question

Intracellular fluid:

answer

is the water contained inside the cells.

question

In a 175-lb man, intravascular fluid accounts for approximately ____ lb.

answer

8

question

Solutes are defined as:

answer

the dissolved particles contained in a solvent.

question

Cations are electrolytes that have an overall __________ charge, and anions are electrolytes that have an overall ___________ charge.

answer

positive, negative

question

Which of the following electrolytes is NOT a cation?

answer

Chloride

question

Sodium is a ________ cation and can react completely with _______.

answer

monovalent, 1 mEq of a singly charged anion

question

The principal extracellular cation that regulates the distribution of water throughout the body is:

answer

sodium.

question

Hyperkalemia would MOST likely result in:

answer

hyperstimulation of neural cell transmission.

question

The chemical sign for sodium bicarbonate is:

answer

NaHCO3.

question

The movement of compounds or charges across a cell membrane to an area of lower concentration is called:

answer

diffusion.

question

Pumping sodium out of the cell and potassium into the cell has the added benefit of:

answer

A) moving glucose into the cell at the same time.

question

The net effect of osmosis is to:

answer

equalize solute concentrations on both sides of the cell membrane.

question

The internal environment's resistance to change is called:

answer

homeostasis.

question

Which of the following statements regarding dehydration is correct?

answer

It is often a chronic condition in elderly patients and may take days to manifest.

question

Overhydration occurs when:

answer

fluid is forced from the engorged interstitial compartment into the intracellular compartment.

question

Signs and symptoms of overhydration include:

answer

edema.

question

Which of the following statements regarding isotonic solutions is correct?

answer

Isotonic solutions have almost the same osmolarity as bodily fluids.

question

It is MOST important to exercise caution when administering isotonic solutions to patients with:

answer

hypertension and congestive heart failure.

question

Lactated Ringer's (LR) solution may be beneficial to patients who have lost large amounts of blood because:

answer

the lactate contained within LR is converted to bicarbonate in the liver and can help combat intracellular acidosis.

question

Hypotonic solutions:

answer

hydrate the cells while depleting the vascular compartment.

question

Which of the following statements regarding isotonic crystalloid solutions is correct?

answer

Approximately two thirds of infused isotonic crystalloid solution will leave the vascular space within 1 hour.

question

How much isotonic crystalloid solution should you administer to a patient who weighs 65 kg and who has signs and symptoms of internal bleeding?

answer

An amount adequate to maintain perfusion

question

All of the following are examples of colloid solutions, EXCEPT:

answer

lactated Ringer's.

question

The use of O-negative blood in the prehospital setting is impractical because: `

answer

it requires refrigeration.

question

The MOST important point to remember about IV therapy is to:

answer

keep the IV equipment sterile.

question

In the prehospital setting, the MOST commonly used IV solutions are:

answer

isotonic crystalloids.

question

Once the pigtail is removed from the sterile access port of an IV solution, the solution must be used:

answer

Immediately.

question

When a patient needs rapid fluid replacement, you should:

answer

select an administration set that contains a large opening between the piercing spike and drip chamber.

question

Blood tubing is a:

answer

macrodrip administration set that is designed to facilitate rapid fluid replacement by manual infusion of multiple IV bags or a combination of IV fluids and blood.

question

When selecting a vein for cannulation, you should avoid areas of the vein that:

answer

pass over joints.

question

When selecting the most appropriate IV catheter, you should routinely consider all of the following, EXCEPT:

answer

the patient's gender.

question

Through which of the following over-the-needle catheters can you infuse the greatest amount of fluid over the shortest period of time?

answer

14 gauge, 1 ¼″

question

If an adult patient is in hypovolemic shock, you should attempt to insert a(n) ______ over-the-needle catheter into the _______.

answer

14-gauge, antecubital vein

question

Large protruding arm veins in an otherwise healthy adult can be difficult to cannulate because they often:

answer

roll from side to side during the cannulation attempt.

question

After observing a flash of blood in the IV catheter's flash chamber, you should:

answer

immediately drop the angle of the catheter to about 15° and advance the catheter a few more centimeters.

question

In the prehospital setting, saline locks are used primarily for patients who:

answer

have cancer and require continuous infusions of chemotherapy.

question

The first step in discontinuing an IV line is to:

answer

shut off the flow of fluid with the roller clamp.

question

Prior to cannulating an external jugular vein, it is MOST important to:

answer

palpate for the carotid pulse.

question

Edema at the IV catheter site and continued IV flow after occlusion of the vein above the insertion site are signs of:

answer

infiltration.

question

The first sign(s) of IV occlusion is/are:

answer

a decreasing drip rate or the presence of blood in the IV tubing.

question

Vein irritation during IV therapy is usually caused by:

answer

an infusion rate that is too rapid.

question

Which of the following conditions or situations is associated with the HIGHEST risk of vein rupture during IV cannulation?

answer

Diabetes

question

To avoid inadvertently cannulating an artery, you should:

answer

always check for a pulse in any vessel you intend to cannulate.

question

Pyrogenic reactions can be largely avoided by:

answer

inspecting the IV solution carefully before use.

question

Signs and symptoms of circulatory overload include:

answer

hypertension.

question

A vasovagal reaction is the result of:

answer

dilation of the vasculature.

question

A lavender-topped blood tube:

answer

is used to determine a patient's hematocrit and hemoglobin levels.

question

IO infusion is a technique of administering IV fluids and medications into:

answer

the IO space of a long bone.

question

Which of the following statements regarding IO cannulation and infusion is correct?

answer

The IO space remains patent, even when peripheral veins have collapsed.

question

Which of the following IO devices is NOT used in children?

answer

FAST1

question

When infusing crystalloid solutions through an IO catheter in an unconscious adult, you should:

answer

use a pressure infuser device.

question

Which of the following statements regarding osteomyelitis is NOT correct?

answer

Osteomyelitis occurs in up to 15% of IO insertions.

question

Medical control orders you to administer 500 mL of normal saline over 1 hour to your patient. You have a macrodrip administration set that allows 15 gtts/mL and an 18-gauge catheter in the patient's antecubital vein. At how many gtts/min should you set the IV flow rate?

answer

125

question

1 mg is equal to ______ µg.

answer

1,000

question

0.2 mg equals:

answer

200 µg.

question

100 mL is equal to:

answer

0.1 L

question

A 130-lb patient weighs ____ kg.

answer

59

question

A patient with a core body temperature of 35° on the Celsius scale has a core body temperature of ____ on the Fahrenheit scale.

answer

95°

question

A prefilled syringe of lidocaine contains 100 mg/5 mL of volume. How many milligrams per milliliter (mg/mL) are present in the syringe?

answer

20

question

If a 10-mL vial contains 1 mg of a drug, how many mg/mL are present?

answer

0.1

question

A 1% lidocaine (Xylocaine) concentration contains:

answer

1,000 mg/100 mL.

question

A hypoglycemic patient requires IV dextrose. Medical control orders you to administer 25 mL. You have a prefilled syringe of 50% dextrose that contains 25 g/50 mL. How much dextrose will you give?

answer

12.5 g

question

Following return of spontaneous circulation, you are ordered to begin a lidocaine infusion at 3 mg/min on your 50-year-old patient. You add 2 g of lidocaine to a 500-mL bag of normal saline and are using a microdrip administration set. At how many drops per minute (gtts/min) will you set the IV flow rate?

answer

45

question

If you receive a medication order from on-line medical control that seems inappropriate to you, you should:

answer

ask the physician to repeat the order.

question

Prior to administering a medication to any patient, the paramedic should:

answer

inquire about drug allergies.

question

A drug that is contraindicated for a particular patient:

answer

should not be administered to the patient.

question

Medical asepsis is MOST accurately defined as:

answer

the practice of preventing contamination of the patient.

question

In contrast to an antiseptic, a disinfectant is:

answer

toxic to living tissues and should never be used on a patient.

question

Which of the following statements regarding sharps containers is correct?

answer

Sharps containers should be puncture-proof and should bear a biohazard logo.

question

If you give a medication via the oral route in the prehospital setting, you should give it early because:

answer

absorption via this route is slow.

question

Which of the following medications is appropriate to administer via the rectal route?

answer

Diazepam (Valium)

question

Compared with enterally administered medications, parenterally administered medications:

answer

are absorbed into the central circulation at a more predictable rate.

question

When drawing medication from an ampule, you should:

answer

gently tap the ampule if medication is stuck in the neck.

question

Drug reconstitution involves:

answer

injecting diluent or sterile water from one vial into the vial that contains the powdered form of the medication.

question

What medication route is typically used during allergy testing or when performing a skin test for tuberculosis?

answer

Intradermal

question

When administering a medication via the intramuscular route, you should:

answer

B) stretch the skin over the injection site and insert the needle at a 90° angle.

question

The IV route is the fastest route of medication administration because:

answer

it bypasses most barriers to drug absorption.

question

When administering a drug via IV bolus, you are giving the drug:

answer

in one mass.

question

Which of the following is NOT always considered a mandatory action after administering a medication via the enteral or parenteral route?

answer

Contacting on-line medical control

question

Electromechanical infusion pumps are MOST beneficial when administering a medication maintenance infusion because:

answer

these devices allow for precise medication dosing.

question

All of the following medications or preparations are commonly given via the transdermal route, EXCEPT:

answer

acetaminophen.

question

When administering sublingual nitroglycerin to a patient, you should do all of the following, EXCEPT:

answer

instruct the patient to chew and swallow the tablet.

question

The MOST common inhaled medication is:

answer

oxygen.

question

When administering a medication via small-volume nebulizer, you should add ___ mL of sterile saline to the medication and set the oxygen flow rate at ___ L/min.

answer

3, 6

question

A 71-year-old woman presents with tachypnea, flushed skin, and postural hypotension. Which of the following chief complaints is MOST consistent with these clinical findings?

answer

Diarrhea

question

You are transporting a 1-year-old child with moderate dehydration. Your estimated time of arrival at the hospital is 45 minutes. When administering an isotonic crystalloid solution to this child, you should:

answer

use a Volutrol administration set and fill the calibrated drip chamber with a precalculated volume of fluid.

question

An elderly man with congestive heart failure and shortness of breath requires an IV line in case medication administration is necessary. Which of the following IV catheters is MOST appropriate to use when starting the IV?

answer

20 gauge, 1 ¼″

question

After inserting an 18-gauge over-the-needle catheter into the hand vein of a 30-year-old woman and securing the IV line in place, you note edema at the catheter site despite continued flow of the IV. The woman complains of pain and tightness around the IV site. You should:

answer

recognize that infiltration has occurred and immediately discontinue the IV.

question

Approximately 20 minutes after starting an IV on a 40-year-old man, he begins complaining of a backache and chills. You should be MOST suspicious of:

answer

a pyrogenic reaction.

question

While establishing IO access in a critically ill patient, you locate the appropriate anatomic landmark, cleanse the site, and insert the IO catheter at a 45° angle. After attaching the IV line and turning the flow on, you note edema developing on the opposite side of the extremity. What has MOST likely happened?

answer

Extravasation due to an inappropriate angle of IO catheter insertion

question

During the attempted resuscitation of a man in V-Fib cardiac arrest, your protocols call for the administration of 1.5 mg/kg of lidocaine. You have prefilled syringes of lidocaine in a concentration of 100 mg/5 mL. The patient weighs 180 lb. How many milliliters will you administer?

answer

6.2

question

While consulting with the attending physician at the receiving facility about a patient with symptomatic bradycardia, the physician orders you to administer 0.5 mg/kg of atropine to the patient. After recognizing that this is an inappropriate dose of atropine, you should:

answer

ask the physician to repeat the order.

question

You reassess your patient after administering a medication via the IV bolus route and note that his clinical condition is unchanged. What is the LEAST likely cause of the patient's unchanged condition?

answer

The IV tubing was occluded proximal to the injection port.

question

A 60-year-old woman with acute chest discomfort requires 0.4 mg of sublingual nitroglycerin. Prior to administering the medication, you should:

answer

ask her if she wears a transdermal nitroglycerin patch.

Paramedic Chapter 11 – Flashcards

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