EMT - Chapter 22: Toxicology

Substance abuse is MOST accurately defined as:

A. knowingly selling illicit drugs in order to buy more drugs.

B. willfully using a therapeutic drug to treat a medical illness.

C. unwillingly and unknowingly consuming drugs or alcohol.

D. knowingly misusing a substance to produce a desired effect.

D. knowingly misusing a substance to produce a desired effect.

The EMT's primary responsibility to the patient who has been poisoned is to:

A. administer the appropriate antidote.

B. recognize that a poisoning occurred.

C. administer 25 g of activated charcoal.

D. contact poison control immediately.

B. recognize that a poisoning occurred.

Heroin is an example of a(n):

A. opioid.

B. hypnotic.

C. cholinergic.

D. sympathomimetic.

A. opioid.

Hypotension, hypoventilation, and pinpoint pupils would be expected following an overdose of:

A. ecstasy.

B. oxycodone (Percocet).

C. amphetamine sulfate (Benzedrine).

D. crack cocaine.

B. oxycodone (Percocet).

Signs and symptoms of a sympathomimetic drug overdose include:

A. sedation.

B. tachycardia.

C. hypotension.

D. slurred speech.

B. tachycardia.

Which of the following drugs is NOT a sedative-hypnotic?

A. secobarbital (Seconal)

B. diazepam (Valium)

C. cocaine

D. flunitrazepam (Rohypnol)

C. cocaine

Your paramedic partner administers atropine to a 49-year-old male with bradycardia. Which of the

following side effects would you expect the patient to experience?

A. pupillary constriction

B. excessive lacrimation

C. a fall in blood pressure

D. dry mucous membranes

D. dry mucous membranes

Which of the following questions would be of LEAST pertinence during the initial questioning of a patient

who ingested a substance?

A. How much of the substance was taken?

B. How long ago was it taken?

C. What type of substance was taken?

D. Why was the substance ingested?

D. Why was the substance ingested?

A poison that enters the body by __________ is the MOST difficult to treat.

A. injection

B. ingestion

C. inhalation

D. absorption

A. injection

The poison control center will be able to provide you with the most information regarding the appropriate

treatment for a patient with a drug overdose if the center:

A. knows the location of the closest hospital.

B. is aware of the patient's age and gender.

C. is aware of the substance that is involved.

D. knows why the patient overdosed on the drug.

C. is aware of the substance that is involved.

Which of the following statements regarding inhaled poisons is correct?

A. Lung damage may progress after the patient is removed from the environment.

B. Carbon monoxide is very irritating to the upper airway and may cause swelling.

C. Burns around the eyes are the most common indication of an inhalation poisoning.

D. Chlorine is a colorless and odorless gas that causes hypoxia and pulmonary edema.

A. Lung damage may progress after the patient is removed from the environment.

Your priority in caring for a patient with a surface contact poisoning is to:

A. move the patient to a safe area.

B. avoid contaminating yourself.

C. decontaminate the patient's skin.

D. obtain and maintain a patent airway.

B. avoid contaminating yourself.

Phosphorus or elemental sodium should be brushed off of the skin instead of irrigated with water because:

A. water makes these chemicals impossible to remove.

B. severe swelling will occur when mixed with water.

C. this will eliminate the chances of you being exposed.

D. these chemicals may ignite upon contact with water.

D. these chemicals may ignite upon contact with water.

Most poisonings occur via the __________ route.

A. ingestion

B. injection

C. inhalation

D. absorption

A. ingestion

Syrup of ipecac is no longer recommended to treat patients who have ingested a poisonous substance

because it:

A. has been linked to hypotension.

B. does not effectively induce vomiting.

C. may result in aspiration of vomitus.

D. has toxic effects on the myocardium.

C. may result in aspiration of vomitus.

Activated charcoal is given to patients who have ingested certain substances because it:

A. induces vomiting and empties the stomach.

B. binds to the substance and prevents absorption.

C. decreases absorption of poisons into the lungs.

D. is a direct antidote for many toxic substances.

B. binds to the substance and prevents absorption.

In general, injected poisons are impossible to dilute or remove because they:

A. are usually absorbed quickly into the body.

B. are usually fatal within 30 minutes of exposure.

C. absorb slowly into the body, despite their potency.

D. react with the blood, which increases their toxicity.

A. are usually absorbed quickly into the body.

As you enter the residence of a patient who has possibly overdosed, you should:

A. be alert for personal hazards.

B. look for drug paraphernalia.

C. observe the scene for drug bottles.

D. quickly gain access to the patient.

A. be alert for personal hazards.

Your unit is dispatched to the county jail for an intoxicated inmate. Upon arrival, you find the patient, a 33-

year-old male, lying supine in a jail cell. He is responsive to painful stimuli only and has slow, shallow

respirations. You should be MOST concerned that this patient:

A. might become violent.

B. may vomit and aspirate.

C. may experience a seizure.

D. is severely hypoglycemic.

B. may vomit and aspirate.

You receive a call to a residence where a man found his wife unconscious on the couch. The patient is

unresponsive, her respiratory rate is 8 breaths/min, her breathing is shallow, her heart rate is 40 beats/min,

and her pulse is weak. The husband hands you an empty bottle of hydrocodone (Vicodin), which was

refilled the day before. You should:

A. initiate ventilatory assistance.

B. contact the poison control center.

C. perform a rapid head-to-toe exam.

D. apply oxygen via a nonrebreathing mask.

A. initiate ventilatory assistance.

It is MOST important to determine a patient's weight when asking questions pertaining to a toxic ingestion

because:

A. additional help may be needed at the scene to lift the patient.

B. this will allow you to predict if the exposure is lethal.

C. this will determine whether or not to give syrup of ipecac.

D. activated charcoal is given based on a patient's weight.

D. activated charcoal is given based on a patient's weight.

Airborne substances are diluted with:

A. oxygen.

B. syrup of ipecac.

C. activated charcoal.

D. an alkaline antidote.

A. oxygen.

Activated charcoal administration is contraindicated in patients who have ingested:

A. ibuprofen.

B. acetaminophen (Tylenol).

C. acids or alkalis.

D. steroid drugs.

C. acids or alkalis.

Common names for activated charcoal include all of the following, EXCEPT:

A. Fructose.

B. Actidose.

C. LiquiChar.

D. InstaChar.

A. Fructose.

The usual dose for activated charcoal is up to ______ for a pediatric patient and up to ______ for an adult

patient.

A. 5 g, 10 g

B. 10 g, 20 g

C. 12.5 g, 25 g

D. 25 g, 50 g

D. 25 g, 50 g

A 4-year-old male ingested an unknown quantity of acetaminophen (Tylenol). The child's mother states that

the ingestion occurred approximately 20 minutes ago. The child is conscious and alert and in no apparent

distress. After contacting medical control, you should:

A. induce vomiting with syrup of ipecac.

B. transport the child for definitive care.

C. administer up to 25 g of activated charcoal.

D. give the child cold milk to absorb the Tylenol.

C. administer up to 25 g of activated charcoal.

Before giving activated charcoal, you should:

A. obtain approval from medical control.

B. have the patient drink a glass of milk.

C. mix it with an equal amount of water.

D. mix the suspension by stirring the bottle.

A. obtain approval from medical control.

The major side effect associated with ingestion of activated charcoal is:

A. headache.

B. black stools.

C. abdominal pain.

D. ringing in the ears.

B. black stools.

After administering activated charcoal to a patient, it is MOST important to:

A. call medical control.

B. be alert for vomiting.

C. reassess the patient's blood pressure.

D. document the intervention.

B. be alert for vomiting.

A person who routinely misuses a substance and requires increasing amounts to achieve the same effect is

experiencing a(n):

A. addiction.

B. dependence.

C. withdrawal.

D. tolerance.

D. tolerance.

The MOST commonly abused drug in the United States is:

A. cocaine.

B. alcohol.

C. codeine.

D. marijuana.

B. alcohol.

A hypnotic drug is one that:

A. induces sleep.

B. prevents amnesia.

C. increases the pulse.

D. increases the senses.

A. induces sleep.

When caring for a known alcoholic patient with severe trauma to the chest and abdomen, you should be

concerned that:

A. delirium tremens (DTs) are commonly induced by physical trauma and can lead to life-threatening seizures.

B. internal bleeding may be profuse because prolonged alcohol use may impair the blood's ability to clot.

C. long bone fractures are likely because chronic alcohol consumption weakens the structure of the bones.

D. signs and symptoms of shock may be masked by the stimulant effects produced by alcohol.

B. internal bleeding may be profuse because prolonged alcohol use may impair the blood's ability to clot.

DTs is a syndrome associated with withdrawal from:

A. cocaine.

B. opioids.

C. alcohol.

D. sedatives.

C. alcohol.

A 49-year-old male presents with confusion, sweating, and visual hallucinations. The patient's wife tells

you that he is a heavy drinker and she thinks he had a seizure shortly before your arrival. This patient is

MOST likely experiencing:

A. acute hypovolemia.

B. alcohol intoxication.

C. acute schizophrenia.

D. DTs.

D. DTs.

During your assessment of a 50-year-old male who was found unconscious in an alley, you note that he has

slow, shallow respirations; significant bradycardia; facial cyanosis; and pinpoint pupils. As your partner

begins assisting the patient's ventilations, he directs your attention to the patient's arms, which have

multiple needle tracks on them. This patient's clinical presentation is MOST consistent with:

A. a heroin overdose.

B. alcohol intoxication.

C. a closed head injury.

D. an overdose of diazepam (Valium).

A. a heroin overdose.

You and your paramedic partner are caring for a patient who ingested codeine, acetaminophen (Tylenol),

and propoxyphene (Darvon). The patient is unresponsive, his breathing is slow and shallow, and his pulse is

slow and weak. Treatment for this patient will include:

A. assisted ventilation, naloxone (Narcan), and rapid transport.

B. oxygen via a nonrebreathing mask and rapid transport.

C. assisted ventilation, flumazenil (Romazicon), and rapid transport.

D. oxygen via a nasal cannula, atropine, and rapid transport.

A. assisted ventilation, naloxone (Narcan), and rapid transport.

You respond to a local motel for a young female who was sexually assaulted. The patient is conscious but

confused. She tells you that the last thing she remembers was drinking beer at a club with her friends the

night before. When she awoke, she was in the bed of the motel room. You should be MOST suspicious that

this patient:

A. is a heroin abuser.

B. is acutely intoxicated.

C. was given flunitrazepam (Rohypnol).

D. is abusing marijuana.

C. was given flunitrazepam (Rohypnol).

You respond to a college campus for a young male who is acting strangely. After law enforcement has

secured the scene, you enter the patient's dorm room and find him sitting on the edge of the bed; he appears

agitated. As you approach him, you note that he has dried blood around both nostrils. He is breathing

adequately, his pulse is rapid and irregular, and his blood pressure is 200/110 mm Hg. Treatment for this

patient includes:

A. requesting a paramedic to administer naloxone (Narcan).

B. assisting his ventilations with a bag-mask device.

C. asking law enforcement to place handcuffs on the patient.

D. attempting to calm him and giving him oxygen if tolerated.

D. attempting to calm him and giving him oxygen if tolerated.

In an apparent suicide attempt, a 19-year-old female ingested a full bottle of amitriptyline (Elavil). At

present, she is conscious and alert and states that she swallowed the pills approximately 30 minutes earlier.

Her blood pressure is 90/50 mm Hg, her pulse is 140 beats/min and irregular, and her respirations are 22

breaths/min with adequate depth. When transporting this patient, you should be MOST alert for:

A. acute respiratory depression.

B. a sudden outburst of violence.

C. an increase in her blood pressure.

D. seizures and cardiac arrhythmias.

D. seizures and cardiac arrhythmias.

You are dispatched to a local nursery for a 39-year-old female who is sick. When you arrive, you find the

patient lying on the floor. She is semiconscious, has copious amounts of saliva coming from her mouth, and

is incontinent of urine. You quickly feel her pulse and note that it is very slow. Initial management for this

patient should include:

A. thoroughly suctioning her oropharynx.

B. assisted ventilation with a bag-mask device.

C. performing a rapid secondary assessment.

D. requesting a paramedic to give her atropine.

B. assisted ventilation with a bag-mask device.

Atropine sulfate and pralidoxime chloride are antidotes for:

A. lysergic acid diethylamide (LSD).

B. diphenhydramine (Benadryl).

C. nerve gas agents.

D. anticholinergic drugs.

C. nerve gas agents.

A patient who presents with rapid breathing, nausea and vomiting, ringing in the ears, and a high fever

should be suspected of ingesting a significant quantity of:

A. cocaine.

B. aspirin.

C. Tylenol.

D. ibuprofen.

B. aspirin.

An overdose on acetaminophen, the active ingredient in Tylenol, will MOST likely cause:

A. liver failure.

B. gastric ulcers.

C. kidney failure.

D. central nervous system (CNS) depression.

A. liver failure.

Which of the following statements regarding the Salmonella bacterium is correct?

A. Refrigeration of food will prevent salmonellosis.

B. Symptoms of salmonellosis appear within 12 hours.

C. The Salmonella bacterium produces toxins that cause food poisoning.

D. The Salmonella bacterium itself causes food poisoning.

D. The Salmonella bacterium itself causes food poisoning.

A 3-year-old female ingested several leaves from a plant in the living room. The child's mother is not sure

what type of plant it is, stating that she bought it simply because it was pretty. After completing your initial

assessment of the child, you should:

A. administer 25 g of activated charcoal.

B. induce vomiting with syrup of ipecac.

C. contact the regional poison control center.

D. immediately transport the child to the hospital.

C. contact the regional poison control center.