Review

One deciliter (dL) is equivalent to:

100 mL

Which of the following is a Schedule II substance?

Demerol

Alzheimer and Parkinson's disease are examples of ____________ causes of an altered mental status.

degenerative

Five percent dextrose in water (D5W) is an isotonic solution until it:

is administered to a patient

500 micrograms (µg) is equal to:

0.5 mg

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

0.5 mg

One milliliter (mL) is the equivalent of:

1 cubic centimeter

What acid-base derangement initially occurs in a tachypneic patient without a physiologic demand for increased oxygen?

respiratory alkalosis

How much IV fluid (per bolus) should you administer to a 65-kg patient with extensive burns and severe shock?

1,300 mL

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:

10 drops

How many grams are present in 25 mL of 50% dextrose (D50)?

12.5 g

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?

12.6 ml

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

15,000

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?

3 mL

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?

33

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

42 mL

An 8-year-old child requires fluid resuscitation to treat severe dehydration. The child's mother is so upset that she cannot tell you how much her child weighs. On the basis of the child's age, you should administer a _____ mL bolus of an isotonic crystalloid.

480

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

500 mg

What percentage of water accounts for the total body weight?

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 (gtts/min) is your IV flow rate set at?

63 gtts/min

When assessing the 1-minute Apgar score, you note that the newborn's hands and feet are cyanotic; it has weak muscle tone, a strong cry, a heart rate of approximately 120 beats/min, and irregular respirations of approximately 40 breaths/min. What is this infant's Apgar score?

8

On the basis of the Parkland formula, how much crystalloid should you administer per hour to a 70-kg patient with severe burns to 50% of his BSA?

800-900 mL

When performing CPR at a 3:1 compression to ventilation ratio on a newborn in cardiac arrest, you should deliver ____ compressions and ____ breaths each minute.

90, 30

What is the difference between a crystalloid and a colloid solution?

A. Crystalloids do not contain large protein molecules

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

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

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

Upon entering the residence of an elderly patient who has fallen, you should ensure personal safety and then:

A. evaluate the patient's living environment

A 5-year-old male presents with respiratory distress, a decreased level of consciousness, bradypnea, and poor muscle tone. When treating this child, you should:

A. recognize that his minute volume is reduced

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

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

A 29-year-old female has experienced a spontaneous abortion during the latter part of her first trimester. She is conscious and alert, with a blood pressure of 100/60 mm Hg and a heart rate of 100 beats/min and strong. In addition to providing emotional support and administering oxygen, you should:

A. start a large-bore IV of normal saline and transport

Which of the following is a systemic complication associated with IV therapy?

Air embolus

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

An MDI delivers the same amount of medication every time it is used

Certain medications must be given in reduced doses to elderly patients because: A. the body may rapidly absorb and process the medication. B. renal function decline may result in toxic drug levels. C. many organs are no longer responsive to certain drugs. D. the liver increases its ability to detoxify certain drugs.

B. renal function decline may result in toxic drug levels

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

Beta 1 receptor stimulation

Major cations in the body include all of the following, EXCEPT:

Bicarbonate

A loss of sensory nerve ending fibers and slowing of the peripheral nervous system predisposes the elderly patient to: A. hypertension that is unresponsive to medications. B. decreased ability to catch himself or herself during a fall. C. decreased reflexes when touching a hot or cold object. D. inability to differentiate between good and spoiled food.

C. decreased reflexes when touching a hot or cold object

By the time a person reaches the age of 65 years: A. the myocardial walls have become thin. B. pulmonary function has decreased by 20%. C. total body water has decreased by 30%. D. he or she will likely develop a disease.

C. total body water has decreased by 30%

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

Chloride

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%.

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

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.

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 statements regarding peripheral cyanosis is correct?

It is limited to the hands and feet and is a common finding.

Which of the following conditions would be LEAST likely to result in cerebral hypoxia?

Methamphetamine overdose

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

Oxygen

While starting an IV on a patient, you see bright red blood quickly traveling up the IV tubing. You should:

Remove the catheter and apply direct pressure.

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 or heparin lock

Which of the following electrolytes is essential for the distribution of water throughout the body?

Sodium

What is the pathophysiology of psychogenic shock?

Temporary, generalized vascular dilation

Which of the following statements regarding medication administration in pediatric patients is correct?

The products of metabolism in children can vary from those seen in adults, which may sometimes result in unexpected responses

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

The sympathetic nervous system does not release catecholamines.

An important neurotransmitter in the parasympathetic nervous system is:

acetylcholine

Which of the following medications is a suspension?

activated charcoal

The sympathetic nervous system is also known as the:

adrenergic nervous system

An over-the-needle catheter is commonly referred to as a/an:

angiocath

A 28-year-old female was the unrestrained driver of a car that struck the rear end of another car while traveling at 35 mph. She is conscious and alert and complains of pain to the anterior chest. During your assessment, you note a large ecchymotic area over the superior aspect of the anterior chest. As your partner assumes manual stabilization of her head, you should:

apply 100% oxygen via a nonrebreathing mask.

When treating a patient who experienced a pulmonary blast injury, you should:

avoid giving oxygen under positive pressure.

Atropine increases the heart rate by:

blocking the vagus nerve and preventing innervation by ACh

Because of the thin-walled thorax in an infant or child:

breath sounds are easily transmitted to all areas of the chest

When replacing lost volume with crystalloids, it is important to remember that:

crystalloids do not have the capacity of carrying oxygen.

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

decreased heart rate

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?

dehydration

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:

diffusion

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/an:

emulsion

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

facial flushing

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:

fentanyl patch

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

filtration

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

has a much higher potential for abuse and dependence.

Perfusion occurs in the capillaries as a result of __________ hydrostatic pressures and __________ in the capillary beds.

high, osmosis

Which of the following is a LATE sign of preeclampsia?

hyperactive reflexes

A 70-year-old female presents with generalized muscle weakness; lethargy; and hot, flushed skin. Which of the following electrolyte disturbances should you suspect?

hypercalcemia

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

hypertonic

A solution that hydrates the cells while depleting the vascular compartment is referred to as being:

hypotonic

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

hypotonic

An adverse condition induced in a patient as a result of the treatment given is called a/an:

iatrogenic response

What is the pathophysiology of gestational diabetes?

in *early* pregnancy, higher levels of estrogen enhance insulin insensitivity, we can see maternal *hypoglycemia*, especially when associated with N/V by the 2nd and 3rd trimesters => increasing *hyperglycemia* due to insulin resistance, likely mediated by the elaboration of placental hormones: - placental growth hormones - cortisol - human placental lactogen - progesterone - prolactin

Stimulation of the sympathetic nervous system results in:

increased blood pressure and heart rate

Excessive exposure to a cholinergic agent would produce:

increased salivation, urination, and vomiting.

Children vigorously compensate for shock by:

increasing their heart rate and increasing peripheral vascular resistance

Reconstituting a drug, such as glucagon, involves:

injecting liquid from one vial into another vial that already contains powder.

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

intracellular fluid

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

intramuscular

Which of the following medication routes will provide the MOST rapid rate of absorption?

intraosseous

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.

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

know that varicose veins allow minimal circulation.

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

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

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 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

Damage to the ___________ valve may cause blood to regurgitate into the lungs.

mitral

Osmosis is defined as the:

movement of water across a semipermeable membrane

The thick, muscular layer of the uterus is called the:

myometrium

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.

Contraindications for intraosseous infusion include all of the following, EXCEPT:

patients who are in cardiac arrest or status epilepticus.

Which of the following physiologic responses would you expect to occur following administration of a drug that possesses alpha-1 (α1) properties?

peripheral vasoconstriction

During early infancy, infants respond mainly to:

physical stimuli such as hunger.

An example of intravascular fluid is:

plasma

A 67-year-old male who smokes three packs of cigarettes per day complains of a productive cough, chills, and generalized weakness. He is in mild respiratory distress; auscultation of his lungs reveals rhonchi to the lower left lobe. This patient's clinical presentation is MOST consistent with:

pneumonia

Oogenesis is defined as the:

process that results in a mature egg

The MOST common site for intraosseous cannulation is the:

proximal tibia

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.

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:

remove the needle and apply pressure to the site.

All patients with closed soft-tissue injuries should be assessed for:

serious hidden injuries

A predictable, yet adverse response to a drug, is called a/an:

side effect

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

solution

Compared to over-the-needle catheters, butterfly catheters are associated with a higher rate of vein infiltration in children because the:

stainless steel needle lies directly in the vein

Syncope in an elderly person is the result of a/an:

temporary interruption of cerebral blood flow

In order for electricity to flow through the body and cause injury:

there must be a complete circuit between the electrical source and the ground

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

they bypass most barriers to drug absorption.

A 37-year-old male with chronic anxiety finds that he has to take more of his antianxiety medication to achieve the same effect. What is this called?

tolerance

A 21-year-old female in her third trimester of pregnancy was involved in a motor-vehicle crash. She was unrestrained and struck a telephone pole while traveling approximately 40 MPH. She complains of severe abdominal pain and vaginal bleeding and has signs of shock. While palpating her abdomen, you can feel a fetal body part through the abdominal wall. On the basis of the mechanism of injury and the patient's clinical presentation, you should suspect a/an:

uterine rupture

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

veins of the scalp.

All of the following signs are indicative of upper airway burns due to an inhalation injury, EXCEPT:

wheezing or rhonchi.

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.