IV and Injections  

On-Line Practice Exam 3 - This exam is from another publisher other than the one used in class.  Therefore some questions may require some research to answer.  Furthermore this exam includes questions that should have been obtained in an EMT-Basic program.  It is recommended that you take the exam by placing your answers on a sheet of paper then Click here for "Answer Key Exam 3".

1.       Under the tongue, between the cheek and gums, the eyes, the nose, and the ear and ear canal are sites where medications can be absorbed into the body through the:

          a.   arterioles.

          b.   capillaries.

          c.   venules.

          d.   mucous membranes.

2.       Scenario: A physician orders 225 mg of acetaminophen to a pediatric patient. The liquid acetaminophen is packaged in a concentration of 160 mg in 5 ml of solution. How much medication would you administer?

          a.   6 ml

          b.   7 ml

          c.   8 ml

          d.   9 ml

3.       Scenario: A physician orders .25 mg/kg of Cardizem for a patient who weighs 176 pounds. The concentration of Cardizem is 25 mg in 5 ml. How many cc's of Cardizem will you be giving to this patient?

          a.   18 ml

          b.   20 ml

          c.   23 ml

          d.   28 ml

4.       Scenario: A physician orders administration of heparin at 1000 units per hour to a patient. You have on hand 25,000 units of heparin in 500 cc of normal saline. You will use a microdrip set to run this IV infusion. What should the infusion rate be?

          a.   16 gtts/minute.

          b.   18 gtts/minute.

          c.   20 gtts/minute.

          d.   22 gtts/minute.

5.       Scenario: A physician orders D51/2 normal saline at 125 cc/hour. The administration tubing is a macrodrip set with a drip factor of 10 gtts/ml. At what drip rate would you run the infusion?

          a.   155.5 gtts/min.

          b.   166.6 gtts/min.

          c.   188.8 gtts/min.

          d.   199.9 gtts/min.

6.       A milliliter equals:

          a.   1/10 of a liter.

          b.   1/100 of a liter.

          c.   1/1000 of a liter.

          d.   1/10000 of a liter.

7.       101.2 degrees Fahrenheit equals how many degrees Celsius?

          a.   37.5 degrees Celsius

          b.   38.4 degrees Celsius

          c.   39.8 degrees Celsius

          d.   39.1 degrees Celsius

8.       A medication's concentration refers to its:

          a.   weight per volume.

          b.   weight per dose.

          c.   dose per volume.

          d.   dose per weight.

9.       One kilogram equals:

          a.   2 pounds.

          b.   2.1 pounds.

          c.   2.2 pounds.

          d.   2.3 pounds. 

10.     All of the following are indications for intravenous access EXCEPT:

          a.   allergy testing.

          b.   fluid and blood replacement.

          c.   drug administration.

          d.   obtaining venous blood specimens.

11.     When choosing a site for routine intravenous access, it is best to start:

          a.   in the thigh.

          b.   in the hand and work towards the antecubital fossa.

          c.   in the antecubital fossa and work towards the hand.

          d.   in the neck.

12.     The veins utilized in central venous access include all of the following EXCEPT:

          a.   femoral veins.

          b.   subclavian veins.

          c.   external jugular veins.

          d.   internal jugular veins.

13.     Lactated Ringer's is a:

          a.   colloid solution.

          b.   isotonic solution.

          c.   hypotonic solution.

          d.   hypertonic solution.

14.     The most desirable fluid for replacement is:

          a.   a crystalloid.

          b.   a colloid.

          c.   albumin.

          d.   blood.

15.     Macrodrip tubing is indicated for all of the following patients EXCEPT:

          a.   a 17-year-old gun shot victim.

          b.   a 68-year-old in anaphylactic shock.

          c.   a 77-year-old in CHF.

          d.   a 24-year-old in heat exhaustion.

16.     Microdrip tubing has how many drops per milliliter?

          a.   20 gtts per ml

          b.   40 gtts per ml

          c.   60 gtts per ml

          d.   80 gtts per ml

17.     A burette chamber IV tubing would be appropriate for which of the following patients?

          a.   a 5-year-old receiving IV antibiotics.

          b.   a 5-year-old in hypovolemic shock.

          c.   a 24-year-old victim of an MVA.

          d.   a 24-year-old in anaphylactic shock.

18.     Blood is administered with which IV solution?

          a.   lactated Ringer's

          b.   normal saline

          c.   D5W

          d.   Dextran

19.     Which type of catheter is preferred for peripheral venous access?

          a.   intraosseous catheter

          b.   hollow-needle catheter

          c.   over-the-needle catheter

          d.   intracatheter catheter

20.     Cleansing of the skin for intravenous access requires use of:

          a.   medically clean techniques.

          b.   sterile techniques.

          c.   aseptic techniques.

          d.   disinfecting techniques.

21.     When establishing a peripheral IV, what is the maximum amount of time a constricting band should be left on?

          a.   1 minute

          b.   2 minutes

          c.   3 minutes

          d.   4 minutes

22.     Which of the following patients would benefit from external jugular cannulation?

          a.   an alert and oriented 5-year-old patient who needs IV antibiotics

          b.   an obtunded 88-year-old patient with pneumonia

          c.   an unconscious 24-year-old stabbing victim

          d.   an alert and oriented 34-year-old victim of a bee sting

23.     For cannulation of the external jugular vein, place the patient in the:

          a.   supine and/or Trendelenburg position.

          b.   prone and/or Trendelenburg position.

          c.   left lateral recumbent position.

          d.   right lateral recumbent position.

24.     Extravasation of an IV site is indicated by:

          a.   edema at the IV site.

          b.   redness of the IV site.

          c.   warmth of the IV site.

          d.   bleeding at the IV site.

25.     What should you do if you suspect that a clot is obstructing an IV?

          a.   Flush the IV with 5cc of normal saline

          b.   Raise the IV bag above the site of cannulation

          c.   Pull the catheter back and retape it once you have obtained adequate flow

          d.   Aspirate the blood clot into a syringe

26.     What is the risk posed by catheter shear?

          a.   local infection at the IV site

          b.   creation of an embolus

          c.   extravasation

          d.   necrosis

27.     Changing an IV bag during infusion is a:

          a.   contraindicated process.

          b.   guarantee of contamination.

          c.   sterile process.

          d.   medically clean process.

28.     How many cc's of flush should be used after an IV medication bolus?

          a.   15 cc

          b.   20 cc

          c.   25 cc

          d.   30 cc

29.     All of the following are advantages of IV drug administration EXCEPT:

          a.   the absorption rate is unreliable.

          b.   the medication can be easily discontinued.

          c.   greater control of medication delivery.

          d.   drug levels can be maintained after an initial bolus.

30.     How many cc's of saline are used in a heparin lock?

          a.   3-5 ml

          b.   6-8 ml

          c.   9-11 ml

          d.   12-14 ml

31.     A venous access device should be accessed with a(n):

          a.   heparin lock.

          b.   Huber needle.

          c.   over-the-needle catheter.

          d.   hollow-needle catheter.

32.     A Huber needle should be inserted into the injection port at a:

          a.   15 degree angle.

          b.   30 degree angle.

          c.   45 degree angle.

          d.   90 degree angle.

33.     Complications of using a venous access device include all of the following EXCEPT:

          a.   infection.

          b.   hypotension.

          c.   thrombus formation.

          d.   dislodgment of the catheter tip from the vein.

34.     Which of the following is a complication associated with use of infusion pumps?

          a.   hypotension

          b.   infection

          c.   extravasation

          d.   thrombus formation 

35.     Situations that may require intraosseous infusion include all of the following EXCEPT:

          a.   pneumonia.

          b.   shock.

          c.   status epilepticus.

          d.   trauma.

36.     The bone most commonly used for intraosseous access is the:

          a.   tibia.

          b.   fibula.

          c.   femur.

          d.   sternum.

37.     The proper site for placement of an intraosseous needle for the pediatric patient is the:

          a.   lateral malleolus.

          b.   medial malleolus.

          c.   lateral aspect of the proximal tibia.

          d.   medial aspect of the proximal tibia.

38.     An intrasosseous needle is flushed with:

          a.   a 5 ml syringe with 3 cc to 5 cc of sterile saline.

          b.   a 5 ml syringe with 3 cc to 5 cc of sterile water.

          c.   a 10 ml syringe with 3 cc to 5 cc of sterile saline.

          d.   a 10 ml syringe with 3cc to 5 cc of sterile water.

39.     All of the following are potential complications of intraosseous access EXCEPT:

          a.   fracture.

          b.   infiltration.

          c.   pulmonary embolism.

          d.   EPS.

40.     Intraosseous infusion is contraindicated for all of the following patients EXCEPT:

          a.   a 72-year-old CHF patient with a history of osteoporosis.

          b.   a 5-year-old drowning victim with a history of multiple dystrophy.

          c.   a 3-year-old patient in status epilepticus with a history of osteogenesis imperfecta.

          d.   an 18-month-old in septic shock receiving IV antibiotics via a heparin lock.

41.     Paramedics operate under the license of a:

          a.   medical director.

          b.   hospital administrator.

          c.   EMS director.

          d.   field supervisor.

42.     All of the following are part of the six "rights" of drug administration EXCEPT:

          a.   right person.

          b.   right drug.

          c.   right brand.

          d.   right route.

43.     Medically clean techniques involve:

          a.   the use of disinfectants on living tissue.

          b.   creation of a medical environment free of pathogens.

          c.   the careful handling of sterile equipment to prevent contamination.

          d.   methods that are difficult to obtain in the prehospital setting.

44.     The simplest form of body substance isolation is:

          a.   donning gloves.

          b.   washing hands.

          c.   wearing a face mask.

          d.   using eye protection.

45.     Enteral drug absorption can be unreliable because of the:

          a.   age of the patient.

          b.   dosage of the medication given.

          c.   level of the patient's physical activity.

          d.   patient's level of orientation.

46.     Administering an oral medication to a patient who cannot support his airway may result in:

          a.   poor absorption of the medication.

          b.   the need to repeat the dose of medication.

          c.   aspiration into the lungs.

          d.   harmful substances after the drug is metabolized.

47.     Medications that are combined with fat or oil are:

          a.   elixirs.

          b.   suspensions.

          c.   syrups.

          d.   emulsions.

48.     The most accurate means of administering liquid-based oral medications is the:

          a.   souffle cup.

          b.   medicine dropper.

          c.   teaspoon.

          d.   oral syringe. 

49.     All of the following are parts that may be found in a typical nebulizer EXCEPT a(n):

          a.   mouthpiece.

          b.   nasal tubing.

          c.   relief valve.

          d.   oxygen port.

50.     In order for a nebulizer to be effective, the patient must be able to:

          a.   hold the mouthpiece by himself.

          b.   maintain adequate tidal volume.

          c.   speak in complete sentences.

          d.   inhale for 3-4 seconds.

51.     Which of the following is NOT an advantage of a nebulizer or metered dose inhaler?

          a.   less medication is needed because it reaches its exact site of action

          b.   implementing or discontinuing drug delivery is easy

          c.   it is a less expensive method of drug delivery for an EMS system

          d.   supplemental oxygen administered simultaneously can assist a hypoxic patient

52.     When administering medication through an endotracheal tube, the amount of medication mixed with normal saline should create a solution equal to:

          a.   8 ml.

          b.   10 ml.

          c.   12 ml.

          d.   14 ml.

53.     Which of the following medications should not be administered via a gastric tube?

          a.   enteric-coated analgesics

          b.   liquid analgesics

          c.   capsule analgesics

          d.   tablet analgesics

54.     When administering tablets through a gastric tube, they should be crushed with how much warm water?

          a.   10 cc

          b.   20 cc

          c.   30 cc

          d.   40 cc

55.     Administration of rectal medication too high in the rectum may result in:

          a.   rectal bleeding.

          b.   vomiting and diarrhea.

          c.   giving twice the normal dosage of medication.

          d.   absorption of the medication into portal circulation.

56.     The preferred site for an intradermal injection is the:

          a.   forearm.

          b.   back of the upper arm.

          c.   abdomen.

          d.   thigh.

57.     An intradermal injection should be given at a:

          a.   5-10 degree angle.

          b.   10-15 degree angle.

          c.   15-20 degree angle.

          d.   20-25 degree angle.

58.     What is the maximum solution administered for a subcutaneous injection?

          a.   Ý5 cc

          b.   1 cc

          c.   1.5 cc

          d.   2 cc

59.     All of the following are acceptable sites for intramuscular injection EXCEPT the:

          a.   rectus femoris.

          b.   vastus lateralis.

          c.   trapezius.

          d.   deltoid.

60.     An intramuscular injection is given at a:

          a.   15 degree angle.

          b.   45 degree angle.

          c.   90 degree angle.

          d.   100 degree angle.

61.     The two major components of a syringe are the:

          a.   barrel and plunger.

          b.   barrel and needle.

          c.   plunger and needle.

          d.   plunger and cap.

62.     A needle's gauge describes its:

          a.   length.

          b.   diameter.

          c.   sharpness.

          d.   volume.

63.     When administering a medication from an ampule, you should verify all of the following on the label EXCEPT:

          a.   volume.

          b.   medication name.

          c.   dose and concentration.

          d.   expiration.

64.     One advantage of the nonconstituted drug vial is that nonconstituted drugs:

          a.   are easier to administer.

          b.   can be used up to one year after expiration date.

          c.   are less expensive.

          d.   extend the viability of drugs that are unstable in liquid form.

65.     Unlike a non-prefilled syringe, the prefilled syringe does not have a:

          a.   needle.

          b.   barrel.

          c.   plunger.

          d.   cap.

66.     Parenteral delivery of a medication is more predictable because the medication:

          a.   is absorbed at a slower rate.

          b.   solution is measured more accurately.

          c.   bypasses the digestive tract.

          d.   can be given over a longer period of time.

67.     Percutaneous medications are absorbed:

          a.   by the liver and excreted through the kidneys.

          b.   unpredictably due to difficulty in administration.

          c.   slowly through the GI tract.

          d.   through the skin or mucous membranes.

68.     Sublingual drugs are absorbed rapidly because the:

          a.   patient chews them quickly.

          b.   sublingual region is extremely vascular.

          c.   drugs are typically smaller than in the oral route of administration.

          d.   medication is given when the patient is awake and alert.

69.     Ocular medications should be placed on the:

          a.   conjunctival sac.

          b.   inner canthus.

          c.   outer canthus.

          d.   pupil.

70.     To administer an aural medication in a 2-year-old patient, you should place the patient in the:

          a.   prone position and pull the ear up and back.

          b.   prone position and pull the ear down and back.

          c.   lateral recumbent position and pull the ear up and back.

          d.   lateral recumbent position and pull the ear down and back.

71.     You should obtain venous blood when starting an IV on all of the following patients EXCEPT:

          a.   a 4-year-old near-drowning victim.

          b.   a 24-year-old hyperglycemic.

          c.   a 54-year-old having an MI.

          d.   a 74-year-old in cardiac arrest.

72.     Which of the following is the correct sequence for the colored tubes used when drawing blood?

          a.   blue, green, purple, red, gray

          b.   red, blue, green, purple, gray

          c.   purple, green, blue, gray, red

          d.   gray, purple, green, blue, red

73.     Smaller veins such as those on the hands should be avoided for venous blood collection because they are more likely to:

          a.   form an embolus.

          b.   develop infection.

          c.   develop extravasation.

          d.   collapse during retrieval.

74.     Skin should be cleansed prior to obtaining blood directly from the vein with a(n):

          a.   disinfectant.

          b.   antiseptic.

          c.   soap and water solution.

          d.   does not need to be cleaned.

75.     The destruction of red blood cells during blood draws is:

          a.   hemoconcentration.

          b.   hemodialysis.

          c.   hemostatis.

          d.   hemolysis.

76.     All of the following reduce the risk of accidental needle sticks EXCEPT:

          a.   minimizing the tasks performed in the back of a moving ambulance.

          b.   dropping sharps on the floor for disposal after the ambulance has stopped.

          c.   disposing of used sharps in a sharps container.