EMT Chapter 22 Toxicology

Atropine sulfate and pralidoxime chloride are antidotes for:

A. diphenhydramine (Benadryl).

B. lysergic acid diethylamide (LSD).

C. nerve gas agents.

D. anticholinergic drugs.

C. nerve gas agents

A 4-year-old, 15-kg male ingested an unknown quantity of acetaminophen (Tylenol). The child's mother states that she does not know when the ingestion occurred. The child is conscious and alert and in no apparent distress. The EMT should:

A. contact medical control for guidance.

B. give the child milk to absorb the Tylenol.

C. administer high-flow supplemental oxygen.

D. administer 15 g of activated charcoal.

D. administer 15 g of activated charcoal

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

A. secobarbital (Seconal)

B. flunitrazepam (Rohypnol)

C. diazepam (Valium)

D. oxycodone (Percocet)

D. oxycodone (Percocet)

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

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

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

C. are usually absorbed quickly into the body.

D. are usually fatal within 30 minutes of exposure.

C. are usually absorbed quickly into the body

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 suspect that this patient:

A. has a hangover from the night before.

B. is a frequent and heavy heroin user.

C. was given flunitrazepam (Rohypnol).

D. is addicted to a benzodiazepine drug.

C. was given flunitrazepam (Rohypnol)

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

A. addiction.

B. tolerance.

C. withdrawal.

D. dependence.

B. tolerance

Before giving activated charcoal, you should:

A. mix it with an equal amount of water.

B. have the patient drink a glass of milk.

C. obtain approval from medical control.

D. mix the suspension by stirring the bottle.

C. obtain approval from medical control

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. Dry mucous membranes

D. A fall in blood pressure

C. dry mucous membranes

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

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

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

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

A. this will allow you to determine if the exposure is lethal.

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

C. naloxone is contraindicated if the patient is very obese.

D. you might need additional lifting and moving assistance.

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

Airborne substances should be diluted with:

A. oxygen.

B. an alkaline antidote.

C. activated charcoal.

D. syrup of ipecac.

A. oxygen

Activated charcoal may be indicated for a patient who ingested:

A. aspirin.

B. methanol.

C. ethanol.

D. iron.

A. aspirin

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 primary assessment of the child, you should:

A. induce vomiting with syrup of ipecac.

B. administer 25 g of activated charcoal.

C. immediately transport the child to the hospital.

D. contact the regional poison control center.

D. contact the regional poison control center

Heroin is an example of a(n):

A. sympathomimetic.

B. opioid.

C. cholinergic.

D. hypnotic.

B. opioid

A patient who presents with rapid breathing, nausea and vomiting, ringing in the ears, and hyperthermia should be suspected of ingesting a significant quantity of:

A. ibuprofen.

B. aspirin.

C. acetaminophen.

D. cocaine.

B. aspirin

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

A. abdominal pain.

B. black stools.

C. headache.

D. ringing in the ears.

B. black stools

The poison control center will 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. knows why the patient overdosed on the drug.

C. is aware of the substance that is involved.

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

C. is aware of the substance that is involved

A hypnotic drug is one that:

A. increases the pulse.

B. induces sleep.

C. increases the senses.

D. prevents amnesia.

B. induces sleep

A construction worker complains of intense pain after a bag of dry powder was spilled on his arm. The EMT should:

A. brush the chemical from his arm and then flush the skin with water.

B. brush the chemical from his arm and cover it with a sterile dressing.

C. immediately flush the skin with clean water for 15 to 20 minutes.

D. cover the exposed area with a sterile dressing and elevate his arm.

A. brush the chemical from his arm and then flush the skin with water

An overdose of acetaminophen, the active ingredient in Tylenol, will most likely cause:

A. acute kidney failure.

B. bleeding gastric ulcers.

C. liver damage and failure.

D. central nervous system depression.

C. liver damage and failure

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 that he might have had a seizure shortly before your arrival. This patient is most likely experiencing:

A. delirium tremens.

B. acute schizophrenia.

C. alcohol intoxication.

D. acute hypovolemia.

A. delirium tremens

Naloxone (Narcan) would reverse the effects of:

A. hydromorphone (Dilaudid).

B. phenobarbital (Luminal).

C. temazepam (Restoril).

D. diazepam (Valium).

A. hydromorphone (Dilaudid)

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

A. move the patient to a safe area.

B. decontaminate the patient's skin.

C. obtain and maintain a patent airway.

D. avoid contaminating yourself.

D. avoid contaminating yourself

You receive a call to a residence where a man found his wife unresponsive on the couch. The patient's 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. contact the poison control center.

B. ventilate her with a bag-mask device.

C. apply oxygen via a nonrebreathing mask.

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

B. ventilate her with a bag-mask device

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

A. Refrigeration of food will prevent salmonellosis.

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

C. The Salmonella bacterium itself causes food poisoning.

D. Symptoms of salmonellosis appear within 12 hours.

C. the Salmonella bacterium itself causes food poisoning

Signs of absorbed poison exposure include all of the following, except:

A. burns, itching, or irritation to the skin.

B. severe nausea, vomiting, and diarrhea.

C. redness of skin in light-skinned people.

D. liquid or powder on a patient's skin.

B. severe nausea, vomiting, and diarrhea

During your assessment of a 50-year-old male who was found unresponsive in an alley, you note that he has slow, shallow respirations; 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. Which of the following would most likely explain the patient's presentation?

A. Closed-head injury

B. Delirium tremens

C. Alcohol intoxication

D. Heroin overdose

D. heroin overdose

Most poisonings occur via the __________ route.

A. ingestion

B. injection

C. absorption

D. inhalation

A. ingestion

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

A. observe the scene for drug bottles.

B. be alert for personal hazards.

C. quickly gain access to the patient.

D. look for drug paraphernalia.

B. be alert for personal hazards

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

A. amphetamine sulfate (Benzedrine).

B. crack cocaine.

C. oxycodone (Percocet).

D. ecstasy.

C. oxycodone (Percocet)

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

A. recognize that a poisoning occurred.

B. administer the appropriate antidote.

C. contact poison control immediately.

D. administer 25 g of activated charcoal.

A. recognize that a poisoning occurred

A man with a prolonged history of alcohol abuse fell from a second-story balcony. His blood pressure is 80/60 mm Hg, his heart rate is 120 beats/min, and his skin is cool and pale. When caring for this patient, the EMT should recall that:

A. reduced blood clotting worsens internal bleeding.

B. patients with alcoholism are prone to hyperthermia.

C. alcohol is a stimulant, which likely caused his fall.

D. patients with alcoholism are prone to hyperglycemia.

A. reduced blood clotting worsens internal bleeding

Substance abuse is most accurately defined as:

A. misusing a substance to produce a desired effect.

B. knowingly selling illicit drugs to buy more drugs.

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

D. unwillingly and unknowingly consuming drugs or alcohol.

A. misusing a substance to produce a desired effect

Which of the following statements regarding inhaled poisons is correct?

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

B. Lung damage might progress after the patient is removed from the environment.

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

D. Carbon monoxide is very irritating to the upper airway and might cause swelling.

B. lung damage might progress after the patient is removed from the environment

Delirium tremens (DTs) is a syndrome associated with withdrawal from:

A. sedatives.

B. alcohol.

C. cocaine.

D. opioids.

B. alcohol

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

A. monitor the patient's blood pressure.

B. be alert for vomiting.

C. document the intervention.

D. call medical control.

B. be alert for vomiting

Which of the following sets of vital signs would the EMT most likely encounter in a patient with acute cocaine overdose?

A. BP, 60/40 mm Hg; pulse, 140 beats/min

B. BP, 180/100 mm Hg; pulse, 50 beats/min

C. BP, 190/90 mm Hg; pulse, 40 beats/min

D. BP, 200/100 mm Hg; pulse, 150 beats/min

D. BP, 200/100 mmHg; pulse, 150 beats/min

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

A. induces vomiting and empties the stomach.

B. decreases absorption of poisons into the lungs.

C. binds to the substance and prevents absorption.

D. is a direct antidote for many toxic substances.

C. binds to the substance and prevents absorption

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. seizures and cardiac dysrhythmias.

B. a sudden outburst of violence.

C. acute respiratory depression.

D. an increase in her blood pressure.

A. seizures and cardiac dysrhythmias

Which of the following questions would be least pertinent during the initial questioning of a patient who ingested a substance?

A. How much of the substance was taken?

B. Why was the substance ingested?

C. What type of substance was taken?

D. How long ago was the substance taken?

B. Why was the substance ingested?