AEMT AAOS. Chapter 8: Vascular Access and Med. Admin.
Which of the following electrolytes determines whether or not the body is acidotic or alkalotic? A. Calcium B. Phosphorus C. Sodium D. Bicarbonate
D. Bicarbonate
The MOST common site for intraosseous cannulation is the: A. proximal tibia. B. distal tibia. C. lateral femur. D. tibial tuberosity.
A. proximal tibia.
An example of intravascular fluid is: A. intraocular fluid. B. amniotic fluid. C. plasma. D. cerebrospinal fluid.
C. plasma.
500 micrograms (µg) is equal to: A. 0.5 mg. B. 0.005 mg. C. 5 mg. D. 0.05 mg.
A. 0.5 mg.
How many grams are present in 25 mL of 50% dextrose (D50)? A. 12.5 g B. 25 g C. 6.25 g D. 50 g
A. 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. 2,000 B. 200 C. 200,000 D. 20,000
A. 2,000
You have a prefilled syringe containing 25g of dextrose in 50 mL of volume. How many milligrams of dextrose are present in each milliliter?*** A. 500 mg B. 0.5 mg C. 2500 mg D. 5000 mg
A. 500 mg
What is the difference between a crystalloid and a colloid solution? A. Crystalloids do not contain large protein molecules. B. Colloids poorly expand the vascular compartment. C. Colloids rapidly move from the vascular space. D. Crystalloids contain large protein molecules.
A. Crystalloids do not contain large protein molecules.
Which of the following formulas is correct for converting a patient's weight in pounds to his or her weight in kilograms? A. Divide the patient's weight in pounds by 2 and subtract 10%. B. Multiply the patient's weight in pounds by 2.2. C. Multiply the patient's weight in pounds by 2. D. Divide the patient's weight in pounds by 2 and add 10%.
A. Divide the patient's weight in pounds by 2 and subtract 10%.
Although painful and difficult to manage, what is the location of choice for starting IVs in pediatric patients? A. Hand vein B. Forearm vein C. Foot vein D. Antecubital vein
A. Hand vein
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. Hypocalcemia B. Hypercalcemia C. Hypernatremia D. Hyperkalemia
A. Hypocalcemia
Which of the following is the smallest unit of weight? A. Microgram B. Gram C. Milligram D. Kilogram
A. Microgram
Which of the following statements regarding subcutaneous injections is correct? A. Subcutaneous injections are usually given with a 24-gauge to 26-gauge needle B. The needle is inserted at a 90° angle when giving a subcutaneous injection. C. The deltoid muscle is the most common location for a subcutaneous injection. D. Volumes of less than 10 mL are usually given by the subcutaneous route.
A. Subcutaneous injections are usually given with a 24-gauge to 26-gauge needle
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. contaminated stick. B. disease contraction. C. infectious exposure. D. communicable stick.
A. contaminated stick.
A hypertonic solution is one that: A. draws fluid and electrolytes out of the cell. B. pulls fluid and electrolytes into the cell. C. has a minimal risk of causing overhydration. D. causes no shift in fluid on either side of the cell.
A. draws fluid and electrolytes out of the cell.
The purpose of a constricting band when starting an IV is to: A. increase venous pressure at the puncture site. B. reduce lymphatic return to the puncture site. C. decrease the flow of venous blood at the puncture site. D. impede arterial flow to the puncture site.
A. increase venous pressure at the puncture site.
When administering nitroglycerin via the sublingual route, you should: A. instruct the patient not to chew or swallow the medication. B. place the medication between the cheek and gum. C. slowly inject the medication into the tongue. D. avoid allowing the medication to dissolve too slowly.
A. instruct the patient not to chew or swallow the medication.
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. cannulate a sclerosed vein since it is less likely to infiltrate. D. choose a vein that weaves back and forth.
A. know that varicose veins allow minimal circulation.
After inserting the needle into the injection port of an IV line, but before administering the medication, you should: A. pinch off the tubing proximal to the injection port. B. withdraw on the plunger of the syringe to detect blood. C. explain the procedure to the patient and obtain consent. D. flush the line with a 20 mL bolus of normal saline.
A. pinch off the tubing proximal to the injection port.
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.
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 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. vein on the hand. B. lateral forearm vein. C. antecubital vein. D. medial forearm vein.
A. vein on the hand.
Which of the following represents a "standard" drug dose? A. 1 mg/kg B. 1 mg C. 0.5 g/kg D. 0.25 mg/kg
B. 1 mg
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. 20 gauge B. 14 gauge C. 18 gauge D. 16 gauge
B. 14 gauge
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. 2,250 mL C. 1,000 mL D. 1,500 mL
B. 2,250 mL
Which of the following medications or solutions can be administered through an intraosseous line? A. Hypertonic drugs and fluids only B. Anything that you can administer via an IV C. Normal saline and hypotonic drugs only D. Whole blood and cardiac medications only
B. Anything that you can administer via an IV
Which of the following techniques is appropriate when cannulating a vein? A. Apply traction to the vein and insert the needle with the bevel side down at a 45° angle. B. Apply traction to the vein and insert the needle with the bevel side up at a 45° angle. C. Avoid traction to the vein and insert the needle with the bevel side up at a 45° angle. D. Avoid traction to the vein and insert the needle with the bevel side down at a 90° angle.
B. Apply traction to the vein and insert the needle with the bevel side up at a 45° angle.
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. Lateral recumbent position, event documented B. Head elevated, medical control notified C. Head lowered, medical control notified D. Trendelenburg's position, event documented
B. Head elevated, medical control notified
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. Hypernatremia B. Hypercalcemia C. Hyperkalemia D. Hypocalcemia
B. Hypercalcemia
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. Redness around the IV site C. Tightness and pain around the IV site D. IV flow despite occlusion proximal to the IV site
B. Redness around the IV site
Third spacing is defined as: A. a collection of blood within the liver, spleen, or pancreas. B. an abnormal fluid shift into the serous linings of the body. C. cellular destruction secondary to a massive influx of water. D. a loss of body water caused by severe vomiting or diarrhea.
B. an abnormal fluid shift into the serous linings of the body.
An ion that has an overall positive charge is called a/an: A. buffer. B. cation. C. electrolyte. D. anion.
B. cation.
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.
Severe hyperkalemia can result in: A. gastrointestinal disturbances. B. hyperstimulation of neural transmission. C. severe dehydration as a result of water loss. D. decreased muscle function.
B. hyperstimulation of neural transmission.
Prior to administering an oral medication to a patient, you must: A. contact medical control to obtain authorization. B. take standard precautions. C. carefully assess the patient. D. determine the need for the medication.
B. take standard precautions.
If used in pediatric patients, butterfly catheters are commonly placed in the: A. anterior forearm. B. veins of the scalp. C. antecubital vein. 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. immediately. D. within 36 hours.
B. within 24 hours.
One milliliter (mL) is the equivalent of: A. 1 cubic deciliter. B. 1 microgram. C. 1 cubic centimeter. D. 1 deciliter.
C. 1 cubic centimeter.
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. 22 B. 24 C. 28 D. 26
C. 28
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. 0.5 mL B. 1 mL C. 5 mL D. 0.1 mL
C. 5 mL
Which of the following is a major anion in the body? A. Potassium B. Sodium C. Chloride D. Calcium
C. Chloride
A patient with congestive heart failure requires medication administration. Which of the following IV solutions would be MOST appropriate to use? A. Lactated ringers B. Normal saline C. Five percent dextrose in water D. An isotonic colloid
C. Five percent dextrose in water
What role does phosphorus play in the body? A. It is the principle cation needed for bone development. B. It is responsible for the distribution of water throughout the body. C. It is an important component in the formation of adenosine triphosphate. D. It is the primary buffer in the body.
C. It is an important component in the formation of adenosine triphosphate.
An over-the-needle catheter is commonly referred to as a/an: A. butterfly catheter. B. arteriocath. C. angiocath. D. intracath.
C. angiocath.
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. medial forearm vein. B. dorsal hand vein. C. antecubital vein. D. lateral forearm vein.
C. antecubital vein.
When inserting an IV into the external jugular vein, you should: A. use the same technique that you use for any other IV. B. ensure that the patient is sitting in a fully upright position. C. insert the catheter with the tip pointing toward the shoulder. D. insert the catheter with the tip pointing toward the head.
C. insert the catheter with the tip pointing toward the shoulder.
Contraindications for intraosseous infusion include all of the following, EXCEPT: A. fracture of the bone in which you will place the catheter. B. the ability to obtain IV access within 90 seconds. C. patients who are in cardiac arrest or status epilepticus. D. successful cannulation of a large antecubital vein.
C. patients who are in cardiac arrest or status epilepticus.
The cell membrane is a ______________ bilayer, which is an important barrier to fluid movement and the acid-base balance. A. lipophilic B. electrophilic C. phospholipid D. hydrophobic
C. phospholipid
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. remove the needle and apply pressure to the site. D. administer the medication since this is a normal finding.
C. remove the needle and apply pressure to the site.
Before you can calculate an IV drip rate, you must know all of the following information, EXCEPT: A. the drop factor of the administration set. B. amount of fluid to deliver. C. the gauge of the IV catheter you will use. D. length of time of the infusion.
C. the gauge of the IV catheter you will use.
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. 4 mL B. 4.5 mL C. 3.5 mL D. 3 mL
D. 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? A. 66 B. 46 C. 74 D. 33
D. 33
What percentage of water accounts for the total body weight? A. 50% B. 70% C. 80% D. 60%
D. 60%
Which of the following routes is the quickest for getting medication into the central circulation? A. Intranasal B. Intramuscular C. Subcutaneous D. Intravenous
D. Intravenous
Which of the following is NOT a crystalloid? A. Lactated ringers B. Normal saline C. Five percent dextrose in water D. Whole blood
D. Whole blood
A breakable glass container that is designed to carry a single medication dose is called a/an: A. vial. B. tubex. C. aboject. D. ampule.
D. ampule.
Factors that can cause an insufficient or absent flow of fluid through an IV line include: A. an IV bag that is placed too high. B. small air bubbles in the IV line. C. a drip chamber that is half full. D. an IV bag that is placed too low.
D. an IV bag that is placed too low.
When selecting the most appropriate site for IV cannulation, you should avoid veins that: A. have the straightest appearance. B. have a rounded appearance. C. are springy when palpated. D. cross or lie over joints.
D. cross or lie over joints.
Signs and symptoms of an air embolus include all of the following, EXCEPT: A. oxygen-refractory cyanosis. B. respiratory distress. C. tachycardia. D. facial flushing.
D. facial flushing.
A solution that hydrates the cells while depleting the vascular compartment is referred to as being: A. hypertonic. B. hyperosmolar. C. isotonic. D. hypotonic.
D. hypotonic.
Reconstituting a drug, such as glucagon, involves: A. injecting liquid from one vial into another vial that contains liquid medication. 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 already contains powder.
D. injecting liquid from one vial into another vial that already contains powder.
The majority of the body's potassium is found within the: A. interstitial fluid. B. extracellular fluid. C. intravascular fluid. D. intracellular fluid.
D. intracellular fluid.
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.
Compared to a 16-gauge catheter, a 22-gauge catheter would be more appropriate for an elderly patient because: A. it more easily penetrates their tough skin. B. the risk of catheter shear is much lower. C. larger fluid volumes can be administered. D. it reduces the risk of fluid extravasation.
D. it reduces the risk of fluid extravasation.
The term applied to the practice of preventing contamination of the patient when performing an invasive procedure is called: A. sterile technique. B. standard precautions. C. universal precautions. D. medical asepsis.
D. medical asepsis.
Other than oxygen, prior to administering any medication to a patient, you must take standard precautions and then: A. administer the medication as soon as possible. B. determine the patient's family medical history. C. check the expiration date of the medication. D. perform a careful assessment of the patient.
D. perform a careful assessment of the patient.
While starting an IV on a patient, you see bright red blood quickly traveling up the IV tubing. You should: A. evaluate the puncture site for signs of infiltration. B. lower the IV bag to ensure viability of the IV line. 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.
When administering a medication via the intramuscular route, you should: A. pinch 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. stretch the skin over the area and insert the needle at a 90° angle.
D. stretch the skin over the area and insert the needle at a 90° angle.
Unlike IM or SC injections, intravenously administered drugs rapidly affect the body because: A. they are excreted from the body more slowly. B. their strength doubles as they enter the bloodstream. C. they do not have to pass through the liver. D. they bypass most barriers to drug absorption.
D. they bypass most barriers to drug absorption.
Minimum documentation following IV therapy includes all of the following, EXCEPT: A. venipuncture site. B. the rate the fluid is running. C. type of fluid being given. D. your certification level.
D. your certification level.
