Chapter 8- Vascular Access and Medication Admin.

An over-the-needle catheter is commonly referred to as a/an: Select one: A. angiocath. B. intracath. C. arteriocath. D. butterfly catheter.

A. angiocath.

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)? Select one: A. 0.25 B. 0.5 C. 5.0 D. 2.5

A. 0.25

Which of the following represents a "standard" drug dose? Select one: A. 1 mg B. 1 mg/kg C. 0.5 g/kg D. 0.25 mg/kg

A. 1 mg

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: Select one: A. 10 drops. B. 15 drops. C. 20 drops. D. 60 drops.

A. 10 drops.

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? Select one: A. 33 B. 46 C. 66 D. 74

A. 33

What is the approximate weight in kilograms of a 155 lb patient? Select one: A. 70 kg B. 72 kg C. 74 kg D. 76 kg

A. 70 kg

A 70-year-old female presents with generalized muscle weakness; lethargy; and hot, flushed skin. Which of the following electrolyte disturbances should you suspect? Select one: A. Hypercalcemia B. Hypocalcemia C. Hypernatremia D. Hyperkalemia

A. Hypercalcemia

An intraosseous line should be inserted in a critical patient if: Select one: A. IV access is unsuccessful after three attempts. B. you cannot readily see a visible peripheral vein. C. the patient will require a whole blood transfusion. D. you cannot establish IV access within three minutes.

A. IV access is unsuccessful after three attempts.

Which of the following potential complications of IV therapy are you LEAST likely to encounter in the prehospital setting? Select one: A. Phlebitis B. Occlusion C. Infiltration D. Vein irritation

A. Phlebitis

You are transporting a patient with an IV of D5W. Which of the following signs would be atypical of infiltration? Select one: A. Redness around the IV site B. Edema at the catheter site C. Tightness and pain around the IV site D. IV flow despite occlusion proximal to the IV site

A. Redness around the IV site

How does lactated ringers solution help combat intracellular acidosis associated with severe blood loss? Select one: A. The lactate is metabolized by the liver to form bicarbonate. B. It overhydrates the patient and forces hydrogen ions from the body. C. It has the same chemical components that are contained in bicarbonate. D. It draws hydrogen ions into the intravascular space and sends them to the kidneys.

A. The lactate is metabolized by the liver to form bicarbonate.

An ion that has an overall positive charge is called a/an: Select one: A. cation. B. anion. C. buffer. D. electrolyte.

A. cation.

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: Select one: A. contaminated stick. B. disease contraction. C. infectious exposure. D. communicable stick.

A. contaminated stick.

Substances that become charged particles when they disassociate in water are called: Select one: A. electrolytes. B. organic molecules. C. inorganic molecules. D. permeable cells.

A. electrolytes.

Once the "pigtail" that covers the access port of a bag of IV fluid has been removed, the fluid must be used: Select one: A. immediately. B. within 12 hours. C. within 24 hours. D. within 36 hours.

A. immediately.

Reconstituting a drug, such as glucagon, involves: Select one: A. injecting liquid from one vial into another vial that already contains powder. B. placing at least 10 mL of saline into a vial that contains powdered medication. C. diluting a medication with at least 20 mL of saline prior to administration. D. injecting liquid from one vial into another vial that contains liquid medication.

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

__________ fluid accounts for approximately 16% of the body's total weight. Select one: A. interstitial B. intravascular C. extracellular D. intracellular

A. interstitial

The majority of the body's potassium is found within the: Select one: A. intracellular fluid. B. interstitial fluid. C. intravascular fluid. D. extracellular fluid.

A. intracellular fluid.

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: Select one: A. remove the needle and apply pressure to the site. B. slightly withdraw the needle and administer the drug. C. advance the needle 1 cm further and administer the drug. D. administer the medication since this is a normal finding.

A. remove the needle and apply pressure to the site.

Prior to administering an oral medication to a patient, you must: Select one: A. take standard precautions. B. carefully assess the patient. C. determine the need for the medication. D. contact medical control to obtain authorization.

A. take standard precautions.

Once the protective wrap is removed from a bag of IV fluid, the fluid must be used: Select one: A. within 24 hours. B. within 36 hours. C. within 48 hours. D. immediately.

A. within 24 hours.

If you have an epinephrine concentration of 0.1 mg/mL, how many milligrams would be present in 5 mL? Select one: A. 5 mg B. 0.5 mg C. 0.05 mg D. 0.005 mg

B. 0.5 mg

500 micrograms (µg) is equal to: Select one: A. 5 mg. B. 0.5 mg. C. 0.05 mg. D. 0.005 mg.

B. 0.5 mg.

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? Select one: A. 25 mL B. 30 mL C. 35 mL D. 40 mL

B. 30 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? Select one: A. 0.5 mg B. 500 mg C. 2500 mg D. 5000 mg

B. 500 mg

What percentage of water accounts for the total body weight? Select one: A. 50% B. 60% C. 70% D. 80%

B. 60%

Which of the following is a systemic complication associated with IV therapy? Select one: A. Phlebitis B. Air embolus C. Infiltration D. Hematoma

B. Air embolus

Which of the following is a major anion in the body? Select one: A. Sodium B. Chloride C. Calcium D. Potassium

B. Chloride

Which of the following electrolytes is essential for the distribution of water throughout the body? Select one: A. Calcium B. Sodium C. Chloride D. Potassium

B. Sodium

When starting an IV on an elderly patient, you should be aware that: Select one: A. the patient's skin is often thick and difficult to puncture. B. certain medications can create fragile skin and veins. C. larger IV catheters minimize the risk of extravasation. D. varicose veins are often the easiest veins to cannulate.

B. certain medications can create fragile skin and veins.

Signs and symptoms of an air embolus include all of the following, EXCEPT: Select one: A. tachycardia. B. facial flushing. C. respiratory distress. D. oxygen-refractory cyanosis.

B. facial flushing.

Perfusion occurs in the capillaries as a result of __________ hydrostatic pressures and __________ in the capillary beds. Select one: A. low, osmosis B. high, osmosis C. high, diffusion D. low, diffusion

B. high, osmosis

Filtration, a type of diffusion, is commonly used to clean the blood via the: Select one: A. liver. B. kidneys. C. pancreas. D. spleen.

B. kidneys.

Following administration of an amiodarone bolus, your paramedic partner begins a continuous infusion. This is necessary in order to: Select one: A. ensure clearance of the drug from the body. B. maintain a therapeutic blood level of the drug. C. slow excretion of the drug by the renal system. D. decrease the therapeutic index of the medication.

B. maintain a therapeutic blood level of the drug.

Other than oxygen, prior to administering any medication to a patient, you must take standard precautions and then: Select one: A. check the expiration date of the medication. B. perform a careful assessment of the patient. C. determine the patient's family medical history. D. administer the medication as soon as possible.

B. perform a careful assessment of the patient.

After inserting the needle into the injection port of an IV line, but before administering the medication, you should: Select one: A. flush the line with a 20 mL bolus of normal saline. B. pinch off the tubing proximal to the injection port. C. withdraw on the plunger of the syringe to detect blood. D. explain the procedure to the patient and obtain consent.

B. pinch off the tubing proximal to the injection port.

While starting an IV on a patient, you see bright red blood quickly traveling up the IV tubing. You should: Select one: A. secure the IV line and apply direct pressure. B. remove the catheter and apply direct pressure. C. lower the IV bag to ensure viability of the IV line. D. evaluate the puncture site for signs of infiltration.

B. remove the catheter and apply direct pressure.

Intraosseous lines require full and careful immobilization because: Select one: A. the needle is only ¼" long and is not firmly in the bone. B. they rest at a 90° angle to the bone and are easily dislodged. C. even when properly placed, the catheter easily moves back and forth. D. insertion of the intraosseous catheter causes fracture of the bone.

B. they rest at a 90° angle to the bone and are easily dislodged.

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: Select one: A. antecubital vein. B. vein on the hand. C. medial forearm vein. D. lateral forearm vein.

B. vein on the hand.

If used in pediatric patients, butterfly catheters are commonly placed in the: Select one: A. back of the hand. B. veins of the scalp. C. antecubital vein. D. anterior forearm.

B. veins of the scalp.

Minimum documentation following IV therapy includes all of the following, EXCEPT: Select one: A. venipuncture site. B. your certification level. C. type of fluid being given. D. the rate the fluid is running.

B. your certification level.

One milliliter (mL) is the equivalent of: Select one: A. 1 microgram. B. 1 deciliter. C. 1 cubic centimeter. D. 1 cubic deciliter.

C. 1 cubic centimeter.

One deciliter (dL) is equivalent to: Select one: A. 0.1 mL B. 10 mL C. 100 mL D. 1000 mL

C. 100 mL

During the IV procedure, when is it MOST appropriate to apply the constricting band? Select one: A. When you assemble the IV equipment. B. After you cleanse the venipuncture site. C. Before you cleanse the venipuncture site. D. After you insert the catheter into the vein. Feedback

C. Before you cleanse the venipuncture site.

Which of the following is the smallest unit of weight? Select one: A. Milligram B. Kilogram C. Microgram D. Gram

C. Microgram

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? Select one: A. Subcutaneous B. Oral C. Rectal D. Intralingual

C. Rectal

Which of the following is NOT a crystalloid? Select one: A. Normal saline B. Lactated ringers C. Whole blood D. Five percent dextrose in water

C. Whole blood

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: Select one: A. remove the needle and prepare a new syringe. B. administer the medication via IM injection instead. C. administer the medication and observe for infiltration. D. flush the saline lock with normal saline before giving the drug.

C. administer the medication and observe for infiltration.

Severe hyperkalemia can result in: Select one: A. decreased muscle function. B. gastrointestinal disturbances. C. hyperstimulation of neural transmission. D. severe dehydration as a result of water loss.

C. hyperstimulation of neural transmission.

The purpose of a constricting band when starting an IV is to: Select one: A. impede arterial flow to the puncture site. B. reduce lymphatic return to the puncture site. C. increase venous pressure at the puncture site. D. decrease the flow of venous blood at the puncture site.

C. increase venous pressure at the puncture site.

An anion is an: Select one: A. electrolyte with a neutral charge. B. ion with an overall positive charge. C. ion with an overall negative charge. D. ion with both a negative and positive charge.

C. ion with an overall negative charge.

The term applied to the practice of preventing contamination of the patient when performing an invasive procedure is called: Select one: A. sterile technique. B. standard precautions. C. medical asepsis. D. universal precautions.

C. medical asepsis.

An isotonic solution is one that causes: Select one: A. water to flow into the cell. B. water to be drawn out of the cell. C. no change in the shape of the cell. D. the cell to swell and eventually burst.

C. no change in the shape of the cell.

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: Select one: A. in Trendelenburg's position. B. in a semi-Fowler's position. C. on the left side with the head down. D. on the left side with the head elevated.

C. 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: Select one: A. assure the patient the symptoms are normal. B. lift the IV catheter to a 45° angle. C. remove the catheter and choose another site. D. carefully continue with the venipuncture.

C. remove the catheter and choose another 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: Select one: A. determine the concentration of Lasix. B. document the order on her patient care form. C. repeat the drug order to the physician as she heard it. D. administer the medication and document the time and dose.

C. repeat the drug order to the physician as she heard it.

When administered to a normally hydrated patient, normal saline will: Select one: A. cause fluid to shift into the cell. B. cause fluid to shift out of the cell. C. stay in the intravascular space. D. engorge the intracellular space.

C. stay in the intravascular space.

Unlike IM or SC injections, intravenously administered drugs rapidly affect the body because: Select one: A. they do not have to pass through the liver. B. they are excreted from the body more slowly. C. they bypass most barriers to drug absorption. D. their strength doubles as they enter the bloodstream.

C. they bypass most barriers to drug absorption.

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? Select one: A. 10.4 mL B. 11.5 mL C. 12.2 mL D. 12.6 mL

D. 12.6 mL

How many pounds does a 90-kg patient weigh? Select one: A. 186 lb B. 189 lb C. 194 lb D. 198 lb

D. 198 lb

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? Select one: A. 39 gtts/min B. 53 gtts/min C. 58 gtts/min D. 63 gtts/min

D. 63 gtts/min

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? Select one: A. Use a length-based resuscitation tape. B. Estimate the child's weight based on his age. C. Determine the child's weight based on his height. D. Ask the mother if she knows the weight of her son.

D. Ask the mother if she knows the weight of her son.

The term "bolus" is defined as: Select one: A. administering at least 20 mL of volume. B. administering less than 10 mL of volume. C. delivering a drug via maintenance infusion. D. administering a drug in one mass of volume.

D. administering a drug in one mass of volume.

Factors that can cause an insufficient or absent flow of fluid through an IV line include: Select one: A. small air bubbles in the IV line. B. a drip chamber that is half full. C. an IV bag that is placed too high. D. an IV bag that is placed too low.

D. an IV bag that is placed too low.

Major cations in the body include all of the following, EXCEPT: Select one: A. sodium. B. calcium. C. potassium. D. bicarbonate.

D. 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: Select one: A. give 1 NTG dose and contact medical control. B. administer up to 3 NTG doses and reassess his BP. C. continue oxygen and transport the patient to the hospital. D. contact medical control for permission to administer the NTG.

D. contact medical control for permission to administer the NTG.

When selecting the most appropriate site for IV cannulation, you should avoid veins that: Select one: A. are springy when palpated. B. have the straightest appearance. C. have a rounded appearance. D. cross or lie over joints.

D. cross or lie over joints.

After inserting an IV catheter into a vein, you should: Select one: A. decrease the angle of the catheter to 45° and insert the catheter 1" farther. B. keep the angle of the catheter at 45° and slide the catheter off the needle. C. increase the angle of the catheter to 90° and insert the catheter a few mm farther. D. decrease the angle of the catheter to 15° and insert the catheter a few mm farther.

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

Compared to a 16-gauge catheter, a 22-gauge catheter would be more appropriate for an elderly patient because: Select one: A. larger fluid volumes can be administered. B. it more easily penetrates their tough skin. C. the risk of catheter shear is much lower. D. it reduces the risk of fluid extravasation.

D. it reduces the risk of fluid extravasation.

As an AEMT, the MOST commonly inhaled medication you will administer is: Select one: A. Albuterol. B. Ventolin. C. Alupent. D. oxygen.

D. oxygen.