Chapter 16 Assessment

Nitroglycerin​ (Nitro) is used for patients with recurrent chest pain or a history of heart attack. Nitro is most commonly supplied in what two​ forms?
A.
Ointment and pills
B.
Pills and spray
C.
Aerosol and spray
D.
Pills and injectable
B
Nitroglycerin is indicated for which of the following chief​ complaints?
A.
Headache
B.
Decreased level of consciousness
C.
Difficulty breathing
D.
Chest pain
D
You are on the scene at a fancy hotel room for a​ 60-year-old male patient who calls 911 at 10 p.m. for chest pains. He states he was about to go to bed when he suddenly had chest pain that would not go away. He rates his pain as a 7 out of 10 and is diaphoretic. His vital signs are​ stable, and he takes medications for​ hypertension, high​ cholesterol, and erectile dysfunction. The patient is allergic to morphine. After placing the patient on​ oxygen, you contact medical control and​ request:
A.
to administer aspirin to the patient.
B.
to administer both aspirin and nitroglycerin to the patient.
C.
no orders.
D.
to administer nitroglycerin to the patient.
A
How does nitroglycerin decrease the level of chest pain that a patient​ experiences?
A.
It constricts the blood​ vessels, forcing more blood into the heart muscle.
B.
It dilates the blood​ vessels, allowing more blood flow to wash away the toxic lactic acid.
C.
It constricts the blood​ vessels, forcing the toxic lactic acid out of the heart.
D.
It dilates the blood​ vessels, allowing more blood to enter the heart muscle.
D
Which of the following medications is most likely to be administered to a chest pain patient with a blood pressure of​ 88/50 and no difficulty​ breathing?
A.
Albuterol
B.
Nitroglycerin
C.
Oxygen
D.
Aspirin
D
What is the first medication that should be administered to a patient experiencing chest pain with difficulty​ breathing?
A.
Nitroglycerin
B.
Aspirin
C.
Albuterol
D.
Oxygen
D
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Albuterol and epinephrine both have bronchodilation properties that improve the amount of oxygen that a person can inhale and absorb.​ However, Albuterol is administered only for​ asthma, whereas epinephrine is administered for both asthma and anaphylaxis. Why is​ epinephrine, and not​ Albuterol, the first choice for​ anaphylaxis?
A.
Albuterol drops the blood pressure too low.
B.
Albuterol slows down the heart rate too much.
C.
Albuterol makes the heart rate increase too much.
D.
Albuterol is not a vasoconstrictor.
D
Epinephrine delivered by​ auto-injector may be indicated for patients with which of the following​ conditions?
A.
Chest pain
B.
Chronic pulmonary diseases
C.
Drug overdose
D.
Severe allergies to​ peanut, shellfish,​ penicillin, or bee stings
D
You are on the scene of a​ 48-year-old male patient complaining of chest pain. He has nitroglycerin prescribed and available. After performing your physical​ examination, you contact medical control and are ordered to assist the patient in taking his nitroglycerin. Five minutes after taking his​ nitroglycerin, the patient complains of being dizzy and having a headache. You lie the patient down on the stretcher and reassess his vital signs. He is now hypotensive. The patient is suffering​ from:
A.
an untoward reaction to nitroglycerin.
B.
the side effects of nitroglycerin.
C.
an allergic reaction to nitroglycerin.
D.
an anaphylactic reaction to nitroglycerin.
B
Which of the following is an example of a​ medication’s trade​ name?
A.
4 dihydroxyphenyl acetate
B.
Oxygen
C.
Nitrostat
D.
Epinephrine
C
Bronchodilator inhalers have several common side​ effects, which​ include:
A.
decreased blood pressure and increased heart rate.
B.
vasoconstriction and increased heart rate.
C.
bronchodilation and decreased heart rate.
D.
jitteriness and increased heart rate.
D
Which of the following is often prescribed for a patient with a heart​ condition?
A.
Ventolin
B.
Epinephrine​ auto-injector
C.
Nitroglycerin
D.
​Non-aspirin pain relievers such as Tylenol
C
Choose the correct completion to this statement regarding IV​ administration: This route is used to administer medication into the body directly or through the bloodstream and​ is:
A.
allowed in larger cities and more advanced EMS services.
B.
beyond the scope of the EMT level.
C.
used in advanced life support only when the patient is intubated.
D.
only performed by air medical personnel.
B
You have just administered nitroglycerin to a​ 68-year-old patient. Within a few​ minutes, she complains of feeling faint and​ lightheaded, but states that she is still having some chest pain. Which of the following would be the BEST sequence of​ actions?
A.
Advise the patient that this is a normal occurrence and administer a second dose of nitroglycerin.
B.
Administer activated charcoal to prevent further absorption of the nitroglycerin and closely monitor the​ patient’s blood pressure.
C.
Lower the head of the stretcher and take the​ patient’s blood pressure.
D.
Increase the amount of oxygen you are giving to the patient before administering a second dose of nitroglycerin.
C
Which of the following BEST describes the five​ rights?
A.
Right​ decision, right​ medication, right​ order, right​ dose, right place
B.
Right​ patient, right​ medication, right​ time, right​ dose, right route
C.
In​ date, right​ medication, right​ order, right​ dose, right time
D.
Right​ patient, right​ medication, in​ date, right​ dose, right route
B
A serious negative interaction for giving Nitrostat is a drug interaction with what​ medications?
A.
Oral​ glucose, Viagra, and aspirin
B.
​Viagra, Levitra, or medication for erectile dysfunction
C.
​Sildenafil, vardenafil, and epinephrine
D.
​Nitroglycerin, Ventolin, and epinephrine
B
What condition must be present before you give oral​ glucose?
A.
The patient must not have a history of diabetes.
B.
The patient must be conscious and able to swallow with an altered mental status and history of diabetes.
C.
The​ patient, if​ conscious, must be able to​ swallow; if​ unconscious, you can apply the gel to a tongue depressor and place it between the cheek and gum or under the tongue.
D.
The patient must be unconscious and have a history of diabetes.
B
How does aspirin actually reduce the chances that a patient suffering a heart attack will​ die?
A.
It reduces the inflammation in the heart.
B.
It reduces the ability of the blood to form clots.
C.
It prevents a deadly fever from developing.
D.
It reduces the amount of pain in the heart.
B
The study of the effects of medications on the body in relation to age and weight is​ called:
A.
pharmacology.
B.
pharmacodynamics
C.
pharmacokinetics.
D.
measurement and documentation.
B
What is the reason for giving an epinephrine​ auto-injector in a​ life-threatening allergic​ reaction?
A.
It will help dilate the​ patient’s blood vessels and relax the airway passages.
B.
It will help raise the​ patient’s blood pressure and slow the heart rate.
C.
It will help constrict the​ patient’s blood vessels and relax the airway passages.
D.
It will constrict the​ patient’s airway passages and blood vessels.
C
Which of the following describes the sublingual route of medication​ administration?
A.
The medication is injected under the skin.
B.
The medication is placed under the tongue.
C.
The medication is breathed into the​ lungs, such as from an inhaler.
D.
The medication is swallowed​ whole, not chewed.
B
Name the type of medical direction consisting of standing orders and protocols.
A.
Written
B.
​On-line
C.
Verbal
D.
​Off-line
D
You are on the scene of a​ 44-year-old female patient who has attempted suicide by taking all 30 pills of her antidepressant medication at once. You are ordered by medical control to administer activated charcoal. How will activated charcoal reduce the effects of the​ medication?
A.
Activated charcoal will inactivate the​ patient’s stomach acid.
B.
Activated charcoal will bind to the​ medication, reducing absorption.
C.
Activated charcoal will coat the​ intestines, preventing absorption.
D.
Activated charcoal will cause the patient to vomit the medication.
B
The epinephrine​ auto-injector is given via the​ ________ route.
A.
enteral
B.
oral
C.
digestive
D.
parenteral
D
Nitroglycerin is given via the​ ________ route.
A.
enteral
B.
sublingual
C.
lingual
D.
parenteral
B
Which of the following statements is true concerning​ oxygen?
A.
Never give oxygen to a chronic obstructed pulmonary disease​ (COPD) patient.
B.
Always document the need for oxygen by pulse oximetry before giving it to the patient.
C.
Never withhold oxygen to any patient who needs it.
D.
Only withhold oxygen to anyone who is allergic to it.
C
What medication is given when a patient suffers from a medical or traumatic condition called​ hypoxia?
A.
Oral glucose
B.
Aspirin
C.
Oxygen
D.
Epinephrine
C
A​ drug’s form refers to which of the​ following?
A.
Its physical​ state, such as​ powder, liquid, or gas
B.
The way in which it is administered
C.
The mandatory paperwork that must be completed when giving any drug
D.
The type of container it comes in
A
The symptoms or circumstances for which a medication is given are​ called:
A.
untoward effects.
B.
indications.
C.
contraindications.
D.
side effects.
B
Which of the following instructions should you give to a patient whom you are about to assist with administering​ epinephrine?
A.
Insert the mouthpiece and inhale deeply as you depress the canister.
B.
I am going to inject medication into your thigh.
C.
Open your mouth and lift your tongue so I can spray this medication under your tongue.
D.
This is not pleasant​ tasting, but it is important that you drink all of it.
B
Which of the following is a desired action of epinephrine delivered by​ auto-injector?
A.
Dilation of coronary arteries
B.
Decrease in blood pressure
C.
Constriction of coronary arteries
D.
Constriction of blood vessels
D
Your patient is a​ 59-year-old woman with a history of emphysema. Per​ protocol, you have assisted the patient in using her medication inhaler. Which of the following must be​ documented?
A.
Expiration date of the medication
B.
​Patient’s response to the medication
C.
Chemical name of the medication
D.
All of the above
B
When you give patients​ nitroglycerin, they sometimes develop a headache. This would be called​ a(n):
A.
untoward effect.
B.
side effect.
C.
indication.
D.
contraindication.
B
You are called to assist a​ 25-year-old female patient who is in profound respiratory distress. The patient has a history of asthma and severe allergies to peanuts. She has a prescribed albuterol inhaler and an epinephrine​ auto-injector. The patient states she was working in her garden when she accidentally stirred up a​ hornets’ nest and was stung multiple times. The patient has wheezing in all​ fields, and is breathing at 28 times per minute. She states that she triggered her asthma by running across the yard to the safety of her home. As you apply​ oxygen, you notice that she is now speaking in​ two- to​ three-word sentences, her skin has​ splotches, and her tongue and neck appear to be swelling. Your next action is to call medical control and then do​ what?
A.
Request to assist the patient with her epinephrine pen for anaphylaxis.
B.
Do not request to give epinephrine. It was prescribed for a peanut​ reaction, not for asthma.
C.
Request to assist the patient with her Albuterol inhaler for her asthma.
D.
Request to assist the patient with her Albuterol for anaphylaxis.
A
You are called to an elementary school for an​ 8-year-old female patient who is experiencing respiratory distress. The school nurse states the patient has an epinephrine​ auto-injector for a possible anaphylactic reaction to bee stings. The patient also has an Albuterol inhaler for asthma. The patient is breathing 30 times a​ minute, is in the tripod​ position, and is speaking in​ two- to​ three-word sentences. The nurse states the patient was playing basketball in the gym when she started having difficulty breathing. The patient has wheezing in all lung fields. An ALS unit is en route but it is 10 minutes away. You are 20 minutes away from the nearest hospital. After placing the patient on​ oxygen, your next intervention should be​ to:
A.
contact medical control and request to assist the patient with her Albuterol.
B.
provide supportive care until the ALS unit arrives.
C.
contact medical control and request to assist the patient with her epinephrine.
D.
cancel the ALS unit and call medical control to assist with the Albuterol administration while en route to the hospital.
A
What are the names given to each medication listed in the U.S. Pharmacopoeia​?
A.
​Official, chemical, and generic
B.
​Trade, chemical, and generic
C.
​Trade, brand, and generic
D.
​Manufacturers, general, and governmental
B
You respond to a medical call for a​ 59-year-old female complaining of tightness in her chest. You place her on a high concentration of oxygen and prepare for a short​ 5-minute transport to the hospital. The patient tells you she is on​ nitroglycerin, which she has not taken. Your partner tells you that you can give aspirin per protocol. Should you delay the patient transport to give the medication and​ why?
A.
​No, any delay will cause the patient more​ stress; she needs to be in a definitive care facility.
B.
​Yes, the nitroglycerin will cause the blood vessels to dilate and restore some blood​ flow, and the aspirin will slow the clotting process.
C.
​No, any delay will cause the patient more heart​ damage; each delay weakens the myocardium.
D.
​Yes, the nitroglycerin will cause the heart to beat stronger and restore some blood​ flow, and the aspirin will ease the pain.
B
The​ EMT, after administering any​ medication, must do which of the​ following?
A.
Reconsider the five​ rights, reassess the​ patient, and contact medical control.
B.
Document the​ route, dose, and​ time; reassess the​ patient; and​ re-administer the medication.
C.
Wait 5​ minutes, repeat the medication if​ needed, and reassess the​ patient’s vitals.
D.
Document the​ administration, reassess the​ patient, and report to the receiving facility.
D
How is activated​ charcoal, which is carried by some EMS​ systems, supplied for use in emergency​ situations?
A.
As a fine liquid spray for inhalation
B.
As a​ powder, which is mixed with water before administration
C.
As tablets
D.
As a gel or paste
B
Which of the following is a commonly accepted list of medications an EMT can assist the patient in taking or administer under the direction of the Medical​ Director?
A.
​Aspirin, oral​ glucose, oxygen, prescribed bronchodilator​ inhalers, nitroglycerin, and epinephrine​ auto-injectors
B.
Prescribed bronchodilator​ inhalers, prescribed​ nitroglycerin, and prescribed epinephrine​ auto-injectors
C.
​Aspirin, acetaminophen, oral​ glucose, insulin, prescribed bronchodilator​ inhalers, nitroglycerin, and epinephrine​ auto-injectors
D.
Any​ over-the-counter medication, oral​ glucose, and oxygen
A
Why would an EMT give aspirin to a​ patient?
A.
It is given to calm the patient by reducing the pain because stress is the real killer.
B.
Aspirin reduces the​ blood’s ability to clot and works to prevent further clot formation in patients suffering chest pain.
C.
Aspirin reduces the​ heart’s ability to beat fast and works to prevent rapid heart rate.
D.
Aspirin reduces the pain level in patients who are in pain.
B
Why should EMTs study​ pharmacology?
A.
As an​ EMT, you will be trusted to administer medications in emergency​ situations, although many of these may do nothing but give the patient false hope.
B.
An EMT must know the​ manufacturer, sources,​ characteristics, and effects of every medication that has been prescribed to the patient.
C.
An EMT must know the​ sources, characteristics, and effects of each medication that the physician may prescribe.
D.
As an​ EMT, you will be trusted to administer medications in emergency​ situations; many of these may be​ lifesaving, but there is potential to do harm.
D
What is the first step in giving aerosol​ medications?
A.
Make sure the patient is suffering from​ asthma, emphysema, or bronchitis.
B.
Complete the primary assessment and take vital signs.
C.
Contact medical control to receive permission to give the medication.
D.
Determine that the inhaler actually belongs to the patient.
D
Which of the following BEST describes a contraindication to a​ medication?
A.
The way in which a drug causes its effects
B.
A reason why you should give a medication to a patient
C.
An unintended action of the drug
D.
A reason why you should a never giving a medication to a patient
D
Which of the following is a potential side effect of​ nitroglycerin?
A.
Decreased blood pressure
B.
Difficulty breathing
C.
Sudden decrease in heart rate
D.
All of the above
A
You are on the scene of a​ 68-year-old patient with a history of COPD who is breathing 44 times per minute and has a diminished level of consciousness. His wife states he has an Albuterol inhaler and nitroglycerin tablets for angina. What is the most important drug you can administer to the​ patient?
A.
Oxygen by​ bag-valve mask
B.
Albuterol
C.
Nitroglycerin
D.
Oxygen by nonrebreather mask
A
An EMT is on the scene of a​ 48-year-old male patient complaining of chest pain. He has nitroglycerin prescribed and available. After performing the primary and secondary​ assessments, the EMT contacts medical control and is ordered to assist the patient in taking his nitroglycerin.​ Carefully, the EMT performs the​ “five rights” and checks the expiration before administering the medication. The patient states the medicine is not helping his pain. The patient also states he does not have a headache. Reassessment of the​ patient’s vital signs shows no change in blood pressure. The EMT suspects the nitro is not working because​ the:
A.
medication was somehow rendered inert.
B.
medication is not nitroglycerin.
C.
medication is expired.
D.
EMT only gave one tablet instead of two.
A