throw and tow, reach, row, and go

D. Throw and tow, reach, go, and row

A. Reach, throw and tow, row, and go

PT-26) A patient has "the bends" following a deep sea dive. The patient's condition is likely due to:A. compression injury.B. severe hypothermia.C. decompression sickness.

D. nitrogen narcosis.

C. decompression sickness.

PT-27) Your patient is a 38-year-old female who was mowing the lawn where the outdoor temperature was 96F with 80% humidity. She is sitting outside on the porch, complaining of severe cramping in the calves of her legs. Which of the following should be your first step in managing this patient?A. Get the patient out of the hot environment.B. Assist the patient in gently stretching her calf muscles.C. Place the patient in a cold water bath.

D. Have the patient drink two 16-oz. bottles of cold water.

A. Get the patient out of the hot environment.

PT-28) Which of the following best describes heat exhaustion?A. An increase in core body temperature above 104FB. A condition characterized by fluid and salt lossC. Loss of electrolytes and buildup of lactic acid in the muscles

D. Swelling in the hands and feet, with lightheadedness on standing up too quickly

B. A condition characterized by fluid and salt loss

PT-29) What effect does humidity have on the efficiency of evaporative heat loss?A. Heat loss is increased by higher humidity.B. Heat loss is reduced by higher humidity.C. The effect of humidity on heat loss is unpredictable.

D. Heat loss is not affected by humidity.

B. Heat loss is reduced by higher humidity.

PT-30) A victim is in the water, and requires rescue. She is too far out in the water to pull to safety from where you stand. You should:A. instruct her to attempt to float on her back.B. tell her to control her breathing.C. throw her something that floats.

D. walk her through a simple swim stroke.

C. throw her something that floats.

PT-31) In cold weather, which of the following persons is most susceptible to a cold emergency?A. A person dressed in warm athletic clothing who is runningB. A person dressed warmly and walkingC. A warmly dressed person lying flat on the cold ground

D. A warmly dressed person sitting next to a heat source

C. A warmly dressed person lying flat on the cold ground

PT-32) Which of the following conditions is associated with a breakdown in the body's heat-regulating mechanisms and a dramatic and dangerous increase in core body temperature?A. Heat exhaustionB. Heat strokeC. Heat collapse

D. Heat cramps

PT-33) Ventilating a drowning victim too quickly or forcefully will likely cause:A. improved BVM compliance.B. increased cardiac output.C. anxiety in the patient.

D. significant gastric distention.

PT-34) During transport of a hypothermic patient who is alert and responding appropriately, and whom local protocols dictate you may actively rewarm, you should:A. wrap the patient in dry blankets.B. remove all the patient's wet clothing.C. gently apply heat to the patient's body.

D. remove the patient from the cold environment.

C. gently apply heat to the patient's body.

CT-1) Which of the following best describes a localized cold injury with a clear line of demarcation of its limits?A. Deep frostnipB. Early frostnipC. Hypothermia

D. Late frostbite

CT-2) To rescue someone who has fallen through the ice, which of the following is the safest device to use?A. Jet-skiB. LadderC. Ring buoy

D. Flat-bottomed aluminum boat

CT-3) Heat stroke is caused by which of the following mechanisms?A. Failure of temperature regulation mechanismsB. Blockage of blood flow to the brainC. Extreme dilation of all the blood vessels

D. Heat-induced swelling of brain tissue

A. Failure of temperature regulation mechanisms

CT-4) To assess skin temperature for a possibly hypothermic patient, the EMT should place the back of his hand against which part of the patient's body?A. CheekB. AbdomenC. Forehead

D. Inner wrist

CT-5) Reducing the pain of a marine animal sting can be accomplished by rinsing the affected area with which of the following?A. VinegarB. Cold waterC. Sterile saline solution

D. Gasoline or kerosene

CT-6) In a patient with extreme hypothermia who appears to be in cardiac arrest, you should assess the pulse for how long?A. 15 to 20 secondsB. at least 60 secondsC. 20 to 30 seconds

D. at least 10 seconds

CT-7) Which of the following describes the condition of having an abnormally high body temperature?A. Heat exhaustionB. HyperthermiaC. Perspiration

D. Heat shock

CT-8) The technique for central rewarming requires the application of heat to which of the following areas of the patient's body?A. Lateral chest, neck, armpits, and groinB. Head, neck, chest, and backC. Head, neck, chest, and groin

D. Chest, back, neck, and armpits

A. Lateral chest, neck, armpits, and groin

CT-9) You respond to the scene of a 14-year-old patient found outside in a cold environment. He is unresponsive and hypothermic. Emergency Medical Responders have moved the patient inside and secured the airway prior to your arrival. What is your next action?A. Vigorously rub the patient to increase the body temperature.B. Actively rewarm the patient.C. Passively rewarm the patient.

D. Assess for signs of frostbite and treat immediately.

C. Passively rewarm the patient.

CT-10) You respond to a professional volleyball tournament for a potential heat stroke. Upon arrival you find a 28-year-old male patient seated inside the air-conditioned first aid trailer. He is alert and in obvious distress. He is complaining of severe cramping of his arms and legs. His vital signs are stable. What is the most likely cause of the cramping?A. Drinking too many sports drinksB. Heat exhaustionC. Cooling off too quickly

D. Sweating too much

CT-11) Which of the following does not make infants and children more prone to hypothermia?A. Large body surface areaB. Inefficient metabolismC. Small muscle mass

D. Little body fat

B. Inefficient metabolism

CT-12) Allowing a patient's body temperature to increase by preventing further heat loss is referred to as which of the following?A. Natural rewarmingB. Active rewarmingC. Passive rewarming

D. Core rewarming

CT-13) You respond to the scene of a local campground. Your patient is a 15-year-old female patient who was stung in the arm by a bee. The patient is anxious and hyperventilating at 28 times a minute. The patient is alert and oriented to time, place, person, and event. Lung sounds are clear bilaterally. The left arm is swollen and the stinger is not present. Blood pressure is 118/72 and pulse is 110. The patient's mother states the patient is allergic to bee stings and has an epinephrine auto-injector. She called 911 because she was afraid the patient would stop breathing. Which of the following is the best treatment plan?A. Assist the patient in administering her epinephrine auto-injector.B. Place the patient in the Trendelenburg position.C. Treat the patient for shock and transport.

D. Place a constricting band around the arm to minimize the spread of the venom.

C. Treat the patient for shock and transport.

CT-14) When submerged in water, biological death may be delayed if the water temperature is below ________F.A. 32B. 70C. 50

D. 98.6

CT-15) You arrive on the scene to find a scuba diver on board a boat slumped over in the captain's chair with frothy blood in his mouth. The captain states that the diver was down no more than 15 feet when he ascended rapidly and called for help. Which of the following is most likely?A. Air embolismB. Decompression sicknessC. Pneumothorax

D. The bends

CT-16) Heat cramps occur due to loss of which of the following substances?A. WaterB. Water and potassiumC. Magnesium

D. Salt

CT-17) When the body is in water, how many times faster does it lose heat than when it is in still air?A. 2B. 10C. 100

D. 25

CT-18) Which of the following is caused by trapped nitrogen gas in the tissues due to a rapid ascent from a scuba dive?A. Arterial gas embolismB. Pulmonary embolismC. Myocardial infarction

D. Decompression sickness

CT-19) Applying an external source of heat to the patient's body to rewarm him is called ________ rewarming.A. centralB. passiveC. peripheral

D. active

CT-20) Why is it important to keep patients at rest when they are hypothermic?A. Because the blood is coldest in the extremities, exercise or unnecessary movement could quickly circulate the cold blood and drop the blood pressure.B. Because the blood is coldest in the extremities, exercise or unnecessary movement could quickly circulate the cold blood and lower the core body temperature.C. Because the blood is warmest in the extremities, exercise or unnecessary movement could quickly circulate the warm blood and raise the core body temperature.

D. None of the above.

B. Because the blood is coldest in the extremities, exercise or unnecessary movement could quickly circulate the cold blood and lower the core body temperature.

CT-21) In mild cases, what may overcome acute mountain sickness?A. Rest and rehydration at altitudeB. Vigorous exerciseC. Moving the patient to a higher altitude

D. Positive-pressure ventilations

A. Rest and rehydration at altitude

CT-22) Which of the following signs would you least expect to see in a patient suffering from severe hypothermia?A. NumbnessB. Heavy shiveringC. Drowsiness

D. Skin cool to the touch

CT-23) In a hypothermic patient the coldest blood is found in what part of the patient's body?A. IntestinesB. HeadC. Extremities

D. Heart and lungs

CT-24) For which of the following reasons are newborns, infants, and the elderly more readily affected by the heat than other age groups?A. Faster metabolismB. Inadequate salt intakeC. Poor ability to regulate body temperature

D. Increased body mass

C. Poor ability to regulate body temperature

CT-25) Your patient is a 24-year-old man who smoked a cigarette dipped in formaldehyde and then went outside with no shoes on and walked in the snow for about an hour. He has deep local cold injuries to both feet. Which of the following should be included in your management of this patient?A. Massage the feet briskly.B. Break blisters before wrapping both feet in sterile dressings.C. Keep the patient cool to avoid rewarming the feet too quickly.

D. Gradually rewarm both feet.

CT-26) Where should constricting bands be placed to reduce lymphatic flow after a venomous snake bite?A. 4 inches above and below the biteB. 2 inches above and below the biteC. Directly over the bite

D. None of the above

B. 2 inches above and below the bite

CT-27) You respond to a construction site on a very hot summer day for a person "not acting right." You find a 38-year-old male patient seated in a work vehicle with the air conditioner on maximum. Coworkers state the patient was working for the last 2 hours pouring concrete when he started "speaking gibberish" and nearly collapsed. The patient is responsive to verbal stimuli. Your initial vital signs are blood pressure 90/60, pulse 136, and respiratory rate 24. The patient's skin is hot to the touch and dry, but his shirt is wet with visible salt rings. Which is the best treatment for the patient?A. Cool the patient with tepid water.B. Have the patient drink at least 1 liter of water to replace what he has lost.C. Apply high-concentration oxygen and rapidly transport to the nearest medical facility.

D. Have the patient sip water slowly to replace what he has lost.

C. Apply high-concentration oxygen and rapidly transport to the nearest medical facility.

CT-28) You respond to a construction site on a very hot summer day for a person "not acting right." You find a 44-year-old male patient seated in a work vehicle with the air conditioner on maximum. Coworkers state the patient was working for the last 2 hours pouring concrete when he started "speaking gibberish" and nearly collapsed. The patient is responsive to verbal stimuli. Your initial vital signs are blood pressure 90/60, pulse 136, and respiratory rate 24. The patient's skin is cool to the touch and moist, and his shirt is wet with visible salt rings. You suspect:A. heat cramps.B. heat exhaustion.C. heat stroke.

D. myocardial infarction.

CT-29) You respond to a boat dock for a diving injury. You find a 24-year-old male patient unresponsive with frothy blood in the mouth and lung sounds absent on the right side. The patient's friends state they were diving when he came out of the water complaining of chest pains and then collapsed. What condition do you suspect?A. Decompression sicknessB. Air embolismC. Near drowning

D. Myocardial infarction

CT-30) Which of the following increases a scuba diver's risk of decompression sickness?A. Flying within several hours after a diveB. Diving on a full stomachC. Breathing 100% oxygen before a dive

D. Taking cold or sinus medications before a dive

A. Flying within several hours after a dive

CT-31) You have responded to a local pool for a drowning patient. Lifeguards have pulled the patient out of the pool prior to your arrival. You find a 22-year-old male patient unresponsive with agonal respirations and a weak carotid pulse. Bystanders state the patient was not using the diving board and was found in the shallow end. Why are cervical spine precautions necessary?A. The patient may have hit his head on the side wall while swimming laps.B. The patient may have suffered a cervical spine injury when pulled out of the water.C. The patient may have suffered a spinal injury by jumping in shallow water.

D. The patient may have been using the diving board after all and injured his cervical spine.

C. The patient may have suffered a spinal injury by jumping in shallow water.

CT-32) You respond to a boat dock for a diving injury. You find a 22-year-old female patient unresponsive with frothy blood in the mouth and lung sounds absent on the right side. The patient is breathing 28 times a minute. The patient's friends state they were diving when she unexpectedly came out of the water complaining of chest pains and then collapsed. The nearest hospital is 25 minutes away and the nearest specialty resource center with a hyperbaric chamber is 30 minutes away. What is the best decision when determining transport?A. Transport the patient by air medical to the nearest facility.B. Transport the patient to the nearest facility.C. Transport the patient by ground to the specialty center.

D. Transport the patient by air medical to the specialty center.

C. Transport the patient by ground to the specialty center.

CT-33) Of the following venomous snakes, which one usually has the highest incidence of a "dry bite"?A. RattlesnakeB. Water moccasinC. Coral snake

D. Copperhead

CT-34) Which of the following occurs when gases leave a damaged lung in a diving accident and enter the bloodstream?A. Arterial gas embolismB. Hyperbaric arterial injuryC. Arterial blood gases

D. Arterial thrombosis

CT-35) A patient who is lying on cold ground is losing the most amount of heat by what mechanism?A. ConductionB. ConvectionC. Shivering

D. Radiation

CT-36) Your patient is a 44-year-old female with a history of alcoholism. She has been walking around at an outdoor fair on a hot, sunny day. She is disoriented to time; has hot, dry skin; and appears to be generally weak. Which of the following is the appropriate sequence of treatment for this patient?A. Get as much ice as possible from the food vendors at the fair, place the patient in a large container of ice, and apply oxygen by nonrebreather mask.B. Give oxygen by nonrebreather mask, remove heavy clothing, and place cold packs on her neck, armpits, and groin.C. Have the patient stand outside the ambulance and slowly drink an electrolyte solution or sports drink.

D. Give oxygen by nonrebreather mask and have the patient rest, monitoring the patient's improvement over time at the scene.

B. Give oxygen by nonrebreather mask, remove heavy clothing, and place cold packs on her neck, armpits, and groin.

CT-37) In cases of extreme hypothermia, you will find the patient unconscious, with no discernible vital signs, and skin cold to your touch with stiff joints as if they appear dead. What is the emergency care for these patients?A. Call the coroner as indications are the patient is cold and deceased, which is a definitive sign of death.B. Contact medical control for input into the best treatment for this patient.C. Assess the carotid pulse for at least 60 seconds; if there is no pulse, start CPR immediately and prepare to apply the AED.

D. Check distal CSM, apply warming packs to the extremities, and transport the patient.

C. Assess the carotid pulse for at least 60 seconds; if there is no pulse, start CPR immediately and prepare to apply the AED.

CT-38) You respond to a farm for a possible snake bite. You find a 36-year-old male patient seated against a tree. Bystanders state the patient was bitten on the arm by a rattlesnake and is "really sick." As you approach, you notice that the patient appears to be in obvious distress and is diaphoretic and holding his right wrist. Which of the following is your highest priority?A. Confirm the location and status of the snake.B. Confirm the type of snake and contact medical control for specific instructions.C. Perform a primary assessment and identify any potential life threats.

D. Immediately apply a constricting band to minimize the spread of the venom.

A. Confirm the location and status of the snake.

CT-39) Which of the following is acceptable when actively rewarming a hypothermic patient?A. Avoid rewarming the limbsB. Warming the patient as quickly as possibleC. Giving the patient hot coffee

D. Encouraging the patient to exercise

A. Avoid rewarming the limbs

CT-40) You respond to a boat dock for a diving injury. You find a 24-year-old male patient unresponsive with frothy blood in the mouth and lung sounds absent on the right side. The patient is breathing 28 times a minute. The patient's friends state they were diving when he unexpectedly came out of the water complaining of chest pains and then collapsed. What is your first action?A. Insert an oropharyngeal airway.B. Place the patient on high-concentration oxygen by nonrebreather mask.C. Transport the patient.

D. Suction the airway.

CT-41) Which of the following is not a classification of localized cold injury?A. HypothermiaB. FrostbiteC. Frostnip

D. All of the above

CT-42) The term blanching, used to describe localized cold injury, means the tissue has turned to which of the following colors?A. Blue or purpleB. RedC. White

D. Black

CT-43) Which of the following should the EMT do during the treatment of localized cold injury?A. Rub the affected area with snow.B. Massage the affected area.C. Gradually warm the affected area.

D. Encourage the patient to use the affected part.

C. Gradually warm the affected area.

CT-44) Which of the following can cause a wound with a characteristic lesion with a bite that is often painless?A. ScorpionB. HornetC. Black widow spider

D. Brown recluse spider

CT-45) You are enjoying some time at the beach on your day off when you hear a swimmer crying for help. As you spot the swimmer about 30 feet from shore, she cries out again but appears to be getting weaker. Although there is no lifeguard on duty, there is a rowboat and a ring buoy available. Assuming you do not know how to swim or consider yourself a poor swimmer, which of the following should you do first?A. Row the boat out to the swimmer.B. Find someone who can swim to try to swim out and save the swimmer.C. Call for help and try to throw the buoy to the swimmer.

D. Use the buoy to float out to the swimmer.

C. Call for help and try to throw the buoy to the swimmer

CT-46) Regarding drowning in adults, which of the following statements is true?A. The warmer the water, the better the chances of survival in saltwater drowning.B. The colder the water, the better the chances of survival in either saltwater or freshwater drowning.C. Colder water improves survival chances in saltwater drowning but not in freshwater drowning.

D. Water temperature makes no difference in the chances of survival in either saltwater or freshwater drowning.

B. The colder the water, the better the chances of survival in either saltwater or freshwater drowning.

CT-47) In which of the following ways does the body produce heat in response to being cold?A. Increasing the respiratory rateB. Burning fewer caloriesC. Shivering

D. Excreting more urine

CT-48) What is a common sign or symptom of high-altitude cerebral edema?A. ParesthesiaB. Peripheral edemaC. Altered mental status

D. Nosebleed

CT-49) You are on a stand-by at a local high school football game. One of the football players comes over to the ambulance and complains that his face feels numb and he has a burning sensation in his fingers. You notice that the patient's cheeks and fingers are bright red. How should you treat the patient?A. Allow the patient to warm up inside the ambulance by passive rewarming measures.B. Warm the affected areas with gentle rubbing.C. Tell the patient that his condition is superficial and allow him to return to the game.

D. Place the patient inside the ambulance and begin active rewarming measures.

A. Allow the patient to warm up inside the ambulance by passive rewarming measures.

CT-50) Which of the following terms describes the temperature of the surrounding air?A. Shell temperatureB. Ambient temperatureC. Core temperature

D. Wind chill

CT-51) Which of the following is often associated with water-related emergencies?A. Cardiac arrestB. Alcohol useC. Hypothermia

D. All of the above

CT-52) The purpose of a constricting band after a venomous snake bite is to impede the spread of which of the following?A. LymphB. Arterial bloodC. Venom

D. Both A and C

CT-53) Which of the following is acceptable in the management of a patient stung by a honey bee?A. Take care not to pull the stinger out using tweezers.B. Treat for shock if you see signs it is developing.C. Encourage the patient to move around.

D. Remove jewelry from any affected limbs.

CT-54) Localized cold injury occurs due to vasoconstriction and:A. loss of calcium.B. blood clots.C. chemical imbalance in the tissues.

D. ice crystal formation in the tissues.

CT-55) In which of the following situations would a person lose heat by conduction?A. BreathingB. Sitting on cold metal bleachers at a football gameC. Going outside without a coat during a cold but calm day

D. Wearing wet clothing in windy weather

B. Sitting on cold metal bleachers at a football game

CT-56) When actively rewarming a frostbitten extremity in warm water, you should change the water when the temperature falls below ________ F.A. 115B. 100C. 85

D. 80

CT-57) You respond to a landing zone to pick up a skier who was lost in the woods for 36 hours and found by the search-and-rescue helicopter. Your patient is a 19-year-old male patient. He is alert and oriented to time, person, place, and event. He is covered in blankets and shivering. He complains of not being able to feel his fingers. Physical exam reveals that the fingers of both extremities have a waxy appearance and feel "frozen" on the surface. After treating the patient for potential hypothermia and rapid transport, your next action is to:A. keep the digits frozen on ice until they can be properly rewarmed at the hospital.B. gently bandage the digits.C. actively rewarm the digits.

D. gently warm the digits by slowly massaging them.

B. gently bandage the digits.

CT-58) Which of the following is the process in which heat is lost from the body as wind passes over it?A. ExposureB. Hydrodynamic coolingC. Condensation

D. Convection

CT-59) Which of the following is the process in which heat is lost from the body as wind passes over it?A. ExposureB. Hydrodynamic coolingC. Condensation

D. Convection

CT-60) Which of the following would you expect to see in a patient with severe hypothermia?A. Irrational behaviorB. Rapid respirationsC. Tachycardia

D. Loss of muscle tone

CT-61) Most radiant heat is lost through which part(s) of the body?A. Hands and feetB. Head and neckC. Buttocks

D. Torso

CT-62) Why is it important to remove constricting items such as rings before thawing a frozen extremity?A. Because thawing leaves clots behind in the veinsB. To prevent damage to the property such as rings and watchesC. Because thawed areas often swell

D. All of the above

C. Because thawed areas often swell

CT-63) Which of the following types of snake is not a pit viper?A. Coral snakeB. RattlesnakeC. Water moccasin

D. Copperhead

CT-64) Why are infants and young children more prone to hypothermia than adults?A. Their immune system is not fully developed.B. They are unable to recognize how cold they are.C. They have less fat than adults.

D. They shiver more than adults.

C. They have less fat than adults

CT-65) Which of the following could worsen the effects of a snake bite?A. Application of iceB. Having the patient lie stillC. Constricting bands above and below the bite

D. Cutting and suctioning out the venom

CT-66) You arrive on the scene and find an unresponsive homeless man lying in the alleyway clutching a wine bottle. He is wearing a long-sleeved shirt but does not have pants on. His skin feels cold to the touch. The week's temperatures have not been above 50F. Which of the following should you do immediately after ensuring the patient has an adequate airway?A. Apply the AED.B. Check the carotid pulse.C. Begin passive rewarming.

D. Provide manual stabilization of the cervical spine.

B. Check the carotid pulse.

CT-67) Rough handling of a patient with severe hypothermia may result in which of the following?A. Rewarming shockB. Heart attackC. Ventricular fibrillation

D. Seizures

C. Ventricular fibrillation

CT-68) The term gangrene means localized tissue:A. infection.B. discoloration.C. swelling.

D. death.