Deck 14: Intravenous Access and Medication Administration

Question 1

When preparing for venipuncture, a constricting band should be applied tight enough to restrict ________ flow.

A) venous but not arterial
B) arterial but not venous
C) neither arterial nor venous
D) both arterial and venous

Answer 1

venous but not arterial

Question 2

Which of the following is a disadvantage of pulmonary drug administration via nebulizer or metered dose inhaler?

A) It requires a larger dose than other routes.
B) It requires the patient to have adequate ventilation.
C) Pulmonary absorption is a slow route for drug administration.
D) Side effects are more likely with pulmonary drug administration.

Answer 2

It requires the patient to have adequate ventilation.

Question 3

Which of the following would NOT be appropriate for intradermal drug administration?

A) 27 gauge, 3/8ʺ needle
B) 20 gauge, 3/4ʺ needle
C) 25 gauge, 1ʺ needle
D) 25 gauge, 3/4ʺ needle

Answer 3

20 gauge, 3/4ʺ needle

Question 4

Which of the following types of medication would be placed in a soufflé cup for administration to a patient?

A) Suppository
B) Powder
C) Syrup
D) Tablet

Question 5

You are to give your patient 50 mg of ketorolac (Toradol) IM for musculoskeletal pain. Ketorolac is supplied 60 mg/2 mL. What volume of drug (in mL) is to be drawn up for administration?

A) 0.17
B) 1.7
C) 17
D) 170

Question 6

Into which of the following containers would it be necessary to inject a volume of air equal to the intended volume of medication before withdrawing the medication with a needle and syringe?

A) Ampule
B) Vial
C) Nebulizer
D) Prefilled syringe

Question 7

Which of the following is the appropriate method for preparing a site for venipuncture or injection?

A) Chemical sterilization
B) Use of a disinfectant
C) Use of an antiseptic
D) Use of a sanitizer

Question 8

A plastic or glass container with a self-sealing rubber top is known as a(n):

A) vial.
B) blister pack.
C) ampule.
D) prefilled syringe.

Question 9

Using microdrip IV tubing, how many drops of fluid equal 1 mL?

A) 60
B) 10
C) 20
D) 15

Question 10

Administration of medication into the dorsal gluteal muscle must be injected into which quadrant of the muscle?

A) Upper inner
B) Upper outer
C) Lower outer
D) Lower inner

Question 11

The maximum volume of medication to be delivered into the deltoid muscle is ________ mL.

A) 3
B) 1
C) 2
D) 5

Question 12

A liquid preparation that contains small particles of a solid medication is known as a(n):

A) suspension.
B) elixir.
C) syrup.
D) reconstituted medication.

Question 13

A solid disk of compressed medicated powder, which may be scored to permit breaking, is known as a:

A) suppository.
B) capsule.
C) tablet.
D) lozenge.

Question 14

Which of the following is appropriate for a subcutaneous injection of medication?

A) Volume of 1 mL or less
B) 18 gauge, ¾ʺ needle
C) Insertion of the needle at a 90-degree angle
D) Up to 2 mL of medication

Question 15

Your patient is a 46-year-old with a history of pancreatitis. He has had abdominal pain and vomiting for 24 hours. The ED physician requests that you initiate an IV for rehydration. You will be using a 15 drops/mL infusion set to administer 250 mL of 5 percent dextrose in 0.9 percent NS per hour. What drip rate (at drops/minute) is needed to deliver the fluids at this rate?

A) 41
B) 63
C) 75
D) 100

Question 16

Your protocols call for a dopamine infusion beginning at 5 micrograms per kilogram per minute. You estimate that your patient weighs 190 pounds. Using a standard dopamine concentration of 800 mg in 500 mL, at what drip rate (in drops/minute) will you need to administer the infusion using microdrip tubing?

A) 27
B) 432
C) 4
D) 16

Question 17

By which of the following routes will medication have the quickest onset of action?

A) Intramuscular
B) Subcutaneous
C) Oral
D) Intradermal

Question 18

Which of the following is a disadvantage to intravascular volume replacement with isotonic crystalloid solutions?

A) Two-thirds of the volume leaves the intravascular space within 1 hour.
B) Intracellular fluid shifts to the vascular space.
C) Sodium shifts into cells, and potassium shifts out of cells.
D) There is an immediate shift of vascular volume to the interstitial space.

Question 19

Your patient weighs 22 pounds and is to receive 0.02 mg/kg of atropine IV push. You have a multidose vial of atropine containing 20 mL at a concentration of 0.04 mg/mL. What volume (in mL) of medication is to be injected?

A) 0.5
B) 2.5
C) 0.25
D) 5

Question 20

Which of the following is considered a site of central venous access?

A) Femoral vein
B) Median cephalic vein
C) External jugular vein
D) Saphenous vein

Question 21

What is the preferred access site for intraosseous infusion in both pediatric and adult patients?

A) Distal tibia
B) Proximal humerus
C) Distal femur
D) Proximal tibia

Question 22

Which of the following is an advantage of sublingual drug administration?

A) Uniform absorption through the conjunctival mucosa
B) Rapid absorption due to sublingual vasculature
C) Slow rate of drug absorption
D) Rapid dissolution of tablets so the medication can be swallowed

Question 23

Your patient is experiencing right lower quadrant pain following a syncopal episode. She reports that her last menstrual period (LMP) was about six weeks ago. While she is awaiting an abdominal CT, the surgery resident asks that you initiate an IV of lactated Ringer's solution using a blood set (10 drops/mL) and infuse 1 liter over 1 hour. What drip rate (in drops/minute) will you use to attain this rate of administration?

A) 17
B) 600
C) 67
D) 167

Question 24

What is defined as the removal or destruction of disease-causing organisms or infected material by using hygienic measures, cleaning agents, antiseptics and/or disinfectants?

A) Medical asepsis
B) Sterilization
C) Cauterization
D) Standard Precautions

Question 25

Administration of a medication to the right eye would be documented medically as:

A) o.d.
B) o.u.
C) o.s.
D) o.g.

Question 26

Which of the following catheters would allow the greatest volume of fluid to be delivered in a given period?

A) 16 gauge, 2ʺ
B) 14 gauge, ʺ
C) 16 gauge, ʺ
D) 14 gauge, 2ʺ

Question 27

Which of the following is a parenteral route of drug administration?

A) Gastric tube
B) Oral
C) Intramuscular
D) Rectal

Question 28

Which of the following is NOT a percutaneous route of medication administration?

A) Buccal
B) Sublingual
C) Transdermal
D) Inhalation

Question 29

Which of the following is a medication that, when inserted into a body opening, dissolves into the surrounding mucosa?

A) Suppository
B) Ointment
C) Liniment
D) Enteric-coated capsule

Question 30

Having a patient swallow a tablet of medication with a drink of water is an example of which route of medication administration?

A) Buccal
B) Sublingual
C) Aural
D) Oral

Question 31

Your patient is having a cholecystectomy this evening. To prevent dehydration, she is to receive 5 percent dextrose in 0.45 percent saline solution at a rate of 150 mL/hour. Using 20 drops/mL tubing, what is the drip rate in drops/minute?

A) 150
B) 75
C) 60
D) 50

Question 32

Which of the following is NOT a route for enteral medication administration?

A) Buccal
B) Oral
C) Rectal
D) Gastric

Question 33

Which of the following is NOT a pulmonary route of medication administration?

A) Inhalation of aerosolized medications
B) Instillation of liquid medications into an endotracheal tube
C) Nasal drops and sprays
D) Nebulization of liquid medications by pressurized air

Question 34

Which of the following veins is NOT a site of peripheral venous access?

A) Subclavian
B) Median basilic
C) Saphenous
D) External jugular

Question 35

Which of the following is a contraindication to intraosseous needle placement?

A) Establishment of a peripheral IV line
B) Development of a pulmonary embolism
C) Too large a needle or forceful insertion
D) Long-term growth complications and swelling

Question 36

Which of the following solutions is appropriate for the patient needing vascular volume replacement in the prehospital setting?

A) 0.9 percent sodium chloride solution
B) Dextran 40
C) 5 percent dextrose in water
D) 0.45 percent sodium chloride and 5 percent dextrose in water

Question 37

Shortly after starting an IV on your patient, you note that the IV is not dripping. You have removed the constricting band, and all the clamps on the tubing are open. You note that there is minor swelling around the venipuncture site. There is no discoloration of the site, but it is cool and firm to the touch. Which of the following most likely accounts for your findings?

A) The site has become infected.
B) The tip of the catheter is occluded by a blood clot.
C) Fluids extravasated into the tissue surrounding the IV site.
D) The tip of the catheter is occluded by a valve in the vein.

Question 38

What must be done to the concentration of a medication if it is given endotracheally?

A) 2 to 2.5 times normal IV dose
B) 1.5 times normal IV dose
C) Same as IV dose
D) 3 times the IV dose

Question 39

Just as you are arriving at the emergency department bay, your patient, on whom you started an IV at the scene, complains of sudden chills, back pain, and nausea. The patient appears flushed, and his skin is hot and moist to the touch. Which of the following most likely accounts for your patient's presentation?

A) Pulmonary thromboembolism
B) Pyrogenic reaction
C) Circulatory overload
D) Anaphylaxis

Question 40

Which of the following intravenous solutions would remain in the vascular system the longest?

A) Plasmanate
B) 5 percent dextrose in water
C) 0.9 percent sodium chloride
D) Lactated Ringer's solution

Question 41

Paramedics administer some medications under direct authorization from the medical director, and some under:

A) Standard Precautions.
B) administration tubing.
C) blood tubing.
D) standing orders.

Question 42

Which of these procedures does NOT require a constricting band?

A) External jugular IV insertion
B) Peripheral IV insertion
C) Cephalic vein IV insertion
D) Basilic vein IV insertion

Question 43

Which of the following sites on the body is NOT used for an intradermal injection?

A) Abdomen
B) Upper back
C) Upper chest
D) Inside of middle forearm

Question 44

After administering a medication by the nasogastric or orogastric tube, how much fluid should you flush with?

A) 50 mL
B) 20 mL
C) 30 mL
D) 10 mL

Question 45

Which of the following are gravity-flow devices that regulate the fluid's passage through the pump?

A) infusion pumps
B) infusion controllers
C) ultrasound-guided intravenous access devices
D) blood tubes

Question 46

When a patient requires occasional medications or IV drips but does NOT need a continuous infusion, which device might be implanted into a patient?

A) Saline lock
B) IV piggyback
C) Through-the-needle catheter
D) Constriction needle

Question 47

Which of the following is a crystalloid solution?

A) Normal saline
B) Dextran
C) Plasmanate
D) Hespan

Question 48

Dislodgement of the catheter from the vein, puncture of the distal vein wall during venipuncture, and/or a poorly secured IV can lead to what?

A) Extravasation
B) Speed shock
C) Venous spasm
D) Septic shock

Question 49

What is the name of the needle used to access an implanted port?

A) Huber
B) Portacath
C) Broviac
D) Hickman

Question 50

What cleaning supply is toxic to living tissue and used on nonliving surfaces or objects?

A) Disinfectant
B) Antiseptic
C) Soap
D) Gel

Question 51

How do you calculate the administration of a specific amount of drug via infusion, based on weight?

A) Dose ordered × total volume of bag used × drip factor of IV tubing × weight in kg/total amount of drug dissolved within the bag
B) Dose ordered × total volume of bag used × drip factor of IV tubing/total amount of drug dissolved within the bag
C) Dose ordered × total volume of the drug container/total amount of drug dissolved within the fluid
D) Dose ordered × total volume of the drug container × weight in kg/total amount of drug dissolved within the fluid

Question 52

In an over-the-needle catheter, which of the following slides over the metal stylet into a successfully punctured vein?

A) metal chamber
B) hub
C) flashback chamber
D) Teflon catheter

Question 53

Which of the following gives you greater control over medication delivery and allows you to easily discontinue the infusion when therapy is complete or must be stopped?

A) piggybacking IV infusions through an existing intravenous line
B) establishing a primary IV line and ensuring patency
C) inserting the hypodermic needle into the medication port and injecting the medication
D) confirming the medication, indication, dosage, and need for an IV bolus

Question 54

What is the MOST common catheter used in prehospital IV starts?

A) Over-the-needle
B) Plastic
C) Hollow-needle
D) Butterfly set

Question 55

The intranasal route of drug administration can be used for which of the following?

A) Analgesia
B) Antiarrhythmic
C) Aural application
D) Airway constriction

Question 56

Which of these is NOT one of the six rights of drug administration?

A) Right person
B) Right dose
C) Right distribution
D) Right documentation

Question 57

In which of the following situations should you NOT obtain venous blood?

A) during peripheral access
B) before medication administration
C) after medication administration
D) when medication administration may be needed

Question 58

With regard to placing peripheral intravenous lines with an ultrasound device, which of the following is NOT a correct statement about arteries and veins?

A) Veins collapse easily and completely when gentle pressure is applied with the transducer.
B) Arteries will not collapse completely, although slight compression of artery walls can be seen.
C) Color-flow Doppler and pulsed-wave spectral Doppler can help identify veins and differentiate them from arteries.
D) Veins will often be pulsating and the venous walls may be thicker than arterial walls.

Question 59

What is a small, sterile glass or plastic container that usually contains a single dose of a solution?

A) Ampule
B) Vial
C) MDI
D) Mix-O-Vial