MA1
Which of the following statements regarding dehydration is correct?
A) It is often a chronic condition in elderly patients and may take days to manifest.
B) During early dehydration, a profound loss of interstitial fluid occurs in the body.
C) In younger patients, dehydration is typically caused by an acute loss of more than 50 mL of blood.
D) During dehydration, fluid shifts from the extracellular compartment to the intracellular compartment.
A) It is often a chronic condition in elderly patients and may take days to manifest. Page 476
Signs and symptoms of dehydration include all of the following, EXCEPT:
A) bradypnea.
B) flushed, dry skin.
C) postural hypotension.
D) dry mucous membranes.
A) bradypnea. page 476
All of the following are peripheral veins, EXCEPT the:
A) subclavian vein.
B) external jugular vein.
C) veins of the hand.
D) lower extremity veins.
A) subclavian vein. page 479
Which of the following statements regarding isotonic solutions is correct?
A) Isotonic solutions have almost the same osmolarity as bodily fluids.
B) D5W becomes an isotonic solution once it is introduced into the body.
C) Normal saline is the only isotonic solution used in the prehospital setting.
D) Isotonic solutions expand the vascular space by shifting fluid from other compartments.
A) Isotonic solutions have almost the same osmolarity as bodily fluids. page 478
Overhydration occurs when:
A) a patient experiences prolonged periods of severe hyperventilation.
B) the left side of the heart fails and blood backs up into the systemic circulation.
C) the intracellular compartment becomes engorged due to a decrease in vascular volume.
D) fluid is forced from the engorged interstitial compartment into the intracellular compartment.
D) fluid is forced from the engorged interstitial compartment into the intracellular compartment. page 476
In the prehospital setting, the MOST commonly used IV solutions are:
A) colloid solutions.
B) hypotonic crystalloids.
C) hetastarch and saline.
D) isotonic crystalloids.
D) isotonic crystalloids. page 479
Colloid solutions:
A) contain proteins that are too large to pass out of the capillary membranes, so the solutions remain in the vascular compartment.
B) include solutions such as lactated Ringer's and normal saline and rapidly expand the intravascular compartment.
C) are safe to use in the prehospital setting because they rapidly and effectively expand the intravascular compartment.
D) do not contain large molecules and are therefore ineffective in expanding the intravascular compartment.
Page 477
A solution of water with 0.9% sodium chloride is:
A) hypotonic until it is introduced into the body.
B) capable of carrying oxygen when it is infused.
C) of minimal value in expanding the vascular space.
D) also called normal saline and is an isotonic solution.
D) also called normal saline and is an isotonic solution. page 478
Once an IV solution is removed from its protective sterile plastic bag, it must be used:
A) immediately.
B) within 24 hours.
C) within 36 hours.
D) within 48 hours.
B) within 24 hours. page 479
A common cause of overhydration is:
A) hypertension.
B) kidney failure
C) gastrointestinal drainage.
D) prolonged hyperventilation.
B) kidney failure page 476
Hypotonic solutions:
A) include normal saline and lactated Ringer's solution.
B) draw fluid from the cells and into the vascular space.
C) hydrate the cells while depleting the vascular compartment.
D) are the preferred solutions to use in patients with head trauma.
C) hydrate the cells while depleting the vascular compartment. page 478
It is MOST important to exercise caution when administering isotonic solutions to patients with:
A) hypotension and severe hypovolemia.
B) hypertension and congestive heart failure.
C) dehydration secondary to excessive diarrhea.
D) a history of insulin-dependent diabetes mellitus.
B) hypertension and congestive heart failure. page 478
Signs and symptoms of overhydration include:
A) edema.
B) oliguria.
C) weight loss.
D) wheezing.
A) edema. page 476
Once the pigtail is removed from the sterile access port of an IV solution, the solution must be used:
A) immediately.
B) within 24 hours.
C) within 36 hours.
D) within 48 hours.
A) immediately. page 479
How much isotonic crystalloid solution should you administer to a patient who weighs 65 kg and who has signs and symptoms of internal bleeding?
A) Boluses of up to 1,625 mL each
B) 10 to 20 mL/kg every 5 to 10 minutes
C) An amount adequate to maintain perfusion
D) Enough to increase blood pressure to a normal level
C) An amount adequate to maintain perfusion page 477
Lactated Ringer's (LR) solution should not be given to patients with liver problems because:
A) LR is a hypertonic solution and cannot be metabolized by the liver.
B) the lactate contained within LR can cause necrosis of the liver tissue.
C) patients with liver disease commonly experience renal insufficiency.
D) the liver cannot metabolize the lactate in the solution.
D) the liver cannot metabolize the lactate in the solution. page 478
A microdrip administration set:
A) allows 10 or 15 drops per milliliter.
B) delivers 1 mL for every 60 drops.
C) should be used when patients need fluid replacement.
D) does not contain a needlelike orifice in its drip chamber.
B) delivers 1 mL for every 60 drops. page 480
When a patient needs rapid fluid replacement, you should:
A) use a microdrip administration set because you can deliver more precise volumes of IV fluid.
B) choose an administration set that delivers the least amount of volume per the most number of drops.
C) select an administration set that contains a large opening between the piercing spike and drip chamber.
D) use a microdrip administration set in order to avoid inadvertently overloading the patient with fluid.
C) select an administration set that contains a large opening between the piercing spike and drip chamber. page 480
When preparing an IV administration set, you should NOT:
A) invert the bag if the drip chamber contains too much fluid.
B) run IV fluid through the administration set to flush air out.
C) fill the drip chamber of the administration set with IV fluid.
D) cleanse the piercing spike before inserting it into the IV bag.
D) cleanse the piercing spike before inserting it into the IV bag. page 480
Once D5W is infused into the body:
A) the body metabolizes the dextrose quickly and the solution becomes hypotonic.
B) it causes fluid to shift from the intracellular space into the vascular space.
C) cellular uptake of dextrose occurs and the solution quickly becomes isotonic.
D) it rapidly expands the vascular space and effectively increases blood pressure.
A) the body metabolizes the dextrose quickly and the solution becomes hypotonic. page 478