167 terms

# Chapter 13: Medication Administration

###### PLAY
1. When measuring a drug using grains, you are using the:

a. Apothecary system
b. Household system
c. Metric system
d. Pharmacy system
a
2. You are attempting to measure blood loss of a patient using quarts. Which measuring system does this represent?

a. Apothecary
b. Household
c. Metric
d. Pharmacy
b
3. You are ordered to infuse 1000 mL of normal saline into a patient over the next 2 hours. Which system of measure is this using?

a. Apothecary
b. Household
c. Metric
d. Pharmacy
c
4. Which of the following is a correct pairing of mathematic equivalents using the apothecary system?

a. One ounce; 1 pound
b. 1 pound; 12 ounces
c. 1 pound; 480 grains
d. 5760 grains; 1 ounce
b
5. Which of the following is an accurate statement regarding the apothecary system?

a. Decimals are used.
b. Fractions are used.
c. Linear measures are in meters.
d. Quantities of less than 20 are expressed in Arabic numbers.
b
6. The unit of measurement most commonly used in the medical community is the:

a. Apothecary system
b. Common household system
c. Metric system
d. Statistical system
c
7. The metric unit for linear measurement is the:

a. Gram
b. Liter
c. Meter
d. Yard
c
8. The metric unit for volume is the:

a. Gram
b. Liter
c. Meter
d. Yard
b
9. The metric unit for weight is the:

a. Gram
b. Liter
c. Meter
d. Yard
a
10. The primary unit of mass in the apothecary system is the:

a. Grain
b. Milligram
c. Minim
d. Ounce
a
11. How many milliliters equal 1 liter?

a. 1
b. 10
c. 100
d. 1000
d
12. How many milligrams equal 1 gram?

a. 1
b. 10
c. 100
d. 1000
d
13. A neonatal patient is said to weigh 1.2 kg. This is equivalent to which of the following?

a. 120 g
b. 240 g
c. 1,200 g
d. 12,000 g
c
14. A patient is taking a medication and the dosage states it is a 100-mg tablet. This is equivalent to which of the following?

a. 0.001 cg
b. 0.1 g
c. 100 kg
d. 1000 grains
b
15. To form secondary units from the basic unit of the metric system, one can divide or multiply by:

a. 5, 10, 20 parts
b. 5, 15, 30 parts
c. 5, 10, 100 parts
d. 10, 100, or 1000 parts
d
16. One liter equals:

a. 10 mL
b. 100 mL
c. 1000 mL
d. 1,000,000 mL
c
17. 1 gram is equal to _____ micrograms.

a. 10
b. 100
c. 1,000
d. 1,000,000
d
18. Insulin syringes are marked in:

a. 1-mL increments
b. 1-unit increments
c. 1000-mL increments
d. 1000- unit increments
b
19. The freezing point of water is:

a. 2° C
b. 12° C
c. 32° F
d. 38° F
c
20. 0° C is equivalent to ___________ F.

a. 0°
b. 32°
c. 40°
d. 10°
b
21. To convert degrees Fahrenheit to Celsius, you must __________ and multiply by 5/9.

c. Subtract 30
d. Subtract 32
d
22. A patient has a temperature of 37°c. Which of the following is the correct temperature in Fahrenheit?

a. 0° F
b. 98.6° F
c. 100.4° F
d. 104° F
b
23. A patient has a temperature that is measured as 102° F. Which of the following equations is correct for the conversion of this measurement into degrees Celsius?

a. (102 × 9)/5 + 32
b. 102 × 32/15 98
c. 102/5 + 32/5
d. (102-32) × 5/9
d
24. A patient weighs 220 lb. What is her weight in kilograms?

a. 100 g
b. 100 kg
c. 120 kg
d. 440 kg
b
25. Which of the following is the equivalent of 200 g?

a. 0.2 kg
b. 0.2 lb
c. 0.2 mcg
d. 0.2 m
a
26. The kilogram is equal to:

a. 2.2 poundslb
b. 4.4 poundslb
c. 8.2 poundslb
d. 8.4 poundslb
a
27. A patient weighing 220 lb weighs:

a. 100 kg
b. 110 kg
c. 440 kg
d. 484 kg
a
28. To convert a temperature from Fahrenheit to Celsius, subtract 32 and then:

b. Multiply by 5/9
c. Multiply by 9/5
d. Subtract 5/9
b
29. The normal body temperature is:

a. 32° C
b. 37° C
c. 40° C
d. 45° C
b
30. You are ordered to administer morphine sulfate (5 mg) to your patient. Your vial contains 10 mg/mL. How many milliliters will you administer?

a. 0.1
b. 0.5
c. 1
d. 5
b
31. You are ordered to administer calcium chloride (450 mg) to your patient. Your vial contains 1 gram in 10 mL. How many milliliters will you administer?

a. 0.45
b. 4.5
c. 44.5
d. 45
b
32. You are ordered to administer amiodarone (300 mg) to your cardiac arrest patient. Packaging is 150 mg in 3 mL. How many milliliters will you administer?

a. 0.6
b. 3
c. 5
d. 6
d
33. You are ordered to administer adenosine (6 mg rapid IV push). Your vial contains 10 mg in 10 mL. How many milliliters will you administer?

a. 0.6
b. 4
c. 6
d. 10
c
34. You are ordered to administer 80 mg of lidocaine to you patient. You vial contains 100 mg in 5 mL. How many milliliters will you administer?

a. 2
b. 3
c. 4
d. 5
c
35. You are ordered to administer lidocaine (1 mg/kg) to your patient. The patient weighs 150 lb and you vial contains 100 mg in 5 mL. How many milliliters will you administer?

a. 3.2
b. 3.4
c. 3.9
d. 4.7
b
36. You are ordered to administer 1 mg/kg of Lasix to your patient. You are supplied with 16 mL at 10 mg/mL. The patient weighs 220 lb. How many milliliters will you administer?

a. 4
b. 6
c. 10
d. 16
c
37. You mix 400 mg of dopamine into a 250-mL bag of D5W. What is your concentration per milliliter?

a. 400 mcg/mL
b. 400 mg/mL
c. 1600 mcg/mL
d. 1600 mg/mL
c
38. You are ordered to administer 1 mg of atropine IV push. Your vial contains 10 mL at 0.1 mg/mL. How many milliliters will you administer?

a. 0.1
b. 1
c. 10
d. 10.1
c
39. You are treating a 200-lb patient. The physician orders 8 mcg/kg/min of dopamine. You have

a microdrip set, a 250-mL bag of D5W, and 400 mg of dopamine. How many drops will you administer?
a. 16
b. 20
c. 24
d. 27
d
40. Your patient is to receive a dosage of 5 mcg/kg. The patient weighs 150 lb. Which of the following is the correct dosage of medication for this patient?

a. 340 mcg
b. 540 g
c. 750 mcg
d. 1000 mcg
a
41. A vial of Valium is supplied with 10 mg in 2 mL. The dosage for this patient is to receive 2 mg. How much solution should be drawn up for this patient?

a. 0.2 mL
b. 0.3 mL
c. 0.4 mL
d. 0.5 mL
c
42. A microdrip administration set delivers:

a. 10 drops/mL
b. 15 drops/mL
c. 20 drops/mL
d. 60 drops/mL
d
43. You are instructed to administer 40 mg of Lasix. You have a prefilled syringe containing 80 mg Lasix in 10 mL. You should administer:

a. 4 mL
b. 5 mL
c. 8 mL
d. 10 mL
b
44. If you want to administer 200 mL/hour of normal saline with a 10 drops/mL administration set, the flow rate will be:

a. 10 drops/minute
b. 20 drops/minute
c. 33 drops/minute
d. 66 drops/minute
c
45. You are ordered to administer 4 mg per minute of lidocaine to a patient with a ventricular dysrhythmia. The lidocaine is mixed 4 mg/mL, and you are using a 60 drops/mL administration set. The flow rate will be:

a. 15 drops/minute
b. 30 drops/minute
c. 45 drops/minute
d. 60 drops/minute
d
46. Your paramedic unit responds to a cardiac emergency. You feel the patient needs a medication that you carry, but its use is not granted in your standing orders. You call the receiving hospital for orders to use the medication. You are using:

a. Offline medical direction
b. Online medical direction
c. State law
d. The Good Samaritan doctrine
b
47. A patient has signs of an allergic reaction. You wish to provide medications for this patient. A written document exists providing written medical direction on which medications are appropriate. Which of the following best describes these documents?

a. DEA documents
b. EMS system
c. Medical direction
d. Protocol
d
48. You are in a situation in which a medication administration is not covered by written offline medical direction. You would like to provide a medication. Which of the following is the most appropriate action?

a. Contact dispatch.
b. Contact medical control.
c. Follow local protocols.
d. Review your textbook.
b
49. You are preparing to administer Lasix to a patient. Before administration, you confirm that the drug you are carrying, furosemide, is the generic for Lasix. This is an example of which of the "six rights"?

a. Right documentation
b. Right dose
c Right drug
d. Right route
c
50. Before you administer lidocaine 2% to a patient, you confirm your partner has drawn up the 2% concentration, not the 20% concentration. This is an example of which of the "six rights"?

a. Right dose
b. Right drug
c. Right route
d. Right time
a
51. Which of the following "rights" refers to the appropriate readministration of a medication?

a. Right documentation
b. Right dose
c. Right patient
d. Right time
d
52. You are on scene with a patient who is having a seizure. You are unable to establish IV access. In determining which medications can be given by an alternative route, which of the following "right" applies?

a. Right dose
b. Right patient
c. Right route
d. Right time
c
53. The six patient rights of drug administration are right patient, right dose, right medication, right route, right time, and right:

a. Amount
b. Concentration
c. Documentation
d. Orders
c
54. The "sixth patient right" of medication administration is:

a. Asking the patient about allergies to medication
b. Correct and thorough documentation of the medication administered
c. Double calculation of a medication dosage
d. Having a co-worker check your calculations
b
55. Your paramedic partner has just finished discussing a medication order with the medical director of your base hospital. Your paramedic partner draws up the medication and hands you the syringe to administer to the patient. What must you do next?

a. Give the medication immediately.
b. Make sure your paramedic partner tells you what medication is in the syringe before you administer the medication .
c. Never administer an unlabeled medication prepared by another person.
d. Talk to the medical direction staff yourself before you can give the medication prepared by your partner.
c
56. You are instructed to administer an intravenous (IV) medication to a patient by medical direction. As you prepare to administer a medication from your drug box, you observe it is discolored and cloudy. Which of the following is your best course of action?

a. Administer the medication slowly in the IV line so it will dilute and clear with the IV fluid.
b. Dilute the medication until it becomes clear.
c. Give the medication as directed.
d. Never administer a medication that is discolored or cloudy.
d
57. When documenting parenteral medications, you must document medication, dosage, time, route, and the:

a. Site of injection
b. Size of the medication container
c. Size of the syringe
d. Type of dressing
a
58. You have just administered an IV medication to your patient that was prepared for you by your paramedic partner. After administering the medication, you realize your partner prepared the wrong medication. Which of the following is your best course of action?

a. Document the drug you intended to give.
b. Immediately advise medical direction and carefully monitor the patient for effects of the medication.
c. Immediately call the state Pharmacy Board and inform them of the error.
d. Place the blame on your partner and have him or her write the report.
b
59. "Clean" technique is also known as:

a. Antiseptics
b. Aseptic
c. Disinfectant
d. Sterile
b
60. Which of the following best describes the conditions found in the ambulance?

a. Asepsis
b. Free of microorganisms
c. Medical asepsis
d. Sterile
c
61. Which of the following is an accurate statement regarding medical asepsis?

a. Eliminates transmission of organisms
b. Free of microorganisms
c. Reduces risk of organism transmission
d. Sterile
c
62. Removal or destruction of disease-causing organisms or infected material is known as:

a. Debridement
b. Medical asepsis
c. Medical cleansing
d. Sterilization
d
63. The use of a face shield is indicated when administering:

a. Endotracheal (ET) medications
b. Intramuscular (IM) medications
c. Intravenous (IV) medications
d. Subcutaneous (Sub-Q) medications
a
64. The minimum level of standard precautions that should be used on every call is:

a. Gloves
b. Gloves and gown
c. Gloves, gown, and mask
d. Gown and mask
a
65. You are treating a 65-year-old male who has had a "substantial cough" for 3 days. You are preparing to administer medication to the patient. What minimum level of standard precautions should be used?

a. Gloves
b. Gloves and gown
c. Gloves and mask
d. Shoe covers
c
66. Which of the following is the best definition of standard precautions?

a. Actions required by personnel every time they are in contact to a patient
b. Actions required by personnel when they encounter a dirty patient
c. Actions required by personnel when they encounter a patient with a known disease
d. Actions required by personnel when they encounter an elderly patient
a
67. You are on scene with multiple patients. Each patient requires medication administration through IV access. Which of the following is an accurate statement regarding standard precautions?

a. Gloves are not necessary for medication administration.
b. Gloves are required only during initial IV access.
c. Gloves should be changed between each patient's treatment.
d. It is not necessary to change gloves between treating patients.
c
68. The process that makes an object free from all forms of life by using extreme heat or certain chemicals is called?

a. Antisepsis
b. Cleaning
c. Disinfection
d. Sterilization
d
69. The use of equipment and fields that are free of all forms and types of life is called:

a. Body substance isolationStandard precautions
b. Medical asepsis
c. Sterile technique
d. Universal precautions
c
70. Clean techniques used in the field:

a. Eliminate the chance of infection
b. Employ sterile techniques and surgical asepsis
c. Ensure the field is free of all forms of life
d. Focus on destroying pathogens
d
71. Antiseptics and disinfectants are chemical agents used to kill:

a. Resistant bacterial strains
b. Specific groups of microorganisms
c. Spores of bacteria
d. Spores of fungi
b
72. Sterilization is recommended for:

a. Environmental surfaces that have become soiled
b. Instruments or devices that penetrate the skin
c. Reusable instruments that come in contact with mucous membranes
d. Surfaces that come into contact with intact skin
b
73. You have just finished administering a patient with a 50-mg IM injection of diphenhydramine. What is your next intervention?

a. Check the airway.
b. Dispose of the needle and syringe in a sharps container.
c. Increase the oxygen being delivered.
d. Recheck vital signs.
b
74. It is 0700 hours, and you arrive at the station as usual. Upon inspecting your vehicle, you notice that the sharps container is 75% full. What should you do?

a. Attempt to empty "nonsharps" from the container.
b. Dispose of the container according to protocol.
c. Do nothing.
d. Throw it in the regular garbage and replace it with a new container.
b
75. Which of the following is an appropriate action to avoid getting stuck with a sharp?

a. Always put sharps in the trash.
b. Do not overfill sharps containers.
c. Recap needles.
d. Stick needles into a mattress for safe keeping.
b
76. You are on scene with a patient who requires multiple intravenous catheters. You dropped a needle following a needle stick. Which of the following is the most appropriate action?

a. Call medical control.
b. Count your sharps to see if one is missing.
c. Do not worry. You can check at the end of your shift.
d. Refuse to transport until sharp is located.
b
77. You are preparing to administer an oral medication to a patient in the emergency department. To accomplish this, your patient must:

a. Be responsive and be uncooperative
b. Have no gag reflex, be cooperative, and be responsive
c. Have an intact gag reflex, be responsive, and be cooperative
d. Have an intact gag reflex, be unresponsive, and be cooperative
c
78. When administering a liquid dose medication to a patient:

a. Allow the patient to drink from the bottle
b. Place it in your hand and administer
c. Place the cap inside down
d. Use a medicine cup, and do not touch the inside
d
79. You are administering nitroglycerine to a patient: What instructions/information should you give the patient?

a. Chew the tablet.
b. Place the tablet between the cheek and gum.
c. Place the tablet under the tongue, and do not chew or swallow it.
d. Rub the injection site for 2 minutes after administration.
c
80. A 25-year-old female with a history of diabetes complains of altered mentation and weakness. BGL is 40 mg/dL. You are unable to establish an IV. What should be your next intervention?

a. Administer D50W—25 g—IVP.
c. Administer oral glucose gel, and tell the patient to put it between her cheek and gum and do not swallow it.
d. Administer oral glucose gel under the patient's tongue.
c
81. Which of the following terms best describes the use of alcohol or iodine to clean the skin before a needle puncture?

a. Antisepsis
b. Cleaning
c. Disinfection
d. Sterilization
a
82. Which of the following is an enteral route of medication administration?

a. Buccal
b. Intramuscular
c. Intravenous
d. Subcutaneous
a
83. You are on scene with a 55-year-old male who has had a previous stroke. He is currently complaining of chest pain. Per your protocol, the patient should receive an aspirin orally. Which of the following is important to verify before administration of this oral medication?

a. Ability of the patient to recite the dose of the aspirin
b. Ability of the patient to swallow an oral medication
c. Adequate aspirin for the remainder of your shift
d. Adequate water to wash down the pill
b
84. Medications administered and absorbed through the gastrointestinal tract are called:

a. Enteral medications
b. IM medications
c. Oral medications
d. Parenteral medications
a
85. The most commonly used route of medication administration is:
a. IM
b. IV
c. Oral
d. Sub-Q
c
86. Administration of a buccal medication means that the medication is placed:

a. Between the patient's cheek and gum
b. Into the patient's subcutaneous tissue
c. Over the skin of the patient's chest
d. Under the patient's tongue
a
87. You are on scene with a 6-year-old who is having a seizure. You are unable to obtain IV access. The medication that is approved by your medical control is diazepam (Valium). Which of the following is an appropriate route for administration of this medication?

a. Oral
b. Rectal
c. Subcutaneous
d. Sublingual
b
88. Which of the following is an appropriate position for a child before administration of rectal medications?

a. Any position will work
b. One leg bent with knee to chest
c. Prone
d. Supine
b
89. How would you position a child for rectal drug administration?

a. Lying in the lateral recumbent position with legs flexed
b. Lying on the back with knees flexed
c. Lying prone
d. Lying supine
a
90. The most common medication given in the prehospital setting via OG/NG tube is:

a. Activated charcoal
b. Diphenhydramine
c. Dopamine
d. Tagamet
a
91. Which of the following medications is most likely to be administered down a nasogastric tube?

a. Activated charcoal
b. Diazepam (Valium)
c. Fentanyl
d. Morphine sulfate
a
92. Which of the following statements best describes the action that should immediately follow the administration of medication down the gastric tube?

a. Contact medical control.
b. Document the administration of a medication.
c. Flush with 30 mL of water.
d. Verify tube placement.
c
93. Before administering a medication through an orogastric or nasogastric tube, the paramedic must do which of the following:
a. Dilute all medications with 100 mL of normal saline.
b. Have the patient standing when the medication is administered.
c. Sedate the patient.
d. Verify correct placement of the tube.
d
94. After administering a medication through an orogastric or nasogastric tube, the paramedic must do which of the following:
a. Confirm tube placement.
b. Encourage the patient to stand for 15 to 20 minutes.
c. Flush the tube with 30 mL of water.
d. Have the patient swallow repeatedly.
c
95. An emergency medication that paramedics administer via a gastric tube is:

a. Activase
b. Activated charcoal
c. Antibiotics
d. Aspirin
b
96. Which of the following is considered a topical administration of medication?

a. Injection of lidocaine
b. Ophthalmic preparations
c. Rectal diazepam
d. Sublingual nitroglycerin
b
97. Upon responding to a call, your paramedic unit finds a 48-year-old complaining of crushing chest pain radiating to the left arm. Medical control orders NTG SL, followed by NTG paste. Your partner administers the NTG SL while you prepare the paste. Administering NTG paste is considered:

d
98. While administering any type of topical medication, it is important to remember to:

a. Not worry about gloves because they are not required
b. Not get any medication on your skin
c. Only place the medication on skin that has been sterilized
d. Use sterile gloves—always
b
99. Medication administration by the intramuscular, intravenous, or intraosseous route is called:

c
100. A patient is having substernal chest pain. After two nitroglycerin, his chest pain is down to a zero on the pain scale. Which of the following administrations of nitroglycerin would be most appropriate?

a. IV piggyback drip
b. IV push, single dose
c. Oral
d. Topical
d
101. You are administering a nebulizer treatment to a patient. To maximize its effect, it is important to advise the patient to do which of the following?

a. Breathe as fast as possible.
b. Lie down.
c. Place teeth around the mouthpiece and leave his or her lips open.
d. Place his or her lips around the mouthpiece and take slow deliberate breaths.
d
102. Your paramedic unit responds to a cardiac arrest call. The patient is intubated successfully. You are ordered to administer epinephrine 1/:10,000 solution via the endotracheal tube. Why is this an acceptable method of drug administration?

a. It is more reliable that IO medication administration.
b. It is more reliable that IV drug administration.
c. It is acceptable because of the large surface area available for absorption of the medication in the respiratory tract.
d. This is not an acceptable method of drug administration for a cardiac arrest patient
c
103. The ideal position for the patients to be in to receive intranasal medication is:

a. Left lateral recumbent
b. Prone
c. Supine, with the head flexed forward
d. Supine, with the head tilted back
d
104. A contraindication of intranasal medication administration would be:

a. A clear airway
b. Copious nasal secretions
c. Narcotic overdose
d. Seizures
b
105. You are about to provide a nebulized breathing treatment of albuterol to a patient. Which of the following pieces of equipment is necessary for a nebulized treatment?

a. Inhaler
b. MDI
c. Mouthpiece
d. Spacer
c
106. Where is the medication placed in the nebulizer system?

b. Nebulizer cup
c. T-piece
d. Tubing
b
107. Liquid or solid particles of a substance dispersed in a gas or solution and given as medications are:

a. Aerosol medications
b. Buccal medications
c. Intraosseous medications
d. Patch medications
a
108. Asthma patients are commonly prescribed medications, such as albuterol, levalbuterol, and isoetharine, that are administered by means of a:
a. Metered-dose inhaler
b. Self-administered saline lock
c. Topical paste
d. Topical patch
a
109. Upon arrival on scene, you find a 23-year-old female who is having difficulty breathing. You hear wheezes and notice urticaria on her arms and chest. The patient is in moderate to severe respiratory distress. The patient also states she was stung by a bee about 10 minutes earlier and she has a history of allergic reactions to bee stings. You contact medical control and are ordered to administer epinephrine 1/1000 solution. Medical control further advises the dose to be administered is 0.3 mg dose Sub-Q. Your package contains 1mg in 1 mL. Your partner hands you the epinephrine out of the drug box, and it is packaged in a small all-glass container with a narrow neck. He also hands you a 3-cc syringe with a needle attached to it. What should you do as you prepare to administer the epinephrine medication?

a. Attempt to administer the medication along the IV route.
b. Check the "six rights."
c. Inform the patient you are concerned about administering the medication.
d. Question medical control.
b
110. A medication that comes in a container that is glass with a narrow neck is called?

a. Ampule
b. Multidose
c. Syringe
d. Vial
a
111. Which of the following is an appropriate way to open the ampule?

a. Cover the top with 2 2 gauze.
b. Open the top of the ampule with your trauma sheers.
c. Open the top toward you.
d. Open the top with your bare fingers.
a
112. A glass container that holds one dose of medication and has a glass top that must be snapped off is a(n):

a. Ampule
b. Prefilled syringe
c. Tubex
d. Vial
a
113. When withdrawing medication from a glass ampule, you should do which of the following?

a. Clean the entire ampule with alcohol.
b. Squeeze the bottom of the ampule tightly enough for it to crack.
c. Tap the top of the ampule against a hard surface to break off the cap.
d. Wrap the neck of the glass ampule with an alcohol swab or gauze.
d
114. A filter needle should be used when withdrawing medication from a(n):

a. Ampule
b. Multidose vial
c. Prefilled syringe
d. Reconstituted powder vial
a
115. Which of the following steps should be taken to avoid a vacuum formation in the vial during withdrawal of a medication?

a. Inject 1 cc of normal saline.
b. Inject 1cc of water.
c. Inject the exact amount of air in cc's as the volume that is to be drawn.
d. Nothing needs to be done; simply insert the needle and draw back.
c
116. What should be done to help ensure aseptic technique?

a. Always use a new vial.
b. Cleanse the top of the vial with an alcohol pad.
c. No cleansing is necessary.
d. Wash the top of the vial with soap and water.
b
117. A glass or plastic container with a rubber stopper that holds multiple medication doses for injection is a(n):

a. Ampule
b. Prefilled syringe
c. Tubex
d. Vial
d
118. When drawing medication from a vial, the paramedic must inject a volume of air into the vial equivalent to the amount of solution being withdrawn to prevent:

a. Creating a vacuum in the vial
b. Creating bubbles in the vial
c. Diluting the medication in the vial
d. Injecting pathogens into the vial
a
119. When reconstituting dry powders for injection, you should do which of the following?

a. Add alcohol to the mixture to allow for even mixing .
b. Add extra normal saline to the mixture to prevent caking in the syringe.
c. Thoroughly mix the diluent and powder in the closed vial.
d. Warm the mixture for 2 to 3 minutes to allow the medication to dissolve.
c
120. An injection commonly used for allergy testing, in which the injection is made just below the epidermis, is called a(n):

a. Epidermal injection
c. Intramuscular injection
d. Subcutaneous injection
b
121. Insert the needle for an intradermal injection at an angle of:

a. 2 to 3 degrees
b. 4 to 5 degrees
c. 5 to 10 degrees
d. 10 to 15 degrees
d
122. The forearm and the back are common sites for:

a. Epidermal injection
c. Intramuscular injection
d. Subcutaneous injection
b
123. A patient is going to receive a subcutaneous injection. Which of the following is a correct description of the procedure?

a. Select a needle, typically 3/8 or 5/8 inches long.
b. Select a site with a lot of nerve endings.
c. The needle should be 1½ inches long.
d. The needle should be held at a 90-degree angle for adults.
a
124. Which is an appropriate site for a subcutaneous injection in a child?

a. Anterior thigh
b. Back
c. Forearm
d. Lateral thigh
a
125. To deliver a subcutaneous injection, you should do which of the following?

a. Insert the needle at a 45-degree angle.
b. Insert the needle with the bevel down.
c. Spread the skin taut.
d. Use a 1- or 1½-inch needle.
a
126. Aspiration is the technique of:

a. Injecting a medication slowly into a muscle
b. Injecting two medications into the same muscle
c. Inserting-injecting-withdrawing-reinserting the needle into a muscle
d. Pulling back on the plunger to ensure that the needle has not been placed in a blood vessel
d
127. When selecting a needle length for an intramuscular injection, which of the following should be considered?

a. A 5/8-inch needle is appropriate for most adults.
b. A 1-inch needle should be used for a morbidly obese patient.
c. It should be long enough to reach the blood vessel.
d. It should be long enough to reach the middle of the muscle.
d
128. What is the maximum amount of medication that can be administered to an adult in the vastus lateralis?

a. 1 mL
b. 2 mL
c. 3 mL
d. 5 mL
c
129. What should you do when cleaning the skin before an IM injection?

a. Clean the skin with water only.
b. Clean with concentric circles, moving outward from the site.
c. Wipe once with an alcohol wipe.
d. Wipe once with a disinfectant.
b
130. The deltoid muscle is found:

a. Anterior to the superior iliac spine
b. In the forearm
c. In the upper arm
d. Lateral to the femur
c
131. When injecting into the deltoid muscle, care must be taken to avoid hitting the:

a. Acromion nerve
b. Femoral nerve
d. Sciatic nerve
c
132. Correct location of injection into gluteal muscle will avoid the closely located:

a. Acromion nerve
b. Femoral nerve
d. Sciatic nerve
d
133. A position that promotes gluteal muscle relaxation is for the patient to lie:

a. Prone with the toes pointing inward
b. Prone with the toes pointing outward
c. Supine with the toes pointing inward
d. Supine with the toes pointing outward
a
134. The quickest method for getting fluids and medications into the bloodstream is by:

b. Intramuscular injection
c. Intravenous injection
d. Subcutaneous injection
c
135. The most common type of IV catheter used in the prehospital setting is the:

a. Needle over guidewire
b. Needle over the catheter
c. Over-the-needle catheter
d. Steel shank catheter
c
136. You are ordered to start an IV in the patient's lower extremity. The site of choice is the:

a. Antecubital
b. Dorsal venous arch
c. External jugular
d. Saphenous
d
137. Which IV site joins the subclavian vein and passes above the sternocleidomastoid?

a. External jugular
b. Femoral
c. Saphenous
d. Subclavian
a
138. Which of the following is the process by which fluid enters the surrounding tissue?

a. Hematoma
b. Infiltration
c. Pneumothorax
d. Thrombus
b
139. Systemic complications of a peripheral IV might include:

a. Air embolus/catheter shear
b. Diverticulitis
c. Hemothorax
d. Pneumothorax
a
140. Which of the following is a vein found in the antecubital fossa?

a. Cephalic
b. Cutaneous
c. Femoral
d. Popliteal
a
141. You are working on a patient who has had a full cardiac arrest. You have attempted an IV in the right antecubital fossa. Multiple attempts on the right arm have resulted in the vein blowing. Which of the following is an appropriate site for the next attempt?

a. Femoral artery
b. Left antecubital fossa
c. Right forearm
d. Right hand
b
142. You have a patient who has significant peripheral vascular disease. He has been in a motor vehicle crash and appears to have a fractured right humerus. His right arm is swollen and edematous. He is currently being intubated. Which of the following would be the most appropriate site for venous cannulation?

a. Left cephalic vein
b. Left external jugular
c. Right cephalic vein
d. Right hand
a
143. Which of the following is the best way to determine which of the three vessels is the vein in an attempt to catheterize the umbilical site in a newborn?

a. The arteries are dilated.
b. The vein is a thin-walled vessel.
c. There is only one artery.
d. There are two veins.
b
144. A potential hazard associated with parenteral medication administration is:

a. Cellulitis or abscess formation
b. Hypovolemia
c. Injection of needle splinters
d. Slow medication absorption
a
145. Tuberculin syringes are marked in:

b. 1- to 2-mL gradient
c. 3- to 6-mL gradient
d. 6- to 10-mL gradient
a
146. Subcutaneous injections can be given with a:

a. 16-gauge needle
b. 25-gauge needle
c. 30-gauge needle
d. 45-gauge needle
b
147. The site most commonly used in the prehospital setting to start a peripheral IV is the:

a. External jugular vein
b. Lower extremity
c. Subclavian vein
d. Upper extremity
d
148. "Butterfly" needles are:

a. Hollow needles
b. Indwelling plastic needles
c. Over-the-catheter needles
d. Plastic needles
a
149. The type of intravenous catheter most commonly used in the prehospital setting is the:

a. Butterfly catheter
b. Hollow catheter
c. Over-the-needle catheter
d. Through-the-needle catheter
c
150. Proper application of a tourniquet for use in establishing an IV should result in tamponade of:

a. Both the venous and the arterial vessels
b. Neither the venous nor the arterial vessel
c. The arterial vessel without occlusion of the venous vessel
d. The venous vessel without occlusion of the arterial vessel
d
151. When choosing a location for venipuncture, choose the most suitable:

a. Central vein
b. Distal vein
c. Leg vein
d. Proximal vein
b
152. To locate the jugular vein, position the patient:

a. Head down, head turned away from you
b. Head down, head turned toward you
c. Head up, head turned away from you
d. Head up, head turned toward you
a
153. Which of the following is a site used for central venous cannulation?

a. Antecubital fossa
b. External jugular vein
c. Saphenous vein
d. Subclavian vein
d
154. Which of the following is a systemic complication associated with peripheral intravenous therapy?

a. Cellulitis
b. Hematoma
c. Pneumothorax
d. Pulmonary embolism
d
155. You have started a central IV line on a critical patient and are en route to the hospital. Just as you notice the IV tubing has accidentally disconnected from the catheter, your patient becomes cyanotic, weak, and dyspneic; has a rapid pulse; and begins to lose consciousness. You suspect the patient is experiencing:

a. An air embolism
c. Hypovolemia
d. Infiltration
a
156. The technique of giving a medication in less than 1 to 3 minutes through an IV line is called an IV:

a. Bolus
b. Hickman
c. Infusion
d. Intermittent infusion
a
157. You initiated an IV in the antecubital space of an unconscious hypoglycemic diabetic patient. You notice that the fluids are running very slowly and the skin in the arm above the IV site is cool and pale. What should you do?

a. Discontinue the IV and restart it in the other arm.
b. Flush the line with normal saline and see if the infusion rate increases.
c. Push D50W 25 g IV slowly.
d. Start another IV below the first one.
a
158. The most common IO site for children is the:

a. Anterior fibula
b. Anterior tibia
c. Posterior fibula
d. Posterior tibia
b
159. The F.A.S.T. IO system is designed to be inserted in the patient's:

a. Clavicle
c. Sternum
d. Tibia
c
160. The standard location for tibial insertion of an IO device is:

a. 1 to 3 cm above the tibial tuberosity
b. 1 to 3 cm below the tibial tuberosity on the medial flat surface of the anterior tibia
c. 1 to 3 cm inferior to the patella
d. 1 to 3 inches below the tibial tuberosity of the lateral flat surface of the anterior tibia
b
161. You are on scene to treat a 3-month-old infant who has no pulse and no spontaneous respirations. CPR has been initiated. You are attempting to gain intravenous access. Which of the following would be an appropriate access site if IV access is delayed?

a. Arterial
b. Central
c. Intraosseous
d. No access is necessary
c
162. You are on scene with an 18-year-old male who has suffered major burns to his lower extremities and arms. You are about to attempt intraosseous access. Which of the following would be an appropriate site?

a. Anterior superior iliac spine
b. Anterior tibial surface
c. Distal femur
d. Sternum
d
163. You are called to the scene of a 4-year-old male who was struck by a van. The child is in cardiopulmonary arrest. You have attempted peripheral IV access three times without success. Your best course of action for administration of fluids and medications in this situation is with a(n):

a. Fourth attempt to establish peripheral IV access
b. Internal jugular IV line
c. Intraosseous infusion
d. Subclavian IV line
c
164. Administration of a sublingual medication means that the medication is placed:

a. Between the patient's cheek and gum
b. Into the patient's subcutaneous tissue
c. Over the skin of the patient's chest
d. Under the patient's tongue
d
165. Which of the following is one of the primary functions you must perform after blood is drawn?

a. Blood samples are never taken in the field.
b. Label it carefully with patient's name, date, time, and other pertinent information.
c. Refrigerate it at once.
d. Turn it over to the hospital staff within minutes or it cannot be used.
b
166. You have a long transport time. You have been instructed by the hospital to draw blood. You have intravenous access in the right antecubital fossa established. Which of the following is an appropriate site for a blood draw?

a. Left antecubital fossa
b. Off of the intravenous access that is currently running
c. Right forearm
d. Right hand
d
167. Which of the following is the most appropriate action with blood samples once you have arrived at the emergency department?

a. Deliver them to the blood bank.
b. Give them to a family member.
c. Give them to the direct staff responsible for the patient.
d. Place them on the counter.
c