10 free AEMT practice questions: Medication Administration Routes

A pain medication given through a transdermal patch: A transdermal patch looks like the least invasive route on the list. Transdermal is still one of the six Paramedic routes. Placing the patch would put you outside your scope.

A sedative instilled through a nasogastric tube: Using a nasogastric tube that is already in place seems like it costs nothing. Nasogastric is a Paramedic route too, and a tube that is already there does not make the route yours.

An antipyretic given by the rectal route: Rectal medication sounds like basic nursing care. Rectal is on the same Paramedic list as the patch and the tube, so an AEMT cannot give the antipyretic that way.

Right dose: catches the wrong amount of a drug. The amount drawn up is not the problem in this scene. The problem is where the label says the drug is allowed to go.

Right time: matters when a repeat dose is due. Nothing in this scene is about when to give the antiemetic, only about how the vial allows it to be given.

Right documentation: Documentation is one of the six rights, and it is the one people forget. You document after the drug is given, so documentation cannot catch a label mismatch before the drug goes in.

Analgesia, antiemetic, dextrose, epinephrine, glucagon, and amiodarone: Amiodarone is an antiarrhythmic used in cardiac arrest. Antiarrhythmics stay at the paramedic level. Amiodarone is not on the AEMT list by any route.

Analgesia, antiemetic, dextrose, epinephrine, lidocaine, and naloxone: Lidocaine is the other antiarrhythmic used in cardiac arrest, and lidocaine is paramedic level too. This list also drops naloxone, which really is one of the six.

Analgesia, antiemetic, dextrose, midazolam, glucagon, and naloxone: Midazolam is a benzodiazepine. No general sedative or anticonvulsant is on the national AEMT list. For an AEMT, midazolam is a paramedic level drug.

Swallowed whole with a full glass of water: Swallowing a tablet whole with water is how most people take pills. A whole tablet has to break down in the stomach first. Chewing skips that delay.

Dissolved under the tongue and held there: Holding a tablet under the tongue is the sublingual route, and the sublingual route really is fast for drugs made for it. Aspirin is not made for that route, and putting aspirin under the tongue does not speed it up.

Crushed and stirred into a spoonful of food: Crushing a tablet into food helps patients who have trouble swallowing pills. Food slows how fast the stomach empties. The aspirin reaches the blood later, not sooner.

Four 81 mg chewable tablets, the full target dose: Four 81 mg tablets is the right dose when the patient has taken no aspirin. This patient already took 81 mg two hours ago. Four more tablets brings the total to 405 mg, which is over the 324 mg target.

A single 325 mg tablet, since the earlier dose has worn off: Aspirin levels in the blood do drop within hours, so the earlier dose can look worn off. The enzyme in the platelets stays shut off for the whole life of the platelet, so the earlier 81 mg still counts. A 325 mg tablet on top of the 81 mg goes over the 324 mg target.

Two 81 mg chewable tablets, half of the target dose: Two tablets is 162 mg. Added to the 81 mg already taken, the total is 243 mg. The total comes up 81 mg short of the 324 mg target, so the patient is undertreated.

Fat holds a larger volume, so the dose lasts longer: Fat as a reservoir that slowly empties sounds like it would make a dose last longer. Volume is not what sets how fast a drug absorbs. Subcutaneous doses are usually smaller than intramuscular doses, not larger.

Fat sits closer to the lymph vessels that carry the drug: Lymph vessels do carry a few types of drugs away from an injection site. The usual way a drug leaves fat is through the local blood supply. The low blood flow in fat is what slows the drug down.

Fat is less sensitive, so a larger needle can be used: Some injection sites do hurt less than others. Needle size is not why a drug is ordered subcutaneous. Subcutaneous injections use a shorter, thinner needle, not a larger one.

Raise the bag higher to increase the gravity head: Raising the bag is the usual fix when an IV drip runs slowly, and with a vein it often works. The marrow will not run by gravity at any bag height. Raising the bag costs you time during a cardiac arrest and changes nothing.

Pull the needle back slightly and reconnect the tubing firmly: Reconnecting the tubing firmly fixes a loose connection at the hub. Pulling the needle back can pull it out of the marrow space completely. The much more likely reason nothing is flowing is that the catheter has not been flushed.

Replace the needle at the proximal humerus site: Moving to the proximal humerus is right when a site has truly failed, and the humerus does give higher flow in an adult. This tibia site has not been shown to fail yet. Pulling a correctly placed needle in the middle of an arrest throws away the access you already have.

Decline the order because the patient has no prescription for that drug: Whether the patient has a prescription matters when you help a patient take their own medication. A service can still give its own stocked nitroglycerin to a patient with no prescription at all. This order fails because of the route, not because of whose drug it is. Declining for the wrong reason would lead you to follow the order the next time a prescription exists.

Place the patch, since the order came from a physician: A physician order carries real authority. Medical direction can only direct care inside your scope. The order cannot make a Paramedic route legal for an AEMT.

Place the patch and record the physician's name in the report: Writing down the physician's name can look like it protects everyone. Putting the name in the report does not change what you are allowed to do. Placing the patch is still outside your scope.

Right patient: the check that fails when the right dose of the right drug goes to the wrong person. Right patient also covers a patient with a documented allergy or contraindication to the drug. Nothing in this question is about who got the medication. This error is the math between the label and the syringe, which is about how much drug was given.

Right route: catches a drug made for one route being given by another, like an intramuscular dose pushed IV. The route matters because it changes how fast and how completely the drug reaches the bloodstream. The question never says the route was wrong. It says the AEMT never checked the concentration against the amount to be given. That is a problem with how much drug went in, not how the drug got in.

Right documentation: fails when the drug, dose, route, time, and the patient's response never get written on the chart. Documentation happens after the drug is given. This error happened before the drug was given. The chart would just show the wrong dose, written down accurately.

Subcutaneous tissue is located closer to major blood vessels: Subcutaneous tissue sits above the muscle, not closer to the major blood vessels. The subcutaneous layer also has poor blood flow, and that poor blood flow is why absorption from it is slow.

Intramuscular injections use a shallower needle angle than subcutaneous injections: Needle angle is real, but option C has it backward. An IM injection uses a steep angle, close to 90 degrees, to go through the fat and into the muscle. An SC injection uses a shallow angle, around 45 degrees, into a pinched fold of skin. The angle decides where the drug lands. The angle does not explain why muscle absorbs the drug faster once the drug is there.

Subcutaneous injections bypass first-pass liver metabolism: First-pass metabolism is the liver breaking down a swallowed drug before it reaches the rest of the body. Sublingual and IV drugs skip it. IM and SC drugs skip it too, because neither one is swallowed. Neither route goes through first-pass metabolism, so first-pass metabolism cannot explain why IM absorbs faster.