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21) 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.
Objective: 20.6
22) 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.
Objective: 20.6
11
23) 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.
Objective: 20.6
24) You are called to a residence for a 60-year-old male complaining of chest pain. You find the
patient seated in bed. His past medical history includes hypertension and high cholesterol. The
patient presents with hives over the chest, stridor, a swollen tongue, and wheezing in the upper
fields. He denies any shortness of breath or respiratory distress, but does so in short two to three
word statements. What condition do you suspect?
A) Anaphylaxis
B) Asthma
C) Acute myocardial infarction
D) Angina pectoris
Objective: 20.6
12
25) You are on the scene of a 22-year-old female patient who is unresponsive. The patient's
mother states that she is deathly allergic to peanuts and accidentally ate stir fry cooked in peanut
oil. The patient is unresponsive with agonal respirations at 6 per minute. What is your first
action?
A) Administer epinephrine with medical control consent.
B) Insert an oral airway and apply oxygen at 15 liters per minute by nonrebreather mask.
C) Insert an oral airway and apply oxygen at 15 liters per minute by bag-valve mask.
D) Perform a complete assessment and confirm that the patient is actually in anaphylaxis.
Objective: 20.6
26) You are treating a 28-year-old female who is 34 weeks pregnant. She has a history of bee
sting anaphylaxis and was stung by a bee while in the garden. She is having severe respiratory
distress and her blood pressure is 72/50 mmHg. Which of the following is the BEST option for
the EMT?
A) Transport rapidly, bypassing the emergency department and taking the patient directly to the
obstetrics unit of the hospital.
B) Immediately administer the patient's Epi-Pen®.
C) Do not administer the Epi-Pen® under any circumstances.
D) Administer the Epi-Pen® only on the advice of medical control.
Objective: 20.7
13
27) You are unsure if a patient's condition requires the administration of an epinephrine auto-
injector. Which of the following actions is most appropriate?
A) Ask a family member if this is the type of situation when the patient usually takes his auto-
injector.
B) Administer the epinephrine, just in case.
C) Consult with a paramedic on your service for advice.
D) None of the above
Objective: 20.7
28) 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
Objective: 20.7
14
29) 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
Objective: 20.7
30) Which of the following does a physician NOT take into consideration when writing a
prescription for a patient to obtain an epinephrine auto-injector?
A) Patient's medical history
B) Severity of previous allergic reactions
C) How far the patient lives from medical attention
D) Patient's known allergies
Objective: 20.7
15
31) 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).
Objective: 20.7
32) 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
Objective: 20.8
16
