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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. 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?
2. 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?
3. You are reassessing a patient whom you are treating for heat exhaustion. Which of these findings indicates that the patient is improving?
4. Medical direction has asked you to remove a tick from behind the left ear of a 5-year-old girl. You would:
5. A 44-year-old female patient 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 the patient complains of discomfort to that area. Closer inspection reveals two puncture wounds in the center of the affected area. The patient asks you if she is going to die from the snake bite. What would be your most appropriate reply?
6. 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?
7. 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?
8. What is the most significant mechanism by which the body can lose heat?
9. You have been called for an alert and oriented male patient. Upon your arrival, his roommate states that the patient spent several hours locked out of his house in the cold temperatures after an evening of drinking since no one was home and the patient lost his house keys. Since the primary and secondary assessments have ruled out immediate life-threatening conditions, you have decided to rewarm the patient. Which of these warming techniques would be most appropriate for this patient?
10. 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:
11. 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?
12. The EMT should recognize which of these patients is experiencing generalized hypothermia?
13. Which of these conditions, in addition to cool temperatures, is necessary for trench foot to develop?
14. 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?
15. 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 42-year-old male patient who was just at an altitude of 14,000 feet while hiking. The patient states that while at this altitude he experienced a severe headache, became very uncoordinated and stumbled often, and felt very nauseous. He became scared, so he left the trail to be seen in the first aid station. The patient indicates that he feels better now. Given this description, what would be the most likely differential diagnosis?
16. What of these patients is most accurately described as suffering an environmental emergency?
17. 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:
18. You are providing a 'stand-by' service at the county fair. At 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 has tremendous pain. Assessment reveals his shoulder to have a large reddened area with a sting mark in the middle. The skin is warm to the touch. Your care of this patient should include:
19. 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. What is your best response?
20. Consumption of large amounts of water during prolonged periods of exertion can result in which disorder?
21. 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:
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:
23. Which of these patients with heat emergency would be the highest priority for transport?
24. In which of these settings will sweating be less effective as a means to cool the body?
25. 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?