CH 25 Poisoning and Overdose Emergencies

Question 1

H-1) Absorbed poisons that are corrosives or irritants​ may:
A. cause respiratory arrest.
B. injure the skin.
C. injure the heart.
D. cause respiratory failure.

Answer 1

B. injure the skin.

Absorbed poisons​ (poisons taken into the body through unbroken​ skin) may or may not damage the skin. Many are corrosives or irritants that will injure the skin then be slowly absorbed into body tissues and the​ bloodstream, possibly causing widespread damage.

Question 2

H-2) Which of the following best describes one way in which systemic poisons cause harm to the​ body?
A. They enter the bloodstream using the same route as ingested foods.
B. They critically depress or overstimulate the central nervous system.
C. They act as a corrosive or​ irritant, destroying skin and other body tissues.
D. They act as a suffocating​ agent, displacing oxygen in the air.

Answer 2

B. They critically depress or overstimulate the central nervous system.

Some poisons are systemic​ poisons, causing harm to the entire body or to an entire body system. These poisons can critically depress or overstimulate the central nervous​ system, cause vomiting and​ diarrhea, prevent red blood cells from carrying​ oxygen, or interfere with the normal biochemical processes in the body at the level of the cell.

Question 3

H-3) An antidote​ is:
A. a substance that protects the patient against the effects of a poison.
B. a binding agent that allows the liver to break a substance down.
C. an agent that causes the body to break the poison down into a nonharmful state.
D. a substance that will neutralize a poison or its effects.

Answer 3

D. a substance that will neutralize a poison or its effects.

Question 4

H-4) Why is activated charcoal best administered in an opaque container and through a​ straw?
A. Because of the unpleasant appearance of the mixture
B. Because activated charcoal is​ light-sensitive
C. Because if activated charcoal is​ spilled, it is​ toxic, and permanently stains clothing and skin
D. So that the patient cannot know how close the patient is to consuming the entire dose

Answer 4

A. Because of the unpleasant appearance of the mixture

The best method of administration for activated charcoal is in an​ opaque, covered container with a straw. The medication looks like​ mud, and patient compliance is improved if the patient cannot see it

Question 5

H-5) Why must activated charcoal be shaken before being administered to the​ patient?
A. Shaking causes the charcoal to float to the top.
B. Shaking activates the medication.
C. Shaking the medication will reduce the risk of nausea.
D. The medication tends to settle in the​ solution, and shaking will mix it.

Answer 5

D. The medication tends to settle in the​ solution, and shaking will mix it.

Activated charcoal is​ heavy, and will settle in the solution. Shaking it will mix the charcoal in the solution

Question 6

H-6) You have administered activated charcoal to your patient. What should you do​ next?
A. Continue with administration of activated charcoal
B. Immediately begin chest compressions
C. Apply​ high-concentration oxygen via a nonrebreather mask
D. Position the patient for​ vomiting, and be prepared to suction the airway

Answer 6

D. Position the patient for​ vomiting, and be prepared to suction the airway

If a patient has emesis or any other obstruction in the​ mouth, position the patient so that the emesis can easily escape the​ mouth, and be ready to suction.

Question 7

H-7) Medical control has ordered you to dilute the poisonous substance an adult patient has​ ingested, which means you should have the patient​ drink:
A. one or two glasses of water or milk.
B. several gulps of running water.
C. three glasses of milk.
D. two cups of coffee.

Answer 7

A. one or two glasses of water or milk. (Page 704)

Occasionally, medical direction will give an order for dilution of a poisonous substance. This means an adult patient should drink one or two glasses of water or​ milk, whichever is ordered.

Question 8

H-8) Which of the following are you most likely to administer for an opioid overdose​ patient?
A. Naloxone 
B. Activated charcoal 
C. Syrup of Ipecac
D. Morphine

Answer 8

A. Naloxone

Naloxone is a medication that directly reverses​ opioids’ depressant effects on level of consciousness and respiratory drive. Many EMTs are now permitted to administer this drug.

Question 9

H-9) If a husband and wife are both unconscious in their home and there is no outward evidence of a safety​ threat, which of the following possible causes should be foremost in your​ mind?
A. Natural gas leak
B. Food poisoning
C. Venomous snake bite
D. Carbon monoxide poisoning

Answer 9

D. Carbon monoxide poisoning

Carbon monoxide poisoning should be suspected in this​ situation, because carbon monoxide is​ odorless, colorless, and​ tasteless, and it is undetectable without special equipment.​ Also, the fact that both the husband and wife have been affected in the same way in an enclosed area suggests carbon monoxide poisoning.

Question 10

H-10) Generally, the longer a patient is exposed to a poisonous​ gas, the:
A. more poison will probably be absorbed.
B. more altered the​ patient’s mental status will be.
C. less severe its effects.
D. less urgent the​ patient’s priority.

Answer 10

A. more poison will probably be absorbed.

Knowing the length of a​ patient’s exposure to a poisonous gas can give you a rough idea of how much of the poison was probably​ absorbed, but it will not necessarily indicate the​ patient’s mental status or lessen the effects or the​ patient’s priority.

Question 11

H-11) A patient has inhaled a​ poison, and specialized personnel have removed the patient to a safe area away from the source of the poison. You​ should:
A. take baseline vital signs.
B. establish an open airway.
C. contact medical direction.
D. gather the​ patient's history.

Answer 11

B. establish an open airway.

You must establish an open airway for this patient before doing anything else.

Question 12

H-12) You are on standby at a structure fire when firefighters pull a victim from the house. He seems to be recovering from unconsciousness but is breathing​ rapidly, and has soot around his nose and mouth. He has a cough that is productive of dark sputum. He says that he is feeling much better and does not want to go to the hospital. What is the most important reason for the patient to go to the​ hospital?
A. He may have other injuries that have gone undetected.
B. The​ body’s reaction to toxic gases and foreign matter in the airway can be delayed.
C. The sudden transition to a​ smoke-free environment typically produces an illusory improvement.
D. He likely has​ first- and​ second-degree skin burns of which he is unaware.

Answer 12

B. The​ body’s reaction to toxic gases and foreign matter in the airway can be delayed.

The​ body’s reaction to toxic gases and foreign matter in the airway can often be delayed. Convince all smoke inhalation patients that they must be seen by a​ physician, even if they are not yet feeling serious effects.

Question 13

H-13) What is the most important part of treatment for a patient suffering from an absorbed poison​ exposure?
A. Transport the patient to the most appropriate facility.
B. Remove all clothing.
C. Contact poison control and identify the specific treatment algorithm for this patient.
D. Get the poison off the skin or out of the eye.

Answer 13

D. Get the poison off the skin or out of the eye.

The most important part of treating a patient exposed to a poison that absorbs is to get the poison off the skin or out of the eye.

Question 14

H-14) You respond to the scene of a construction site. On​ arrival, you find a female patient complaining of pain and irritation in both arms. You note a​ dry, powder-like substance all over her arms. Which of the following actions would be your first​ priority?
A. Contact poison control after identifying the powder substance that is on the patient.
B. Ensure that the​ patient’s airway is patent and that she did not inhale any of the powder.
C. Irrigate with sterile water for at least 20 minutes.
D. Brush the powder away and irrigate with sterile water for at least 20 minutes.

Answer 14

B. Ensure that the​ patient’s airway is patent and that she did not inhale any of the powder.

As in all​ scenarios, always detect and treat immediately any​ life-threatening problems in the primary assessment. This includes assessing and managing the​ patient’s airway before targeting the specific poison.

Question 15

H-15) Why are EMTs tempted to neglect proper treatment and care of a patient who is suffering from alcohol​ abuse?
A. EMTs assume that alcoholics do not take their health seriously.
B. Chronic drinkers do not call 911 for​ non-serious injuries or illness.
C. EMTs may disregard alcoholic patients because of their belligerent behavior or frequent calls to EMS.
D. Caring for alcoholic patients takes time away from treating patients with more​ serious, life-threatening illnesses such as heart attacks or strokes.

Answer 15

C. EMTs may disregard alcoholic patients because of their belligerent behavior or frequent calls to EMS.

Patients who abuse alcohol may frustrate EMT responders because these patients often are not cooperative or have made frequent calls to EMS while intoxicated. For this​ reason, EMTs may feel tempted to overlook these patients and not treat them the same way they would treat a​ sober, coherent patient.

Question 16

H-16) Which of the following conditions has similar symptoms to alcohol​ intoxication, and can make a patient appear to be​ intoxicated?
A. Food poisoning
B. Myocardial infarction
C. Diabetic emergency
D. Abdominal trauma

Answer 16

C. Diabetic emergency

Keep in mind that although alcohol abuse may be the​ patient’s apparent​ problem, another problem may be present. Conduct a complete assessment to identify any medical emergencies. Remember that​ diabetes, epilepsy, high​ fever, hypoxia, and other medical problems can make a patient appear to be intoxicated. One particular item of note is​ “acetone breath,” which is an odor of alcohol on the​ patient’s breath that is associated with diabetic​ emergency, not alcohol consumption.

Question 17

H-17) Which of the following is an acute​ life-threatening complication that may result from habitual alcohol​ abuse?
A. Overall deterioration in​ patient’s health leading to cirrhosis of the liver
B. Head injuries
C. An increase in alcohol tolerance
D. Alterations in the ability to maintain a regular blood sugar level

Answer 17

D. Alterations in the ability to maintain a regular blood sugar level

Chronic drinkers​ (alcoholics) often have derangements in blood sugar levels. A person can be both intoxicated and experiencing​ hypoglycemia, and alcohol abuse can mask the signs and symptoms of hypoglycemia. —– While alcohol abuse can lead to other health​ problems, cirrhosis and other medical conditions do not present as​ life-threatening emergencies.
– Head injuries may be present in an intoxicated​ patient, but not as a complication of alcohol abuse.

Question 18

H-18) Delirium tremens is a condition characterized by​ sweating, trembling,​ anxiety, and:
A. blackout.
B. lethargy.
C. euphoria.
D. hallucinations.

Answer 18

D. hallucinations.

Delirium tremens is a condition characterized by​ sweating, trembling,​ anxiety, and hallucinations.

Question 19

H-19) Your patient has been abusing alcohol for some​ time, and now has experienced a sudden withdrawal from it. You should most expect to​ see:
A. watery​ eyes, runny​ nose, diarrhea,​ cramps, and nausea.
B. ​apathy, long periods of​ sleep, irritability,​ depression, and disorientation.
C. a prolonged​ trance-like state followed by a serious of vivid hallucinations.
D. confusion and​ restlessness, tremors,​ hypertension, and hallucinations.

Answer 19

D. confusion and​ restlessness, tremors,​ hypertension, and hallucinations.

Question 20

H-20) A patient who is exhibiting​ hallucinations, gross​ tremors, confusion,​ restlessness, hypertension, and tachycardia may be suffering​ from:
A. amphetamine overdose.
B. opioid overdose.
C. alcohol overdose.
D. alcohol withdrawal.

Answer 20

D. alcohol withdrawal.

Question 21

H-21) our patient presents with seizures and DTs from acute alcohol withdrawal. You​ should:
A. restrain the patient for transport.
B. have the patient sign a form of refusal.
C. make the patient a high transport priority.
D. refer the patient to a social service agency.

Answer 21

C. make the patient a high transport priority.

Patients can die from acute alcohol withdrawal. They should be a high transport priority.

Question 22

H-22) Which of the following terms is used to describe the​ body's severe reaction when deprived of an abused​ substance?
A. Overdose
B. Dependency
C. Withdrawal
D. Toxicity

Answer 22

C. Withdrawal

Question 23

H-23) Uppers produce an excited state in the user by stimulating​ the:
A. central nervous system.
B. autonomic nervous system.
C. peripheral nervous system.
D. cardiovascular system.

Answer 23

A. central nervous system.

Question 24

H-24) Many hallucinogens may be absorbed​ through:
A. intranasal inhalation.
B. subcutaneous injection.
C. the skin and mucous membranes.
D. injection into the muscle of the thigh.

Answer 24

C. the skin and mucous membranes.

Question 25

H-25) You arrive on scene to a home for a patient with altered mental status. He is calm and talkative at​ first, but as you start to talk to family​ members, he becomes belligerent and hostile. What should you do​ next?
A. Back away from the scene and call for police to be dispatched to the scene.
B. Tell the patient that if he does not calm​ down, you will have him arrested.
C. Try to get the family to calmly restrain the​ patient, so that he does not hurt himself or others.
D. Calmly place your hands on the​ patient’s shoulders to try to relax him.

Answer 25

A. Back away from the scene and call for police to be dispatched to the scene.

Scene safety is always the first priority. Immediately back away to a safe location at a safe distance and call police to the scene. All other options could make the scenario worse.

Question 26

H-26) Your patient is very lethargic​ and, according to​ family, acting abnormally. During your​ assessment, you note that the patient has bilateral pinpoint pupils. This finding is most likely due​ to:
A. a subdural hematoma.
B. a traumatic brain injury.
C. an allergic reaction.
D. opioid use.

Answer 26

D. opioid use.

Bilateral pinpoint pupils are often associated with opioid use.

Question 27

H-27) ​"Bath salts" are classified​ as:
A. stimulants.
B. hallucinogens.
C. depressants.
D. opioids.

Answer 27

A. stimulants.

​”Bath salts” are synthetic drugs that have very potent stimulant effects and sometimes hallucinogenic effects as well. They are classified as stimulants.

Question 28

H-28) The​ “opioid triad” of opioid overdose is characterized​ by:
A. ​belligerence, anxiety, and confusion.
B. ​coma, pinpoint​ pupils, and respiratory depression.
C. ​hallucinations, nausea, and bronchodilation.
D. ​hallucination, tachycardia, and tachypnea.

Answer 28

B. ​coma, pinpoint​ pupils, and respiratory depression.

Question 29

H-29) A patient on uppers will most typically​ be:
A. sluggish and sleepy.
B. docile and cooperative.
C. restless and hyperactive.
D. completely detached from reality.

Answer 29

C. restless and hyperactive.

Patients on uppers will be​ restless, hyperactive, and usually very apprehensive and uncooperative.

Question 30

H-30) Both opioids and downers can easily​ cause:
A. ​violence, increased body​ temperature, and hallucinations.
B. reduced pulse and respiratory rates.
C. ​suffocation, headache, unsteady​ gait, glazed​ eyes, and erratic pulse.
D. excitability and increased pulse and blood pressure.

Answer 30

B. reduced pulse and respiratory rates.

Question 31

H-31) You are assessing an unresponsive patient with a known overdose of an opioid. What changes would you expect to find with the​ patient’s breathing​ status?
A. The respiratory rate will be​ increased, but the depth will be shallow.
B. Breathing will be of a normal​ depth, but the rhythm will be irregular.
C. The respiratory depth will be​ normal, but the breathing rate will be slow.
D. Breathing may be depressed or absent.

Answer 31

D. Breathing may be depressed or absent.

Opioid abuse and overdose can be a causative factor in respiratory depression and arrest. Opioids depress areas of the brain that are responsible for initiating​ respirations, lowering the rate and depth of breathing and possibly causing apnea. These changes in combination can quickly kill the patient if the EMT does not intervene rapidly.

Question 32

H-32) You are responding to the home of a young male patient who is believed to have overdosed on​ “angel dust.” Which of the following will you most likely​ find?
A. A comatose patient who has shallow​ respirations, slow​ pulse, and low blood pressure
B. A​ wild, manic patient who may be irrational and unaware of the environment
C. A patient who is doubled over in abdominal​ pain, breathing rapidly with a very high temperature
D. A pleasant and calm patient who is lethargic

Answer 32

B. A​ wild, manic patient who may be irrational and unaware of the environment

Question 33

H-33) If you find gross​ soft-tissue damage that appears as darkened or red areas of scar tissue or scabs over veins on your​ patient's arms, this suggests a history​ of:
A. diabetes.
B. injection drug abuse.
C. phlebitis.
D. huffing.

Answer 33

B. injection drug abuse.

Question 34

PT-1) You are caring for a patient who has apparently attempted suicide by taking her​ father’s prescription drug. In addition to knowing what drug it​ is, its​ dosage, and when she took the​ drug, what other detail related to the drug is​ important?
A. How many capsules were in the container before and after the ingestion
B. When the medication was prescribed to the father
C. Whether the medication is a brand name or generic
D. The expiration date on the container

Answer 34

A. How many capsules were in the container before and after the ingestion

Question 35

PT-2) Volatile chemicals​ are:
A. injectable liquids.
B. pills.
C. powders.
D. vaporizing compounds.

Answer 35

D. vaporizing compounds.

Question 36

PT-3) Which of the following is an inhaled​ poison?
A. Chlorine gas
B. Rat poison
C. Snake venom
D. Detergent

Answer 36

A. Chlorine gas

Question 37

PT-4) You respond to a home where the parents found their​ 12-year-old son unconscious on the floor. A​ half-empty bottle of vodka is next to him. After you assess and protect the​ airway, providing oxygen to the​ patient, you​ should:
A. treat for shock.
B. assess for trauma.
C. monitor vital signs.
D. transport the patient.

Answer 37

B. assess for trauma

Question 38

PT-5) The therapeutic mechanism by which activated charcoal works is​ by:
A. increasing the motility​ (movement) of substances through the gastrointestinal system to expulsion.
B. causing an unpleasant taste and resultant vomiting.
C. binding poisons through​ adsorption, thus preventing poisons from being absorbed by the body.
D. causing the substances in the stomach to solidify into a​ single, solid mass.

Answer 38

C. binding poisons through​ adsorption, thus preventing poisons from being absorbed by the body.

Question 39

PT-6) After​ you've opened the airway of a patient who has inhaled​ poison, the single most important treatment you can administer​ is:
A. dilution.
B. naloxone.
C. ​high-concentration oxygen.
D. activated charcoal.

Answer 39

C. ​high-concentration oxygen.

Question 40

PT-7) A patient with a history of alcohol abuse who reports visual and auditory hallucinations is​ reporting:
A. a symptom that indicates abuse of hallucinogenics.
B. one of the symptoms of alcohol abuse.
C. a symptom that is unusual for alcohol abuse.
D. a symptom that indicates head trauma.

Answer 40

C. a symptom that is unusual for alcohol abuse.

Question 41

PT-8) Emergency medical care for a patient who has ingested a poison​ includes:
A. flushing the mouth of an unresponsive patient.
B. noting the appearance of the vomitus prior to disposing of it.
C. inducing vomiting as soon as possible.
D. administering activated​ charcoal, per medical direction.

Answer 41

D. administering activated​ charcoal, per medical direction.

Question 42

PT-9) Which of the following patients should not be administered activated​ charcoal?
A. A patient who has overdosed on acetaminophen
B. A patient experiencing altered mental status
C. A patient who is currently taking antibiotics
D. A patient who has overdosed on aspirin

Answer 42

B. A patient experiencing altered mental status

Question 43

PT-10) Which of the following is not a characteristic effect of systemic​ poisoning?
A. Corrosion or irritation of skin and mucous membranes
B. Overstimulation of the central nervous system
C. Prevention of red blood cell transport of oxygen
D. Interference with biochemical processes at the cell level

Answer 43

A. Corrosion or irritation of skin and mucous membranes

Question 44

PT-11) When ventilating a patient who has ingested a​ poison, mouth-to-mouth ventilation is dangerous not only because of the possibility of​ infection, but also​ because:
A. the toxic action of the poison on the patient will become worse.
B. of possible contact with the ingested substance.
C. the​ patient’s breath will be toxic.
D. a poisoned patient will become more hypoxic through this method of ventilation.

Answer 44

B. of possible contact with the ingested substance.

Question 45

PT-12) Your unit has arrived at a private​ residence, where the scene has been determined to be safe. According to the​ parents, their​ 6-year-old son may have taken a handful of​ pills, thinking they were candy. You should contact medical direction or the poison control center to​ consider:
A. rinsing the​ patient’s mouth out with water.
B. providing ventilation.
C. administering syrup of ipecac.
D. administering activated charcoal.

Answer 45

D. administering activated charcoal.

Question 46

PT-13) Which of the following is true of sudden alcohol​ withdrawal?
A. Patients who quit​ “cold turkey” usually experience few side effects.
B. It can lead to death.
C. It is the best way to manage alcohol addiction.
D. Sudden withdrawal from alcohol is always fatal.

Answer 46

B. It can lead to death.

Question 47

PT-14) A patient who displays​ excitement, increased pulse and breathing​ rates, rapid​ speech, dry​ mouth, dilated​ pupils, and sweating has most likely been​ using:
A. volatile chemicals.
B. opioids.
C. downers.
D. uppers.

Answer 47

D. uppers.

Table 25-2 – Page 720

Question 48

PT-15) Which of the following statements regarding the assessment of patients who abuse alcohol is​ true?
A. The health risks related to alcohol abuse are only a concern when the patient is intoxicated.
B. Indications of head injury will be obvious in patients who abuse alcohol.
C. It is easy for the EMT to miss other medical conditions or injuries.
D. Confusion and disorientation are uncommon in patients who abuse alcohol.

Answer 48

C. It is easy for the EMT to miss other medical conditions or injuries.

Question 49

PT-16) A patient is drunk and refusing treatment or transport. You​ should:
A. respect the​ patient’s wishes but remain on scene to perform as much of a secondary assessment as possible.
B. call law enforcement to take custody of the patient.
C. treat and arrange for transport of the patient as necessary.
D. respect the​ patient’s wishes and leave the scene.

Answer 49

C. treat and arrange for transport of the patient as necessary.

Question 50

PT-17) .A patient with carbon monoxide poisoning was exposed​ by:
A. inhalation.
B. absorption.
C. ingestion.
D. injection.

Answer 50

A. Inhalation

Question 51

PT-18) In a patient who is experiencing​ tachycardia, hypertension,​ nausea, and​ tremors, you should most​ suspect:
A. a benzodiazepine overdose.
B. an aspirin overdose.
C. an antidepressant overdose.
D. an opioid overdose.

Answer 51

C. an antidepressant overdose

Question 52

PT-19) When on a call for substance​ abuse, as a​ precaution, EMTs should be on the lookout for weapons​ and:
A. money possibly used in illegal drug transactions.
B. unused drugs.
C. spoons used to cook drugs.
D. loose hypodermic needles.

Answer 52

D. loose hypodermic needles.

Question 53

PT-20) Which of the following is true of absorbed​ poisons?
A. Absorbed poisons cause local reactions at the point of contact but rarely cause systemic reactions.
B. For an absorbed​ liquid, irrigate with clean water for 20 minutes and continue en​ route, if possible.
C. If the poison is a dry​ chemical, immediately flush the area with clean water.
D. A contaminated eye should be irrigated from the corner of the eye across the bridge of the nose.

Answer 53

B. For an absorbed​ liquid, irrigate with clean water for 20 minutes and continue en​ route, if possible.

Question 54

PT-21) ​Mind-affecting or​ mind-altering drugs such as ecstasy that act on the central nervous system to produce excitement and distortion of perceptions are​ called:
A. stimulants.
B. hallucinogens.
C. depressants.
D. opioids.

Answer 54

B. hallucinogens.

Question 55

PT-22) When providing care for substance abuse​ patients, make sure you are safe​ and:
A. do not provide care to any substance abuse patient not in legal custody.
B. identify yourself as an EMT to the patient and bystanders.
C. indicate that law enforcement officers are on their way.
D. do not provide care to patients who are behaving erratically.

Answer 55

B. identify yourself as an EMT to the patient and bystanders.

Question 56

PT-23) To treat a patient exposed to dry lime​ powder, you​ should:
A. dilute the effect of the chemical by having the patient drink water.
B. brush the powder from the​ patient’s skin.
C. neutralize the chemical with the appropriate substance.
D. soak the affected area with copious amounts of warm water.

Answer 56

B. brush the powder from the​ patient’s skin.

Question 57

PT-24) ​Depressants, such as​ benzodiazepines, depress the central nervous system. They are often used to bring on a more relaxed state of mind. Because of​ this, depressants are often​ called:
A. downers.
B. uppers.
C. opioids.
D. hallucinogens.

Answer 57

A. downers

Question 58

PT-25) When transporting a patient who has inhaled​ poison, what do you take with​ you?
A. A liability waiver signed by the patient.
B. A transport form signed by law enforcement.
C. All​ containers, bottles, and labels from the substance.
D. A sample of the​ substance, if it is possible to obtain

Answer 58

C. All​ containers, bottles, and labels from the substance.

Question 59

CT-1) What clinical finding is most suggestive of an inhaled​ poison?
A. Altered mental status
B. Tachypnea
C. ​Black-colored sputum
D. Swollen tongue

Answer 59

C. ​Black-colored sputum

Question 60

CT-2) Which of the following is one of the most common inhaled poisons associated with fire​ suppression?
A. Carbon monoxide
B. Carbon dioxide
C. Chlorine gas
D. Hydrogen sulfide

Answer 60

A. Carbon monoxide

Question 61

CT-3) Which of the following is an injury that commonly occurs in alcoholic patients with even minor head​ injuries?
A. Concussion
B. Intracerebral hematoma
C. Skull fracture
D. Subdural hematoma

Answer 61

D. Subdural hematoma

Question 62

CT-4) Signs and symptoms of alcohol abuse include all of the following except​:
A. swaying and unsteadiness of movement.
B. an acetone or ketone odor to the breath.
C. nausea and vomiting.
D. confusion.

Answer 62

B. an acetone or ketone odor to the breath.

Question 63

CT-5) What is the most important treatment for a patient who has inhaled a​ poison?
A. Administer​ high-concentration oxygen.
B. Administer epinephrine via​ auto-injector.
C. Administer activated charcoal.
D. Administer the correct antidote.

Answer 63

A. Administer​ high-concentration oxygen.

Question 64

CT-6) Gamma hydroxybutyrate​ (GHB) is an example of which of the following types of​ drugs?
A. Volatile spirit
B. Stimulant
C. Depressant
D. Cannabis

Answer 64

C. Depressant

Question 65

CT-7) Which of the following most affects the extent of damage a poison does to the​ body?
A. ​Patient’s genetics,​ height, and medications taken
B. ​Patient’s nutritional​ status, genetics, and strength of the immune system
C. ​Patient’s age,​ weight, and general health
D. ​Patient’s race,​ age, and medications taken

Answer 65

C. ​Patient’s age,​ weight, and general health

Question 66

CT-8) When a chemical substance is taken for reasons other than therapeutic​ use, this action is​ called:
A. psychological dependence.
B. tolerance.
C. addiction.
D. substance abuse.

Answer 66

D. substance abuse.

Question 67

CT-9) The drug ecstasy is classified as what type of​ drug?
A. Hallucinogen
B. Tranquilizer
C. Barbiturate
D. Depressant

Answer 67

A. Hallucinogen

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Question 68

CT-10) Which of the following effects may occur due to chronic abuse of​ alcohol?
A. Poor nutrition
B. Abnormal blood sugar levels
C. Potential for gastrointestinal bleeding
D. All of the above

Answer 68

D. All of the above

Question 69

CT-11)  It is a chilly fall morning and you are called to an RV campground for three patients who are complaining of​ headache, dizziness, and nausea. Your primary assessment reveals that they are cyanotic and have an altered mental status. You​ suspect:
A. snake bite.
B. carbon monoxide poisoning.
C. food poisoning.
D. bee sting.

Answer 69

B. carbon monoxide poisoning.

Question 70

CT-12) Cleaning​ fluid, glue, and model cement are common examples of which of the​ following?
A. Narcotics
B. Volatile chemicals
C. Roofies
D. Hallucinogens

Answer 70

B. Volatile chemicals

Question 71

CT-13) Regarding activated​ charcoal, which of the following is not​ true?
A. It can reduce the amount of poison absorbed by the gastrointestinal system.
B. Ingestion of strong acids or alkalis is a contraindication to its use.
C. It does not work on all poisons.
D. It is an antidote to many poisons.

Answer 71

D. It is an antidote to many poisons.

Question 72

CT-14) By​ definition, a systemic poison causes harm to which of the​ following?
A. Stomach and intestines
B. Localized areas of tissue
C. Specific organ
D. Entire body

Answer 72

D. Entire body

Question 73

CT-15) You are called to a farm for a possible insecticide poisoning of one of the workers. Your first action is​ to:
A. decontaminate the patient.
B. bag the patient before he dies.
C. call for specialized hazardous materials units.
D. call for an ALS unit.

Answer 73

C. call for specialized hazardous materials units.

Question 74

CT-16) You respond to the county jail for a​ 48-year-old inmate arrested two days ago for public intoxication. Guards state the patient is a known alcoholic and​ “frequent flier.” The guards state that for several hours the patient was​ “acting crazy” and seeing​ “bugs on the​ walls.” The patient then began seizing and they called for an ambulance. You notice the patient is no longer​ seizing, diaphoretic, or confused. What condition do you​ suspect?
A. Alcohol poisoning
B. LSD abuse
C. Acute episode of paranoid schizophrenia
D. Delirium tremens

Answer 74

D. Delirium tremens

Question 75

CT-17) Your patient is a​ 17-year-old male who is spitting and coughing after swallowing some gasoline while siphoning from a gas tank. Which of the following should you do​ first?
A. Have the patient drink a glass of milk.
B. Contact medical control.
C. Insert a Combitube or another blind insertion​ device, if you are trained to do so.
D. Administer syrup of ipecac.

Answer 75

B. Contact medical control.

Question 76

CT-18) A patient who has abused​ “uppers” will display which of the following signs and​ symptoms?
A. Constricted​ pupils, hypotension, and blurred vision
B. Dilated​ pupils, excessive​ salivation, and food cravings
C. Excessive​ talkativeness, dilated​ pupils, and dry mouth
D. Slurred​ speech, constricted​ pupils, and frequent urination

Answer 76

C. Excessive​ talkativeness, dilated​ pupils, and dry mouth

Question 77

CT-19) Which of the following describes any substance produced by a living organism that is poisonous to human​ beings?
A. Antibody
B. Toxin
C. Antigen
D. Acid

Answer 77

B. Toxin

Question 78

CT-20) Your patient is an​ 18-year-old male who fell into a​ neighbor's swimming pool but was pulled out by bystanders. The neighbors report that the patient wandered into their yard and that he said he had a​ "funny numb​ feeling" in his head and his chest hurt before stumbling into the pool. As you are performing​ CPR, you notice that the mucous membranes in his mouth and nose are swollen. Which of the following would account for the​ patient's behavior and current​ condition?
A. Carbon monoxide poisoning
B. Volatile chemicals
C. Methamphetamine
D. GHB

Answer 78

B. Volatile chemicals

Question 79

CT-21) Which patient would most likely benefit from the administration of activated​ charcoal?
A. ​18-year-old patient who is passed out from drinking too much beer
B. ​8-year-boy who has a headache from carbon monoxide poisoning
C. ​14-year-old female who overdoses on her​ grandfather’s cardiac medication
D. ​45-year-old patient suffering from insecticide poisoning

Answer 79

C. ​14-year-old female who overdoses on her​ grandfather’s cardiac medication

Question 80

CT-22) Your patient has come in contact with a strong acid substance. Using an alkaline solution to treat the patient may result in which of the​ following?
A. Neutralization of the acid substance
B. Further damage to the​ patient’s tissues
C. Production of heat when the acid and alkali interact
D. All of the above

Answer 80

D. All of the above

Question 81

CT-23) Which of the following statements regarding syrup of ipecac is not​ true?
A. It can cause a patient to aspirate stomach contents into the lungs.
B. It has an immediate action.
C. It causes vomiting in all patients with a single dose.
D. It removes only about​ one-third of stomach contents.

Answer 81

B. It has an immediate action.

Question 82

CT-24) The opioid triad includes all of the following except​:
A. coma.
B. pinpoint pupils.
C. hypertension.
D. respiratory depression.

Answer 82

C. hypertension.

Question 83

CT-25) When a poison attaches to the chemical structure of activated​ charcoal, which of the following best describes this mechanism of​ action?
A. Adsorption
B. Incorporation
C. Inactivation
D. Absorption

Answer 83

A. Adsorption

Question 84

CT-26) Why should an EMT utilize a local poison control center in managing a poisoning​ patient?
A. It places any legal liability on the poison control center.
B. They can assist in finding out important information about the poison.
C. It prevents the EMT from having to do training on poisons.
D. They can activate a specialty team to come and treat the patient.

Answer 84

B. They can assist in finding out important information about the poison.

Question 85

CT-27) Why would an EMT give activated charcoal to a patient who overdosed on a​ medication?
A. Activated charcoal prevents the patient from vomiting.
B. Activated charcoal coats the intestinal​ tract, preventing absorption by the body.
C. Activated charcoal is the antidote to medication poisoning.
D. Activated charcoal binds to the​ medication, preventing absorption by the body.

Answer 85

D. Activated charcoal binds to the​ medication, preventing absorption by the body.

Question 86

CT-28) Which of the following is not a way in which poisons can access the​ body?
A. Radiation
B. Inhalation
C. Injection
D. Absorption

Answer 86

A. Radiation

Question 87

CT-29) You are treating a​ 61-year-old who is a chronic alcohol abuser. He is complaining of​ “snakes slithering around his​ ankles,” and he tells you that he had only two drinks tonight. You notice that he is​ sweating, trembling, and anxious. Before you can complete your​ assessment, he begins to have a seizure. Which of the following is the most likely cause of this​ situation?
A. The patient is suffering from acute alcohol poisoning.
B. The patient could not find an alcoholic beverage and drank antifreeze instead.
C. The patient drank mouthwash instead of beverage alcohol.
D. The patient is suffering from alcohol withdrawal.

Answer 87

D. The patient is suffering from alcohol withdrawal.

Question 88

CT-30) When a substance enters the body through unbroken​ skin, it has entered the body by which of the following​ routes?
A. Injection
B. Consumption
C. Absorption
D. Ingestion

Answer 88

C. Absorption

Question 89

CT-31) Your patient is a​ 23-year-old male who is unresponsive in the restroom of a bar. His respirations are slow and​ shallow, he has a heart rate of 50 beats per​ minute, he is sweating​ profusely, and he has constricted pupils. Which of the following substances is most likely responsible for the​ patient's condition?
A. Heroin
B. Ecstasy
C. LSD
D. PCP

Answer 89

A. Heroin

Question 90

CT-32) Which of the following is a common sign and symptom in poisonings of all​ types?
A. Pain and diaphoresis
B. Headache and diaphoresis
C. Dizziness and palpitations
D. Nausea and vomiting

Answer 90

D. Nausea and vomiting

Question 91

CT-33) Volatile chemicals are agents that are able to change easily from a​ \_\_\_\_\_\_\_\_ into a​ \_\_\_\_\_\_\_\_.
A. ​liquid; gas
B. ​solid; liquid
C. ​solid; vapor
D. ​gas; liquid

Answer 91

A. ​liquid; gas

Question 92

CT-34) Which of the following substances may be ordered by medical control to dilute a​ poison?
A. Water with syrup of ipecac
B. Milk of magnesia or magnesium citrate
C. Milk or water
D. Milk or milk of magnesia

Answer 92

C. Milk or water

Question 93

CT-35) Which of the following is not part of the treatment for a​ 15-year-old female who has swallowed drain​ cleaner?
A. Administer activated charcoal.
B. Maintain the airway.
C. Administer milk or water.
D. Call medical control.

Answer 93

A. Administer activated charcoal.

Question 94

CT-36) Your patient is a​ 7-year-old male who ate an unknown type of mushroom on a dare by his friends. You should ask all of the following questions except​:
A. Why did you eat the​ mushroom?
B. When did you eat the​ mushroom?
C. How much did you​ eat?
D. Are there any more of the​ mushrooms?

Answer 94

A. Why did you eat the​ mushroom?

Question 95

CT-37) You have just arrived on the scene of an agricultural business and see three men coming out of a​ building, choking and holding their heads. One of the men tells you there are two workers still inside. What should you do​ next?
A. Get the assistance of the men who made it out of the building to prevent delay in finding the workers inside.
B. Cover your nose and mouth with a wet towel and check on the status of the two workers inside the building.
C. Evaluate the three men and administer​ high-concentration oxygen, then help them get a safe distance away from the scene.
D. Call for properly trained assistance and stay a safe distance away from the scene.

Answer 95

D. Call for properly trained assistance and stay a safe distance away from the scene.

Question 96

CT-38) You are called to the scene of a​ 17-year-old female patient who is unresponsive. Her mother suspects that she tried to commit suicide by taking her pain pills. The patient is unresponsive to painful​ stimuli, has agonal​ respirations, and has vomited. She has a weak carotid pulse. After securing the airway and providing oxygen by​ bag-valve mask, what is your next​ action?
A. Perform a focused assessment.
B. Ask the mother the name of her pain medication.
C. Question the mother about the​ patient’s suicidal tendencies.
D. Perform a secondary assessment of the patient.

Answer 96

D. Perform a secondary assessment of the patient.

Question 97

CT-39) Immediate effects of alcohol are due to effects on which body​ system?
A. Gastrointestinal system
B. Central nervous system
C. Respiratory system
D. Cardiovascular system

Answer 97

B. Central nervous system

Question 98

CT-40) Your patient is a conscious​ 4-year-old female who has ingested a medication prescribed for her grandfather. To determine appropriate​ treatment, which of the following information is not necessary to provide to medical​ control?
A. ​Patient’s vital signs and the time the medication was taken
B. Any home remedies attempted by the​ patient’s family
C. ​Patient’s weight and the amount of medication taken
D. ​Grandfather’s name and the name of the physician who prescribed the medication

Answer 98

D. ​Grandfather’s name and the name of the physician who prescribed the medication

Question 99

CT-41) You are called to the scene of a local night club for a​ 21-year-old female patient who is bradycardic and in respiratory arrest. The​ patient’s airway is patent and the chest easily rises with​ bag-valve-mask ventilation. The​ patient’s friends state the patient had only one or two drinks when she suddenly complained of dizziness and​ “seeing things.” Her friends state that she then passed​ out, started twitching like she was​ seizing, and then stopped. Her friends adamantly state that she does not do drugs. What situation do you​ suspect?
A. Cocaine overdose
B. GHB overdose
C. Alcohol overdose
D. Anaphylactic reaction to the alcoholic drink

Answer 99

B. GHB overdose

Question 100

CT-42) Barbiturates may be referred to as which of the​ following?
A. Meth
B. Acid
C. Downers
D. Uppers

Answer 100

C. Downers

Question 101

CT-43) Which of the following is a trade name for activated​ charcoal?
A. Actidose
B. Mesquite
C. Charcoal
D. Actifed

Answer 101

A. Actidose

Question 102

CT-44) You are called to the scene of a​ 21-year-old female patient who is unresponsive. Her boyfriend suspects that she tried to commit suicide by overdosing on her depression medications. The patient is unresponsive to painful​ stimuli, with agonal​ respirations, and has vomited. She has a weak carotid pulse. After securing the airway and providing oxygen by​ bag-valve mask, what is the most important question the EMT can ask regarding the​ medication?
A. How many pills did she​ take?
B. Were the medications​ new?
C. What medication did she​ take?
D. Why is she on that particular depression​ medication?

Answer 102

C. What medication did she​ take?

Question 103

CT-45) Which patient would most likely benefit from the administration of activated​ charcoal?
A. ​28-year-old male who is suffering from food poisoning after eating eggs contaminated with salmonella
B. Unresponsive​ 28-year-old female who overdosed on sleeping pills
C. Alert​ 16-year-old female who overdosed on Tylenol
D. ​48-year-old man who attempted suicide by drinking Drano

Answer 103

C. Alert​ 16-year-old female who overdosed on Tylenol

Contraindications for Activated Charcoal include:

1. Patients who cannot swallow
2. Patients with altered mental status (they may choke and aspirate)
3. Anyone who has ingested acids or alkalis. They may have damaged the mouth, throat and esophagus. Activated charcoal CANNOT help the damage that has been done, and swallowing it may cause further damage
4. A patient that has siphoned gasoline and accidently ingested it, using Activated Charcoal will cause the patient to cough and the chances of aspirating the gasoline are there.
5. Activated charcoal is not indicated for use in cases of food poisoning

Question 104

CT-46) Which of the following is a substance that will neutralize a poison or its​ effects?
A. Antibody
B. Vaccine
C. Deactivator
D. Antidote

Answer 104

D. Antidote

Page 704 - Definition on side

Question 105

CT-47) Which of the following is least often seen in carbon monoxide​ poisoning?
A. Altered mental status
B. Headache
C. Nausea
D. Cherry red lips

Answer 105

D. Cherry red lips

Question 106

CT-48) Which of the following is the best initial intervention for a patient who has inhaled a​ poison?
A. Provide a patent​ airway, ventilation, and​ high-concentration oxygen.
B. Perform abdominal thrusts to clear the​ airway, followed by​ high-concentration oxygen.
C. Provide plenty of fresh air and monitor pulse oximetry readings.
D. Transport in a position of comfort and provide oxygen for patients with a decreased level of consciousness.

Answer 106

A. Provide a patent​ airway, ventilation, and​ high-concentration oxygen.

Question 107

CT-49) Which of the following is true concerning a​ patient’s reaction to toxic gases from smoke​ inhalation?
A. The patient will present with​ vague, flulike symptoms.
B. If the patient is feeling​ fine, they do not need to see a physician.
C. Signs and symptoms may be delayed.
D. Inhalation of the toxic gases will cause​ cherry-red skin or lips.

Answer 107

C. Signs and symptoms may be delayed.

Question 108

CT-50) How does carbon monoxide cause toxic​ effects?
A. Prevents the blood from clotting
B. Prevents red blood cells from releasing carbon dioxide
C. Causes red blood cells to clump together
D. Prevents red blood cells from carrying oxygen

Answer 108

D. Prevents red blood cells from carrying oxygen

Question 109

CT-51) OxyContin is an example of which of the following types of​ drugs?
A. Narcotic
B. Appetite suppressant
C. Antidepressant
D. Barbiturate

Answer 109

A. Narcotic

Question 110

CT-52) Your patient is a​ 50-year-old female with a history of alcoholism. She is found unresponsive in bed by her son. Which of the following possibilities should you keep in mind during your​ assessment?
A. Heart attack
B. Low blood sugar
C. Head injury
D. All of the above

Answer 110

D. All of the above

Question 111

CT-53) Your patient is a​ 48-year-old male who has been exposed to a toxic powder that can be absorbed through the skin. Which of the following measures should be taken by the​ EMT?
A. Wipe the powder away with a damp cloth.
B. Flush the​ patient’s skin with copious amounts of water.
C. Brush off the powder and flush the​ patient’s skin with a solution of baking soda and water.
D. Brush off the powder and flush the​ patient’s skin with copious amounts of water.

Answer 111

D. Brush off the powder and flush the​ patient’s skin with copious amounts of water.

Question 112

CT-54) Which of the following conditions can mimic the signs of alcohol​ intoxication?
A. Diabetes
B. Head injuries
C. Epilepsy
D. All of the above

Answer 112

D. All of the above

Question 113

CT-55) Your patient is a​ 3-year-old female who has taken an unknown quantity of aspirin. She is conscious and alert. Which of the following orders is likely to be given by medical​ control?
A. Induce vomiting by placing your finger in the​ child’s throat.
B. Administer activated charcoal.
C. Administer syrup of ipecac.
D. Administer one to two glasses of milk.

Answer 113

B. Administer activated charcoal.

Question 114

CT-56) Carbon monoxide poisoning should be suspected when a patient has been in an enclosed area and has which of the following signs​ and/or symptoms?
A. Breathing difficulty and altered mental status
B. ​Headache, dizziness, and nausea
C. ​Flu-like symptoms
D. All of the above

Answer 114

D. All of the above

Question 115

CT-57) Which of the following types of drugs may induce sleep or​ stupor?
A. Hallucinogens
B. Narcotics
C. Tranquilizers
D. Both A and B

Answer 115

D. Both A and B

Question 116

CT-58) A patient has a dry powder poison covering both upper extremities and chest. You​ should:
A. brush the powder off and irrigate the contaminated area with large amounts of water.
B. cover the​ patient’s arms with a burn sheet to preserve the powder for the emergency room.
C. immediately wash the powder off to prevent further exposure.
D. flush the area with large amounts of water and then brush the remaining poison off.

Answer 116

A. brush the powder off and irrigate the contaminated area with large amounts of water.

Question 117

CT-59) Which of the following is the most important means of managing a patient who has inhaled a​ poison, after the airway has been​ established?
A. Hyperventilation
B. High concentrations of oxygen
C. Monitoring pulse oximetry
D. Administering a specific antidote

Answer 117

B. High concentrations of oxygen

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Question 118

CT-60) Most cases of accidental poisoning involve which of the​ following?
A. Infants
B. Young children
C. Adults
D. Adolescents

Answer 118

B. Young children

Question 119

CT-61) Your patient is a conscious​ 16-year-old female who has ingested an unknown number of sleeping pills. Which of the following questions is least pertinent to the care of this​ patient?
A. Over what period of time did you take the​ pills?
B. Who do these sleeping pills belong​ to?
C. How much do you​ weigh?
D. Has anyone tried to treat you with​ anything?

Answer 119

B. Who do these sleeping pills belong​ to?

Question 120

CT-62) Carbon monoxide poisoning occurs by which of the following​ routes?
A. Absorption
B. Inhalation
C. Aspiration
D. Radiation

Answer 120

B. Inhalation

Question 121

CT-63) Your patient is a​ 38-year-old male who has taken an overdose of several different medications and has consumed some household cleaning agents as well. On your​ arrival, the patient only responds to painful stimuli and has a heart rate of 90 beats per minute with a respiratory rate of 12 breaths per minute. Medical control orders you to give the patient two to three glasses of milk to drink to dilute the contents of the stomach. Which of the following actions should you​ do?
A. Ask medical control if you can substitute water for the milk since water will not damage the lungs if aspirated.
B. Refuse the order and explain why.
C. Assist the patient in drinking only one glass of milk to reduce the risk of aspiration.
D. Assist the patient in drinking as much of the two to three glasses of milk as he can.

Answer 121

B. Refuse the order and explain why.

Question 122

CT-64) Which of the following is a sign or symptom of withdrawal from​ alcohol?
A. Sweating
B. Seizures
C. Hallucinations
D. All of the above

Answer 122

D. All of the above

Question 123

CT-65) Which of the following groups is the most susceptible to the effects of a​ poison?
A. Teenager
B. Elderly
C. Adults
D. ​Pre-teens

Answer 123

B. Elderly

Question 124

CT-66) You are called to the residence of a​ 78-year-old widow who lives alone with no children. She was found by neighbors on the floor of the living room. She has fallen and fractured her left humerus. She is disoriented and responds to verbal stimuli only. She has a blood pressure of​ 78/40 and a pulse of 48. She has a history of high blood pressure and takes medication for it. She also takes medication for high cholesterol and a medication to slow down a fast heart rate. Emergency Medical Responders find the medication bottles in the medicine cabinet and they are empty. Your partner suspects that she overdosed on her medications. Do you agree or​ disagree?
A. Disagree. The​ patient’s vital signs are related to her broken arm.
B. Disagree. The vital signs indicate that she has not taken her medication in several days.
C. Agree. It is obvious that the broken arm is causing the decreased heart rate.
D. Agree. The vital signs agree with this hypothesis.

Answer 124

D. Agree. The vital signs agree with this hypothesis.

Question 125

CT-67) You are called to the scene of a​ 14-year-old female patient who is unresponsive. Her mother states she has been teased and bullied at school and she suspects that she tried to commit suicide by taking her pain pills. The patient is unresponsive to painful​ stimuli, with agonal​ respirations, and has vomited. She has a weak carotid pulse. Your first action is​ to:
A. administer an oropharyngeal airway​ (OPA).
B. administer oxygen by​ bag-valve mask​ (BVM).
C. administer oxygen by nonrebreather mask​ (NRB).
D. suction the​ patient’s airway.

Answer 125

D. suction the​ patient’s airway.

Question 126

CT-68) Smoke inhalation can result in all of the following except​:
A. carbon monoxide poisoning.
B. respiratory arrest.
C. lung contusion.
D. cardiac arrest.

Answer 126

C. lung contusion.

Question 127

CT-69) Your patient is a​ 3-year-old male with a stoma in his neck to assist his breathing. The patient has swallowed a household cleaner. Medical direction gives you an order for milk to dilute the stomach contents. Which of the following is the correct way of carrying out this​ order?
A. Refuse the order and explain why.
B. Have the patient drink one glass of milk.
C. Have the patient drink a glass of milk while you plug the stoma to prevent leakage.
D. Administer one glass of milk through the stoma.

Answer 127

B. Have the patient drink one glass of milk.

Question 128

CT-70) Which of the following is the cause of the black residue found in a​ patient's mouth and nose following smoke​ inhalation?
A. Carbon monoxide
B. Tar
C. Cyanide
D. Carbon

Answer 128

D. Carbon

Question 129

CT-71) You respond to assist law enforcement with a​ 35-year-old male patient​ who, according to​ them, is​ "high as a​ kite." The patient is​ anxious, tachycardic, and angry. What condition do you​ suspect?
A. Cocaine overdose
B. Marijuana overdose
C. Alcohol overdose
D. GHB overdose

Answer 129

A. Cocaine overdose

Question 130

CT-72) The term poison is best described as any substance that can do which of the​ following?
A. Harm the body
B. Increase cellular activity
C. Depress the​ body's respirations
D. Deactivate nerve transmission

Answer 130

A. Harm the body