Chapter 8 - Vascular Access and Medication Administration
Which of the following represents a "standard" drug dose? A. 0.5 g/kg B. 1 mg/kg C. 1 mg D. 0.25 mg/kg
C. 1 mg
The term "bolus" is defined as: A. delivering a drug via maintenance infusion. B. administering less than 10 mL of volume. C. administering a drug in one mass of volume. D. administering at least 20 mL of volume.
C. administering a drug in one mass of volume
Medical control has ordered you to start an IV on a dehydrated patient and administer normal saline at a rate of 200 mL/hr. Using macrodrip (10 gtts/mL) tubing and an 18-gauge catheter, how many drops per minute will you set the flow rate at? A. 66 B. 33 C. 46 D. 74
B. 33
An over-the-needle catheter is commonly referred to as a/an: A. intracath. B. angiocath. C. butterfly catheter. D. arteriocath.
B. angiocath
Which of the following potential complications of IV therapy are you LEAST likely to encounter in the prehospital setting? A. Phlebitis B. Occlusion C. Infiltration D. Vein irritation
A. Phlebitis
Actions taken after administering a medication to a patient include all of the following, EXCEPT: A. inquiring about drug allergies. B. notifying medical control of any changes. C. carefully assessing the patient. D. documenting the time the drug was given.
A. inquiring about drug allergies
If you have an epinephrine concentration of 0.1 mg/mL, how many milligrams would be present in 5 mL? A. 0.005 mg B. 0.5 mg C. 5 mg D. 0.05 mg
B. 0.5 mg
The concentration of sodium in the cells of the body is approximately: A. 0.225%. B. 0.9%. C. 0.45%. D. 9.0%.
B. 0.9%
A 70-year-old female presents with generalized muscle weakness; lethargy; and hot, flushed skin. Which of the following electrolyte disturbances should you suspect? A. Hypocalcemia B. Hypercalcemia C. Hypernatremia D. Hyperkalemia
B. Hypercalcemia
A solution that has a greater concentration of sodium than does the cell is referred to as being: A. hypotonic. B. hypertonic. C. isotonic. D. hyperosmolar.
B. hypertonic
There is 0.5 mg/10 mL of epinephrine in an auto-injector. How many milligrams (mg) would you deliver if you administered 5 milliliters (mL)? A. 0.5 B. 5.0 C. 0.25 D. 2.5
C. 0.25
A 60-year-old man is in cardiac arrest. As emergency medical responders are performing CPR, your partner is managing the patient's airway. After preparing your IV set, you should FIRST attempt to cannulate the: A. lateral forearm vein. B. medial forearm vein. C. antecubital vein.
C. antecubital vein
When attaching an administration set to a bag of IV fluid and priming the IV tubing, you should ensure that the drip chamber is: A. completely full. B. one fourth full. C. one half full. D. three fourths full.
C. one half full
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? A. Hypernatremia B. Hypercalcemia C. Hyperkalemia D. Hypocalcemia
D. Hypocalcemia
Minimum documentation following IV therapy includes all of the following, EXCEPT: A. venipuncture site. B. type of fluid being given. C. your certification level. D. the rate the fluid is running.
D. the rate the fluid is running
One milliliter (mL) is the equivalent of: A. 1 cubic centimeter. B. 1 deciliter. C. 1 cubic deciliter. D. 1 microgram.
A. 1 cubic centimeter
Which of the following is NOT a crystalloid? A. Whole blood B. Five percent dextrose in water C. Normal saline D. Lactated ringers
A. Whole blood
An intraosseous line should be inserted in a critical patient if: A. the patient will require a whole blood transfusion. B. IV access is unsuccessful after three attempts. C. you cannot readily see a visible peripheral vein. D. you cannot establish IV access within three minutes.
B. IV access is unsuccessful after three attempts
After starting an IV on a patient in shock, the AEMT accidentally gets stuck with the IV needle. This is referred to as a/an: A. disease contraction. B. contaminated stick. C. infectious exposure. D. communicable stick.
B. contaminated stick
As an AEMT, the MOST commonly inhaled medication you will administer is: A. Ventolin. B. oxygen. C. Alupent. D. Albuterol.
B. oxygen
The MOST appropriate administration set to use for a patient who requires rapid fluid replacement is one that delivers 1 mL of IV fluid per: A. 15 drops. B. 60 drops. C. 10 drops. D. 20 drops.
C. 10 drops
Which of the following electrolytes determines whether or not the body is acidotic or alkalotic? A. Phosphorus B. Calcium C. Bicarbonate D. Sodium
C. Bicarbonate
500 micrograms (µg) is equal to: A. 0.05 mg. B. 0.005 mg. C. 5 mg. D. 0.5 mg.
D. 0.5 mg
Severe hyperkalemia can result in: A. gastrointestinal disturbances. B. decreased muscle function. C. severe dehydration as a result of water loss. D. hyperstimulation of neural transmission.
D. hyperstimulation of neural transmission
A breakable glass container that is designed to carry a single medication dose is called a/an: A. ampule. B. aboject. C. tubex. D. vial.
A. ampule
What physiologic response causes a vasovagal reaction? A. Vasodilation and an increase in blood pressure B. Vasodilation and a decrease in blood pressure C. Vasoconstriction and a decrease in blood pressure D. Vasoconstriction and an increase in heart rate
B. Vasodilation and a decrease in blood pressure
After removing the stylet from the IV catheter, you should next: A. occlude the proximal end of the catheter to prevent blood leaking. B. dispose of the needle in the appropriate container. C. remove the constricting band from the patient's arm. D. attach the prepared IV line to the catheter.
B. dispose of the needle in the appropriate container
You have inserted an IV catheter into a vein in a patient's hand and have secured the IV line appropriately. You assess the flow of the IV and note that it is not flowing. You should FIRST: A. gently manipulate the catheter until the IV starts flowing. B. ensure that the constricting band has been released. C. immediately stop the infusion and apply pressure. D. lower the IV bag to see if blood flows up the IV tubing.
B. ensure that the constricting band has been released
In order to prevent catheter shear when starting an IV, you should: A. insert the IV in a vein where the catheter cannot bend. B. never rethread the needle into the catheter. C. place the patient on their side prior to starting the IV. D. use an 18-gauge or smaller catheter.
B. never rethread the needle into the catheter
Contraindications for intraosseous infusion include all of the following, EXCEPT: A. the ability to obtain IV access within 90 seconds. B. patients who are in cardiac arrest or status epilepticus. C. successful cannulation of a large antecubital vein. D. fracture of the bone in which you will place the catheter.
B. patients who are in cardiac arrest or status epilepticus
An example of intravascular fluid is: A. cerebrospinal fluid. B. plasma. C. intraocular fluid. D. amniotic fluid.
B. plasma
Prior to administering an oral medication to a patient, you must: A. carefully assess the patient. B. take standard precautions. C. contact medical control to obtain authorization. D. determine the need for the medication.
B. take standard precautions
Unlike IM or SC injections, intravenously administered drugs rapidly affect the body because: A. they are excreted from the body more slowly. B. they bypass most barriers to drug absorption. C. they do not have to pass through the liver. D. their strength doubles as they enter the bloodstream.
B. they bypass most barriers to drug absorption
A stable patient requires an IV line in the event that medication therapy is needed. When selecting the appropriate vein, you should first attempt to cannulate the: A. medial forearm vein. B. vein on the hand. C. antecubital vein. D. lateral forearm vein.
B. vein on the hand
If used in pediatric patients, butterfly catheters are commonly placed in the: A. antecubital vein. B. veins of the scalp. C. anterior forearm. D. back of the hand.
B. veins of the scalp
Once the protective wrap is removed from a bag of IV fluid, the fluid must be used: A. within 48 hours. B. within 24 hours. C. within 36 hours. D. immediately.
B. within 24 hours
When administering a medication via the intranasal route with a mucosal atomizer device, it is important to remember that: A. the patient must be conscious for this route to be effective. B. you must spray half of the medication dose into each nostril. C. at least half of the drug must be diluted in normal saline. D. it will absorb slower than if given via intramuscular injection.
B. you must spray half of the medication dose into each nostril
You are transporting a patient with an IV of D5W. Which of the following signs would be atypical of infiltration? A. Edema at the catheter site B. Tightness and pain around the IV site C. Redness around the IV site
C. Redness around the IV site
Which of the following statements regarding subcutaneous injections is correct? A. The needle is inserted at a 90° angle when giving a subcutaneous injection. B. The deltoid muscle is the most common location for a subcutaneous injection. C. Subcutaneous injections are usually given with a 24-gauge to 26-gauge needle D. Volumes of less than 10 mL are usually given by the subcutaneous route.
C. Subcutaneous injections are usually given with a 24-gauge to 26-gauge needle
Compounds or charges concentrated on one side of a cell membrane will move across it to an area of lower concentration to maintain balance on both sides of the cell wall. This process is called: A. filtration. B. active transport. C. diffusion. D. osmosis.
C. diffusion
Signs and symptoms of an air embolus include all of the following, EXCEPT: A. oxygen-refractory cyanosis. B. tachycardia. C. facial flushing. D. respiratory distress.
C. facial flushing
Once the "pigtail" that covers the access port of a bag of IV fluid has been removed, the fluid must be used: A. within 12 hours. B. within 24 hours. C. immediately. D. within 36 hours.
C. immediately
The most commonly carried IV solutions in the prehospital setting are: A. hypertonic colloids. B. hypotonic crystalloids. C. isotonic crystalloids. D. hypotonic colloids.
C. isotonic crystalloids
Filtration, a type of diffusion, is commonly used to clean the blood via the: A. spleen. B. pancreas. C. kidneys. D. liver.
C. kidneys
A severely injured patient has lost approximately 750 mL of blood. What is the appropriate volume of crystalloid solution to administer to the patient? A. 750 mL B. 1,500 mL C. 1,000 mL D. 2,250 mL
D. 2,250 mL
A microdrip administration set features a small, needle-like orifice inside the drip chamber and delivers: A. 100 gtts/mL. B. 15 gtts/mL. C. 10 gtts/mL. D. 60 gtts/mL.
D. 60 gtts/mL
What percentage of water accounts for the total body weight? A. 50% B. 70% C. 80% D. 60%
D. 60%
One deciliter (dL) is equivalent to: A. 100 mL B. 1000 mL C. 0.1 mL D. 10 mL
A. 100 mL
A 30-year-old construction worker lacerated his brachial artery and has lost a significant amount of blood. His blood pressure is 70/40 mm Hg and his pulse rate is 130 beats/min. Which of the following IV catheters would be MOST appropriate for this patient? A. 14 gauge B. 20 gauge C. 18 gauge D. 16 gauge
A. 14 gauge
How many pounds does a 90-kg patient weigh? A. 198 lb B. 186 lb C. 189 lb D. 194 lb
A. 198 lb
During an attempted resuscitation of a 9-year-old boy in cardiac arrest, your paramedic partner asks you to prepare epinephrine in a dose of 0.01 mg/kg. The child's mother tells you that he weighs approximately 65 pounds. You have a prefilled syringe of epinephrine containing 1 mg in 10 mL. How many milliliters should be administered to this child? A. 3 mL B. 4 mL C. 3.5 mL D. 4.5 mL
A. 3 mL
Which of the following is a systemic complication associated with IV therapy? A. Air embolus B. Infiltration C. Hematoma D. Phlebitis
A. Air embolus
Which of the following statements regarding intraosseous infusion is correct? A. Compared to an IV line, fluid does not flow well into the bone because of resistance B. Manual IO insertion is performed by approaching the bone at a 45° angle. C. The incidence of osteomyelitis is high following intraosseous infusion. D. Intraosseous needles consist of a solid boring needle inside a hollow Teflon catheter
A. Compared to an IV line, fluid does not flow well into the bone because of resistance
What is the difference between a crystalloid and a colloid solution? A. Crystalloids do not contain large protein molecules. B. Colloids rapidly move from the vascular space. C. Crystalloids contain large protein molecules. D. Colloids poorly expand the vascular compartment.
A. Crystalloids do not contain large protein molecules
A patient with congestive heart failure requires medication administration. Which of the following IV solutions would be MOST appropriate to use? A. Five percent dextrose in water B. An isotonic colloid C. Lactated ringers
A. Five percent dextrose in water
Which of the following is the MOST significant complication associated with IV therapy in geriatric patients? A. Massive hematoma. B. Easily infiltrated veins. C. Fluid extravasation. A. Fluid overloading.
A. Fluid overloading
Although painful and difficult to manage, what is the location of choice for starting IVs in pediatric patients? A. Hand vein B. Antecubital vein C. Foot vein D. Forearm vein
A. 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? A. Head elevated, medical control notified B. Trendelenburg's position, event documented C. Lateral recumbent position, event documented D. Head lowered, medical control notified
A. Head elevated, medical control notified
You respond to a call for an unresponsive diabetic. Upon arrival, you find a 23-year-old female unresponsive on her couch. During your assessment, you determine that her blood glucose level is 38 mg/dL. You attempt to start an IV, but are unsuccessful after several attempts. Which of the following routes could be used as a last resort to administer 50% dextrose? A. Rectal B. Subcutaneous C. Intralingual D. Oral
A. Rectal
Factors that can cause an insufficient or absent flow of fluid through an IV line include: A. an IV bag that is placed too low. B. small air bubbles in the IV line. C. a drip chamber that is half full. D. an IV bag that is placed too high.
A. an IV bag that is placed too low
Major cations in the body include all of the following, EXCEPT: A. bicarbonate. B. potassium. C. sodium. D. calcium.
A. bicarbonate
A 52-year-old man complains of chest pressure. He is diaphoretic and has a blood pressure of 110/90 mm Hg. He has a prescription for nitroglycerin (NTG), but has not taken any. After administering oxygen to the patient you should: A. contact medical control for permission to administer the NTG. B. give 1 NTG dose and contact medical control. C. continue oxygen and transport the patient to the hospital. D. administer up to 3 NTG doses and reassess his BP.
A. contact medical control for permission to administer the NTG
When inserting an IV into the external jugular vein, you should: A. insert the catheter with the tip pointing toward the shoulder. B. ensure that the patient is sitting in a fully upright position. C. insert the catheter with the tip pointing toward the head. D. use the same technique that you use for any other IV.
A. insert the catheter with the tip pointing toward the shoulder
Compared to a 16-gauge catheter, a 22-gauge catheter would be more appropriate for an elderly patient because: A. it reduces the risk of fluid extravasation. B. the risk of catheter shear is much lower. C. larger fluid volumes can be administered. D. it more easily penetrates their tough skin.
A. it reduces the risk of fluid extravasation
When choosing an IV site on an elderly patient, you should: A. know that varicose veins allow minimal circulation. B. always cannulate veins in the antecubital fossa. C. choose a vein that weaves back and forth. D. cannulate a sclerosed vein since it is less likely to infiltrate.
A. know that varicose veins allow minimal circulation
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: A. on the left side with the head down. B. on the left side with the head elevated. C. in a semi-Fowler's position. D. in Trendelenburg's position.
A. on the left side with the head down
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: A. remove the catheter and choose another site. B. carefully continue with the venipuncture. C. assure the patient the symptoms are normal. D. lift the IV catheter to a 45° angle.
A. remove the catheter and choose another site
When discontinuing an IV line, you should FIRST: A. shut off the flow from the IV with the roller clamp. B. disconnect the administration set from the IV bag. C. remove the securing tape from the site. D. remove the IV tubing from the catheter hub.
A. shut off the flow from the IV with the roller clamp
When administering a medication via the intramuscular route, you should: A. stretch the skin over the area and insert the needle at a 90° angle. B. stretch the skin over the area and insert the needle at a 45° angle. C. pinch the skin over the area and insert the needle at a 45° angle. D. pinch the skin over the area and insert the needle at a 90° angle.
A. stretch the skin over the area and insert the needle at a 90° angle
Before you can calculate an IV drip rate, you must know all of the following information, EXCEPT: A. the gauge of the IV catheter you will use. B. amount of fluid to deliver. C. length of time of the infusion. D. the drop factor of the administration set.
A. the gauge of the IV catheter you will use
Intraosseous lines require full and careful immobilization because: A. they rest at a 90° angle to the bone and are easily dislodged. B. even when properly placed, the catheter easily moves back and forth. C. the needle is only ¼" long and is not firmly in the bone. D. insertion of the intraosseous catheter causes fracture of the bone.
A. they rest at a 90° angle to the bone and are easily dislodged
A 7-year-old child has swallowed a bottle of aspirin. Medical control orders you to give the child 0.5 g/kg of activated charcoal. Based on the child's weight of 45 pounds, how much charcoal will you administer? A. 15 g B. 10 g C. 20 g D. 5 g
B. 10 g
Prior to administering oral glucose to your diabetic patient, you look at the dosage, which reads 15g. How many milligrams is this equivalent to? A. 150 B. 15,000 C. 1,500 D. 150,000
B. 15,000
You have been requested to infuse 1,000 mL of lactated ringers over six hours. You have macrodrip (10 gtts/mL) tubing and a 16-gauge IV catheter. At how many drops per minute will you set the IV flow rate? A. 26 B. 28 C. 22 D. 24
B. 28
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 (gtts/min) is your IV flow rate set at? A. 53 gtts/min B. 63 gtts/min C. 39 gtts/min D. 58 gtts/min
B. 63 gtts/min
What is the approximate weight in kilograms of a 155 lb patient? A. 72 kg B. 70 kg C. 76 kg D. 74 kg
B. 70 kg
You respond to a residence where a 5-year-old male has ingested an unknown substance. Upon arrival at the scene, the child's mother tells you that her son swallowed approximately 20 Tylenol capsules. What is the MOST logical way of determining how much this child weighs? A. Estimate the child's weight based on his age. B. Ask the mother if she knows the weight of her son. C. Determine the child's weight based on his height. D. Use a length-based resuscitation tape.
B. Ask the mother if she knows the weight of her son
During the IV procedure, when is it MOST appropriate to apply the constricting band? A. After you cleanse the venipuncture site. B. Before you cleanse the venipuncture site. C. When you assemble the IV equipment. D. After you insert the catheter into the vein.
B. Before you cleanse the venipuncture site
Which of the following steps for drawing medication from a vial is NOT necessary when drawing medication from an ampule? A. Checking the expiration date and clarity of the drug. B. Injecting air into the container before withdrawing the drug. C. Expelling air bubbles from the syringe prior to giving the drug. D. Looking at the container to ensure the appropriate concentration.
B. Injecting air into the container before withdrawing the drug
What is the MOST significant drawback to cannulating a scalp vein in a child with a butterfly catheter? A. It is aesthetically unpleasant. B. It does not allow for rapid fluid administration. C. It causes apprehension for the family. D. Scalp veins are often difficult to cannulate.
B. It does not allow for rapid fluid administration
What role does phosphorus play in the body? A. It is the primary buffer in the body. B. It is an important component in the formation of adenosine triphosphate. C. It is responsible for the distribution of water throughout the body. D. It is the principle cation needed for bone development.
B. It is an important component in the formation of adenosine triphosphate
How does lactated ringers solution help combat intracellular acidosis associated with severe blood loss? A. It has the same chemical components that are contained in bicarbonate. B. The lactate is metabolized by the liver to form bicarbonate. C. It draws hydrogen ions into the intravascular space and sends them to the kidneys. D. It overhydrates the patient and forces hydrogen ions from the body.
B. The lactate is metabolized by the liver to form bicarbonate
Third spacing is defined as: A. cellular destruction secondary to a massive influx of water. B. an abnormal fluid shift into the serous linings of the body. C. a collection of blood within the liver, spleen, or pancreas. D. a loss of body water caused by severe vomiting or diarrhea.
B. an abnormal fluid shift into the serous linings of the body
When replacing lost volume with crystalloids, it is important to remember that: A. one mL should be given for every 3 mL of estimated blood loss. B. crystalloids do not have the capacity of carrying oxygen. C. one-third of the fluid will leave the vascular spaces within an hour. D. giving too little fluid may interfere with the process of hemostasis.
B. crystalloids do not have the capacity of carrying oxygen
After inserting an IV catheter into a vein, you should: A. keep the angle of the catheter at 45° and slide the catheter off the needle. B. decrease the angle of the catheter to 15° and insert the catheter a few mm farther. C. decrease the angle of the catheter to 45° and insert the catheter 1" farther. D. increase the angle of the catheter to 90° and insert the catheter a few mm farther.
B. decrease the angle of the catheter to 15° and insert the catheter a few mm farther
A solution that hydrates the cells while depleting the vascular compartment is referred to as being: A. hypertonic. B. hypotonic. C. isotonic. D. hyperosmolar.
B. hypotonic
A solution that results in water flowing into a cell, causing it to burst, is referred to as being: A. hyperosmolar. B. hypotonic. C. isotonic. D. hypertonic.
B. hypotonic
The purpose of a constricting band when starting an IV is to: A. reduce lymphatic return to the puncture site. B. increase venous pressure at the puncture site. C. impede arterial flow to the puncture site. D. decrease the flow of venous blood at the puncture site.
B. increase venous pressure at the puncture site
When administering nitroglycerin via the sublingual route, you should: A. place the medication between the cheek and gum. B. instruct the patient not to chew or swallow the medication. C. slowly inject the medication into the tongue. D. avoid allowing the medication to dissolve too slowly.
B. instruct the patient not to chew or swallow the medication
How many grams are present in 25 mL of 50% dextrose (D50)? A. 50 g B. 25 g C. 12.5 g D. 6.25 g
C. 12.5 g
A 42-year-old man was splashed in the eye by a corrosive substance. Medical control orders you to irrigate the patient's eye with 2 liters of sterile saline. How many milliliters is this? A. 200,000 B. 200 C. 2,000 D. 20,000
C. 2,000
You receive an order from medical control to start an IV of lactated ringers and administer 150 mL/hr. Using macrodrip (15 gtts/mL) tubing, how many drops per minute will you set the flow rate at? A. 40 B. 42 C. 38 D. 44
C. 38
A 40-year-old female requires a medication to decrease her heart rate. The medication to be administered is supplied in a prefilled syringe in a concentration of 6 mg/2 mL. How many milliliters are required to achieve a dose of 12 mg? A. 8 mL B. 2 mL C. 4 mL
C. 4 mL
Which of the following medications or solutions can be administered through an intraosseous line? A. Hypertonic drugs and fluids only B. Whole blood and cardiac medications only C. Anything that you can administer via an IV D. Normal saline and hypotonic drugs only
C. Anything that you can administer via an IV
Which of the following would be LEAST likely to result in overhydration? A. Unmonitored IV B. Prolonged hypoventilation C. Excessive GI drainage D. Kidney failure
C. Excessive GI drainage
A 29-year-old female experiences shortness of breath, urticaria, and bilateral wheezing shortly after you started an IV of normal saline. How should you manage this situation? A. Place her on her left side with her head down. B. Change the IV tubing and continue the IV. C. Leave the catheter in place and remove the solution. D. Discontinue the IV and remove the catheter.
C. Leave the catheter in place and remove the solution
Which of the following is the smallest unit of weight? A. Gram B. Milligram C. Microgram D. Kilogram
C. Microgram
An ion that has an overall positive charge is called a/an: A. electrolyte. B. buffer. C. cation. D. anion.
C. cation
When selecting the most appropriate site for IV cannulation, you should avoid veins that: A. have the straightest appearance. B. are springy when palpated. C. cross or lie over joints. D. have a rounded appearance.
C. cross or lie over joints
Osmosis is defined as the: A. passive transport of molecules across the cell membrane. B. diffusion of molecules across a cell membrane. C. movement of water across a semipermeable membrane. D. movement of water to an area of lower concentration.
C. movement of water across a semipermeable membrane
An isotonic solution is one that causes: A. water to flow into the cell. B. the cell to swell and eventually burst. C. no change in the shape of the cell. D. water to be drawn out of the cell.
C. no change in the shape of the cell
After inserting the needle into the injection port of an IV line, but before administering the medication, you should: A. flush the line with a 20 mL bolus of normal saline. B. withdraw on the plunger of the syringe to detect blood. C. pinch off the tubing proximal to the injection port. D. explain the procedure to the patient and obtain consent.
C. pinch off the tubing proximal to the injection port
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/10mL. How many milliliters should your partner administer to this patient? A. 11.5 mL B. 10.4 mL C. 12.2 mL D. 12.6 mL
D. 12.6 mL
You are performing an interfacility transport of a patient that will take approximately 15 minutes. The patient has an IV line of normal saline set at a rate of 125 mL/hr. What is the approximate total fluid amount this patient will receive during the transport? A. 40 mL B. 35 mL C. 25 mL D. 30 mL
D. 30 mL
A 68-year-old female with unstable bradycardia requires 0.5 mg of atropine. Your paramedic partner opens a prefilled syringe of atropine containing 1 mg/10mL. How many milliliters should be administered to the patient? A. 1 mL B. 0.1 mL C. 0.5 mL D. 5 mL
D. 5mL
After starting an IV on a patient, you set the flow at a "KVO" rate. How many drops per minute does this rate deliver? A. 3 to 8 B. 7 to 12 C. 15 to 25 D. 8 to 15
D. 8 to 15
Which of the following techniques is appropriate when cannulating a vein? A. Avoid traction to the vein and insert the needle with the bevel side down at a 90° angle. B. Avoid traction to the vein and insert the needle with the bevel side up at a 45° angle. C. Apply traction to the vein and insert the needle with the bevel side down at a 45° angle. D. Apply traction to the vein and insert the needle with the bevel side up at a 45° angle.
D. Apply traction to the vein and insert the needle with the bevel side up at a 45° angle
A 70-year-old man presents with generalized weakness and dizziness. His blood pressure is 110/70 mm Hg when he is sitting, 96/56 mm Hg when he is standing. His heart rate is 120 beats/min and his skin is flushed and dry. What is the MOST likely cause of this patient's signs and symptoms? A. Overhydration B. Liver failure C. Kidney failure D. Dehydration
D. Dehydration
Which of the following routes is the quickest for getting medication into the central circulation? A. Intramuscular B. Subcutaneous C. Intranasal D. Intravenous
D. Intravenous
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? A. 14-gauge angiocath B. Intracath C. Butterfly catheter D. Saline lock
D. Saline lock
Which of the following electrolytes is essential for the distribution of water throughout the body? A. Chloride B. Calcium C. Potassium D. Sodium
D. Sodium
When starting an IV on an elderly patient, you should be aware that: A. larger IV catheters minimize the risk of extravasation. B. varicose veins are often the easiest veins to cannulate. C. the patient's skin is often thick and difficult to puncture. D. certain medications can create fragile skin and veins.
D. certain medications can create fragile skin and veins
A hypertonic solution is one that: A. causes no shift in fluid on either side of the cell. B. pulls fluid and electrolytes into the cell. C. has a minimal risk of causing overhydration. D. draws fluid and electrolytes out of the cell.
D. draws fluid and electrolytes out of the cell
Substances that become charged particles when they disassociate in water are called: A. permeable cells. B. organic molecules. C. inorganic molecules. D. electrolytes.
D. electrolytes
Sclerosis of a vein is caused by: A. use of elicit drugs. B. infrequent cannulation. C. atherosclerosis. D. frequent cannulation.
D. frequent cannulation
Perfusion occurs in the capillaries as a result of __________ hydrostatic pressures and __________ in the capillary beds. A. low, osmosis B. low, diffusion C. high, diffusion D. high, osmosis
D. high, osmosis
An anion is an: A. ion with an overall positive charge. B. electrolyte with a neutral charge. C. ion with both a negative and positive charge. D. ion with an overall negative charge.
D. ion with an overall negative charge
Five percent dextrose in water (D5W) is an isotonic solution until it: A. is shaken to mix the ingredients. B. has expired and is no longer active. C. is mixed with a hypotonic medication. D. is administered to a patient.
D. is administered to a patient
You have attempted to cannulate a vein in a patient's hand; however, shortly after inserting the IV catheter, the vein infiltrates. You should: A. search for a vein in the opposite extremity. B. attempt to cannulate the distal part of the same vein. C. reattempt to cannulate the same vein when the swelling subsides. D. look for a vein that is proximal to the infiltrated vein.
D. look for a vein that is proximal to the infiltrated vein
Following administration of an amiodarone bolus, your paramedic partner begins a continuous infusion. This is necessary in order to: A. ensure clearance of the drug from the body. B. decrease the therapeutic index of the medication. C. slow excretion of the drug by the renal system. D. maintain a therapeutic blood level of the drug.
D. maintain a therapeutic blood level of the drug
To calculate a drug dosage, you must know the weight of the drug present in each: A. liter. B. dekaliter. C. deciliter. D. milliliter.
D. milliliter
While starting an IV on a patient, you see bright red blood quickly traveling up the IV tubing. You should: A. lower the IV bag to ensure viability of the IV line. B. evaluate the puncture site for signs of infiltration. C. secure the IV line and apply direct pressure. D. remove the catheter and apply direct pressure.
D. remove the catheter and apply direct pressure
Following insertion of a needle into a patient's skin to administer an intramuscular injection, you pull back on the plunger and note the presence of blood in the syringe. You should: A. advance the needle 1 cm further and administer the drug. B. slightly withdraw the needle and administer the drug. C. administer the medication since this is a normal finding. D. remove the needle and apply pressure to the site.
D. remove the needle and apply pressure to the site
Medical control has ordered your paramedic partner, via two-way radio, to administer 40 mg of Lasix to a patient with congestive heart failure. You should anticipate that your partner will first: A. determine the concentration of Lasix. B. document the order on her patient care form. C. administer the medication and document the time and dose. D. repeat the drug order to the physician as she heard it.
D. repeat the drug order to the physician as she heard it
When administered to a normally hydrated patient, normal saline will: A. cause fluid to shift into the cell. B. engorge the intracellular space. C. cause fluid to shift out of the cell. D. stay in the intravascular space.
D. stay in the intravascular space
