Chapter 20 Test Questions

Question 1

General management for a patient who has overdosed on a benzodiazepine includes:

A. administering 0.4 to 2 mg of naloxone, administering oxygen, and transporting.

B. maintaining airway patency, supporting ventilations as needed, and transporting.

C. inserting an oropharyngeal airway, administering oxygen, and transporting promptly.

D. inserting a multilumen airway, deferring IV therapy, and transporting without delay.

Answer 1

B. maintaining airway patency, supporting ventilations as needed, and transporting.

Question 2

Approximately 12 hours after eating at a restaurant with his wife, a 49-year-old male complains of blurred vision, severe weakness, and difficulty breathing. This patient’s clinical signs are MOST consistent with exposure to:

A. C botulinum

B. Salmonella

C. Toxoplasma

D. Listeria

Answer 2

A. C botulinum

Question 3

Upon entering the residence of a young female with a possible toxic exposure, you begin surveying the scene. Which of the following findings would provide you with the LEAST amount of information regarding the type of exposure?

A. An unpleasant odor in the residence

B. General condition of the living area

C. Presence of empty medication bottles

D. Needles or syringes in the residence

Answer 3

B. General condition of the living area

Question 4

Which of the following is consistent with a narcotic (opiate/opioid) toxidrome?

A. Hyperventilation, tachycardia, and agitation

B. Increased salivation, seizures, and dilated pupils

C. Respiratory depression, pinpoint pupils, and coma

D. Hyperthermia, dilated pupils, and blurred vision

Answer 4

C. Respiratory depression, pinpoint pupils, and coma

Question 5

The vast majority of all poisonings, intentional and unintentional, occur via:

A. injection.

B. inhalation.

C. ingestion.

D. absorption.

Answer 5

C. ingestion.

Question 6

You respond to the residence of a 39-year-old male who, according to his wife, is not acting right. Law enforcement has secured the scene prior to your arrival. As you assess the patient, you find that he is confused, has a fever, and is agitated. The patient’s wife states that he is an alcoholic and stopped drinking 2 days ago. In addition to assessing and managing his airway, you should be MOST concerned with the potential for:

A. seizures.

B. vomiting.

C. hypovolemia.

D. hyperglycemia.

Answer 6

A. seizures.

Question 7

Patients with cyanide poisoning often have breath odor that resembles:

A. camphor.

B. wintergreen.

C. bitter almonds.

D. acetone.

Answer 7

C. bitter almonds.

Question 8

What is the mechanism of action of activated charcoal when administered to a patient who has ingested a poisonous substance?

A. It directly counteracts the effects of the ingested substance.

B. It adsorbs the toxic substance and delays the digestive process.

C. It induces vomiting through the emetic effects that it possesses.

D. It absorbs the toxin and facilitates rapid digestion and excretion.

Answer 8

B. It adsorbs the toxic substance and delays the digestive process.

Question 9

The self-administration of licit or illicit substances in a manner that is not consistent with approved medical or social practice is called:

A. drug addiction.

B. substance abuse.

C. unintentional poisoning.

D. psychological dependence.

Answer 9

B. substance abuse.

Question 10

You and your partner are standing by at the scene of a structural fire when two firefighters carry a patient to you that they rescued from one of the rooms inside the house. The patient is not moving and has no obvious burns. You should:

A. apply 100% oxygen via a nonrebreathing mask and apply the pulse oximeter.

B. determine if the patient’s airway is patent and then assess ventilatory effort.

C. insert an advanced airway device and begin positive-pressure ventilation.

D. rapidly assess the patient for gross external bleeding and apply 100% oxygen.

Answer 10

B. determine if the patient’s airway is patent and then assess ventilatory effort.

Question 11

Which of the following signs or symptoms would you be LEAST likely to encounter during your assessment of a patient who has overdosed on a benzodiazepine?

A. Drowsiness

B. Combativeness

C. Slurred speech

D. Confusion

Answer 11

B. Combativeness

Question 12

Carbon monoxide (CO) causes severe tissue hypoxia because it:

A. obstructs the pulmonary capillary bed and prevents gas exchange.

B. causes anemia by destroying the body’s circulating red blood cells.

C. binds to the hemoglobin molecule and inhibits cellular oxygenation.

D. produces excess carbon dioxide when it binds to the red blood cells.

Answer 12

C. binds to the hemoglobin molecule and inhibits cellular oxygenation.

Question 13

Amphetamines and methamphetamines are examples of:

A. sympatholytics.

B. sympathomimetics.

C. anticholinergics.

D. parasympatholytics.

Answer 13

B. sympathomimetics.

Question 14

Which of the following statements regarding ethyl alcohol (ETOH) is correct?

A. ETOH dulls the sense of awareness and slows reflex times.

B. ETOH is associated with a relatively low incidence of suicide.

C. Acute ETOH intoxication often results in severe hyperglycemia.

D. ETOH results in profound CNS stimulation regardless of the dose.

Answer 14

A. ETOH dulls the sense of awareness and slows reflex times.

Question 15

A 47-year-old male ingested an unknown type of medication. After ensuring scene safety, you approach the patient and begin to assess him. Which of the following questions would be of LEAST pertinence with regard to the acute management of this patient?

A. “Why did you take the medication?”

B. “What kind of medication did you take?”

C. “Do you know how much you weigh?”

D. “When did you take the medication?”

Answer 15

A. “Why did you take the medication?”

Question 16

The presence of _____________ often contributes to the signs and symptoms of acute alcohol intoxication.

A. severe sepsis

B. ketoacidosis

C. hypoglycemia

D. epidural bleeding

Answer 16

C. hypoglycemia

Question 17

Which of the following medications will NOT respond to the administration of naloxone (Narcan)?

A. Cocaine

B. Fentanyl

C. Morphine

D. Oxycodone

Answer 17

A. Cocaine

Question 18

A 67-year-old female complains of nausea, vomiting, and abdominal pain that woke her from her sleep. As you and your partner enter her residence, you immediately note the smell of natural gas. Suspecting carbon monoxide toxicity, you quickly remove the patient from her home and place her in the ambulance. When assessing her, it is important to remember that:

A. a pulse oximetry reading that is high does not rule out significant hypoxemia.

B. hyperbaric oxygen must be given within 20 minutes in order to prevent death.

C. definitive airway management is the most effective treatment for her condition.

D. breathing room air will not eliminate any carbon monoxide from the bloodstream.

Answer 18

A. a pulse oximetry reading that is high does not rule out significant hypoxemia.

Question 19

In an attempt to kill herself, a 56-year-old female ingested a large quantity of Darvon. Your primary assessment reveals that she is semiconscious; has slow, shallow respirations; and a heart rate of 40 beats/min. Further assessment reveals that her BP is 80/50 mm Hg. Initial management for this patient includes:

A. assisted ventilation with a bag-mask device and 100% oxygen.

B. 100% oxygen via a nonrebreathing mask and suction as needed.

C. a large-bore IV and 20 mL/kg fluid boluses to increase her BP.

D. insertion of a King airway and hyperventilation with 100% oxygen.

Answer 19

A. assisted ventilation with a bag-mask device and 100% oxygen.

Question 20

A 40-year-old female with chronic anxiety finds that she requires more of her anti-anxiety medication in order to achieve the same effect. This is an example of:

A. addiction.

B. tolerance.

C. dependence.

D. potentiation.

Answer 20

B. tolerance.

Question 21

A 32-year-old male ingested a large quantity of Dilaudid, a powerful opiate. Which of the following clinical signs would you MOST likely encounter during your assessment?

A. Respiratory depression and hypotension

B. Slurred speech and combative behavior

C. Pupillary dilation and severe hypertension

D. Hyperventilation and excessive tachycardia

Answer 21

A. Respiratory depression and hypotension

Question 22

Which of the following clinical signs would suggest significant exposure to an anticholinergic substance?

A. Excessive salivation

B. Severe hypotension

C. Pupillary constriction

D. Profound tachycardia

Answer 22

D. Profound tachycardia

Question 23

Which of the following chemicals reacts violently and may ignite when they come into contact with water?

A. Chloride and calcium

B. Sodium and phosphorus

C. Calcium and magnesium

D. Potassium and bicarbonate

Answer 23

B. Sodium and phosphorus

Question 24

During your assessment of a 19-year-old male who has abused an unknown type of drug, you note severe deformity to his hand. The patient, who is very agitated, states that he bent his fingers back in an attempt to break them. This abnormal behavior is MOST consistent with the use of:

A. PCP.

B. LSD.

C. cocaine.

D. marijuana.

Answer 24

A. PCP.

Question 25

Which of the following signs or symptoms is MOST suggestive of organophosphate poisoning?

A. Urinary retention

B. Dry mouth and thirst

C. Excessive tachycardia

D. Excessive lacrimation

Answer 25

D. Excessive lacrimation

Question 26

Which of the following scenarios is an example of an intentional poisoning?

A. A 4-year-old male gets into the medicine cabinet and swallows approximately 10 sleeping pills.

B. A 24-year-old female sprays mace into the eyes of a perpetrator during a burglary attempt.

C. A 68-year-old female inadvertently takes too much of her high blood pressure medication.

D. A 40-year-old male is exposed to organophosphates after failing to wear the appropriate protective gear.

Answer 26

B. A 24-year-old female sprays mace into the eyes of a perpetrator during a burglary attempt.

Question 27

If you suspect that your patient has ingested a poisonous substance, you should:

A. transport the patient to the closest medical facility.

B. administer activated charcoal as soon as possible.

C. initiate emergency care and notify medical control.

D. call poison control for specific treatment guidelines.

Answer 27

C. initiate emergency care and notify medical control.

Question 28

A 65-year-old man takes two medications for two separate disorders, and notices that the effects he experiences are greater when he takes both medications but less when he only takes one of the medications. This is an example of:

A. potentiation.

B. habituation.

C. tolerance.

D. synergism.

Answer 28

D. synergism.

Question 29

With regard to substance abuse, tolerance is defined as a:

A. chronic disorder characterized by the compulsive use of a substance that results in physical or psychological harm.

B. physiologic adaptation to the effects of a drug such that increasingly larger doses are required to achieve the same effect.

C. physiologic state of adaptation to a drug, which is characterized by withdrawal symptoms if the drug is stopped.

D. predictable set of signs and symptoms that occurs after the abrupt cessation of a drug or after rapidly decreasing the dosage.

Answer 29

B. physiologic adaptation to the effects of a drug such that increasingly larger doses are required to achieve the same effect.

Question 30

A 6-year-old, 44-lb male ingested an unknown quantity of aspirin approximately 20 minutes ago. He is conscious and alert and has stable vital signs. The appropriate dose of activated charcoal for this child is:

A. 10 g.

B. 20 g.

C. 30 g.

D. 40 g.

Answer 30

B. 20 g.

Question 31

When caring for a patient who was exposed to a dry chemical, it is important to:

A. remove all contaminated clothing and brush away the chemical prior to irrigating.

B. flush the skin with running water and then wash the skin with soap and sterile water.

C. attempt to neutralize the chemical with baking soda if the chemical was a strong acid.

D. remove all contaminated clothing and then irrigate the affected area with sterile water.

Answer 31

A. remove all contaminated clothing and brush away the chemical prior to irrigating.

Question 32

When assessing a patient suspected of overdosing on cocaine, you must be especially alert for:

A. respiratory depression.

B. significant bradycardia.

C. profound hypotension.

D. cardiac dysrhythmias.

Answer 32

D. cardiac dysrhythmias.

Question 33

A 55-year-old male ingested a large quantity of bourbon whiskey. He is deeply unconscious and has slow, shallow breathing. His “drinking buddy” tells you that the patient frequently abuses alcohol. You should:

A. insert a King airway and hyperventilate him, start an IV and give a 20 mL/kg normal saline bolus, and transport.

B. insert a nasal airway, give high-flow oxygen via a nonrebreathing mask, assess his blood glucose level, and transport.

C. insert an oral airway, assist his ventilations, assess his blood glucose level, transport, and start an IV line en route.

D. administer oxygen via a nonrebreathing mask, request a paramedic unit to intubate him, and assess his blood glucose level.

Answer 33

C. insert an oral airway, assist his ventilations, assess his blood glucose level, transport, and start an IV line en route.

Question 34

A 40-year-old female presents with confusion, slurred speech, and tachycardia. Her blood pressure is low and her pupils are dilated. Which of the following medications has she MOST likely ingested?

A. Opiate

B. Barbiturate

C. Benzodiazepine

D. Tricyclic antidepressant

Answer 34

D. Tricyclic antidepressant

Question 35

Antidotes or reversal agents exist for all of the following drugs or chemicals, EXCEPT:

A. opiates/opoids.

B. acetaminophen.

C. acetylsalicylic acid.

D. organophosphates.

Answer 35

C. acetylsalicylic acid.

Question 36

When responding to the scene of a patient who has possibly overdosed on a drug, your primary responsibility is to:

A. notify law enforcement.

B. rapidly assess the patient.

C. identify the drug involved.

D. ensure that you are safe.

Answer 36

D. ensure that you are safe.

Question 37

Patients with acute alcohol withdrawal commonly need:

A. extended management in a psychiatric facility.

B. to be restrained in a laterally recumbent position.

C. injected insulin to treat associated hyperglycemia.

D. IV crystalloid fluid boluses to treat hypovolemia.

Answer 37

D. IV crystalloid fluid boluses to treat hypovolemia.

Question 38

Severe aspirin toxicity would MOST likely cause:

A. metabolic acidosis.

B. metabolic alkalosis.

C. respiratory acidosis.

D. respiratory alkalosis.

Answer 38

A. metabolic acidosis.

Question 39

You should NOT administer emergency care to a patient who inhaled a toxic substance until:

A. an antidote, if available, has been given.

B. he or she has been properly decontaminated.

C. you have assessed his or her oxygen saturation.

D. it has been determined how the exposure occurred.

Answer 39

B. he or she has been properly decontaminated.

Question 40

You are assessing a patient who has self-injected an unknown substance. He is unconscious with rapid, shallow breathing and tachycardia. As you are assessing and treating this patient, it is important to note that:

A. he has most likely injected himself with an opiate.

B. injected toxins are slowly absorbed into the body.

C. cocaine is the single most commonly injected drug.

D. it is impossible to dilute or remove injected poisons.

Answer 40

D. it is impossible to dilute or remove injected poisons.

Question 41

A 20-year-old female, who is a known IV drug abuser, has overdosed on heroin. Your assessment reveals that she is semiconscious, bradycardic, and hypotensive. Her respirations are slow and shallow. As your partner is assisting her ventilations, you should start an IV and give:

A. 20 mL/kg boluses of normal saline to raise her BP.

B. 50 mL of 50% dextrose to rule out hypoglycemia.

C. 1 mg of glucagon to raise her blood glucose level.

D. 0.4 mg of naloxone, followed by a reassessment.

Answer 41

D. 0.4 mg of naloxone, followed by a reassessment.

Question 42

You are dispatched to the residence of a 30-year-old female who complains of severe weakness and vomiting. During your assessment, you note that she is incontinent of urine, has copious oral secretions, and is tearing. Her BP is 88/58 mm Hg, pulse is 40 beats/min and weak, and respirations are 24 breaths/min with adequate depth. You should suspect:

A. severe food poisoning.

B. organophosphate poisoning.

C. methamphetamine overdose.

D. that she has abused cocaine.

Answer 42

B. organophosphate poisoning.