Environmental Emergencies

Sample questions.

8 free environmental emergencies questions with answers and explanations. MedRelay's full question bank covers every NREMT domain, plus live scenarios that grade the decision, not just the answer.

1. Question 1

   At a church basement, a 63-year-old male is bitten by a snake and has swelling around the bite. What is appropriate care?

   • A.Suction venom
   • B.Cut the wound
   • C.Apply ice tightly
   • D.Keep calm and transportCorrect

   Why:Correct. Keep the patient calm, limit movement, remove constricting items, and transport.

2. Question 2

   Multiple lightning-strike patients are down. One is pulseless and apneic. What triage principle applies?

   • A.Treat arrest patient earlyCorrect
   • B.Ignore arrest patients
   • C.Only treat walkers
   • D.Delay CPR for all vitals

   Why:Correct. Lightning arrest may be reversible with prompt ventilation, CPR, and AED use, so reverse triage may apply.

3. Question 3

   You respond to a 48-year-old male who was in the ocean and had a close encounter with a jellyfish. He has raised linear welts across his right arm with intense burning pain. His skin is erythematous. HR 108, BP 118/76, SpO2 97%. He is not having systemic reactions. His companion suggests urinating on the sting. What is the evidence-based management?

   • A.Urine is the correct treatment — recommend this approach
   • B.Urine is NOT recommendedCorrect
   • C.Apply freshwater irrigation for 15 minutes
   • D.Apply ice packs and nothing else

   Why:Correct. Urine (hypotonic) and fresh water trigger remaining nematocyst discharge — both are contraindicated. Seawater rinse does not trigger discharge. Tentacle removal with a barrier (gloves, card). Hot water immersion (as hot as tolerable without burning) inactivates venom proteins. Monitor for systemic anaphylaxis — this patient currently has only localized effects.

4. Question 4

   A hiker has a frozen hand and rescue says evacuation will take hours in freezing weather. What should you avoid?

   • A.Protecting the hand
   • B.Rewarming if refreezing may occurCorrect
   • C.Removing wet gloves
   • D.Checking circulation

   Why:Correct. Do not rewarm frostbite if refreezing is likely. Protect the part and prevent further injury.

5. Question 5

   At a dialysis center, a 68-year-old male drowning patient is awake but coughing and short of breath. What should you recommend?

   • A.No monitoring
   • B.Immediate refusal
   • C.Drink water
   • D.Oxygen and transportCorrect

   Why:Correct. Drowning patients can worsen later. Monitor breathing, provide oxygen if needed, and transport.

6. Question 6

   At a grocery store, a 36-year-old female frostbitten hand may refreeze before arrival at the hospital. What should you avoid?

   • A.Removing jewelry
   • B.Keeping it dry
   • C.Protecting the part
   • D.Active rewarmingCorrect

   Why:Correct. Do not rewarm frostbite if refreezing may occur.

7. Question 7

   A frostbitten foot has hard waxy skin. Transport will be short. What should you do?

   • A.Massage until warm
   • B.Protect and keep dryCorrect
   • C.Break blisters
   • D.Apply direct flame

   Why:Correct. Protect frostbitten tissue, keep it dry, prevent refreezing, and transport. Do not rub or use direct heat.

8. Question 8

   You respond to a mountain trail where a 28-year-old female hiker was found at an elevation of 3400 meters. She has been at altitude for 36 hours and now has a severe headache, ataxia, and her partner says she is confused and seeing double. SpO2 is 76% on room air. HR 128. She has crackles bilaterally in her lungs. What is the single most important prehospital treatment?

   • A.Administer aspirin for the headache
   • B.Immediate descent. Both high altitude cerebral edema (HACECorrect
   • C.Rest the patient at altitude and reassess in 4 hours
   • D.Administer oral fluids and apply warming blankets

   Why:Correct. HACE plus HAPE at 3400 meters is immediately life-threatening. SpO2 76% is a medical emergency. Descent is the single most important and definitive treatment — every meter of descent reduces atmospheric hypoxia. High-flow oxygen during descent. Portable hyperbaric chambers if available. Every minute at altitude worsens the condition.