Medic General Review II
(16).webp "Medic General Review II - Quiz")
Second installment of 25 general questions to practice on toward the NR exam.
Questions and Answers
- 1.
You just administered atropine 0.5 mg to a patient with a symptomatic bradycardia and multifocal PVCs. Suddenly your patient becomes unconscious and goes into ventricular fibrillation. Your next action is to:
- A.
Administer lidocaine 1.5 mg/kg
- B.
Administer another 0.5 mg of atropine IVP
- C.
Cardiovert at 100 joules
- D.
Defibrillate at 200 joules
Correct Answer
D. Defibrillate at 200 joulesExplanation
This is a national registry question... keep in mind how national standards look at lower energy doses for defibrillation with a biphasic monitorRate this question:
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- 2.
In a pediatric patient, initial defibrillation should be performed at:
- A.
0.5 J/kg
- B.
1.0 J/kg
- C.
2.0 J/kg
- D.
4.0 J/kg
Correct Answer
C. 2.0 J/kgExplanation
Again... think national standards, not PA protocol.Rate this question:
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- 3.
Which of the following statements is correct regarding a Glasgow Coma Scale score of 7?
- A.
A perfect GCS score is 10, and a score of 7 represents minor injuries
- B.
A perfect GCS score is 12, and a score of 7 represents moderate injuries
- C.
A perfect GCS score is 15, and a score of 7 represents moderate injuries
- D.
A perfect GCS score is 15, and a score of 7 represents significant injuries
Correct Answer
D. A perfect GCS score is 15, and a score of 7 represents significant injuriesExplanation
A Glasgow Coma Scale (GCS) score of 7 represents significant injuries. The GCS is a neurological scale that assesses a person's level of consciousness following a head injury. It evaluates three components: eye-opening response, verbal response, and motor response. The maximum score on the GCS is 15, indicating normal brain function. A score of 7 suggests a severe impairment in consciousness, indicating significant injuries.Rate this question:
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- 4.
Your ambulance is assigned to stand by at a building fire. The outside temperature is 103-degrees Fahrenheit and the firefighters are wearing full protective clothing. Your patient is a 36-year-old male in good physical condition. He appears anxious and complains of nausea and headache. He is sweating profusely with cool clammy skin. BP is 116/48, radial pulse of 150 and weak, respirations are 36 and shallow, temperature is 101.2-degrees Fahrenheit. The patient's signs/symptoms indicate:
- A.
Heatstroke
- B.
Heat exhaustion
- C.
Heat stress
- D.
Heat fatigue
Correct Answer
B. Heat exhaustionExplanation
The patient's signs and symptoms, such as nausea, headache, profuse sweating, cool clammy skin, and an elevated temperature, are consistent with heat exhaustion. Heat exhaustion occurs when the body becomes dehydrated and is unable to cool itself effectively in hot weather conditions. This can lead to symptoms such as weakness, dizziness, and fatigue. The patient's vital signs, such as a weak pulse and shallow respirations, further support the diagnosis of heat exhaustion. Heatstroke, on the other hand, is a more severe condition that involves a dangerously high body temperature and can be life-threatening.Rate this question:
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- 5.
Which of the following is NOT considered a sign or symptom indicating a tension pneumothorax?
- A.
Dyspnea
- B.
Hyperresonance to percussion
- C.
Distended jugular veins
- D.
Clear lung sounds
Correct Answer
D. Clear lung soundsExplanation
Clear lung sounds are not considered a sign or symptom indicating a tension pneumothorax. Tension pneumothorax is a condition where air accumulates in the pleural space, causing the lung to collapse and putting pressure on the heart and other structures. Dyspnea, hyperresonance to percussion, and distended jugular veins are commonly associated with tension pneumothorax due to the compromised lung function and increased pressure in the chest. However, clear lung sounds suggest that there is no obstruction or abnormality in the airways, which is not consistent with tension pneumothorax.Rate this question:
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- 6.
Management of cardiogenic shock may include:
- A.
Administration of morphine
- B.
Administration of IV dopamine
- C.
Administration of nitroglycerin gr 1/150 sublingual
- D.
Establishing an IV 500 cc/hr
Correct Answer
B. Administration of IV dopamineExplanation
The management of cardiogenic shock may include the administration of IV dopamine. Dopamine is a medication that helps to increase blood pressure and improve blood flow by stimulating the heart. In cardiogenic shock, the heart is unable to pump enough blood to meet the body's needs, leading to low blood pressure and organ failure. IV dopamine can help to support the heart's function and improve cardiac output, thereby improving the patient's condition.Rate this question:
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- 7.
A 78-year-old male is alert and oriented to person, place, and time, and complains of chest pain and difficulty breathing. You attach him to the ECG and notice a rhythm of 42 with a corresponding pulse, a P-R interval of 0.20, and normal R-R intervals. Vitals are BP 76/42, respirations 42. The patient also states that he feels nauseated and dizzy. Treatment for this patient should include:
- A.
Atropine 0.5 mg
- B.
Oxygen 3 liters per minute via nasal cannula
- C.
Immediate transvenous pacing
- D.
Isuprel 2-10 mcg/min
Correct Answer
A. Atropine 0.5 mgExplanation
The patient is presenting with symptoms of chest pain, difficulty breathing, low blood pressure, and bradycardia (heart rate of 42). These symptoms indicate a possible heart block, specifically a type of heart block called symptomatic bradycardia. Atropine is a medication commonly used to treat bradycardia by blocking the action of the vagus nerve, which slows down the heart rate. Therefore, administering atropine 0.5 mg would be the appropriate treatment for this patient to increase his heart rate and improve blood flow.Rate this question:
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- 8.
Management of pediatric bradycardia with significant signs and symptoms related to cardiac or respiratory compromise should be treated with:
- A.
Atropine
- B.
Lidocaine
- C.
Sodium bicarbonate
- D.
Epinephrine
Correct Answer
D. EpinephrineExplanation
Epinephrine is the correct answer for managing pediatric bradycardia with significant signs and symptoms related to cardiac or respiratory compromise. Epinephrine is a medication that stimulates the heart and increases the heart rate, making it an appropriate choice for treating bradycardia. Atropine is commonly used for bradycardia in adults, but it may not be as effective in pediatric patients. Lidocaine is used for managing certain types of arrhythmias, but it is not the first-line treatment for bradycardia. Sodium bicarbonate is used for managing acidosis and certain drug overdoses, but it is not indicated for bradycardia.Rate this question:
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- 9.
Disadvantages of using a cellular telephone for EMS communications include the fact that:
- A.
The conversation is less formal.
- B.
The system promotes discussion.
- C.
The system reduces on-line time.
- D.
Geography can interfere with the system or signals.
Correct Answer
D. Geography can interfere with the system or signals.Explanation
The correct answer is "geography can interfere with the system or signals." This means that one of the disadvantages of using a cellular telephone for EMS communications is that the geographical location can affect the quality of the system or signals. This can lead to dropped calls, poor reception, or difficulty in establishing and maintaining communication in remote or rural areas with weak cellular coverage.Rate this question:
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- 10.
One reason that the respiratory system of a geriatric patient becomes less effective is that:
- A.
The muscles of the diaphragm weaken.
- B.
Tidal volume increases.
- C.
There is decreased chest wall compliance.
- D.
The lungs become more compliant.
Correct Answer
C. There is decreased chest wall compliance.Explanation
As individuals age, the elasticity of their chest wall decreases, leading to decreased chest wall compliance. This means that the chest wall becomes stiffer and less able to expand and contract effectively during breathing. This reduced compliance can result in a decreased ability to take in an adequate amount of air, leading to a less effective respiratory system. The other options, such as weakened diaphragm muscles or increased tidal volume, do not directly relate to the decreased effectiveness of the respiratory system in geriatric patients.Rate this question:
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- 11.
Which of the following medications would be the MOST acceptable alternative to morphine for analgesia in patients with an acute coronary syndrome?
- A.
Versed
- B.
Fentanyl
- C.
Diazepam
- D.
Narcan
Correct Answer
B. FentanylExplanation
Fentanyl would be the most acceptable alternative to morphine for analgesia in patients with an acute coronary syndrome because it is a potent opioid analgesic that provides effective pain relief. It has a rapid onset and short duration of action, making it suitable for acute pain management. Additionally, fentanyl has less potential for causing respiratory depression and hemodynamic instability compared to morphine, which is important in patients with acute coronary syndrome who may already have compromised cardiovascular function.Rate this question:
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- 12.
You are providing positive-pressure ventilation to a newborn. Which of the following statements is correct regarding oxygen administration to a newborn?
- A.
An anesthesia bag provides the best ventilation and is easiest to use.
- B.
A large bag-valve is needed to provide adequate tidal volume.
- C.
Never deprive a newborn of oxygen for fear of oxygen toxicity.
- D.
Positive-pressure ventilations are often required in newborn resuscitation.
Correct Answer
C. Never deprive a newborn of oxygen for fear of oxygen toxicity.Explanation
Oxygen is essential for newborns, and depriving them of oxygen can lead to serious complications. However, it is important to administer oxygen carefully and avoid oxygen toxicity, which can also be harmful. Therefore, the correct statement is that a newborn should never be deprived of oxygen for fear of oxygen toxicity.Rate this question:
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- 13.
The compression-ventilation ratio for two-person CPR in an infant is:
- A.
5:1
- B.
3:1
- C.
15:2
- D.
5:2
Correct Answer
C. 15:2Explanation
http://www.mycprpros.com/2010-cpr-guidelinesRate this question:
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- 14.
A 68-year-old woman is complaining of chest pain and shortness of breath. Her blood pressure is 110/64, pulse 60, respirations 32. ECG shows a sinus bradycardia with a PR interval of 0.24. Lung sounds reveal crackles in the posterior bases. Management should include:
- A.
Nitroglycerin gr 1/150 SL.
- B.
A 200 cc fluid bolus.
- C.
Atropine 0.5 mg to 1.0 mg IVP.
- D.
Preparation for immediate transcutaneous pacing.
Correct Answer
A. Nitroglycerin gr 1/150 SL.Explanation
The patient is presenting with chest pain and shortness of breath, indicating a possible cardiac issue. The blood pressure and pulse are within normal range, but the respiratory rate is elevated. The ECG shows sinus bradycardia with a prolonged PR interval. Crackles in the lung bases suggest fluid overload, which could be due to heart failure. Given these findings, the most appropriate management would be nitroglycerin, as it helps relieve chest pain and improves blood flow to the heart. The other options, such as fluid bolus, atropine, or transcutaneous pacing, are not indicated based on the given information.Rate this question:
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- 15.
You have been called to treat a five-year-old child previously diagnosed with an upper respiratory infection. She now presents with increased work of breathing, fever, and increased cough. The child appears pale, is lying on the couch, and is slow to respond. She had obvious nasal flaring with a respiratory rate of 8 per minute. From the information in the scenario, the child is most likely in:
- A.
Respiratory distress with impending respiratory failure.
- B.
No acute distress.
- C.
Respiratory insufficiency easily corrected with oxygen.
- D.
Cardiogenic shock.
Correct Answer
A. Respiratory distress with impending respiratory failure.Explanation
The child's symptoms of increased work of breathing, fever, increased cough, pale appearance, slow response, and obvious nasal flaring indicate respiratory distress. The respiratory rate of 8 per minute is significantly lower than the normal range, suggesting impending respiratory failure. These findings suggest that the child is in respiratory distress with impending respiratory failure.Rate this question:
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- 16.
You encouter a patient with a P-R interval of 0.16, a QRS duration of 0.08, and a regular R-R interval. This patient is in:
- A.
Atrial fibrillation.
- B.
Sinus rhythm with first-degree heart block.
- C.
Sinus rhythm.
- D.
Supraventricular tachycardia.
Correct Answer
C. Sinus rhythm.Explanation
The given parameters indicate a normal P-R interval (0.16 seconds), a normal QRS duration (0.08 seconds), and a regular R-R interval. These findings are consistent with a sinus rhythm, which is the normal electrical activity of the heart. Atrial fibrillation would show an irregular R-R interval and no discernible P-R interval. Sinus rhythm with first-degree heart block would show a prolonged P-R interval. Supraventricular tachycardia would show a rapid heart rate, which is not indicated in the given parameters. Therefore, the correct answer is sinus rhythm.Rate this question:
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- 17.
You are caring for a 13-year-old tricyclic antidepressant overdose. What cardiac arrhythmia is likely to develop as a result of this type of overdose?
- A.
Tall, peaked T-waves
- B.
SVT
- C.
Wide QRS complexes with a prolonged QT interval
- D.
Narrow QRS complexes with normal PR interval
Correct Answer
C. Wide QRS complexes with a prolonged QT intervalExplanation
Tricyclic antidepressants (TCAs) can block cardiac sodium channels, leading to a decrease in the rate of depolarization and prolongation of the action potential duration. This can result in widening of the QRS complex on the ECG. Additionally, TCAs can also block cardiac potassium channels, leading to a prolonged QT interval. Therefore, the correct answer is "Wide QRS complexes with a prolonged QT interval." This combination of ECG findings is characteristic of TCA overdose and can predispose the patient to potentially life-threatening ventricular arrhythmias such as torsades de pointes.Rate this question:
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- 18.
Blind nasotracheal intubation:
- A.
Should be attempted only on an apneic patient.
- B.
Is preferred over oral intubation.
- C.
Should be attempted on a patient with spontaneous respirations.
- D.
In contraindicated when facial trauma is present.
Correct Answer
C. Should be attempted on a patient with spontaneous respirations.Explanation
http://www.ncbi.nlm.nih.gov/pubmed/9144052Rate this question:
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- 19.
The initial dose of adenosine that should be administered is:
- A.
6 mg rapid IV push, repeated in 5 minutes if necessary.
- B.
6 mg IV push, repeated in 10 minutes.
- C.
6 mg rapid IV push followed by a 20 cc fluid bolus.
- D.
12 mg IV push.
Correct Answer
C. 6 mg rapid IV push followed by a 20 cc fluid bolus.Explanation
The initial dose of adenosine that should be administered is 6 mg rapid IV push followed by a 20 cc fluid bolus. This is the correct answer because adenosine is used to treat supraventricular tachycardia (SVT), and the recommended initial dose is 6 mg given rapidly through an IV. The fluid bolus is given immediately after to help flush the medication into the systemic circulation and improve its effectiveness. Repeating the dose or waiting longer periods of time before repeating the dose are not the recommended initial treatment approaches for SVT.Rate this question:
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- 20.
Initial treatment for the thermal burn patient would include which of the following?
- A.
Debridement of the blistered skin and antibiotic ointment.
- B.
Covering the burn area with gauze and cooling with iced saline.
- C.
Administering morphine and then cleaning the burn area with an iodine solution.
- D.
Covering the burn area with dry bulky dressings and keeping the patient warm.
Correct Answer
D. Covering the burn area with dry bulky dressings and keeping the patient warm.Explanation
The initial treatment for a thermal burn patient involves covering the burn area with dry bulky dressings to protect it from further injury and infection. Keeping the patient warm helps to prevent hypothermia, which can occur due to the loss of body heat from the burn. This treatment approach promotes wound healing and provides comfort to the patient.Rate this question:
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- 21.
The pediatric dose of lorazepam in the treatment of seizures is:
- A.
0.5-1.0 mg/kg IV/IO
- B.
0.05-0.1 mg/kg IV/IO
- C.
0.05-0.01 mg/kg IV/IO
- D.
5-10 mg IV/IO
Correct Answer
B. 0.05-0.1 mg/kg IV/IOExplanation
The correct answer is 0.05-0.1 mg/kg IV/IO. This range represents the recommended pediatric dose of lorazepam for the treatment of seizures. It is important to administer the medication intravenously or intraosseously. This dose range ensures that the medication is administered in a safe and effective manner, taking into account the weight of the child.Rate this question:
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- 22.
Treatment for heat exhaustion should include all of the following EXCEPT:
- A.
Removing clothing.
- B.
Establishing an IV of normal saline.
- C.
Placing the patient in air conditioning.
- D.
Administering salt tablets.
Correct Answer
D. Administering salt tablets.Explanation
Salt tablets should not be administered as a treatment for heat exhaustion because they can actually worsen the condition. Heat exhaustion is caused by excessive sweating, which leads to the loss of both water and electrolytes, including sodium. Administering salt tablets can further disrupt the electrolyte balance and potentially lead to dehydration. Therefore, it is important to focus on rehydrating the patient with fluids such as normal saline, placing them in a cool environment, and removing any excessive clothing to promote cooling.Rate this question:
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- 23.
You are caring for a lethargic two-year-old. A blood glucose test confirms hypoglycemia. You are able to establish IV access. What is the appropriate drug to administer?
- A.
50% dextrose
- B.
10 mg glucagon
- C.
Instant glucose
- D.
25% dextrose
Correct Answer
D. 25% dextroseExplanation
In a case of hypoglycemia, the appropriate drug to administer is 25% dextrose. Dextrose is a form of glucose that can be given intravenously to rapidly increase blood sugar levels. It is commonly used in emergency situations to treat low blood sugar levels, especially in children. The 25% concentration is preferred over 50% dextrose as it is less likely to cause complications such as tissue irritation or extravasation. Glucagon can also be used to raise blood sugar levels, but it is typically administered when IV access is not available. Instant glucose is not typically used in IV administration and is more commonly used for oral administration in milder cases of hypoglycemia.Rate this question:
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- 24.
The recommended dose of vasopressin in v-fib or pulseless v-tach is:
- A.
17 mg/min IV infusion
- B.
2-4 mg/min IV infusion
- C.
40 units IV repeated once in five minutes
- D.
40 units IV in a single dose
Correct Answer
D. 40 units IV in a single doseExplanation
The recommended dose of vasopressin in v-fib or pulseless v-tach is 40 units IV in a single dose. This is the correct answer because vasopressin is a medication used in cardiac arrest situations to increase blood pressure and improve blood flow to the heart and brain. The recommended dose of 40 units IV in a single dose is based on clinical guidelines and studies that have shown its effectiveness in these specific situations.Rate this question:
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- 25.
If succinylcholine is supplied 20 mg/mL, approximately what volume of medication would you administer to a 185-pound patient?
- A.
1.25 mL
- B.
5 mL
- C.
6.25 mL
- D.
12.5 mL
Correct Answer
C. 6.25 mLExplanation
Though we kept the math simple in class, in reality the Weight in Kg is really equal to 0.9 x half the weight in pounds. Or, divide the weight in pounds then subtract ten percent.Rate this question:
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