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135 Cards in this Set
- Front
- Back
Common components of a medication profile include all of the following, EXCEPT:
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A. the weight of the drug.
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Stimulation of beta-2 receptors will cause:
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B. the airway diameter to dilate.
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Stimulation of alpha-1 receptors results in:
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C. vasoconstriction.
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First-pass metabolism of a medication occurs when:
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the bioavailability of a medication is reduced before it reaches the systemic circulation.
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Decreased efficacy or potency of a medication when taken repeatedly by a patient is called:
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tolerance
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A paramedic gives a woman with chronic pain an injection of sterile saline and tells her that it is a narcotic analgesic. The paramedic's action:
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could result in criminal prosecution
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In which of the following situations would the paramedic MOST likely administer a drug via the rectal route?
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Seizure termination
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The term affinity, as it applies to pharmacology, is MOST accurately defined as the:
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ability of a medication to bind to a receptor.
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The rectal route is preferred over the oral route for certain emergency medications because:
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rectal medications are usually not subject to first-pass metabolism
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All of the following are Schedule II substances, EXCEPT:
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heroin.
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A medication undergoes first-pass metabolism in the:
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liver
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Medications commonly administered via a nebulizer include all of the following, EXCEPT:
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lidocane
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A drug is assigned a pregnancy category “A” if:
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B. controlled studies in women fail to demonstrate a risk to the fetus in the first trimester, there is no evidence of risk in later trimesters, and the possibility of fetal harm appears remote.
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A patient takes 500 mg of a medication that has a half-life of 2 hours. How much medication will be in the patient's body after 6 hours?
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62.5
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All of the following are common sites for emergency IO cannulation, EXCEPT the:
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iliac crest
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The peak of a medication's effect depends on _____________, whereas the duration of effect depends on ______________.
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absorption, metabolism
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The paramedic can avoid technical errors in medication administration by:
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having a partner confirm the volume in a syringe or a weight-based medication calculation.
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The physical, emotional, or behavioral need for a medication in order to maintain a certain level of “normal” function is called:
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dependence
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Stimulation of alpha-2 receptors:
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suppresses the release of norepinephrine
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A medication is used “off-label.” This means that it:
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is used for a purpose not approved by the FDA, at doses different from the recommended doses, or by a route of administration not approved by the FDA.
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Cross-tolerance to a medication occurs when:
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repeated exposure to a medication within a particular class causes tolerance to other medications in the same class.
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IO infusion rates are comparable to IV infusion rates:
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when a pressure bag or mechanical infusion device is used
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The therapeutic index of a medication is defined as the:
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difference between the median effective dose and the median toxic dose
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Medications administered by the ___________ route, by definition, have 100% bioavailability.
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intravenous
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When the paramedic administers a medication via the IV route:
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A. he or she has the ability to titrate the medication carefully in a rapidly evolving clinical situation.
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Transdermal medication patches:
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may alter a patient's clinical presentation or interfere with medications administered by the paramedic.
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Which of the following factors would be the LEAST likely to affect a patient's response to a medication?
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Past medical history
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Compared to Schedule III drugs, Schedule IV drugs:
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B. have a lower abuse potential and include medications such as diazepam (Valium) and lorazepam (Ativan).
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A medication that has a narrow therapeutic index:
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C. can be given, but not without close patient monitoring. Correct
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When administering naloxone to a patient who overdosed on an opioid, it is important for the paramedic to remember that:
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the duration of action of naloxone in the body is less than that of many opioid chemicals.
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Newer medications are designed to target only specific receptor sites on certain cells in an attempt to:
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C. minimize the adverse effects.
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Medications that are manufactured synthetically:
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do not use animal, mineral, or vegetable sources
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If studies in animals or human beings have demonstrated fetal abnormalities, or if there is evidence of fetal risk based on human experience, a pregnancy category ___ is assigned to a medication.
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X
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Stimulation of beta-1 adrenergic receptors would produce all of the following effects, EXCEPT:
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decreased myocardial contractility.
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The paramedic should be MOST suspicious that a controlled substance has been tampered with if:
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D. an appropriate dose of the drug seems ineffective, especially when patient tolerance is unlikely.
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The IV route is the fastest route of medication administration because:
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A. it bypasses most barriers to drug absorption.
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IO cannulation is contraindicated in all of the following situations, EXCEPT:
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penetrating thoracic trauma
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Common risks associated with cannulation of the external jugular vein include all of the following, EXCEPT:
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cannulation of the subclavian vein
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If you give a medication via the oral route in the prehospital setting, you should give it early because:
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B. absorption via this route is slow.
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The ________ route of medication administration refers to any route in which medication is absorbed through some portion of the gastrointestinal tract.
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enteral
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In the prehospital setting, saline locks are used primarily for patients who:
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do not need additional fluids but may need rapid medication delivery.
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How many mg/mL are contained in a prefilled syringe of 50% dextrose with a concentration of 25 g/50 mL?
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500
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Shortly after establishing an IV line of normal saline, your patient complains of a burning sensation along the course of the vein. You should:
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observe the patient for signs and symptoms of an allergic reaction.
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Which of the following steps is usually necessary when administering a drug via the IO route, but not necessary when administering a drug via the IV bolus route?
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Placing a pressure infuser device around the IV bag
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When drawing medication from an ampule, you should:
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gently tap the ampule if medication is stuck in the neck.
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When administering a medication via the intramuscular route, you should:
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stretch the skin over the injection site and insert the needle at a 90° angle
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A composition of dissolved elements and water is called a(n):
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solution
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A 60-year-old woman with acute chest discomfort requires 0.4 mg of sublingual nitroglycerin. Prior to administering the medication, you should:
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ask her if she wears a transdermal nitroglycerin patch.
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A 130-lb patient weighs ____ kg.
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59
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If you receive orders to administer more than one drug to the same patient, it is MOST important to:
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make sure the drugs are compatible
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When selecting a vein for cannulation, you should avoid areas of the vein that:
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pass over joints
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Signs and symptoms of circulatory overload include:
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hypertension
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While attempting to start an IV on a patient with large protruding veins, you note that the vein rolls from side to side during your cannulation attempt. The BEST way to remedy this situation is to:
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apply downward manual traction below the venipuncture site to stabilize the vein in position.
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When changing an IV bag, it is important to:
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ensure the fluid stays in the drip chamber
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In contrast to an antiseptic, a disinfectant is:
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toxic to living tissues and should never be used on a patient.
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Medication absorption through a nitroglycerin patch would be increased if the patient has:
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skin that is thin or nonintact
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A microdrip administration set:
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A. delivers 1 mL for every 60 drops.
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When using a vial of medication, you must FIRST determine:
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how much of the drug is needed and how many doses are in the vial.
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After inserting the needle during an intramuscular or subcutaneous injection, but before delivering the medication, you should:
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pull back on the plunger to aspirate for blood.
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If the posterior aspect of the leg rapidly becomes edematous during IO infusion, you should:
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suspect extravasation of fluid
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A prefilled syringe of lidocaine contains 100 mg/5 mL of volume. How many milligrams per milliliter (mg/mL) are present in the syringe?
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20
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When injecting a medication via the rectal route, you should:
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instruct the patient not to bear down.
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Osmosis occurs when:
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water moves from an area of lower solute concentration to an area of higher solute concentratio
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An 80-kg patient weighs ____ lb.
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176
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Medical asepsis is MOST accurately defined as:
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the practice of ensuring no patient contamination
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If a 10-mL vial contains 1 mg of a drug, how many mg/mL are present?
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.1
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Large protruding arm veins in an otherwise healthy adult can be difficult to cannulate because they often:
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A. roll from side to side during the cannulation attempt. Correct
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As you are preparing to start an IV on a young man, he sees the needle, becomes acutely diaphoretic, and passes out. After placing him in the appropriate position, you should:
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administer high-flow oxygen
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If you discover that an IV is not flowing sufficiently, you should:
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check the height of the Iv bag
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Damage to nerves, tendons, or ligaments would MOST likely occur during venipuncture if:
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the selected IV site is next to a joint
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When a patient needs rapid fluid replacement, you should:
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select an administration set that contains a large opening between the piercing spike and drip chamber.
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The first step in discontinuing an IV line is to:
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shut off the flow of fluid with the roller clamp
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When initiating an IV line in the upper extremity of a stable patient, you should:
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start distally and work proximally.
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The ___________ route is the MOST commonly used medication route in the prehospital setting.
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IV
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Prior to administering a medication to any patient, the paramedic should:
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inquire about drug allergies
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Drug reconstitution involves:
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injecting diluent or sterile water from one vial into the vial that contains the powdered form of the medication.
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After observing a flash of blood in the IV catheter's flash chamber, you should:
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immediately drop the angle of the catheter to about 15° and advance the catheter a few more centimeters.
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When administering a medication, the paramedic:
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is just as responsible for the administration of the drug and its possible consequences as the physician giving the order.
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If you receive a medication order from on-line medical control that seems inappropriate to you, you should:
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ask the physician to repeat the order.
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Once the pigtail is removed from the sterile access port of an IV solution, the solution must be used:
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immediantly
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The MOST common cause of circulatory overload in the prehospital setting is:
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failure to readjust the drip rate after flushing the IV line immediately after insertion.
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Approximately ___% of an adult male's weight is constituted by water.
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60
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A healthy person loses approximately ___ to ___ liters of fluid daily through urine output, through exhalation, and through the skin.
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2,2.5
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1 cc is equal to _____ mL.
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1
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All of the following are peripheral veins, EXCEPT the:
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subclavin vein
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The standard adult dose for levalbuterol (Xopenex) is:
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1.25 to 2.5 mg in 3 mL of normal saline every 20 minutes, up to 3 times.
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Verapamil hydrochloride (Isoptin, Calan) is indicated for patients with:
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re-entry supraventricular tachycardia
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The onset of action of rocuronium bromide (Zemuron) is:
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1 to 2 minutes
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Clopidogrel (Plavix) is a(n):
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antiplatelet aggregant
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Adenosine is contraindicated for patients with:
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drug-induced tachycardia.
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Indications for magnesium sulfate include:
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digitalis-induced dysrhythmias
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The amount of medication, expressed in milligrams, grams, or grains, that is present in an ampule or vial is called the:
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concentration
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Pralidoxime (2-PAM) reverses the effects of organophosphate poisoning by:
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reactivating cholinesterase
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Which of the following medications is indicated for patients with delirium tremens?
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Thiamine
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The prefix value for micro (µ) is:
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0.00001.
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An appropriate dose of activated charcoal for a patient who weighs 160 pounds is:
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145g
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Glucagon would be ineffective in patients with:
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depleted glycogen stores
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In addition to rapidly increasing serum glucose levels, dextrose:
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provides a short-term diuretic effect.
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Indications for epinephrine include all of the following, EXCEPT:
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hypothermic cardiac arrest.
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Verapamil hydrochloride (Isoptin, Calan) is classified as a(n):
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calcium channel blocker.
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The peak effect of pancuronium bromide (Pavulon) is:
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3 to 5 minutes
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A drug that is contraindicated for pregnant women is assigned an FDA pregnancy category:
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X
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Which of the following medications antagonizes the action of benzodiazepines on the central nervous system?
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Flumazenil
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In general, the paramedic can administer up to ___ mg of naloxone (Narcan) before contacting medical control.
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10
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Ketorolac tromethamine (Toradol) should NOT be given to patients:
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with a bleeding disorder
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When given during cardiac arrest due to torsade de pointes, the dose for magnesium sulfate is:
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1 to 2 g of a 10% solution over 5 to 20 minutes.
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Diltiazem is commonly used for patients with:
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rapid atrial fibulation
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Which of the following medications converts hemoglobin to methemoglobin, which chemically binds with cyanide and prevents its toxic effect?
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Amyl nitrate
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Fentanyl citrate (Sublimaze) is a(n):
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opioid analgesic
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Indications for lidocaine hydrochloride (Xylocaine) include all of the following, EXCEPT:
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AV heart block in the absence of an artificial pacemakee
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Which of the following represents the correct dose for pancuronium bromide (Pavulon) for a 140-pound adult?
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6.4mg
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The typical adult dose for midazolam (Versed) is:
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2 to 2.5
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Which of the following statements regarding hetastarch (Hespan) is correct?
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Hetastarch can expand circulating volume for up to 36 hours.
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What is the initial dose of sodium bicarbonate for a 240-pound man?
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110mEq
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What is the mechanism of action of nitroglycerin?
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Smooth muscle relaxation; decreased preload and afterload
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Diazepam may be indicated for patients with:
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acute alcohol withdraw
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Rocuronium bromide (Zemuron) is classified as a:
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nondepolarizing neuromuscular blocker
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Which of the following statements regarding clopidogrel (Plavix) is correct?
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It should not be given to patients taking a proton pump inhibitor
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Which of the following statements regarding Phenergan is correct?
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Phenergan possesses sedative and anticholinergic activity.
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Side effects of albuterol may include:
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tremors, lightheadedness, and irritability
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Epinephrine is deactivated by:
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alkaline solutions
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Which of the following statements regarding morphine sulfate is correct?
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Morphine is indicated for patients with unstable angina if nitroglycerin does not relieve their pain
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The onset of action of naloxone (Narcan) is:
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less than 2 minutes.
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Which of the following classifications of medication may potentiate atenolol?
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calcium channel blocker
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The standard adult dose for ondansetron (Zofran) is:
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4mg
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Furosemide (Lasix) increases urinary output by:
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blocking sodium absorption at the distal and proximal tubules and the loop of Henle.
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Methylprednisoline (Solu-Medrol) is classified as a:
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corticosteroid
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Aspirin is relatively contraindicated in patients with:
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asthma
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Dextrose is classified as a(n):
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carbohydrate
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Atropine should NOT be given to patients with:
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hypothermic bradycardia
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To prepare an epinephrine infusion, the paramedic should add ___ mg of a _________ solution to 250 mL of normal saline.
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1, 1:1,000
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Plasma protein fraction (Plasmanate) is especially useful for patients with:
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burn shock
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0.45% sodium chloride (½ normal saline) should NOT be used when:
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rapid fluid rehydration is required.
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Glucagon may be indicated for all of the following conditions, EXCEPT:
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hyperglycemia
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The correct second dose of adenosine for a 50-pound child is:
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4.6mg
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