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Chapters 06-08
Intermediate Emergency Care And Transportation Of The Sick And Injured-Chapters 6-8:Pharmacology, IV Access, Medication Administration
109
Medical
Professional
02/15/2013
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Term
The study of the properties and effects of medications on the body is called:
 Definition
pharmacology.
Term
The function of a drug or the particular action of a drug on an organism is called:
 Definition
mechanism of action.
Term
Which of the following is NOT a physiologic effect of the sympathetic nervous system?
 Definition
Decreased heart rate
Term
A form of solid drug that is stored in a gelatin shell filled with liquid or powder is called a:
 Definition
capsule.
Term
An agonistic drug is defined as one that:
 Definition
interacts with receptor sites to stimulate a response.
Term
Which of the following is NOT a form of liquid drug?
 Definition
Capsule
Term
Which of the following medications is a suspension?
 Definition
Activated charcoal
Term
How is nitroglycerin usually given?
 Definition
Sublingual
Term
Which of the following medications is administered in gel form?
 Definition
Oral glucose
Term
What is an enteral drug?
 Definition
Any drug that is administered along any portion of the GI tract.
Term
After receiving an order from medical control to administer a medication, you should first:
 Definition
repeat the order back to medical control, word for word.
Term
What is the term used to describe the absorption, distribution, metabolism, and excretion of a drug?
 Definition
Pharmacokinetic
Term
A predictable, yet adverse response to a drug, is called a/an:
 Definition
side effect.
Term
Which of the following is the FASTEST route of medication administration?
 Definition
Intravenous
Term
The removal of particles from a solution by allowing the liquid portion to pass through a membrane or other partial barrier is called:
 Definition
filtration.
Term
The subcutaneous route of drug administration is commonly used for which of the following medications?
 Definition
Insulin and epinephrine
Term
What might happen if a drug is given to a patient with liver disease?
 Definition
Toxic blood levels of the drug
Term
Factors that alter a patient's response to a drug include:
 Definition
body mass and genetic factors.
Term
A 78-year-old female takes six medications every day, each one for a different condition. What is this an example of?
 Definition
Polypharmacy
Term
Which DEA classification is given to a drug that has no accepted medical uses and a high abuse and dependence potential?
 Definition
Schedule I
Term
As an EMT-I certified at the 1985 level, which of the following medications would you be allowed to administer to a patient?
 Definition
Fifty percent dextrose
Term
The MOST common contraindication for any medication is:
 Definition
hypersensitivity.
Term
All of the following are general steps in administering a medication, EXCEPT:
 Definition
confirming the patient's date of birth.
Term
Medications that the EMT-I is authorized to administer are ultimately determined by his or her:
 Definition
medical director.
Term
A liquid mixture of one or more substances that cannot be separated by filtering or allowing the mixture to stand is called a/an:
 Definition
solution.
Term
The original chemical name of a drug, which is not capitalized, and is suggested by the drug's first manufacturer is called the:
 Definition
generic name.
Term
Which of the following statements regarding over-the-counter (OTmedications is correct?
 Definition
They do not require a prescription.
Term
Medications that fight or antagonize the effects of the sympathetic nervous system are referred to as being:
 Definition
sympatholytic.
Term
Drugs that attach to a receptor to inhibit or block a response are called:
 Definition
antagonists.
Term
A mixture of two liquids that are not mutually soluble is called a/an:
 Definition
emulsion.
Term
Which of the following medications could cause a potentially fatal interaction if given within 24 hours of Viagra, Cialis, or Levitra?
 Definition
Nitroglycerin
Term
Which of the following methods of drug administration involves the parenteral route?
 Definition
Intravenous
Term
Subcutaneous injections deliver the medication:
 Definition
between the skin and the muscle.
Term
Who regulates the selling and prescribing of controlled substances, such as narcotics?
 Definition
Drug Enforcement Administration
Term
What is the mechanism of aspirin when given to a patient with a possible myocardial infarction?
 Definition
Decreases platelet aggregation and vasoconstriction
Term
You are treating a 55-year-old male with chest pain. As you are applying oxygen, he tells you that he has a bleeding ulcer. Which of the following medications that would routinely be given in this situation is contraindicated?
 Definition
Aspirin
Term
What is the appropriate dose and concentration of epinephrine for an adult patient in cardiac arrest?
 Definition
1.0 mg of 1:10,000
Term
Epinephrine is classified as a/an:
 Definition
sympathomimetic.
Term
Which of the following signs indicate narcotic-induced CNS depression and would indicate the administration of naloxone?
 Definition
Hypoventilation
Term
Side effects of epinephrine include all of the following, EXCEPT:
 Definition
bradycardia.
Term
You administer 0.4 mg of nitroglycerin to your 55-year-old patient with chest pain. Which of the following side effects should you be MOST observant for?
 Definition
Hypotension
Term
Substances that become charged particles when they disassociate in water are called:
 Definition
electrolytes.
Term
Which of the following electrolytes determines whether or not the body is acidotic or alkalotic?
 Definition
Bicarbonate
Term
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:
 Definition
diffusion.
Term
Osmosis is defined as the:
 Definition
diffusion of water across a semipermeable membrane.
Term
A solution that has a greater concentration of sodium than does the cell is referred to as being:
 Definition
hypertonic.
Term
An isotonic solution is one that causes:
 Definition
no change in the shape of the cell.
Term
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?
 Definition
Dehydration
Term
You are transporting an elderly man to the hospital because of complications associated with his congestive heart failure. Approximately 20 minutes after starting an IV of normal saline on the patient, he begins to complain of shortness of breath. You auscultate his lungs and hear rales in all lung fields. What should you do?
 Definition
Check the flow rate of the IV line.
Term
Which of the following is NOT a crystalloid?
 Definition
Whole blood
Term
The most commonly carried IV solutions in the prehospital setting are:
 Definition
isotonic crystalloids.
Term
A microdrip administration set features a small, needle-like orifice inside the drip chamber and delivers:
 Definition
60 gtts/mL.
Term
When attaching an administration set to a bag of IV fluid and priming the IV tubing, you should ensure that the drip chamber is:
 Definition
one half full.
Term
When selecting the most appropriate site for IV cannulation, you should avoid veins that:
 Definition
cross or lie over joints.
Term
You have attempted to cannulate a vein in a patient's hand; however, shortly after inserting the IV catheter, the vein infiltrates. You should:
 Definition
look for a vein that is proximal to the infiltrated vein.
Term
A 60-year-old man is in cardiac arrest. As first responders are performing CPR, your partner is managing the patient's airway. After preparing your IV set, you should FIRST attempt to cannulate the:
 Definition
antecubital vein.
Term
Which of the following IV catheters would deliver the largest volume of fluid?
 Definition
1 ¼” 14-gauge catheter
Term
Which of the following techniques is MOST appropriate when cannulating a vein?
 Definition
Apply traction to the vein and insert the needle with the bevel side up at a 45° angle.
Term
The purpose of a constricting band when starting an IV is to:
 Definition
increase venous pressure at the puncture site.
Term
After removing the stylet from the IV catheter, you should next:
 Definition
dispose of the needle in the appropriate container.
Term
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?
 Definition
Saline or heparin lock
Term
When inserting an IV into the external jugular vein, you should:
 Definition
insert the catheter with the tip pointing toward the shoulder.
Term
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?
 Definition
33
Term
Before you can calculate an IV drip rate, you must know all of the following information, EXCEPT:
 Definition
amount of fluid to deliver.
Term
Minimum documentation following IV therapy includes all of the following, EXCEPT:
 Definition
the rate the fluid is running.
Term
What is the MOST appropriate management for a patient with circulatory overload due to excessive IV fluid administration?
 Definition
Oxygen, head elevated, medical control notified
Term
The MOST significant complication associated with IV therapy in geriatric patients is:
 Definition
massive hematoma.
Term
When choosing an IV site on an elderly patient, you should:
 Definition
know that varicose veins allow minimal circulation.
Term
An ion that has an overall positive charge is called a/an:
 Definition
cation.
Term
Which of the following electrolytes is essential for the distribution of water throughout the body?
 Definition
Sodium
Term
Filtration, a type of diffusion, is commonly used to clean the blood via the:
 Definition
kidneys.
Term
A solution that results in water flowing into a cell, causing it to burst, is referred to as being:
 Definition
hypotonic.
Term
An example of intravascular fluid is:
 Definition
plasma.
Term
When the body is deficient in glucose, a feedback system responds by creating glucose. This process is an example of:
 Definition
homeostasis.
Term
When administering a crystalloid solution to a patient with severe blood loss, it is important to remember that:
 Definition
crystalloid IV solutions do not have the ability to carry oxygen.
Term
What is the difference between a crystalloid and a colloid solution?
 Definition
Crystalloids do not contain large protein molecules.
Term
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:
 Definition
10 drops.
Term
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:
 Definition
vein on the hand.
Term
Sclerosis of a vein is caused by:
 Definition
frequent cannulation.
Term
After starting an IV on a patient in shock, the EMT-I accidentally gets stuck with the IV needle. This is referred to as a/an:
 Definition
contaminated stick.
Term
While starting an IV on a patient, you see bright red blood quickly traveling up the IV tubing. You should:
 Definition
remove the catheter and apply direct pressure.
Term
During the IV procedure, when is it MOST appropriate to apply the constricting band?
 Definition
Before you cleanse the venipuncture site.
Term
When discontinuing an IV line, you should FIRST:
 Definition
shut off the flow from the IV with the roller clamp.
Term
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:
 Definition
ensure that the constricting band is not still in place.
Term
Which of the following is a systemic complication associated with IV therapy?
 Definition
Air embolus
Term
Which of the following complications of IV therapy are you LEAST likely to encounter in the prehospital setting?
 Definition
Phlebitis
Term
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:
 Definition
remove the catheter and choose another site.
Term
The MOST effective way to prevent catheter shear when starting an IV is to:
 Definition
never rethread the needle into the catheter.
Term
Which of the following is the smallest unit of weight?
 Definition
Microgram
Term
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?
 Definition
2,000
Term
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)?
 Definition
0.25
Term
The term applied to the practice of preventing contamination of the patient when performing an invasive procedure is called:
 Definition
medical asepsis.
Term
Which of the following formulas is correct for converting a patient's weight in pounds to his or her weight in kilograms?
 Definition
Divide the patient's weight in pounds by 2 and subtract 10%.
Term
What is the approximate weight in kilograms of a 155 lb patient?
 Definition
70 kg
Term
One milliliter (mL) is equal to:
 Definition
1 cubic centimeter.
Term
How many grams are present in 25 mL of 50% dextrose (D50)?
 Definition
12.5 g
Term
If you have an epinephrine concentration of 0.1 mg/mL, how many milligrams would be present in 5 mL?
 Definition
0.5 mg
Term
Other than oxygen, prior to administering any medication to a patient, you must take BSI precautions and then:
 Definition
perform a careful assessment of the patient.
Term
As an EMT-I, the MOST commonly inhaled medication you will administer is:
 Definition
oxygen.
Term
Which of the following medication routes is considered a percutaneous route?
 Definition
Intramuscular
Term
Which of the following routes is the quickest for getting medication into the central circulation?
 Definition
Intravenous
Term
A breakable glass container that is designed to carry a single medication dose is called a/an:
 Definition
ampule.
Term
Which of the following steps for drawing medication from a vial is NOT necessary when drawing medication from an ampule?
 Definition
Injecting air into the container before withdrawing the drug.
Term
When administering a medication via the intramuscular route, you should:
 Definition
stretch the skin over the area and insert the needle at a 90° angle.
Term
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:
 Definition
remove the needle and apply pressure to the site.
Term
Unlike IM or SC injections, intravenously administered drugs rapidly affect the body because:
 Definition
they bypass most barriers to drug absorption.
Term
The term “bolus” is defined as:
 Definition
administering a drug in one mass of volume.
Term
After inserting the needle into the injection port of an IV line, but before administering the medication, you should:
 Definition
pinch off the tubing proximal to the injection port.
Term
When administering a medication via the sublingual route, you should:
 Definition
instruct the patient not to chew or swallow the medication.
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