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Emergency Care, 13e (Limmer et al.)
Chapter 20 Allergic Reaction
1) What is another name for a severe allergic reaction?
A) Dermatitis
B) Asthma
C) Anaphylaxis
D) Psychosomatic reaction
Objective: 20.1
2) 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.
Objective: 20.2
1
3) Which of the following is NOT a sign or symptom of an allergic reaction involving the skin?
A) Cyanosis
B) Flushing
C) Hives
D) Itching
Objective: 20.2
4) You are called to a farmhouse on a sunny spring afternoon. Upon arrival, a frantic mother tells
you that her 3-year-old daughter was playing in the yard, accidentally stepped on a hornets' nest,
and was stung repeatedly. The patient is alert, screaming and crying, and can follow her mother's
commands. Her arms and legs are swollen and show the marks of several stings. Her body is
covered in hives. Her vital signs are blood pressure 90/40, pulse 110, respiratory rate 24, and
oxygen saturation 99%. Her lung sounds are clear and equal bilaterally. Her mother states she put
"nox-a-sting" on the bites but the bites only seemed to get worse. What condition is the patient
suffering from?
A) Minor anaphylactic reaction
B) Moderate anaphylactic reaction
C) Allergic reaction from the hornets' stings
D) Anaphylactic reaction from the "nox-a-sting" swabs
Objective: 20.2
2
5) Which of the following is MOST likely to be a complaint of a patient suffering from
anaphylaxis?
A) "I am having severe muscle pains."
B) "My legs are numb and I can't move them."
C) "My throat feels like it is closing."
D) "I can't remember what happened."
Objective: 20.2
6) Which of the following would you expect to hear when auscultating the lungs of a patient
having an anaphylactic reaction?
A) Clear, adequate air movement
B) Fine, wet crackles or rales
C) Coarse-sounding rhonchi
D) Wheezing
Objective: 20.2
3
7) You have responded to a park where you find a 23-year-old female sitting on a bench near a
running trail. She states that she has been running for the past 30 minutes, and all of a sudden she
cannot catch her breath. She states that this has never happened before and she usually runs 5
miles a day. Your assessment reveals that she is flushed, her pulse is fast and weak, her
respirations are fast and she is wheezing, and she has hives on her arms and chest. She is most
likely suffering from which of the following?
A) Anaphylaxis
B) Heat stroke
C) Allergic reaction
D) Hyperventilation syndrome
Objective: 20.2
8) Which of the following occurs to blood vessels during an anaphylactic reaction?
A) Constriction
B) No change
C) Spasm
D) Dilation
Objective: 20.2
4
9) Your patient is a 7-year-old girl who was prescribed an antibiotic for an ear infection. After 4
days on the antibiotic, the patient is experiencing hives and itching on her face, throat, and neck.
Which of the following should you do?
A) Advise the parents that these symptoms are related to the ear infection and the antibiotic will
take care of these symptoms if taken as directed.
B) Provide supportive care and monitor the patient's condition during transport to the hospital.
C) Advise the parents to call the pediatrician for a different antibiotic.
D) Immediately administer Epi-Pen Jr.®
Objective: 20.2
10) You are called to the local park on a hot summer day for an 8-year-old child in respiratory
distress. The child can barely speak and appears to be getting sleepy. Vital signs are blood
pressure 90/60, pulse 120, and respiratory rate 32. Your physical exam reveals a swollen tongue,
inspiratory stridor, wheezing, and hives on the neck and chest. What condition do you suspect?
A) Asthma
B) Heat exhaustion
C) Allergic reaction
D) Anaphylaxis
Objective: 20.2
5
11) Which of the following changes commonly occurs in the cardiovascular system during
anaphylaxis?
A) Low blood pressure due to vasodilation
B) High blood pressure due to tachycardia
C) High blood pressure due to vasoconstriction
D) Low blood pressure due to bradycardia
Objective: 20.2
12) A 35-year-old female has just eaten lobster and is now complaining of itchy, watery eyes.
Her blood pressure is beginning to fall, but she denies difficulty breathing. Which of the
following best describes her condition?
A) Anaphylaxis
B) Dyspnea
C) Shock
D) Mild allergy
Objective: 20.2
6
13) 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.
Objective: 20.3
14) 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
Objective: 20.3
7
15) Which of the following is the result of histamine and other chemicals in the body during
anaphylaxis?
A) Urticaria occurs due to fluid being shunted from the skin, causing dehydration of tissue.
B) Blood vessels constrict, capillaries become leaky, and bronchoconstriction occurs.
C) Capillaries become leaky, bronchoconstriction occurs, and swelling appears in areas around
the vocal cords.
D) Bronchodilation occurs, blood vessels dilate, and swelling appears in areas around the vocal
cords.
Objective: 20.4
16) Which of the following is a general term for a substance to which the body may have an
anaphylactic reaction?
A) Pathogen
B) Allergen
C) Antibody
D) Pyrogen
Objective: 20.5
8
17) Which of the following does NOT commonly lead to anaphylaxis?
A) Peanuts
B) Cat dander
C) Wasp stings
D) Sulfa drugs
Objective: 20.5
18) 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.
Objective: 20.5
9
19) As you prepare to enter a patient's room in a nursing home, you see a sign posted on the door
indicating that the patient has a latex allergy. Which of the following is the BEST way to care for
the patient?
A) Only perform a history on this patient, not a physical exam, so you can avoid contacting him
with your gloves.
B) Ask the nursing staff if the patient has an epinephrine auto-injector available in case of a
reaction to your gloves.
C) Put on latex gloves anyway; you must protect yourself with BSI.
D) Ask the nursing facility staff to find synthetic exam gloves to wear for contact with this
patient.
Objective: 20.6
20) 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
Objective: 20.6
10
