1.

A patient tells you that he is allergic to poison ivy and that while burning it yesterday he accidentally inhaled some of the smoke. He awoke today to find a red rash on the back of his left hand and is concerned. Assessment reveals him to be alert and oriented, with easy respirations and a blood pressure of 128/ ! mm/Hg. "hich of the following actions should you take ne#t$ a. b. c. d. %ell him you are calling an A&' ambulance for him. Assist him with his epinephrine auto(in)ector. *btain a medical history using the 'A+,&- acronym. tell him the rash probably has nothing to do with inhaling the smoke.

Answer. c *b)ective. 'upplemental /eference. 001 2. "hich of the following statements best suggests that the speaker may be having a mild allergic reaction$ a. b. c. d. 23 have had a fever and chills for the past two days.4 2+y heart feels as though it is skipping some beats.4 23 feel di55y and weak.4 23 have a rash on my face and neck.4

Answer. d *b)ective. 10(0 /eference. 016, 000 1. A patient who is responsive only to painful stimuli is covered with hives. He has labored respirations and a weak and tachycardic pulse. His vital signs are pulse 128, respirations 20, and blood pressure 8!/7! mmHg. 8iven this presentation, you would suspect. a. b. c. d. hypotension. an anaphylactic reaction. a stroke. a head in)ury.

Answer. b *b)ective. 10(0 /eference. 00!, 000 0. 9uring a primary assessment, which of the following findings would most lead you to suspect an allergic reaction$ a. b. c. d. Hives on the face and neck :lood pressure of 1!!/;! mmHg Heart rate of 77 beats per minute A complaint of di55iness

Answer. a *b)ective. 10(0 /eference. 000 7. A patient who is severely short of breath and covered with hives states that she is very allergic to crab. 'he admits to trying some seafood dip about 1! minutes ago. "hich of the following <uestions should you ask her first$ a. b. c. d. 2How many allergic reactions have you had$4 2"hy did you eat the dip if you are allergic to crab$4 2"hat medications are you currently taking$4 29o you have an epinephrine auto(in)ector$4

Answer. d *b)ective. 'upplemental /eference. 001 ;. %he patient has swollen lips and hives. "hich of the following scene si5e(up observations supports your suspicion that the patient is having an allergic reaction$ a. b. c. d. He has a glucometer among his belongings. He has a new container of antibiotics with only two pills missing. He states that several members of his family have the flu. He has a bottle of e#pired nitroglycerin tablets.

Answer. b *b)ective. 10(1 /eference. 018 . %he most severe form of an allergic reaction is called. a. b. c. d. vascular shock. anaphyla#is. an antigen response. rhinorrhea.

Answer. b *b)ective. 10(0 /eference. 01 8. "hen the respiratory effects of an allergic reaction are obvious within a few seconds to minutes. a. the reaction tends to be more severe. b. the reaction tends to be locali5ed. c. a large amount of allergen is likely involved.

d. epinephrine will not be effective. Answer. a *b)ective. 10(0 /eference. 00! 6. *n scene you assisted a patient with his epinephrine auto(in)ector after he was stung multiple times by bees. =ou are now transporting him to the first aid room. As you reassess him, which of the following signs best indicates that the epinephrine is benefiting him$ a. b. c. d. 3ncreasing heart rate 9ecreasing mental status 9ecreasing whee5ing 9ecreasing blood pressure

Answer. c *b)ective. 'upplemental /eference. 00 1!. A patient who is allergic to peanuts was )ust e#posed to peanut butter. Assessment reveals her to be alert and oriented, with swollen lips and hives on her face. 'he states that she is lightly short of breath> her respiratory rate is 2! per minute. 'he has a heart rate of 82 and a blood pressure of 118/ 2 mmHg. 'he states that she is nauseated and has a headache. "hich of the following actions is your immediate treatment for this patient$ a. b. c. d. 3nsert an oropharyngeal airway. ,rovide o#ygen via nonrebreather mask. 'tart positive pressure ventilation with :?+. ,lace the patient in a supine position.

Answer. b *b)ective. 'upplemental /eference. 00;@00 11. =ou have arrived by the side of a patient who is allergic to late# and was e#posed to it when she spilled a late#(containing powder on her right hand. Assessment reveals her to be panicked. 'he is able to speak only a few words with each breath. Her tongue is swollen and her respirations are rapid, labored, and noisy. "hich of the following actions should be your priority$ a. b. c. d. 3nsert an oropharyngeal airway. "ash the late# powder off of the hand. *btain a heart rate and blood pressure. 8et a 'A+,&- history.

Answer. b *b)ective. 'upplemental

/eference. 00; 12. =ou are responding to a call for a patient with an allergic reaction. =our partner is a new *-A %echnician, and this is his first call. "hich of the following instructions to him about assessment and treatment of an allergic reaction would be correct$ a. 23f the allergic reaction was caused by e#posure to chocolate or eggs, donBt let the patient use auto(in)ect epinephrine.4 b. 2-pinephrine should be given to any patient suffering an allergic reaction to prevent anaphyla#is.4 c. 2*ur first priority is to treat the patientBs A:A9s.4 d. 23f the allergic reaction was caused by food, we should try to make the patient vomit.4 Answer. c *b)ective. 'upplemental /eference. 00; 11. A patient informs you that any time she uses a particular soap, she e#periences a mild allergic reaction. =ou recogni5e that. a. b. c. d. the soap contains an allergen. her airway will swell shut if she inhales the soap. the soap contains antibodies that react in her body. she must have been e#posed to the soap as an infant.

Answer. a *b)ective. 10(2 /eference. 01 10. "hich of the following statements indicates that the speaker understands allergic reactions and anaphyla#is$ a. 2An allergic reaction only occurs when the patient ingests or inhales an allergen> anaphyla#is occurs when the allergen is in)ected.4 b. 2Allergic reactions are caused by pollen and food> anaphylactic reactions are caused by venoms and medications.4 c. 2Anaphyla#is is a severe allergic reaction that will lead to death without emergency care.4 d. 2Anaphyla#is describes a severe allergic reaction that occurs the first time a person is e#posed to an allergen.4 Answer. c *b)ective. 10(1 /eference. 01 17. "hich of the following foods most commonly causes an allergic reaction$

a. b. c. d.

'hellfish Ahocolate ,eanuts -ggs

Answer. c *b)ective. 10(1 /eference. 016 1;. =ou are called to the lodge to help a patient who has developed an allergic reaction after taking an antibiotic medication. =ou would describe this route of e#posure as. a. b. c. d. in)ection. contact. ingestion. inhalation.

Answer. c *b)ective. 10(2 /eference. 01 1 . "hich of the following statements e#plains why patients e#periencing a moderate or severe allergic reaction have difficulty breathing$ a. b. c. d. *#ygen molecules are being used up by allergens. %he brainBs respiratory center is being depressed. %he bronchioles constrict and are clogged by thick secretions. %he workload on the heart has increased.

Answer. c *b)ective. 'upplemental /eference. 00! 18. "hich of the following statements made by the patient after you assist him with his epinephrine auto(in)ector best indicates that the epinephrine is working and that the patient is improving$ a. b. c. d. 2+y breathing feels a lot easier.4 2+y heart feels as though it is racing.4 23 am getting a little bit of a headache.4 23 am more rela#ed and getting sleepy.4

Answer. a *b)ective. 'upplemental /eference. 006

16. Cive minutes after you assist a patient with her epinephrine auto(in)ector, she states that she feels much better and would like to refuse additional care. "hat of the following statements would be most appropriate given the situation$ a. 23f you feel better now, there is probably no need to go to the hospital. :ut you should get another auto(in)ector.4 b. 2Dow that you have taken your epinephrine, you should to go to the hospital for additional care.4 c. 2-pinephrine can make your heart race. :ut donBt worry, you donBt need more care> )ust be sure that someone is with you.4 d. 2%he epinephrine will wear off in 1! to 2! minutes. As long as you have another in)ector 3 can watch you and see what happens.4 Answer. b *b)ective. 'upplemental /eference. 006 2!. After assisting a patient with his epinephrine auto(in)ector, you note that his blood pressure has improved. =ou reali5e that this finding probably resulted from epinephrineBs ability to. a. b. c. d. rela# the smooth muscle of blood vessels. constrict blood vessels. increase the number of circulating red blood cells. increase the o#ygen(carrying capacity of the red blood cells.

Answer. b *b)ective. 'upplemental /eference. 00 21. =our patient is having an allergic reaction and needs to use his epinephrine auto(in)ector. He is concerned that he does not recall the correct way to do it. "hich of the following things would you tell him$ a. 2,ress the in)ector onto the outer thigh, push the tip against the thigh until the needle deploys, and wait for it to automatically in)ect.4 b. 2,lace the in)ector against the outer upper arm, push the tip until the needle deploys, and then push the plunger slowly to in)ect the medication.4 c. 2,inch the skin on the anterior thigh, press the in)ector tip against the skin, and wait until it activates.4 d. 2,inch the skin on the lateral thigh, press the in)ector against the skin, and rapidly push the plunger to in)ect the medication.4 Answer. a *b)ective. 10(7 /eference. 008

22. =ou are staffing a first(aid booth at a mountain bike event. A mother approaches you with her 17( year(old son and informs you that her son is severely allergic to bees. Although he hasnBt been stung, she is concerned about the auto(in)ector he carries. %he mother states that it was prescribed when her son was 11 years old. 'he shows you the !.17 mg auto(in)ector, and you note that it e#pired about 12 months ago. "hich of the following statements would be most appropriate for you to make$ a. 2Aall your doctorBs office for a new prescription because this auto(in)ector is out of date.4 b. 23f you go to the pharmacy where you got this they will be able to give you a new one.4 c. 2+ost medications are still good for months after the e#piration date. =ou can use this one for a little while longer.4 d. 2%his medication is good for today but you should call your doctor as soon as possible to replace this.4 Answer. a *b)ective. 10(7 /eference. 008 21. "hich of the following findings would be a contraindication to the administration of epinephrine for a patient suffering an anaphylactic reaction$ a. b. c. d. %he patient is allergic to eggs. %he patient has a heart rate of 12! bpm. %he name on the in)ector is not the patientBs name. %he patient has hypertension or bradycardia.

Answer. c *b)ective. 10(7 /eference. 00 20. "hen administering epinephrine to an infant or child, the in)ector should be placed at what location$ a. b. c. d. %he outer buttock %he anterior thigh %he upper arm %he lateral thigh

Answer. d *b)ective. 10(7 /eference. 00 (008 27. A patient e#periencing an allergic reaction tells you that it is easier to breathe following administration of epinephrine. "hich of the following effects is an effect of epinephrine that would be responsible for this improvement$ a. 9ilation of the upper airway b. 9ilation of the bronchioles

c. 3ncreased blood flow to the lungs d. 9ecreased blood pressure Answer. b *b)ective. 'upplemental /eference. 00 2;. "hich of the following findings is present in anaphyla#is but is not a sign of a mild allergic reaction$ a. b. c. d. An#iousness 'welling at the site of a bee sting Hives Hypotension

Answer. d *b)ective. 10(0 /eference. 000@007 2 . An ac<uired, abnormal immune response to a substance that does not normally cause a reaction is known as. a. b. c. d. angioedema. an allergy. an allergen. an antigen.

Answer. b *b)ective. 10(1 /eference. 017 28. A foreign substance that triggers an allergic response in the body is known as. a. b. c. d. an antigen. histamine. an antibody. a mast cell.

Answer. a *b)ective. 10(1 /eference. 01; 26. A patient can have an allergic reaction caused by intramuscular administration of a medication. %his method by which an allergen enters the body is called. a. inhalation.

b. in)ection. c. ingestion. d. topical. Answer. b *b)ective. 10(1 /eference. 01 1!. %he overreaction of the immune system to a substance that is otherwise harmless is known as. a. b. c. d. hypersensitivity. hives. anaphyla#is. immunity.

Answer. a *b)ective. 10(1 /eference. 01 11. "hich of the following statements concerning allergies is true$ a. Allergies affect young healthy individuals only. b. An allergic reaction to a substance can occur minutes, or hours, after e#posure to the substance. c. *nce hypersensiti5ed to a substance, a given individual will e#perience allergic reactions to that substance randomly, not consistently. d. Anaphyla#is is the mildest type of allergic reaction. Answer. b *b)ective. 10(1 /eference. 01 12. %he approach allergists recommend to allergies is called 2%riple A,4 which refers to. a. b. c. d. awareness, avoidance, and action. allergy, antigen, and anaphyla#is. antibody, airway, and alveoli. airway, assisted ventilations, and advanced life support.

Answer. a *b)ective. 'upplemental /eference. 001