1.

You are working at a mountain resort and are presented with a 50-year-old woman who states that she does not feel well. From your assessment, which of the following findings would seemingly indicate that the patient is being adversely affected by the high altitude a. b. c. d. !omiting after eating large meals "n elevated blood glucose level with no history of diabetes " heart rate of #$ beats per minute " complaint of dyspnea on e%ertion

"nswer& d 'b(ective& $)-5 *eference& +0,-+0. $. " patient at a mountain ski resort has notable shortness of breath. /he denies any past medical history and takes no medications. "fter applying o%ygen, you reali0e that the key to helping this patient improve is to& a. b. c. d. descend to a lower altitude. administer a respiratory medication by a metered-dose inhaler. position her in a left lateral recumbent position. place her in a supine position with her legs elevated.

"nswer& a 'b(ective& $)-1 *eference& +1$ ,. You are accompanying a team of hikers up a high mountain. 2he ne%t morning you are summoned to a tent and find one of the climbers confused and complaining of a headache. 3is airway is patent and his respirations are ade4uate. 3e has no medical history and was in good health until found ill this morning by his friend. /uspicious of high-altitude cerebral edema 53"678, which of the following actions should you take a. b. c. d. 9mmobili0e the patient. :rovide high-flow o%ygen. 9nsert an oropharyngeal airway. "dminister oral glucose.

"nswer& b 'b(ective& $)-1 *eference& +1$ .. 2he height or vertical elevation above a fi%ed point is known as& a. b. c. d. ascent. elevation. altitude. ata%ia.

"nswer& c

'b(ective& $)-1 *eference& )+) 5. "s altitude increases& a. b. c. d. barometric pressure increases. the partial pressure of o%ygen decreases. the concentration of o%ygen decreases. air density becomes greater.

"nswer& b 'b(ective& $)-$ *eference& +00 #. 2he concentration of o%ygen at sea level is appro%imately& a. b. c. d. ,5 percent. ., percent. .0 percent. $1 percent.

"nswer& d 'b(ective& $)-$ *eference& +00 1. Your family is planning a ski trip to a resort that is at about 10,000 feet of elevation. You suggest that you spend the first two nights of the trip at a hotel where the elevation is about #,500 feet. ;hen your children protest that they are in good shape and want to go immediately to the resort, you e%plain that you are concerned about altitude sickness and that& a. <physical fitness does not necessarily prevent altitude sickness.= b. <(ust because you children are fit and don>t need the gradual change doesn>t mean your mom and 9 don>t need it.= c. <your mom and 9 will e%ercise more before the trip so that maybe we can reduce the delay to one night.= d. <9>ll see if 9 can get some medication so that we don>t need to stop over at the lower elevation.= "nswer& a 'b(ective& $)-. *eference& +0, ). You are teaching a class on acute mountain sickness. ;hen one of your students asks you to e%plain the term acclimatization in relation to "?/, your best response would be which of the following statements a. <:hysiologic changes that increase the body>s ability to ad(ust to e%treme changes in temperature.= b. <:hysiologic changes that decrease the body>s need for o%ygen at high altitudes.=

c. <:hysiologic changes that decrease the body>s need for slow ascents.= d. <:hysiologic ad(ustments that increase the delivery of o%ygen to cells.= "nswer& d 'b(ective& $)-. *eference& +0$ +. ;hich of the following processes does not occur during acclimati0ation a. b. c. d. "n increase in respiratory rate and depth @ilation of pulmonary blood vessels "n increase in red blood cell production "n increase in heart rate

"nswer& b 'b(ective& $)-$ *eference& +0$ 10. 9n an otherwise healthy individual, the presence of a headache and feelings of sickness at high altitude is known as& a. b. c. d. a high-altitude migraine. acute mountain encephalitis. acute mountain sickness. high-altitude pulmonary edema.

"nswer& c 'b(ective& $)-5 *eference& +0, 11. 2he most common cause of death related to high altitude is& a. b. c. d. 3":7. chilblains. "?/. 3"67.

"nswer& a 'b(ective& /upplemental *eference& +0. 1$. You are with a group of hikers on the third day of an 11,000-foot mountain ascent. 'ne of the hikers has not been feeling well for a couple of days. 2oday, members of the group notice that he is having difficulty getting dressed and speaking. From your training in outdoor emergency care, you recogni0e that these signs and symptoms are most often associated with& a. acute mountain sickness. b. peripheral neuropathy. c. frostbite.

d. 3"67. "nswer& d 'b(ective& $)-5 *eference& +05 1,. You are teaching a class to '76 candidates and e%plain that a pre-e%isting illness may be complicated by the effects of high altitude. 9n teaching this concept to your class, you e%plain that the reason for this effect is that& a. b. c. d. the increased barometric pressure at high altitude makes the heart work harder. less o%ygen is available to vital organs at high altitude. dehydration can limit circulating blood volume. nausea makes it difficult for people to take their medications.

"nswer& b 'b(ective& /upplemental *eference& +0# 1.. 3igh-altitude pulmonary edema most commonly affects& a. b. c. d. young healthy individuals. individuals with a history of 6':@. middle-aged, out-of-shape hikers. individuals who ascend higher than 1,500 feet.

"nswer& a 'b(ective& /upplemental *eference& +0. 15. Aabored breathing at rest and audible chest congestion herald the development of a serious, potentially life-threatening stage of what altitude-related condition a. b. c. d. "cute mountain sickness :eripheral edema 3":7 Bhumbu cough

"nswer& c 'b(ective& $)-5 *eference& +0.-+05 1#. 2he most effective method for preventing high-altitude illness is to& a. b. c. d. make gradual ascents. maintain ade4uate hydration and eat a high-carbohydrate diet. take medications such as @iamo%. avoid drinking alcohol.

"nswer& a 'b(ective& $)-. *eference& +0+ 11. You are working at the summit of a +,000-foot mountain. " #0-year-old woman is brought to you complaining of headache, fatigue, and shortness of breath. You prepare to do your assessment and recogni0e that your goal is to& a. give her some ibuprofen to ease her headache. b. determine whether this is an emergent condition so that you can initiate life-saving treatment. c. get the patient lying down to relieve her presenting symptoms. d. find out if she has an inhaler she can use to relieve her shortness of breath. "nswer& b 'b(ective& $)-# *eference& +11 1). Civen that 50 percent of patients with 3":7 also have symptoms of "?/, it is important that you ask patients if they have had which of the following groups of signsDsymptoms a. b. c. d. 3eadache, blurred vision, peripheral edema 3arsh cough, itchy skin, nausea @ifficulty sleeping, vomiting, ata%ia Fatigue, nausea, difficulty sleeping

"nswer& d 'b(ective& $)-# *eference& +11 1+. ;hat percentage of patients who have 3":7 do not develop "?/ first a. b. c. d. 10 percent $0 percent .0 percent 50 percent

"nswer& d 'b(ective& $)-# *eference& +0. $0. 9n order to assess for a key symptom of 3"67, you would ask patients to& a. b. c. d. walk a straight line heel to toe. take a deep breath and let you know if it hurts. tell you if their rings are fitting tightly. read an eye chart.

"nswer& a

'b(ective& $)-# *eference& +1$ $1. You have a ,$-year-old male patient who (ust arrived at the aid room on the top of a +,000foot peak. You think he may be e%hibiting signs of altitude sickness. You recogni0e that the key to a successful outcome of treatment is to& a. b. c. d. get him to lie down so his symptoms do not worsen. start him on o%ygen via a nasal cannula. prevent further body cooling by covering him with blankets. recogni0e the patient>s signs and descend to a lower elevation.

"nswer& d 'b(ective& $)-1 *eference& +1$ $$. Your group of climbers has reached an elevation of ),500 feet. 'ne of the climbers is increasingly short of breath and now has audible chest congestion. Your party has a limited supply of o%ygen, which you immediately apply to the climber at 15 A:? via a nonrebreather mask. Eased on your assessment that the climber has 3":7, you recogni0e that the ne%t necessary treatment is& a. b. c. d. a rapid descent of at least 1,500 to ,,000 feet. to administer diuretics such as @iamo% to reduce the patient>s pulmonary edema. to get the patient to a physician who can administer de%amethesone. to place the patient in the shock position.

"nswer& a 'b(ective& $)-1 *eference& +1, $,. 9n order to en(oy their upcoming skiing trip, your family has gathered information about risk factors for high-altitude illnesses. 6ontributing factors that could make altitude illness worse include& a. b. c. d. a history of angina. a diet that is high in carbohydrates. the lack of regular e%ercise. 6':@.

"nswer& b 'b(ective& $)-, *eference& +0+ $.. You are asked to speak to a college group that is planning a ski trip to the "lps. 9n order to help them plan for reducing their risks for developing altitude-related illnesses, you suggest all of the following except: a. plan a layover day at between #,000 feet and ),000 feet.

b. drink ,-. 4uarts of fluid a day. c. do a lot of heavy physical e%ertion early in the trip to help them acclimate. d. sleep at an elevation that is lower than where they will be skiing. "nswer& c 'b(ective& $)-. *eference& +0+