REMS CLINICAL GUIDELINES EXAM QUESTIONS AND ACCURATE ANSWERS VERIFIED BY EXPERTS |ACCURATE ACTUAL EXAM WITH FREQUENTLY TESTED QUESTIONS |ALREADY GRADED A+ |GUARANTEED PASS |LATEST UPDATE

REMS CLINICAL GUIDELINES EXAM QUESTIONS AND ACCURATE ANSWERS VERIFIED BY EXPERTS |ACCURATE ACTUAL EXAM WITH FREQUENTLY TESTED QUESTIONS |ALREADY GRADED A+ |GUARANTEED PASS |LATEST UPDATE Hypertensive Emerg ency: Interventions - CORRECT ANSWER -vitals --> manual blood pressure -LAPSS -elevate head to 15 degrees -12 lead -IV access Hypertensive Emergency: Considerations - CORRECT ANSWER -don't treat asymptomatic hypertension -don't reduce BP in symptomati c hypertension by more than 10% -means end -organ damage --> assessment should include ACS, stroke, and renal failure Neonatal Resuscitation: Interventions - CORRECT ANSWER -position newborn on back, airway in sniffing position -suction mouth and nose usi ng bulb suction if thick meconium or secretions present and signs of respiratory distress -dry, place on blanket, cover head, keep warm -tactile stimulation -resuscitation: PPV, compressions -BGL -IV NS Neonatal Resus: HR < 100 bpm, gasping, or apnea - CORRECT ANSWER -PPV w room air at 40-60 breaths/min -no improvement after 90s --> ventilate w oxygen until heart rate normalizes then reassess Neonatal Resus: HR < 60 bpm - CORRECT ANSWER -PPV w/ oxygen @ 40 -60 breaths/min -no improvements after 60 s--> chest compressions at 3:1 ratio Hypoglycemia in newborns - CORRECT ANSWER -BGL < 30 in first 24 hr of life -BGL < 45 thereafter Neonatal Resus: NS admin - CORRECT ANSWER 10 mL/kg over 5 - 10 min Neonatal Resus: persistent obtundation and susp icion of maternal narcotic use - CORRECT ANSWER Naloxone 0.1 mg/kg ever 5 min (max 4 mg) Pre-eclampsia/Eclampsia: Criteria - CORRECT ANSWER -SBP > 160 or DBP > 110 -peripheral edema -persistent/severe headaches -visual abnormalities -upper abdominal pai n or epigastric pain -n/v -dyspnea and/or retrosternal chest pain -AMS Pre-eclampsia/Eclampsia: Treatment - CORRECT ANSWER -vital signs -left lateral recumbent -IV and NS Pre-eclampsia/Eclampsia: IV and NS - CORRECT ANSWER -TKO if SBP > 100 w/o hypote nsion symptoms -250 mL bolus if SBP < 100 w/ hypotension symptoms and no signs of pulmonary edema (repeat up to 1 L) Vaginal Bleeding: Causes - CORRECT ANSWER -abruptio placenta -placenta previa -uterine rupture -miscarriage -postpartum hemorrhage Vaginal Bleeding: Treatment - CORRECT ANSWER -vitals -manage CABCs -oxygen -left lateral recumbent or trendelenburg -uterine massage starting from pubis towards umbilicus clockwise if postpartum hemorrhage -neonatal resus if miscarriage and f etus greater than or equal to 20 weeks in gestation -IV and NS admin (same as pre -eclampsia) Vaginal Bleeding: miscarriage and fetus < 20 weeks - CORRECT ANSWER -if pulseless and apneic, no resus -any question to gestation --> resus -spontaneous respir ations and/or pulses --> resus and transport APGAR: A - CORRECT ANSWER 2: active moment w/ flexed arms and legs 1: arms and legs extended 0: no response APGAR: P - CORRECT ANSWER 2: >100 bpm 1: < 100 bpm 0: absent Student Health Services - CORRECT ANSWER 713 -348-4966 Send burns to: - CORRECT ANSWER Memorial Hermann Send chemical exposures to: - CORRECT ANSWER Memorial Hermann Send dental emergencies to: - CORRECT ANSWER hospital -based emergency department Send eye injury/condition to: - CORRECT ANSWER hospital -based emergency department Send psych to: - CORRECT ANSWER -Ben Taub -Methodist (inpatient care) Send sexual assault to: - CORRECT ANSWER -Ben Taub: SANE -TCH or Hermann for peds Peds pads are used on: - CORRECT ANSWER pt less than 8 or under 25 kg 5 rights of med administration - CORRECT ANSWER -patient -route -dose -time -medication Contraindications of IV access - CORRECT ANSWER -risk of introducing in fection -distal to a fracture -underlying cellulitis/abscess -same extremity as AV fistula in ESRD pt -upper extremities of pt w/ axillary node removal When to stop attempting IV - CORRECT ANSWER after 2 min or 2 tries Contraindications to IO - CORRECT ANSWER -can't locate anatomical landmarks -suspected cellulitis at insertion site -suspected acute or non -healed fracture proximal to foot in same leg or proximal to forearm in same arm -suspected total knee arthroplasty/replacement -poor circulat ion extremity IO: Pink needle - CORRECT ANSWER 15 mm for 3 -39 kg IO: Blue needle - CORRECT ANSWER 25 mm for 3 kg IO: Yellow needle - CORRECT ANSWER 45 mm for 40 kg IO Complications - CORRECT ANSWER -through and through bone penetration -extravasati on -fracture of bone -infection -growth plate injury in peds Which pts require careful monitoring of the airway? - CORRECT ANSWER intoxicated, trauma, or AMS Contraindications for O2 - CORRECT ANSWER SpO2 > or equal to 95 Flow rate of nasal cannula - CORRECT ANSWER 2 -6 L/min Flow rate of nebulizer - CORRECT ANSWER 6 -8 L/min Flow rate of NRB - CORRECT ANSWER 10 -15 L/min Flow rate of BVM - CORRECT ANSWER 15 -20 L/min Criteria for Supraglottic Airway - CORRECT ANSWER -hypoxia and/or hypoventilation refractory to noninvasive airway/respiratory management -airway protection to reduce aspiration in setting of sustained AMS w/ GCS < 8 Contraindications for Supraglottic Airway - CORRECT ANSWER -maintain oxygenation/ventilation by less in vasive methods (BVM) -intact gag reflex -known esophageal disease -ingestion of caustic substance or extensive airway burns -tracheotomy or laryngectomy -suspected foreign body airway obstruction Green king tube - CORRECT ANSWER -cuff volume: 25 -35 mL -height: 35 -45 in, 90 -115 cm Orange king tube - CORRECT ANSWER -cuff volume: 30 -40 mL -height: 41 -51 in, 105 -130 cm Yellow king tube - CORRECT ANSWER -cuff volume: 45 -60 mL -height: 4 -5 ft, 122 -155 cm -recalled for peds use, can use in adults Red king t ube - CORRECT ANSWER -cuff volume: 60 -80 mL -height: 5 -6 ft, 155 -180 cm Purple king tube - CORRECT ANSWER -cuff volume: 70 -90 mL -height: >6 ft, >180 cm LAPSS - CORRECT ANSWER -Age > 45 -no history of seizures and epilepsy -symptoms duration < 24 hr