Chapter 14 - Medication Administration

Question 1

Approximately ___% of an adult male’s weight is constituted by water.
A) 40
B) 50
C) 60
D) 70

Answer 1

C) 60

Question 2

Intracellular fluid:
A) is the fluid that bathes the cells.
B) transports red and white blood cells.
C) is the water contained inside the cells.
D) accounts for about 15% of body weight.

Answer 2

C) is the water contained inside the cells.

Question 3

Cerebrospinal fluid and intraocular fluid are types of:
A) plasma.
B) interstitial fluid.
C) intracellular fluid.
D) intravascular fluid.

Answer 3

B) interstitial fluid.

Question 4

In a 175-lb man, intravascular fluid accounts for approximately ____ lb.
A) 8
B) 9
C) 10
D) 12

Answer 4

A) 8

Question 5

A composition of dissolved elements and water is called a(n):
A) solute.
B) solvent.
C) solution.
D) electrolyte.

Answer 5

C) solution.

Question 6

Solutes are defined as:
A) atoms that carry an electrical charge.
B) solutions that exclusively carry electrolytes.
C) solutions that contain dissolved components.
D) the dissolved particles contained in a solvent.

Answer 6

D) the dissolved particles contained in a solvent.

Question 7

Which of the following statements regarding electrolytes is correct?
A) Electrolytes are nonreactive and relatively harmless if they are left to circulate in the body.
B) Electrolytes are also called ions and dissociate into charged components when placed in water.
C) Electrolytes help to regulate muscular contraction, but have no effect on cardiac function.
D) Electrolyte charges are stabilized by blood so that they can aid in the body’s metabolic functions.

Answer 7

B) Electrolytes are also called ions and dissociate into charged components when placed in water.

Question 8

Cations are electrolytes that have an overall __________ charge, and anions are electrolytes that have an overall ___________ charge.
A) negative, neutral
B) positive, negative
C) neutral, positive
D) negative, positive

Answer 8

B) positive, negative

Question 9

Major cations of the body include all of the following, EXCEPT:
A) sodium.
B) calcium.
C) potassium.
D) bicarbonate

Answer 9

D) bicarbonate

Question 10

Which of the following electrolytes is NOT a cation?
A) Chloride
B) Calcium
C) Potassium
D) Magnesium

Answer 10

A) Chloride

Question 11

The milliequivalent (mEq) represents the chemical combining power of the ion and is based on the:
A) percentage of sodium in a given electrolyte solution.
B) ability to unite with an electrolyte with the same charge.
C) number of available ionic charges in an electrolyte solution.
D) ratio of positively and negatively charged ions.

Answer 11

C) number of available ionic charges in an electrolyte solution.

Question 12

Sodium is a ________ cation and can react completely with _______.
A) monovalent, 1 mEq of a singly charged anion
B) bivalent, 2 mEq of a doubly charged cation
C) monovalent, 2 mEq of a singly charged anion
D) bivalent, 1 mEq of a doubly charged cation

Answer 12

A) monovalent, 1 mEq of a singly charged anion

Question 13

Which of the following statements regarding calcium is correct?
A) Calcium is needed for bone growth and proper blood clotting.
B) Patients with ataxia should be suspected of being hypocalcemic.
C) Calcium can react completely with 1 mEq of a singly charged anion.
D) Abdominal cramps are a sign of an increased level of serum calcium.

Answer 13

A) Calcium is needed for bone growth and proper blood clotting.

Question 14

The principal extracellular cation that regulates the distribution of water throughout the body is:
A) calcium.
B) sodium.
C) chloride.
D) phosphorus.

Answer 14

B) sodium.

Question 15

Potassium:
A) helps stimulate the release of insulin.
B) is found predominantly outside the cell.
C) is a bivalent cation that tends to follow water.
D) plays a major role in neuromuscular function.

Answer 15

D) plays a major role in neuromuscular function.

Question 16

Hyperkalemia would MOST likely result in:
A) abnormal gastrointestinal function.
B) decreased skeletal muscle function.
C) hyperstimulation of neural cell transmission.
D) severe bradycardia due to increased vagal tone.

Answer 16

C) hyperstimulation of neural cell transmission.

Question 17

The primary buffer used in all circulating body fluids is:
A) bicarbonate.
B) phosphorus.
C) potassium.
D) magnesium.

Answer 17

A) bicarbonate.

Question 18

The chemical sign for sodium bicarbonate is:
A) NaCl.
B) H2CO3.
C) NaHCO3.
D) KCl.

Answer 18

C) NaHCO3.

Question 19

Which of the following electrolytes plays the MOST active role in metabolism?
A) Potassium
B) Magnesium
C) Bicarbonate
D) Phosphorus

Answer 19

B) Magnesium

Question 20

The movement of compounds or charges across a cell membrane to an area of lower concentration is called:
A) osmosis.
B) diffusion.
C) filtration.
D) selective permeability.

Answer 20

B) diffusion.

Question 21

The antidiuretic hormone (ADH) prevents the loss of water from the kidneys during the process of:
A) osmosis.
B) dialysis.
C) diffusion.
D) filtration.

Answer 21

D) filtration.

Question 22

Pumping sodium out of the cell and potassium into the cell has the added benefit of:
A) moving glucose into the cell at the same time.
B) transiently decreasing serum levels of calcium.
C) facilitating water reabsorption in the renal tubules.
D) expending minimal levels of adenosine triphosphate.

Answer 22

A) moving glucose into the cell at the same time.

Question 23

Osmosis occurs when:
A) water moves from an area of higher solute concentration to an area of lower solute concentration.
B) solutes move from an area of lower water concentration to an area of higher water concentration.
C) water moves from an area of lower solute concentration to an area of higher solute concentration.
D) solutes move from an area of higher water concentration to an area of lower water concentration.

Answer 23

C) water moves from an area of lower solute concentration to an area of higher solute concentration.

Question 24

The net effect of osmosis is to:
A) balance the concentration of water on both sides of the cell wall.
B) equalize solute concentrations on both sides of the cell membrane.
C) utilize ATP to actively move solutes across the cell membrane.
D) maintain a higher concentration of solutes outside of the cell.

Answer 24

B) equalize solute concentrations on both sides of the cell membrane.

Question 25

The tonicity of a solution is determined by the:
A) velocity with which potassium ions shift outside of the cell and sodium ions shift inside the cell.
B) permeability of the cell and the ability of sodium and potassium to actively move across its membrane.
C) amount of antidiuretic hormone the body produces and the volume of water that is reabsorbed in the tubules of the kidneys.
D) concentration of sodium in a solution and the movement of water in relation to the sodium levels inside and outside the cell.

Answer 25

D) concentration of sodium in a solution and the movement of water in relation to the sodium levels inside and outside the cell.

Question 26

The internal environment’s resistance to change is called:
A) hemostasis.
B) homeostasis.
C) hypertonicity.
D) hypotonicity.

Answer 26

B) homeostasis.

Question 27

A healthy person loses approximately ___ to ___ liters of fluid daily through urine output, through exhalation, and through the skin.
A) 0.5, 1
B) 1, 1.5
C) 2, 2.5
D) 3, 4

Answer 27

C) 2, 2.5

Question 28

Which of the following statements regarding dehydration is correct?
A) It is often a chronic condition in elderly patients and may take days to manifest.
B) During early dehydration, a profound loss of interstitial fluid occurs in the body.
C) In younger patients, dehydration is typically caused by an acute loss of more than 50 mL of blood.
D) During dehydration, fluid shifts from the extracellular compartment to the intracellular compartment.

Answer 28

A) It is often a chronic condition in elderly patients and may take days to manifest.

Question 29

Signs and symptoms of dehydration include all of the following, EXCEPT:
A) bradypnea.
B) flushed, dry skin.
C) postural hypotension.
D) dry mucous membranes.

Answer 29

A) bradypnea.

Question 30

Overhydration occurs when:
A) a patient experiences prolonged periods of severe hyperventilation.
B) the left side of the heart fails and blood backs up into the systemic circulation.
C) the intracellular compartment becomes engorged due to a decrease in vascular volume.
D) fluid is forced from the engorged interstitial compartment into the intracellular compartment.

Answer 30

D) fluid is forced from the engorged interstitial compartment into the intracellular compartment.

Question 31

A common cause of overhydration is:
A) hypertension.
B) kidney failure.
C) gastrointestinal drainage.
D) prolonged hyperventilation.

Answer 31

B) kidney failure.

Question 32

Signs and symptoms of overhydration include:
A) edema.
B) oliguria.
C) weight loss.
D) wheezing.

Answer 32

A) edema.

Question 33

IV fluids introduced into the circulatory system:
A) are only effective if the patient is experiencing renal insufficiency.
B) will always cause a fluid shift out of the intracellular compartment.
C) can affect the tonicity of the extracellular fluid and can be harmful.
D) usually do not cause a fluid shift into or out of the intracellular space.

Answer 33

C) can affect the tonicity of the extracellular fluid and can be harmful.

Question 34

Which of the following statements regarding isotonic solutions is correct?
A) Isotonic solutions have almost the same osmolarity as bodily fluids.
B) D5W becomes an isotonic solution once it is introduced into the body.
C) Normal saline is the only isotonic solution used in the prehospital setting.
D) Isotonic solutions expand the vascular space by shifting fluid from other compartments.

Answer 34

A) Isotonic solutions have almost the same osmolarity as bodily fluids.

Question 35

A solution of water with 0.9% sodium chloride is:
A) hypotonic until it is introduced into the body.
B) capable of carrying oxygen when it is infused.
C) of minimal value in expanding the vascular space.
D) also called normal saline and is an isotonic solution.

Answer 35

D) also called normal saline and is an isotonic solution.

Question 36

It is MOST important to exercise caution when administering isotonic solutions to patients with:
A) hypotension and severe hypovolemia.
B) hypertension and congestive heart failure.
C) dehydration secondary to excessive diarrhea.
D) a history of insulin-dependent diabetes mellitus.

Answer 36

B) hypertension and congestive heart failure.

Question 37

Lactated Ringer’s (LR) solution should not be given to patients with liver problems because:
A) LR is a hypertonic solution and cannot be metabolized by the liver.
B) the lactate contained within LR can cause necrosis of the liver tissue.
C) patients with liver disease commonly experience renal insufficiency.
D) the liver cannot metabolize the lactate in the solution.

Answer 37

D) the liver cannot metabolize the lactate in the solution.

Question 38

Lactated Ringer’s (LR) solution may be beneficial to patients who have lost large amounts of blood because:
A) it takes less LR to effectively expand the intravascular compartment than any other isotonic solution.
B) LR has the ability to carry oxygen and can maintain cellular perfusion until the patient receives definitive care.
C) the lactate contained within LR is converted to bicarbonate in the liver and can help combat intracellular acidosis.
D) the likelihood of causing acute circulatory overload is minimal relative to other hypertonic solutions.

Answer 38

C) the lactate contained within LR is converted to bicarbonate in the liver and can help combat intracellular acidosis.

Question 39

Once D5W is infused into the body:
A) the body metabolizes the dextrose quickly and the solution becomes hypotonic.
B) it causes fluid to shift from the intracellular space into the vascular space.
C) cellular uptake of dextrose occurs and the solution quickly becomes isotonic.
D) it rapidly expands the vascular space and effectively increases blood pressure.

Answer 39

A) the body metabolizes the dextrose quickly and the solution becomes hypotonic.

Question 40

Hypotonic solutions:
A) include normal saline and lactated Ringer’s solution.
B) draw fluid from the cells and into the vascular space.
C) hydrate the cells while depleting the vascular compartment.
D) are the preferred solutions to use in patients with head trauma.

Answer 40

C) hydrate the cells while depleting the vascular compartment.

Question 41

A hypertonic solution has an osmolarity higher than that of serum, meaning that the solution:
A) may cause the cells to expand and rupture due to the increased intracellular osmotic pressure exerted by the solution.
B) has more ionic concentration than serum and pulls fluid and electrolytes from the intracellular and interstitial compartments into the intravascular compartment.
C) contains high concentrations of proteins and can result in fluid overloading in patients with impaired cardiac function or renal insufficiency.
D) has a lower ionic concentration than serum and pulls fluid and electrolytes from the intravascular compartment into the intracellular and interstitial compartments.

Answer 41

B) has more ionic concentration than serum and pulls fluid and electrolytes from the intracellular and interstitial compartments into the intravascular compartment.

Question 42

Which of the following statements regarding isotonic crystalloid solutions is correct?
A) You should infuse 1 mL of isotonic crystalloid solution for every 3 mL of estimated blood loss.
B) Approximately two thirds of infused isotonic crystalloid solution will leave the vascular space within 1 hour.
C) Isotonic crystalloids, such as normal saline, have the ability to carry and deliver oxygen to the body’s cells.
D) The ability of isotonic crystalloids to cross membranes and alter fluid levels makes them dangerous to use for fluid replacement.

Answer 42

B) Approximately two thirds of infused isotonic crystalloid solution will leave the vascular space within 1 hour.

Question 43

Administering large amounts of an isotonic crystalloid solution to a patient with internal bleeding would MOST likely:
A) expand the vascular space and improve systemic perfusion.
B) cause acute hypotension as fluid is drawn from the vascular space.
C) change the ratio of hemoglobin and red blood cells.
D) increase the severity of internal bleeding by interfering with hemostasis.

Answer 43

D) increase the severity of internal bleeding by interfering with hemostasis.

Question 44

How much isotonic crystalloid solution should you administer to a patient who weighs 65 kg and who has signs and symptoms of internal bleeding?
A) Boluses of up to 1,625 mL each
B) 10 to 20 mL/kg every 5 to 10 minutes
C) An amount adequate to maintain perfusion
D) Enough to increase blood pressure to a normal level

Answer 44

C) An amount adequate to maintain perfusion

Question 45

Colloid solutions:
A) contain proteins that are too large to pass out of the capillary membranes, so the solutions remain in the vascular compartment.
B) include solutions such as lactated Ringer’s and normal saline and rapidly expand the intravascular compartment.
C) are safe to use in the prehospital setting because they rapidly and effectively expand the intravascular compartment.
D) do not contain large molecules and are therefore ineffective in expanding the intravascular compartment.

Answer 45

A) contain proteins that are too large to pass out of the capillary membranes, so the solutions remain in the vascular compartment.

Question 46

All of the following are examples of colloid solutions, EXCEPT:
A) dextran.
B) hetastarch.
C) Plasmanate.
D) Lactated Ringer’s.

Answer 46

D) Lactated Ringer’s.

Question 47

Which of the following statements regarding synthetic blood substitutes is correct?
A) Type O-negative blood is a synthetic blood substitute.
B) They have the ability to carry oxygen to the body’s cells.
C) They do not possess the ability to carry and deliver oxygen.
D) Hespan is the most commonly used synthetic blood substitute.

Answer 47

B) They have the ability to carry oxygen to the body’s cells.

Question 48

The use of O-negative blood in the prehospital setting is impractical because:
A) it expires in 24 hours.
B) it requires refrigeration.
C) not everyone can receive O-negative blood.
D) the blood cannot be typed and cross-matched.

Answer 48

B) it requires refrigeration.

Question 49

All of the following are peripheral veins, EXCEPT the:
A) subclavian vein.
B) external jugular vein.
C) veins of the hand.
D) lower extremity veins.

Answer 49

A) subclavian vein.

Question 50

The MOST important point to remember about IV therapy is to:
A) locate the largest vein.
B) wear two pairs of gloves.
C) keep the IV equipment sterile.
D) prepare all supplies ahead of time.

Answer 50

C) keep the IV equipment sterile.

Question 51

Which of the following questions does the paramedic generally NOT ask himself or herself when determining the most appropriate IV solution to use on a patient?
A) Is the patient’s condition critical?
B) Will the patient need medications?
C) Has the patient had IV therapy before?
D) Will the patient need fluid replacement?

Answer 51

C) Has the patient had IV therapy before?

Question 52

In the prehospital setting, the MOST commonly used IV solutions are:
A) colloid solutions.
B) hypotonic crystalloids.
C) hetastarch and saline.
D) isotonic crystalloids.

Answer 52

D) isotonic crystalloids.

Question 53

Once an IV solution is removed from its protective sterile plastic bag, it must be used:
A) immediately.
B) within 24 hours.
C) within 36 hours.
D) within 48 hours.

Answer 53

B) within 24 hours.

Question 54

Once the pigtail is removed from the sterile access port of an IV solution, the solution must be used:
A) immediately.
B) within 24 hours.
C) within 36 hours.
D) within 48 hours.

Answer 54

A) immediately.

Question 55

A microdrip administration set:
A) allows 10 or 15 drops per milliliter.
B) delivers 1 mL for every 60 drops.
C) should be used when patients need fluid replacement.
D) does not contain a needlelike orifice in its drip chamber.

Answer 55

B) delivers 1 mL for every 60 drops.

Question 56

When a patient needs rapid fluid replacement, you should:
A) use a microdrip administration set because you can deliver more precise volumes of IV fluid.
B) choose an administration set that delivers the least amount of volume per the most number of drops.
C) select an administration set that contains a large opening between the piercing spike and drip chamber.
D) use a microdrip administration set in order to avoid inadvertently overloading the patient with fluid.

Answer 56

C) select an administration set that contains a large opening between the piercing spike and drip chamber.

Question 57

When preparing an IV administration set, you should NOT:
A) invert the bag if the drip chamber contains too much fluid.
B) run IV fluid through the administration set to flush air out.
C) fill the drip chamber of the administration set with IV fluid.
D) cleanse the piercing spike before inserting it into the IV bag.

Answer 57

D) cleanse the piercing spike before inserting it into the IV bag.