Chapter 12 Workbook

Question 1

The process by which medications travel through body tissues until they reach the bloodstream

Answer 1

Absorption

Question 2

A situation in which a drug should not be given

Answer 2

Contraindication

Question 3

Any action of a drug other than the desired one

Answer 3

Adverse effect

Question 4

The amount of medication given

Answer 4

Dose

Question 5

Reasons or conditions for which a medication is given

Answer 5

Indication

Question 6

Intended therapeutic effect that a drug is supposed to have

Answer 6

Action

Question 7

The science of drugs and their ingredients, uses, and actions

Answer 7

Pharmacology

Question 8

Gelatin shells filled with powdered or liquid medication

Answer 8

Capsules

Question 9

Lotions, creams, ointments

Answer 9

Topical medications

Question 10

Which of the following is taken into consideration when determining the dose of a medicine?
A. Sex
B. Occupation
C. Ability to swallow
D. Age

Answer 10

D. Age

Question 11

Nitroglycerin relieves the squeezing or crushing pain associated with angina by:
A. dilating the arteries to increase the oxygen supply to the heart muscle
B. causing the heart to contract harder and increase cardiac output
C. causing the heart to beat faster to supply more oxygen to the heart
D. causing the heart to beat faster and more efficiently

Answer 11

A. dilating the arteries to increase the oxygen supply to the heart muscle

Question 12

The brand name that a manufacturer gives to a medication is called the ________ name.
A. trade
B. generic
C. chemical
D. prescription

Answer 12

A. trade

Question 13

The fastest way to deliver a chemical substance is by the ________ route.
A. intravenous
B. oral
C. sublingual
D. intramuscular

Answer 13

A. intravenous

Question 14

Which of the following is considered a relative contraindication to administration of aspirin?
A. Hypersensitivity to aspirin
B. History of asthma
C. Preexisting liver damage
D. History of nausea

Answer 14

B. History of asthma

Question 15

The most common technique for naloxone administration is via the:
A. oral route
B. intramuscular route
C. intranasal route
D. intravenous route

Answer 15

C. intranasal route

Question 16

Outside a hospital, a(n) ________ is the preferred method of giving oxygen to patients who are experiencing significant respiratory distress.
A. nasal cannula
B. nonrebreathing mask
C. bag mask device
D. endotracheal tube

Answer 16

B. nonrebreathing mask

Question 17

Which of the following is NOT a characteristic of epinephrine?
A. Dilating passages in the lungs
B. Secreted naturally by the pituitary gland
C. Increasing the heart rate and blood pressure
D. Dilating blood vessels

Answer 17

B. Secreted naturally by the pituitary gland

Question 18

What medication is commonly administered in a metered dose inhaler (MDI)?
A. Nitroglycerine
B. Albuterol
C. Activated charcoal
D. Naloxone

Answer 18

B. Albuterol

Question 19

Nitroglycerin relieves pain because its purpose is to increase blood flow by relieving the spasms or causing the arteries to:
A. dilate
B. constrict
C. thicken
D. contract

Answer 19

A. dilate

Question 20

Which of the following routes of administration involves medication being absorbed in the fat tissue between the skin and muscle?
A. Intravenous
B. Intramuscular
C. Subcutaneous
D. Intranasal

Answer 20

C. Subcutaneous

Question 21

You are called to a home of a 34 year old male who is unresponsive. When you arrive, you find the patient supine and unconscious on the living room floor, with snoring respirations.

Which of the following medications might be useful in this situation?
A. Nitroglycerin
B. Albuterol
C. Naloxone
D. Aspirin

Answer 21

C. Naloxone

Question 22

You are called to a home of a 34 year old male who is unresponsive. When you arrive, you find the patient supine and unconscious on the living room floor, with snoring respirations.

Which medication commonly comes in gel form?
A. Naloxone
B. Epinephrine
C. Glucose
D. Activated charcoal

Answer 22

C. Glucose

Question 23

You are called to a home of a 34 year old male who is unresponsive. When you arrive, you find the patient supine and unconscious on the living room floor, with snoring respirations.

The government publication listing all drugs in the United States is called the:
A. United States Pharmacopoeia
B. Department of Transportation Reference Guide
C. US Pharmacology
D. Nursing Drug Reference

Answer 23

A. United States Pharmacopoeia

Question 24

You are called to a home of a 34 year old male who is unresponsive. When you arrive, you find the patient supine and unconscious on the living room floor, with snoring respirations.

Oral glucose is ________ for this patient.
A. indicated
B. contraindicated
C. not normally given
D. prescribed

Answer 24

B. contraindicated

Question 25

You are called to a home of a 34 year old male who is unresponsive. When you arrive, you find the patient supine and unconscious on the living room floor, with snoring respirations. Which of the following statements about oxygen is FALSE? A. It is the most commonly administered medication in the prehospital setting. B. It should be administered to all patients. C. It is not safe to use around open flames. D. The nonrebreathing mask is the preferred route of administration for shock.

Answer 25

B. It should be administered to all patients.

Question 26

True/False Oxygen is a catalyst for combustion.

Answer 26

True

Question 27

True/False Oral glucose may be administered to an unconscious patient in order to save his or her life.

Answer 27

False

Question 28

True/False Epinephrine is a hormone produced by the pancreas.

Answer 28

False

Question 29

True/False Nitroglycerin can decrease blood pressure.

Answer 29

True

Question 30

True/False Sublingual medications are rapidly absorbed into the digestive tract.

Answer 30

False

Question 31

True/False Parenteral medications enter the body through the digestive tract.

Answer 31

False

Question 32

True/False Enteral medications enter the body through the skin.

Answer 32

False

Question 33

True/False Nitroglycerin should be administered only when the patient’s systolic blood pressure is above 100 mm Hg.

Answer 33

True

Question 34

________ is a simple sugar that is readily absorbed by the bloodstream.

Answer 34

Glucose

Question 35

________ is the main hormone that controls the body’s fight or flight response.

Answer 35

Epinephrine

Question 36

Nitroglycerin is usually taken ________.

Answer 36

sublingually

Question 37

________ ________ are the effects that are undesirable but pose little risk to the patient.

Answer 37

Unintended effects

Question 38

When given by mouth, ________ may be absorbed from the stomach fairly quickly because the medication is already dissolved.

Answer 38

solutions

Question 39

A(n) ________ is a chemical substance that is used to treat or prevent disease or relieve pain.

Answer 39

medications

Question 40

You and your partner are dispatched to a home on the east side of town for a possible heart attack. On arrival, you are met by a distressed wife who says her husband began having chest pain while mowing the lawn. After obtaining the patient’s vital signs, you begin to take a SAMPLE history. When you ask about medications, the patient begins listing off all of the medications he has been prescribed by his doctor. Nitroglycerin may be contraindicated if the patient was currently taking which of the following medications? A. Albuterol B. Aspirin C. Oxygen D. Sildenafil

Answer 40

D. Sildenafil

Question 41

Your patient is a 73 year old man who complains of severe chest pressure with trouble breathing while having dinner at a local diner. He has a small vial of nitroglycerin in his pocket but says that he has not taken any in several days and needs you to help him to get the vial open. After administering oxygen, what is the first thing that you should do? A. Obtain the patient’s blood pressure and ensure that his systolic pressure is not below 100 mm Hg. B. Begin assisting the patient’s ventilations. C. Place him in the recovery position. D. Check his blood glucose level.

Answer 41

A. Obtain the patient’s blood pressure and ensure that his systolic pressure is not below 100 mm Hg.

Question 42

You are called to the beach for a 15 year old boy who is having trouble breathing. He tells you between gasps that he was stung by something and that his body feels “swollen.” Just then, his mother runs up to you and puts an EpiPen into your hand. “Here,” she says breathlessly. “This is his EpiPen. He needs this!” Would you administer epinephrine to this patient? A. Yes. Push the EpiPen firmly against the patient’s thigh for several seconds. B. No. The EpiPen will make his condition worse. C. Yes. Use the sublingual route. D. No. His signs and symptoms contraindicate an epinephrine injection.

Answer 42

A. Yes. Push the EpiPen firmly against the patient’s thigh for several seconds.

Question 43

“I think she’s drunk!” a bystander yells as you and your partner arrive on the scene of an unknown medical problem. You observe an approximately 45 year old woman stumbling between several cars in the parking lot of a grocery store. As you catch up to the woman, you ask her if she is diabetic. She nods clumsily and leans against one of the cars. You test her blood glucose and obtain a reading of 49 mg/dL. What should you do? A. Administer glucose gel orally. B. Contact medical control for further instructions. C. Restrain her onto the gurney and insert a nasopharyngeal airway. D. Wait for an ALS response so that glucose can be administered intravenously.

Answer 43

A. Administer glucose gel orally.

Question 44

You are dispatched to the county fair for a 54 year old woman complaining of chest pain. You arrive to find her pressing on the center of her chest and note that she has pale, clammy skin. You ask if she has any cardiac history, and she tells you, “No, I just have arthritis, and my doctor says that I am prediabetic.” Her vital signs are: pulse 112 beats/minute, respiratory rate 18 breaths/minute, blood pressure 94/62 mm Hg, and oxygen saturation 99% on room air. Would you give this patient aspirin? A. No. Nitroglycerin would be more appropriate. B. Yes. Her signs and symptoms indicate a cardiac problem, and aspirin could help. C. No. Aspirin is contraindicated for arthritis. D. Yes. Its analgesic properties may help with the discomfort.

Answer 44

B. Yes. Her signs and symptoms indicate a cardiac problem, and aspirin could help.

Question 45

Short Answers List seven routes of medication administration.

Answer 45

1. Intravenous 2. Intramuscular 3. Transcutaneous 4. Oral 5. Intraosseous 6. Inhalation 7. Sublingual 8. Subcutaneous 9. Per rectum 10. Intranasal

Question 46

Short Answers What are the “nine rights” of medication administration?

Answer 46

1. Right patient 2. Right medication and indication 3. Right dose 4. Right route 5. Right time 6. Right education 7. Right to refuse 8. Right response and evaluation 9. Right documentation

Question 47

Short Answers List three characteristics of epinephrine.

Answer 47

1. Secreted naturally by the adrenal glands 2. Dilates lung passages 3. Constricts blood vessels 4. Increases heart rate and blood pressure

Question 48

Short Answers What are the steps for administering intranasal naloxone?

Answer 48

1. Obtain medical direction per local protocol. 2. Confirm correct medication and expiration date. 3. Attempt to determine if the patient is allergic to any medications. 4. Prepare the medication and attach the atomizer. 5. Place the atomizer in one nostril, pointing up and slightly outward. 6. Administer a half dose (1 mL maximum) into each nostril. 7. Reassess the patient and document appropriately.

Question 49

Short Answers List four effects of nitroglycerin.

Answer 49

1. Relaxes the muscular walls of the coronary arteries and veins 2. Results in less blood returning to the heart 3. Decreases blood pressure 4. Relaxes arteries throughout the body 5. Often causes a mild headache and/or burning under the tongue after administration

Question 50

Short Answers Explain why metered‑dose inhalers are often used with a spacer.

Answer 50

To avoid misdirecting the spray of the MDI and ensure inhalation of all medication.

Question 51

Ambulance Calls You are dispatched to “difficulty breathing” at one of your town’s many parks. As you near the park entrance, you see a crowd of people who frantically wave for you. You arrive to find a city employee who was apparently mowing the park grounds when he accidentally mowed over a yellow jacket nest. He was wearing coveralls, but he was repeatedly stung around his neck and face. He appears to be somewhat confused; you can hear stridor with each inspiration, and his blood pressure is 80/40 mm Hg. Your local protocols allow EMTs to carry EpiPens. How do you best manage this patient?

Answer 51

This patient is in serious trouble. The history of the events combined with his level of consciousness, stridor, and hypotension are obvious signs of an anaphylactic reaction. You must immediately administer epinephrine in order to counteract the effects of the insect stings (ie, histamine release). If available, ALS providers should be requested. If not available, transport to the nearest appropriate facility should occur without delay. With the presence of multiple stings, this patient will likely need repeat doses of epinephrine as well as the administration of antihistamines, breathing treatments, and possibly advanced airway maneuvers. Your partner should apply high flow oxygen and remove any remaining stingers in the neck or face by scraping them from the skin. Your prompt action is essential to patient survival.

Question 52

Ambulance Calls You are dispatched to an “unknown medical problem” at the Crosstown Mall. You were called after police were summoned to subdue a combative male shopper. Police officers were able to calm him down but felt that something was “not right” about him. You arrive to find a calm but confused man who is sweaty and pale. He has no complaints but keeps repeating, “I have to get home now.” You notice a medical ID bracelet indicating that this patient is an insulin dependent diabetic. How do you best manage this patient?

Answer 52

This patient is most likely suffering from hypoglycemia. Although this patient is confused, he is able to talk and swallow. Some states allow EMTs to perform blood glucose tests, and this would provide information regarding this patient’s blood glucose level. If your local protocols do not allow for this skill, you can gather much information about this patient through his physical signs and medical history (all indicative of low blood sugar). You should administer (at least) one tube of oral glucose and reassess his mentation and vital signs. Provide treatment and transport according to local protocols.

Question 53

Ambulance Calls You are dispatched to the residence of a 68 year old man who is complaining of “crushing” chest pain radiating down his left arm and trouble breathing for the past hour. He is pale, cool, diaphoretic, and is very nauseated. He tells you he had a heart attack several years ago and takes nitroglycerin as needed. He took two tablets prior to your arrival and reports no relief. How would you best manage this patient?

Answer 53

Place the patient in a position of comfort. Call for an ALS unit to assist. Give 100% oxygen via a nonrebreathing mask. Check blood pressure. Check the expiration date on the nitroglycerin. Contact medical control for permission to assist the patient with one nitroglycerin tablet, sublingual. Monitor vital signs. Provide rapid transport.