CH 28 Flashcards by Alexis Bobbitt

Exposure to sarin or tabun would result in:
severe tachycardia.
pupillary dilation.
excessive lacrimation.
hyperthermia.

excessive lacrimation.

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What is a lethal dose of ethylene glycol in a 190-pound man?

50 mL
150 mL
120 mL
175 mL

175 ml

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The toxicity of carbon monoxide arises primarily from its:

affinity for hemoglobin in red blood cells.
ability to destroy hemoglobin molecules.
destructive properties on ferric ions.
ability to markedly decrease the metabolic rate.

affinity for hemoglobin in red blood cells.

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Which of the following is a sign or symptom of organophosphate poisoning?

Pupillary dilation
Constipation
Vomiting
Tachycardia

Vomiting

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You would expect a person to be hypertensive and tachycardic following exposure to:

phenobarbital.
ethanol.
bath salts.
morphine.

Bath salts

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Which of the following is a sign of marijuana use?

Hallucinations
Significant delirium
Drowsiness
Decreased appetite

Drowsiness

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In general, symptoms of arsenic poisoning appear within which timeframe after arsenic ingestion?

24 to 36 hours
2 to 6 hours
12 to 24 hours
30 minutes to several hours

30 minutes to several hours

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Common signs and symptoms of a tricyclic antidepressant overdose include:

altered mental status and tachycardia.
constricted pupils and AV heart block.
tachypnea and severe hypertension.
excessive salivation and diarrhea.

altered mental status and tachycardia.

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Drug misuse is defined as:

any use of a drug that causes physical, psychological, or legal harm to the user.
the habitual use of illicit drugs for the purpose of inducing a euphoric feeling.
inadvertent misuse of a licit or illicit drug that causes physical harm to the user.
the use of legal medications that is not in accordance with a physician’s order.

any use of a drug that causes physical, psychological, or legal harm to the user.

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The toxic chemical in castor beans is:

caladium oxalate.
ricin.
lantadene A.
cyanide.

Ricin

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Metabolic acidosis, hyperkalemia, and rhabdomyolysis that occurs with MAOI toxicity are usually the result of:
Metabolic acidosis, hyperkalemia, and rhabdomyolysis that occurs with MAOI toxicity are usually the result of:
cardiac dysrhythmias.
respiratory failure.
acute renal failure.
persistent seizures.

persistent seizures.

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Appropriate prehospital treatment for a patient who has overdosed on a stimulant and is excessively tachycardic and violent includes:

antidepressants.
activated charcoal.
benzodiazepines.
beta-blockers.

benzodiazepines.

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An acetone breath odor is common following exposure to:

camphor.
aspirin.
turpentine.
chloral hydrate.

Aspirin

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A common sign or symptom of carbon monoxide toxicity is:

bradycardia.
pallor or cyanosis.
cherry red skin color.
jaundice.

pallor or cyanosis.

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Gamma-hydroxybutyrate is most commonly used to:

enhance the senses.
induce euphoria.
treat chronic coughing.
facilitate sexual assault.

facilitate sexual assault.

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From an anatomic and physiologic perspective, inhaled toxins:

quickly reach the alveoli and rapidly gain access to the circulatory system.
generally provide a large window of opportunity for treatment.
often take several hours before clinical signs and symptoms manifest.
typically take between 15 and 20 minutes to exert a systemic effect.

quickly reach the alveoli and rapidly gain access to the circulatory system.

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Which of the following is an ECG change that would most likely be observed in a patient with tricyclic antidepressant toxicity?

Terminal R wave in aVR
Shortened QT interval
High-grade AV block
Shortened PR interval

Terminal R wave in aVR

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Immediate treatment for a patient who overdosed on a narcotic and is hypercarbic includes:
endotracheal intubation.
naloxone, 0.4 to 2 mg IV push.
insertion of a nasogastric tube.
ventilation with a bag-mask device.

ventilation with a bag-mask device.

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Upon arriving at the scene of an incident involving a chlorine gas spill, you should:

don a protective breathing apparatus.
begin triaging all patients.
park the ambulance upwind.
remove all patients from the scene.

park the ambulance upwind.

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Which of the following medications is a tricyclic antidepressant?

Zoloft
Prozac
Clomipramine
Fluoxetine

Clomipramine

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A 45-year-old woman is found unresponsive in an alley. During your assessment, you note that she is tachycardic and breathing rapidly. She has an obvious odor of alcohol on her breath. Your most immediate concern should be to:

obtain a blood glucose reading.
start an IV line and administer naloxone.
take actions to prevent aspiration.
determine the etiology of her tachycardia.

take actions to prevent aspiration.

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Severe salicylate toxicity produces:

bradypnea.
metabolic acidosis.
respiratory acidosis.
increased pH levels.

metabolic acidosis.

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A middle-aged woman who has been taking 2 mg of clonazepam each day for 6 months finds that she now requires 4 mg each day to achieve the same effect. This is an example of:

tolerance.
physical dependence.
habituation.
drug abuse.

Tolerance

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Which of the following types of medications contain amphetamine?

Nasal decongestants
Drugs used to treat anxiety
Anti-inflammatory drugs
Drugs used to treat insomnia

Nasal decongestants

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Organophosphates exert their effect by: blocking the parasympathetic nervous system. stimulating the cholinergic nervous system. agonizing the sympathetic nervous system. destroying the body's acetylcholine.

stimulating the cholinergic nervous system.

Ingestion of the foxglove plant can result in which of the following symptoms? Bradycardia Dysrhythmias Severe gastroenteritis Renal failure

Dysrhythmias

You are caring for an alcoholic patient who has been abstinent for about 2 days. The patient is confused, restless, and tells you that he sees snakes crawling on the walls. His blood pressure is 76/52 mm Hg, pulse rate is 150 beats/min and weak, and respirations are 24 breaths/min with adequate depth. In addition to administering oxygen, you should: sedate him with 5 mg of Valium and transport at once. administer 6 mg of adenosine to slow his heart rate. treat his hypotension with crystalloid fluid boluses. provide emotional support only and transport immediately.

treat his hypotension with crystalloid fluid boluses.

Patients with alcoholism are prone to subdural hematomas and gastrointestinal bleeding because: they fall more frequently than sober people. their blood-clotting mechanisms are impaired. alcohol causes significant immunocompromise. they are at higher risk for violent assault.

their blood-clotting mechanisms are impaired.

Treatment for cyanide poisoning may include: activated charcoal. calcium gluconate. amyl nitrite. calcium chloride.

amyl nitrite.

Management for an ingested poison focuses mainly on: administering a counteracting agent. neutralizing the poison in the stomach. the prompt induction of vomiting. treating the systemic effects that result.

neutralizing the poison in the stomach.

A person who is “speedballing” is: highly addicted to methamphetamine, cocaine, and marijuana and mixes all three drugs together to achieve various levels of euphoria. packaging cocaine in small plastic bags and swallowing them for the purpose of transporting the cocaine from one location to another location. using cocaine in combination with heroin, by injecting them either underneath the skin or directly into a vein, in order to regulate the high. using heroin to withdraw or detoxify themselves from cocaine by gradually increasing the amounts of heroin taken while decreasing the amounts of cocaine used.

using cocaine in combination with heroin, by injecting them either underneath the skin or directly into a vein, in order to regulate the high.

A person who compulsively uses a drug, despite the fact that they know the drug will cause physical or psychological harm, is: tolerant. addicted. an abuser. dependent.

Addicted

When chlorine gas comes in contact with the body's mucous membranes, it forms: boric acid. hydrochloric acid. a strong alkali. sulfuric acid.

hydrochloric acid.

The recommended dose and method for administering naloxone to a patient who overdosed on a narcotic and is unresponsive and hypoventilating is: 0.4 to 2 mg rapidly until the patient regains consciousness. 0.1 mg/kg rapidly until the patient's respirations improve. 0.4 to 2 mg slowly until the patient's respirations improve. 5 to 10 mg via the endotracheal tube until the pupils dilate.

0.4 to 2 mg slowly until the patient's respirations improve.

Which of the following is a sign of severe MAOI toxicity? Dementia Hypertension Hyperthermia Diaphoresis

Hyperthermia

A known alcoholic man is found unresponsive by a law enforcement officer. An empty container of antifreeze was found near him. Your assessment reveals that his respirations are deep and rapid, his pulse rate is rapid and weak, and his pupils are dilated and sluggishly reactive. As your partner administers high-flow oxygen to the patient, you should: assess his blood glucose level and apply a cardiac monitor. start an IV line and begin administering a saline fluid bolus. start an IV line and give 1 mEq/mg of sodium bicarbonate. give him 100 mg of thiamine IM and assess his blood pressure.

assess his blood glucose level and apply a cardiac monitor.

What is the poisonous part of the apricot plant? Seed Bulb Root Leaf

Seed

Your first priority when dealing with a patient who may have overdosed is to: ascertain what the patient took. request law enforcement. assess the patient's airway. enter the scene carefully.

request law enforcement.

Which of the following antidepressant medications has the highest safety margin? Imipramine Paroxetine Nortriptyline Doxepin

Paroxetine

The hyperpnea and tachypnea associated with methyl alcohol intoxication is secondary to: metabolic acidosis. hypoxemia. an elevated blood pH. heart failure.

metabolic acidosis.

Lithium is most commonly used to treat patients with: bipolar disorder. chronic anxiety. depression. schizophrenia.

Bipolar disorder

Symptoms of delirium tremens usually begin within how many hours after the last alcohol intake? 24 to 48 72 to 96 12 to 24 48 to 72

48 to 72

Prehospital treatment for a patient who overdosed on aspirin may include: an antipyretic. flumazenil. calcium chloride. sodium bicarbonate.

sodium bicarbonate.

Which of the following drugs is classified as an anticholinergic? Diazinon Atropine Phenylephrine Thiopental

Atropine

During your assessment of a 33-year-old woman who you suspect is under the influence of a drug, the patient tells you that she was “listening to the painting on the wall” before you arrived. Her pulse rate and blood pressure are both elevated. This clinical presentation is most consistent with the use of: marijuana. methamphetamine. PCP. LSD.

LSD

A 69-year-old man presents with confusion, a headache, dyspnea, and palpitations after he rescued his two grandchildren from their burning house. During your assessment, you note that he has an odd odor on his breath; however, he denies being diabetic. You should: administer 1 to 2 g of pralidoxime infused with normal saline solution over a 5- to 10-minute period. start an IV line, sedate and chemically paralyze the patient, and then perform endotracheal intubation. have him inhale amyl nitrate for 20 seconds and then 100% oxygen for 40 seconds out of each minute. start an IV line of normal saline and administer 10 mL of a 10% solution of calcium chloride.

have him inhale amyl nitrate for 20 seconds and then 100% oxygen for 40 seconds out of each minute.

A 29-year-old woman was found unresponsive by her husband. When you arrive at the scene and begin your assessment, you note that the patient's respirations are slow and shallow, her pulse is slow and weak, and her pupils are dilated. Your partner begins assisting the patient's ventilations as you assess her blood pressure, which is 70/48 mm Hg. The patient's husband hands you an empty bottle of phenobarbital, which was filled the day before, and tells you that his wife takes the medication for seizures. After establishing vascular access, you should: begin a dopamine infusion at 10 mg/kg/min and titrate as needed. instruct your partner to hyperventilate the patient at 24 breaths/min. administer crystalloid fluid boluses to improve her blood pressure. give her up to 10 mg of naloxone to reverse the effects of the drug.

administer crystalloid fluid boluses to improve her blood pressure.

Pulse oximetry will not provide a true assessment of arterial oxygenation in patients with carbon monoxide toxicity because: the device falsely interprets oxyhemoglobin as carboxyhemoglobin. carbon monoxide damages the computer chip inside the pulse oximeter. the device cannot determine whether carbon monoxide or oxygen is bound to the hemoglobin. carbon monoxide turns the blood dark red, which indicates low oxygen content.

the device cannot determine whether carbon monoxide or oxygen is bound to the hemoglobin.

In adult patients, oral ingestion of a caustic substance: is usually intentional. contraindicates intubation. causes immediate death. requires activated charcoal.

is usually intentional.

Crack is a combination of: marijuana, heroin, and baking soda. heroin, cocaine, and distilled water. ecstasy, marijuana, and alcohol. cocaine, baking soda, and water.

cocaine, baking soda, and water.

Alcohol potentiates Valium. This means that: Valium makes alcohol a toxic substance. the use of alcohol negates the use of Valium. alcohol antagonizes the effects of Valium. alcohol enhances the effects of Valium.

alcohol enhances the effects of Valium.

The most important prehospital treatment intervention for a patient with carbon monoxide poisoning is: providing high-flow oxygen. establishing vascular access. monitoring cardiac rhythm. monitoring pulse oximetry.

providing high-flow oxygen.

If you are treating a patient with a suspected benzodiazepine overdose and find that the patient is hypotensive, bradycardic, and comatose: you should rapidly administer 2 mg of naloxone via the IV, IO, or IM route. avoid administering flumazenil and transport the patient immediately. you should consider concomitant overdose with another CNS depressant. it is likely that the patient is also under the influence of methamphetamine.

you should consider concomitant overdose with another CNS depressant.

Spray paints and lacquer thinner contain which of the following substances? Carbon tetrachloride Methylene chloride Toluene Benzene

Toluene

Which of the following cardiac rhythm disturbances most commonly results from inadvertent overdose of a prescribed cardiac medication? Bradycardia Atrial flutter Atrial fibrillation Tachycardia

Bradycardia

Which of the following is a sign of severe barbiturate withdrawal? Hallucinations Nausea and vomiting Diaphoresis Abdominal cramping

Hallucinations

A 100-pound violent young woman who requires four large paramedics to subdue and contain her is most likely under the influence of: mescaline. ketamine. LSD. PCP.

PCP

Which of the following interventions is influenced strongly by the amount of time that has elapsed since a patient ingested a toxic substance? IV therapy Transport Gastric lavage Intubation

Gastric lavage

You are transporting a young female who intentionally ingested a large quantity of her prescribed Pamelor. She is conscious, but drowsy, and complains of a dry mouth and blurred vision. The cardiac monitor reveals sinus tachycardia at 120 beats/min. You are administering high-flow oxygen and have established a patent IV line. With regard to her ECG rhythm, you should be especially alert for: QT interval narrowing. AV heart block. a prolonged PR interval. QRS widening.

QRS widening.

Which of the following statements regarding methyl alcohol is correct? Methyl alcohol is not recognized as a poison, although it has many properties of a poison when consumed in sufficient quantities. Also referred to as methanol, methyl alcohol is colorless and odorless and requires large amounts to cause toxicity. Methyl alcohol is also known as wood alcohol, and is present in paints, paint removers, windshield washer fluid, and varnishes. The signs and symptoms of methyl alcohol poisoning typically appear within 15 to 20 minutes following ingestion of as little as 5 to 10 mL.

Methyl alcohol is also known as wood alcohol, and is present in paints, paint removers, windshield washer fluid, and varnishes.

You are dispatched to a residence for a 61-year-old woman with flulike symptoms. Upon your arrival, the patient greets you at the door. She complains of a headache and nausea, and tells you that she has vomited twice. Her husband, who is lying on the couch in the living room, began experiencing the same symptoms at about the same time. You should: suspect that both patients have been exposed to cyanide. carefully assess the residence for any unusual findings. immediately open all of the windows in the house. remove both patients from the residence at once.

remove both patients from the residence at once.

A patient in the later stages of iron poisoning would be expected to present with: liver failure. tachycardia. diarrhea. hypotension.

Liver failure

A patient who ingested a significant quantity of acetaminophen less than 24 hours ago would most likely present with: signs of renal failure and severe vomiting. pain in the right upper abdominal quadrant. flushed skin, high fever, and abdominal pain. malaise, nausea, and a loss of appetite.

malaise, nausea, and a loss of appetite.

You respond to a local motel for a young woman who was sexually assaulted. Upon your arrival, you find the patient sitting on the bed talking to a police officer. The last thing she remembers is meeting “some guy” at a nightclub the evening before and then having a few drinks with him. She is conscious, but sleepy. Her respirations are 12 breaths/min and regular, pulse rate is 56 beats/min and strong, and blood pressure is 102/58 mm Hg. The cardiac monitor reveals sinus bradycardia at 50 beats/min. You should: conclude that she was unknowingly administered a narcotic analgesic, start an IV line, and give her 2 mg of naloxone. give her supplemental oxygen, conduct a secondary assessment at the scene to collect evidence, and transport her. monitor her oxygen saturation, start an IV line at a keep-vein-open rate, transport, and monitor her en route to the hospital. assist her ventilations with a bag-mask device, start an IV line, administer 0.5 mg of atropine, and transport.

monitor her oxygen saturation, start an IV line at a keep-vein-open rate, transport, and monitor her en route to the hospital.

You have administered a total of 10 mg of Narcan to an unresponsive 30-year-old man whom you believe has overdosed on a narcotic. However, the patient remains unresponsive, is hypoventilating, and is bradycardic. Your transport time to the closest appropriate hospital is 40 minutes. You should: insert a laryngeal mask airway, transport at once, and begin an epinephrine infusion en route to the hospital. insert a nasogastric tube to decompress his stomach, administer another 2 mg of Narcan, and transport. insert an oropharyngeal airway, continue bag-mask ventilations at a rate of 20 breaths/min, and transport. continue assisted ventilation for 2 to 3 minutes, insert an advanced airway device, and transport immediately.

continue assisted ventilation for 2 to 3 minutes, insert an advanced airway device, and transport immediately.

Death from acetaminophen overdose is most often caused by: gastrointestinal bleeding. progressive liver failure. metabolic alkalosis. acute splenic rupture.

progressive liver failure.

A 22-year-old woman experienced an acid chemical burn to her left forearm. She complains of intense pain and tingling in her fingers. She is conscious and alert, and denies any other symptoms. You should: apply a light coat of baking soda to the burn. cover the burn and transport at once. administer oxygen via nonrebreathing mask. begin immediate irrigation with water.

begin immediate irrigation with water.

A young man is found unresponsive by his girlfriend. Your assessment reveals marked respiratory depression; a slow, weak pulse; and pinpoint pupils. There are numerous medication bottles found in his home. Which of the following has he most likely ingested? Benadryl Sudafed Oxycodone Valium

Oxycodone

You should be most suspicious that a patient has systemic iron toxicity if they present with: bradypnea. severe nausea. hematemesis. hypertension.

hematemesis

Mild to moderate iron toxicity should be expected with ingestion of how much iron? 20 to 60 mg/kg 60 to 90 mg/kg 30 to 80 mg/kg 10 to 20 mg/kg

20 to 60 mg/kg

Inadvertent lithium toxicity would most likely occur in a patient who is taking: SSRIs. NSAIDs. any medication used to control blood pressure. a tricyclic antidepressant.

NSAIDs

A woman drives her husband to your EMS station after he was exposed to a large amount of pesticide. Your assessment reveals that he is responsive to pain only, is hypoventilating, is markedly bradycardic, and is incontinent of urine and feces. The cardiac monitor reveals marked sinus bradycardia. As your partner assists the patient's ventilations, you should: start an IV line and give sodium bicarbonate to alkalinize his urine. establish vascular access and begin administering atropine sulfate. administer 1 to 2 mg of pralidoxime IM and transport immediately. obtain a 12-lead ECG tracing to detect signs of myocardial injury.

establish vascular access and begin administering atropine sulfate.

The clinical presentation of a stimulant abuser includes: somnolence, hypotension, bradycardia, and a staggering gait. an irregular pulse, hyperpyrexia, hypotension, and bradycardia. excitement, hypertension, tachycardia, and dilated pupils. hypotension, tachycardia, constricted pupils, and hypothermia.

excitement, hypertension, tachycardia, and dilated pupils.

Poisoning with which of the following is most often the result of improper food storage or canning? Toxoplasma Salmonella Listeria Clostridium botulinum

Clostridium botulinum

If administered in conjunction with nitrates, sildenafil would most likely cause: severe hypotension. respiratory depression. ventricular tachycardia. coronary vasospasm.

Severe hypotension

CH 28 Flashcards

(75 cards)