AEMCA MCQ 4 — Questions and Answers
Question 1: A neonate is delivered in the field and is limp with a heart rate of 55 bpm despite 30 seconds of positive pressure ventilation. What is the next intervention?
- Administer epinephrine 0.01 mg/kg IV
- Begin chest compressions at a 3:1 compression-to-ventilation ratio (Correct answer)
- Increase PPV rate and administer blow-by oxygen
- Intubate immediately and transport
Correct answer: Begin chest compressions at a 3:1 compression-to-ventilation ratio
For neonates with a heart rate below 60 bpm after adequate PPV, chest compressions are initiated at a 3:1 ratio (3 compressions to 1 ventilation).
Question 2: Which of the following best describes compensated shock?
- Hypotension, altered mental status, and cyanosis
- Normal or near-normal blood pressure maintained by increased heart rate and vasoconstriction (Correct answer)
- Blood pressure that cannot be restored despite fluid resuscitation
- Cardiogenic shock requiring vasopressors
Correct answer: Normal or near-normal blood pressure maintained by increased heart rate and vasoconstriction
In compensated shock, the body uses tachycardia and vasoconstriction to maintain blood pressure despite decreased perfusion; hypotension has not yet occurred.
Question 3: A patient presents with a suspected opioid overdose: unresponsive, pinpoint pupils, respiratory rate of 4/min. What is the correct naloxone dose for an adult?
- 2 mg IV once only
- 0.4–2 mg IV/IM/IN, titrated to restore adequate breathing (Correct answer)
- 10 mg IV push
- 0.1 mg/kg IV every 5 minutes
Correct answer: 0.4–2 mg IV/IM/IN, titrated to restore adequate breathing
Naloxone is titrated at 0.4–2 mg IV/IM/IN to restore spontaneous respirations without precipitating acute withdrawal; repeat as needed based on response.
Question 4: During a mass casualty incident (MCI), a patient is found apneic after repositioning the airway. Under START triage, this patient is tagged:
- Immediate (Red)
- Delayed (Yellow)
- Minor (Green)
- Expectant (Black) (Correct answer)
Correct answer: Expectant (Black)
Under START triage, a patient who remains apneic after airway repositioning is tagged Expectant (Black) because resources are insufficient to save them during MCI.
Question 5: A patient is having an acute asthma attack unresponsive to two albuterol treatments. Which additional medication is most appropriate for the AEMCA to administer?
- Diphenhydramine 50 mg IV
- Magnesium sulfate 2 g IV over 20 minutes (Correct answer)
- Furosemide 40 mg IV
- Calcium gluconate 1 g IV
Correct answer: Magnesium sulfate 2 g IV over 20 minutes
Magnesium sulfate acts as a bronchodilator by blocking calcium in smooth muscle and is indicated for severe asthma refractory to bronchodilator therapy.
Question 6: Which of the following is the correct landmark for adult IO (intraosseous) access using the tibial site?
- Lateral aspect of the distal tibia, 2 cm above the medial malleolus
- Proximal tibia, 2 cm below the tibial tuberosity on the flat anteromedial surface (Correct answer)
- The tibial tuberosity directly
- Posterior aspect of the proximal tibia
Correct answer: Proximal tibia, 2 cm below the tibial tuberosity on the flat anteromedial surface
The proximal tibia IO site is 2 cm below the tibial tuberosity on the flat anteromedial surface, away from the growth plate.
Question 7: A 70 kg patient in cardiogenic shock requires a dopamine infusion at 5 mcg/kg/min. You have dopamine 400 mg in 250 mL NS. What is the infusion rate in mL/hr?
- 10.5 mL/hr
- 13.1 mL/hr (Correct answer)
- 21.0 mL/hr
- 26.3 mL/hr
Correct answer: 13.1 mL/hr
Concentration = 400 mg/250 mL = 1600 mcg/mL; dose = 5 mcg/kg/min × 70 kg = 350 mcg/min = 21,000 mcg/hr; rate = 21,000/1600 ≈ 13.1 mL/hr.
AEMCA MCQ 4
A neonate is delivered in the field and is limp with a heart rate of 55 bpm despite 30 seconds of positive pressure ventilation.
What is the next intervention?