Question 1

Regarding the pathophysiology underlying anaphylaxis, which of the following is true?

Accepted Answer

A)  Histamine causes the capillaries to become leaky. 
B)  High blood pressure forces blood from the blood vessels. 
C)  IgE immunoglobulins make antibodies that cause bronchoconstriction. 
D)  Smooth muscle dilation on the lungs impairs the exchange of oxygen. 
A)  Histamine causes the capillaries to become leaky. 
B)  High blood pressure forces blood from the blood vessels. 
C)  IgE immunoglobulins make antibodies that cause bronchoconstriction. 
D)  Smooth muscle dilation on the lungs impairs the exchange of oxygen.

Question 2

When reassessing a patient you are treating for an anaphylactic reaction, what finding would be of the most concern to the EMT?

Accepted Answer

A)  Respiratory rate change from 28 to 10 breaths per minute 
B)  Red, warm, and dry skin 
C)  Pulse oximetry reading of 95% despite high-concentration oxygen 
D)  New hives appearing on the chest 
A)  Respiratory rate change from 28 to 10 breaths per minute 
B)  Red, warm, and dry skin 
C)  Pulse oximetry reading of 95% despite high-concentration oxygen 
D)  New hives appearing on the chest

Question 3

A patient informs you that any time she is exposed to a particular soap, she experiences a mild allergic reaction. As a knowledgeable EMT, you should recognize that:

Accepted Answer

A)  the soap contains an antigen. 
B)  the patient's airway will swell shut if she inhales the soap. 
C)  the soap contains antibodies that react in the patient's body. 
D)  she must have been exposed to the soap as an infant. 
A)  the soap contains an antigen. 
B)  the patient's airway will swell shut if she inhales the soap. 
C)  the soap contains antibodies that react in the patient's body. 
D)  she must have been exposed to the soap as an infant.

Question 4

A patient states that he is allergic to poison ivy and was burning it yesterday when he accidentally inhaled some of the smoke. Today, he awoke and found a red rash to the back of his left hand and called 911. Assessment reveals him to be alert and oriented, with easy respirations, and a blood pressure of 128/70 mmHg. Your next action would be to:

Accepted Answer

A)  provide immediate and rapid transport. 
B)  assist the patient with his epinephrine auto-injector. 
C)  obtain a medical history. 
D)  call for advanced life support (ALS) assistance. 
A)  provide immediate and rapid transport. 
B)  assist the patient with his epinephrine auto-injector. 
C)  obtain a medical history. 
D)  call for advanced life support (ALS) assistance.

Question 5

You are staffing an information booth at the county fair when a mother and her 15-year-old son approach. The mother informs you that her son is severely allergic to bee stings and had an epinephrine auto-injector prescribed to him when he was 5 years old. She hands you the 0.15 mg auto-injector and notes that it expired several years ago. Which one of the following statements would be most appropriate for you to make?

Accepted Answer

A)  "Call your doctor as soon as possible for a new injector because this one is out of date." 
B)  "We have some on the ambulance. I can get you one until you are able to get a new one from your doctor." 
C)  "Make sure to call the doctor since this is out of date. Also ask him if he wants to add a steroid to the injector." 
D)  "Call your doctor to get a new injector and ask him if he wants to change the dose." 
A)  "Call your doctor as soon as possible for a new injector because this one is out of date." 
B)  "We have some on the ambulance. I can get you one until you are able to get a new one from your doctor." 
C)  "Make sure to call the doctor since this is out of date. Also ask him if he wants to add a steroid to the injector." 
D)  "Call your doctor to get a new injector and ask him if he wants to change the dose."

Question 6

When assessing a patient with an anaphylactic reaction, which one of the following findings would you expect?

Accepted Answer

A)  Weak radial pulse 
B)  Rapid and strong carotid pulse 
C)  Normal to slightly increased blood pressure 
D)  Slow and bounding radial pulse 
A)  Weak radial pulse 
B)  Rapid and strong carotid pulse 
C)  Normal to slightly increased blood pressure 
D)  Slow and bounding radial pulse

Question 7

Which one of the following assessment findings would indicate that the patient is suffering from an anaphylactic reaction and requires immediate intervention?

Accepted Answer

A)  Hives and a heart rate of 96 beats per minute 
B)  Localized swelling around the site of a bee sting 
C)  Swollen lips with a blood pressure of 84/50 mmHg 
D)  Edema to the feet with an SpO₂ of 93% on room air 
A)  Hives and a heart rate of 96 beats per minute 
B)  Localized swelling around the site of a bee sting 
C)  Swollen lips with a blood pressure of 84/50 mmHg 
D)  Edema to the feet with an SpO₂ of 93% on room air

Question 8

Which one of the following is the primary difference between an anaphylactic reaction and an anaphylactoid reaction?

Accepted Answer

A)  An anaphylactoid reaction may occur without prior sensitization to the antigen; anaphylaxis requires prior sensitization. 
B)  Anaphylactoid reactions are less severe than anaphylactic reactions. 
C)  Epinephrine is contraindicated in anaphylactoid reactions, but not in anaphylactic reactions. 
D)  Anaphylactoid reactions are commonly caused by environmental substances; anaphylactic reactions are most commonly caused by foods. 
A)  An anaphylactoid reaction may occur without prior sensitization to the antigen; anaphylaxis requires prior sensitization. 
B)  Anaphylactoid reactions are less severe than anaphylactic reactions. 
C)  Epinephrine is contraindicated in anaphylactoid reactions, but not in anaphylactic reactions. 
D)  Anaphylactoid reactions are commonly caused by environmental substances; anaphylactic reactions are most commonly caused by foods.

Question 9

On scene you assisted a patient with his epinephrine auto-injector after he was stung multiple times by bees. You are now transporting the patient to the hospital. As you reassess the patient, which one of the following signs would best indicate that the epinephrine is benefiting the patient?

Accepted Answer

A)  Increasing heart rate 
B)  Complaint of fatigue 
C)  Decreasing wheezing 
D)  Decreasing blood pressure 
A)  Increasing heart rate 
B)  Complaint of fatigue 
C)  Decreasing wheezing 
D)  Decreasing blood pressure

Question 10

You have arrived by the side of a lethargic patient who is allergic to latex and was exposed to it when she spilled a latex-containing powder on her right hand. She is only able to speak a few words with each breath. Additionally, her tongue is swollen and respirations are rapid, labored, and noisy. What action is your immediate priority?

Accepted Answer

A)  Insert an oropharyngeal airway. 
B)  Wash the latex powder from the patient's hand. 
C)  Obtain a heart rate and blood pressure. 
D)  Start positive pressure ventilation. 
A)  Insert an oropharyngeal airway. 
B)  Wash the latex powder from the patient's hand. 
C)  Obtain a heart rate and blood pressure. 
D)  Start positive pressure ventilation.

Question 11

You have just assisted a patient with his epinephrine auto-injector. The patient states that he has never taken epinephrine before. You would inform him of which one of the following?

Accepted Answer

A)  "The epinephrine may make you drowsy, so just close your eyes." 
B)  "Be prepared to feel dizzy and nauseated. These are common when taking epinephrine." 
C)  "You may feel a little shaky, but that is normal and will pass." 
D)  "If you pass out, that is normal. I will just give you some oxygen if that happens." 
A)  "The epinephrine may make you drowsy, so just close your eyes." 
B)  "Be prepared to feel dizzy and nauseated. These are common when taking epinephrine." 
C)  "You may feel a little shaky, but that is normal and will pass." 
D)  "If you pass out, that is normal. I will just give you some oxygen if that happens."

Question 12

Five minutes after assisting a patient with his epinephrine auto-injector, you determine the patient to be getting progressively worse. The patient has a second auto-injector available; however, written protocols do not address the administration of a second dose. Which one of the following should be your next best action?

Accepted Answer

A)  Request advanced life support (ALS) assistance. 
B)  Administer the second dose of epinephrine. 
C)  Continue to monitor the patient. 
D)  Contact medical direction for further orders. 
A)  Request advanced life support (ALS) assistance. 
B)  Administer the second dose of epinephrine. 
C)  Continue to monitor the patient. 
D)  Contact medical direction for further orders.

Question 13

You have assisted an adult patient with his epinephrine auto-injector. When giving a report to the emergency department nurse, you should inform her that ________ mg of epinephrine was administered.

Accepted Answer

A)  0.15 
B)  0.25 
C)  0.30 
D)  1 
A)  0.15 
B)  0.25 
C)  0.30 
D)  1

Exam 21: Anaphylactic Reactions

Regarding the pathophysiology underlying anaphylaxis, which of the following is true?

When reassessing a patient you are treating for an anaphylactic reaction, what finding would be of the most concern to the EMT?

A patient informs you that any time she is exposed to a particular soap, she experiences a mild allergic reaction. As a knowledgeable EMT, you should recognize that:

When assessing a patient with an anaphylactic reaction, which one of the following findings would you expect?

Which one of the following assessment findings would indicate that the patient is suffering from an anaphylactic reaction and requires immediate intervention?

Which one of the following is the primary difference between an anaphylactic reaction and an anaphylactoid reaction?

On scene you assisted a patient with his epinephrine auto-injector after he was stung multiple times by bees. You are now transporting the patient to the hospital. As you reassess the patient, which one of the following signs would best indicate that the epinephrine is benefiting the patient?

You have just assisted a patient with his epinephrine auto-injector. The patient states that he has never taken epinephrine before. You would inform him of which one of the following?

You have assisted an adult patient with his epinephrine auto-injector. When giving a report to the emergency department nurse, you should inform her that ________ mg of epinephrine was administered.

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