Angelina College : EMSP 1381 Exam 2 Pretest 2025/26| Answered 100% Correct.

Angelina College : EMSP 1381 Exam 2 Pretest 2025/26| Answered 100% Correct. Exam 2 Pretest 2025/26. 1. Diazepam and midazolam provide which of the following therapeutic effects? CNS depressant Dissociative anesthetic Sedative Analgesic 2. You have decided to intubat e an 198 lb patient to control airway. Given your protocol of 0.6 mg/kg, you administer of Rocuronium to perform endotracheal intubation. Given the below packaging, you should administer . When using rocuronium, it's extremely important to also . - 108mg -198mg -54 mg -30mg -30cc -5.4cc -19.8ml -.108ml -keep the patient cool -remove the patient’s clothing -obtain a 12 lead EKG first -sedate the patient 3. Drugs such as vecuronium bromide (Norcuron) and pancuronium bromide (Pavulon) are appropriate to administer when: you have a transport time of less than 15 minutes. longer-acting paralytics are contraindicated. extended periods of paralysis are needed. intubation of the patient is anticipated to be difficult. 4. Fentanyl (Sublimaze) is a: narcotic analgesic. butyrophenone sedative. sedative-hypnotic drug. benzodiazepine sedative. 5. If the patient's oxygen saturation drops at any point during rapid sequence intubation, you should: apply posterior cricoid pressure and continue the intubation attempt. continue the intubation attempt and monitor the cardiac rhythm closely. abort the intubation attempt and ventilate with a bag-mask device. stop and hyperventilate the patient at a rate of 24 breaths/min. 6. Neuromuscular blocking agents: have a negative effect on both cardiac and smooth muscle and commonly cause dysrhythmias. convert a breathing patient with a marginal airway into an apneic patient with no airway. induce total body paralysis within 10 to 15 minutes following administration via IV push. are most commonly used as the sole agent to facilitate placement of an ET tube. 7. Paralytic medications exert their effect by: blocking the function of the autonomic nervous system and impeding the action of acetylcholinesterase. competitively binding to the motor neurons in the brain, thus blocking their ability to send messages. blocking the release of epinephrine and norepinephrine from the sympathetic nervous system. functioning at the neuromuscular junction and relaxing the muscle by impeding the action of acetylcholine. 8. You are drawing up medications prior to an RSI procedure on an adult patient. The patient weighs 242 pounds. Based on the standard adult dose, you need to draw up mg of Etomidate, which is ml. (Based on the below vial) Answer 1: 33 Answer 2: 16.5 You need to draw up 33 mg of Etomidate, which is 16.5 ml. 9. The process of delayed sequence intubation involves: administering a paralytic only, followed by intubation in 2 to 3 minutes. administering a sedative in order to facilitate oxygenation of the patient. administering a sedative only, followed by intubation in 3 to 5 minutes. avoiding the need to intubate a patient through the use of CPAP or BPAP. 10. This is the vial your agency uses. Your protocol calls for an initial dose of 5 mg and a secondary dose of 2.5 mg. Assuming you give both doses, how much remaining medication will you have to waste once you arrive at the hospital? 2 ml 1 ml 1.5 ml 0.5 ml 11. The use of phenylephrine hydrochloride (Neo-Synephrine) during nasotracheal intubation may: sedate the patient and facilitate his or her compliance. reduce the likelihood and severity of nasal bleeding. anesthetize the nasopharynx and reduce patient discomfort. dilate the nasal vasculature and facilitate tube insertion. 12. To prevent muscular fasciculations associated with the use of succinylcholine, you should administer: 10% of the usual dose of a nondepolarizing paralytic. 0.5 mg of atropine sulfate via rapid IV push. an infusion of potassium chloride set at 5 mEq per hour. 1 to 1.5 mg/kg of lidocaine over 10 to 15 minutes. 13. Two attempts to ventilate an unconscious 10-year-old boy have been unsuccessful. You should next: look inside his mouth. perform chest compressions. deliver abdominal thrusts. intubate his trachea. 14. You are preparing to RSI an adult patient who weighs 176 pounds. Given a protocol of 1 mg/kg, the proper induction dose of succinylcholine is mg. Based on the concentration indicated on the vial below, you would draw up milliliters. Prior to pushing a paralytic, you need to push because succinylcholine mental status. Answers: 80 mg 4 mL a sedative/hypnotic does not affect -80mg -64mg -45.3mg -120mg -2 -8 -4 -8.8 -lidocaine -epinephrine -acetylcholine -a sedative/hypnotic -sedates -does not affect 15. Undersedation of a patient during airway management would likely result in: pulmonary aspiration. severe hypotension. respiratory depression. loss of airway reflexes. 16. When a patient is given a paralytic without sedation: they are fully aware and can hear and feel. you should only give one-tenth of the standard dose. paralysis is not achieved and intubation is not possible. placement of an ET tube is less traumatic. 17. A patient that weighs 154 pounds was intubated with the use of Etomidate, but is still showing physiologic signs of pain and distress. Your protocols call for 2 mcg/kg of Fentanyl in this case. The patient should thus receive 140 mcg of Fentanyl. Based on the concentration of the vial pictured below, you would draw up 2.8 ml. Final Answers: • Dose: 140 mcg • Volume: 2.8 mL Explanation: You calculated the correct dose based on weight, then converted the required dose into volume using the vial’s concentration. This ensures safe and accurate medication administration. Answer 1: 140 mcg Answer 2: 2.8 18. Which of the following is a depolarizing neuromuscular blocking agent? Succinylcholine chloride Midazolam Vecuronium bromide Atropine sulfate 19. Which of the following medications is a dissociative anesthetic that produces anesthesia through hallucinogenic, amnesic, analgesic, and sedative effects? Versed Diazepam Ketamine Fentanyl 20. During your intubation attempt, your partner tells you that the patient's heart rate is slowing down, or becoming bradycardic . You recognize this might be due to Vagus nerve stimulation . After you secure the tube, your partner notes they cannot feel a radial pulse. Your NEXT immediate step should be to check a carotid pulse . Answer 1: bradycardic Answer 2: Vagus nerve stimulation Answer 3: check a carotid pulse Correct Answers and Explanation: • Answer 1: bradycardic • Answer 2: Vagus nerve stimulation • Answer 3: check a carotid pulse Step-by-Step Explanation: 1. Recognition of Bradycardia: If during intubation the patient’s heart rate slows, this is described as becoming bradycardic (having a slow heart rate). 2. Cause—Vagus Nerve Stimulation: The bradycardia may be due to Vagus nerve stimulation, which can happen when manipulating the airway, especially during intubation. This reflex can slow the heart rate. 3. Next Step When Radial Pulse is Absent: If you cannot feel a radial pulse, it may indicate hypotension or cardiac arrest. The carotid pulse is more central and persists longer in low blood pressure states, so your next immediate step is to check a carotid pulse to quickly assess for the presence of central circulation. 21. Which of the following medications is a sedative-hypnotic drug? Alfentanil Fentanyl Etomidate Ketamine 22. Compared to succinylcholine, rocuronium: binds with nicotinic receptors on muscles and causes a brief activation known as fasciculation. has a rapid (30 to 60 seconds) onset of action and a relatively brief (3 to 8 minutes) duration of action. does not bind with nicotinic receptor sites on muscle cells and does not antagonize acetylcholine. has a rapid onset of action, a longer (15 to 60 minutes) duration of action, and fewer adverse effects. 23. Unlike a nondepolarizing paralytic, a competitive depolarizing paralytic: does not induce full paralysis. lowers serum potassium. causes muscle fasciculations. causes profound sedation. 24. Based on the standard adult dosing, Etomidate has an onset of about . Etomidate is meant to provide sedation. -20 minutes -1 minute -5 seconds -10 minutes -long term -Short term - no Correct Answer: • 1 minute • Short term 25. You arrive on scene for a 24 year old male weighing about 220 pounds, in dire need of RSI. Your ketamine is packaged as the picture below, and your protocol calls for 3 mg/kg IM. How many mL will you administer? 1. Convert weight from pounds to kilograms: 220 lbs÷2.2=100 kg220 lbs÷2.2=100 kg 2. Calculate ketamine dose: 3 mg/kg×100 kg=300 mg3 mg/kg×100 kg=300 mg 3. Determine concentration of ketamine (from typical vial, usually 100 mg/mL): If the vial says "100 mg/mL" (which is standard for ketamine vials as in the image): 4. Calculate the volume to administer: 300 mg100 mg/mL=3 mL100 mg/mL300 mg=3 mL ________________________________________ Final Answer: 3 mL3 mL Step-by-step explanation: • Convert lbs to kg: 220÷2.2=100220÷2.2=100 kg • Dose: 100 kg×3 mg/kg=300 mg100 kg×3 mg/kg=300 mg • Volume: 300 mg÷100 mg/mL=3 mL300 mg÷100 mg/mL=3 mL So, you will administer 3 mL of ketamine. 1 26. Which of the following medications is safest to use in patients with borderline hypotension or hypovolemia? Sublimaze Brevital Pentothal Etomidate 27. Which of the following factors increase a person's respiratory rate? The use of benzodiazepines Narcotic analgesic use Decreased metabolism The use of amphetamines 28. What class of drug is Midazolam? NSAID opiate benzodiazepine barbiturate 29. You are preparing to RSI a patient. Your partner is managing the airway and you are responsible for medications. Your patient weighs 176 lbs. The patient looks to be a difficult intubation. You first give Etomidate, which is a . If the dose is 0.3 mg / kg, and your drug is packaged 40 mg / 20 ml, you would need to push mL. Since you successfully gave Etomidate, you should now give a . If the dose is 1.5 mg / kg, and your drug is packaged 200 mg / 20 ml, you would need to push mL. You may also add an adjunct opiate at this point. Your protocols call for 2 mcg / kg of Fentanyl, and your packaging is 250 mcg / 5 mL. You will need to push mL on this patient. Once the ET Tube is secure, your protocols call for Midazolam 5 mg and Rocuronium 1.2 mg / kg. Midazolam is packaged 10 mg in 1 mL, and Rocuronium is packaged 50 mg in 5 mL. You will need to push mL of Midazolam and mL of Rocuronium. You place an OG tube, and attach suction. You are careful not to keep it on continuous suction, as the removal of so much stomach acid can result in which will their pH levels. During transport, you notice your partner who is ventilating is starting to get distracted and is slowing down the rate. You check the ETCO2 and, as expected, it is now . You instruct them to correct the rate, and the CO2 levels balance out. The patient begins to develop an increased pulse rate and shows signs of lacrimation. To correct this, you since you remember that . 1. Etomidate — Sedative Class: Short acting sedative Dose: 0.3 mg/kg 80,kg×0.3,mg/kg=24,mg80,kg×0.3,mg/kg=24,mg Packaging: 40 mg/20 ml 24,mg×20,ml40,mg=12,ml24,mg×40,mg20,ml=12,ml ________________________________________ 2. Succinylcholine — Paralytic Class: Short acting paralytic Dose: 1.5 mg/kg 80,kg×1.5,mg/kg=120,mg80,kg×1.5,mg/kg=120,mg Packaging: 200 mg/20 ml 120,mg×20,ml200,mg=12,ml120,mg×200,mg20,ml=12,ml ________________________________________ 3. Fentanyl — Opiate Analgesic (Adjunct) Dose: 2 mcg/kg 80,kg×2,mcg/kg=160,mcg80,kg×2,mcg/kg=160,mcg Packaging: 250 mcg/5 ml 160,mcg×5,ml250,mcg=3.2,ml160,mcg×250,mcg5,ml=3.2,ml ________________________________________ 4. Post-intubation: Midazolam and Rocuronium Midazolam: Packaged 10 mg/1 ml. Give 5 mg. 5,mg×1,ml10,mg=0.5,ml5,mg×10,mg1,ml=0.5,ml Rocuronium: 1.2 mg/kg × 80 kg = 96 mg Packaged 50 mg/5 ml 96,mg×5,ml50,mg=9.6,ml96,mg×50,mg5,ml=9.6,ml ________________________________________ 5. OG Tube/Suction Consideration Continuous suction can cause: Alkalosis (removal of stomach acid raises pH) ________________________________________ 6. Hypoventilation/ETCO2 If partner is slowing the rate, expect high ETCO2 (hypercapnia). ________________________________________ 7. Increasing Pulse/Lacrimation (Pain/Distress) -long acting paralytic -short acting paralytic -short acting sedative -long acting sedative - 26.4 -24 -12 -0.6 -short acting sedative -long acting sedative -short acting paralytic -long acting paralytic -12 -13.2 -20 -26.4 -3.2 -7 -160 -2.3 -0.5 -1 -5 -0.1 -48 -9.6 -2.5 -19.2 -alkalosis -acidosis -raise -drop -high -low -infuse fluid bolus -administer paralytics -administer a vasopressor -administer sedation -tear production is usually unaffected by paralytics -milk production can be triggered by sedatives -lactated ringers contains magnesium - aerobic metabolism can build up lactic acid