Ch 12,13,14,15

One milliliter (mL) is the equivalent of:

1 cubic centimeter.

What is the minimum number of chest compressions that should be delivered per minute to a 4-month-old infant?

120

In two-rescuer adult CPR, you should deliver a compression-to-ventilation ratio of:

30:2.

What is the pulse pressure of a patient with a blood pressure of 104/58 mm Hg?

46 mm Hg

You have a prefilled syringe containing 25 g of dextrose in 50 mL of volume. How many milligrams of dextrose are present in each milliliter?

500 mg

Which of the following represents the official name for aspirin?

Acetylsalicylic acid, USP

Which of the following medications is a suspension?

Activated charcoal

In which of the following situations can aortocaval compression reduce the chance of successful resuscitation from cardiac arrest?

Advanced pregnancy

Which of the following medications would the AEMT help a patient self-administer?

Albuterol

Which of the following medications would the AEMT typically not be allowed to administer to a patient?

Amiodarone

Which of the following assessment findings would be the least reliable indicator of inadequate perfusion?

BP of 104/60 mm Hg

A man is unresponsive after overdosing on heroin. He is apneic and his pulse is slow. Which of the following is the most critical intervention?

Bag-mask ventilation

Which of the following is not a form of liquid drug?

Capsule

You are transporting an elderly man to the hospital because of complications associated with his congestive heart failure. Approximately 20 minutes after starting an IV of normal saline on the patient, he begins to complain of shortness of breath. You auscultate his lungs and hear rales in all lung fields. What should you do?

Check the flow rate of the IV line.

Which of the following statements regarding multiple-organ dysfunction syndrome (MODS) is correct?

MODS occurs when injury or infection triggers a massive immune, inflammatory, and coagulation response.

Which of the following physiologic responses would you expect to occur following administration of a drug that possesses alpha-1 properties?

Peripheral vasoconstriction

What is the mechanism of aspirin when given to a patient who is experiencing an acute myocardial infarction?

Prevents platelets from aggregating and forming emboli

Which of the following organs is the most tolerant of low blood flow?

Skin

What happens when systemic vascular resistance is decreased?

Systolic blood pressure falls.

What is the pathophysiology of psychogenic shock?

Temporary, generalized vascular dilation

How does lactated Ringer solution help combat intracellular acidosis associated with severe blood loss?

The lactate is metabolized by the liver to form bicarbonate.

Which of the following statements regarding over-the-counter (OTC) medications is correct?

They do not require a prescription.

What might happen if a drug is given to a patient with liver disease?

Toxic blood levels of the drug

What physiologic response causes a vasovagal reaction?

Vasodilation and a decrease in blood pressure

Most prehospital cardiac arrests occur as the result of:

a cardiac dysrhythmia.

You remove the shirt of a patient in cardiac arrest and note an adhesive patch applied to his upper right arm. This medication is most likely:

a fentanyl patch.

Ventricular tachycardia is:

a rapid contraction of the ventricles that does not allow for normal filling of the heart.

The passage of a substance through some surface of the body into body fluids and tissues is known as:

absorption.

The term "bolus" is defined as:

administering a drug in one mass of volume.

Appropriate treatment for a patient with a mild upper airway obstruction includes:

administering oxygen and transporting immediately.

The sympathetic nervous system is also known as the:

adrenergic nervous system.

According to Starling's law of the heart:

an increase in diastolic filling increases contractility.

If ventilation becomes difficult due to gastric distention, the patient will require:

an orogastric or nasogastric tube.

The fourth link in the chain of survival includes:

basic and advanced EMS care.

You and your partner arrive at the side of a 60-year-old woman who suddenly collapsed about 7 minutes ago. She is unresponsive, apneic, and pulseless. You should:

begin CPR and apply the AED as soon as possible.

After an advanced airway device has been inserted during cardiac arrest, you should ventilate an infant or child:

by giving one breath every 6 seconds.

A form of solid drug that is stored in a gelatin shell filled with liquid or powder is called a:

capsule

Rapid isotonic crystalloid boluses in a patient with cardiogenic shock would most likely result in:

congestion of blood in the lungs.

Once the "pigtail" that covers the access port of a bag of IV fluid has been removed, the fluid must be used:

immediately

When choosing an IV site on an elderly patient, you should:

know that varicose veins allow minimal circulation.

You are dispatched to a football game, where a spectator fell approximately 20 feet from the stands. As you approach the patient, you can see that he has obvious bilateral femur fractures and is not moving. Your initial action should be to:

open his airway and assess his breathing.

An example of intravascular fluid is:

plasma

In contrast to afterload, preload is:

precontraction pressure caused by blood returning to the heart.

There is 0.5 mg/10 mL of medication in a container. How many milligrams (mg) would you deliver if you administered 5 milliliters (mL)?

0.25

If you have an epinephrine concentration of 0.1 mg/mL, how many milligrams would be present in 5 mL?

0.5 mg

Which of the following represents a "standard" drug dose?

1 mg

During one-rescuer adult CPR, you should compress the patient's chest at a rate of at least ________ compressions per minute.

100

A 44-year-old man is experiencing a ventricular dysrhythmia. Medical control orders your paramedic partner to administer 1.5 mg/kg of lidocaine to the patient, who weighs 185 pounds. Lidocaine is supplied in a concentration of 100 mg/10 mL. How many milliliters should your partner administer to this patient?

12.6 mL

Prior to administering oral glucose to your diabetic patient, you look at the dosage, which reads 15 g. How many milligrams is this equivalent to?

15,000

What is the correct ratio of compressions to ventilations when performing two-rescuer child CPR?

15:2

How many pounds does a 90-kg patient weigh?

198 lb

Which of the following IV catheters would deliver the largest volume of fluid?

1¼ in 14-gauge catheter

You have set an IV to deliver 250 mL of normal saline over 3 hours using microdrip tubing. How much fluid are you delivering every 30 minutes?

42 mL

You respond to an apartment complex for an unconscious male. When you arrive, the patient's friend tells you that he overdosed on heroin. Following your local protocol, you administer 2 mg of naloxone. You have 1 mL ampules of naloxone that contain 0.4 mg per ampule. How many ampules will you have to use?

5

A patient with congestive heart failure requires medication administration. Which of the following IV solutions would be most appropriate to use?

5% dextrose in water

A microdrip administration set features a small, needle-like orifice inside the drip chamber and delivers:

60 gtt/mL.

During cardiac arrest, the resuscitation team should maintain a chest compression fraction of at least:

60%.

During a long-distance transport, you initiate an IV of normal saline and infuse 125 mL over 2 hours. Using microdrip tubing, how many drops per minute (gtt/min) is your IV flow rate set at?

63 gtt/min

In most people, a systolic BP of _______ is sufficient to perfuse the brain and other vital organs.

80-90 mm Hg

Which of the following types of shock are caused by "relative hypovolemia"?

Anaphylactic and neurogenic

If you administered naloxone (Narcan) to a patient who overdosed on morphine, what effect would occur?

Antagonism

What is an enteral drug?

Any drug that is administered along any portion of the GI tract

A patient in shock is experiencing tachycardia, among other signs. What physiologic response causes tachycardia during times of decreased perfusion?

Beta 1 receptor stimulation

A 17-year-old female is experiencing a mild asthma attack. You auscultate her lungs and hear expiratory wheezing. In addition to oxygen, which of the following classifications of medication would be indicated for this patient?

Beta-2 agonist

Which of the following physiologic responses occurs during irreversible shock?

Blood is shunted from the liver and kidneys to the brain and heart.

Cellular ischemia results in anaerobic metabolism. What occurs during this process?

Blood stagnates in the capillaries and lactic acid is produced.

Which of the following techniques should you use to dislodge a foreign body airway obstruction in a patient who is in an advanced stage of pregnancy or who is very obese?

Chest thrusts

Which of the following is a major anion in the body?

Chloride

Which of the following statements regarding intraosseous infusion is correct?

Compared to an IV line, fluid does not flow well into the bone because of resistance.

Which of the following is not a physiologic effect of sympathetic nervous system stimulation?

Decreased heart rate

Which of the following is considered an obvious sign of death and would not require the initiation of CPR?

Dependent blood pooling

Which of the following formulas is correct for converting a patient's weight in pounds to his or her weight in kilograms?

Divide the patient's weight in pounds by 2 and subtract 10%.

As an AEMT, which of the following medications would you be allowed to administer to a patient?

Epinephrine

Which of the following is a Schedule II substance?

Fentanyl

Which of the following drugs dissolves a thrombus and prevents it from entering the bloodstream?

Fibrinolytic

Which of the following is the most significant complication associated with IV therapy in geriatric patients?

Fluid overloading

Although painful and difficult to manage, what is the location of choice for starting IVs in pediatric patients?

Hand vein

In addition to administering supplemental oxygen, what is the most appropriate management for a patient with circulatory overload caused by excessive IV fluid administration?

Head elevated, medical control notified

A 50-year-old patient complains of abdominal muscle cramps and spasms of his hands. Which of the following electrolyte disturbances does this patient most likely have?

Hypocalcemia

You administer 0.4 mg of nitroglycerin to your 55-year-old patient with chest pain. Which of the following adverse reactions should you be most observant for?

Hypotension

Which of the following signs indicate narcotic-induced CNS depression and would indicate the administration of naloxone?

Hypoventilation

Which of the following steps for drawing medication from a vial is not necessary when drawing medication from an ampule?

Injecting air into the container before withdrawing the drug

Which of the following medications are typically administered via the subcutaneous route?

Insulin and epinephrine

_______ fluid accounts for approximately 16% of the body's total weight.

Interstitial

Which of the following medication administration routes would result in uneven, unreliable absorption if given to a patient with decreased peripheral perfusion?

Intramuscular

You are unable to establish an IV on a critically injured conscious patient. What route should you use for gaining vascular access?

Intraosseous

Which of the following routes is the quickest for getting medication into the central circulation?

Intravenous

When treating a patient with decompensated shock, which of the following interventions is best performed en route to the hospital as opposed to at the scene?

Intravenous therapy

_______ solutions provide a stable medium for the administration of medications and provide effective fluid and electrolyte replacement.

Isotonic

Which of the following statements regarding a metered-dose inhaler (MDI) is correct?

It administers the same dose of medication each time it is used.

What is the most significant drawback to cannulating a scalp vein in a child with a butterfly catheter?

It does not allow for rapid fluid administration.

Which of the following maneuvers should be used to open a patient's airway when a spinal injury is suspected?

Jaw-thrust

A 29-year-old female experiences shortness of breath, urticaria, and bilateral wheezing shortly after you start an IV of normal saline. How should you manage this situation?

Leave the catheter in place and remove the solution.

Which of the following medications could be administered via the intranasal route with a mucosal atomizer device?

Naloxone

A 20-year-old male has sustained blunt trauma to the face, chest, and abdomen after being attacked by a rival gang. Which of the following signs or symptoms is most suggestive of decompensated (progressive) shock?

Narrowing pulse pressure

Which of the following medications could cause a potentially fatal interaction if given within 24 to 36 hours of Viagra, Cialis, or Levitra?

Nitroglycerin

Which of the following medications is administered in gel form?

Oral glucose

Which of the following potential complications of IV therapy are you least likely to encounter in the prehospital setting?

Phlebitis

A 78-year-old female takes several medications every day, each for a different condition. What is this an example of?

Polypharmacy

A 66-year-old male with congestive heart failure presents with pulmonary edema and difficulty breathing. His blood pressure is 180/90 mm Hg and his pulse rate is 110 beats/min and irregular. When starting an IV, which of the following, if available, would be most appropriate for this patient?

Saline lock

A 50-year-old female with nausea, vomiting, and diarrhea complains of intense thirst and generalized weakness. Her blood pressure is 86/50 mm Hg and her pulse rate is 130 beats/min and thready. Which of the following interventions would not be appropriate for her?

Salt-containing solutions by mouth

Because it has accepted medical uses, a low abuse potential, and a limited dependence potential, lorazepam (Ativan) is classified as a:

Schedule IV drug.

Which of the following occurs during shock (hypoperfusion)?

The removal of metabolic waste products is decreased.

Why does the clinical presentation of neurogenic shock differ from that of hypovolemic shock?

The sympathetic nervous system does not release catecholamines.

Which of the following statements regarding pulmonary respiration is correct?

There are more oxygen molecules in the alveoli than in the blood; therefore, the oxygen molecules move from the alveoli into the blood.

Which of the following statements regarding central chemoreceptors is correct?

They adjust respirations based on arterial PaCO 2 and PO 2 levels.

What physiologic response would be expected to occur if a patient's systolic blood pressure dropped below 80 mm Hg?

Vasomotor stimulation with resultant arterial vasoconstriction

Which of the following injuries or conditions would be least likely to result in hypovolemic shock?

Widespread vasodilation

After inserting the needle into the injection port of a saline lock, you pull back on the plunger and observe blood return in the syringe. You should next:

administer the medication and observe for infiltration.

A breakable glass container that is designed to carry a single medication dose is called a(n):

ampule.

Factors that can cause an insufficient or absent flow of fluid through an IV line include:

an IV bag that is placed too low.

An over-the-needle catheter is commonly referred to as a(n):

angiocath

Drugs that attach to a receptor and counteract the effects of something else are called:

antagonists

Initial treatment to dislodge a severe foreign body airway obstruction in a responsive infant involves:

back blows.

Subcutaneous injections deliver the medication:

between the skin and the muscle.

A parasympatholytic drug blocks the effects of the parasympathetic nervous system by:

binding with cholinergic receptors and blocking the release of acetylcholine.

Factors that alter a patient's response to a drug include:

body mass and psychological factors.

An ion that has an overall positive charge is called a(n):

cation.

After establishing that an adult patient is unresponsive and not breathing, you should:

check for a carotid pulse.

A 72-year-old male presents with black tarry stools and weakness. He is restless, pale, and diaphoretic. His blood pressure is 100/60 mm Hg, pulse is 110 beats/min and weak, and respirations are 24 breaths/min. On the basis of this patient's clinical presentation, you should suspect:

compensated shock.

You should deliver chest compressions to an adult patient in cardiac arrest by:

compressing over the lower half of the sternum.

After starting an IV on a patient in shock, the AEMT accidentally gets stuck with the IV needle. This is referred to as a(n):

contaminated stick.

A 40-year-old man with diabetes has a blood glucose level of 38 mg/dL. However, because he is unconscious and unable to swallow oral glucose, that medication is:

contraindicated.

After inserting an IV catheter into a vein, you should:

decrease the angle of the catheter to 15° and insert the catheter a few millimeters farther.

Ventilating a patient too fast or with too much volume would most likely cause:

decreased blood return to the heart.

After an advanced airway has been inserted during two-rescuer CPR, you should:

deliver ventilations at a rate of 10 breaths per minute.

While eating dinner at a restaurant with his wife, a man remembers that he did not take his antianxiety medication. He immediately begins to experience anxiety and tells his wife that they must leave immediately. This response is typical of:

dependence

A hypertonic solution is one that:

draws fluid and electrolytes out of the cell.

A mixture of two liquids that are not mutually soluble is called a(n):

emulsion

You receive a call for a 66-year-old female who was found unresponsive by her husband. Your primary survey reveals that the patient is responsive to painful stimuli and has rapid, shallow respirations. Her blood pressure is 70/50 mm Hg and her pulse rate is 120 beats/min and irregular. The patient's husband tells you that she complained of chest pressure the previous day, but would not allow him to call EMS. This patient is:

experiencing cardiogenic shock and requires assisted ventilation, IV therapy, and rapid transport.

Signs and symptoms of an air embolus include all of the following, except:

facial flushing.

The removal of particles from a solution by allowing the liquid portion to pass through a membrane or other partial barrier is called:

filtration

Signs of a sudden severe upper airway obstruction include all of the following, except:

forceful coughing.

Complications that may be associated with chest compressions include all of the following, except:

gastric distention.

Compared to drugs such as phenobarbital and diazepam (Valium), heroin:

has a much higher potential for abuse and dependence.

Medications that the AEMT is authorized to administer are ultimately determined by:

his or her medical director.

The most common contraindication for any medication is:

hypersensitivity.

A solution that has a greater concentration of sodium than the cell is referred to as being:

hypertonic

A solution that results in water flowing into a cell, causing it to burst, is referred to as being:

hypotonic

Your patient is a 56-year-old man with chest pain. Medical control orders you to assist the patient with his prescribed nitroglycerin. The patient later tells you that the palms of his hands itch. His vital signs, however, remain stable. This peculiar effect of the drug is referred to as a(n):

idiosyncratic reaction

Atropine increases the heart rate by:

improves the atrioventricular conduction by blocking the parasympathetic influences on the heart.

Stimulation of beta 1 receptors causes a positive inotropic effect, resulting in:

increased cardiac contractility.

The alpha 1 effects of norepinephrine result in:

increased peripheral vascular resistance.

Excessive exposure to a cholinergic agent would produce:

increased salivation, urination, and vomiting.

All of the following can lead to shock (hypoperfusion), except:

increased venous return to the right atrium.

Benzodiazepines are a classification of medication that are used to:

induce sedation.

The AEMT must be especially cautious when administering IV fluids to patients with:

internal hemorrhage.

Your patient is a 29-year-old male who presents with signs and symptoms of shock. However, your assessment reveals no obvious external signs of injury. You should suspect:

intraabdominal bleeding.

The majority of the body's potassium is found within the:

intracellular fluid.

A known contraindication to the administration of 50% dextrose (D 50) is:

intracranial hemorrhage.

Nitroglycerin is especially useful in treating patients with cardiac ischemia because it:

is a vasodilator and lowers preload on the heart.

Five percent dextrose in water (D 5W) is an isotonic solution until it:

is administered to a patient.

The most commonly carried IV solutions in the prehospital setting are:

isotonic crystalloids.

Compared to a 16-gauge catheter, a 22-gauge catheter would be more appropriate for an elderly patient because:

it reduces the risk of fluid extravasation.

Anaerobic metabolism is a condition of the cell that results in:

lactic acid production, decreased blood pH, and metabolic acidosis.

Common site for intraosseous cannulation include all of the following, except the:

lateral femur.

You have attempted to cannulate a vein in a patient's hand; however, shortly after inserting the IV catheter, the vein infiltrates. You should:

look for a vein that is proximal to the infiltrated vein.

The Narcotic Control Act of 1956:

made the possession of heroin illegal and outlawed the acquisition and transportation of marijuana.

Following administration of an amiodarone bolus, your paramedic partner begins a continuous infusion. This is necessary in order to:

maintain a therapeutic blood level of the drug.

The goal of IV fluid replacement for the patient in shock is to:

maintain adequate perfusion.

A 29-year-old woman, who is 35 weeks pregnant, is in cardiac arrest. You should:

manually displace her uterus to the left.

Following blunt and penetrating chest trauma, your patient presents with signs of shock and jugular venous distention. These clinical findings indicate:

mechanical obstruction of the heart, which is impairing pump function.

The term applied to the practice of preventing contamination of the patient when performing an invasive procedure is called:

medical asepsis.

The liver performs synthetic reactions that yield inactive products called:

metabolites

To calculate a drug dosage, you must know the weight of the drug present in each:

milliliter

During two-rescuer CPR, the compressor and ventilator switch positions. While rescuer one is finishing his or her cycle of 30 compressions, rescuer two should:

move to the opposite side of the patient's chest.

In order to prevent catheter shear when starting an IV, you should:

never rethread the needle into the catheter.

An isotonic solution is one that causes:

no change in the shape of the cell.

Basic life support (BLS) is defined as:

noninvasive emergency care that is used to treat conditions such as airway obstruction, respiratory arrest, and cardiac arrest.

You are preparing to administer a medication to a pregnant patient. You read the medication information and note that, according to the FDA, it is a "Category X" drug. You should:

not administer the drug to the patient.

A patient who presents with hypotension, jugular venous distention, and a rapid irregular pulse should be suspected of experiencing:

obstructive shock.

Shortly after starting an IV on a patient with a possible femur fracture, the patient experiences a sudden onset of shortness of breath and develops cyanosis. After reassessing airway patency and breathing adequacy, you should position the patient:

on the left side with the head down.

As an AEMT, the most commonly inhaled medication you will administer is:

oxygen.

Other than oxygen, prior to administering any medication to a patient, you must take standard precautions and then:

perform a careful assessment of the patient.

The cell membrane is a(n) _______ bilayer, which is an important barrier to fluid movement and the acid-base balance.

phospholipid

After inserting the needle into the injection port of an IV line, but before administering the medication, you should:

pinch off the tubing proximal to the injection port.

When injury occurs to tissues in the healthy human body:

platelets aggregate at the site of the injury.

A glass drug cartridge and syringe are components of a(n):

prefilled syringe.

The pressure in the heart immediately before a contraction is called the:

preload

The most reliable indicator that suggests crystalloid IV fluids have improved perfusion is when the:

radial pulses become stronger.

Bioavailability is defined as the:

rate and extent to which an active drug enters the general circulation.

During times of decreased perfusion, the autonomic nervous system:

redirects blood to the most vital organs of the body.

You are attempting to start an IV in a vein on the back of your patient's hand. As you insert the catheter, the patient complains of sudden, severe shooting pain followed by numbness in the extremity. You should:

remove the catheter and choose another site.

A patient in cardiac arrest requires defibrillation with an AED. You remove his shirt and see a nitroglycerin patch applied to his right upper chest. You should:

remove the patch and wipe off the excess medication.

Long-term control of blood pressure is regulated by the:

renal system.

In most cases, cardiopulmonary arrest in infants and children is caused by:

respiratory arrest.

After blood diffuses across the capillary membrane and perfuses the cells, it:

returns waste products to the right side of the heart, starting with the venules.

While reading the package insert that accompanies a medication, you note that it has been assigned a pregnancy category D. This means that:

risk to the human fetus has been demonstrated; however, administration of the drug may outweigh the risk of potential adverse effects in certain circumstances.

Baroreceptors, which are located in the aortic arch and carotid sinuses, help regulate blood pressure by:

sensing changes in systemic vascular resistance.

When discontinuing an IV line, you should first:

shut off the flow from the IV with the roller clamp.

A liquid mixture of one or more substances that cannot be separated by filtering or allowing the mixture to stand is called a(n):

solution

When administering a medication via the intramuscular route, you should:

stretch the skin over the area and insert the needle at a 90° angle.

How is nitroglycerin usually given?

sublingual

Medications that fight or antagonize the effects of the sympathetic nervous system are referred to as being:

sympatholytic

Epinephrine is classified as a(n):

sympathomimetic

Prior to administering an oral medication to a patient, you must:

take standard precautions.

When treating a patient with severe bleeding, you must:

take standard precautions.

Mean arterial pressure (MAP) is:

the blood pressure required to sustain organ perfusion.

The main benefit of using a mechanical piston or load-distributing band device for chest compressions is:

the elimination of rescuer fatigue that results from manual compressions.

When cellular perfusion is diminished:

the postcapillary sphincters remain constricted, causing the capillaries to engorge with fluid.

Unlike IM or SC injections, intravenously administered drugs rapidly affect the body because:

they bypass most barriers to drug absorption.

Abdominal thrusts in a responsive child or adult with a severe upper airway obstruction are performed:

until he or she becomes unresponsive.

If used in pediatric patients, butterfly catheters are commonly placed in the:

veins of the scalp.

When ventilating an apneic adult with a simple barrier device, you should deliver each breath:

while watching for adequate chest rise.

Once the protective wrap is removed from a bag of IV fluid, the fluid must be used:

within 24 hours.

When administering a medication via the intranasal route with a mucosal atomizer device, it is important to remember that:

you must spray half of the medication dose into each nostril.

Minimum documentation following IV therapy includes all of the following, except:

your certification level.