Quiz 16 - Neurologic and Toxicology Flashcards
A 56-year-old diabetic woman presents with numbness and tingling to both of her hands that have gradually intensified over the past few weeks. Your assessment reveals stable vital signs, adequate breathing, and a blood glucose level of 190 mg/dL. The cardiac monitor reveals a normal sinus rhythm. The patient tells you that she has eaten but has not taken her insulin yet. You should:
A. assist her with her prescribed insulin to lower her blood glucose.
B. advise her to take ibuprofen and to follow up with her physician.
C. provide supportive care and safely transport her to the hospital.
D. conclude that she has peripheral neuropathy and give her fentanyl.
C. provide supportive care and safely transport her to the hospital.
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 to 60 beats/min. You should:
A. administer high-flow oxygen, monitor her oxygen saturation, begin transport, and start an IV line en route to the hospital.
B. assist her ventilations with a bag-mask device, start an IV line, administer 0.5 mg of atropine, and transport.
C. conclude that she was unknowingly administered a narcotic analgesic, start an IV line, and give her 2 mg of naloxone.
D. give her supplemental oxygen, conduct a secondary assessment at the scene to collect evidence, and transport her.
A. administer high-flow oxygen, monitor her oxygen saturation, begin transport, and start an IV line en route to the hospital.
Common signs and symptoms of a cerebral abscess include:
A. an absence of fever, severe localized headache, and vomiting without nausea.
B. high-grade fever, persistent localized headache, confusion, and focal impairment.
C. paralysis below the waist, high fever, a diffuse headache, and slurred speech.
D. hemiplegia, low-grade fever, hyperactivity, and a diffuse stabbing headache
B. high-grade fever, persistent localized headache, confusion, and focal impairment.
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:
A. QRS widening.
B. a prolonged PR interval.
C. AV heart block.
D. QT interval narrowing.
A. QRS widening.
For any patient with an increase in intracranial pressure, the paramedic must:
A. maintain an adequate blood pressure.
B. avoid administering IV fluid boluses.
C. give glucose to prevent hypoglycemia.
D. take measures to lower blood pressure.
A. maintain an adequate blood pressure.
Severe salicylate toxicity produces:
A. bradypnea.
B. metabolic acidosis.
C. increased pH levels.
D. respiratory acidosis.
B. metabolic acidosis.
You are dispatched to a local pharmacy, where a 24-year-old woman experienced an apparent seizure. During your assessment, you note that the patient is conscious but combative. The patient’s supervisor states that she has a history of seizures and takes Tegretol. The patient’s blood pressure is 146/90 mm Hg, pulse rate is 110 beats/min and regular, and respirations are 24 breaths/min with adequate depth. The MOST appropriate treatment for this patient includes:
A. giving her high-flow oxygen, inserting an IO catheter in her proximal tibia, transporting, and observing for further seizure activity.
B. establishing vascular access, administering diazepam or lorazepam to reduce her combativeness, and transporting to the closest hospital.
C. administering oxygen as tolerated, establishing an IV line, padding the rails of the ambulance cot, and transporting without lights and siren.
D. administering oxygen, restraining her to protect her from further injury, placing a bite block in her mouth in case she seizes again, and transporting.
C. administering oxygen as tolerated, establishing an IV line, padding the rails of the ambulance cot, and transporting without lights and siren.
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 markedly 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:
A. begin a dopamine infusion at 10 μg/kg/min and titrate as needed.
B. instruct your partner to hyperventilate the patient at 24 breaths/min.
C. give her up to 10 mg of naloxone to reverse the effects of the drug.
D. administer crystalloid fluid boluses to improve her blood pressure.
D. administer crystalloid fluid boluses to improve her blood pressure.
The foxglove plant contains ______________ and can result in ______________ when it is ingested.
A. lantadene A, renal failure
B. caladium oxalate crystals, bradycardia
C. solanine, severe gastroenteritis
D. cardiac glycosides, dysrhythmias
D. cardiac glycosides, dysrhythmias
The MOST common sign of an infectious disease is the presence of
A. seizures.
B. a fever.
C. tachycardia.
D. a headache.
B. a fever.
A 29-year-old man, who was recently prescribed an antipsychotic medication, presents with an acute onset of bizarre contortions of the face. Treatment should include:
A. ondansetron, 4 mg.
B. diphenhydramine, 25 mg.
C. diazepam, 5 mg.
D. promethazine, 25 mg.
B. diphenhydramine, 25 mg.
Alcohol potentiates Valium. This means that:
A. alcohol enhances the effects of Valium.
B. Valium makes alcohol a toxic substance.
C. alcohol antagonizes the effects of Valium.
D. the use of alcohol negates the use of Valium.
A. alcohol enhances the effects of Valium.
Which of the following cardiac medications has a small therapeutic window and the GREATEST propensity to reach toxic levels?
A. Lisinopril
B. Cardizem
C. Digoxin
D. Vasotec
C. Digoxin
If you are treating a patient with a suspected benzodiazepine overdose and find that the patient is hypotensive, bradycardic, and comatose:
A. you should consider concomitant overdose with another CNS depressant.
B. you should rapidly administer 2 mg of naloxone via the IV, IO, or IM route.
C. avoid administering flumazenil and transport the patient immediately.
D. it is likely that the patient is also under the influence of methamphetamine.
A. you should consider concomitant overdose with another CNS depressant.
Any sympathomimetic drug will cause:
A. hypothermia.
B. hallucinations.
C. tachycardia.
D. ataxia.
C. tachycardia.
You are dispatched to a residence for a 61-year-old woman with flu-like 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:
A. immediately open all of the windows in the house.
B. carefully assess the residence for any unusual findings.
C. suspect that both patients have been exposed to cyanide.
D. remove both patients from the residence at once.
D. remove both patients from the residence at once.
Common signs and symptoms of a tricyclic antidepressant overdose include:
A. altered mental status and tachycardia.
B. excessive salivation and diarrhea.
C. constricted pupils and AV heart block.
D. tachypnea and severe hypertension.
A. altered mental status and tachycardia.
A patient with suspected meningitis involuntarily flexes her knees when her head is flexed toward her chest. This is called:
A. Kernig sign.
B. Cullen sign.
C. Grey Turner sign.
D. Brudzinski sign.
D. Brudzinski sign.
Applying pressure to the supraorbital foramen of a patient with a neurologic insult is intended to:
A. elicit a response to painful stimuli.
B. determine if the spinal cord is intact.
C. assess for an orbital skull fracture.
D. stimulate the vagus nerve.
A. elicit a response to painful stimuli.
Among other functions, the medulla oblongata:
A. directly regulates body temperature.
B. communicates with the pituitary gland.
C. sends messages to move skeletal muscles.
D. controls blood pressure and heart rate.
D. controls blood pressure and heart rate.
