EMT - Chapter 22 - Toxicologic Emergencies
The EMT accurately understands alcoholism when he states: A. "Aside from the excessive amounts of alcohol, much of the health deterioration that accompanies alcoholism comes from malnutrition." B. "The diagnosis of alcoholism is applied to a person who drinks hard liquor, not beer or wine." C. "Surprisingly, in the late stages of their condition, persons with alcoholism are very functional and able to hold down a job and maintain good family relations." D. "Alcohol is classified as a drug on which the addict becomes psychologically dependent, not physically dependent."
"Aside from the excessive amounts of alcohol, much of the health deterioration that accompanies alcoholism comes from malnutrition."
A middle-aged male with behavioral problems states that he drank some "chemicals" to kill the bugs in his body. The patient is alert and oriented and shows no life-threatening conditions to the airway, breathing, or circulation. At this point, which of these questions should the EMT ask? A. "Are you taking other medications?" B. "Do you know exactly what it was you drank?" C. "When did you drink it?" D. "Have you thrown up?"
"Do you know exactly what it was you drank?"
Firefighters have pulled a 62-year-old male patient from a bedroom that was on fire. According to the firefighters, the patient was smoking in bed and fell asleep. They found him supine on the floor. Assessment reveals him to be responsive to painful stimuli, with soot in his airway. He is breathing rapidly, but has no evidence of burns to his body. His pulse is 124 beats/min, respirations are 24 breaths/min, blood pressure is 146/90 mmHg, and SpO2 is 95%. After providing the appropriate care, which of these questions would be the most important to ask the firefighters prior to transport? A. "Which materials were burning in the room?" B. "How did the fire start?" C. "How fast was the patient breathing when you found him?" D. "How long was the patient trapped in the room?"
"How long was the patient trapped in the room?"
After determining that a patient intentionally overdosed on blood pressure medications, which of these questions would be most appropriate? A. "Why did you take so many pills?" B. "How many pills did you take?" C. "Were you confused about the proper dose?" D. "Are you on other medications?"
"How many pills did you take?"
A 17-year-old male patient was stung by an unidentified insect. On scene, the sting site to his right forearm showed some redness and mild swelling. During the reassessment, which statement made by the patient would indicate that venom from the sting is being absorbed into the bloodstream? A. "The area around the bite feels numb." B. "The bite seems to be hurting worse now." C. "I think that my arm is more swollen." D. "I feel sick to my stomach and dizzy."
"I feel sick to my stomach and dizzy."
Which of these complaints would the EMT expect from a person who has just used crack cocaine for the first time? A. "My nose feels raw." B. "I see spiders." C. "My heart feels slow." D. "I have chest pain."
"I have chest pain."
You have been called to a residence for a 31-year-old patient who is complaining of confusion, nausea, vomiting, and a headache. His symptoms started this morning and have been getting worse all day. Despite lying in bed and resting all day, he is more fatigued than before. Which of these statements made by the patient would the EMT recognize as most important in relation to the patient's present complaint? A. "I just turned the furnace on last night." B. "I tried some raw seafood last week." C. "I have not been sleeping well the past few nights." D. "My wife is taking penicillin, to which I am allergic."
"I just turned the furnace on last night."
You have been summoned to a residence for a child who ingested a liquid pesticide. On scene, the worried parents inform you that their 4-year-old son and some friends were playing in the garage and apparently found some pesticide, which their son says he tasted. Assessment indicates that he is alert, oriented, and crying and has some white powder around his mouth. After performing the initial assessment and finding no life-threatening conditions, it is imperative that the EMT make which question or statement: A. "Do you think this was an intentional act?" B. "I need to see the other children." C. "These chemicals need to be put out of reach." D. "Are all of his shots up-to-date?"
"I need to see the other children."
Which set of instructions given to another EMT would be most appropriate when managing a patient who ingested numerous household cleaners in an attempt to kill himself? A. "Before we leave, please call the hospital and tell them what he took so that they will know." B. "Let's gather up all of the containers of the chemicals he may have taken and take them with us." C. "We need to pour a sample of each cleaner that he may have taken into containers and take the samples with us." D. "I need you to write down all of the cleaners he may have taken so we can let the hospital know."
"Let's gather up all of the containers of the chemicals he may have taken and take them with us."
Emergency Medical Responders have removed a female patient from her bedroom, where she was found lying on her bed with a suicide bag over her head. The bag is removed and you note the woman to be unresponsive, pulseless, and apneic. Given the use of a suicide bag and the presentation of the patient, which of these statements indicates proper initial care? A. "Do not apply the AED since the arrest was not caused by a cardiac event." B. "Let's open the airway manually first." C. "I need someone to assess the patient's blood glucose level." D. "I need someone to get a pulse oximetry reading immediately!"
"Let's open the airway manually first."
Which of these statements made by an EMT indicates an accurate understanding of inhalation poisonings? A. "The onset of signs and symptoms associated with an inhalation poisoning are often rapid." B. "Inhalation poisons affect the lungs, but they do not circulate throughout the body." C. "Most inhalation poisonings are easily identified by residue or burns around the patient's mouth." D. "It is probably safe to enter the scene of an inhalation emergency if I do not smell anything."
"The onset of signs and symptoms associated with an inhalation poisoning are often rapid."
You are responding to a drug-related emergency. While you are en route to the scene, the dispatcher informs you that the patient has overdosed on an unspecified narcotic. Which of these statements made by your partner indicates an understanding of overdoses with narcotic drugs? A. "We will have to be careful because narcotic overdoses can cause hallucinations, and the patient may be violent." B. "If the patient is conscious, we will have to ask about chest pain since narcotics can increase the heart's workload." C. "We need to look at the pupils. If they are constricted, the patient has most likely taken a narcotic and we will have to administer naloxone intravenously." D. "When performing the primary assessment, we need to be alert for respiratory depression and have the naloxone ready."
"When performing the primary assessment, we need to be alert for respiratory depression and have the naloxone ready."
You are preparing to administer activated charcoal to a patient who has ingested a poison. The activated charcoal authorized by your medical director also contains a cathartic. Which of these statements would you make to the patient regarding this additive? A. "This charcoal will most likely give you a slight headache." B. "The additive in the charcoal may cause you to vomit." C. "You may experience diarrhea after taking the charcoal." D. "If you have a heart condition, I cannot give you this medication."
"You may experience diarrhea after taking the charcoal."
Following a large wedding that occurred the previous night, health authorities announce that some of the food was contaminated with Salmonella. Consequently, your EMS service receives notice that it may receive a significant number of calls involving food poisoning. A new EMT asks you how to treat patients with food poisoning. What is your best response? A. "If the patient has a fever, we can administer a medication to make him vomit so as to get the food out of his system." B. "The primary role of EMS in this situation is just to transport the patient to the hospital." C. "You should treat the patient based on his signs and symptoms, just like a patient who ingested any other poison." D. "After assessing the patient, the administration of activated charcoal can be effective if there are no obvious contraindications."
"You should treat the patient based on his signs and symptoms, just like a patient who ingested any other poison."
What is the typical dosage for intranasal administration of naloxone? A. 2 mg repeated every 5 minutes only if the patient responds to the initial dose B. 1 mg every 10 minutes C. 1 mg in each nostril D. 2 mg every 5 minutes until the patient regains consciousness
1 mg in each nostril
Medical direction has ordered the administration of activated charcoal to a 3-year-old boy. Which of these doses would be most appropriate? A. 0.5 mg/kg B. 50 grams C. 1 gram/kg D. 100 mg
1 gram/kg
A patient informs you that he smoked marijuana all night and now has great anxiety, hunger, and tremors to both hands. The EMT would recognize marijuana is best described as: A. A hallucinogen B. A sedative C. A cannabis product D. An appetite stimulant
A cannabis product
A 42-year-old patient weighs 154 pounds (70 kg). How much activated charcoal would you administer to him? A. 70 grams B. 500 grams C. 100 grams D. 154 grams
70 grams
For which of these patients would you be most concerned about accidental exposure to cyanide? A. An auto mechanic working near exhaust fumes B. A worker who paints cars in an auto body shop C. A firefighter battling a smoky structure fire D. A coal miner working long hours in a mine
A firefighter battling a smoky structure fire
Which of these statements about poisonings is correct? A. All toxins are poisonous when in contact with the human body B. The majority of poisonings are intentional and result in homicide or suicide C. A poison is any substance that impairs a person's health by its chemical action D. The number one cause of poisoning in the United States is medications
A poison is any substance that impairs a person's health by its chemical action
A 44-year-old male patient had a pesticide splashed into his eyes. Aside from local irritation and damage to the eyes, he developed systemic complications when the pesticide entered and circulated throughout his body. When completing the prehospital care report, the EMT would note the route of exposure as: A. Visual B. Injection C. Absorption D. Topical
Absorption
Medical direction has ordered you to administer activated charcoal to a patient who ingested a large amount of poison. When looking in your medical kit, which medication would you prepare and administer? A. Glyburide B. Ecotrin C. Nitrostat D. Actidose
Actidose
You are on scene in a remote part of a local park, where an unresponsive female patient was found by a passing security guard. The female patient, who looks to be in her 20s, has needle tracks on her arms; an empty syringe was found nearby. You have initiated spine motion restriction precautions, inserted a nasal airway, and alerted dispatch for ALS backup. The patient is currently breathing adequately and has a blood pressure of 102/78 mmHg, a heart rate of 68 beats/min, and respirations of 12 breaths/min. While awaiting arrival of the ALS unit, which of these steps is most appropriate? A. Administer 1 mg of Narcan either intramuscularly or subcutaneously B. Repeat the reassessment and vital signs every 15 minutes C. Lay the patient on her side and administer one tube of oral glucose D. Administer oxygen so as to maintain a pulse oximeter reading of 94% or greater
Administer oxygen so as to maintain a pulse oximeter reading of 94% or greater
A 19-year-old female patient with diabetes is unresponsive after drinking a large amount of alcohol and trying some "pills" that her friend provided. She has snoring respirations and an intact radial pulse. Emergency Medical Responders are maintaining her airway with a head-tilt, chin-lift maneuver, which has eliminated the snoring respirations. Vital signs are pulse, 116; respirations, 14 breaths/min; minimal chest wall motion with absent breath sounds in the bases; and SpO2, 92%. Advanced life support has been contacted for assistance. Your next action would be to: A. Determine the patient's blood glucose level B. Identify the pills that the patient took C. Attempt to contact the parents for permission to treat D. Administer oxygen through positive pressure ventilation
Administer oxygen through positive pressure ventilation
A 44-year-old male patient was using an industrial drain cleaning solvent to clean the drains in his house. The solvent corroded through the pipes on the second floor, spilling into the walls and filling the house with fumes. The patient was in the house for several minutes prior to getting himself out. The primary assessment reveals him to be alert and oriented with a patent airway. He is complaining of dizziness and has rapid respirations. His radial pulse is fast and strong, and his skin is warm and pink. Which action should the EMT take first? A. Start positive pressure ventilation B. Insert a nasopharyngeal airway C. Administer supplemental oxygen D. Provide rapid transport with the patient in semi-Fowler's position
Administer supplemental oxygen
A patient who has ingested a toxic substance is to receive activated charcoal. The EMT knows that the charcoal will benefit the patient by: A. Coating the small intestine, limiting absorption of the poison B. Neutralizing the poison in the bloodstream C. Causing vomiting, thereby removing the poison from the body D. Adsorbing the poisonous substance in the stomach
Adsorbing the poisonous substance in the stomach
The EMT is transporting a patient with the diagnosis of Wernicke-Korsakoff syndrome. The EMT recognizes that this patient has a past medical history of: A. Drug abuse B. Pancreatic failure C. Alcoholism D. Liver failure
Alcoholism
Which of these statements regarding antidotes is correct? A. Antidotes are beneficial because they will remove the poison from the body B. An antidote will neutralize or counteract the effects of a poison or toxic substance C. There are many antidotes for a large number of poisons and toxic substances D. An antidote can only be given in the emergency department by the physician or nurse
An antidote will neutralize or counteract the effects of a poison or toxic substance
At the scene of an industrial accident, you are presented with a male patient who was exposed to a powerful pesticide in powder form. The patient states that he was moving sacks of the pesticide when one broke open, creating a cloud of powder that surrounded him, and which he then inhaled. During the incident, his face and arms became covered with the powder. At the present time, he complains of difficulty breathing and burning of his skin on his face and arms. You note that some of the pesticide remains on these areas of the body. Your first action in caring for this patient would be to: A. Apply supplemental oxygen B. Obtain vital signs and a medical history C. Flush the pesticide with copious amounts of water D. Brush off the remaining pesticide
Apply supplemental oxygen
For which of these patients is a "talk down" technique indicated? A. A 59-year-old whose heart is racing after trying cocaine B. An 18-year-old who is having a "bad trip" after taking his parent's antihypertensive medication to get "high" C. A 47-year-old who has chronic alcoholism and is demanding help D. A 26-year-old who took LSD and is panicked because spiders are after him
A 26-year-old who took LSD and is panicked because spiders are after him
For which of these patients would activated charcoal be indicated given the type of poisoning? A. A 24-year-old female who was sniffing glue and now complains of a headache B. A 17-year-old male who drank bleach 30 minutes ago C. A 53-year-old female who took an overdose of antidepressants earlier in the day D. A 27-year-old who intentionally took a large amount of Tylenol 45 minutes ago
A 27-year-old who intentionally took a large amount of Tylenol 45 minutes ago
Which of these patients would the EMT recognize as a drug abuser? A. A 41-year-old male who tried marijuana for the first time B. A 56-year-old male who accidentally took an additional dose of blood pressure medication C. A 46-year-old female who used cocaine for 10 years but has not used it in 5 years D. A 39-year-old female who takes pain medications even though she is not in pain
A 39-year-old female who takes pain medications even though she is not in pain
A frantic mother called 911 because she found her 18-month-old daughter playing with a bottle of drain cleaner. When assessing this patient, what would provide the strongest evidence that the child ingested some of the liquid? A. Elevated heart rate B. Garbled speech C. Burns to her mouth D. Persistent crying
Burns to her mouth
A 44-year-old male patient who works at a petroleum-refining plant inhaled a significant amount of hydrocarbon fumes and now complains of a headache with associated dizziness and nausea, as well as mild shortness of breath. He is alert and oriented, and there are no life threats to his airway, breathing, or circulation. Which of these steps should be included in his assessment and care? A. Continuous high-concentration oxygen B. Head-to-toe decontamination C. Aspirin for the headache D. Intranasal naloxone
Continuous high-concentration oxygen
Which of these guidelines would the EMT follow when talking down a patient with a drug-related emergency? A. Inform the patient that restraints will be used if he does not listen to you B. Calmly explain to the patient that this is a consequence of abusing drugs C. Make frequent physical contact with the patient to establish trust D. Be authoritative and tell the patient to follow your directions
Calmly explain to the patient that this is a consequence of abusing drugs
You are a new EMT in a very busy urban EMS system. Before joining this agency, you worked as a volunteer in a rural EMS system, where you did not experience many EMS calls. You are working with a seasoned EMT when you are requested to respond to a residential home for an unresponsive 13-year-old male patient. Upon your arrival, the family escorts you into the garage, where the boy is being cradled by his crying mother. The boy is unresponsive. As you draw nearer to the boy, your partner says to you, "Hey, you smell that moth ball smell? I know what might be going on." Given your partner's statement, how might the odor be related to the patient's condition? A. Camphor overdose B. Organophosphate overdose C. Chloral hydrate overdose D. Acetone overdose
Camphor overdose
Which of these descriptions is most characteristic of carbon monoxide? A. Carbon monoxide is a tasteless gas that is produced by household appliances such as electric furnaces B. Carbon monoxide is an odorless gas that can kill a person by causing severe hypoxia C. Carbon monoxide poisoning symptoms mimic the flu, but it tends to cause a higher fever than the flu D. It generally takes several days for a toxic level of carbon monoxide to accumulate in the body
Carbon monoxide is an odorless gas that can kill a person by causing severe hypoxia
You have been called to a residence for a 14-year-old male patient, who states that he intentionally took some medication to kill himself. Assessment indicates that he is alert and oriented, and has an open airway and adequate breathing. Given the situation, the EMT's next action should be to: A. Check the radial pulse and skin characteristics B. Ask the patient if he feels nauseated C. Inquire why the patient took the medication D. Determine what was taken
Check the radial pulse and skin characteristics
You have been called for a 41-year-old female patient who is confused. According to her husband, she is an alcoholic who has been in and out of rehabilitation programs for the past five years. Assessment reveals her airway to be open and her breathing adequate. Her pulse is regular and strong. Which finding would cause the EMT to classify and treat this patient as a high priority? A. Irritable and uncooperative with your effort to treat her B. Complaint of nausea and a temperature of 103.6degrees°F C. Smell of alcohol on the breath and complaint of headache D. Blood pressure of 108/72 mmHg and complaint of nausea
Complaint of nausea and a temperature of 103.6degrees°F
An 11-year-old boy with a history of mild developmental delays has possibly ingested parts of a household plant; his mother states that she found him eating the plant, then immediately called 911. You note that the plant has been overturned and is missing a considerable number of leaves. Assessment reveals the boy to be lethargic and confused; he complains of abdominal pain, accompanied by nausea and vomiting. His airway is patent and his respirations are adequate. Which of these assessment findings would be most suggestive that the poison from the plant leaves has been absorbed into the patient's body? A. Leaves missing from the plant B. Nausea and vomiting C. Abdominal pain D. Confusion and lethargy
Confusion and lethargy
The Poison Control Center has advised you to administer milk to a patient who has overdosed on a medication. Given this information, you would: A. Contact medical command to confirm this treatment B. Transport the patient immediately instead and arrange for ALS intercept C. Administer the milk as ordered D. Contact ALS backup and wait on scene until they arrive
Contact medical command to confirm this treatment
You have been called to a dilapidated residence for a 26-year-old female patient complaining of generalized weakness. After applying gloves, you enter the home and find the patient on a couch in minimal distress. Your assessment reveals no life threats, but you do note track marks to both hands and arms. When asked about the marks, she states that she is an IV drug user and has hepatitis C. Given this information, you would: A. Place a HEPA mask on yourself B. Apply goggles and a gown C. Apply goggles D. Continue care with gloves
Continue care with gloves
What is the greatest risk related to the ingestion of cyanide? A. Widespread hypoxia B. High fever C. Lung damage D. Gastrointestinal damage
Widespread hypoxia
A patient who is agitated and hyperactive with dilated pupils and tachypnea has most likely ingested: A. Heroin B. Methadone C. Hallucinogens D. Crack cocaine
Crack cocaine
You have been called for a 13-year-old boy who was caught sniffing glue by his parents. The boy is lethargic and confused, complains of "burning" in his mouth and nose, and has nausea and vomiting. Based on the clinical presentation and mechanism of illness, how has this poison affected the patient's brain? A. Crossing from the lungs into the bloodstream and then circulating to the brain B. Being absorbed through the small intestine into the bloodstream and then going to the brain C. Absorbing fumes through the skin, nose, and eyes and then going on to the brain D. Directly contacting the brain by crossing the mucous membranes of the mouth and nose
Crossing from the lungs into the bloodstream and then circulating to the brain
Which of these actions should you and your partner take when you arrive on the scene at a large factory where an unresponsive patient was subjected to a powdered chemical that contacted large portions of his unprotected skin? A. Allow your partner to enter the scene while you remain behind so as to offer "buddy-rescue" should he become overwhelmed by the toxic powder B. Ensure that you are properly protected with gloves and protective gear to prevent the powder from contacting your skin C. Do not enter the scene until all buildings that make up the factory complex have been evacuated D. Wrap the patient up in a large sheet of plastic to minimize the risk of the powder contaminating other surfaces
Ensure that you are properly protected with gloves and protective gear to prevent the powder from contacting your skin
You have been called for a "drunk" male patient at a halfway house known to provide living quarters to persons with drug and alcohol problems. Residents tell you that the patient is a heavy drinker and must have had too much last night. This morning he was found "passed out" with alcohol on his breath. Quick assessment of the scene reveals the patient to be prone on a dirty bed in a room littered with liquor containers. Aside from the alcohol, which of these observations would be most significant to the EMT? A. Smell of urine in the room B. An empty fast-food bag on the bedside table C. Dried vomit on the floor D. Glucometer on the table
Glucometer on the table
You have been called for a 46-year-old male patient who just smoked crack cocaine. In reviewing his past medical history, which of these conditions would be most of most concern? A. Heart disease B. Migraine headaches C. Diabetes D. Alcoholism
Heart disease
You have been called for a young female patient who overdosed on several drugs. What is the most essential step for the EMT to perform while caring for this patient? A. Identify and correct the loss of vital function(s) B. Identify the drug(s) and amount(s) taken C. Identify medical conditions that may be worsened by the drug(s) D. Determine whether the patient has a history of drug abuse
Identify and correct the loss of vital function(s)
You have been called to an alcoholism rehabilitation center. On scene, one of the counselors tells you that the patient is a 44-year-old woman who just came to the center this morning. She has not had any alcohol for 24 hours and is now sweating profusely and has an elevated heart rate and blood pressure. Based on this information, the EMT would recognize that the patient is: A. Experiencing delirium tremens B. Psychologically dependent on alcohol C. Physically dependent on alcohol D. Experiencing alcohol tolerance
Physically dependent on alcohol
On the scene of a drug-related emergency, the 22-year-old patient tells you that he has been taking amphetamines because he likes the way that they make him feel. Over the past two days, he has been taking more and more, and today he feels as though his heart is racing. He also tells you that he recognizes he has a problem and wants to get help. When you are assessing the patient, which sign or symptom would provide further evidence that the patient has been abusing amphetamines? A. Constricted pupils B. Fatigue and prolonged sleep C. Auditory hallucinations D. Increased blood pressure
Increased blood pressure
What is the most common route by which a poison enters the body? A. Ingestion B. Topical C. Inhalation D. Exposure
Ingestion
Which of these correctly identifies the routes by which a poison can enter the human body? A. Exposure, ingestion, inhalation, injection B. Ingestion, inhalation, injection, absorption C. Inhalation, injection, nasal-oral, visual D. Topical, inhalation, nasal-oral, absorption
Ingestion, inhalation, injection, absorption
A 44-year-old patient was found unresponsive at home. Based on his mental status and the fact that he was burning a kerosene heater in an enclosed room, you suspect carbon monoxide poisoning. Based on this information, which route of exposure would you recognize as responsible for the poisoning? A. Absorption B. Nasal-oral C. Inhalation D. Ingestion
Inhalation
A 31-year-old female patient was stung by a hornet while golfing. Your assessment reveals her to be confused with stridorous respirations. Her skin is warm and flushed and covered with hives. A stinger is located on the back of her neck. Based on this information, you would recognize that the route of poisoning for this patient is: A. Topical B. Injection C. Anaphylactic D. Absorption
Injection
You have been called to a residence for a cognitively challenged 32-year-old female patient who drank from a bottle of floor cleaner. She is unconscious, exhibits snoring respirations, and is having a difficult time breathing due to swelling from burns in her mouth. Which of these steps should be included in the initial care for this patient? A. Apply high-flow oxygen via nonrebreather B. Insert a nasal airway C. Suction the airway D. Contact poison control
Insert a nasal airway
While he was changing the battery on a truck, acid from the battery splashed into a 66-year-old man's right eye. The patient now complains of burning pain to his right eye and is having a hard time keeping it open. He is alert and oriented and has no problems with his airway, breathing, or circulation. Your next action would be to: A. Place a cold pack to the eye and immediately transport the patient to the hospital B. Rinse the eye with a mixture of sterile water and sodium bicarbonate C. Irrigate the eye with water for a minimum of 20 minutes D. Cover both eyes and provide immediate and rapid transport
Irrigate the eye with water for a minimum of 20 minutes
After a 911 call hang-up, you are dispatched to the caller's residence. When you enter the room with a police escort, you find an unresponsive female patient with a bag over her head. A person in the neighboring apartment tells you that the patient has depression and warned that "there is going to be a death today." Your immediate action would be to: A. Remove the bag and assess for airway occlusion B. Move the patient out to the ambulance before initiating care C. Provide manual spine motion restriction precautions D. Leave the room until it is cleared by the fire department
Leave the room until it is cleared by the fire department
You are called to an alcoholic crisis center to transport a patient experiencing delirium tremens. When assessing the patient, which signs or symptoms would you associate with this condition? A. High fever, seizure activity, sweating, lethargy B. Constricted pupils, hypothermia, confusion, hypotension C. Loss of memory, hallucinations, fever, dilated pupils D. Seizure activity, memory impairment, bradycardia, tremors
Loss of memory, hallucinations, fever, dilated pupils
When treating a patient for an overdose, the highest priority of care is placed on: A. Managing the airway and breathing B. Determining what and how much drug was taken C. Establishing the patient's risk for suicide D. Contacting law enforcement
Managing the airway and breathing
You have been called for an unresponsive patient. When you arrive at the scene, hysterical family members direct you to an unresponsive 32-year-old woman who is lying on the bedroom floor. Her husband says that she left a note saying that she wanted to kill herself and took an unspecified poison. Assessment reveals a green-colored liquid in her mouth and respirations that are rapid, shallow, and gurgling. The patient's pulse is weak, and her skin is cool and dry with cyanosis to her fingertips. Your immediate action would be to: A. Extricate the patient and provide care en route to the hospital B. Start positive pressure ventilation C. Read the note for clues to what the patient took D. Manually open the patient's airway and perform suction
Manually open the patient's airway and perform suction
A 32-year-old female patient calls 911 to say that she injected herself with some heroin 15 minutes ago, which she just bought from "some guy" on the street. She has never tried heroin and is now scared about what she has done. Assessment reveals her to be conscious and well oriented. Her airway is open and she is breathing 14 times a minute. Her pulse is moderate in strength and her skin is warm and dry. What would be the appropriate care for this patient? A. Apply a tourniquet above the site of injection B. Administer intranasal naloxone C. Place a warm pack to the injection site D. Monitor her and initiate transport
Monitor her and initiate transport
You are assessing a young male patient who was found in an alley by sanitation workers. Assessment reveals the patient responds to painful stimuli by opening his eyes, but then closes them once you stop pinching the muscles on his neck. His airway is open and his breathing is shallow. His skin is cool and diaphoretic, and his pupils are constricted and do not react to light. Based on these assessment findings, the EMT would be suspicious of: A. Stroke or hypoglycemia B. Methamphetamine overdose C. Traumatic assault D. Narcotic overdose
Narcotic overdose
A 17-year-old female patient was at a party where she tried a Percocet pill (narcotic pain reliever). After taking the pill, she became scared that she was going to die and is now crying. At the present time, she feels slightly nauseated, but has no other complaints. There are no life threats and her vital signs are pulse, 88; respirations, 14 breaths/min; blood pressure, 108/68 mmHg; and SpO2, 98% on room air. The patient has no medical history but is allergic to peanuts, for which she has a prescribed epinephrine auto-injector. Appropriate care for this patient would include: A. Nonemergent transport B. Asking if she has an epinephrine auto-injector with her C. Talk-down technique D. Supplemental oxygen via a nasal cannula at 2 lpm
Nonemergent transport
On arrival at a tailgate party in a parking lot near a college, you observe a crowd around a young man who is seizing. As you get equipment from the ambulance and make your way to the patient, his friends tell you that the patient has been up all night "partying" by drinking alcohol and smoking crack cocaine. At the patient's side, you note that he is no longer seizing, but is unresponsive and has snoring respirations. His respirations are labored at 16 breaths/min and his radial pulse is strong. His skin is cool and diaphoretic. Friends also inform you that he has diabetes; about an hour ago, they heard him say that he thought his blood sugar was becoming low. Which of these interventions would most likely be included in your care? A. Open the airway, check the blood glucose level, and administer oral glucose B. Open the airway, provide oxygen, and administer oral glucose C. Insert an oral airway, provide positive pressure ventilation, and administer oral glucose D. Open the airway, provide oxygen, and give rapid transport to the hospital
Open the airway, provide oxygen, and give rapid transport to the hospital
You suspect food poisoning in a 51-year-old male patient with nausea, vomiting, diarrhea, and fever. He is alert and oriented with no life threats to his airway, breathing, or circulation. His vital signs are pulse, 124; respirations, 20 breaths/min; blood pressure, 198/98 mmHg; and SpO2, 93% on room air. The patient has a history of COPD and hypertension, for which he did not take his medications today. In this situation, what would be the appropriate initial care? A. Encourage water by mouth for rehydration B. Oxygen at 2 lpm through a nasal cannula C. Take the blood pressure pill that the patient missed earlier D. Follow up with his family doctor
Oxygen at 2 lpm through a nasal cannula
A 56-year-old male patient has been exposed to fumes containing cyanide. Why should the EMT call for advanced life support assistance? A. Paramedics can induce vomiting, so as to rid the body of the cyanide B. Paramedics may be able to administer a cyanide antidote C. Oxygen will make this patient worse if given by the EMT D. IV fluids are needed to flush the cyanide from the patient's body
Paramedics may be able to administer a cyanide antidote
You are by the side of a young female college student who is unresponsive. Friends say that she is normally not a heavy drinker, but tonight she drank an excessive amount of alcohol because her boyfriend broke up with her at the party. She responds to painful stimuli and has snoring respirations. Her respiratory rate is 8 breaths/min and her radial pulse is weak. Your immediate action would be to: A. Apply oxygen via a nonrebreather mask B. Determine whether drugs are also involved C. Administer positive pressure ventilation D. Perform a manual airway maneuver
Perform a manual airway maneuver
Which of these is the EMT's highest priority when presented with a patient who has been exposed to a poisonous substance? A. Perform a primary assessment B. Administer activated charcoal C. Induce vomiting D. Identify the poison
Perform a primary assessment
The family of a 31-year-old female patient reports that she has taken an overdose of her father's diabetes medication. Assessment reveals her to be unresponsive, lying on the floor, with snoring respirations. Her pulse is rapid and her skin is cool to the touch. The patient has no history of diabetes but is allergic to penicillin. It is believed that she took the medication within the past hour. Your initial intervention in caring for this patient would be to: A. Administer activated charcoal B. Induce vomiting C. Perform a jaw-thrust maneuver D. Administer glycogen or intranasal naloxone
Perform a jaw-thrust maneuver
You are respond to an "unknown/unresponsive" emergency called in by a bystander. On scene, you find the female patient to be conscious but confused and extremely nauseated; she has vomited twice. Examination of the vomitus reveals fragments of different pills. Her past medical history includes diabetes and alcoholism. En route to the hospital, the patient vomits again and suddenly becomes unresponsive. Your first action would be to: A. Get another set of vital signs B. Check the patient's blood sugar C. Contact medical command D. Position the patient on her side
Position the patient on her side
A 49-year-old patient with alcoholism has fallen down a flight of stairs after consuming two-fifths of whiskey. He presents with confused and slurred speech and the smell of alcohol on his breath. Family states that he is "hopeless" and has been drinking more and more every night. They also say that he must be more drunk than usual because he usually does not slur his speech. Assessment reveals his airway to be open, breathing adequate, and circulation intact. He has a hematoma from the fall to the left side of his head and complains of pain to his left wrist. Given these assessment findings, the EMT would be most concerned about the: A. Possible brain injury B. Amount of alcohol consumed C. Possible wrist fracture D. Lack of family support
Possible brain injury
An 18-year-old female patient has eaten a poisonous mushroom. Medical direction has ordered you to administer activated charcoal. Immediately following administration, the patient vomits the medication. She remains alert and oriented with no current life threats to the airway, breathing, or circulation. Your next action would be to: A. Readminister the activated charcoal B. Reassess and continue transport C. Place the patient supine D. Administer a glass of milk
Readminister the activated charcoal
You are transporting a patient who overdosed on medications from a community emergency department (ED) to a large medical center for continued care. In the ED, the patient received two doses of activated charcoal. When performing your reassessment of the patient, which of the findings would be most concerning? A. Diarrhea B. Red-colored stool C. Dark black stool D. Nausea
Red-colored stool
You have been called to a railroad yard for an unknown emergency. When you arrive on scene, you are directed to a tanker car, where two men are lying on the ground next to the railcar. The men are mechanics for the railroad company and were performing some type of repair work on the valves for the tanker car. The only other person around is a security guard, who saw the men suddenly collapse on a surveillance video camera and called 911 immediately. He has an automated external defibrillator (AED) at his side. Your initial action would be to: A. Remain at a safe distance and call for fire department assistance B. Take manual spine motion restriction of the head and neck and assess the ABCs for each patient C. Quickly retrieve the patients and move them to safety D. Determine which chemical the tanker contains and assess the leaks
Remain at a safe distance and call for fire department assistance
A patient working at an ice plant is trapped in a room filled with sulfur dioxide. You don a self-contained breathing apparatus and enter the room, finding the patient unresponsive on the floor. The room remains filled with the gas. Your immediate priority in caring for this patient is to: A. Assess the airway, breathing, and circulation B. Remove the patient from the immediate environment C. Loosen all tight-fitting clothing D. Start positive pressure ventilation
Remove the patient from the immediate environment
An alert and oriented 5-year-old child drank some ammonia that was placed in a cup in the garage. He is very scared and complains of abdominal pain, but states that he has not vomited. Assessment shows ammonia in and around his mouth as well as on his breath. He has an open airway and is breathing adequately. His pulse and skin show no abnormalities. Appropriate care for this patient would include: A. Administering activated charcoal B. Inducing vomiting C. Initiating positive pressure ventilation D. Rinsing his face and mouth with water
Rinsing his face and mouth with water
You are en route for a possible heroin overdose. As an EMT, you would recognize heroin fits best into which drug category based on its effects? A. Sedatives B. Psychedelics C. Hallucinogens D. Stimulants
Sedatives
Emergency Medical Responders (EMRs) respond to a female patient who was found by her husband in their second-floor bedroom. When the responders arrived, she was lying on her bed, with a tourniquet on her arm. They also found a syringe, with unknown contents, lying on the floor next to the bed. Her husband denies that she abuses any drugs. The EMRs have removed the tourniquet and inserted a nasopharyngeal airway, and they are providing positive pressure ventilations at the rate of 10 breaths/min with a bag-valve-mask device and supplemental oxygen. You note the woman to be unresponsive, with a pulse rate of 52, and apneic. What would your initial proper care include? A. Immediately move the patient to a firm surface B. Seek an order to administer naloxone C. Apply the AED D. Extricate the patient from the bedroom
Seek an order to administer naloxone
This is the third day that a patient is in withdrawal from alcohol. If called to care for this patient, the EMT would recognize the need for: A. Warm blankets B. Restraints C. Positive pressure ventilation D. Seizure precautions
Seizure precautions
Medical direction has ordered the administration of activated charcoal to an adult patient who has overdosed on several unspecified medications. Prior to administering the medication, the EMT must: A. Determine whether the patient has a prescription for the medication B. Shake the medication thoroughly to mix it C. Determine whether the patient has a history of diabetes D. Ask the patient if he has had diarrhea over the past two weeks
Shake the medication thoroughly to mix it
A patient has been found unresponsive on her bedroom floor. When assessing her, the EMT would have the highest index of suspicion for a narcotic overdose when he notes: A. A glass pipe with a sticky residue in it B. Bottle of Valium next to her C. Shallow and slow respirations D. Dilated pupils
Shallow and slow respirations
You are transporting a patient who wants help to rid herself of an addiction to pain medications. She says she has not taken any pain medications since yesterday, and needs help. Which of these findings would you recognize as a sign of withdrawal? A. Her body temperature falls B. She begins to cry uncontrollably C. Her mental status decreases D. She starts to become agitated
She starts to become agitated
A 53-year-old female patient has intentionally ingested a large amount of Valium. This medication is primarily absorbed into the body through which structure? A. Small intestine B. Large intestine C. Stomach D. Esophagus
Small intestine
You have been called for a 28-year-old male patient with a history of behavioral problems. He responds to painful stimuli with garbled speech. His airway is patent, but breathing is inadequate. His radial pulse is rapid and his skin cool and moist. He has crackles at the bases of both lungs and the following vital signs: pulse, 108; respirations, 6 breaths/min and shallow; blood pressure, 98/64 mmHg; and SpO2, 92%. A friend informs you that the patient may have drunk a considerable amount of antifreeze, possibly up to 12 hours ago, in a suicide attempt. The first thing you should do is: A. Look for confirmation that the antifreeze was ingested B. Call poison control C. Provide low-flow oxygen to increase the pulse oximeter reading to 94% D. Start positive pressure ventilation
Start positive pressure ventilation
A worker at a chemical plant was working on a high-pressure tank containing chlorine gas when the valve broke, filling the room with chlorine gas and throwing the patient forcefully against the wall. He was unresponsive and trapped in the room for 10 minutes, until being pulled out by firefighters. When the patient is brought to your location, he appears unresponsive. Your first action in caring for this patient would be to: A. Determine the presence or absence of a pulse B. Take manual spine motion restriction of the head and neck and perform the jaw-thrust maneuver C. Assess breathing and auscultate breath sounds D. Open the airway using the head-tilt, chin-lift maneuver
Take manual spine motion restriction of the head and neck and perform the jaw-thrust maneuver
A female patient in her forties has overdosed and is lying at the bottom of some stairs. Her husband reluctantly informs you that she is addicted to pain medications and was chewing a fentanyl (narcotic pain reliever) patch this evening. She was having difficulty standing up and fell down the stairs. The husband is so frustrated with her that he immediately leaves the scene. The patient has snoring respiration and is incontinent of urine. You first step in caring for this patient would be to: A. Check her pupils for signs of a narcotic overdose B. Take manual spine motion restriction precautions C. Apply supplemental oxygen D. Open the airway with a head-tilt, chin-lift maneuver
Take manual spine motion restriction precautions
A 14-year-old female patient has taken an excessive amount of Tylenol with codeine. Family members were asleep when they heard a crash and found her at the bottom of the stairs. When they asked the adolescent if she was okay, she replied that her boyfriend broke up with her and she saw no point in going on with her life, so she took an overdose. When you arrive by the patient's side, you note that she is responsive to verbal stimuli with eye opening and is breathing, has an intact airway, and is breathing somewhat shallow but still adequately. Your first action would be to: A. Determine exactly how much medication she took B. Start positive pressure ventilation with oxygen C. Take manual spine motion restriction precautions D. Open the airway with the head-tilt, chin-lift maneuver
Take manual spine motion restriction precautions
The grandfather of an alert and oriented 2-year-old girl found her on the floor playing with pills from his open bottle of Digoxin (a heart medication that slows the heart rate). He cannot remember how many pills were in the bottle, but he thinks that some are missing and suspects that his granddaughter may have eaten them thinking that they were candy. Assessment reveals the patient's airway to be open and breathing adequate. Her pulse is appropriate for a child her age and her skin warm and dry. Her grandfather is not sure of how long ago she may have taken the pills. Given the assessment findings, the EMT would assume: A. The Digoxin pills have yet to be absorbed into the body B. The child must have spit the pills out before swallowing them C. The child apparently did not take any Digoxin D. Not enough Digoxin was taken to harm the child
The Digoxin pills have yet to be absorbed into the body
When the EMT contacts the Poison Control Center for a female patient who accidentally overdosed on her blood pressure medications when she misread the label, which additional information would the center personnel most likely need to determine care options for the patient? A. The patient's weight B. The type of container in which the medication was found C. The most recent bowel/bladder characteristics D. The patient's birthday
The patient's weight
You have been called for a patient with alcoholism who is experiencing a medical emergency. On scene, a home health nurse informs you that the patient is experiencing delirium tremens. As an EMT, you recognize that: A. The patient will require the administration of glucose B. This is a life-threatening condition requiring rapid transport C. The patient is in the early stages of alcohol withdrawal D. The patient is extremely intoxicated and in danger of dying
This is a life-threatening condition requiring rapid transport
A drug addict informs you that he has been taking OxyContin and now requires more and more of the drug to take his chronic back pain away. The EMT would recognize this patient as experiencing: A. Tolerance B. Adverse reaction C. Dependence D. Overdose
Tolerance
You are caring for a patient who intentionally drank a compound containing a high percentage of methanol. He is confused and lethargic, but has no obvious deficits to his airway, breathing, or circulation. En route to the hospital, the patient states that he is very nauseated and thinks that he is going to vomit. Your immediate action would be to: A. Turn the patient on his side B. Prepare the suction C. Check the patient's breath sounds D. Assess the patient's abdomen
Turn the patient on his side
Which action indicates that the EMT is correctly administering activated charcoal to a patient who has ingested a toxic substance? A. The charcoal is squirted into the mouth B. The charcoal is mixed with milk C. Sugar is added to make the charcoal taste better D. The patient drinks the charcoal through a straw
The patient drinks the charcoal through a straw
You have assessed a 25-year-old female who states that she took a large number of antidepressants and other medications in an effort to end her life. The primary assessment reveals no life-threatening conditions. Why is it important to get the patient's medical history at this time, rather than later on in the assessment or during transport? A. The police on scene will need the information prior to transport from the scene B. Patients are generally scared early on and more truthful with information C. The patient may become confused and be unable to provide information D. Further assessment may not be needed if there is no past medical history
The patient may become confused and be unable to provide information
When assessing a patient who has been exposed to a poisonous substance, it is essential to understand: A. The signs and symptoms of toxic exposure will vary depending on the specific poison B. Absorption into the body has not occurred if the signs of illness are not apparent within 15 minutes C. Vomiting indicates that the poison has not yet been absorbed into the body D. The route of entry into the body will determine the signs and symptoms
The signs and symptoms of toxic exposure will vary depending on the specific poison
Generally speaking, which technique should the EMT use first when confronted with a patient in a drug or alcohol abuse situation who is experiencing a "bad trip" and expressing some potentially violent tendencies? A. The "patient restraint" technique B. The "talk down" technique C. The "take down" technique D. The "assessment down" technique
The "talk down" technique
A confused female patient states that she was intoxicated and accidentally drank a glass of household bleach. When transporting this patient, which complication would you continually assess for? A. Chest pain B. Headache C. Diaphoresis D. Vomiting
Vomiting
Which of these statements indicates that the EMT understands the condition of withdrawal? A. "Withdrawal is a term that is applied to the cessation of street drugs to which the patient is addicted, not prescription drugs." B. "Withdrawal indicates that a patient is addicted to a drug and is presently overdosed on that drug." C. "Withdrawal is typically not a life-threatening situation and is easily managed by EMS." D. "Withdrawal from drugs or alcohol can be just as serious a medical emergency as an overdose."
"Withdrawal from drugs or alcohol can be just as serious a medical emergency as an overdose."