1.
The physician orders 8 mcg/min of isuprell for a 70 kg patient. You put 2 mg in 250 mls of D5W. What is the rate of microdrips?
Correct Answer
D. 60 gtts/min
Explanation
The physician orders 8 mcg/min of isuprell for a 70 kg patient. The medication is prepared by putting 2 mg in 250 ml of D5W. To calculate the rate of microdrips, we need to convert the medication concentration from mg/ml to mcg/ml. Since 1 mg is equal to 1000 mcg, 2 mg is equal to 2000 mcg. Therefore, the concentration of the medication is 2000 mcg/250 ml, which is 8 mcg/ml. Since the physician orders 8 mcg/min, the rate of microdrips would be 1 ml/min. Since 1 ml is equal to 60 gtts (microdrips), the rate of microdrips would be 60 gtts/min.
2.
If a rescuer inadvertently increase rate and depth while ventilationg a patient is may result in:
Correct Answer
D. Hypocarbia and respiratory acidosis
Explanation
If a rescuer inadvertently increases the rate and depth while ventilating a patient, it can lead to hypocarbia and respiratory acidosis. Hypocarbia refers to a decrease in the levels of carbon dioxide in the blood, which can occur when there is excessive ventilation. Respiratory acidosis occurs when there is an accumulation of carbon dioxide in the blood, leading to an increase in acidity. Therefore, the combination of hypocarbia and respiratory acidosis is the most likely outcome of the described situation.
3.
You are treating a 35 year old male who was the driver in a MVA. He is complaining of chest pain and shows steering wheel imprints on the chest. Lung sounds are equal bilaterally. Patient is hypertensive but has bilateral decreased femoral pulses. Which is the most likely diagnosis?
Correct Answer
C. Dissected aorta
Explanation
The most likely diagnosis in this case is a dissected aorta. The patient's complaint of chest pain and the presence of steering wheel imprints on the chest suggest a significant impact to the chest during the motor vehicle accident (MVA). The bilateral decreased femoral pulses indicate a disruption in blood flow, which can occur in aortic dissection. Additionally, the patient's hypertension may be a contributing factor to the development of aortic dissection. Fractured sternum and rib fractures may cause chest pain but would not explain the decreased femoral pulses. Tension pneumothorax would typically present with asymmetrical lung sounds, which is not the case here.
4.
In a normal person, respiration is triggered by:
Correct Answer
A. CO2 level
Explanation
Respiration in a normal person is triggered by the level of CO2 in the body. When CO2 levels rise, it signals the body to increase respiration in order to remove the excess CO2 and maintain a balance. This is known as the respiratory drive. Oxygen levels also play a role in respiration, but it is primarily the CO2 level that triggers the respiratory response. CO levels and HCO3 levels are not directly involved in the regulation of respiration.
5.
Which injuries have the lowest priority in the field?
Correct Answer
D. Spinal injury and open fractures
Explanation
Spinal injury and open fractures have the lowest priority in the field because they are not immediately life-threatening. While they require medical attention, they can often be managed with stabilization and do not require immediate intervention to save a person's life. In contrast, thoracic trauma and airway obstruction, respiratory burns and abdominal trauma, and cardiac trauma and head injury are all potentially life-threatening and require immediate medical attention.
6.
Initial therapy for a child with a high fever, drooling, and anxiety is:
Correct Answer
B. Humidified O2 by mask
Explanation
The initial therapy for a child with a high fever, drooling, and anxiety is to administer humidified O2 by mask. This is because these symptoms are suggestive of epiglottitis, a potentially life-threatening condition that causes swelling of the epiglottis and can lead to airway obstruction. Administering humidified oxygen helps to provide respiratory support and alleviate symptoms while preparing for further interventions if necessary. Direct laryngoscopy, preparing for intubation, and administering racemic epinephrine may be required in more severe cases or if the airway becomes compromised.
7.
What would you NOT use in neonatal resuscitation?
Correct Answer
D. A high flow O2 by demand valve
Explanation
A high flow O2 by demand valve would not be used in neonatal resuscitation. Neonatal resuscitation involves providing oxygen and support to a newborn baby who is not breathing or is experiencing respiratory distress. While epinephrine, CPR, and endotracheal intubation are commonly used techniques in neonatal resuscitation, a high flow O2 by demand valve is not appropriate in this scenario. This type of device is typically used to deliver oxygen to patients with chronic respiratory conditions, not for immediate resuscitation of a newborn.
8.
Catecholamines are:
Correct Answer
A. Sympathomimetic
Explanation
Catecholamines are a group of neurotransmitters that are released by the adrenal glands in response to stress or excitement. They include substances such as adrenaline and noradrenaline, which are known for their stimulating effects on the sympathetic nervous system. This makes them sympathomimetic, meaning that they mimic the actions of the sympathetic nervous system. Therefore, the correct answer is sympathomimetic.
9.
How do you know your treatment for shock is effective?
Correct Answer
B. Blood pressure rises
Explanation
An effective treatment for shock can be determined by monitoring the patient's blood pressure. In shock, the blood pressure drops significantly, so if it rises after treatment, it indicates that the treatment is successful in improving the patient's condition. Blood pressure is a crucial indicator of organ perfusion and oxygen delivery, and its increase suggests that the body's vital organs are receiving adequate blood supply again. Therefore, the rise in blood pressure is a positive sign that the treatment for shock is effective.
10.
A drug with predominantly alpha effects will cause:
Correct Answer
A. Vasoconstriction
Explanation
A drug with predominantly alpha effects will cause vasoconstriction. Alpha receptors are found in smooth muscle cells lining blood vessels, and when activated by a drug, they cause the muscles to contract. This results in narrowing of the blood vessels, leading to vasoconstriction.
11.
Hypovolemic shock is an emergency condition in which severe blood and fluid loss makes the heart unable to pump enough blood to the body. This type of shock can cause many organs to stop working.
Correct Answer
A. True
Explanation
Hypovolemic shock is indeed an emergency condition caused by severe blood and fluid loss, resulting in insufficient blood being pumped by the heart to the body. This condition can lead to multiple organ failure due to the inadequate blood supply. Therefore, the statement "Hypovolemic shock is an emergency condition in which severe blood and fluid loss makes the heart unable to pump enough blood to the body" is true.
12.
A 5 year old is leaning forward, drooling, stridorous, feverish, and has pain on swallowing. He most likely has:
Correct Answer
B. Epiglottitis
Explanation
Epiglottitis is the most likely diagnosis based on the symptoms described. Epiglottitis is an inflammation of the epiglottis, a flap of tissue that covers the windpipe, and it can cause difficulty in swallowing, drooling, stridor (a high-pitched sound during breathing), and fever. These symptoms are consistent with epiglottitis, especially in a young child. Bronchiolitis is a viral infection that affects the small airways in the lungs, croup is a viral infection that causes swelling in the upper airways, and asthma is a chronic condition characterized by inflammation and narrowing of the airways. None of these conditions match the symptoms described as closely as epiglottitis.
13.
Which area reflects the central venous pressure?
Correct Answer
B. Right atrium
Explanation
The central venous pressure is reflected in the right atrium. This is because the right atrium receives blood from the body's veins and pumps it into the right ventricle to be sent to the lungs for oxygenation. The pressure in the right atrium is an important indicator of the blood volume and the ability of the heart to pump effectively. Monitoring the central venous pressure in the right atrium can help assess the fluid status and cardiac function of a patient.
14.
The patient who is decorticate will move his hands and arms:
Correct Answer
A. Toward the body
Explanation
When a patient is decorticate, it means that there is damage to the cerebral hemisphere of the brain. This results in abnormal posture and movement. In decorticate posturing, the patient's hands and arms are flexed and pulled towards the body. This is due to the involvement of the corticospinal tract, which controls voluntary movement. Therefore, the correct answer is "toward the body".
15.
A drug with beta effects will cause:
Correct Answer
C. Increased heart rate
Explanation
A drug with beta effects will increase heart rate because beta receptors are located in the heart and when activated, they increase the heart's contractility and rate of contraction. This leads to an increased heart rate. Vasoconstriction refers to the narrowing of blood vessels, and bronchoconstriction refers to the narrowing of the airways in the lungs. These are not directly affected by drugs with beta effects. Therefore, the correct answer is increased heart rate.
16.
Which is the correct placement of the paddles for defibrillation?
Correct Answer
D. Cardiac apex and below clavicle, right of sternum
Explanation
The correct placement of the paddles for defibrillation is cardiac apex and below clavicle, right of sternum. This placement ensures that the electrical shock is delivered directly to the heart, which is located at the cardiac apex. Placing the paddles below the clavicle and to the right of the sternum helps to avoid interference with the heart's electrical system and ensures effective delivery of the shock.
17.
Acetylcholine is active which systems:
Correct Answer(s)
C. Sympathetic
D. Parasympathetic
Explanation
Acetylcholine is a neurotransmitter that is active in both the sympathetic and parasympathetic nervous systems. In the sympathetic nervous system, acetylcholine is released by preganglionic neurons to transmit signals to postganglionic neurons. In the parasympathetic nervous system, acetylcholine is the main neurotransmitter used by both preganglionic and postganglionic neurons. Therefore, the correct answer is sympathetic and parasympathetic.
18.
What do you call a coarse rub or bark on expiration?
Correct Answer
C. Rhonchi
Explanation
Rhonchi refers to a coarse rub or bark sound that is heard during expiration. It is commonly associated with conditions such as bronchitis, pneumonia, or chronic obstructive pulmonary disease (COPD). This sound is caused by the narrowing or obstruction of the larger airways in the lungs, resulting in turbulent airflow and the production of a low-pitched, snoring or rattling sound. Therefore, rhonchi is the appropriate term to describe a coarse rub or bark sound during expiration.
19.
The most significant problem resulting from hypoglycemia is:
Correct Answer
C. Damage to the brain cells
Explanation
Hypoglycemia is a condition characterized by low blood sugar levels. When blood sugar levels drop too low, the brain is deprived of the glucose it needs to function properly. This can lead to damage to the brain cells, as they are not receiving the necessary fuel to perform their functions. This can result in symptoms such as confusion, dizziness, seizures, and in severe cases, loss of consciousness. Therefore, the most significant problem resulting from hypoglycemia is damage to the brain cells.
20.
By what process does a solute move from a higher concentration to a lower concentration?
Correct Answer
D. Diffusion
Explanation
Diffusion is the process by which a solute moves from an area of higher concentration to an area of lower concentration. This movement occurs due to the random motion of particles, causing them to spread out and become evenly distributed. Unlike osmosis, which specifically refers to the movement of water molecules across a selectively permeable membrane, diffusion can involve any type of solute and does not require a membrane. Therefore, diffusion is the correct process that explains the movement of solute from higher to lower concentration.
21.
A diabetic with hypertension who experiences numbness of the left arm for 30 minutes has likely had:
Correct Answer
D. Transient ischemic attacks
Explanation
A diabetic with hypertension who experiences numbness of the left arm for 30 minutes has likely had a transient ischemic attack. Transient ischemic attacks (TIAs) are often referred to as "mini-strokes" and occur when blood flow to the brain is temporarily blocked. The numbness in the left arm could be a result of reduced blood flow to that area. Given the patient's medical history of diabetes and hypertension, both of which are risk factors for TIAs, it is likely that this is the cause of their symptoms.
22.
You put 1 gm of lidocaine in 250 mls of D5W. You are told to administer 2mg/min. How many gtts/min is this?
Correct Answer
D. 30 gtts