2207 Final Flashcards by Justine Pugh

A car has struck a pedestrian at about 45 mph. While assessing the patient, you note bilateral tibia and fibula fractures. Which of the following best describes why the patient should be transported to a trauma center?

Pain from the fractures cannot be treated in the prehospital setting.
Analyzing the Mechanism of Injury suggests other serious injuries are likely to be present.
These fractures cannot be treated in a community hospital.
Fractures always require immediate surgery.

Analyzing the Mechanism of Injury suggests other serious injuries are likely to be present.

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You respond to a call of “man down”, and gunshots have been heard on scene. When should you enter the scene?
Answers: When you arrive on the scene
Dispatch informs you the scene is safe
You observe the gunman fleeing the scene
Police officers arrive and secure the scene

Police officers arrive and secure the scene

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When approaching a potential crime scene, you should:

Enter the scene if no signs of danger are noted
Quickly enter the scene, retrieve the victim, and withdraw to the vehicle
Park away from the scene until the police arrive and secure the scene
Park and wait in front of the scene so the victim knows you are there

Park away from the scene until the police arrive and secure the scene

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A paramedic should wear a properly fitted HEPA mask when evaluating a patient exhibiting signs and symptoms of:

Influenza
Asthma
COPD
Tuberculosis

Tuberculosis

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When should a paramedic wear eye protection when caring for patients?

Coughing up blood-tinged sputum
Complaining of dizziness
Unresponsive
All of the above

All of the above

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Components of a scene size-up include all of the following EXCEPT:

Patient’s chief complaint
Number of patients
Mechanism of injury
Dangers to bystanders

Patient’s chief complaint

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Which of the following factors may influence your index of suspicion of a patient’s condition? Select the letter choice with the best combination of the following factors:
1 Age
2 Gender
3 Race
4 Forces involved with the mechanism of injury

1, 2, and 4
1, 3, and 4
1, 2, 3, and 4
4 only

1, 2, 3, and 4

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Your patient is a 75-year-old male who is alert and responds to your questions. Which of the following is the best source of information about this patient?
Answers:	Family or friends
	The medical record
	The patient
	The physician

The patient

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You find an adult patient lying supine on the sidewalk after being struck by a vehicle traveling at 10 mph. The patient is alert with stable vital signs. The mechanism of injury and initial patient presentation are most consistent with suspected:
Answers:	
Pneumothorax
	Closed-head injury
	Abdominal trauma
	Lower extremity trauma

Lower extremity trauma

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Which of the following best describes when you should perform a scene size-up?
Answers:
Once you arrive at the patient’s side

Upon dispatch and throughout your time on the scene

When you initially arrive at the scene

As you are leaving the scene

Upon dispatch and throughout your time on the scene

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All of the following are signs of inadequate breathing in an infant EXCEPT:
Answers: Cyanosis
Use of accessory muscles
Altered mental status
A respiratory rate of 32 breaths per minute

Selected Answer: A respiratory rate of 32 breaths per minute

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In an infant the heart rate is best detected by either palpating the brachial artery or:	
		Answers:
Auscultating the carotid pulse
Palpating the femoral pulse
	Palpating the carotid pulse
	Auscultating the apical pulse

unknown

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Devices for maintaining airway patency in a five-year-old patient include all of the following EXCEPT a(n):

Endotracheal tube
Oropharyngeal airway
Suction unit
Pharyngotracheal lumen airway

Pharyngotracheal lumen airway

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Skin color is best evaluated by observing the:			
Answers:	Limbs and torso
	Dorsum of the hand
	Nail beds and conjunctiva
	Face

Selected Answer: Nail beds and conjunctiva

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You locate a 55-year-old female lying supine on the side of a road. There are no bystanders. You determine that the patient is unresponsive. Which of the following should be your next action?
Answers: Apply a cervical collar.
Provide high-flow oxygen.
Open the airway with a jaw-thrust maneuver.
Intubate the trachea.

Selected Answer: Open the airway with a jaw-thrust maneuver.

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Your three-year-old patient opens her eyes and responds when you speak to her. Her mental status is best described as:
Answers:	Alert
	Responsive to tactile stimuli
	Responsive to verbal stimuli
	Lethargic

unknown

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How should you open an infant's airway?			
Answers:	Perform a tongue-jaw lift
	Hyperextend the head and lift the chin
	Perform a jaw-thrust maneuver
	Carefully extend the head and neck

Carefully extend the head and neck

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Your patient appears awake but barely looks at you when you call his name. His airway is open, and he is breathing at 34 times per minute. He appears cyanotic. Which of the following adjuncts is most appropriate at this point?
Answers:	Nonrebreather mask
	Bag-valve mask
	Nasopharyngeal airway
	Nasal cannula

Bag-valve mask

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Forming a general impression as part of your primary assessment helps you to: Answers: Determine baseline mental status
Determine general clinical status and priority
Make a determination about stabilization of the cervical spine
Estimate vital signs

Selected Answer: Determine general clinical status and priority

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What is another way to describe "clammy" skin?
Answers:	Cool and dry
	Warm and dry
	Warm and moist
	Cool and moist

Selected Answer: Cool and moist

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Mottled, cyanotic, pale, or ashen skin color may indicate any of the following EXCEPT: Answers: Hypertensive crisis
Impaired blood flow to an extremity
Significant blood loss
Loss of spinal cord function

Selected Answer: Hypertensive crisis

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After determining that a patient does not respond to verbal stimuli, your next action would be to:
Answers: Place him in the recovery position
Pinch one of his fingernails
Insert an oropharyngeal airway
Apply manual cervical spine stabilization

Pinch one of his fingernails

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Which of the following sounds can typically be heard without the use of a stethoscope?
Answers:	Wheezes
	Bowel sounds
	Stridor
	Crackles

Selected Answer: Stridor

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The best method for determining responsiveness to painful stimuli in an infant is to:Answers: Pinch his cheeks
Pinch his fingernails
Rub his sternum
Flick the soles of his feet

Flick the soles of his feet

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``` Your patient is a three-year-old who presents with a fever. His parents state that he has had diarrhea and vomiting for two days. The patient has not eaten in 24 hours. To best evaluate the patient's peripheral perfusion status, you should evaluate: Answers: Respiratory rate Fingertip sensation Capillary refill Blood pressure ```

Capillary refill

Your patient is awake and complaining of chest pain. His airway is patent, and he is breathing at 18 times per minute with adequate tidal volume. What is your NEXT action? Answers: Administer oxygen at 15 lpm via nonrebreather mask. Begin positive pressure ventilations via bag-valve-mask device. Insert a nasopharyngeal airway. Administer oxygen at 2 lpm via nasal cannula.

Administer oxygen at 2 lpm via nasal cannula.

``` You are assessing a 28-year-old male with multiple gunshots to his abdomen. You should expect his skin to be: Answers: Cool and moist Hot and moist Warm and dry Cold and dry ```

Selected Answer: Cool and moist

Select the item that is NOT a pattern of deterioration in a patient's condition. Answers: Skin becomes cool, pale, and moist The heart rate significantly increases or decreases The respiratory rate significantly increases or decreases The level of consciousness increases

The level of consciousness increases

``` When you ask the patient to puff out her cheeks, show her upper and lower teeth, and raise her eyebrows, which cranial nerve are you evaluating? Answers: VI V VII IX ```

VII

A patient who is misinterpreting what is happening is experiencing a(n): Answers: Parasethesia Hallucination Delusion Illusion

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``` Select the choice below that best describes the sequence of a joint examination. 1 Palpation 2 Passive range of motion 3 Range of motion against resistance 4 Range of motion against gravity 5 Inspection ``` Answers: 5, 1, 2, 4, 3 5, 2, 1, 3, 4 2, 3, 4, 5, 1 1, 5, 2, 4, 3

Selected Answer: 5, 1, 2, 4, 3

Which of the following is an abnormal finding of the pupils? Answers: Constriction when focusing on a near object Both pupils constrict when a penlight is shone in one eye Slow but equal reaction to light Less than 2 mm difference in size with normal reaction to light

Slow but equal reaction to light

You respond to a patient complaining of lower abdominal pain. Upon your arrival you find a 25-year-old male who also complains of groin pain. After inspecting the penis and scrotum, your next step would be to: Answers: Inspect the glans Lift the scrotum and inspect for swelling or lumps Palpate the testicles Take a urine sample

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``` You are examining a 70-year-old female patient with altered mental status. She is awake and can speak. You detect an odor of acetone and suspect that the patient is suffering from which condition? Answers: Cyanide poisoning Alcohol poisoning Bowel obstruction Diabetic ketoacidosis ```

Diabetic ketoacidosis

A complete neurological exam includes assessment of mental status and speech, the motor and sensory systems, reflexes, and the: Answers: Speed of peripheral nervous conduction Tympanic membrane Cranial nerves Visual acuity

Cranial nerves

``` You have just percussed the patient's chest and heard a loud, booming, low-pitched sound. This indicates: Answers: Atelectasis A normal lung field A hypoinflated lung field A hyperinflated lung field ```

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``` Which of the following techniques is used to evaluate effectively for tenderness, rigidity, pain, or crepitus? Answers: Auscultation Inspection Percussion Palpation ```

Palpation

``` While you are assessing for a Babinski response, the patient's big toe dorsiflexes and the other toes fan out. This indicates a ________ response, which is ________. Answers: Negative, normal Positive, abnormal Negative, abnormal Positive, normal ```

Selected Answer: Positive, abnormal

When auscultating the posterior chest, you should listen: Answers: Only at the apices Only at the bases Down one side first, then the other From side to side as you proceed down the chest

Selected Answer: From side to side as you proceed down the chest

``` What does Nasal flaring indicate? Answers: Dysfunction of cranial nerve I Respiratory distress Hypoxia Rhinitis ```

Respiratory distress

How do you test an extremity for pain sensation? Answers: Use a sharp object, and have the patient tell you if he feels a sharp or dull sensation Firmly pinch a fold of skin over the most sensitive part of the extremity Stroke the extremity in a distal-to-proximal direction Briskly tap the tendon of the elbow or knee

Selected Answer: Use a sharp object, and have the patient tell you if he feels a sharp or dull sensation

Pain in the right upper quadrant may be related to any of the following organs EXCEPT the: Answers: Liver Spleen Gall bladder Ascending colon

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``` Cyanosis is caused by increased: Answers: Methemoglobin Oxyhemoglobin Carboxyhemoglobin Deoxyhemoglobin ```

Deoxyhemoglobin

You can test the oculomotor, trochlear, and abducens nerves by: Answers: Shining a light into the pupils and observing constriction of the pupils Conducting a visual acuity test Evaluating the patient's extraocular movements Closing one nostril while presenting a strong smell under the other nostril

Shining a light into the pupils and observing constriction of the pupils

``` When evaluating dorsiflexion, you should instruct the patient to point his: Answers: Foot upward Hand downward Foot downward Hand upward ```

footupward

``` Testing for a fluid wave in the abdomen is one way to examine the patient for the presence of: Answers: Peritonitis Intraabdominal bleeding Intestinal gas buildup Ascites ```

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``` You are palpating the abdomen of a 60-year-old male, and you feel a solid structure in the right upper quadrant. Upon percussion of the area, you hear a dull sound. The underlying structure is probably: Answers: An adrenal tumor The liver The pancreas An aneurysm ```

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Which of the following is included in an examination of the cardiovascular system? Answers: Auscultate for carotid bruits. Palpate to check for Murphy's sign. Auscultate breath sounds. Palpate both carotid arteries simultaneously.

Auscultate for carotid bruits.

``` Your patient has a swollen, painful leg. You flex the knee and palpate the calf, causing more pain. This might suggest: Answers: Hypokalemia Deep vein thrombosis Intermittent claudication Osteomyelitis ```

Deep vein thrombosis

``` Your patient was in a motor vehicle collision but was not discovered until 3 hours after the event. When you examine her, you discover bilateral discolored skin over the mastoid process. You should suspect: Answers: Temporal bone Frontal bone fracture Basilar skull fracture A fractured sinus ```

Selected Answer: Basilar skull fracture

Auscultation for bowel sounds should be done: Answers: Over the umbilical area In all nine regions Over the epigastrium In all four quadrants

Selected Answer: In all four quadrants

``` Which condition Does Not attribute to "Pale" skin color? Answers: Carotenemia Compensatory shock Anemia Decreased blood flow to the skin ```

Carotenemia

Which of the following describes where you should listen for S1 heart sounds? Answers: At the apex of the heart, along the lower left sternal border At the base of the heart, at the second intercostal space near the sternum At the base of the heart, along the lower left sternal border At the apex of the heart, at the second intercostal space near the sternum

At the apex of the heart, along the lower left sternal border

Which of the following guidelines should be observed when examining a one- to three-year-old child? Selected Answer: Focus on the vital areas as indicated by the chief complaint. Answers: Restrain the child if necessary. Do not distract the toddler with toys. Perform a comprehensive head-to-toe exam on all children in this age group.

Focus on the vital areas as indicated by the chief complaint

Which of the following best describes the technique of percussion? Answers: Using a reflex hammer to produce vibrations Pressing the bell of the stethoscope against the skin Shining a penlight into the ear to see the eardrum Striking the knuckle of one hand with the tip of a finger on the opposite hand

Selected Answer: Striking the knuckle of one hand with the tip of a finger on the opposite hand

``` To auscultate the S2 heart sound, a provider must listen over what intercostal space at the end of systole?Answers: Second Sixth First Fifth ```

Second

The sounds of turbulent blood flow around a partial obstruction in the carotid sinuses are known as:Answers: Stridor Vibrations Bruits Thrills

Bruits

When checking for skin turgor, you should Answers: Gently pick up a fold of skin, then release it Use the back of your hand to determine temperature Press the nail beds, then release Palpate the skin for flaking

Gently pick up a fold of skin, then release it

Which of the following best describes the correct positioning of a patient for an abdominal exam?Answers: Lateral recumbent Supine with the head flat and legs extended Semi-Fowler's position Supine with the head and knees supported by pillows

Lateral recumbent

``` Moving a finger in an "H" pattern in front of your patient's eyes tests: Answers: Accommodation Extraocular muscles Visual acuity Corneal reflex ```

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Which of the following statements about pulse oximetry is FALSE? Answers: Oxygen saturation is the percentage of hemoglobin that is bound with some molecular structure. Pulse oximetry values can be expected to decrease within seconds in cases of developing hypoxia. Pulse oximetry should be used on all patients with respiratory complaints. It may be difficult to obtain a reading in patients experiencing peripheral vasoconstriction.

Selected Answer: Pulse oximetry values can be expected to decrease within seconds in cases of developing hypoxia.

Your patient is a 16-year-old male who attempted suicide. He is unconscious and apneic, lying supine on a garage floor. The family states they found the patient unconscious in the front seat of a car that was running in an enclosed garage. HR = 70, BP = 100/60, RR = 0. In addition to an IV of normal saline enroute, select the correct sequence of treatments? Answers: Intubate, remove the patient from the garage, and transport to a hospital with a hyperbaric chamber. Remove the patient from the garage, initiate BVM ventilations with 100 percent oxygen, intubate, and transport to a hospital with a hyperbaric chamber. Remove the patient from the garage, initiate BVM ventilations with 100 percent oxygen, intubate, and transport to the nearest facility. Remove the patient from the garage, intubate, and transport to the nearest hospital.

Remove the patient from the garage, initiate BVM ventilations with 100 percent oxygen, intubate, and transport to a hospital with a hyperbaric chamber.

``` The most common cause of death resulting from myocardial infarction is: Answers: End-organ failure Inadequate tissue perfusion Heart failure Dysrhythmia ```

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``` A male patient with an acute exacerbation of his emphysema presents in severe distress with decreased air movement and diffuse inspiratory wheezes in all fields. HR = 132, BP = 142/88, RR = 30, SaO2 = 88%. Which of the following blood gas values is most likely? Answers: pH of 7.6 PO2 of 100 mmHg PCO2 of 70 mmHg PCO2 of 35 mmHg ```

Selected Answer: PCO2 of 70 mmHg

Your patient is a 54-year-old male who is unresponsive and cyanotic and has agonal respirations. A "quick look" shows ventricular tachycardia. Which of the following is most important when determining the immediate treatment of this patient? Answers: How long he has been "down" Whether he has a pulse Whether he is allergic to lidocaine Whether he has an implanted cardioverter-defibrillator

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Your patient is a 15-year-old asthmatic who has been having difficulty breathing for 45 minutes but does not have his Xopenex inhaler with him. Capnography shows an ETCO2 of 45 mmHg. The best way to interpret this finding is that: Answers: This is a normal ETCO2, indicating that this is a mild asthma attack The patient's ETCO2 first dropped as he began to hyperventilate but now is rising again and may continue to rise to dangerous levels This is a high ETCO2, and the patient requires immediate ventilatory assistance to prevent respiratory arrest This is a low ETCO2 indicating that the patient is hyperventilating, and thus in the early stages of an asthma attack

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You are working in the ED caring for a 55-year-old female with a long history of COPD. She is more short of breath today than usual and states she has an increased cough. She has a tympanic temperature of 99.8°F. You have drawn arterial blood gases with the patient on room air and when the report comes back, it shows that the patient has a PaO2 of 92 mmHg. Which of the following is most likely? Answers: You have inadvertently drawn a venous sample. The patient is critically hypoxic and requires assisted ventilation. This is the typical value for this patient. The lab performed the test incorrectly.

Selected Answer: This is the typical value for this patient.

You are working at the triage desk in the ED when a young man on crutches approaches the desk. He appears moderately short of breath. He states he had a cast put on his left leg seven days ago after surgery for a ruptured Achilles tendon. This morning, while he was watching television, he suddenly became short of breath. He has a history of asthma, for which he takes Xopenex as needed, and is taking Tylenol with codeine for pain related to his surgery. The patient's lung sounds are clear and equal, SpO2 is 90 percent on room air, heart rate is 100 and regular, respirations are 24 and slightly labored, blood pressure is 128/88, and the patient is afebrile. These findings are most consistent with: Answers: Allergic reaction to codeine Asthma exacerbated by recent anesthesia Pneumonia secondary to recent anesthesia Pulmonary embolism associated with immobilization of the lower extremity

Selected Answer: Pulmonary embolism associated with immobilization of the lower extremity

You have applied a CO-oximeter to your patient, and it is displaying an SpCO of 15 percent. Which of the following is the most appropriate interpretation of this finding? This is consistent with mild carbon monoxide poisoning. This is consistent with a fatal level of carbon monoxide poisoning. This is a normal reading for a smoker and nothing to worry about. This is a normal reading for a nonsmoker and nothing to worry about.

Selected Answer: This is consistent with mild carbon monoxide poisoning.

``` An increased hydrogen ion concentration in the cerebrospinal fluid results in a(n) ________ respiratory rate Erratic Decreased Unchanged Increased ```

Selected Answer: Increased

``` What is the most important factor in determining the respiratory rate? Arterial pCO2 Arterial pO2 Alveolar pCO2 Alveolar pO2 ```

Arterial pCO2

Which of the following would result in an increased respiratory rate? Answers: A decrease of cerebrospinal fluid PO2 Stimulation of chemoreceptors by an increase of PCO2 An increase of cerebrospinal fluid pH Stimulation of baroreceptors by an increase of PCO2

Stimulation of chemoreceptors by an increase of PCO2

``` An action potential begins in a myocardial cell when ________ enters the cell, giving it a ________ charge. Answers: Calcium, positive Sodium, positive Sodium, negative Calcium, negative ```

Selected Answer: Sodium, positive

Your patient is a 73-year-old male who is sitting in a recliner, cyanotic, pulseless, and apneic. The patient's skin is cool and dry. The patient's wife last saw him an hour and a half ago. Which of the following should you do first? Answers: Check for rigor mortis. Start CPR. Attach the monitor/defibrillator. Inform the patient's wife that he is dead and nothing can be done for him.

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For a resting potential in a cardiac cell to exist, there must be an: Answers: Adequate number of potassium ions inside the cell and sodium ions outside the cell Adequate number of sodium ions inside the cell and potassium ions outside the cell Influx of calcium ions into the cell Ionic equilibrium between the inside and outside of the cell

Selected Answer: Adequate number of potassium ions inside the cell and sodium ions outside the cell

``` ETCO2 is recorded during phase ________ of the capnogram Answers: I II III IV ```

III

``` Which of the following is the most important determinant of ventilatory rate? Answers: Arterial PO2 Venous PCO2 Venous PO2 Arterial PCO2 ```

Arterial PCO2

An ECG monitor is useful for which situation? Answers: Determining cardiac output Evaluating the heart's electrical conduction system for abnormalities Determining stroke volume Evaluating the effectiveness of cardiac contractions

Selected Answer: Evaluating the heart's electrical conduction system for abnormalities

Your patient is a 44-year-old female, alert and oriented, in moderate distress and complaining of difficulty breathing. She gives a one-week history of fever and malaise, with shortness of breath developing three days ago. She also has left-sided chest pain with deep inspiration and a "phlegmy" cough. Physical examination reveals hot, pale, dry skin, and rhonchi and rales throughout the left lung. The right lung sounds are clear. HR = 134, BP = 88/64, RR = 24, SaO2 = 92%. She has a history of two previous myocardial infarctions and takes nitroglycerin as needed. Which of the following is the best course of prehospital management? Answers: Endotracheal intubation, ventilation with supplemental oxygen, IV of NS KVO, nebulized albuterol and Atrovent, and corticosteroids IV Albuterol via nebulizer with 100 percent oxygen and IV of NS KVO Oxygen via nonrebreathing mask and IV of NS with fluid challenge Oxygen by nonrebreathing mask; IV of NS KVO; and furosemide, 40 mg IV

Oxygen via nonrebreathing mask and IV of NS with fluid challenge

2207 Final Flashcards

(79 cards)