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Which of the following is the reason why infants rarely experience anaphylactic reactions?


A) Infants have not yet developed antibodies to allergens.
B) Infants have received natural immunity to allergens from their mothers before birth.
C) Allergens do not affect infants.
D) None of the above

E) A) and B)
F) A) and C)

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Which of the following occurs to blood vessels during an anaphylactic reaction?


A) Constriction
B) No change
C) Spasm
D) Dilation

E) All of the above
F) A) and D)

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If a patient was having a myocardial infarction,not an allergic reaction,and received an epinephrine auto-injection,which of the following would most likely occur?


A) Bradycardia
B) Stronger and faster heartbeat
C) No reaction if administered inadvertently
D) Relief of shortness of breath

E) B) and D)
F) A) and B)

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After administering epinephrine per medical control via an auto-injector to an unresponsive anaphylactic adult patient,your partner reassesses the lung sounds.He tells you that the patient is now wheezing loudly in all fields whereas before the injection they were diminished in the upper fields and absent in the lower.What is your suspicion regarding the patient's condition?


A) The patient's condition is worsening.
B) The patient's condition is improving.
C) There is no change in the patient's condition.
D) The patient is about to go into cardiac arrest.

E) A) and B)
F) C) and D)

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You are on the scene of a motor vehicle collision in which a car has driven off the roadway and is resting at the bottom of an embankment.The driver is in severe respiratory distress and is unable to speak.His skin is flushed and he has hives.A Medic-Alert bracelet indicates an allergy to peanuts.You notice a candy bar wrapper on the floor of the car.Which of the following should you do first?


A) Administer high-concentration oxygen.
B) Read the candy wrapper to see if it contains peanuts.
C) Perform rapid extrication.
D) Search the patient for an epinephrine auto-injector.

E) A) and B)
F) All of the above

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At which of the following sites should the EMT administer an epinephrine auto-injector?


A) Abdomen
B) Upper arm
C) Thigh
D) Buttocks

E) B) and C)
F) A) and D)

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You are called to a residence for a 50-year-old male complaining of difficulty breathing.He is alert and oriented to time,place,and person.The patient presents with hives over the chest,stridor,a swollen tongue,and wheezing in the upper fields.He is breathing 32 times per minute.He is speaking in two- to three-word sentences.What is the best treatment for the patient?


A) Administering epinephrine with consent from medical control
B) Oxygen at 15 liters per minute by nonrebreather mask
C) Oxygen at 15 liters per minute by bag-valve mask
D) Rapid transport to the nearest facility

E) B) and D)
F) A) and D)

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Which of the following statements concerning severe allergic reactions is true?


A) The quicker the onset of symptoms, the greater the likelihood of a severe allergic reaction.
B) A severe allergic reaction can be prevented by the use of an epinephrine auto-injector before exposure to the substance.
C) Allergies do not develop until a person is in his late teens to early 20s.
D) A severe allergic reaction occurs only when the patient has never been exposed to the substance before.

E) B) and C)
F) A) and D)

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Your patient is a 45-year-old female who is allergic to sesame seeds,which she accidentally ingested when she ate a deli sandwich.She is having difficulty breathing,and she has hives,watery eyes,a weak pulse of 120 per minute,and swelling of the face and tongue.Which of the following is the BEST course of immediate action?


A) Transport immediately.
B) Contact medical control for orders to administer the patient's epinephrine auto-injector.
C) Contact dispatch to see where the closest ALS unit is.
D) Insert an oropharyngeal airway (OPA) .

E) B) and C)
F) All of the above

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B

Which of the following is an action caused by epinephrine in anaphylaxis?


A) Decreased heart rate
B) Vasoconstriction
C) Bronchoconstriction
D) All of the above

E) A) and B)
F) A) and C)

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B

Which of the following is included in the primary assessment of a conscious patient suffering from anaphylactic shock?


A) Assessing whether the patient is able to speak without difficulty
B) Finding out how the patient was exposed to the substance to which she is allergic
C) Looking for hives and swelling
D) Determining whether the patient's systolic blood pressure is over 100 mmHg

E) B) and D)
F) B) and C)

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Your patient has eaten a casserole that may have contained seafood.The patient is worried because he has a seafood allergy.Upon assessment,you find no signs or symptoms of anaphylaxis.The patient's vital signs are stable and he has an epinephrine auto-injector prescribed to him.Which of the following actions is most appropriate?


A) Assist him with the administration of his epinephrine auto-injector.
B) Advise the patient that he does not require treatment and transport at this time.
C) Try to find out if the casserole contained seafood.
D) Transport the patient rapidly before the onset of anaphylaxis.

E) None of the above
F) A) and C)

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Which of the following explains why a patient may experience difficulty breathing during anaphylaxis?


A) Swelling in the brain decreases the respiratory drive.
B) Swelling of the airway tissues causes difficulty breathing.
C) Allergens clump together and block blood flow through the lungs.
D) Allergens bind to hemoglobin, preventing it from carrying oxygen.

E) A) and C)
F) B) and D)

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B

You are transporting a 41-year-old female suffering from severe anaphylaxis.Her respiratory rate is 42 per minute,she is cyanotic,and she has a decreased level of responsiveness.Which of the following is the highest priority of care for this patient?


A) Elevate the patient's head.
B) Transport rapidly.
C) Search for an epinephrine auto-injector.
D) Assist ventilations with a bag-valve mask.

E) None of the above
F) B) and C)

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Which of the following is NOT an indication that epinephrine is helping the anaphylaxis patient's condition?


A) Increased blood pressure
B) Increased heart rate
C) Increased dyspnea
D) Both B and C

E) B) and D)
F) C) and D)

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Your patient has a history of severe anaphylaxis and carries several auto-injectors.You have administered one of the auto-injectors,but the patient's condition continues to worsen.Which of the following is the next best course of action?


A) Divert transport to a hospital with critical care capabilities.
B) Continue supportive care en route to the hospital.
C) Contact medical control.
D) Immediately administer a second auto-injector.

E) A) and B)
F) None of the above

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Upon delivering a patient to the emergency department,you remove your gloves and find that your hands are red and itchy.Which of the following is most likely?


A) You are showing early signs of an anaphylactic reaction.
B) You have come into contact with poison ivy in the patient's yard.
C) You have been exposed to an infectious disease through contact with the patient.
D) You are having an allergic reaction to the latex in the gloves.

E) B) and C)
F) A) and B)

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Most epinephrine auto-injectors,except the Twinject,contain how many doses of epinephrine?


A) Two
B) Three
C) One
D) None of the above

E) A) and B)
F) A) and C)

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Which of the following is NOT a side effect of epinephrine?


A) Pallor
B) Vomiting
C) Bradycardia
D) Chest pain

E) C) and D)
F) None of the above

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You respond to a local swim park for a 29-year-old male who was stung by a bee and "passed out." Upon arrival,you find the patient unresponsive to all stimuli with agonal respirations at 6 per minute.You insert an oral airway and administer oxygen at 15 liters per minute by bag-valve mask.You notice that it is difficult to bag the patient.Your partner listens to lung sounds and states they are very diminished in the upper fields and absent in the lower fields.What is the best action?


A) Request an ALS unit.
B) Hyperventilate the patient.
C) Request orders from medical control for an emergency cricothyroidotomy.
D) Request orders from medical control to administer epinephrine.

E) C) and D)
F) A) and C)

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