Ch.Ch. 21 Toxicology Quiz

After administering activated charcoal to a patient, it is MOST important to: A) call medical control. B) be alert for vomiting. C) monitor the patient's BP. D) document the intervention.

Correct Answer B) be alert for vomiting.

Victims of inhaled poisoning will require which of the following? A) Ventilation with a bag-valve mask B) An oropharyngeal or nasopharyngeal device to maintain an airway C) Suctioning to clear the airway Correct Answer D) Transport to an emergency department for evaluation

Correct Answer D) Transport to an emergency department for evaluation

A person who routinely misuses a substance and requires increasing amounts to achieve the same effect is experiencing: A) addiction. B) dependence. C) withdrawal. D) tolerance.

Correct Answer D) tolerance.

Common names for activated charcoal include all of the following, EXCEPT: A) Fructose. B) Actidose. C) LiquiChar. D) InstaChar.

Correct Response A) Fructose.

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.

Correct Response A) are usually absorbed quickly into the body.

You and your paramedic partner are caring for a patient who ingested codeine, acetaminophen (Tylenol), and hydrocodone (Vicodin). The patient is unresponsive, his breathing is slow and shallow, and his pulse is slow and weak. Treatment for this patient should include: A) assisted ventilation and naloxone (Narcan). B) high-flow oxygen via a nonrebreathing mask. C) assisted ventilation and flumazenil (Romazicon). D) oxygen via a nasal cannula and atropine sulfate.

Correct Response A) assisted ventilation and naloxone (Narcan).

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.

Correct Response A) be alert for personal hazards.

"Nerve gases" overstimulate normal body functions that are controlled by parasympathetic nerves, causing: A) increased salivation. B) pupil dilation. C) decreased urination. D) decreased lacrimation.

Correct Response A) increased salivation.

Most poisonings occur via the __________ route. A) ingestion B) injection C) inhalation D) absorption

Correct Response A) ingestion

An overdose of acetaminophen, the active ingredient in Tylenol, will MOST likely cause: A) liver failure. B) gastric ulcers. C) kidney failure. D) CNS depression.

Correct Response A) liver failure

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.

Correct Response A) obtain approval from medical control.

Heroin is an example of a(n): A) opioid. B) hypnotic. C) cholinergic. D) sympathomimetic.

Correct Response A) opioid.

Airborne substances should be diluted with: A) oxygen. B) syrup of ipecac. C) activated charcoal. D) an alkaline antidote.

Correct Response A) oxygen.

The recommended treatment for absorbed or contact poisons includes _________. A) safely removing or diluting the poisonous substance B) neutralizing the poisonous substance with a chemical C) transporting the patient to the emergency department with the poisonous substance in place D) collecting and transporting the poisonous substance to the emergency department for identification

Correct Response A) safely removing or diluting the poisonous substance

Signs and symptoms of a sympathomimetic drug overdose include: A) tachycardia. B) hypothermia. C) hypotension. D) slurred speech.

Correct Response A) 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. Immediate management for this patient should include: A) thoroughly suctioning her oropharynx. B) assisted ventilation with a BVM. C) performing a rapid secondary assessment. D) requesting a paramedic to give her atropine.

Correct Response A) thoroughly suctioning her oropharynx.

If the victim of a toxicologic emergency vomits, an EMT should _________. A) use appropriate personal protective equipment and examine the vomitus for pill fragments or other clues for patient care. B) have the patient enclose the vomitus in a container and take it to the emergency department. C) safely dispose of the vomitus as soon as possible and decontaminate the vehicle as necessary. D) not approach the vomitus.

Correct Response A) use appropriate personal protective equipment and examine the vomitus for pill fragments or other clues for patient care.

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) ventilate her with a BVM. B) contact the poison control center. C) perform a rapid head-to-toe exam. D) apply oxygen via a nonrebreathing mask.

Correct Response A) ventilate her with a BVM.

How do poisons typically act to harm the body? A) By interfering with normal neurologic function B) By changing the normal metabolism of cells or by destroying them C) By causing burns and damage to either external or internal organs D) By causing a slowing of nearly all bodily functions

Correct Response B) By changing the normal metabolism of cells or by destroying them

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) administer 15 g of activated charcoal. C) give the child milk to absorb the Tylenol. D) administer high-flow supplemental oxygen.

Correct Response B) administer 15 g of activated charcoal.

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.

Correct Response B) avoid contaminating yourself.

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.

Correct Response B) binds to the substance and prevents absorption

The major side effect associated with administration of activated charcoal is: A) headache. Correct Response B) black stools. C) abdominal pain. D) ringing in the ears.

Correct Response B) black stools

A 25-year-old man overdosed on heroin and is unresponsive. His breathing is slow and shallow and he is bradycardic. He has track marks on both arms. The EMT should: A) administer naloxone via the intranasal route. B) insert a nasal airway and ventilate with a BVM. C) position the patient on his side and transport. D) administer naloxone via the intramuscular route

Correct Response B) insert a nasal airway and ventilate with a BVM.

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.

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

Hypotension, hypoventilation, and pinpoint pupils would be expected following an overdose of: A) ecstasy. B) oxycodone (Percocet). C) amphetamine sulfate (Benzedrine). D) crack cocaine.

Correct Response B) oxycodone (Percocet)

Medical problems that may cause the patient to present as intoxicated include all of the following, EXCEPT: A) head trauma. B) syncope. C) uncontrolled diabetes. D) toxic reactions.

Correct Response B) syncope.

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, 190/90 mm Hg; pulse, 40 beats/min C) BP, 200/100 mm Hg; pulse, 150 beats/min D) BP, 180/100 mm Hg; pulse, 50 beats/min

Correct Response C) BP, 200/100 mm Hg; pulse, 150 beats/min

You have responded to the home of a 26-year-old woman who has reportedly taken a large number of pills in an attempt to commit suicide. As you enter the living room, you see her sleeping in her chair, and several empty alcohol containers are present. She is breathing heavily. You are able to arouse her consciousness for a short period of time. Which course of action takes priority? A) Administer syrup of ipecac. B) Cover her with a blanket to maintain body temperature. C) Have her take activated charcoal while she is conscious. D) Ask her why she attempted suicide.

Correct Response C) Have her take activated charcoal while she is conscious.

Which of the following statements regarding injected poisons is FALSE? A) They may result in dizziness, fever, and chills. B) They are frequently caused by a drug overdose. C) They are easily diluted once in the bloodstream. D) You should remove rings, watches, and bracelets in areas of swelling.

Correct Response C) They are easily diluted once in the bloodstream.

Treatment for ingestion of poisonous plants includes all of the following, EXCEPT: A) assessing the patient's airway and vital signs. B) taking the plant to the emergency department. C) administering activated charcoal. D) prompt transport.

Correct Response C) administering activated charcoal.

Activated charcoal may be indicated for a patient who ingested: A) iron. B) ethanol. C) aspirin. D) methanol.

Correct Response C) aspirin.

The MOST important consideration in caring for a patient who has been exposed to an organophosphate insecticide or some other cholinergic agent is to: A) maintain the airway. B) apply high-flow oxygen. C) avoid exposure yourself. D) initiate CPR.

Correct Response C) avoid exposure yourself.

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.

Correct Response C) is aware of the substance that is involved.

Which of the following is NOT considered a sign or symptom of alcohol withdrawal? A) Agitation and restlessness B) Fever and sweating C) Seizures D) Chest pain

Correct Response D) Chest pain

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

Correct Response D) Dry mucous membranes

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.

Correct Response D) The Salmonella bacterium itself causes food poisoning

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) How long ago was the substance taken? C) What type of substance was taken? D) Why was the substance ingested?

Correct Response D) Why was the substance ingested?

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-valve mask device. C) asking law enforcement to place handcuffs on the patient. D) attempting to calm him and giving him oxygen if tolerated.

Correct Response D) attempting to calm him and giving him oxygen if tolerated.

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) delirium tremens.

Correct Response D) delirium tremens.

Of the four avenues of poisoning, generally ___________ is the most worrisome in terms of treatment to the EMS provider. A) inhalation B) absorption C) ingestion D) injection

Correct Response D) injection

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.

Correct Response 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 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.

Correct Response D) seizures and cardiac arrhythmias