Chapter 19, 20

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; perioral 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 Valium.

A. A heroin overdose.

The MOST common route for poisonings is: A. Ingestion. B. Injection. C. Inhalation. D. Absorption.

A. Ingestion.

You receive a call to a residence where a man found his wife unconscious on the couch. The patient is unresponsive, has a respiratory rate of 8 breaths/min with reduced tidal volume, and a heart rate of 40 beats/min and weak. The husband hands you an empty bottle of 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.

A poison that enters the body by _____ is the MOST difficult to treat. A. Injection. B. Ingestion. C. Inhalation. D. Absorption.

A. Injection.

Heroin is an example of a/an: A. Opioid. B. Hypnotic. C. Cholingeric. D. Sympathomimetic.

A. Opioid.

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 most likely hypoglycemic.

B. May vomit and aspirate.

Atropine sulfate and pralixodime chloride are antidotes for: A. Anticholinergic drugs. B. Nerve gas agents. C. Lysergic acid diethylamide. D. Diphenhydramine (Benadryl).

B. Nerve gas agents.

The EMT-B'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.

Signs and symptoms of a sympathomimetic drug overdose include: A. Sedation. B. Tachycardia. C. Hypotension. D. Slurred speech.

B. Tachycardia.

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. Assisting her ventilations with a BVM. B. Thoroughly suctioning her oropharynx. C. Performing a rapid medical assessment. D. Requesting a paramedic to give her Atropine.

B. Thoroughly suctioning her oropharynx.

A 4-year-old male ingested an unknown quantity of 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.

Which of the following drugs is NOT a sedative-hypnotic? A. Secondal. B. Valium. C. Cocaine. D. Rophynol.

C. Cocaine.

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. Oxygen via a nonrebreathing mask and rapid transport. B. Assisted ventilation, flumazenil (Romazicon), and rapid transport. C. Oxygen via a nasal cannula, atropine, and rapid transport. D. Assisted ventilation, naloxone (Narcan), and rapid transport.

D. Assisted ventilation, naloxone (Narcan), and rapid transport.

You respond to a college campus for a young male who is "acting strange." 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, has a rapid, irregular pulse, and his BP is 200/110 mm Hg. Treatment for this patient includes. A. Requesting a paramedic to administer naloxone (Narcan). B. Assisting his ventilations with a BVM and 100% oxygen. 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.

Your paramedic partner administers atropine to a middle-aged male. Which of the following 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.

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.

In an apparent suicide attempt, a 19-year-old female ingested a full bottle of 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, pulse is 140 beats/min and irregular, and respirations are 22 breaths/min with adequate depth. When transporting the 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.

Which of the following question is of LEAST pertinence when obtaining information from a patient who ingested a substance? A. How much 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?