EMT - Chapter 21: Toxicology

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

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

DTs is a syndrome associated with withdrawal from:

C. alcohol.

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

A. Fructose.

Which of the following statements regarding inhaled poisons is correct?

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

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.

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

A. are usually absorbed quickly into the body.

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.

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

A. be alert for personal hazards.

A hypnotic drug is one that:

A. induces sleep.

Most poisonings occur via the __________ route.

A. ingestion

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.

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

A. injection

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

A. liver failure.

Before giving activated charcoal, you should:

A. obtain approval from medical control.

Heroin is an example of a(n):

A. opioid.

Airborne substances are diluted with:

A. oxygen.

The MOST commonly abused drug in the United States is:

B. alcohol.

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:

B. aspirin.

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:

B. assisted ventilation with a bag-mask device.

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

B. avoid contaminating yourself.

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

B. be alert for vomiting.

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

B. binds to the substance and prevents absorption.

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

B. black stools.

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

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

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:

B. may vomit and aspirate.

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

B. oxycodone (Percocet).

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

B. recognize that a poisoning occurred.

Signs and symptoms of a sympathomimetic drug overdose include:

B. tachycardia.

Activated charcoal administration is contraindicated in patients who have ingested:

C. acids or alkalis.

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:

C. administer up to 25 g of activated charcoal.

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

C. cocaine

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:

C. contact the regional poison control center.

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:

C. is aware of the substance that is involved.

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

C. may result in aspiration of vomitus.

Atropine sulfate and pralidoxime chloride are antidotes for:

C. nerve gas agents.

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:

C. was given flunitrazepam (Rohypnol).

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

D. 25 g, 50 g

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:

D. DTs.

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

D. The Salmonella bacterium itself causes food poisoning.

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

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:

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

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?

D. dry mucous membranes

Substance abuse is MOST accurately defined as:

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:

D. seizures and cardiac arrhythmias.

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

D. these chemicals may ignite upon contact with water.

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

D. tolerance.


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