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

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Primary Care Paramedic Medical Directives Version 3.2 ALS

Question 1 of 41

1

Fill the blank spaces to complete the text.

The conditions for salbutamol are:
AGE: N/A
LOA:
HR:
RR:
SBP: N/A
Other:

Explanation

Question 2 of 41

1

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The contraindications for salbutamol are:

Explanation

Question 3 of 41

1

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The conditions for epinephrine under the bronchoconstriction directive are:
AGE: N/A
LOA:
HR:
RR:
SBP:
Other:

Explanation

Question 4 of 41

1

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The contraindications for Epinephrine under the Bronchoconstriction Medical Directive are:

Explanation

Question 5 of 41

1

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

Explanation

Question 6 of 41

1

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

Explanation

Question 7 of 41

1

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Under the Bronchoconstriction Clinical Considerations:
should be the drug administered if the patient is .
MDI may be administered subsequently using a .

Explanation

Question 8 of 41

1

Under the Bronchoconstriction Clinical Considerations:
Nebulizations is contraindicated in patients with a known or suspected or in the setting of a declared by the local of .

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    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

Explanation

Question 9 of 41

1

Under the Bronchoconstriction Clinical Considerations:
When administering salbutamol MDI, the rate of administration should be:

Select one of the following:

  • 100 mcg every 4 breaths

  • 1 puff every breath

  • gradual, so as not to cause reflux hypokalemia

  • 1000 mcg every 6 breaths

Explanation

Question 10 of 41

1

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Under the Bronchoconstriction Clinical Considerations:
A should be used when administering salbutamol .

Explanation

Question 11 of 41

1

Under the Bronchoconstriction Medical Directive Consider Salbutamol:
Weight: <25 kg
Route: Dose: 2.5 mg
Max. Single Dose:
Dosing interval min. PRN
Max # of doses

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    3
    5
    10
    1
    5-15
    4-5
    2
    2.5 mg
    5.0 mg
    50 mcg
    5.0 mcg
    NEB
    NRB
    BVM
    MDI

Explanation

Question 12 of 41

1

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The indications for the Moderate to Severe Allergic Reaction Medical Directive:
to a
AND
and/or symptoms of a allergic reaction ()

Explanation

Question 13 of 41

1

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Conditions for Epinephrine under the Moderate to Severe Allergic Reaction Medical Directive:
AGE:
WEIGHT: N/A
LOA:
HR:
RR:
SBP: N/A
Other: For

Explanation

Question 14 of 41

1

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"

Select one of the following:

  • True
  • False

Explanation

Question 15 of 41

1

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Under the Moderate to Severe Allergic Reaction Medical Directive Consider epinephrine:
Weight:
Route: IM
Concentration: 1/
Dose: 0.01mg/kg
Max. Single Dose: mg
Dosing interval: N/A
Max # of doses:

Explanation

Question 16 of 41

5

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According to the formula for approximate pediatric weight (kg) calculation, a 4 year old child should weigh ( 18, 15, 28, 20 ) 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 ( 0.18, 0.28, 0.5, 1.8 ) mg which may be rounded to the nearest ( 0.05, 1, 0.5, 0.1 ) mg, making the proper dose ( 0.2, 0.19, 0.5, 2.00 ) 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 ( 0.15, 0.20, 0.10, 0.18 ) mg.
However, according to the same chart, a child weighing 28 kg should receive a dose of ( 0.3, 0.5, 0.28, 0.25 ) mg.

Explanation

Question 17 of 41

1

The two drugs administered under the Moderate to Severe Allergic Reaction Medical Directive are:

Select one of the following:

  • Epinephrine and Diphenhydramine

  • Epinephrine and Dimenhydrinate

  • Epinephrine and Salbutamol

  • Salbutamol and Benadryl

Explanation

Question 18 of 41

3

Fill the blank spaces to complete the text.

Conditions for Diphenhydramine under the Moderate to Severe Allergic Reaction Medical Directive:
AGE:
WEIGHT: ≥kg
LOA:
HR: N/A
RR: N/A
SBP: N/A
Other: N/A

Explanation

Question 19 of 41

1

Fill the blank spaces to complete the text.

Under the Moderate to Severe Allergic Reaction Medical Directive Consider diphenhydramine (if certified and authorized):
Weight: ≥ kg to < kg
Route: or IM
Dose: mg
Max. Single Dose: mg
Dosing interval:
Max # of doses:

Explanation

Question 20 of 41

1

Fill the blank spaces to complete the text.

Under the Moderate to Severe Allergic Reaction Medical Directive Consider diphenhydramine (if certified and ):
Weight: ≥ kg
Route: or IM
Dose: mg
Max. Single Dose: mg
Dosing interval:
Max # of doses:

Explanation

Question 21 of 41

1

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Patch to BHP for authorization to use pediatric auto injector for patients <( 10, 5, 12, 25 )kg

Explanation

Question 22 of 41

1

Epinephrine should be the first drug administered in anaphylaxis.

Select one of the following:

  • True
  • False

Explanation

Question 23 of 41

1

Fill the blank spaces to complete the text.

Under the Croup Medical Directive, the indications are:
r
AND
r
AND
history of
AND
B OR history of cough

Explanation

Question 24 of 41

1

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Conditions for Epinephrine under the Croup Medical Directive:
AGE: ( <8, >8, ≤8, N/A )
LOA: ( N/A, unaltered, altered )
HR: ( <200, 60-159, ≥50, Normocardic )/min
RR: ( N/A, <10/min, absent, bradypneic )
SBP: N/A
Other: N/A

Explanation

Question 25 of 41

1

Number of contraindications listed under the Croup Medical Directive for Epinephrine:

Select one of the following:

  • Only one

  • 2

  • 3

  • 5

Explanation

Question 26 of 41

1

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

Explanation

Question 27 of 41

1

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

Explanation

Question 28 of 41

1

Fill the blank spaces to complete the text.

The largest single dose of epinephrine in the PCP medical directives v3.2 is in the directive. A Primary Care Paramedic can give of 1:1000 epinephrine to a patient who meets the conditions and is ≥ year(s) old.

Explanation

Question 29 of 41

1

Match the assessment findings with their point vales according to the Westley Croup Score chart on page 30.
Altered level of consciousness is worth point(s).
Audible inspiratory stridor with a stethoscope is worth point(s).
Severely Decreased Air Entry is worth point(s).
Cyanosis with agitation is worth point(s)
The highest score possible is point(s)
The lowest score possible is point(s)
Moderate croup is considered a score of points
Severe croup is a score of points

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    5
    6
    1
    2
    4
    17
    19
    15
    21
    0
    -5
    -10
    4-7
    3-6
    5-9
    >7
    7-19
    ≥7
    >8

Explanation

Question 30 of 41

1

Croup is generally the result of a:

Select one of the following:

  • viral infection.

  • bacterial infection.

  • pneumonia.

  • genetic enzyme deficiency.

  • otherwise benign fungal spore.

Explanation

Question 31 of 41

1

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Croup is a(n) ( upper, lower, vesicular, esophageal ) ( respiratory, end-expiratory, alimentary, glial cellular ) ( infection, rupture, reflux, foramen ).

Explanation

Question 32 of 41

1

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Croup tends to occur in children aged months to years and is most prevalent at the age of years.

Explanation

Question 33 of 41

1

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Generally speaking, patients with ( moderate, mild, new onset, compensatory ) to ( severe, epiglottital ) croup should be considered for therapy as per the medical directive.

Explanation

Question 34 of 41

1

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?

Select one of the following:

  • 12

  • 11

  • 10

  • 17

  • 14

Explanation

Question 35 of 41

1

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?

Select one of the following:

  • 6

  • 7

  • 5

  • 9

  • 10

Explanation

Question 36 of 41

1

Your croup patient has a Westley Croup Score of 7. According to ALS, they would be considered to have:

Select one of the following:

  • moderate croup.

  • severe croup.

  • mild croup.

  • no indication to suspect croup.

Explanation

Question 37 of 41

1

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Indications for Continuous Positive Airway Pressure (CPAP) Medical Directive - Auxiliary:
S
AND
and/or of OR

Explanation

Question 38 of 41

1

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Conditions for Continuous Positive Airway Pressure (CPAP) Medical Directive - Auxiliary
AGE: ≥ years
LOA:
HR:
RR:
SBP:
Other: <% or

Explanation

Question 39 of 41

1

Contraindications for CPAP
Asthma
Suspected
Unprotected or unstable
Major to the
ostomy
Inability to
Unable to

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    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

Explanation

Question 40 of 41

1

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

Explanation

Question 41 of 41

1

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

Explanation

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