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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. Which of these statements about immersion hypothermia is false?
2. You are called to a construction site on a hot and humid day for a male patient with a heat emergency. On scene, you find a 49-year-old man who is responsive to verbal stimuli. Coworkers state that the patient had been moving concrete blocks all day in the hot weather and had not rested, eaten, or had anything to drink in the past two hours. During the primary assessment, you note the patient's airway to be open and breathing rapid but adequate. His radial pulse is rapid and bounding, and his skin is hot and dry. Which of these findings makes this patient a priority for immediate and rapid transport?
3. 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?
4. Consumption of large amounts of water during prolonged periods of exertion can result in which disorder?
5. In addition to brain injury from the high voltage and amperage, the patient who experiences a lightning strike also typically develops:
6. You are en route to the hospital with a patient who is unresponsive and has hot, dry skin. His friends state that the patient had 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 supplemental oxygen. Which of these actions would be most beneficial to the patient next?
7. 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:
8. The EMT would recognize that a hypothermic patient's condition is deteriorating when he observes:
9. In which of these settings will sweating be less effective as a means to cool the body?
10. Which of these findings would present earliest in a patient with hypothermia?
11. 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. What should you do immediately?
12. 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?
13. You have been called to a park for a teenage boy who is 'sick.' On scene, you find a 16- year-old male patient 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. The patient's 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 by Emergency First Responders. Which other step would be appropriate care for this patient?
14. 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?
15. On entering an apartment for a call related to a confused elderly female patient, you note that the air conditioner is running on high and the room is extremely cold. Which other clue obtained during the scene size-up would best indicate that this patient may be suffering from urban hypothermia?
16. Which of these conditions, in addition to cool temperatures, is necessary for trench foot to develop?
17. Which of these statements made by your EMT partner would require immediate correction when treating a patient with hypothermia and a deep freezing cold injury to his left foot, ankle, and lower leg?
18. A landscaper who has been working in 105°F weather is found collapsed in a client's yard. He is responsive to painful stimuli and has an open airway. His breathing is shallow, alveolar breath sounds are absent, and radial pulse is weak. The patient's skin is hot and dry and appears to be sunburned. The EMT should immediately:
19. You are reassessing a patient whom you are treating for heat exhaustion. Which of these findings indicates that the patient is improving?
20. A patient has been bitten by a nonpoisonous grass snake. Your care would include:
21. 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. You suspect that he is suffering from a superficial freezing cold injury. Which sign or symptom would help confirm this suspicion?
22. You have been called for a 78-year-old female patient who slipped while getting out of her bathtub. She is confused and cold to the touch. You learn that the patient slipped 24 hours ago and has been on the bathroom's tile floor ever since. Since it is summer, she also had her air conditioner running on high. The EMT would best categorize this emergency as:
23. You are on scene with a patient who has a freezing cold injury. The patient stated that he had no sensation in his hand or fingers prior to the initiation of a rewarming process. You have subsequently begun rewarming his hand and fingers. Which of these statements made by the patient following the rewarming process is of greatest concern?
24. 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?
25. You are called to treat a homeless person who complains of an inability to walk due to sores and numbness of his feet. The EMR tells you that the patient is well oriented with good pulses and respiration but that his feet are edematous with open sores and broken-down skin. This finding is the typical result of which condition?

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