Preview Extract
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 nutritionr
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 airr
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. antagonistr
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 abover
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
Correct Feedback:
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. meningitisr
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 bicarbonater
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 acidosisr
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 bicarbonater
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.r
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 bicarbonater
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.r
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. norepinephriner
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 effectsr
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 crossmatched 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 reactionr
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. pneumothoraxr
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 abover
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. TPNr
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. plateletsr
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. plasmar
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.r
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)r
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. emeticr
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.r
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 deathr
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. atropiner
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 factorsr
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 crossmatched.
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 infusing fluid A. access to veins without the need for
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
