Please enter something

Chapter 40

question

may identify myocardial ischemia or injury.
answer

A 12-lead ECG: A. is only performed in the hospital setting. B. may identify myocardial ischemia or injury. C. is used by the EMT to diagnose a heart attack. D. does not indicate the heart’s primary pacemaker.
question

ensure that her airway is clear, attempt to insert a nasopharyngeal airway, and assist her ventilations with a bag-mask device.
answer

A 50-year-old female is found semiconscious by her son. Your assessment reveals that her respirations are slow and shallow and there is vomitus draining from her mouth. When you attempt to suction her oropharynx, she begins to gag. You should: A. ensure that her airway is clear, attempt to insert a nasopharyngeal airway, and assist her ventilations with a bag-mask device. B. abort the suction attempt at once, preoxygenate her with a bag-mask device, and prepare to perform endotracheal intubation. C. continue to suction her airway until the secretions are clear, insert an oropharyngeal airway, and ventilate with a bag-mask device. D. remove the suction catheter immediately, insert a nasopharyngeal airway, and administer oxygen via a nonrebreathing mask.
question

place him on his left side with his head down.
answer

A 50-year-old male develops acute respiratory distress and cyanosis shortly after an IV line has been established. You should administer high-flow oxygen and: A. position him supine with his legs elevated. B. place him on his left side with his head down. C. position him supine with his head elevated 45°. D. place him on his right side with his head elevated.
question

does not completely protect the airway from aspiration.
answer

A disadvantage of the King LT airway is that it: A. cannot be used in patients who are shorter than 5′. B. does not completely protect the airway from aspiration. C. is contraindicated in patients who are in cardiac arrest. D. most often enters the trachea because it is blindly inserted.
question

maintenance of a mask-to-face seal is not required.
answer

A major benefit when using a multilumen airway device is that: A. it can be used on patients of any age and size. B. it can be visualized as it enters the esophagus. C. the airway is better protected than with an ET tube. D. maintenance of a mask-to-face seal is not required.
question

60
answer

A microdrip administration set delivers 1 mL of fluid after every ______ drops. A. 20 B. 40 C. 60 D. 80
question

an irregular heart rate.
answer

A normal sinus rhythm (NSR) is characterized by all of the following, EXCEPT: A. an irregular heart rate. B. a heart rate of 80 beats/min. C. consistent P-R intervals. D. P waves of the same shape.
question

electricity travels through the atria.
answer

A P wave is created when: A. the heart is in its resting phase. B. the SA node generates an impulse. C. electricity travels through the atria. D. ventricular depolarization is complete.
question

ventricular fibrillation.
answer

A rapid, chaotic rhythm that is completely disorganized is called: A. asystole. B. atrial fibrillation. C. ventricular fibrillation. D. pulseless electrical activity.
question

an R-R interval.
answer

A single ECG complex consists of all of the following components, EXCEPT: A. a T wave. B. an R-R interval. C. a QRS complex. D. an ST segment.
question

30 seconds.
answer

A single intubation attempt in the adult patient should not exceed: A. 20 seconds. B. 30 seconds. C. 40 seconds. D. 45 seconds.
question

basic airway techniques have been completed.
answer

Advanced airway management techniques are performed ONLY after: A. the patient is assessed as being apneic. B. the patient has been delivered to the hospital. C. basic airway techniques have been completed. D. the upper airway has been thoroughly suctioned.
question

reconfirm that the ET tube is still correctly positioned.
answer

After intubating a 44-year-old unconscious, apneic male, you place him on the ambulance stretcher and prepare to load him into the ambulance. After he is placed into the ambulance, you should: A. continue ventilations with an automatic ventilator. B. reassess the patient’s vital signs and attach an AED. C. reconfirm that the ET tube is still correctly positioned. D. hyperventilate the patient for approximately 30 seconds.
question

ensure the airway is clear.
answer

After opening a patient’s airway, you should: A. insert an airway adjunct. B. ensure the airway is clear. C. assess for breathing effort. D. administer oxygen as needed.
question

remove the ET tube at once, ventilate with a bag-mask device for 2 to 3 minutes, and reattempt intubation.
answer

After performing endotracheal intubation on an elderly male in cardiac arrest, you think you hear breath sounds, but also hear gurgling over the epigastrium. You should: A. withdraw the ET tube approximately 1″ and then reauscultate over the epigastrium. B. attach an end-tidal CO2 detector to the ET tube and observe for the appropriate color change. C. remove the ET tube at once, ventilate with a bag-mask device for 2 to 3 minutes, and reattempt intubation. D. secure the tube with the proper device, continue ventilations, and confirm placement with an esophageal bulb.
question

prime the line and flush the air out of the tubing.
answer

After sliding the piercing spike of the administration set into the IV bag port, you should next: A. ensure that the drip chamber is only half filled. B. adjust the drip chamber until fluid slowly drains. C. prime the line and flush the air out of the tubing. D. remove the protective cap and allow air to escape.
question

perform asynchronous CPR.
answer

After successfully intubating a 56-year-old man who is in cardiac arrest, you should: A. perform asynchronous CPR. B. defibrillate him with the automated external defibrillator (AED). C. ventilate at a rate of 20 breaths/min. D. occlude the esophagus with a Combitube.
question

gender of the patient.
answer

ALS providers choose the type and size of the IV catheter based on all of the following factors, EXCEPT the: A. vein’s location B. purpose of the IV. C. condition of the vein. D. gender of the patient.
question

7.5-mm
answer

Although you should carry a variety of endotracheal (ET) tube sizes, a _____ ET tube will adequately fit most adults. A. 6.0-mm B. 7.5-mm C. 8.5-mm D. 9.0-mm
question

proximal tibia.
answer

An IO needle is inserted into the: A. proximal tibia. B. distal humerus. C. distal femur. D. proximal fibula.
question

ensure that the tourniquet has been released.
answer

An IV line is not running as fast as it should be. There are no signs of infiltration. You should: A. ensure that the tourniquet has been released. B. lower the IV bag as low as you possibly can. C. manipulate the catheter until the flow improves. D. suspect that the patient has circulatory overload.
question

wide, abnormally shaped QRS complexes.
answer

Any electrical impulse that originates in the ventricular conduction system has: A. peaked P waves and narrow P-R intervals. B. narrow, inverted QRS complexes. C. upright QRS complexes and broad P waves. D. wide, abnormally shaped QRS complexes.
question

direct your partner to apply posterior cricoid pressure.
answer

Approximately 10 seconds into an intubation attempt, you are unable to view the vocal cords. You should: A. abort the attempt and preoxygenate for 30 seconds. B. direct your partner to apply posterior cricoid pressure. C. gently pry on the laryngoscope to improve your view. D. continue the intubation attempt until 30 seconds pass.
question

an allergic reaction.
answer

Approximately 20 minutes after initiating an IV line of normal saline, your patient complains of generalized itching and develops a generalized rash. These are signs and symptoms of: A. a vasovagal reaction. B. acute air embolism. C. an allergic reaction. D. circulatory overload.
question

5% albumin solution.
answer

Common IV solutions used in the prehospital setting include all of the following, EXCEPT: A. 5% albumin solution. B. normal saline solution. C. lactated Ringer’s solution. D. 5% dextrose in water (D5W).
question

left main stem bronchus intubation.
answer

Complications associated with endotracheal intubation include all of the following, EXCEPT: A. left main stem bronchus intubation. B. hypoxia due to prolonged attempts. C. a marked decrease in the heart rate. D. trauma to the soft tissues in the mouth.
question

rise and fall of the abdomen.
answer

Confirmation techniques and devices used to determine correct ET tube placement include all of the following, EXCEPT: A. rise and fall of the abdomen. B. esophageal detector devices. C. auscultation of breath sounds. D. end-tidal carbon dioxide detectors.
question

mixing and administering medications.
answer

D5W is MOST commonly used for: A. rapidly increasing the patient’s blood pressure. B. replacing the body’s lost salt and water. C. treating patients in hypovolemic shock. D. mixing and administering medications.
question

directly lifts the epiglottis and exposes the vocal cords.
answer

During visualized orotracheal intubation, the straight blade: A. directly lifts the epiglottis and exposes the vocal cords. B. indirectly lifts the epiglottis by fitting into the vallecula. C. is contraindicated in infants and children younger than 5 years. D. has a broad flange and provides better tongue displacement.
question

who are unconscious and cannot protect their own airway.
answer

Endotracheal intubation is indicated for patients: A. prior to defibrillation if ventricular fibrillation is present. B. who are unconscious and cannot protect their own airway. C. in need of assisted ventilation due to reduced tidal volume. D. who are extremely combative and have an intact gag reflex.
question

inserting a tube into the trachea to maintain the airway and ventilate.
answer

Endotracheal intubation is MOST accurately defined as: A. inserting a tube through the mouth and in between the vocal cords. B. inserting a tube into the trachea to maintain the airway and ventilate. C. inserting a suction catheter into the trachea to remove thick secretions. D. blindly inserting a tube through the nose and into the tracheal opening.
question

62-year-old man with severe respiratory distress, a history of congestive heart failure, and audible rhonchi in the lungs
answer

For which of the following patients would the use of a continuous positive airway pressure (CPAP) device be of MOST benefit? A. 50-year-old woman who is unable to follow verbal commands and is in severe respiratory distress due to asthma B. 58-year-old man with mild shortness of breath after being diagnosed by his physician with left lower lobe pneumonia C. 60-year-old woman with emphysema, moderate shortness of breath, and a systolic blood pressure of 78 mm Hg D. 62-year-old man with severe respiratory distress, a history of congestive heart failure, and audible rhonchi in the lungs
question

endotracheal intubation may not be necessary.
answer

If a patient is being adequately ventilated with a bag-mask device attached to high-flow oxygen: A. intubation should be performed after 5 minutes. B. endotracheal intubation may not be necessary. C. the patient should be intubated via the nasal route. D. it can safely take up to 60 seconds to perform intubation.
question

remove the catheter and apply direct pressure.
answer

If an IV line is found to be infiltrated, you should: A. apply a chemical heat pack to the IV site. B. slow the flow rate down to keep the vein open. C. remove the catheter and apply direct pressure. D. immediately change the IV administration set.
question

30
answer

If each small box on the ECG graph paper represents 0.04 seconds, and there are 5 small boxes in one large box, how many large boxes represent 6 seconds? A. 10 B. 15 C. 20 D. 30
question

turn the patient onto his or her side and have suction ready.
answer

If it is necessary to remove a multilumen airway in the field, you should: A. hyperventilate the patient prior to removing the device. B. place the patient in a sitting position with his neck flexed. C. turn the patient onto his or her side and have suction ready. D. intubate the patient’s trachea after removal of the device.
question

inflate the distal cuff and detach the syringe.
answer

Immediately after you place an ET tube in the trachea, you should remove the stylet and then: A. attach the bag-mask device and ventilate. B. listen for breath soun ds to confirm placement. C. secure the ET tube with the appropriate device. D. inflate the distal cuff and detach the syringe.
question

decompress the stomach.
answer

In the prehospital setting, gastric tubes are used primarily to: A. remove gastric toxins. B. administer medications. C. provide gastric nutrition. D. decompress the stomach.
question

immediate IV access is difficult or impossible to obtain.
answer

Intraosseous (IO) needles are used when: A. at least two large-bore IV lines have been established. B. immediate IV access is difficult or impossible to obtain. C. blood products must be administered to elderly patients. D. the patient does not require large volumes of IV fluid.
question

the patient has been assessed to determine if defibrillation is indicated.
answer

Intubating a patient who is in cardiac arrest should occur after: A. the stomach has been adequately decompressed with a gastric tube. B. the patient has been assessed to determine if defibrillation is indicated. C. adequate chest compressions have been performed for at least 5 minutes. D. two attempts to insert a multilumen airway device have been unsuccessful.
question

they are at least 10 cm from the heart.
answer

It does not matter if you place the arm leads on the patient’s shoulders or arms, as long as: A. you apply the green lead first. B. the patient is in a supine position. C. the red lead is placed on the right side. D. they are at least 10 cm from the heart.
question

on each side of the sternum at the fourth intercostal space.
answer

Leads V1 and V2 in a 12-lead ECG should be positioned: A. approximately 1″ apart, directly over the sternum. B. 2″ away from both sides of the xiphoid process. C. on each side of the sternum at the fourth intercostal space. D. on each side of the upper sternum at the first intercostal space.
question

catheter shear.
answer

Local reactions associated with IV therapy include all of the following, EXCEPT: A. phlebitis. B. hematoma. C. infiltration. D. catheter shear.
question

the patient is often diaphoretic.
answer

Obtaining an accurate ECG tracing can be difficult in patients experiencing a cardiac emergency because: A. the patient is often diaphoretic. B. the rhythm is typically chaotic. C. the pulse is often very weak. D. severe bradycardia is common.
question

24 hours.
answer

Once an IV solution is removed from its protective wrap, it must be used within: A. 12 hours. B. 18 hours. C. 24 hours. D. 36 hours.
question

obtain authorization from medical control.
answer

Prior to attempting endotracheal intubation, the EMT should: A. obtain authorization from medical control. B. ventilate the patient for at least 30 seconds. C. contact a paramedic and obtain permission. D. suction the patient’s airway for 30 seconds.
question

adequately preoxygenate with a bag-mask device.
answer

Prior to performing orotracheal intubation in a cardiac arrest patient, it is MOST important to: A. ensure that the stomach is not distended. B. perform CPR for at least 5 to 10 minutes. C. hyperventilate the patient for 20 to 30 seconds. D. adequately preoxygenate with a bag-mask device.
question

injecting air into the tube and auscultating the stomach for gurgling.
answer

Proper confirmation of correct gastric tube placement includes: A. attaching an end-tidal carbon dioxide detector to the end of the tube. B. injecting air into the tube and auscultating the stomach for gurgling. C. instilling 25 mL of saline down the tube and connecting the tube to suction. D. applying manual pressure to the stomach and observing the tube for contents.
question

have one tube smaller and one tube larger.
answer

Regardless of the size of the ET tube that you will use to intubate your patient, you should: A. have one tube smaller and one tube larger. B. have several ET tubes of identical size. C. only use a stylet for tubes larger than 7.0 mm. D. always have a 9.0-mm tube in case it is needed.
question

a drop in blood pressure.
answer

Signs and symptoms of acute circulatory overload include all of the following, EXCEPT: A. shortness of breath. B. jugular vein distention. C. acute peripheral edema. D. a drop in blood pressure.
question

edema at the catheter site.
answer

Signs of an infiltrated IV include: A. edema at the catheter site. B. acute shortness of breath. C. redness at the catheter site. D. an extremely fast IV flow.
question

irregular heart rate.
answer

Sinus tachycardia is differentiated from a normal sinus rhythm by the: A. shape of the P waves. B. irregular heart rate. C. width of the QRS complexes. D. consistency of the P-R intervals.
question

insert the blade in the right side of the mouth, sweep the tongue to the left, and lift.
answer

The appropriate method of inserting a laryngoscope blade into the patient’s mouth to visualize the vocal cords is to: A. insert the blade in the left side of the mouth, sweep the tongue to the left, and pry. B. insert the blade in the right side of the mouth, sweep the tongue to the left, and pry. C. insert the blade in the right side of the mouth, sweep the tongue to the left, and lift. D. use the tongue-jaw lift maneuver, insert the blade in the center of the mouth, and lift.
question

10 mL
answer

The distal cuff on an ET tube should be inflated with no more than ______ of air after it is placed into the trachea. A. 10 mL B. 15 mL C. 20 mL D. 25 mL
question

sinoatrial (SA) node.
answer

The heart’s primary pacemaker is the: A. sinoatrial (SA) node. B. internodal pathway. C. atrioventricular (AV) node. D. ventricular bundle of His.
question

molding and sealing itself around the laryngeal opening by inflation of the mask.
answer

The laryngeal mask airway (LMA) helps protect the airway and allows for adequate ventilation by: A. entering the trachea, just below the vocal cords, after it is blindly inserted. B. entering the esophagus and isolating the trachea by the inflation of two cuffs. C. molding and sealing itself around the laryngeal opening by inflation of the mask. D. depressing the tongue and propelling it forward, resulting in an unobstructed airway.
question

travel through the interventricular septum and lead to the Purkinje fibers.
answer

The left and right bundle branches: A. cause a slight delay of the electrical impulse at the AV node. B. transmit the electrical impulses from the SA node to the AV node. C. divide into the internodal pathways that stimulate the atria to contract. D. travel through the interventricular septum and lead to the Purkinje fibers.
question

prompt, rapid defibrillation.
answer

The MOST effective treatment for ventricular fibrillation or pulseless ventricular tachycardia is: A. effective CPR. B. cardiac drug therapy. C. advanced airway care. D. prompt, rapid defibrillation.
question

strictly adhere to standard precautions.
answer

The MOST important step in assembling intravenous (IV) equipment is to: A. follow the orders of your ALS partner. B. strictly adhere to standard precautions. C. choose the appropriate administration set. D. select the most appropriately sized IV catheter.
question

AV node.
answer

The only route of communication between the atria and the ventricles is/are the: A. AV node. B. SA node. C. bundle of His. D. bundle branches.
question

maintain an active IV site without running fluids through the vein.
answer

The purpose of a saline lock is to: A. clamp off the IV tubing to decrease the rate at which the fluid flows. B. maintain an active IV site without running fluids through the vein. C. keep an IV line patent in patients who do not require medications. D. allow the delivery of large volumes of isotonic crystalloid solutions.
question

vomiting and aspiration.
answer

The purpose of the Sellick maneuver is to prevent: A. vomiting and aspiration. B. spasm of the vocal cords. C. collapsing of the trachea. D. airway blockage by the tongue.
question

ventricular contraction.
answer

The QRS complex is an electrical representation of: A. atrial contraction. B. ventricular contraction. C. ventricular filling. D. atrial filling.
question

60 to 100 beats/min.
answer

The SA node normally paces at a rate of: A. 40 to 60 beats/min. B. 60 to 100 beats/min. C. 80 to 110 beats/min. D. 110 to 120 beats/min.
question

cricoid cartilage.
answer

The Sellick maneuver is performed by applying pressure to the: A. tracheal rings. B. thyroid cartilage. C. cricoid cartilage. D. cricothyroid membrane.
question

rapidly restore perfusion to the coronary arteries.
answer

The ultimate goal in treating a patient who is experiencing an ST-segment elevation myocardial infarction (STEMI) is to: A. apply high-flow oxygen and administer aspirin. B. rapidly restore perfusion to the coronary arteries. C. give nitroglycerin to dilate the coronary arteries. D. send the prehospital 12-lead ECG to the physician.
question

not pass the ET tube down the center of the laryngoscope blade.
answer

To avoid obscuring your view of the vocal cords during intubation, you should: A. not pass the ET tube down the center of the laryngoscope blade. B. gently pry against the patient’s teeth to achieve adequate leverage. C. direct your assistant to apply firm pressure to the thyroid cartilage. D. ensure that the straight blade is in the vallecular space before lifting.
question

a fear of needles or the sight of blood.
answer

Vasovagal reactions that occur in patients receiving IV therapy are MOST often the result of: A. the pain associated with venipuncture. B. a fear of needles or the sight of blood. C. too much IV fluid being administered. D. an unexpected reaction to the IV fluid.
question

wide QRS complexes and a heart rate greater than 100 beats/min.
answer

Ventricular tachycardia is characterized by: A. a markedly irregular rhythm and narrow QRS complexes. B. wide QRS complexes and a heart rate greater than 100 beats/min. C. QRS complexes greater than 0.08 seconds in duration. D. a heart rate greater than 200 beats/min and identifiable P waves.
question

straight or curved blade.
answer

Visualized orotracheal intubation requires all of the following equipment, EXCEPT a: A. stylet. B. laryngoscope. C. 10-mL syringe. D. straight or curved blade.
question

Volutrol is a 100-mL calibrated drip chamber that can be shut off from the IV bag. It should be used to prevent fluid overload in pediatric and geriatric patients.
answer

What is a Volutrol and when should it be used? A. Volutrol is a 100-mL calibrated drip chamber that can be shut off from the IV bag. It should be used to prevent fluid overload in pediatric and geriatric patients. B. Volutrol is a filter that is located inline between the IV bag and the IV insertion site. It should be used to minimize the risk of vein irritation caused by the IV fluid. C. Volutrol is a special type of macrodrip that has two large drip chambers that attach to the IV bag. It should be used to administer large amounts of fluid to shock patients. D. Volutrol is an electronic pump that delivers a precise amount of fluid over a specific period of time. It should be used to rehydrate patients who are not in shock.
question

the ECG records an upward wave.
answer

When an electrical impulse moves toward a positive electrode: A. the electrocardiogram (ECG) records a negative wave. B. the patient’s heart rate decreases. C. the ECG records an upward wave. D. the cardiac rhythm will be irregular.
question

22 cm.
answer

When an ET tube is placed in an adult patient, the tube-to-teeth mark is usually around: A. 15 cm. B. 20 cm. C. 22 cm. D. 25 cm.
question

on the right shoulder.
answer

When applying the 4-lead ECG electrodes to a patient, the white (negative) lead should be placed: A. on the left upper arm. B. on the right shoulder. C. to the left of the sternum. D. on the left side of the abdomen.
question

use a length-based resuscitation tape measure.
answer

When determining the proper size ET tube to use in an infant or small child, you should: A. double the child’s age in years and add two. B. use a length-based resuscitation tape measure. C. select the smallest possible tube with a cuff. D. use a tube that is the size of the child’s thumb.
question

avoid inserting the stylet past Murphy’s eye.
answer

When inserting the stylet inside an ET tube, you should: A. bend the ET tube in the shape of a “U.” B. recede the stylet 3″ from the tube’s distal tip. C. apply petroleum jelly to the tube’s distal tip. D. avoid inserting the stylet past Murphy’s eye.
question

0.20 seconds.
answer

When looking at ECG graph paper, one large box represents: A. 0.04 seconds. B. 0.08 seconds. C. 0.12 seconds. D. 0.20 seconds.
question

ventricular filling time decreases.
answer

When the heart rate becomes exceedingly high: A. ventricular filling time decreases. B. cardiac output markedly increases. C. stroke volume remains unaffected. D. the patient’s blood pressure rises.
question

Asystole
answer

Which of the following cardiac arrhythmias is characterized by a complete absence of myocardial electrical and mechanical activity? A. asystole B. ventricular fibrillation C. ventricular tachycardia D. pulseless electrical activity
question

SA node, internodal pathways, AV node, bundle of His, left and right bundle branches, Purkinje system
answer

Which of the following correctly describes the normal path of electricity through the cardiac conduction system? A. SA node, AV node, internodal pathways, bundle of His, Purkinje system, left and right bundle branches B. SA node, internodal pathways, AV node, bundle of His, left and right bundle branches, Purkinje system C. AV node, internodal pathways, SA node, bundle of His, left and right bundle branches, Purkinje system D. internodal pathways, SA node, AV node, left and right bundle branches, bundle of His, Purkinje system
question

visualization of the tube passing between the vocal cords
answer

Which of the following is the MOST reliable indicator of successful endotracheal intubation? A. the presence of bilaterally clear and equal breath sounds B. visualization of the tube passing between the vocal cords C. when the paper in the end-tidal CO2 detector turns yellow D. the presence of mist or vapor in the tube during exhalation
question

22-gauge
answer

Which of the following IV catheters would deliver fluid at the slowest rate? A. 14-gauge B. 16-gauge C. 18-gauge D. 22-gauge
question

V5 and V6
answer

Which of the following leads views the lateral wall of the left ventricle? A. V1 only B. V1 and V2 C. V3 and V4 D. V5 and V6
question

14-gauge
answer

Which of the following over-the-needle IV catheters has the largest diameter? A. 14-gauge B. 16-gauge C. 18-gauge D. 20-gauge
question

Elderly patients often have fragile skin that is easily damaged.
answer

Which of the following statements regarding IV therapy in geriatric patients is correct? A. IO infusions are more effective in elderly patients. B. Fluid overload occurs less commonly in the geriatric patient. C. Elderly patients often have fragile skin that is easily damaged. D. Large-bore IV catheters should be used in all geriatric patients.
question

Ventilations can be provided whether the device is in the trachea or the esophagus.
answer

Which of the following statements regarding multilumen airway devices is correct? A. They are contraindicated in patients who have experienced a severe spinal injury. B. Ventilations can be provided whether the device is in the trachea or the esophagus. C. Insertion of a multilumen airway device requires visualization of the upper airway. D. Multilumen airway device insertion does not require medical control authorization.
question

It may be a normal variant in some individuals.
answer

Which of the following statements regarding sinus bradycardia is correct? A. It is significant and must always be treated. B. The heart rate is usually less than 70 beats/min. C. It is characterized by inconsistent P-R intervals. D. It may be a normal variant in some individuals.
question

It moves fluid from the IV bag into the patient’s vascular system.
answer

Which of the following statements regarding the IV administration set is correct? A. It moves fluid from the IV bag into the patient’s vascular system. B. Microdrip administration sets are used for rapid fluid replacement. C. The administration set remains sterile up to 24 hours after it is opened. D. Macrodrip administration sets are used to keep the vein open.
question

When the King LT is properly placed in the esophagus, one cuff is designed to seal the esophagus and the other cuff is designed to seal the oropharynx.
answer

Which of the following statements regarding the King LT airway is correct? A. The King LT is a multilumen airway that is inserted into the esophagus using a laryngoscope and a curved or straight blade. B. Ventilation through a King LT is provided through an opening at the distal end of the tube that is blindly inserted into the trachea. C. When the King LT is properly placed in the esophagus, one cuff is designed to seal the esophagus and the other cuff is designed to seal the oropharynx. D. Because the King LT is placed into the esophagus, the end-tidal CO2 detector will not adequately confirm proper placement and should not be used.
question

give her a sedative drug per local protocol.
answer

You are transporting an intubated 24-year-old female when her level of consciousness improves and she becomes combative. Without assisted ventilation, she appears to be breathing adequately. You should anticipate that your ALS partner will: A. extubate her to prevent laryngospasm. B. give her a sedative drug per local protocol. C. have suction available and remove the ET tube. D. carefully restrain her and continue ventilations.
question

insert an oral airway, ventilate with a bag-mask device, and transport.
answer

You have attempted to intubate a 66-year-old male twice without success. Medical control is unable to be contacted. Your MOST appropriate action should be to: A. have your partner attempt to successfully intubate the patient. B. insert an oral airway, ventilate with a bag-mask device, and transport. C. preoxygenate with a bag-mask device and insert a multilumen airway. D. continue intubation attempts until medical control has been contacted.
question

withdraw the tube approximately 1″ and reassess breath sounds.
answer

You have inserted an ET tube but are unable to hear breath sounds on the left side of the chest. You should: A. treat the patient for a pneumothorax and transport immediately. B. extubate the patient and preoxygenate for at least 2 to 3 minutes. C. advance the tube as you are auscultating the patient’s breath sounds. D. withdraw the tube approximately 1″ and reassess breath sounds.
question

maintain stabilization of his head, open his airway with the jaw-thrust maneuver, ventilate with a bag-mask device, and prepare to intubate him.
answer

You respond to a construction site where a steel girder collapsed on a 22-year-old male’s chest. Coworkers removed the girder prior to your arrival. Your assessment reveals that he is unconscious and apneic. You should: A. open his airway with the jaw-thrust maneuver, maintain his head in a neutral in-line position, and insert a Combitube. B. apply a cervical collar, maintain an open airway with the jaw-thrust maneuver, and insert a multilumen airway device. C. ensure that his spine is fully immobilized, maintain his airway with an oropharyngeal airway, and perform endotracheal intubation. D. maintain stabilization of his head, open his airway with the jaw-thrust maneuver, ventilate with a bag-mask device, and prepare to intubate him.
question

has ingested a caustic substance.
answer

You should NOT attempt to insert a Combitube in a patient who: A. has ingested a caustic substance. B. is in full cardiopulmonary arrest. C. is unconscious without a gag reflex. D. has experienced a severe spinal injury.
question

the manufacturer.
answer

You should routinely inspect a bag of IV fluid for all of the following, EXCEPT: A. the solution type. B. the manufacturer. C. the clarity of the fluid. D. the expiration date.
question

She has detected ST segment elevation in leads V3 and V4.
answer

Your paramedic partner has just acquired a 12-lead ECG on a middle-aged man with chest discomfort. The patient is conscious, but anxious. His blood pressure is 140/84 mm Hg and his heart rate is 80 beats/min. He has a history of hypertension and type 2 diabetes. Your partner states that she believes the patient is experiencing a myocardial infarction of the anterior wall. Which of the following is the MOST likely basis for her statement? A. She has detected ST segment elevation in leads V3 and V4. B. The patient’s vital signs suggest injury to the anterior wall. C. Chest discomfort is more common with an anterior wall myocardial infarction. D. The patient’s past medical history places him at high risk for a myocardial infarction.
question

are not contagious.
answer

Unlike viruses and bacteria, neurotoxins: A. cause high fever. B. are not contagious. C. cause skin blistering. D. have a slow onset of symptoms.