Chapter 19 EMT

20. 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.

Answer: A Question Type: Critical Thinking Page: 677

36. 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).

Answer: A Question Type: Critical Thinking Page: 681

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

Answer: A Question Type: General Knowledge Page: 670

9. A poison that enters the body by __________ is the MOST difficult to treat. A. injection B. ingestion C. inhalation D. absorption

Answer: A Question Type: General Knowledge Page: 671

11. 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.

Answer: A Question Type: General Knowledge Page: 672

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

Answer: A Question Type: General Knowledge Page: 674

18. 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.

Answer: A Question Type: General Knowledge Page: 676

22. Airborne substances are diluted with: A. oxygen. B. syrup of ipecac. C. activated charcoal. D. an alkaline antidote.

Answer: A Question Type: General Knowledge Page: 678

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

Answer: A Question Type: General Knowledge Page: 679

27. 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.

Answer: A Question Type: General Knowledge Page: 679

32. A hypnotic drug is one that: A. induces sleep. B. prevents amnesia. C. increases the pulse. D. increases the senses.

Answer: A Question Type: General Knowledge Page: 680

44. 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.

Answer: A Question Type: General Knowledge Page: 686

37. 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.

Answer: A Question Type: Critical Thinking Page: 681-682

17. 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.

Answer: A Question Type: General Knowledge Page: 676

19. 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.

Answer: B Question Type: Critical Thinking Page: 677

41. 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.

Answer: B Question Type: Critical Thinking Page: 685

2. 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.

Answer: B Question Type: General Knowledge Page: 669

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

Answer: B Question Type: General Knowledge Page: 670

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

Answer: B Question Type: General Knowledge Page: 670, 681

12. 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.

Answer: B Question Type: General Knowledge Page: 673

16. 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.

Answer: B Question Type: General Knowledge Page: 674

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

Answer: B Question Type: General Knowledge Page: 679

29. 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.

Answer: B Question Type: General Knowledge Page: 679

31. The MOST commonly abused drug in the United States is: A. cocaine. B. alcohol. C. codeine. D. marijuana.

Answer: B Question Type: General Knowledge Page: 680

33. 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.

Answer: B Question Type: Critical Thinking Page: 680-681

43. 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.

Answer: B Question Type: General Knowledge Page: 685

26. 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

Answer: C Question Type: Critical Thinking Page: 679

38. 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.

Answer: C Question Type: Critical Thinking Page: 682

46. 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.

Answer: C Question Type: Critical Thinking Page: 689

6. Which of the following drugs is NOT a sedative-hypnotic? A. secobarbital (Seconal) B. diazepam (Valium) C. cocaine D. flunitrazepam (Rohypnol)

Answer: C Question Type: General Knowledge Page: 670

10. 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.

Answer: C Question Type: General Knowledge Page: 671

15. 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.

Answer: C Question Type: General Knowledge Page: 674

23. Activated charcoal administration is contraindicated in patients who have ingested: A. ibuprofen. B. acetaminophen (Tylenol). C. acids or alkalis. D. steroid drugs.

Answer: C Question Type: General Knowledge Page: 679

34. DTs is a syndrome associated with withdrawal from: A. cocaine. B. opioids. C. alcohol. D. sedatives.

Answer: C Question Type: General Knowledge Page: 681

42. Atropine sulfate and pralidoxime chloride are antidotes for: A. lysergic acid diethylamide (LSD). B. diphenhydramine (Benadryl). C. nerve gas agents. D. anticholinergic drugs.

Answer: C Question Type: General Knowledge Page: 685

35. 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.

Answer: D Question Type: Critical Thinking Page: 681

39. 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.

Answer: D Question Type: Critical Thinking Page: 684

40. 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.

Answer: D Question Type: Critical Thinking Page: 685

1. 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.

Answer: D Question Type: General Knowledge Page: 669

7. 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

Answer: D Question Type: General Knowledge Page: 670

8. 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?

Answer: D Question Type: General Knowledge Page: 670

13. 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.

Answer: D Question Type: General Knowledge Page: 674

21. 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.

Answer: D Question Type: General Knowledge Page: 678

25. 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

Answer: D Question Type: General Knowledge Page: 679

30. 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.

Answer: D Question Type: General Knowledge Page: 679

45. 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.

Answer: D Question Type: General Knowledge Page: 687