Deck 47: ALS-Assist Skills

Question 1

When assisting an advanced life support provider with IV therapy, the best way to avoid potential clinical complications is to:

A) only assist with setting up IV equipment if the patient is critically ill or injured.
B) only assist with setting up IV equipment if the patient is not critically ill or injured.
C) ask medical direction for approval each time prior to assisting with the equipment.
D) gain and maintain proficiency through knowledge and practice.

Answer 1

D

Question 2

What is the name of the tubing that attaches to the IV bag and IV catheter, thereby allowing the fluid to flow into the body?

A) Intracatheter tubing
B) Administration set
C) Intravenous flow tubing
D) Flow control tubing

Answer 2

B

Question 3

You are preparing to obtain an ECG tracing while using a 4-lead cardiac monitor. Where would you place the red "RL" lead?

A) Right thorax, under the clavicle
B) Lower left chest wall, anterior axillary line
C) Left thorax, under the clavicle
D) Lower right chest wall, anterior axillary line

Answer 3

B

Question 4

The ECG leads labeled V₁, V₂, V₃, V₄, V₅, and V₆ are known as:

A) precordial leads.
B) thoracic leads.
C) cardiac leads.
D) limb leads.

Question 5

The EMT has retrieved all the correct equipment necessary to initiate an IV. Before assembling any equipment, what should she do first?

A) Place the constricting band on the patient's arm.
B) Remove the protective cap from the IV tubing spike.
C) Check the expiration date on the intravenous bag.
D) Open the outer wrapping of the intravenous catheter.

Question 6

While assisting a paramedic to start an IV on a critical patient, he asks you to set up the IV bag with a "mini drip" administration set. Which one of the following administration sets should you use?

A) 10 drop/mL set
B) 15 drop/mL set
C) 20 drop/mL set
D) 60 drop/mL set

Question 7

What is the function of the flow regulator?

A) Increases or decreases the flow rate of IV fluid
B) Attaches the IV tubing to the IV catheter
C) Increases or decreases the drop size of the IV fluid infusing
D) Connects the IV bag to the patient

Question 8

You are preparing to administer fluids. When should the air be flushed from the intravenous tubing?

A) After attaching the tubing to the IV bag, but prior to attaching the tubing to the IV catheter
B) After the administration tubing is attached to the IV bag and the IV catheter
C) Prior to the administration of intravenous medications into the patient
D) Only after the IV catheter is properly placed in the vein of the patient

Question 9

Where would you place the electrode if you were going to attach the V₄ lead to it?

A) Right sternal border, fourth intercostal space on the right thorax
B) Fifth intercostal space, midclavicular line on the left thorax
C) Left leg, just proximal to the medial malleolus
D) Lateral to V₅, on the left midaxillary line of the left thorax

Question 10

In an EMS system where both paramedics and EMTs work side by side, one benefit of having the EMT help set up intravenous (IV) equipment is that it:

A) provides additional tasks that the EMT could perform.
B) allows the paramedic to focus on other advanced life support tasks.
C) decreases the number of paramedics needed in an ALS system.
D) decreases the working relationship between the EMT and ALS providers.

Question 11

After attaching the administration set to the intravenous fluid bag, how is the drip chamber initially filled?

A) Open the flow control and let the drip chamber fill passively.
B) Close flow control, and then squeeze the bag to force fluid into the drip chamber.
C) Open the flow control and keep it positioned higher than the intravenous fluid bag.
D) Close the flow control, and then squeeze and release the drip chamber.

Question 12

For the acquisition of a 4-lead tracing, why is the skin cleansed, dried, and shaved of hair (if necessary) prior to applying the ECG electrodes?

A) Because ECG monitoring is a sterile procedure
B) To decrease the amount of energy needed should the patient need to be defibrillated
C) To enhance the conductivity between the electrode and the skin
D) Because it makes the heart more responsive to defibrillatory shocks

Question 13

Which piece of equipment is not needed when initiating an IV on a patient?

A) Syringe
B) Bag of fluids
C) Catheter
D) Tubing

Question 14

Which one of the following is not a common lead configuration for obtaining an ECG tracing on a patient?

A) 3-lead
B) 4-lead
C) 8-lead
D) 12-lead

Question 15

If the ALS provider you were working with wanted to infuse as much fluid as possible in the shortest amount of time, which administration set should you use to assist?

A) 10 drop/mL set
B) 15 drop/mL set
C) 20 drop/mL set
D) 60 drop/mL set

Question 16

How many leads are applied to the patient's body to obtain a 12-lead ECG tracing?

A) 6
B) 10
C) 12
D) 13

Question 17

Which of the following intravenous catheter sizes is best when you must quickly infuse a large amount of fluid on a trauma patient?

A) 14 gauge
B) 16 gauge
C) 20 gauge
D) 22 gauge

Question 18

While caring for a patient with congestive heart failure, a paramedic asks you to set up equipment for IV access so he can administer medications to remove the fluid that has accumulated in the patient's s lungs. What administration set and catheter size seems most appropriate?

A) Macrodrip set with an 18-gauge catheter
B) Microdrip set with a 16-gauge catheter
C) Macrodrip set with a 16-gauge catheter
D) Microdrip set with a 20-gauge catheter

Question 19

An IV is properly established when the IV catheter is placed into the:

A) vein.
B) artery.
C) capillary.
D) venule.

Question 20

If the EMT fails to protect the sterility of the spike on the IV administration tubing while preparing equipment for starting an IV, what negative outcome may occur?

A) Clogging of the catheter
B) Infection in the patient
C) Too slow IV flow rate
D) Occlusion of the drip chamber

Question 21

You are having trouble getting the electrodes to remain adhered to your adult male patient due to excessive diaphoresis. What can you do to better ensure electrode adhesion?

A) Shave the chest hair.
B) Keep wiping the skin dry and using another new electrode.
C) Wipe the site dry, and then apply spray antiperspirant to the skin.
D) Wipe the site dry, and then re-cleanse the site with two to three alcohol preps.

Question 22

Where would you place the electrode if you were going to attach the V₂ lead to it?

A) Right sternal border, fourth intercostal space on the right side
B) Fifth intercostal space, midclavicular line of the left thorax
C) Left sternal border, fourth intercostal space
D) Left leg, just proximal to the medial malleolus

Question 23

An IV administration set is described as 10 gtt/mL. Which of the following is true?

A) 10 mL are in each drop of IV solution.
B) 10 drops equal 1 mL of IV solution.
C) 10 drops of solution are to be placed in the drip chamber.
D) 10 mL of fluid are needed to fill the administration tubing.

Question 24

When a small and carefully regulated amount of fluid must be administered, what administration set is best?

A) 60 gtt/mL
B) 20 gtt/mL
C) 15 gtt/mL
D) 10 gtt/mL

Question 25

A paramedic is preparing to give a pain medication intravenously. You would expect him to administer the medication through what component of the IV setup?

A) Hub connector
B) Flow regulator
C) Needleless injection port
D) Spike

Question 26

Where would you place the electrode if you were going to attach the V₆ lead to it?

A) Right sternal border, fifth intercostal space
B) Third intercostal space, midclavicular line on the right thorax
C) Right leg, just distal to the medial malleolus
D) Lateral to V₅, on the left midaxillary line of the left thorax

Question 27

When preparing an IV for administration, what part of the administration set is inserted into the bag of fluid?

A) Administration hub
B) Drip chamber
C) Spike
D) Flow regulator

Question 28

Your partner works as a registered nurse in a local emergency department, but also volunteers as an EMT with a community EMS service. Given his background, which of the following would require immediate intervention by the supervisor or yourself?

A) Applies the cardiac monitor
B) Starts a small IV
C) Applies (continuous positive airway pressure (CPAP)
D) Titrates oxygen from low-concentration to high-concentration

Question 29

What information would the EMT expect to find on the IV solution bag?

A) Indications for use
B) Expiration date
C) Temperature to maintain fluid
D) Type and size of IV catheter to be used

Question 30

Your paramedic partner states that he needs to start an IV solution of "sugar water" on a diabetic patient. You would assist her by obtaining what solution?

A) 0.9% normal saline
B) Lactated ringers
C) Sodium chloride solution
D) 5% dextrose in water (D5W)

Question 31

In order to assist your ALS partner with acquiring a 12-lead ECG tracing, what must be present first and foremost?

A) An adult male or female patient with chest pain
B) A patient who is not suffering from thoracic trauma
C) Isopropyl alcohol to help dry the skin if the patient is diaphoretic
D) Medical direction protocol that allows the EMT to assist the ALS provider with this skill

Question 32

A paramedic states that he is going to decrease the amount of IV fluid that the patient is currently receiving. You would anticipate him:

A) switching to a smaller bag of IV fluid.
B) changing the position of the flow regulator.
C) changing to a 10 gtt/mL administration set.
D) reinserting a smaller IV catheter.

Question 33

You are preparing an IV for your paramedic partner, and have just inserted the administration tubing into the IV solution bag. Your next step is to:

A) check the expiration date on the solution.
B) close the flow regulator.
C) attach the administration set to the IV catheter.
D) squeeze fluid into the drip chamber.

Question 34

A hypotensive patient in septic shock requires are large amount of fluid to be administered as quickly as possible. What IV catheter would be best?

A) 14 gauge
B) 16 gauge
C) 18 gauge
D) 20 gauge

Question 35

You have arrived at the bedside of a 56-year-old male complaining of chest pain and shortness of breath with a history of coronary heart disease, diabetes, and emphysema. A 12-lead EKG is to be performed. As you have completed an ALS-assist class and are permitted to help with ALS skills, which of the following can you do in caring for this patient?

A) Apply the electrodes for a 12-lead ECG.
B) Start a small-gauge IV, but not hang fluids.
C) Interpret a 12-lead ECG tracing.
D) Decrease the rate of IV fluid to avoid overhydration.

Question 36

The hub connector on an IV is used to:

A) connect into the IV solution bag.
B) administer medications intravenously.
C) regulate the flow of IV fluid.
D) connect to the IV administration set.

Question 37

Where would you place the electrode if you were going to attach the V₁ lead to it?

A) Right sternal border, fourth intercostal space on the right thorax
B) Fifth intercostal space, midclavicular line of the left thorax
C) Left leg, just proximal to the medial malleolus
D) Lateral to V₅, on the left midaxillary line

Question 38

The EMT recognizes that the IV catheter is used to:

A) connect the IV needle and IV solution.
B) control the volume of fluid the patient receives.
C) access the patient's vein.
D) pierce the IV solution bag.

Question 39

A trauma patient has been struck in the abdomen by the steering column of the car he was driving. He is hypotensive, confused, and short of breath. Both you and your partner are concerned that he may have ruptured his spleen and is bleeding internally. Normal saline is being provided through the IV for transport. As such, you recognize that this solution will provide:

A) sugar for cellular energy.
B) red blood cells to carry oxygen.
C) clotting factors to stop bleeding.
D) electrolytes to replenish lost plasma.

Question 40

As an EMT allowed to assist with ALS interventions, you realize that IV therapy is beneficial for patients because it:

A) provides arterial blood for analysis.
B) allows constant monitoring of the patient's oxygen level.
C) provides a route to administer medications.
D) provides IV solutions that carry oxygen to the cells.

Question 41

When helping a paramedic apply a 3-lead ECG, what action would demand immediate and corrective intervention?

A) Cleaning the skin with alcohol prior to adhering an electrode
B) Placing an electrode on the lower right chest
C) Attaching the electrode to the cable prior to placing it on the patient
D) Using antiperspirant to dry the moist and clammy skin of the patient

Question 42

The white lead (RA) should be placed over the:

A) right atrium.
B) right chest.
C) right apex.
D) right abdomen.

Question 43

After appropriately filling the drip chamber with IV fluid, you would:

A) flush air from the IV tubing.
B) remove the protective cap from the spike.
C) check the IV solution for particles or other impurities.
D) adjust the flow to the appropriate rate.

Question 44

As an EMT educated to assist the paramedic with advanced life support care, you know that an ECG provides information on:

A) the electrical activity of the heart.
B) how well oxygenated blood is flowing through the body.
C) the degree of health of the heart and lungs.
D) the amount of blood being pumped by the heart.

Question 45

When performing a 3-lead ECG, how would you place the electrodes?

A) Right anterior chest, left anterior chest, right lower chest
B) Right anterior chest, right lower chest, left lower chest
C) Right anterior chest, mid chest over heart, left lower chest
D) Right anterior chest, left anterior chest, left lower chest