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Prehospital Emergency Care Practice Test: Handling Environmental Emergencies
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Environmental emergencies can include a variety of patient presentations, such as heat and cold exposure, toxic envenomation, exposure to allergens, and noxious plants.  Here are some symptoms of environmental emergencies: Hyperthermia: Elevated core temperature, muscle cramps, altered mental status, weakness, headache, nausea or vomiting, rapid, strong pulse at first, which deteriorates into thready pulse, deep, rapid breathing at first, which deteriorates into shallow and weak breathing, skin that is cool and moist during early stages, skin that is hot at late stages,... Show more
Prehospital Emergency Care Practice Test: Handling Environmental Emergencies
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25 Questions

1. The primary assessment of a teenage male patient who is unresponsive with hot, moist, and flushed skin reveals his airway to be open, breathing shallow, and radial pulse weak. You have initiated positive pressure ventilation with supplemental oxygen. What should you consider doing next?
2. 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 of these statements to his teammates would be most appropriate?
3. The stinger of a bee is evident in the left thigh of a female patient who states that she is allergic to bees and has an EpiPen for such occasions. According to the patient, the sting occurred two hours ago and she just now noticed that the stinger remains in place. She did not take her epinephrine and appears asymptomatic for an allergic reaction. At this time, you would:
4. During the summer months, you work as an EMT at a first aid station that helps people who hike trails in the high mountains of the western United States. One afternoon, you are presented with a 13-year-old male patient who presents as alert and oriented, but complains of chest pain, dyspnea, and a headache. He is tachypneic and tachycardic and has slight inspiratory crackles. Given this presentation, what would be the most likely differential diagnosis?
5. 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:
6. When obtaining a history of a 5-year-old boy with generalized hypothermia, which question should be asked before all others?
7. 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 sonorous respirations. The patient remains unresponsive. Which priority care should the EMT provide?
8. 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 '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 of 18 breaths/min, adequate blood pressure of 128/68 mmHg, and an oral temperature of 100.2°F. Based on these data, the EMT should recognize that:
9. Medical direction has ordered you to begin rewarming an unresponsive patient with a core temperature of 93°F. Which of these measures would most benefit this patient?
10. A 23-year-old female patient has been stung in the right arm by some unidentified marine life. Her arm and hand are swollen and red. The primary assessment is unremarkable and she is complaining of pain to the site of injury. You would:
11. A young male patient who was angry with friends wandered away from a party and spent the night outside uncovered in 40-50°F temperatures. He is confused, has decreased but adequate breathing, and has a weak radial pulse. His skin is cool and capillary refill delayed. You note that he is not shivering. Based on this presentation, what can you safely conclude?
12. An 18-month-old child has a temperature of 105.2°F. Without treatment, what will most likely occur?
13. 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 the patient states that the muscles in her shoulders and back are starting to hurt, as if they are cramping up. After ensuring that no life-threatening conditions are present and administering oxygen, the EMT should:
14. A young female patient 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 and her injury, it is critical that the EMT:
15. A patient has been bitten by a nonpoisonous grass snake. Your care would include:
16. After ensuring that there are no life-threatening conditions to the airway, breathing, and circulation, the priority in caring for a patient with hypothermia is:
17. A person is in a hot environment and his body is successfully compensating to off-load excess heat. Which assessment findings best illustrate this process?
18. 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 in the summer months. Regarding these standing orders, which of these instructions would seem most appropriate?
19. You are transporting a patient who was bitten on her hand by a spider approximately 20 minutes ago. On scene, the primary assessment revealed no life threats and vital signs were stable. While conducting the reassessment, which of these findings would be of most concern to the EMT?
20. 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, providing manual spine motion restriction. Once you arrive at the patient's side, what should you do first?
21. You are caring for a patient with an extensive freezing cold injury to his right hand and arm. Which of these instructions would be appropriate to give to your EMT partner?
22. Regarding snakebites, which of these statements is true?
23. A young man has been struck by lightning on a golf course and is in cardiac arrest. Other golfers say that he was struck 8-10 minutes ago. What should the EMT do immediately?
24. A patient with hypothermia is alert and confused, but complains of left arm pain. His friends found him outside, where the patient spent the night after he got drunk and passed out in the cold. It appears as though he has a localized freezing cold injury to the arm in question. In caring for this patient, which of these treatments would be acceptable?
25. 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:

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