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Cardiovascular effects of anaphylaxis include:
tachycardia, flushed skin, and hypotension.
Which of the following medications has the SLOWEST onset of action when given to a patient with a severe allergic reaction?
The three MOST significant indicators of anaphylactic shock are:
dyspnea, hypotension, and tachycardia.
Following the primary response to a foreign substance, the body:
develops sensitivity and is able to recognize the substance following subsequent exposure.
What physiologic effect of anaphylactic shock is seen MOST commonly in patients with neurogenic shock?
A 31-year-old man presents with diffuse hives, intense itching, and watery eyes that began acutely about an hour ago. He is conscious and alert, is breathing without difficulty, and tells you that he does not have any allergies or significant medical problems. His blood pressure is 126/76 mm Hg, pulse is 110 beats/min and strong, and respirations are 16 breaths/min and unlabored. The MOST appropriate drug, dose, and route for this patient are:
diphendydramine, 25 to 50 mg, IM.
In the absence of IV or IO access, the ____ route is the preferred route for the administration of epinephrine to a patient in anaphylactic shock.
In contrast to acquired immunity, natural immunity occurs when:
the body encounters the antigen and experiences a full immune response with all the pathology of the disease.
The longer the time between exposure to a substance:
the less likely a severe anaphylactic reaction will occur.
When a person is vaccinated against a disease:
the body develops antibodies in response to the vaccine and produces an immune response before the disease can enter the body and cause damage.
Systemic lupus erythematosus is a disease caused by:
a multisystem autoimmune disorder.
A middle-aged male who received a kidney transplant called EMS because he was not feeling well. Which of the following assessment findings is MOST suggestive of organ rejection?
Fever with swelling and tenderness over the implanted kidney
You have treated the same patient several times for a severe allergic reaction. While educating him about the prevention of future reactions, you should advise him to:
avoid the substance he is allergic to.
When administering an EpiPen to a 30-year-old man with a severe allergic reaction, you should recall that:
the drug cartridge contains 0.3 mg of a 1:1,000 solution.
The term anaphylaxis is MOST accurately defined as:
You have administered the appropriate dose of epinephrine to a patient with a severe allergic reaction. Reassessment reveals that the patient's condition has improved markedly. The patient, who has a history of coronary artery disease, is receiving high-flow oxygen and is on a cardiac monitor. You should next:
transport at once, monitor airway and breathing en route, and administer up to 50 mg of Benadryl IV or IM.
The correct dose, concentration, and route of epinephrine for a 40-pound child with an allergic reaction and no signs of cardiovascular collapse are:
0.18 mg 1:1,000 SQ.
Hypotension secondary to histamine release is due to:
vasodilation and decreased cardiac contractility.
Histamine release causes all of the following effects, EXCEPT:
increased cardiac contractility, which results in hypertension.
Which of the following general statements regarding anaphylactic shock is correct?
In the presence of anaphylaxis, intervention takes precedence over identifying the offending antigen.
Patients with ______________ are at an increased risk for anaphylaxis.
Patients with systemic lupus erythematosus:
often take medications that suppress their immune system.
The MOST ominous respiratory sign in a patient with anaphylactic shock is:
diminished lung sounds.
You are caring for a 40-year-old man in obvious anaphylactic shock after being stung by a scorpion. The patient is responsive to pain only, has poor respiratory effort, and is hypotensive and tachycardic. Which of the following represents the MOST appropriate treatment sequence for this patient?
Assisted ventilation, intubation if necessary, at least one large-bore IV with normal saline, 1 mg epinephrine 1:10,000 IV, and up to 50 mg of Benadryl IV or IM
An unresponsive patient with signs of anaphylactic shock:
indicates cerebral hypoxia and hypercarbia.
A 26-year-old female presents with a fever, rash, and joint pain. Which of the following should you suspect?
An antigen is MOST accurately defined as a:
substance that causes the immune system to produce antibodies.
Common central nervous system manifestations of anaphylactic shock include all of the following, EXCEPT:
In contrast to cellular immunity, humeral immunity:
involves the use of antibodies dissolved in the blood plasma to fight off invading organisms.
Assessment of patients with collagen vascular diseases should focus on:
ruling out life threats.
Allergic rhinitis and asthma are MOST often the result of exposure to an allergen via the ___________ route.
Physiologic effects of histamine include all of the following, EXCEPT:
increased cardiac contractility.
A 20-year-old woman complains of difficulty breathing and the feeling of a lump in her throat approximately 10 minutes after being stung by a wasp. Your assessment reveals that she is anxious, is in obvious respiratory distress, and has hives covering her arms and legs. Further assessment reveals diffuse wheezing, a blood pressure of 80/50 mm Hg, and a heart rate of 120 beats/min. You should:
apply oxygen via nonrebreathing mask, start an IV with normal saline, and administer 1 mg of epinephrine 1:10,000 via IV push.
The chemical mediators that initiate and maintain the immune response are:
basophils and mast cells.
The primary treatment for hypotension secondary to anaphylaxis is:
Which of the following immunoglobulins is thought to stimulate antibody-producing cells to make antibodies?
Diphenhydramine (Benadryl) is used to treat allergic reactions because it:
blocks the histamine effects at the H1 receptor sites.
Early clinical manifestations of an allergic reaction include all of the following, EXCEPT:
Adults in anaphylactic shock should receive the ________ concentration of epinephrine via the ____ route in a dose of ____ mg.
1:10,000, IV, 0.1
Which of the following statements regarding the EpiPen Jr is correct?
It contains 0.15 mg of a 1:2,000 solution and is given IM.
A 56-year-old man is experiencing a severe allergic reaction following multiple ant bites. He tells you that he has a prescribed EpiPen, which is expired, and that he takes a beta blocker for hypertension. Which of the following medications would MOST likely improve his condition, given his medical history?
Glucagon and ipratropium
An abnormal immune response that the body develops when it is reexposed to an allergen is called:
an allergic reaction.
Which of the following clinical signs or symptoms are MOST indicative of upper airway swelling in a patient experiencing a severe allergic reaction?
Hoarseness and stridor
Which of the following statements regarding leukotrienes is correct?
Leukotrienes compound the physiologic effects of histamine and cause additional bronchoconstriction.
Which of the following medications causes the MOST IgE-mediated drug reactions in the United States?
____ antibodies respond in allergic reactions and are located _______.
IgE, on the mast and basophil cells
Transport of a patient in anaphylactic shock may be delayed for all of the following reasons, EXCEPT:
a secondary assessment.
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