Question 1

Within the body, the release of histamine would cause dilation of the:

Accepted Answer

A)  blood vessels. 
B)  small airways. 
C)  upper airway. 
D)  salivary glands.

Question 2

When the signs and symptoms of anaphylaxis are rapid, the EMT must realize that:

Accepted Answer

A)  the reaction tends to be severe. 
B)  the reaction tends to be localized. 
C)  there is an increased amount of antigens. 
D)  epinephrine will not be effective.

Question 3

A patient suffers an allergic reaction after taking penicillin. In this case, the penicillin would be recognized as a/an:

Accepted Answer

A)  IgE immunoglobulin. 
B)  antigen. 
C)  mast cell. 
D)  antibody.

Question 4

Why would the patient experiencing an allergic reaction tell you that it is easier to breathe following administration of epinephrine?

Accepted Answer

A)  Drying of mucus in the airways 
B)  Dilation of the bronchioles 
C)  Increased blood flow to the lungs 
D)  Decreased blood pressure

Question 5

A patient who is responsive to painful stimuli is covered with hives. He has labored respirations and a weak and rapid pulse. His vital signs are: pulse 128, respirations 24, and blood pressure 80/50 mmHg. Given this presentation, the EMT should be suspicious of what condition?

Accepted Answer

A)  Sensitization 
B)  Anaphylaxis 
C)  Hypersensitivity 
D)  Localized allergic reaction

Question 6

For the EMT to achieve the best results when assisting with epinephrine, the medication should be placed into:

Accepted Answer

A)  an artery. 
B)  the skin. 
C)  a vein. 
D)  a muscle.

Question 7

A patient with an allergy to bees and a prescribed Epi-pen was working in the garden when she noted swelling to the right side of her face. Assessment reveals swelling that is red and hot to the right cheek area. Her airway is patent, respirations easy and adequate, and radial pulse strong. Her vital signs are: pulse 76, respirations 16, blood pressure 156/62 mmHg, and SpO₂ at 99%. Which one of the following should you do next?

Accepted Answer

A)  Perform a secondary assessment. 
B)  Assist the patient with her Epi-pen. 
C)  Treat as an anaphylactoid reaction. 
D)  Immediate and rapid transport

Question 8

A patient who is severely short of breath and covered with hives states that she is allergic to crab but tried some crab dip 10 minutes ago. Which one of the following questions would the EMT ask first?

Accepted Answer

A)  "How many allergic reactions have you had?" 
B)  "Why did you eat the dip if you are allergic to crab?" 
C)  "What medications are you currently taking?" 
D)  "Do you have an epinephrine auto-injector?"

Question 9

Which statement indicates that the EMT understands airway management in a patient suffering from anaphylaxis?

Accepted Answer

A)  "When providing positive pressure ventilation, it may be difficult to pass air through the swollen tissues." 
B)  "Epinephrine will help the patient's blood pressure, but not the swollen tissue in the airway." 
C)  "The best way to open the airway in a patient with upper airway edema is to place the patient in an upright position." 
D)  "If an oral or nasal airway is used, the airway will be opened and positive pressure ventilation will not be needed."

Question 10

You are providing bag-valve-mask ventilations to a patient in anaphylactic shock. There is increasing resistance to ventilation, despite using proper technique. Which of the following is the best way to address this situation?

Accepted Answer

A)  Stop ventilations and administer an albuterol metered-dose inhaler. 
B)  Occlude the pop-off valve on the bag-valve mask and continue ventilations. 
C)  Increase both the ventilatory rate and force of ventilation. 
D)  Turn the patient to her side and apply manual pressure over the epigastrium.

Question 11

You have been called for a male patient experiencing a severe allergic reaction. The patient is very confused and having great difficulty breathing. He has an epinephrine auto-injector; however, your service does not have protocols related to its use. In EMT class, you went over and passed a test on the use of an epinephrine auto-injector for allergic reactions. In this case, you should:

Accepted Answer

A)  assist the patient with his epinephrine auto-injector. 
B)  provide oxygen and respiratory support followed by immediate transport. 
C)  assist the patient with his epinephrine using implied consent as justification. 
D)  contact the physician prescribing the medication for permission to use the auto-injector.

Question 12

A patient has just taken her first dose of Zocor for her high cholesterol. Within minutes, she begins to develop hives, shortness of breath, and low blood pressure. In this case, the EMT would recognize a/an:

Accepted Answer

A)  sensitized immune response. 
B)  anaphylaxis. 
C)  hypersensitivity reaction. 
D)  anaphylactoid reaction.

Question 13

A patient informs you that he found out he is allergic to certain molds and was prescribed an epinephrine auto-injector. He asks you how the epinephrine will help him the next time he is exposed to mold. Your response would be:

Accepted Answer

A)  "It will quickly destroy the allergen in the mold." 
B)  "It will provide antibodies to your body and give you temporary immunity." 
C)  "It will reverse the reaction by mimicking the parasympathetic nervous system in your body." 
D)  "It will cause the blood vessels to constrict and increase your blood pressure."

Question 14

After you assist a patient with his epinephrine auto-injector, which one of the following statements made by the patient best indicates that the epinephrine is working and the patient is improving?

Accepted Answer

A)  "My breathing feels a lot easier." 
B)  "My heart feels as though it is racing." 
C)  "I am getting a little bit of a headache." 
D)  "I am more relaxed and getting sleepy."

Question 15

A young female patient, who is allergic to peanuts, was just exposed to peanut butter. Assessment reveals her to be alert and oriented with swollen lips and hives on her face. She is breathing adequately at a rate of 18 breaths per minute and has a heart rate of 82. Your partner advises you that her blood pressure is 118/72 mmHg and room air SpO₂ 92%. She states that she also has asthma for which she uses an inhaler. Of the following, what would you do first?

Accepted Answer

A)  Assist her with her inhaler. 
B)  Provide supplemental oxygen. 
C)  Start positive pressure ventilation. 
D)  Determine the amount of peanut butter consumed.

Question 16

A mother has called you for her 9-year-old daughter who was stung in the right hand by a bee. She states that her older daughter is allergic to bees and she is scared that the patient may also be allergic, although she has never been stung before. Assessment of the patient reveals a red, painful, and swollen area on the back of the girl's right hand. The primary assessment is unremarkable and her vital signs are normal. The mother hands you her older daughter's epinephrine pen. You would:

Accepted Answer

A)  administer the epinephrine into the patient's thigh. 
B)  ask the mother to administer the pen into the patient's thigh. 
C)  wash the patient's hand with soap and water. 
D)  contact medical direction for permission to use the Epi-pen.

Question 17

Which of the following explains why patients experiencing an anaphylactic reaction have difficulty breathing?

Accepted Answer

A)  Allergens use the available oxygen molecules. 
B)  Antibodies depress the brain's respiratory center. 
C)  Histamine constricts the bronchioles. 
D)  Antigens increase the body's need for oxygen.

Question 18

An awake but confused patient experiencing an allergic reaction begins to exhibit stridorous respirations. The EMT knows that the underlying condition responsible for this presentation is:

Accepted Answer

A)  constriction of the small airways. 
B)  spasm of the lower airway. 
C)  swelling to the upper airway. 
D)  loss of the gag reflex.

Question 19

You have been called to a kindergarten class for a 5-year-old boy who is allergic to peanuts. He ate some in the form of a birthday treat brought to school by a classmate who is celebrating a birthday. From the door of the classroom, you note the patient to have swollen lips and hives to his face and arms. As you begin the primary assessment, which one of the following should you do first?

Accepted Answer

A)  Contact the patient's parents for permission to treat him. 
B)  Inspect the inside of his mouth. 
C)  Determine how many peanuts he ingested. 
D)  Check breath sounds for wheezing and assess the vital signs.

Question 20

A 39-year-old female, who is allergic to peanuts, thinks that she may have accidentally ingested some. When assessing her, which statement would be suggestive that the patient is in the early stages of an anaphylactic reaction?

Accepted Answer

A)  "I feel as though I am getting a fever." 
B)  "My heart suddenly feels as though it is skipping some beats." 
C)  "I feel dizzy and weak." 
D)  "I suddenly feel like a have a lump in my throat."

Exam 21: Anaphylactic Reactions