Chapter 24: Emergency Drugs, Intravenous Fluids, and Blood Products Multiple Choice Questions 1. TPN is also known as ______. a. hyperalimentation solution b. intravenous lipids c. total parenteral nutrition d. a and c Answer: d. a and c Correct Feedback: Patients whose nutritional needs cannot be met with dextrose and electrolyte fluids can be given a specially prepared intravenous fluid known as total parenteral nutrition (TPN). TPN is also known as hyperalimentation solution. a. hyperalimentation solution Incorrect Feedback: This is true, but it is not the only correct answer. b. intravenous lipids Incorrect Feedback: TPN is not known as intravenous lipids. c. total parenteral nutrition Incorrect Feedback: This is true, but it is not the only correct answer. 2. Basic life support measures ______ . a. are known as cardiac resuscitation b. involve mechanically circulating the blood c. involve mechanically inflating the lungs with air d. all of the above Answer: d. all of the above Correct Feedback: Basic life support measures, as performed in cardiopulmonary resuscitation (CPR), involve mechanically circulating the blood and inflating the lungs with air. a. are known as cardiac resuscitation Incorrect Feedback: This is true, but it is not the only correct answer. b. involve mechanically circulating the blood Incorrect Feedback: This is true, but it is not the only correct answer. c. involve mechanically inflating the lungs with air Incorrect Feedback: This is true, but it is not the only correct answer. 3. _____ refers to the anticoagulant that is commonly used to preserve whole blood and prolong its refrigerated shelf life. a. crystalloid b. anaphylactic c. antagonist d. citrated Answer: d. citrated Correct Feedback: Citrated refers to the anticoagulant (citrate) that is commonly used to preserve whole blood and prolong its refrigerated shelf life. a. crystalloid Incorrect Feedback: Crystalloid is not an anticoagulant for whole blood. b. anaphylactic Incorrect Feedback: Anaphylactic is not an anticoagulant for whole blood. c. antagonist Incorrect Feedback: Antagonist is not an anticoagulant for whole blood. 4. Narcan is a/an _____ that is given for an overdose of a narcotic drug. a. antagonist drug b. agonist drug c. antidote drug d. all of the above Answer: a. antagonist drug Correct Feedback: Narcotic antagonist drugs compete for the same receptor sites as the narcotic drug when there is an overdose and block those receptors to decrease the narcotic drug’s effects. b. agonist drug Incorrect Feedback: Narcan is not an agonist drug. c. antidote drug Incorrect Feedback: Narcan is not an antidote drug. d. all of the above Incorrect Feedback: Only one of the answers is correct. 5. Which of the following is a symptom of an overdose of a narcotic drug? a. unconsciousness b. hypotension c. respiratory depression d. all of the above Answer: d. all of the above Correct Feedback: Narcotic antagonist drugs decrease the narcotic drugs’ effects of unconsciousness, respiratory depression, and hypotension. a. unconsciousness Incorrect Feedback: This is true, but it is not the only correct answer. b. hypotension Incorrect Feedback: This is true, but it is not the only correct answer. c. respiratory depression Incorrect Feedback: This is true, but it is not the only correct answer. 6. Infant Darlene has eaten many tablets from her mother’s bottle of acetaminophen. She could experience _____. a. cardiac arrhythmias b. liver damage c. infection d. meningitis Answer: b. liver damage Correct Feedback: Mucomyst is used to treat acetaminophen overdose. It protects the liver, the main site of symptoms from acetaminophen overdose. a. cardiac arrhythmias Incorrect Feedback: Acetaminophen overdose does not cause cardiac arrhythmias. c. infection Incorrect Feedback: Acetaminophen overdose does not cause infection. d. meningitis Incorrect Feedback: Acetaminophen overdose does not cause meningitis. 7. Of the following drugs, which is the only drug that can be administered by intracardiac injection? a. atropine b. epinephrine c. lidocaine d. sodium bicarbonate Answer: b. epinephrine Correct Feedback: : Only the drugs calcium chloride and epinephrine (Adrenalin) can be given by the intracardiac route of administration. a. atropine Incorrect Feedback: Atropine cannot be administered by intracardiac injection. c. lidocaine Incorrect Feedback: Lidocaine cannot be administered by intracardiac injection. d. sodium bicarbonate Incorrect Feedback: Sodium bicarbonate cannot be administered by intracardiac injection. 8. Lidocaine is the drug of choice and indicated for the management of life-threatening _____. a. asystole b. anaphylaxis c. metabolic acidosis d. ventricular fibrillation Answer: d. ventricular fibrillation Correct Feedback: : Lidocaine is indicated for the management of life-threatening ventricular fibrillation and is the drug of choice in resuscitative efforts for patients with this problem. a. asystole Incorrect Feedback: Lidocaine has no therapeutic effect if the heart is already in asystole. b. anaphylaxis Incorrect Feedback: Lidocaine is not used to treat anaphylaxis. c. metabolic acidosis Incorrect Feedback: Lidocaine is not used to treat metabolic acidosis. 9. Which of the following drugs is used specifically to treat severe bradycardia and bradyarrhythmias such as heart block? a. atropine b. calcium chloride c. epinephrine d. sodium bicarbonate Answer: a. atropine Correct Feedback: When acetylcholine is released, the heart rate slows. Atropine blocks this action and is used specifically to treat severe bradycardia and bradyarrhythmias such as heart block. b. calcium chloride Incorrect Feedback: Calcium chloride is not used to treat bradycardia. c. epinephrine Incorrect Feedback: Epinephrine is not used to treat bradycardia. d. sodium bicarbonate Incorrect Feedback: Sodium bicarbonate is not used to treat bradycardia. 10. During resuscitation, which of the following statements about epinephrine is FALSE? a. Epinephrine makes the myocardium more responsive to the use of a defibrillator. b. If the heart has stopped beating, epinephrine can stimulate heart contractions. c. Epinephrine also maintains the blood pressure to improve the chances of a successful resuscitation. d. Epinephrine can reverse the metabolic acidosis that occurs when the heart stops. Answer: d. Epinephrine can reverse the metabolic acidosis that occurs when the heart stops. Correct Feedback: Epinephrine makes the myocardium more responsive to the use of a defibrillator that can restore a normal rhythm. If the heart has stopped beating completely (asystole), epinephrine can actually stimulate contractions of the myocardium. As epinephrine stimulates the heart to beat, it also helps to maintain blood pressure and blood flow to the heart and brain to improve the chances of a successful resuscitative effort. a. Epinephrine makes the myocardium more responsive to the use of a defibrillator. Incorrect Feedback: This is a true statement. b. If the heart has stopped beating, epinephrine can stimulate heart contractions. Incorrect Feedback: This is a true statement. c. Epinephrine also maintains the blood pressure to improve the chances of a successful resuscitation. Incorrect Feedback: This is a true statement. 11. Which drug is given to stimulate the myocardium to contract more forcefully and may even stimulate a contraction when the heart is in asystole and has failed to respond to epinephrine? a. atropine b. calcium chloride c. lidocaine d. sodium bicarbonate Answer: b. calcium chloride Correct Feedback: Calcium chloride is also use to stimulate the myocardium to contract more forcefully and may even stimulate a contraction when the heart is in asystole and has failed to respond to epinephrine. a. atropine Incorrect Feedback: Atropine is not given when the heart is in asystole. c. lidocaine Incorrect Feedback: Lidocaine is not given when the heart is in asystole. d. sodium bicarbonate Incorrect Feedback: Sodium bicarbonate does not stimulate contraction of the heart. 12. Which of the following effects is NOT attributed to vasopressor drugs? a. They maintain blood flow to the kidneys during resuscitation. b. They stimulate alpha receptors in the blood vessels to produce vasoconstriction and raise blood pressure. c. They stimulate beta1 receptors to increase the heart rate. d. They correct the decreased pH of the blood. Answer: d. They correct the decreased pH of the blood. Correct Feedback: Vasopressor drugs stimulate beta1 receptors to increase the heart rate; they also stimulate alpha receptors in the blood vessels to produce vasoconstriction and raise the blood pressure. Vasopressor drugs also have the desirable effect of maintaining blood flow to the kidneys. a. They maintain blood flow to the kidneys during resuscitation. Incorrect Feedback: Vasopressor drugs do maintain blood flow to the kidneys. b. They stimulate alpha receptors in the blood vessels to produce vasoconstriction and raise blood pressure. Incorrect Feedback: Vasopressor drugs do stimulate alpha receptors to raise the blood pressure. c. They stimulate beta1 receptors to increase the heart rate. Incorrect Feedback: Vasopressor drugs do stimulate beta1 receptors to increase the heart rate. 13. Which of the following drugs does NOT belong to the category of vasopressor drugs? a. calcium chloride b. dopamine c. isoproterenol d. norepinephrine Answer: a. calcium chloride Correct Feedback: Calcium chloride stimulates the heart to contract more forcefully. It is not a vasopressor drug. b. dopamine Incorrect Feedback: Dopamine is a vasopressor drug. c. isoproterenol Incorrect Feedback: Isoproterenol is a vasopressor drug. d. norepinephrine Incorrect Feedback: Norepinephrine is a vasopressor drug. 14. Which of the following is NOT one of the three ways that drugs work in treating overdoses, suicide attempts, or an accidental poisoning? a. binding the ingested drug to another substance to make it inert b. inactivating the drug in the blood c. metabolizing the drug in the blood, liver, or kidneys d. removing the drug from the stomach Answer: c. metabolizing the drug in the blood, liver, or kidneys Correct Feedback: Any drug or substance, when ingested in large amounts, can be toxic and fatal. Treatment consists of removing the drug from the stomach (emetic drugs), binding the ingested drug to another substance to make it inert (adsorbent drugs), and/or inactivating the drug in the blood (antagonist drugs). a. binding the ingested drug to another substance to make it inert Incorrect Feedback: This is one of the ways. b. inactivating the drug in the blood Incorrect Feedback: This is one of the ways. d. removing the drug from the stomach Incorrect Feedback: This is one of the ways. 15. Which of the following is NOT an effect of drugs nalmefene (Revex) and naloxone (Narcan)? a. blocking the same receptors as a narcotic drug b. competing for the same receptors as narcotic drugs c. decreasing a narcotic drug’s effects d. decreasing a narcotic drug’s potency Answer: d. decreasing a narcotic drug’s potency Correct Feedback: Narcotic antagonist drugs compete for the same receptor sites as a narcotic drug, block those receptors, and decrease the narcotic drug’s effects of unconsciousness, respiratory depression, and hypotension. a. blocking the same receptors as a narcotic drug Incorrect Feedback: This is an effect of these drugs. b. competing for the same receptors as narcotic drugs Incorrect Feedback: This is an effect of these drugs. c. decreasing a narcotic drug’s effects Incorrect Feedback: This is an effect of these drugs. 16. Which I.V. fluid contains the same electrolytes in proportions that parallel those in tissue fluid? a. D5W b. crystalloid c. 0.9% NaCl d. whole blood Answer: c. 0.9% NaCl Correct Feedback: The intravenous fluid 0.9% NaCl contains electrolytes in proportions that parallel those in tissue fluids. This concentration is known as a physiologic salt solution or normal saline (NS). a. D5W Incorrect Feedback: The contents of D5W do not parallel tissue fluid. b. crystalloid Incorrect Feedback: The contents of crystalloid do not parallel tissue fluid. d. whole blood Incorrect Feedback: Whole blood is not an I.V. fluid. 17. PRBCs have an advantage over whole blood in that they can be given ________. a. to any patient without cross-matching b. during emergency resuscitation c. without causing fluid overload d. without the risk of causing a transfusion reaction Answer: c. without causing fluid overload Correct Feedback: Packed red blood cells (PRBCs) have an advantage over whole blood in that they can be given without causing fluid overload. This is especially important in patients with congestive heart failure and in premature infants who need the benefit of whole blood but cannot tolerate the increased blood volume. a. to any patient without cross-matching Incorrect Feedback: PRBCs need to be cross-matched before being transfused. b. during emergency resuscitation Incorrect Feedback: Drugs, rather than PRBCs, are given during emergency resuscitation. d. without the risk of causing a transfusion reaction Incorrect Feedback: PRBCs do cause a transfusion reaction if they are not typed and cross-matched before administration. 18. Unmatched platelets ________. a. can be given in an emergency and do not provoke a transfusion reaction b. can be given in an emergency, but still run the risk of causing a transfusion reaction c. cannot be given in an emergency because they are not effective d. cannot be given in an emergency because they may cause a transfusion reaction Answer: a. can be given in an emergency and do not provoke a transfusion reaction Correct Feedback: Platelets are cross-matched for best results, but in an emergency unmatched platelets can be given. Unmatched platelets do not provoke a transfusion reaction, but the body’s antibodies quickly destroy them and they are less effective than matched platelets. b. can be given in an emergency, but still run the risk of causing a transfusion reaction Incorrect Feedback: Unmatched platelets do not cause a transfusion reaction. c. cannot be given in an emergency because they are not effective Incorrect Feedback: Unmatched platelets can be given and are effective, but just less than matched platelets. d. cannot be given in an emergency because they may cause a transfusion reaction Incorrect Feedback: Unmatched platelets can be given in an emergency and do not cause a transfusion reaction. 19. A crash cart ________. a. is available in every patient area in a hospital Incorrect Feedback: This is true, but it is not the only correct answer. b. contains emergency drugs and resuscitative equipment Incorrect Feedback: This is true, but it is not the only correct answer. c. is in physician offices and clinics Incorrect Feedback: This is true, but it is not the only correct answer. d. all of the above Answer: d. all of the above Correct Feedback: A crash cart containing all necessary emergency drugs and resuscitative equipment is available in every patient area in the hospital, in physicians’ offices and clinics, and in other healthcare facilities. a. is available in every patient area in a hospital Incorrect Feedback: This is true, but it is not the only correct answer. b. contains emergency drugs and resuscitative equipment Incorrect Feedback: This is true, but it is not the only correct answer. c. is in physician offices and clinics Incorrect Feedback: This is true, but it is not the only correct answer. 20. Cryoprecipitate does NOT contain ______. a. factor VIII b. fibrinogen c. albumin d. von Willebrand’s factor Answer: c. albumin Correct Feedback: Cryoprecipitate contains concentrated amounts of factor VIII, fibrinogen, and von Willebrand’s factor, but does not contain albumin. a. factor VIII Incorrect Feedback: Cryoprecipitate does contain factor VIII. b. fibrinogen Incorrect Feedback: Cryoprecipitate does contain fibrinogen. d. von Willebrand’s factor Incorrect Feedback: Cryoprecipitate does contain von Willebrand’s factor. 21. Which of the following is NOT one of the risks associated with intracardiac injection of drugs? a. anaphylaxis b. cardiac tamponade c. coronary artery laceration d. pneumothorax Answer: a. anaphylaxis Correct Feedback: The intracardiac route carries with it the risk of pneumothorax, cardiac tamponade, or coronary artery laceration if the injection is not properly placed within the left ventricle. Anaphylaxis is not associated with intracardiac injection of drugs. b. cardiac tamponade Incorrect Feedback: Cardiac tamponade is a risk associated with the intracardiac injection of drugs. c. coronary artery laceration Incorrect Feedback: Coronary artery laceration is a risk associated with the intracardiac injection of drugs. d. pneumothorax Incorrect Feedback: Pneumothorax is a risk associated with the intracardiac injection of drugs. 22. The most commonly used intravenous fluids contain ______. a. dextrose b. electrolytes c. dextrose, electrolytes, or a combination of both d. lipids Answer: c. dextrose, electrolytes, or a combination of both Correct Feedback: The most commonly used intravenous fluids contain dextrose, electrolytes, or a combination of both. a. dextrose Incorrect Feedback: This is true, but it is not the only correct answer. b. electrolytes Incorrect Feedback: This is true, but it is not the only correct answer. d. lipids Incorrect Feedback: Intravenous lipids are not a common intravenous fluid. 23. When a drug is mixed into a large I.V. bag and the fluid is allowed run in over several hours, this is known as _____. a. I.V. push b. I.V. drip c. I.V. piggyback d. none of the above Answer: b. I.V. drip Correct Feedback: In an intravenous drip, a drug can be injected into the IV bag and administered continuously over several hours along with the IV fluid, at the same rate of flow prescribed for the IV fluid. a. I.V. push Incorrect Feedback: A drug in a large bag of I.V. fluids given over several hours is not I.V. push. c. I.V. piggyback Incorrect Feedback: A drug in a large bag of I.V. fluids given over several hours is not I.V. piggyback. d. none of the above Incorrect Feedback: One of the answers is correct. 24. Intravenous fluids contain what type of sugar to provide energy to the patient? a. electrolytes b. glucose c. dextrose d. saline Answer: c. dextrose Correct Feedback: Glucose, a simple sugar, is the only form of carbohydrate that cells can use as a source of energy. Intravenous fluids contain a glucose-type sugar known as dextrose. a. electrolytes Incorrect Feedback: Electrolytes are not a type of sugar. b. glucose Incorrect Feedback: Glucose is the sugar found in the blood. d. saline Incorrect Feedback: Saline is not a type of sugar. 25. A 0.9 percent solution of sodium chloride is also known as _____. a. Ringer’s lactate b. D5W c. TPN d. normal saline Answer: d. normal saline Correct Feedback: normal saline (NS) is 0.9% NaCl. a. Ringer’s lactate Incorrect Feedback: This is not true. b. D5W Incorrect Feedback: This is not true. c. TPN Incorrect Feedback: This is not true. 26. Total parenteral nutrition contains all of the following ingredients EXCEPT _____. a. dextrose and electrolytes b. vitamins and minerals c. fats d. amino acids Answer: c. fats Correct Feedback: Patients whose nutritional needs cannot be met with dextrose and electrolyte fluids can be given a specially prepared intravenous fluid known as total parenteral nutrition (TPN). It contains specific amounts of essential amino acids (proteins), as well as electrolytes, vitamins, and minerals. Only intravenous lipids contain fat. a. dextrose and electrolytes Incorrect Feedback: Total parenteral nutrition does contain dextrose and electrolytes. b. vitamins and minerals Incorrect Feedback: Total parenteral nutrition does contain vitamins and minerals. d. amino acids Incorrect Feedback: Total parenteral nutrition does contain amino acids. 27. All of the following are cross-matched EXCEPT _____. a. whole blood b. fresh frozen plasma c. packed red blood cells d. platelets Answer: b. fresh frozen plasma Correct Feedback: Plasma has an advantage over blood in that it does not need to be typed and cross-matched. Before whole blood can be given as a transfusion, the patient and the unit of blood must both be typed (for blood type) and crossmatched (to each other) to assure compatibility and avoid a transfusion reaction (hemolysis of red blood cells due to incompatibility of blood types). PRBCs must be typed and cross-matched before being given to a patient. Platelets are crossmatched for best results. a. whole blood Incorrect Feedback: Whole blood is cross-matched. c. packed red blood cells Incorrect Feedback: Packed red blood cells are cross-matched. d. platelets Incorrect Feedback: Platelets are cross-matched. 28. Which of the following is an example of a plasma volume expander? a. hetastarch (Hespan) b. dextran (Macrodex, Rheomacrodex) c. plasma d. a and b Answer: d. a and b Correct Feedback: Plasma volume expanders are given intravenously to restore blood volume to normal levels and include dextran (Macrodex, Rheomacrodex) and hetastarch (Hespan). a. hetastarch (Hespan) Incorrect Feedback: This is true, but it is not the only correct answer. b. dextran (Macrodex, Rheomacrodex) Incorrect Feedback: This is true, but it is not the only correct answer. c. plasma Incorrect Feedback: Plasma is not a plasma volume expander. 29. A patient in cardiac arrest may be given drugs to resuscitate him/her by all of the following routes EXCEPT _____. a. intracardiac b. intravenous c. oral d. endotracheal tube Answer: c. oral Correct Feedback: In an emergency, most routes of administration (like the oral route) result in too slow an absorption rate for the drug to produce a therapeutic effect before the patient dies. a. intracardiac Incorrect Feedback: The intracardiac route is used during cardiac arrest. b. intravenous Incorrect Feedback: The intravenous route is used during cardiac arrest. d. endotracheal tube Incorrect Feedback: The endotracheal tube route is used during cardiac arrest. 30. Which of the following statements is FALSE? a. Intravenous drugs are given as a bolus in an emergency. b. Atropine is used to treat bradycardia. c. Some intravenous drugs may be given through an endotracheal tube. d. Adrenalin is given to slow the heart rate. Answer: d. Adrenalin is given to slow the heart rate. Correct Feedback: As epinephrine (Adrenalin) stimulates the heart to beat; it also helps to maintain blood pressure. a. Intravenous drugs are given as a bolus in an emergency. Incorrect Feedback: This is a true statement. b. Atropine is used to treat bradycardia. Incorrect Feedback: This is a true statement. c. Some intravenous drugs may be given through an endotracheal tube. Incorrect Feedback: This is a true statement. 31. Which drug is used to treat an overdose of a narcotic drug? a. epinephrine (Adrenalin) b. naloxone (Narcan) c. calcium chloride d. lidocaine (Xylocaine) Answer: b. naloxone (Narcan) Correct Feedback: An overdose of a narcotic drug can be reversed by giving a narcotic antagonist or blocker drug, such as naloxone (Narcan), intravenously. a. epinephrine (Adrenalin) Incorrect Feedback: Epinephrine (Adrenalin) is not used to treat an overdose of a narcotic drug. c. calcium chloride Incorrect Feedback: Calcium chloride is not used to treat an overdose of a narcotic drug. d. lidocaine (Xylocaine) Incorrect Feedback: Lidocaine (Xylocaine) is not used to treat an overdose of a narcotic drug. 32. Activated charcoal is classified as a/an ______ drug. a. absorbent b. vasopressor c. tranquilizer antagonist d. emetic Answer: a. absorbent Correct Feedback: Absorbent drugs such as activated charcoal attract and attach other substances, such as an overdose of a drug or a toxic substance, to themselves, so that the drugs or toxic substances are not absorbed from the stomach into the blood. b. vasopressor Incorrect Feedback: Activated charcoal is not a vasopressor drug. c. tranquilizer antagonist Incorrect Feedback: Activated charcoal is not a tranquilizer antagonist drug. d. emetic Incorrect Feedback: Activated charcoal is not an emetic drug. 33. Which of the following statements is FALSE? a. Digoxin has a low therapeutic index and a long half-life. b. It is not uncommon for elderly patients to experience digoxin toxicity. c. Digoxin immune Fab is an antidote for digoxin toxicity. d. Digoxin immune Fab is a drug derived from cow antibodies. Answer: d. Digoxin immune Fab is a drug derived from cow antibodies. Correct Feedback: Digoxin immune fab is an antigen-binding fragment obtained from sheep that have been treated to produce antibodies against the drug molecule of digoxin. a. Digoxin has a low therapeutic index and a long half-life. Incorrect Feedback: This is a true statement. b. It is not uncommon for elderly patients to experience digoxin toxicity. Incorrect Feedback: This is a true statement. c. Digoxin immune Fab is an antidote for digoxin toxicity. Incorrect Feedback: This is a true statement. 34. Ethylene glycol _____ . a. is also known as antifreeze b. can be abused recreationally or swallowed accidentally c. can cause central nervous system damage, blindness or death d. all of the above Answer: d. all of the above Correct Feedback: Ethylene glycol (antifreeze) abused recreationally or swallowed accidentally can result in central nervous system damage, blindness, or death. a. is also known as antifreeze Incorrect Feedback: This is true, but it is not the only correct answer. b. can be abused recreationally or swallowed accidentally Incorrect Feedback: This is true, but it is not the only correct answer. c. can cause central nervous system damage, blindness or death Incorrect Feedback: This is true, but it is not the only correct answer. 35. Intravenous fluids may be administered for any of the following reasons EXCEPT ______. a. to correct decreased levels of electrolytes, glucose, and fluids b. to administer drugs c. to eliminate the need for eating in patients with bulimia d. to provide nutritional support to patients who are NPO Answer: c. to eliminate the need for eating in patients with bulimia Correct Feedback: Intravenous (IV) fluids may be prescribed and administered for any of these reasons: 1. to correct decreased levels of body fluid volume, electrolytes, or glucose; 2. to provide nutritional support to patients who are NPO (nothing by mouth) or who are temporarily unable to take in sufficient nutrients or fluids; 3. to administer drugs, blood, or plasma products; and 4. to maintain venous access between drug doses. a. to correct decreased levels of electrolytes, glucose, and fluids Incorrect Feedback: This is a true statement. b. to administer drugs Incorrect Feedback: This is a true statement. d. to provide nutritional support to patients who are NPO Incorrect Feedback: This is a true statement. 36. An overdose of Tylenol is treated with the drug ______. a. NAVEL b. Chemet c. atropine d. Mucomyst Answer: d. Mucomyst Correct Feedback: Acetylcysteine (Acetadote, Mucomyst) is used to treat acetaminophen overdose. a. NAVEL Incorrect Feedback: NAVEL is not used to treat Tylenol overdose. b. Chemet Incorrect Feedback: Succimer (Chemet) is not used to treat Tylenol overdose. c. atropine Incorrect Feedback: Atropine is not used to treat Tylenol overdose. 37. Whole blood contains all of the following EXCEPT ______. a. red blood cells, white blood cells, and platelets b. lactated Ringer’s c. plasma d. albumin, globulins, electrolytes, and clotting factors Answer: b. lactated Ringer’s Correct Feedback: Whole blood contains all of the cellular components (red blood cells, white blood cells, and platelets), as well as plasma and its constituents (albumin, globulins, clotting factors, and electrolytes). Lactated Ringer’s is an intravenous fluid. a. red blood cells, white blood cells, and platelets Incorrect Feedback: Whole blood does contain these. c. plasma Incorrect Feedback: Whole blood does contain plasma. d. albumin, globulins, electrolytes, and clotting factors Incorrect Feedback: Whole blood does contain these. 38. Intracardiac injections are used frequently and can be valuable when other routes have failed to produce a therapeutic effect. Answer: False Feedback: Intracardiac injection is not used frequently, but can be valuable when other routes have failed to produce a therapeutic effect. 39. Ipecac syrup can only be given to a patient who is conscious. Answer: True Feedback: Drugs such as ipecac syrup that induce vomiting are useful only if the patient is conscious and will not aspirate vomited stomach contents. 40. Basic cardiopulmonary resuscitation involves the use of drug therapy. Answer: False Feedback: Advanced cardiac life support (ACLS) includes the use of drug therapy. 41. Laypersons think that donating a unit of blood is about equal to a pint of blood, but they are not equivalent. Answer: False Feedback: A unit of whole blood contains 500 mL. The common phrase “a pint of blood” is fairly accurate and easy for laypersons to remember. One pint is equivalent to 473.17 mL, or nearly 1 unit of blood. 42. Histamine is released in massive amounts during anaphylaxis. Answer: True Feedback: Any allergic reaction involves the release of histamine. However, in anaphylaxis, massive amounts of histamine are released. 43. Lidocaine (Xylocaine) has no effect when given during resuscitation if the heart has already stopped. Answer: True Feedback: Lidocaine (Xylocaine) has no therapeutic effect if the heart is already in asystole. 44. An ampule can be used only once and the remaining, unused drug must be discarded because it contains no preservative. Answer: True Feedback: An ampule can be used only once and the remaining, unused drug must be discarded because it contains no preservative. 45. Intravenous lipids contain about 30 percent more calories per gram than intravenous dextrose. Answer: True Feedback: Lipids (fats) are a more concentrated source of calories than dextrose (fats contain about 30 percent more calories per gram than dextrose). 46. The sodium bicarbonate that is used to treat metabolic acidosis during resuscitation is the same drug that is given orally as an antacid to neutralize excess acid in the stomach and treat an upset stomach and heartburn. Answer: True Feedback: Sodium bicarbonate is given orally as an antacid to neutralize excess acid in the stomach and treat an upset stomach and heartburn. 47. Ipecac syrup can be a drug of abuse in patients with bulimia who use it to induce vomiting. Answer: True Feedback: Bulimia is a psychiatric disease in which patients eat excessive amounts of food (binge) and then try to rid themselves of the food (purge) by using ipecac syrup to induce vomiting. 48. An ampule has a rubber stopper in its top so that multiple doses of the drug can be withdrawn at different times. Answer: False Feedback: A vial has a rubber stopper in its top so that multiple doses of the drug can be withdrawn at different times. 49. All donated blood is tested for syphilis, hepatitis, and HIV according to guidelines established by the Food and Drug Administration. Answer: True Feedback: All donated blood is tested for syphilis, hepatitis, and HIV according to guidelines established by the Food and Drug Administration. 50. Glucose is the form of sugar that is used in intravenous fluids. Answer: False Feedback: Intravenous fluids contain a glucose-type sugar known as dextrose. 51. PRBCs are a concentrated preparation of RBCs in a small amount of plasma. Answer: True Feedback: Packed red blood cells (PRBCs) are a concentrated preparation of red blood cells in a small amount of plasma. 52. Plasma and plasma volume expanders do not contain any blood cells. Answer: True Feedback: Plasma and plasma volume expanders do not contain blood cells. 53. Plasma needs to be typed and cross-matched prior to administration because of the risk associated with transfusion reactions. Answer: False Feedback: Plasma has an advantage over blood in that it does not need to be type and cross-matched. 54. FFP contains all of the plasma proteins, but does not contain the clotting factors. Answer: False Feedback: Fresh frozen plasma (FFP) consists of plasma that contains all of the plasma proteins and clotting factors. 55. The routes of administration for emergency drugs are the same routes that are commonly used to administer other drugs. Answer: False Feedback: Most of the routes used to administer emergency drugs are different from the routes normally used to administer drugs. This is because of the need to have the drugs take immediate effect throughout the body. 56. If the heart has completely stopped beating (asystole), epinephrine can actually stimulate contractions of the myocardium. Answer: True Feedback: If the heart has stopped beating completely (asystole), epinephrine can actually stimulate contractions of the myocardium. 57. Absorbent drugs can be administered at any time after an overdose of a drug of an accidental ingestion of a toxic substance. Answer: False Feedback: Treatment with absorbent drugs is not effective if the overdosed drug or toxic substance has already been absorbed from the stomach into the blood. 58. Dextrose and electrolyte intravenous fluids are used to maintain fluid and electrolyte balance and supply calories, but they are unable to completely meet long-term needs. Answer: True Feedback: Dextrose and electrolyte intravenous fluids are used to maintain fluid and electrolyte balance and supply calories, but they are unable to completely meet long-term nutritional needs. 59. Drugs used to treat anaphylaxis constrict the blood vessels to restore a normal blood pressure and relax bronchial smooth muscle to allow adequate air flow. Answer: True Feedback: Drugs used to treat anaphylaxis constrict the blood vessels to restore a normal blood pressure and relax bronchial smooth muscle to allow adequate air flow. 60. Whole blood has a refrigerated shelf life of _____ days. Answer: 42; forty two; forty-two Feedback: Whole blood and red blood cells have a refrigerated shelf life of 42 days, according to the American Red Cross. 61. Give the trade name for the intravenous form of the generic drug epinephrine. _______ Answer: Adrenalin Feedback: epinephrine (Adrenalin, EpiPen) 62. What mnemonic device helps you remember which emergency drugs can be given by endotracheal tube? _____________ Answer: NAVEL Feedback: Healthcare professionals use the acronym NAVEL, as given in the Advanced Cardiac Life Support (ACLS) Guidelines, to help them remember which emergency drugs are appropriate to give via an endotracheal tube: naloxone, atropine, Valium (diazepam), epinephrine, and lidocaine. 63. The abbreviation _____ stands for the federal organization that is responsible for the safety of blood and blood products in the United States. Answer: FDA Feedback: The Food and Drug Administration (FDA) is the federal organization that is responsible for the safety of blood and blood products in the United States. 64. Patients preparing to have surgery can donate a unit of their own blood in advance so they can receive it during surgery. This is known as a/an _____ blood transfusion. Answer: autologous Feedback: Patients preparing to have surgery can donate a unit of their own blood in advance so they can receive it during surgery. This is known as an autologous blood transfusion. 65. Drugs used to treat an acetaminophen drug overdose act to protect the ______, the main site of acetaminophen toxicity. Answer: liver Feedback: Drugs used to treat an acetaminophen drug overdose act to protect the liver, the main site of acetaminophen toxicity. 66. When a patient is in ventricular fibrillation, the drug lidocaine slows the electrical impulses of the heart by inhibiting the flow of _____ into the myocardial cell. Answer: sodium Feedback: Lidocaine is indicated for the management of life-threatening ventricular fibrillation and is the drug of choice in resuscitative efforts for patients with this problem. It inhibits the flow of sodium into the myocardial cell; this slows the electrical impulse that causes the heart to fibrillate. 67. To treat bradycardia, the drug __________ blocks the action of acetylcholine released from the vagus nerve. Answer: atropine Feedback: When acetylcholine is released, the heart rate slows. Atropine blocks this action and is used specifically to treat severe bradycardia and bradyarrhythmias such as heart block. 68. Ipecac syrup is classified as a/an _________ drug, because it induces vomiting. Answer: emetic Feedback: Emetic drugs induce vomiting: Ipecac syrup. 69. An overdose of a narcotic drug can be reversed by giving intravenously a narcotic ________ drug (also known as a narcotic blocker drug). Answer: antagonist Feedback: An overdose of a narcotic drug can be reversed by giving a narcotic antagonist drug or narcotic blocker drug intravenously. 70. __________ is the name of a general category that refers to any intravenous fluid that provides dextrose and sodium chloride alone or in combination with other electrolytes. Answer: Crystalloid Feedback: Crystalloid is the name of a general category that refers to any intravenous fluid that provides dextrose and sodium chloride alone or in combination with other electrolytes. 71. To meet the dietary fat requirements of a patient who cannot eat, a separate intravenous solution of __________ may be ordered. Answer: lipids Feedback: To meet a patient’s dietary fat requirements, a separate intravenous solution of lipids may be ordered. 72. Define these abbreviations. CPR _____________ FFP ______________ PRBCs ___________ TPN ______________ Answer: cardiopulmonary resuscitation, fresh frozen plasma, packed red blood cells, total parenteral nutrition Feedback: Basic life support measures are performed in cardiopulmonary resuscitation (CPR). The abbreviation FFP stands for fresh frozen plasma. Packed red blood cells (PRBCs) are a concentrated preparation of red blood cells (RBCs) in a small amount of plasma. Patients whose nutritional needs cannot be met with dextrose and electrolyte fluids can be given a specially prepared intravenous fluid known as total parenteral nutrition (TPN). 73. 1. fomepizole (Antizol) A. cyanide or pesticide poisoning 2. methylene blue (Urolene Blue) B. ethylene glycol and methanol poisoning 3. nalmefene (Revex) C. lead, mercury, arsenic, gold, iron, or aluminum toxicity 4. physostigmine (Antilirium) D. narcotic overdose 5. succimer (Chemet) E. tricyclic-type antidepressant overdose Answer: B Answer: A Answer: D Answer: E Answer: C Feedback: These drugs and what they are used to treat are found throughout the chapter. 74. 1. continuous infusion A. access to veins without the need for infusing fluid 2. saline or heparin lock main I.V. tubing. B. drug mixed in a small bag and connected to the 3. I.V. piggyback predetermined rate C. fluid flowing through an I.V. line at a 4. I.V. push patent D. infusion at a very slow rate, keeping the vein 5. KVO tubing E. injection as a bolus through a port on the I.V. Answer: C Answer: A Answer: B Answer: E Answer: D Feedback: In continuous infusion, the intravenous fluid flows continuously at a predetermined rate through an intravenous line and into a vein. Saline or heparin lock is a special device allowing IV access without the need for continuously infusing IV fluids. IV piggyback refers to a drug that can be added to the intravenous fluids in a very small IV bag whose tubing is connected into the main IV tubing. IV push refers to a drug injected all at one time (a bolus) through a port (rubber stopper) into the end of the IV tubing. If the patient does not need a large volume of IV fluid, but does need to have access maintained via the IV route, the physician can order the IV fluid to infuse at a very slow rate to just keep the vein open (KVO). 75. Briefly explain how the endotracheal tube route of drug administration is used to give emergency drugs and how the drugs are able to move into the blood. Answer: Drugs are administered by placing them into an endotracheal tube. As the lungs are mechanically ventilated, the drug solution is propelled into the lungs, where it is absorbed by the lung tissue and rapidly enters the blood. 76. List two of the three actions that epinephrine performs in preparing the body to respond with either “flight or fight.” Answer: Epinephrine prepares the body to respond with either “flight or fight” by stimulating alpha receptors to constrict the peripheral blood vessels and raise the blood pressure; stimulating beta1 receptors in the heart to increase the heart rate and cardiac output; and stimulating beta2 receptors in the lungs to relax bronchial smooth muscle, dilate the bronchi, and increase air flow to the lungs. 77. Briefly explain why sodium bicarbonate is used in resuscitation and why some say that its use should be limited. Answer: During cardiac and respiratory arrest, the pH of the blood decreases rapidly as carbon dioxide and waste products accumulate in the blood. In this environment of severe acidosis, the effectiveness of any emergency drug is greatly diminished. Sodium bicarbonate corrects the acidosis by buffering excess hydrogen ions and returning the blood pH to within a normal range. There is controversy as to the true effectiveness of sodium bicarbonate. It may actually increase acidosis through a chemical reaction that releases more CO2 in the blood. The American Heart Association guidelines recommend using it only after other measures have failed. 78. When an alcoholic drinks methanol (wood alcohol), what happens to it in the body that makes it a poison? Answer: Sometimes, an alcoholic patient will drink methanol instead of ethanol (liquor). In the body, methanol is metabolized into formaldehyde, a toxic chemical that is used by pathologists to preserve biopsied tissue specimens. 79. Briefly explain when type and cross-match are done and why they are done. Answer: Before whole blood can be given as a transfusion, the patient and the unit of blood must both be typed (for blood type) and cross-matched (to each other) to assure compatibility and avoid a transfusion reaction (hemolysis of red blood cells due to incompatibility of blood types). 80. Why is it so important to maintain blood flow to the kidneys during resuscitation? Answer: The desirable effect of maintaining blood flow to the kidneys so that kidney ischemia does not later result in renal failure, which would complicate an otherwise successful resuscitative effort. 81. Why is the intravenous fluid half normal saline written as 0.45% instead of as 0.5%? Answer: Normal saline is an intravenous solution of 0.9 percent sodium chloride and water. Half normal saline is written as 0.45% (not 0.5%), because 0.45% is one half of 0.9%.ss Test Bank for Understanding Pharmacology for Health Professionals Susan M. Turley 9780135145708, 9780133911268
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