Pa ALS Protocol Review I

20 Questions | By Medicmcgill | Updated: Mar 19, 2022 | Attempts: 194

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Original 20 question quiz reviewing 2011 PA ALS protocols.

Questions and Answers

1.

For which of the following protocols is a fluid bolus of normal saline solution NOT indicated?
- A.
  
  Allergic reaction
- B.
  
  Burns
- C.
  
  Systemic inflammatory response syndrome
- D.
  
  Narrow complex tachycardia
2.

For which of the following cardiac drugs should the paramedic first ask the patient whether he or she is taking drugs for the treatment of erectile dysfunction?
- A.
  
  Amiodarone
- B.
  
  Nitroglycerine
- C.
  
  Diltiazem
- D.
  
  Adenosine
3.

Which of the following statements is false?
- A.
  
  Ondansetron and Lorazepam is one combination of drugs that could be given to a patient complaining of both severe nausea and severe vertigo.
- B.
  
  You can administer as much as 2 mg naloxone to a hypoglycemic patient whose altered mental status is refractory to 25 g of 50% dextrose.
- C.
  
  Standing orders permit administering narcotic analgesics to patients complaining of left lower flank pain associated with extensive renal calculus.
- D.
  
  You may proceed directly to administering a benzodiazepine drug to an actively seizing patient if that patient is known to have a history of seizures.
4.

Nitroglycerin may be administered to a patient prior to establishing IV access for patients experience an acute coronary syndrome.
- A.
  
  True
- B.
  
  False
5.

Aspirin may be administered to a patient prior to obtaining a 12-lead electrocardiogram for patients experience an acute coronary syndrome.
- A.
  
  True
- B.
  
  False
6.

What is the value of the first digit for numbered protocols associated with respiratory conditions?
- A.
  
  4
- B.
  
  5
- C.
  
  6
- D.
  
  7
- E.
  
  8
7.

Which of the following is not one of the criteria that must be met to administer acetaminophen to a patient without online medical command?
- A.
  
  Patient must be at least 3 months of age.
- B.
  
  The patient’s temperature must exceed 100.4 degrees Fahrenheit.
- C.
  
  The patient has not had a dose of acetaminophen within the last 4 hours.
- D.
  
  Acetaminophen cannot be taken in conjunction with aspirin or other NSAIDs.
8.

Suppose your 7 year-old ill-looking patient is tachypnic with hyperpyrexia. Your patient’s mass is 20 kg. Which of the following interventions is not permitted per standing order?
- A.
  
  4 mg ondansetron
- B.
  
  400 mg acetaminophen
- C.
  
  400 mL bolus of normal saline solution
- D.
  
  40% oxygen delivered via simple face mask in blow-by configuration
9.

Which of the following drugs is administered slowly?
- A.
  
  Atropine for bradycardia
- B.
  
  Epinephrine in cardiac arrest
- C.
  
  Ondansetron for nausea
- D.
  
  Adenosine for symptomatic atrial flutter
10.

Which of the following ALS drugs may have an ototoxic effect on the patient if delivered too quickly?
- A.
  
  Morphine Sulfate
- B.
  
  Midazolam
- C.
  
  Furosemide
- D.
  
  Ondansetron
11.

Which of the following drugs would not be administered via small volume nebulizer?
- A.
  
  Epinephrine, 5 mL, 1:1000
- B.
  
  Albuterol, 2.5 mg
- C.
  
  Terbutaline, 0.25 mg
- D.
  
  Ipratropium Bromide, 500 mcg
12.

Which of the following combinations of D50 and fluid results in the correct weight-based dose of 10% dextrose to a 10 kg pediatric patient?
- A.
  
  10 mL of D50 mixed with 40 mL normal saline solution
- B.
  
  10 mL of D50 mixed with 40 mL D5W
- C.
  
  20 mL of D50 mixed with 80 mL normal saline solution
- D.
  
  10 mL of D50 mixed with 90 mL normal saline solution
13.

Under which of the following circumstances is a dose of 2 mg of Lorazepam not consistent with off-line orders for a 100 kg patient?
- A.
  
  Patient with a heart rate of 45, altered mental status attributable to cardiac output, blood pressure of 102/40, prior to pacing.
- B.
  
  Patient in an active, focal seizure in her legs who is conscious, alert, and oriented.
- C.
  
  Patient complaining of severe vertigo.
- D.
  
  Unrestrained agitated behavioral patient with no underlying medical conditions who continues to struggle despite attempts to use verbal techniques.
14.

Which of the following medications cannot be delivered intranasally per PA State protocol?
- A.
  
  Epinephrine
- B.
  
  Glucagon
- C.
  
  Lorazepam
- D.
  
  Fentanyl Citrate
15.

What is the appropriate protocol dose for an epinephrine drip in a 75 kg unstable bradycardic patient in which both atropine and pacing is ineffective?
- A.
  
  7 mcg/min
- B.
  
  7.5 mcg/min titrated upward until a systolic blood pressure of at least 100 mmHg is achieved
- C.
  
  0.1 – 0.5 mcg/kg/min titrated until SBP > 90 mmHg
- D.
  
  Begin at 7.5 mcg/min and increase slowly until either SBP > 90 mmHg or until a maximum dose of 10 mcg/min
16.

Which of the following is not a maximum protocol dose prior to contacting medical command?
- A.
  
  20 mcg/kg/min of dobutamine for treatment of cardiogenic shock secondary to CHF
- B.
  
  0.1 mg/kg of midazolam for treatment of seizures
- C.
  
  35 mcg/min of epinephrine for treatment of bradycardia
- D.
  
  5 mL/kg of D10 to a pediatric patient with glucose of 42 mg/dL
17.

For which of the following rhythms is atropine expected to have the least effect on heart rate, for good or bad?
- A.
  
  Sinus bradycardia with a first degree heart block
- B.
  
  Junctional rhythm
- C.
  
  Sinus tachycardia with occasional ectopy
- D.
  
  Third degree AV block
18.

You must attempt to contact medical command prior to administering oxytocin to a patient with post-partum hemorrhage refractory to fundal massage.
- A.
  
  True
- B.
  
  False
19.

Under which of the following circumstances would you contact medical command prior to administration of the associated drug?
- A.
  
  Diltiazem, 0.25 mg/kg, for treatment of an regular narrow complex tachycardia in an adult patient
- B.
  
  Adenosine, 0.1 mg/kg, for treatment of stable SVT in a pediatric patient
- C.
  
  Lidocaine, 1.5 mg/kg, for treatment of a regular wide QRS rhythm in an adult patient
- D.
  
  Amiodorone, 150 mg, for treatment of an irregular wide complex tachycardia in an adult patient
20.

For which of the following rhythms is the initial energy dose for cardioversion 50 joules?
- A.
  
  Unstable atrial flutter
- B.
  
  Unstable atrial fibrillation
- C.
  
  Unstable ventricular tachycardia
- D.
  
  Unstable pulsed ventricular fibrillation