The correct answer is (A). Contraindications are reasons to not give a medication. For NTG, contraindications include recent use of phosphodiesterase-5 inhibitors (sildenafil, among others) and an SBP <100 mmHg. Indication (B) is a reason the medication would be administered. Side effects (C) are expected actions of a particular medication that are not therapeutic. For example, for NTG, a side effect could be a headache. Untoward effects (D) are unexpected effects of a medication that occur in only 1 patient. They can range from severe and life threatening to a nuisance.
The correct answer is (C). Parenteral medication administration routes include all those that do not use any portion of the digestive tract. Rectal administration of a drug is considered an enteral medication because the rectum is still part of the digestive tract.
The correct answer is (C). Medications subjected to first-pass metabolism in the liver are those that are absorbed through the digestive tract in either the stomach or the intestines. These routes include oral administration, administration via orogastric or nasogastric tubes, and those medications that are occasionally administered through gastrointestinal tract ostomies (PEG-, G-, and J-tubes). Medications absorbed rectally and sublingually (D) are able to avoid the first-pass effect despite being administered via the oral route and directly enter systemic circulation. Inhalation (A) and intravenous routes (B) are parenteral routes and avoid first-pass metabolism.
The correct answer is (D). Image number 3 represents a hypertonic solution. The only medications that paramedics can administer that are hypertonic to the cells is D50 and mannitol. Hypertonic solutions will draw fluid out of the cell, which is indicated in the image. Normal saline (A) is isotonic to the cells, meaning there is no net movement of water in or out of the cell. D5 in 1/4 normal saline (B) also is hypotonic for the same reason. D5 (C) is isotonic in the bag and hypotonic shortly after administration.
The correct answer is (A). Water will move in a direction of lower solute concentration to an area of higher solute concentration, which is the definition of osmosis. Since the diagram indicates more solute inside the cell than out, the water will move into the cell because that is the area of higher solute concentration.
The correct answer is (A). Catheter shear can embolize a piece of plastic from the catheter if the needle is removed, in whole or part, from the catheter and reinserted. This piece can block an artery in the lung and cause an almost immediate decline in patient status. Pyrogenic reactions (B), thrombophlebitis (C), and vasovagal reactions (D) are serious complications, but they are rarely life threatening.
The correct answer is (C). In the event you are unable to aspirate blood or bone marrow after a sudden decrease in resistance, this does not necessarily mean that the needle is misplaced. If the needle still stands freely, the needle has likely entered the bone. The remaining options are not the best choice and should be considered only if the site infiltrates.