EMT Chapter 11 - Principles of Pharmacology

A 31-year-old female is experiencing an acute asthma attack. She is conscious and alert, but in obvious respiratory distress. After assisting her with her prescribed MDI, you should:

A. administer another treatment in 30 seconds if she is still in distress.

B. reassess the patient and document her response to the medication.

C. check the drug's expiration date to ensure that it is still current.

D. contact medical control and apprise him or her of what you did.

B

A 62-year-old male is seen with crushing chest pain, which he describes as being the same kind of pain that he had with a previous heart attack. He has prescribed nitroglycerin but states that he has not taken any. After administering supplemental oxygen if needed and contacting medical control, you should:

A. administer up to three doses of nitroglycerin before assessing his blood pressure.

B. administer the nitroglycerin unless he has taken Viagra within the past 72 hours.

C. begin immediate transport and request a rendezvous with a paramedic unit.

D. assist him with his nitroglycerin unless his systolic blood pressure is less than 100 mm Hg

D

Activated charcoal is an example of a(n):

A. elixir.

B. suspension.

C. solution.

D. gel.

B

Advil, Nuprin, and Motrin are trade names for the generic medication:

A. acetaminophen.

B. aspirin.

C. nitrostat.

D. ibuprofen.

D

In ___________ administration, you are administering medication to yourself or your partner.

A. patient-assisted

B. peer-assisted

C. EMT-administered

D. paramedic-administered

B

Medications encased in a gelatin shell that are taken by mouth are called:

A. pills.

B. caplets.

C. capsules.

D. tablets.

C

The process of binding or sticking to a surface is called:

A. digestion.

B. suspension.

C. adsorption.

D. absorption.

C

When assessing an elderly male who complains of nausea and generalized weakness, you find that he takes atorvastatin (Lipitor) and amlodipine (Norvasc). These medications suggest a history of:

A. cardiovascular disease.

B. non-insulin-dependent diabetes.

C. reactive airway disease.

D. bacterial infection.

A

Which of the following patient populations typically require a modified drug dose?

A. Females

B. Pediatric patients

C. Patients with asthma

D. Middle adults

B

While assisting a paramedic in the attempted resuscitation of a 55-year-old male in cardiac arrest, you should expect the paramedic to:

A. give the patient nitroglycerin to increase his blood pressure.

B. withhold drug therapy until an intraosseous catheter is in place.

C. give the patient activated charcoal to rule out a drug overdose.

D. administer drugs via the IV route to achieve the fastest effect.

D

a 49-year-old-male with an extensive cardiac history presents with 2 hours of crushing chest pain and shortness of breath. He is pale and diaphoretic and tells you that he feels like he is going to die. His medications include nitroglycerin, sildenafil (Viagra), and enalapril (Vasotec). His blood pressure is 140/90 mm Hg and his heart rate is 110 beats/min. In addition to administering supplemental oxygen if needed, you should:

A. administer one nitroglycerin and call medical control.

B. obtain physician approval to give the nitroglycerin.

C. place him in a supine position and transport at once.

D. ask him if he took his Viagra within the past 24 hours.

D

Aspirin is beneficial to patients suspected of having a heart attack because it:

A. prevents the aggregation of platelets.

B. dissolves the coronary artery clot.

C. causes direct coronary vasodilation.

D. reduces the associated chest pain.

A

A drug is contraindicated for a patient when it:

A. may cause harm or have no positive effect.

B. produces actions other than the desired ones.

C. is used to treat a multitude of conditions.

D. is used to treat a specific medical condition.

A

EMTs arrive at the scene of a patient who was "found down." A family member states that she gave naloxone (Narcan) to the patient before the ambulance arrived. The EMTs should suspect that the patient:

A. had a heart attack

B. is having a stroke

C. overdosed on an opioid drug

D. is severely intoxicated

C

Generally, parenteral medications are more commonly used in the emergency setting as opposed to enteral medications. The characteristic that separates the two routes with respect to administration in the emergency setting is:

A. Enteral medications are often liquid and can be administered using syringes and needles.

B. Enteral routes offer a more predictable and measurable response.

C. Parenteral routes tend to be absorbed more quickly than enteral.

D. Parenteral medications tend to have fewer side effects.

C

A medication with antagonistic properties is one that:

A. blocks receptor sites and prevents other chemicals from attaching to them.

B. produces a cumulative effect when mixed with the same type of medication.

C. stimulates receptor sites and allows other chemicals to attach to them.

D. enhances the effects of another medication when given in a higher dose.

A

The _____ of a medication usually dictates the route by which it will be administered.

A. type

B. form

C. class

D. name

B

Shortly after assisting a 65-year-old female with her prescribed nitroglycerin, she begins complaining of dizziness and experiences a drop of 30 mm Hg in her systolic blood pressure. The patient remains conscious and her breathing is adequate. You should:

A. transport her in a sitting position.

B. place her supine and elevate her legs.

C. assist ventilations with a bag-mask device.

D. wait 5 minutes and reassess her blood pressure.

B

Subcutaneous injections deliver the medication:

A. directly into the muscle tissue.

B. between the skin and the muscle.

C. below the first layer of muscle.

D. through the mucosa under the tongue.

B

What medication form does oral glucose come in:

A. Suspension

B. Gel

C. Liquid

D. Fine powder

B

Which of the following is an example of a trade name of a drug.

A. Tylenol

B. Ibuprofen

C. Furosemide

F. Nitroglycerin

A

Which of the following medication routes has the slowest rate of absorption?

A. oral

B. inhalation

C. rectal

D. sublingual

A

You are dispatched to a movie theater for a 39-year-old female with signs and symptoms of an allergic reaction. As you are assessing her, she pulls an epinephrine auto-injector out of her purse and hands it to you. After administering 100% oxygen, you should:

A. verify the medication name.

B. administer the drug.

C. contact medical control.

D. check the drug's expiration date.

C

You are dispatched to a movie theater for a 39-year-old female with signs and symptoms of an allergic reaction. As you are assessing her, she pulls an epinephrine auto-injector out of her purse and hands it to you. After confirming the drug's name and expiration date, you should:

A. administer the drug.

B. contact medical control.

C. ask her if she takes other medications.

D. request an ALS ambulance to administer the drug.

B

You are dispatched to a state park for a young female experiencing an allergic reaction. Your assessment reveals that her breathing is severely labored and her blood pressure is very low. You carry epinephrine auto-injectors on your ambulance and have been trained and approved by your medical director to administer them. As your partner gives the patient high-flow oxygen, you attempt to contact medical control but do not have a signal from your cell phone. You should:

A. immediately load the patient into the ambulance, begin transport, and reattempt to contact medical control when you receive a cell signal.

B. notify dispatch and request that a paramedic unit respond to the scene so they can administer epinephrine to the patient.

C. administer epinephrine to the patient, begin immediate transport, and attempt to contact medical control en route to the hospital.

D. elevate the patient's legs 6″ to 12″, keep her warm, begin transport to the hospital, and request a paramedic intercept en route.

E. place her in a supine position, keep her warm, begin transport to the hospital, and request a paramedic intercept en route.

C

You are treating a 45-year-old woman who was stung by a hornet and has a rash. She tells you that she is allergic to hornets and has her own epinephrine auto-injector. She also tells you that she takes medication for hypertension. Her breath sounds do not reveal any wheezing, her breathing is unlabored, and her blood pressure is 154/94 mm Hg. What should you do if you are not able to make contact with medical control?

A. Begin immediate transport and request an intercept with a paramedic ambulance.

B. Administer her epinephrine, reassess her condition, and transport her promptly.

C. Give her half the dose of her epinephrine in case her allergic reaction is delayed.

D. Give her oxygen, transport her to the hospital, and monitor her condition en route.

D

You are treating a middle-aged man with chest discomfort. He has a history of three previous heart attacks and takes nitroglycerin as needed for chest pain. You have standing orders to administer aspirin to patients with suspected cardiac-related chest pain or discomfort. While your partner is preparing to give oxygen to the patient, you should:

A. contact medical control, apprise him or her of the patient's chief complaint and vital signs, and request permission to give him aspirin.

B. confirm that the patient is not allergic to aspirin, give him the appropriate dose of aspirin, and document the time and dose given.

C. assist the patient in taking one of his prescribed nitroglycerin, assess his vital signs, and give him aspirin if he is still experiencing chest discomfort.

D. ensure that the patient's systolic blood pressure is at least 100 mm Hg since aspirin dilates the blood vessels and can cause a drop in blood pressure

B

You arrive at a residence approximately 20 minutes after a 7-year-old boy, who weighs 22 kg, ingested a bottle of Advil. He is conscious and alert and has stable vital signs. Medical control orders you to administer activated charcoal and then transport the child at once. The appropriate maximum dose of activated charcoal for this child is:

A. 22 g.

B. 44 g.

C. 11 g.

D. 36 g.

B

Your patient is complaining of chest pain. He states it feels just like his last heart attack. You have applied oxygen with no relief. He does not take any medications. His BP is 88/64, pulse is 100, and respirations are 20. Your treatment should include.

A. Asprin

B. Nitroglycerin

C. albuterol MDI

D. epinephrine

A

After taking diphenhydramine (Benadryl) for an allergic reaction, a person begins experiencing drowsiness and a dry mouth. These findings are an example of a(n):

A. side effect.

B. unpredictable effect.

C. untoward effect.

D. therapeutic effect

A

The amount of medication that is given is known as the _________.

A. contraindication

B. indication

C. side effect

D. dose

D

An EMT may administer aspirin to a patient if:

A. the patient is believed to be experiencing an acute stroke.

B. transport time to the hospital is greater than 30 minutes.

C. the patient is currently experiencing hypotension.

D. authorization from medical control has been obtained.

D

EMTs respond to a known heroin abuser who is unresponsive. If they give naloxone (Narcan) to this patient, the EMTs should recall that:

A. naloxone should be administered in increments of 2 mg.

B. naloxone administration could cause seizures in this patient.

C. naloxone should not be given if the patient's breathing is slow.

D. the effects of naloxone last longer than most opioid drugs.

B

How is nitroglycerin usually given by the EMT?

A. Orally

B. Injected

C. Inhaled

D. Sublingually

D

The medical term for an extremely low blood glucose level is:

A. hypoglycemia.

B. hypertension.

C. hypotension.

D. hyperglycemia.

A

A mucosal atomizer device (MAD) is used to deliver certain medications via the:

A. inhalation route.

B. transdermal route.

C. sublingual route.

D. intranasal route.

D

Nitroglycerin, when given to patients with cardiac-related chest pain:

A. increases myocardial contraction force.

B. increases blood return to the right atrium.

C. relaxes the walls of the coronary arteries.

D. constricts the veins throughout the body.

C

The term "pharmacology" is MOST accurately defined as:

A. the study of drugs that are produced illegally.

B. the study of drugs and their actions on the body.

C. the study of how medications affect the brain.

D. the study of drug excretion from the human body.

B

What is the route of administration for the EpiPen auto-injector?

A. Intraosseous

B. Intramuscular

C. Sublingual

D. Intravenous

B

Which of the following clinical signs would necessitate the administration of naloxone (Narcan)?

A. Hypertension

B. Extreme agitation

C. Slow respirations

D. Tachycardia

C

Which of the following is an example of a rules-based medication error?

A. The EMT administers a drug that is not approved by the medical director.

B. The EMT administers the correct drug, but gives it by the wrong route.

C. The EMT accidentally gives a higher drug dose than what is indicated.

D. The EMT administers a drug that is contraindicated for the patient.

A

Which of the following is NOT a characteristic of epinephrine?

A. Secreted naturally by the adrenal glands

B. Decreases heart rate and blood pressure

C. Constricts the blood vessels

D. Dilates passages in the lungs

B

Which of the following is required for an EMT to administer a drug to a patient?

A. A patient with an altered level of consciousness

B. Medical direction approval

C. An alert adult patient

D. A patient with stable vital signs

B

Which of the following statements regarding glucose is correct?

A. Glucose is a complex sugar that rapidly absorbs into the bloodstream.

B. Glucose is given to patients who are suspected of being hyperglycemic.

C. Glucose is a simple sugar that is readily absorbed by the bloodstream.

D. Glucose is usually administered by the EMT via the intravenous route.

C

Which of the following statements regarding parenteral medications is correct?

A. Compared to enteral medications, parenteral medications have fewer side effects.

B. Parenteral medications are absorbed by the body through the digestive system.

C. Parenteral medications are absorbed more quickly than enteral medications.

D. Tylenol is an example of a parenteral medication because it is taken orally.

C

Which of the following statements regarding the epinephrine auto-injector is correct?

A. The adult auto-injector delivers 0.5 to 1 mg of epinephrine.

B. The epinephrine auto-injector delivers a preset amount of the drug.

C. EMTs do not need physician authorization to use the auto-injector.

D. The auto-injector delivers epinephrine via the subcutaneous route.

B

A 37-year-old male is found unresponsive in his car. His airway is patent and his respirations are rapid and labored. As you and your partner are assessing and treating the patient, a police officer hands you a medication named Alupent, which he found in the backseat of the patient's car. This medication suggests that the patient has a history of:

A. hypertension.

B. asthma.

C. heart disease.

D. allergic reactions

B

A 74-year-old woman complains of heaviness in her chest, nausea, and sweating that suddenly began about an hour ago. She is conscious and alert, but anxious. Her blood pressure is 144/84 mm Hg and her heart rate is 110 beats/min. She took two of her prescribed nitroglycerin (0.4-mg tablets) before your arrival but still feels heaviness in her chest. You should:

A. Recall that geriatric patients often have slower absorption and elimination times, which may necessitate modification of the dosing of certain drugs

B. Give her high-flow oxygen, avoid giving her any more nitroglycerin because it may cause a drop in her blood pressure, and transport

C. Transport her at once and wait at least 20 minutes before you consider assisting her with a third dose of her prescribed nitroglycerin

D. Assist her in taking one more of her nitroglycerin tablets, reassess her blood pressure, and contact medical control for further instructions

A

Which of the following medication routes delivers a drug through the skin over an extended period of time, such as a nitroglycerin or nicotine patch?

A. Sublingual

B. Subcutaneous

C. Transcutaneous

D. Intraosseous

C

Which of the following medication routes would be the MOST appropriate to use in an unresponsive patient when intravenous access cannot be obtained?

A. subcutaneous

B. intramuscular

C. intraosseous (IO)

D. transcutaneous

C