Primary Care Paramedic Medical Directives Version 3.2 ALS

thecatspyjamaz
Quiz by thecatspyjamaz, updated more than 1 year ago
thecatspyjamaz
Created by thecatspyjamaz about 4 years ago
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Description

Diploma Paramedic Quiz on Primary Care Paramedic Medical Directives Version 3.2 ALS, created by thecatspyjamaz on 02/24/2016.

Resource summary

Question 1

Question
The conditions for salbutamol are: AGE: N/A LOA: [blank_start]N/A[blank_end] HR: [blank_start]N/A[blank_end] RR: [blank_start]N/A[blank_end] SBP: N/A Other: [blank_start]N/A[blank_end]
Answer
  • N/A
  • N/A
  • N/A
  • N/A

Question 2

Question
The contraindications for salbutamol are: [blank_start]Allergy or sensitivity to salbutamol[blank_end]
Answer
  • Allergy or sensitivity to salbutamol

Question 3

Question
The conditions for epinephrine under the bronchoconstriction directive are: AGE: N/A LOA: [blank_start]N/A[blank_end] HR: [blank_start]N/A[blank_end] RR: [blank_start]BVM ventilation required[blank_end] SBP: [blank_start]N/A[blank_end] Other: [blank_start]Hx of asthma[blank_end]
Answer
  • N/A
  • N/A
  • BVM ventilation required
  • N/A
  • Hx of asthma

Question 4

Question
The contraindications for Epinephrine under the Bronchoconstriction Medical Directive are: [blank_start]Allergy or sensitivity to epinephrine[blank_end]
Answer
  • Allergy or sensitivity to epinephrine

Question 5

Question
Under the Bronchoconstriction Medical Directive Consider Salbutamol: Weight: <[blank_start]25[blank_end] kg Route: MDI Dose: Up to [blank_start]600[blank_end] mcg ([blank_start]6[blank_end] puffs) Max. Single Dose: [blank_start]600[blank_end] mcg Dosing interval [blank_start]5[blank_end]-[blank_start]15[blank_end] min. PRN Max # of doses [blank_start]3[blank_end]
Answer
  • 25
  • 30
  • 20
  • 5
  • 600
  • 800
  • 500
  • 700
  • 6
  • 1
  • 4
  • 8
  • 600
  • 800
  • 100
  • 10000
  • 5
  • 3
  • 8
  • 10
  • 15
  • 10
  • 8
  • 20
  • 3
  • 5
  • 7
  • 12

Question 6

Question
Under the Bronchoconstriction Medical Directive Consider epinephrine: Weight: [blank_start]N/A[blank_end] Route: [blank_start]IM[blank_end] Concentration: [blank_start]1:1,000[blank_end] Dose: [blank_start]0.01[blank_end]mg/kg Max. Single Dose: [blank_start]0.5[blank_end] mg Dosing interval : [blank_start]N/A[blank_end] Max # of doses: [blank_start]1[blank_end]
Answer
  • N/A
  • >25 kg
  • <25 kg
  • >50 kg
  • IM
  • IV
  • PO
  • SC
  • 1:1,000
  • 1:10,000
  • 2:20,000
  • 1:10
  • 0.01
  • 0.05
  • 0.5
  • 1.0
  • 0.5
  • 0.2
  • 1.0
  • 5.0
  • N/A
  • 10 min.
  • 3-5 min.
  • 5-15 min. PRN
  • 1
  • 2
  • 3
  • 6

Question 7

Question
Under the Bronchoconstriction Clinical Considerations: [blank_start]Epinephrine[blank_end] should be the [blank_start]first[blank_end] drug administered if the patient is [blank_start]apneic[blank_end]. [blank_start]Salbutamol[blank_end] MDI may be administered subsequently using a [blank_start]BVM MDI adapter[blank_end].
Answer
  • Epinephrine
  • first
  • apneic
  • Salbutamol
  • BVM MDI adapter

Question 8

Question
Under the Bronchoconstriction Clinical Considerations: Nebulizations is contraindicated in patients with a known or suspected [blank_start]fever[blank_end] or in the setting of a declared [blank_start]febrile[blank_end] [blank_start]respiratory[blank_end] [blank_start]illness[blank_end] [blank_start]outbreak[blank_end] by the local [blank_start]medical officer[blank_end] of [blank_start]health[blank_end].
Answer
  • fever
  • infection
  • pnneumonia
  • DNR
  • febrile
  • bacterial
  • HIV
  • water-based
  • respiratory
  • automimmune
  • urinary tract
  • gastrointestinal
  • oral
  • illness
  • contagion
  • vector
  • epidemic
  • pandemic
  • outbreak
  • situation
  • uprising
  • patient
  • medical officer
  • minister
  • jurisdiction
  • College of Nursing Representative
  • health
  • Ontario
  • the Medical Advisory Committee
  • Base Hospital

Question 9

Question
Under the Bronchoconstriction Clinical Considerations: When administering salbutamol MDI, the rate of administration should be:
Answer
  • 100 mcg every 4 breaths
  • 1 puff every breath
  • gradual, so as not to cause reflux hypokalemia
  • 1000 mcg every 6 breaths

Question 10

Question
Under the Bronchoconstriction Clinical Considerations: A [blank_start]spacer[blank_end] should be used when administering salbutamol [blank_start]MDI[blank_end].
Answer
  • spacer
  • MDI

Question 11

Question
Under the Bronchoconstriction Medical Directive Consider Salbutamol: Weight: <25 kg Route: [blank_start]NEB[blank_end]Dose: 2.5 mg Max. Single Dose: [blank_start]2.5 mg[blank_end] Dosing interval [blank_start]5-15[blank_end] min. PRN Max # of doses [blank_start]3[blank_end]
Answer
  • 3
  • 5
  • 10
  • 1
  • 5-15
  • 4-5
  • 2
  • 2.5 mg
  • 5.0 mg
  • 50 mcg
  • 5.0 mcg
  • NEB
  • NRB
  • BVM
  • MDI

Question 12

Question
The indications for the Moderate to Severe Allergic Reaction Medical Directive: [blank_start]Exposure[blank_end] to a [blank_start]probable allergen[blank_end] AND [blank_start]Signs[blank_end] and/or symptoms of a [blank_start]moderate to severe[blank_end] allergic reaction ([blank_start]including anaphylaxis[blank_end])
Answer
  • Exposure
  • probable allergen
  • Signs
  • moderate to severe
  • including anaphylaxis

Question 13

Question
Conditions for Epinephrine under the Moderate to Severe Allergic Reaction Medical Directive: AGE: [blank_start]N/A[blank_end] WEIGHT: N/A LOA: [blank_start]N/A[blank_end] HR: [blank_start]N/A[blank_end] RR: [blank_start]N/A[blank_end] SBP: N/A Other: For [blank_start]anaphylaxis only[blank_end]
Answer
  • N/A
  • N/A
  • N/A
  • N/A
  • anaphylaxis only

Question 14

Question
The ONLY contraindication to giving a pediatric patient IM epinephrine without an autoinjector in the case of anaphylaxis according to the Moderate to Severe Allergic Reaction Medical Directive "contraindications" for Epinephrine is: "Allergy or sensitivity to epinephrine"
Answer
  • True
  • False

Question 15

Question
Under the Moderate to Severe Allergic Reaction Medical Directive Consider epinephrine: Weight: [blank_start]N/A[blank_end] Route: IM Concentration: 1/[blank_start]1000[blank_end] Dose: 0.01mg/kg Max. Single Dose: [blank_start]0.5[blank_end] mg Dosing interval: N/A Max # of doses: [blank_start]1[blank_end]
Answer
  • N/A
  • 1000
  • 0.5
  • 1

Question 16

Question
According to the formula for approximate pediatric weight (kg) calculation, a 4 year old child should weigh [blank_start]18[blank_end] kg. Using this weight, the proper dose of IM epinephrine for this child according to the Moderate to Severe Allergic Reaction Medical Directive for anaphylaxis would be [blank_start]0.18[blank_end] mg which may be rounded to the nearest [blank_start]0.05[blank_end] mg, making the proper dose [blank_start]0.2[blank_end] mg. According to the Epinephrine 1:1000 IM Dosing Chart on page 24, the dose of epinephrine that would be given to a 4 year old child who weighs 18kg is actually [blank_start]0.15[blank_end] mg. However, according to the same chart, a child weighing 28 kg should receive a dose of [blank_start]0.3[blank_end] mg.
Answer
  • 18
  • 15
  • 28
  • 20
  • 0.18
  • 0.28
  • 0.5
  • 1.8
  • 0.05
  • 1
  • 0.5
  • 0.1
  • 0.2
  • 0.19
  • 0.5
  • 2.00
  • 0.15
  • 0.20
  • 0.10
  • 0.18
  • 0.3
  • 0.5
  • 0.28
  • 0.25

Question 17

Question
The two drugs administered under the Moderate to Severe Allergic Reaction Medical Directive are:
Answer
  • Epinephrine and Diphenhydramine
  • Epinephrine and Dimenhydrinate
  • Epinephrine and Salbutamol
  • Salbutamol and Benadryl

Question 18

Question
Conditions for Diphenhydramine under the Moderate to Severe Allergic Reaction Medical Directive: AGE: [blank_start]N/A[blank_end] WEIGHT: ≥[blank_start]25[blank_end]kg LOA: [blank_start]N/A[blank_end] HR: N/A RR: N/A SBP: N/A Other: N/A
Answer
  • N/A
  • 25
  • N/A

Question 19

Question
Under the Moderate to Severe Allergic Reaction Medical Directive Consider diphenhydramine (if certified and authorized): Weight: ≥[blank_start]25[blank_end] kg to <[blank_start]50[blank_end] kg Route: [blank_start]IV[blank_end] or IM Dose: [blank_start]25[blank_end] mg Max. Single Dose: [blank_start]25[blank_end] mg Dosing interval: [blank_start]N/A[blank_end] Max # of doses: [blank_start]1[blank_end]
Answer
  • 25
  • 50
  • IV
  • 25
  • 25
  • N/A
  • 1

Question 20

Question
Under the Moderate to Severe Allergic Reaction Medical Directive Consider diphenhydramine (if certified and [blank_start]authorized[blank_end]): Weight: ≥[blank_start]50[blank_end] kg Route: [blank_start]IV[blank_end] or IM Dose: [blank_start]50[blank_end] mg Max. Single Dose: [blank_start]50[blank_end] mg Dosing interval: [blank_start]N/A[blank_end] Max # of doses: [blank_start]1[blank_end]
Answer
  • authorized
  • 50
  • IV
  • 50
  • 50
  • N/A
  • 1

Question 21

Question
Patch to BHP for authorization to use pediatric auto injector for patients <[blank_start]10[blank_end]kg
Answer
  • 10
  • 5
  • 12
  • 25

Question 22

Question
Epinephrine should be the first drug administered in anaphylaxis.
Answer
  • True
  • False

Question 23

Question
Under the Croup Medical Directive, the indications are: [blank_start]Severe[blank_end] r[blank_start]espiratory[blank_end] [blank_start]distress[blank_end] AND [blank_start]Stridor[blank_end] [blank_start]at[blank_end] r[blank_start]est[blank_end] AND [blank_start]Current[blank_end] history of [blank_start]URTI[blank_end] AND B[blank_start]arking[blank_end] [blank_start]cough[blank_end] OR [blank_start]recent[blank_end] history of [blank_start]barking[blank_end] cough
Answer
  • Severe
  • espiratory
  • distress
  • Stridor
  • at
  • est
  • Current
  • URTI
  • arking
  • cough
  • recent
  • barking

Question 24

Question
Conditions for Epinephrine under the Croup Medical Directive: AGE: [blank_start]<8[blank_end] LOA: [blank_start]N/A[blank_end] HR: [blank_start]<200[blank_end]/min RR: [blank_start]N/A[blank_end] SBP: N/A Other: N/A
Answer
  • <8
  • >8
  • ≤8
  • N/A
  • N/A
  • unaltered
  • altered
  • <200
  • 60-159
  • ≥50
  • Normocardic
  • N/A
  • <10/min
  • absent
  • bradypneic

Question 25

Question
Number of contraindications listed under the Croup Medical Directive for Epinephrine:
Answer
  • Only one
  • 2
  • 3
  • 5

Question 26

Question
You are giving epinephrine to a 6 month old under the croup medical directive. Her weight is 17.7lbs or approximately [blank_start]8[blank_end]kg. The correct dose is [blank_start]2.5[blank_end][blank_start]mg[blank_end] of 1:1,000 concentration epinephrine. You can give [blank_start]1[blank_end] dose and the dosing interval is [blank_start]N/A[blank_end]. The route you use is [blank_start]NEB[blank_end].
Answer
  • 8
  • 9
  • 10
  • 12
  • 2.5
  • 0.5
  • 0.25
  • 5.0
  • mg
  • g
  • millequivelents/cm
  • CC/kg
  • 0.01
  • /kg
  • 1
  • the second
  • N/A
  • q5 mins
  • 3-5 mins
  • 10-15 mins
  • NEB
  • IM
  • MDI
  • IV

Question 27

Question
You are giving epinephrine to a 3 month old under the croup medical directive. Her weight is 8.8lbs or approximately [blank_start]4[blank_end]kg. The correct dose is [blank_start]0.5[blank_end][blank_start]mg[blank_end] of 1:1,000 concentration epinephrine. You can give [blank_start]1[blank_end] dose(s) and the dosing interval is [blank_start]N/A[blank_end]. The route you use is [blank_start]NEB[blank_end].
Answer
  • 4
  • 3
  • 5
  • 6
  • 0.5
  • 5
  • 0.01
  • 2.5
  • mg
  • g
  • /kg
  • /min.
  • 1
  • 2
  • unlimited
  • N/A
  • 1-3 mins
  • 3-5 mins
  • 20 mins
  • NEB
  • MDI
  • IM
  • NRM

Question 28

Question
The largest single dose of epinephrine in the PCP medical directives v3.2 is in the [blank_start]croup[blank_end] directive. A Primary Care Paramedic can give [blank_start]5mg[blank_end] of 1:1000 epinephrine to a patient who meets the conditions and is ≥[blank_start]1[blank_end] year(s) old.
Answer
  • croup
  • 5mg
  • 1

Question 29

Question
Match the assessment findings with their point vales according to the Westley Croup Score chart on page 30. Altered level of consciousness is worth [blank_start]5[blank_end] point(s). Audible inspiratory stridor with a stethoscope is worth [blank_start]1[blank_end] point(s). Severely Decreased Air Entry is worth [blank_start]2[blank_end] point(s). Cyanosis with agitation is worth [blank_start]4[blank_end] point(s) The highest score possible is [blank_start]17[blank_end] point(s) The lowest score possible is [blank_start]0[blank_end] point(s) Moderate croup is considered a score of [blank_start]4-7[blank_end] points Severe croup is a score of [blank_start]>7[blank_end] points
Answer
  • 5
  • 6
  • 1
  • 2
  • 4
  • 17
  • 19
  • 15
  • 21
  • 0
  • -5
  • -10
  • 4-7
  • 3-6
  • 5-9
  • >7
  • 7-19
  • ≥7
  • >8

Question 30

Question
Croup is generally the result of a:
Answer
  • viral infection.
  • bacterial infection.
  • pneumonia.
  • genetic enzyme deficiency.
  • otherwise benign fungal spore.

Question 31

Question
Croup is a(n) [blank_start]upper[blank_end] [blank_start]respiratory[blank_end] [blank_start]infection[blank_end].
Answer
  • upper
  • lower
  • vesicular
  • esophageal
  • respiratory
  • end-expiratory
  • alimentary
  • glial cellular
  • infection
  • rupture
  • reflux
  • foramen

Question 32

Question
Croup tends to occur in children aged [blank_start]6[blank_end] months to [blank_start]3[blank_end] years and is most prevalent at the age of [blank_start]2[blank_end] years.
Answer
  • 6
  • 3
  • 2

Question 33

Question
Generally speaking, patients with [blank_start]moderate[blank_end] to [blank_start]severe[blank_end] croup should be considered for therapy as per the medical directive.
Answer
  • moderate
  • mild
  • new onset
  • compensatory
  • severe
  • epiglottital

Question 34

Question
You are following the croup medical directive for a patient whose stridor is audible without a stethoscope, has no retraction, has somewhat decreased air entry, cyanosis only when agitated and a GCS of 13 (this child is normally GCS 15). According the Westley Croup score, what score does this patient receive?
Answer
  • 12
  • 11
  • 10
  • 17
  • 14

Question 35

Question
You are following the croup medical directive for a patient whose stridor is audible with a stethoscope, has severe retraction, has severely decreased air entry, no cyanosis and a GCS of 15. According the Westley Croup score, what score does this patient receive?
Answer
  • 6
  • 7
  • 5
  • 9
  • 10

Question 36

Question
Your croup patient has a Westley Croup Score of 7. According to ALS, they would be considered to have:
Answer
  • moderate croup.
  • severe croup.
  • mild croup.
  • no indication to suspect croup.

Question 37

Question
Indications for Continuous Positive Airway Pressure (CPAP) Medical Directive - Auxiliary: S[blank_start]evere[blank_end] [blank_start]respiratory[blank_end] [blank_start]distress[blank_end] AND [blank_start]Signs[blank_end] and/or [blank_start]symptoms[blank_end] of [blank_start]acute[blank_end] [blank_start]pulmonary[blank_end] [blank_start]edema[blank_end] OR [blank_start]COPD[blank_end]
Answer
  • evere
  • respiratory
  • distress
  • Signs
  • symptoms
  • acute
  • pulmonary
  • edema
  • COPD

Question 38

Question
Conditions for Continuous Positive Airway Pressure (CPAP) Medical Directive - Auxiliary AGE: ≥[blank_start]18[blank_end] years LOA: [blank_start]N/A[blank_end] HR: [blank_start]N/A[blank_end] RR: [blank_start]Tachypnea[blank_end] SBP: [blank_start]Normotension[blank_end] Other: [blank_start]SpO2[blank_end] <[blank_start]90[blank_end]% or [blank_start]accessory muscle use[blank_end]
Answer
  • 18
  • N/A
  • N/A
  • Tachypnea
  • Normotension
  • 90
  • accessory muscle use
  • SpO2

Question 39

Question
Contraindications for CPAP Asthma [blank_start]exacerbation[blank_end] Suspected [blank_start]pneumothorax[blank_end] Unprotected or unstable [blank_start]airway[blank_end] Major [blank_start]trauma or burns[blank_end] to the [blank_start]head or torso[blank_end] [blank_start]Trache[blank_end]ostomy Inability to [blank_start]sit upright[blank_end] Unable to [blank_start]cooperate[blank_end]
Answer
  • exacerbation
  • without prior Hx
  • without relief from nebulized salbutamol
  • pneumothorax
  • tension pneumothorax
  • spontaneous hemothorax
  • airway
  • mandible
  • cervical spine
  • trauma or burns
  • stroke
  • extremity deformity
  • facial asymmetry
  • head or torso
  • neck and chest
  • lung apices
  • Trache
  • laryng
  • gastr
  • pharyng
  • sit upright
  • communicate verbally
  • ventilate
  • position airway
  • cooperate
  • open mouth
  • administer salbutamol
  • diagnose cause

Question 40

Question
Consider CPAP: Initial setting [blank_start]5[blank_end] cm H2O or equivalent flow rate of device as per BH direction. [blank_start]Titration[blank_end] [blank_start]increment[blank_end] [blank_start]2.5[blank_end] cm H2O or equivalent flow rate of device as per BH direction. [blank_start]Titration[blank_end] [blank_start]interval[blank_end] [blank_start]5[blank_end] [blank_start]min[blank_end]. Max. [blank_start]setting[blank_end] [blank_start]15[blank_end] cm H2O or equivalent flow rate of device as per BH direction
Answer
  • 5
  • 2.5
  • 3
  • 10
  • 15
  • Titration
  • Amplitude
  • Concentration
  • Adjustment
  • 2.5
  • 3
  • 5
  • 10
  • 0.5
  • increment
  • level
  • period
  • parameters
  • Titration
  • Timing
  • Cutoff
  • Rest
  • interval
  • period
  • zone
  • timeframe
  • 5
  • 30
  • 90
  • 15
  • min
  • secs
  • hours
  • breaths
  • setting
  • suction
  • resistance
  • power
  • 15
  • 30
  • 45
  • 5

Question 41

Question
Under the treatment section of the Continuous Positive Airway Pressure Medical Directive: Consider increasing FiO2 (if available): Initial FiO2: [blank_start]50[blank_end]-[blank_start]100[blank_end]% FiO2 increment (if available on device) SpO2 [blank_start]<92%[blank_end] despite treatment and/or [blank_start]10[blank_end] cm H2O pressure or equivalent flow rate of device as per BH direction. Max FiO2: [blank_start]100%[blank_end]
Answer
  • 50
  • 10
  • 25
  • 95
  • 100
  • 20
  • 90
  • 65
  • <92%
  • ≥92%
  • >92%
  • ≤92%
  • 93%
  • 10
  • 2.5
  • 8
  • 5
  • 25
  • 100%
  • 25lpm
  • N/A
  • 94-99%
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