Ch 8

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)?

0.25

500 micrograms (µg) is equal to:

0.5 mg

The concentration of sodium in the cells of the body is approximately:

0.9%

One deciliter (dL) is equivalent to:

100 mL

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

Chloride

What role does phosphorus play in the body?

It is an important component in the formation of adenosine triphosphate.

An example of intravascular fluid is:

plasma

A glass drug cartridge and syringe are components of a/an:

prefilled syringe

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

Which of the following is the smallest unit of weight?

microgram

When administered to a normally hydrated patient, normal saline will:

stay in the intravascular space.

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:

vein on the hand.

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

Air embolus

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

Sodium

Which of the following statements regarding subcutaneous injections is correct?

Subcutaneous injections are usually given with a 24-gauge to 26-gauge needle

The term "bolus" is defined as:

administering a drug in one mass of volume.

Substances that become charged particles when they disassociate in water are called:

electrolytes

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.

One milliliter (mL) is the equivalent of:

1 cubic centimeter

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

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?

12.6 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

14 gauge

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

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

1mg

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?

2,000

A severely injured patient has lost approximately 750 mL of blood. What is the appropriate volume of crystalloid solution to administer to the patient?

2,250 mL

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

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?

30 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

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?

4 mL

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

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

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

60 gtts/mL

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

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

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

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

A. Fluid overloading

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

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

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

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

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

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

Which of the following electrolytes determines whether or not the body is acidotic or alkalotic?

Bicarbonate

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.

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

Interstitial

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.

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?

Leave the catheter in place and remove the solution.

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.

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

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/an:

ampule

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

angiocath

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:

contact medical control for permission to administer the NTG.

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

crystalloids do not have the capacity of carrying oxygen.

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.

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

draws hydrogen ions into the intravascular space and sends them to the kidneys.

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:

ensure that the constricting band is not still in place.

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

facial flushing

A potential complication of intraosseous infusion is compartment syndrome. This occurs when:

fluid leaks out of the bone and into the osteofascial compartment.

Sclerosis of a vein is caused by:

frequent cannulation.

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

high, osmosis

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

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

immediately

Reconstituting a drug, such as glucagon, involves:

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

When inserting an IV into the external jugular vein, you should:

insert the catheter with the tip pointing toward the shoulder.

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

intracellular fluid

Five percent dextrose in water (D5W) 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.

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.

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

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

milliliter

Osmosis is defined as the:

movement of water across a semipermeable membrane

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 potential complications of IV therapy are you LEAST likely to encounter in the prehospital setting?

phlebitis

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?

rectal

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.

Before you can calculate an IV drip rate, you must know all of the following information, EXCEPT:

the gauge of the IV catheter you will use.

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

they bypass most barriers to drug absorption.

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.