Emergency Care, 13e (Limmer et al.)
Chapter 31 Environmental Emergencies
1) In which of the following situations would a person lose heat by conduction?
A) Sitting on cold metal bleachers at a football game
B) Wearing wet clothing in windy weather
C) Breathing
D) Going outside without a coat during a cold but calm day
Objective: 31.1
2) Which of the following is the process in which heat is lost from the body as wind passes over
it?
A) Convection
B) Hydrodynamic cooling
C) Exposure
D) Condensation
Objective: 31.1
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3) Applying an external source of heat to the patient’s body to rewarm him is called ________
rewarming.
A) central
B) active
C) endogenous
D) peripheral
Objective: 31.1
4) A patient who is lying on cold ground is losing the most amount of heat by what mechanism?
A) Radiation
B) Convection
C) Conduction
D) Shivering
Objective: 31.1
5) In which of the following ways does the body produce heat in response to being cold?
A) Excreting more urine
B) Burning fewer calories
C) Shivering
D) Increasing the respiratory rate
Objective: 31.2
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6) Which of the following is the most significant way in which the body cools itself?
A) Respiration
B) Perspiration
C) Radiation
D) Vasoconstriction
Objective: 31.2
7) Most radiant heat is lost through which part of the body?
A) Hands and feet
B) Head
C) Buttocks
D) Torso
Objective: 31.2
8) When the body is in water, how many times faster does it lose heat than when it is in still air?
A) 2
B) 100
C) 10
D) 25
Objective: 31.2
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9) Which of the following terms describes the temperature of the surrounding air?
A) Wind chill index
B) Shell temperature
C) Core temperature
D) Ambient temperature
Objective: 31.2
10) Which of the following does NOT make infants and children more prone to hypothermia?
A) Inefficient metabolism
B) Large body surface area
C) Small muscle mass
D) Little body fat
Objective: 31.3
11) For which of the following reasons are newborns, infants, and the elderly more readily
affected by the heat than other age groups?
A) Faster metabolism
B) Increased body mass
C) Inadequate salt intake
D) Poor ability to regulate body temperature
Objective: 31.3
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12) Why are infants and young children more prone to hypothermia than adults?
A) Their immune system is not fully developed.
B) They are unable to recognize how cold they are.
C) They shiver more than adults.
D) They have less fat than adults.
Objective: 31.3
13) Who is the most susceptible to hypothermia?
A) 21-year-old near-drowning patient on a warm spring day
B) 55-year-old male patient who sprained his knee snow skiing
C) 76-year-old male patient involved in a vehicle accident on icy roads
D) 80-year-old male patient on the ground who slipped and has a hip fracture
Objective: 31.3
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14) Which of the following signs would you NOT expect to see in a patient suffering from severe
hypothermia?
A) Numbness
B) Shivering
C) Drowsiness
D) Skin cool to touch
Objective: 31.4
15) Which of the following would you expect to see in a patient with severe hypothermia?
A) Irrational behavior
B) Loss of muscle tone
C) Rapid respirations
D) Tachycardia
Objective: 31.4
16) Why is it important to remove constricting items such as rings before thawing a frozen
extremity?
A) Because thawed areas often swell
B) To prevent damage to the property such as rings and watches
C) Because thawing leaves clots behind in the veins
D) All of the above
Objective: 31.5
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17) Allowing a patient’s body temperature to increase by preventing further heat loss is referred
to as which of the following?
A) Core rewarming
B) Passive rewarming
C) Active rewarming
D) Natural rewarming
Objective: 31.5
18) Which of the following is acceptable when actively rewarming a hypothermic patient?
A) Encouraging the patient to exercise
B) Giving coffee or brandy to drink
C) Warming the patient as quickly as possible
D) Applying humidified oxygen
Objective: 31.5
19) When actively rewarming a frostbitten extremity in warm water, you should change the
water when the temperature falls below ________ °F.
A) 115 to 120
B) 100 to 105
C) 85 to 95
D) 80 to 90
Objective: 31.5
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20) The technique for central rewarming requires the application of heat to which of the
following areas of the patient’s body?
A) Chest, back, neck, and armpits
B) Lateral chest, neck, armpits, and groin
C) Head, neck, chest, and back
D) Head, neck, chest, and groin
Objective: 31.5
21) To assess skin temperature for a possibly hypothermic patient, the EMT should place the
back of his hand against which part of the patient’s body?
A) Forehead
B) Cheek
C) Abdomen
D) Inner wrist
Objective: 31.6
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22) Why is it important to keep patients at rest when they are hypothermic?
A) Since the blood is warmest in the extremities, exercise or unnecessary movement could
quickly circulate the warm blood and raises the core body temperature.
B) Since the blood is coldest in the extremities, exercise or unnecessary movement could quickly
circulate the cold blood and drop the blood pressure.
C) Since the blood is coldest in the extremities, exercise or unnecessary movement could quickly
circulate the cold blood and lower the core body temperature.
D) None of the above
Objective: 31.6
23) When resuscitating a hypothermic patient in cardiac arrest, resuscitation attempts must
continue until the patient has:
A) been ventilated for at least 30 minutes with an oropharyngeal airway (OPA) in place.
B) developed rigor mortis.
C) been defibrillated a total of nine times.
D) been rewarmed.
Objective: 31.6
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24) You are on a stand-by at a local high school football game. One of the football players comes
over to the ambulance and complains that his face feels numb and that he has a burning sensation
in his fingers. You notice that the patient’s cheeks and fingers are bright red. How should you
treat the patient?
A) Allow the patient to warm up inside the ambulance by passive rewarming measures.
B) Place the patient inside the ambulance and begin active rewarming measures.
C) Warm the affected areas with gentle rubbing.
D) Tell the patient that his condition is superficial and allow him to return to the game.
Objective: 31.6
25) You respond to a landing zone to pick up a skier who was lost in the woods for 36 hours and
found by the search and rescue helicopter. Your patient is a 19-year-old male patient. He is alert
and oriented to time, person, place, and event. He is covered in blankets and shivering. He
complains of not being able to feel his fingers. Physical exam reveals that the fingers of both
extremities have a waxy appearance and feel “frozen” on the surface. After treating the patient
for potential hypothermia and rapid transport, your next action is to:
A) bandage the digits.
B) actively rewarm the digits.
C) gently warm the digits by slowly massaging them.
D) keep the digits frozen on ice until they can be properly rewarmed at the hospital.
Objective: 31.6
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