Name: __________________________ Date: _____________



1.
When administering epinephrine via auto-injector, you should hold the injector in place for:
A.
5 seconds.
B.
10 seconds.
C.
15 seconds.
D.
20 seconds.


2.
While auscultating breath sounds of a patient who was stung multiple times by a yellow jacket, you hear bilateral wheezing over all lung fields. This indicates:
A.
rapid swelling of the upper airway tissues.
B.
a significant amount of fluid in the alveoli.
C.
narrowing of the bronchioles in the lungs.
D.
enlargement of the bronchioles in the lungs.


3.
Which of the following MOST accurately defines an allergic reaction?
A.
an exaggerated immune system response to any substance
B.
destruction of the immune system by an external substance
C.
a release of erythrocytes in response to a foreign substance
D.
a direct negative effect on the body by an external substance


4.
You respond to the residence of a 55-year-old female with a possible allergic reaction to peanuts that she ate approximately 30 minutes ago. The patient is conscious and alert, but has diffuse urticaria and the feeling that she has a lump in her throat. As your partner applies oxygen to the patient, you should:
A.
ask her if she has prescribed epinephrine.
B.
obtain a complete set of baseline vital signs.
C.
ascertain if she has a family history of allergies.
D.
ask her when her last allergic reaction occurred.


5.
Which of the following patients would MOST likely have a delayed onset of an allergic reaction?
A.
a 21-year-old female who inhaled pollen
B.
a 30-year-old male who was stung by a bee
C.
a 45-year-old male who ingested penicillin
D.
a 50-year-old male who was exposed to latex


6.
Most patients who die of anaphylaxis do so within the first __________ following exposure.
A.
5 minutes
B.
30 minutes
C.
60 minutes
D.
90 minutes


7.
Anaphylaxis is MOST accurately defined as a(n):
A.
moderate allergic reaction that primarily affects the vasculature.
B.
extreme allergic reaction that may affect multiple body systems.
C.
severe allergic reaction that typically resolves without treatment.
D.
allergic reaction that causes bronchodilation and vasoconstriction.


8.
Common signs and symptoms of an allergic reaction include all of the following, EXCEPT:
A.
abdominal cramps.
B.
drying of the eyes.
C.
flushing of the skin.
D.
persistent dry cough.


9.
The adult epinephrine auto-injector delivers ______ mg of epinephrine, and the pediatric auto-injector delivers ______ mg.
A.
0.1, 0.01
B.
0.01, 0.1
C.
0.03, 0.3
D.
0.3, 0.15


10.
You are assessing a young male who was stung on the leg by a scorpion. He is conscious and alert, his breathing is regular and unlabored, and his blood pressure is 122/64 mm Hg. Assessment of his leg reveals a wheal surrounded by an area of redness. He states that he had a “bad reaction” the last time he was stung by a scorpion, and carries his own epinephrine auto-injector. You should:
A.
apply high-flow oxygen, apply a chemical cold pack directly to the injection site, and transport at once.
B.
apply high-flow oxygen, obtain approval from medical control to assist him with his epinephrine, and transport.
C.
assess his ABCs and vital signs in 15 minutes and allow him to drive himself to the hospital if he remains stable.
D.
apply oxygen as needed, clean the area with soap and water or a mild antiseptic, and transport him to the hospital.


11.
Common side effects of epinephrine include all of the following, EXCEPT:
A.
drowsiness.
B.
tachycardia.
C.
headache.
D.
dizziness.


12.
Which of the following sounds indicates swelling of the upper airway?
A.
rales
B.
stridor
C.
rhonchi
D.
wheezing


13.
A 19-year-old female was stung multiple times on the legs by fire ants. She states that she is allergic to fire ants, but does not carry her own epinephrine. The patient is conscious and alert and complains of pain to the area of the bites. Her blood pressure is 122/70 mm Hg, her pulse is 100 beats/min and strong, and her respirations are 18 breaths/min and unlabored. You should:
A.
position her legs well above the level of her heart.
B.
administer oxygen and transport her to the hospital.
C.
request a paramedic unit to administer epinephrine.
D.
advise her to see her physician as soon as possible.


14.
Which of the following statements regarding fire ants is correct?
A.
Fire ants often bite a person repeatedly.
B.
Fire ant bites rarely cause anaphylaxis.
C.
Fire ant bites typically occur on the face.
D.
Most people are allergic to fire ant toxin.


15.
The foreign substance responsible for causing an allergic reaction is called a(n):
A.
allergen.
B.
antibody.
C.
histamine.
D.
leukotriene.


16.
Which of the following would MOST likely provide clues regarding the source of a patient's allergic reaction?
A.
the patient's family history
B.
the patient's general physical appearance
C.
the environment in which the patient is found
D.
the time of season in which the exposure occurred


17.
Which of the following medications blocks the release of histamines?
A.
albuterol (Ventolin)
B.
epinephrine
C.
acetaminophen (Tylenol)
D.
diphenhydramine (Benadryl)


18.
After administering 0.3 mg of epinephrine via auto-injector to a 22-year-old female with an allergic reaction, you note improvement in her breathing and dissipation of her hives. However, she is still anxious and tachycardic. You should:
A.
contact medical control and obtain authorization to administer another 0.3 mg of epinephrine.
B.
transport her rapidly, as it is obvious that she is having a severe reaction to the epinephrine.
C.
monitor her closely but recall that anxiety and tachycardia are side effects of epinephrine.
D.
consider administering 0.15 mg of epinephrine to completely resolve her allergic reaction.


19.
Epinephrine is indicated for patients with an allergic reaction when:
A.
wheezing and hypotension are present.
B.
the patient is anxious and tachycardic.
C.
a paramedic is present at the scene.
D.
the reaction produces severe urticaria.


20.
Chemicals that are responsible for the signs and symptoms of an allergic reaction to a bee sting include:
A.
the bee venom itself.
B.
adrenaline and histamines.
C.
leukocytes and epinephrine.
D.
histamines and leukotrienes.


21.
Immediately after giving an epinephrine injection, you should:
A.
properly dispose of the syringe.
B.
record the time and dose given.
C.
reassess the patient's vital signs.
D.
notify medical control of your action.


22.
Urticaria is the medical term for:
A.
hives.
B.
burning.
C.
swelling.
D.
a wheal.


23.
A 48-year-old male is found unconscious in the garden by his wife. When you arrive at the scene and assess the man, you find that he is unresponsive, has severely labored breathing, and has hives over his entire trunk. You should:
A.
perform a detailed secondary assessment.
B.
maintain his airway and assist his ventilations.
C.
ask his wife if he has any known allergies.
D.
apply the automated external defibrillator (AED) in the event that cardiac arrest occurs.


24.
The effects of epinephrine are typically observed within _________ following administration.
A.
30 seconds
B.
1 minute
C.
30 minutes
D.
1 hour


25.
You have administered one dose of epinephrine to a 40-year-old female to treat an allergic reaction that she developed after being stung by a scorpion. Your reassessment reveals that she is still having difficulty breathing, has a decreasing mental status, and has a blood pressure of 80/50 mm Hg. You should:
A.
monitor her en route to the hospital and call medical control if she worsens.
B.
crush up an antihistamine tablet and place it in between her cheek and gum.
C.
request permission from medical control to give another dose of epinephrine.
D.
administer a nebulized bronchodilator to improve the status of her breathing.


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