Chapter 21

Front 1

Most cases of accidental poisoning involve which of the following?

Back 1

Young children

Front 2

Which of the following is NOT part of the treatment for a 15-year-old female who has swallowed drain cleaner?

Back 2

Administer activated charcoal. Page Ref: 579Objective: 21.5

Front 3

Which of the following is a trade name for activated charcoal?

Back 3

Actidose

Front 4

Volatile chemicals are agents that are able to change easily from a ________ form to a ________ form.

Back 4

liquid; gas

Front 5

Which of the following is a sign or symptom of withdrawal from alcohol?

Back 5

All of theseCORRECT. Signs of alcohol withdrawal include: confusion and restlessness; unusual behavior, to the point of demonstrating insane behavior; hallucinations; gross tremor (obvious shaking) of the hands; profuse sweating; seizures (common and often very serious); hypertension; and tachycardia.

Front 6

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?

Back 6

The patient is suffering from alcohol withdrawal.CORRECT. Signs of alcohol withdrawal include: confusion and restlessness; unusual behavior, to the point of demonstrating insane behavior; hallucinations; gross tremor (obvious shaking) of the hands; profuse sweating; seizures (common and often very serious); hypertension; and tachycardia. This patient is suffering from a chronic condition and not an acute issue like alcohol poisoning from overdrinking, or the drinking of antifreeze, mouthwash or other substance to maintain an inebriated state.

Front 7

By definition, a systemic poison causes harm to which of the following?

Back 7

Entire body Page Ref: 576Objective: 21.1

Front 8

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?

Back 8

Grandfather's name and the name of the physician who prescribed the medicationCORRECT. Which physician prescribed the medication and the grandfather's name is of no consequence in this scenario to deliver adequate patient care at the EMT level.

Front 9

The opiate triad includes all of the following except:

Back 9

hypertension.CORRECT. The opiate triad is characterized by three signs: coma (or depressed level of consciousness), pinpoint pupils, and respiratory depression (slow, shallow respirations). Hypertension is not part of the opiate triad.

Front 10

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?

Back 10

GHB overdoseCORRECT. The patient most likely had consumed an alcoholic beverage that someone slipped a date rape drug into such as GHB. Patients who consume GHB will have hallucinations and will have central nervous system depression to the point of respiratory arrest. Seizure-like twitches are possible with severe hypoxia.

Front 11

Which of the following conditions can mimic the signs of alcohol intoxication?

Back 11

All of theseCORRECT. Diabetes, epilepsy, head injuries, high fevers, hypoxia, and other medical problems may make the patient appear to be intoxicated when he is not.

Front 12

Which of the following is NOT a way in which poisons can access the body?

Back 12

RadiationCORRECT. Poisons can be classified into four types, according to how they enter the body: ingested, inhaled, absorbed, and injected. Radiation is not one of the ways in which poisons enter the body.

Front 13

Your patient is a 48-year-old male who has n exposed to a toxic powder that can be absorbed through the skin. Which of the following measures should be taken by the EMT?

Back 13

Brush off the powder and flush the patient's skin with copious amounts of water.

CORRECT. Emergency care of a patient with absorbed poisons includes the following steps:1. Detect and treat immediately life-threatening problems in the primary assessment. Evaluate the need for prompt transport of critical patients.2. Perform a secondary assessment; obtain vital signs. This includes removing contaminated clothing while protecting oneself from contamination.3. Remove the poison by doing one of the following:∙ Powders. Brush powder off the patient and then continue as for other absorbed poisons.∙ Liquids. Irrigate with clean water for at least 20 minutes and continue en route if possible.∙ Eyes. Irrigate with clean water for at least 20 minutes and continue en route if possible. A copious amount of water implies massive amounts of water after the powder is brushed off first. The water is applied to the skin where the powder made contact with it.

Front 14

Which of the following is a substance that will neutralize a poison or its effects?

Back 14

AntidoteCORRECT. An antidote is a substance that will neutralize the poison or its effects.

Front 15

By what route does nitroglycerin spray enter the body?

Back 15

AbsorptionCORRECT. Even though the medication is in spray form, it is not inhaled but absorbed under the tongue in the oral mucosa, so it is referred to as sublingual, which means under the tongue. Nitroglycerin is also a medication that is absorbed through the skin in spray, tablet, or paste form so caution must be used by the EMT assisting a patient in taking a prescribed dosage of medical control approved nitroglycerine.

Front 16

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?

Back 16

All of theseCORRECT. Neutralizing acids or alkalis with solutions such as dilute vinegar or baking soda in water should not be done. When incidents like these occur, such substances are almost never readily available. Even if they were, they would not be appropriate. They have never been shown to help, and there is good reason to believe they would make matters worse. When an acid is mixed with an alkali, it is true that the two may be neutralized. It is also true, though, that this reaction produces heat. Skin that has been injured already by an acid or alkali may be further damaged by attempts to neutralize the chemical.

Front 17

Which of the following describes any substance produced by a living organism that is poisonous to human beings?

Back 17

Toxin

CORRECT. A toxin, a substance that is poisonous to humans. For example, some mushrooms and other common plants can be poisonous if eaten. These include some varieties of house plants, including the rubber plant and certain parts of holiday plants such as mistletoe and holly berries. In addition, bacterial contaminants in food may produce toxins, some of which can cause deadly diseases (such as botulism).

Front 18

Your patient is a 3-year-old male with a stoma who 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?

Back 18

Have the patient drink one glass of milk. Page Ref: 581Objective: 21.6

Front 19

Which of the following is one of the MOST common inhaled poisons associated with fire suppression?

Back 19

Carbon monoxideCORRECT. Carbon monoxide (CO) is one of the most commonly inhaled poisons. It is usually associated with motor-vehicle exhaust and fire suppression.

Front 20

Which of the following statements regarding syrup of ipecac is NOT true?x

Back 20

It has an immediate action.CORRECT. Ipecac is an orally administered drug that causes vomiting in most people with just one dose, but it sometimes takes an additional dosage. When vomiting occurs, it results, on the average, in removal of less than one-third of the stomach contents. Because ipecac is slow, is relatively ineffective, and has the potential to make a patient aspirate vomitus, it is rarely used today.

Front 21

Carbon monoxide poisoning should be suspected when a patient has n in an enclosed area and has which of the following signs and/or symptoms?

Back 21

Headache, dizziness, and nauseaFlu-like symptomsVomiting and altered mental statusAll of thesePage Ref: 587Objective: 21.4

Front 22

Barbiturates may be referred to as which of the following?

Back 22

DownersCORRECT. Downers, such as barbiturates, have a depressant effect on the central nervous system. This type of drug may be used as a relaxing agent, sleeping pill, or tranquilizer.

Front 23

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?

Back 23

All of theseCORRECT. Chronic drinkers (alcoholics) often have derangements in blood sugar levels, poor nutrition, the potential for considerable gastrointestinal bleeding, and other problems. A person can be both intoxicated and having a heart attack or hypoglycemia. The chronic alcoholic is prone to experiencing subdural hematomas from falls and blows to the head associated with the alcohol abuse. If the patient has ingested alcohol and other drugs, this can produce a serious medical emergency.

Front 24

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?

Back 24

HeroinCORRECT. Illegal narcotics such as heroin are also commonly abused. Heroin is often injected into a vein. Other narcotics are typically in pill form. Narcotic overdoses are generally characterized by three signs: coma (or depressed level of consciousness), pinpoint pupils, and respiratory depression (slow, shallow respirations). Together, these are sometimes referred to as the opiate triad.

Front 25

Gamma-hydroxybutyrate (GHB) is an example of which of the following types of drugs?

Back 25

DepressantCORRECT. A downer (depressant) you may see is GHB (gamma-hydroxybutyrate), also known as Georgia Home Boy or goop. In addition to depressing the central nervous system, it produces a sense of euphoria and sometimes hallucinations. It has caused respiratory depression so severe that patients have required assisted ventilations even though some of them were still breathing.

Front 26

The term poison is BEST described as any substance that can do which of the following?

Back 26

Harm the bodyCORRECT. Once on or in the body, poisons can do damage and harm the body in a variety of ways. A poison may act as a corrosive or irritant, destroying skin and other body tissues. A poisonous gas can act as a suffocating agent, displacing oxygen in the air. Some poisons are systemic poisons, causing harm to the entire body or to an entire body system.

Front 27

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?

Back 27

Volatile chemicalsCORRECT. Volatile chemicals produce vapors that can be inhaled. They can give an initial rush and then act as a depressant on the central nervous system. Cleaning fluid, glue, model cement, and solutions used to correct typing mistakes are commonly abused volatile chemicals. These chemicals will make the patient experience a numb feeling. Inhalation of a volatile chemical will also produce headache and possible chest pain. GHB, methamphetamines, and CO poisonings would not cause swollen mucous membranes and numbness like a volatile chemical would.

Front 28

Regarding activated charcoal, which of the following is NOT true?It is an antidote to many poisons.

Back 28

CORRECT. Activated charcoal is not an antidote for any specific poison.

Front 29

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?

Back 29

What medication did she take? Page Ref: 578Objective: 21.4

Front 30

Cleaning fluid, glue, and model cement are common examples of which of the following

Back 30

Volatile chemicalsCORRECT. Volatile chemicals produce vapors that can be inhaled. They can give an initial rush and then act as a depressant on the central nervous system. Cleaning fluid, glue, model cement, and solutions used to correct typing mistakes are commonly abused volatile chemicals.

Front 31

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?

Back 31

Delirium tremensCORRECT. The patient is a known alcoholic who has been incarcerated for 48 hours and thus is unable to obtain any alcohol. This history-along with his signs and symptoms of altered mental status, hallucinations, unusual behavior, and seizure-is the classic presentation of delirium tremens.

Front 32

Which of the following is a common sign and symptom in poisonings of all types?

Back 32

Nausea and vomitingCORRECT. Nausea and vomiting are two of the most common results of all kinds of poisoning. When a poison is ingested you may also find altered mental status, abdominal pain, diarrhea, chemical burns around the mouth, and unusual breath odors. With inhaled poisons, find out if the patient is having difficulty breathing, chest pain, coughing, hoarseness, dizziness, headache, confusion, seizures, or altered mental status.

Front 33

Which of the following substances may be ordered by medical control to dilute a poison?

Back 33

Milk or waterCORRECT. Occasionally, medical direction will give an order for dilution of a poisonous substance. This means an adult patient should drink one to two glasses of water or milk, whichever is ordered. A child should typically be given one-half to one full glass. Dilution with water may slow absorption slightly, whereas milk may soothe stomach upset.

Front 34

How does carbon monoxide cause toxic effects?

Back 34

Prevents red blood cells from carrying oxygen Page Ref: 587Objective: 21.3

Front 35

Which of the following is the BEST initial intervention for a patient who has inhaled a poison?

Back 35

Provide a patent airway, ventilation, and high-concentration oxygen.CORRECT. The principal prehospital treatment of inhaled poisoning consists of maintaining the airway and supporting respiration. In the case of inhaled poisoning, oxygen is a very important drug. Some inhaled poisons prevent the blood from transporting oxygen in the normal manner. Some prevent oxygen from getting into the bloodstream in the first place. In either case, your ability to keep the airway open, ventilate as needed, and give high-concentration oxygen may make the difference in the patient's survival and quality of life.

Front 36

Which of the following is LEAST often seen in carbon monoxide poisoning?

Back 36

Cherry red lips CORRECT. There is a commonly accepted idea that a patient exposed to carbon monoxide will have cherry red lips. In fact, cherry red skin is NOT typically seen in patients with carbon monoxide poisoning.

Front 37

When a substance enters the body through unbroken skin, it has entered the body by which of the following routes?

Back 37

AbsorptionCORRECT. 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 and then be slowly absorbed into body tissues and the bloodstream, possibly causing widespread damage. Others are absorbed into the bloodstream without injuring the skin.

Front 38

Which patient would most likely benefit from the administration of activated charcoal?

Back 38

14-year-old female who overdoses on her grandfather's cardiac medicationCORRECT. The use of activated charcoal is limited to ingestions of solid substances where adsorption may be beneficial.

Front 39

Which patient would MOST likely benefit from the administration of activated charcoal?

Back 39

Alert 16-year-old female who overdosed on Tylenol®CORRECT. The alert 16-year-old female who overdosed on Tylenol will most likely benefit from administration of activated charcoal.

Front 40

Carbon monoxide poisoning occurs by which of the following routes?

Back 40

InhalationCORRECT. Inhaled poisons (poisons that are breathed in) take the form of gases, vapors, and sprays. Such poisons include carbon monoxide (from car exhaust, wood-burning stoves, and furnaces), ammonia, chlorine, insect sprays, and the gases produced from volatile liquid chemicals.

Front 41

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?

Back 41

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

CORRECT. Poisons such as insecticides and agricultural chemicals may be absorbed through the skin of anyone coming in contact with them. Many of these chemicals are considered organophosphates, which causes overstimulation of the parasympathetic nervous system. Since EMT safety is a critical part of all calls, do not hesitate to ask for assistance with any patient who appears exposed to an absorbed agricultural chemical and maintain a safe distance from the substance and any patients until properly trained responders mitigate the incident.

Front 42

Which of the following types of drugs may induce sleep or stupor?

Back 42

Both Tranquilizers and Narcotics Page Ref: 594-596Objective: 21.11

Front 43

OxyContin is an example of which of the following types of drugs?

Back 43

NarcoticCORRECT. Narcotics are drugs capable of producing stupor or sleep. They are often used to relieve pain. Many drugs legitimately used for these purposes (such as codeine) are also abused, affecting the nervous system and changing many of the normal activities of the body, often producing an intense state of relaxation or feeling of well-being. One narcotic, in particular, OxyContin (oxycodone), has become a common drug of abuse.

Front 44

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?

Back 44

Administer activated charcoal.CORRECT. Activated charcoal works through adsorption, the process of one substance becoming attached to the surface of another. In contrast to ordinary charcoal, which adsorbs some substances, activated charcoal has been manufactured to have many cracks and crevices. As a result, activated charcoal has an increased amount of surface available for poisons to bind to.

Front 45

Which of the following is the cause of the black residue found in a patient's mouth and nose following smoke inhalation?

Back 45

CarbonCORRECT. The following signs indicate an airway injured by smoke inhalation: difficulty breathing; coughing; breath that has a smoky smell or the odor of chemicals involved at the scene; black (carbon) residue in the patient's mouth and nose; black residue in any sputum coughed up by the patient; and nose hairs singed from superheated air.

Front 46

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:

Back 46

Why did you eat the mushroom?CORRECT. The fact that the patient took the drug on a dare or for any other reason for that matter is irrelevant for the EMT to deliver good patient care. The presence of peer pressure as well if the patient knows the mushrooms are poisonous or not does not play into the EMT being able to deliver good patient care.

Front 47

Which of the following is the MOST important means of managing a patient who has inhaled a poison, after the airway has been established?

Back 47

High concentrations of oxygenCORRECT. The principal prehospital treatment of inhaled poisoning consists of maintaining the airway and supporting respiration. In the case of inhaled poisoning, oxygen is a very important drug. Some inhaled poisons prevent the blood from transporting oxygen in the normal manner. Some prevent oxygen from getting into the bloodstream in the first place. In either case, your ability to keep the airway open, ventilate as needed, and give high-concentration oxygen may make the difference in the patient's survival and quality of life.

Front 48

Which of the following MOST affects the extent of damage a poison does to the body?

Back 48

Patient's age, weight, and general healthCORRECT. The actual effect and extent of damage is dependent on the nature of the poison, on its concentration, and sometimes on how it enters the body. These factors vary in importance depending on the patient's age, weight, and general health.

Front 49

Which of the following is NOT true concerning a patient's reaction to toxic gas exposure?

Back 49

If the patient is treated immediately, there will be no long-term effects.CORRECT. These patients need immediate medical evaluation because they have serious long-term effects and consequences, including neurological deficits, from their exposure, despite the most definitive care. The patients may experience long-term effects from exposure.

Front 50

Which of the following is an injury that commonly occurs in alcoholic patients with even minor falls and blows to the head?

Back 50

Subdural hematomaCORRECT. A chronic alcoholic is prone to subdural hematomas, which is bleeding between the dura mater and brain due to balance issues associated with drinking and the frailty of the blood vessels in the head due to alcoholism. Be especially careful of patients with even minor head injuries, since subdural hematoma is common in alcoholics.

Front 51

Which of the following is the immediate toxic effect of alcohol?

Back 51

Central nervous system depressionCORRECT. Many persons consume alcohol without having any problems. However, others occasionally or chronically abuse alcohol. Even though adults can legally drink alcohol, it is still a drug that can have a potent depressive effect on a person's central nervous system. Emergencies arising from the use of alcohol may be due to the effect of alcohol that has just been consumed, or it may be the result of the cumulative effects of years of alcohol abuse.

Front 52

how much wood would a wood chuck chuck if a wood chuck could chuck wood?

Back 52

duh, purple

Front 53

You are called to a farm for a possible organophosphate poisoning of one of the workers. Your first action is to:

Back 53

call for specialized hazardous materials units.CORRECT. The patient is potentially covered with a hazardous and poisonous material. Calling for a specialized hazardous materials unit that has the training and resources to properly decontaminate the patient is the best first action.

Front 54

Which of the following would LEAST likely indicate that an emergency is due to drugs or alcohol?

Back 54

Unresponsive patient with unequal pupilsCORRECT. It is important to determine whether the patient is suffering from a medical condition or the effects of drugs and/or alcohol. Many medical conditions can mimic the effect of drugs and alcohol. Search the area immediately around the patient for evidence of drug or alcohol use. An unresponsive patient who has unequal pupils is likely suffering from a structural problem (head injury, stroke, tumor) within the cranium, not a drug- or alcohol-related problem

Front 55

Which of the following effects may occur due to chronic abuse of alcohol?

Back 55

Abnormal blood sugar levelsPoor nutritionPotential for gastrointestinal bleedingAll of theseCORRECT. Chronic drinkers (alcoholics) often have derangements in blood sugar levels, poor nutrition, the potential for considerable gastrointestinal bleeding, and other problems. A person can be both intoxicated and having a heart attack or hypoglycemia. If the patient has ingested alcohol and other drugs, this can produce a serious medical emergency.

Front 56

Q: What does a nosey pepper do?

Back 56

A: Gets jalapeno business!

Front 57

Why would an EMT give activated charcoal to a patient who overdosed on the medication Soma?

Back 57

Activated charcoal binds to the Soma, preventing absorption by the body.CORRECT. Activated charcoal is designed to chemically bind to the poison in order to prevent and minimize the absorption of the poison by the body.

Front 58

A patient has a dry powder poison covering both upper extremities and chest. You should:

Back 58

brush the powder off and irrigate the contaminated area with large amounts of water.CORRECT. Dry powders should be brushed off before the area is irrigated. Many chemicals are inactive in the powder form but are active, or become more activated, when they come in contact with water, creating a reaction that increases the heat and extends the burn. Once the powder has been brushed off, irrigate the area with large (copious) amounts of water.

Front 59

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?

Back 59

Cocaine overdoseCORRECT. The patient is tachycardic. GHB, marijuana, and alcohol are all downers. They would not cause tachycardia. Cocaine is the only choice that causes tachycardia.

Front 60

You are called to the scene of a 14-year-old female patient who is unresponsive. Her mother states she has n 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:

Back 60

suction the patient's airway.CORRECT. The patient is unresponsive with emesis. Before any airway or oxygen will be effective, the patient's airway must first be cleared of any obstruction. The emesis must be suctioned.

Front 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?

Back 61

Who do these sleeping pills belong to?CORRECT. It is important in the case of ingestion of pills to ascertain how many pills the patient has taken along with the time duration over which the pills were taken in minutes or hours. It is also important for the EMT to figure out if anyone else has previously tried any treatments for the patient prior to EMS arrival. Where the patient got the sleeping pills from and who the pills belong to are irrelevant facts for the EMT delivering patient care.

Front 62

What is the most important treatment for a patient who has inhaled a poison?

Back 62

Administer high-concentration oxygen.

CORRECT. The single most important treatment for inhaled poisons is high-concentration oxygen.

Front 63

Signs and symptoms of alcohol abuse include all of the following except:

Back 63

an acetone or ketone odor to the breath.Page Ref: 592-593Objective: 21.10

Front 64

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 accidentally overdosed on her medications. Do you agree or disagree

Back 64

Agree. The vital signs agree with this hypothesis.CORRECT. The patient is normally hypertensive and tachycardic and must take medicines to regulate these conditions. If her vital signs were from a broken humerus, we would expect her pulse to be normotensive or tachycardic, not bradycardic. It is more likely that the patient fell and broke her arm from a syncopal episode secondary to the bradycardia. There is no evidence in the question that she is suicidal or depressed. Living alone does not automatically mean one is lonely. If the patient had not taken her medications, she would be tachycardic and hypertensive. In fact, she is profoundly hypotensive and bradycardic. The most logical answer is that she accidentally overdosed on her medications, resulting in the heart rate and blood pressure dropping to unhealthy levels.

Front 65

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?

Back 65

Refuse the order and explain why. CORRECT. Occasionally, medical direction will give an order for dilution of a poisonous substance. This means an adult patient should drink one to two glasses of water or milk, whichever is ordered. A child should typically be given one-half to one full glass. However, because the patient has an altered mental status, the patient should receive nothing by mouth because he may aspirate. In this instance you should question the order from medical direction.

Front 66

Which of the following groups is the most susceptible to the effects of a poison?

Back 66

ElderlyCORRECT. For most poisonous substances, the reaction is far more serious in the ill, the very young, and the elderly.

Front 67

what do you call a fake noodle?

Back 67

an impasta!

Front 68

A patient who has abused "uppers" will display which of the following signs and symptoms?

Back 68

Excessive talkativeness, dilated pupils, and dry mouthCORRECT. Uppers are stimulants that affect the nervous system and excite the user. Many abusers use these drugs in an attempt to relieve fatigue or to create feelings of well-being. Examples are caffeine, amphetamines, and cocaine. Cocaine may be snorted, smoked, or injected. Other stimulants are frequently taken in pill form. Also included in this category are so-called bath salts. These are synthetic drugs that have very potent stimulant effects and sometimes hallucinogenic effects as well.

Front 69

What clinical finding is MOST suggestive of an inhaled poison?

Back 69

Black-colored sputum Page Ref: 588Objective: 21.7

Front 70

Why should an EMT utilize a local poison control center in managing a poisoning patient?

Back 70

They can assist in finding out important information about the poison.CORRECT. A poison control center does not remove the need for an EMT to train for poisonings nor does it remove any liability from the EMT. Poison control centers do not have specialty teams that can be activated to treat patients. Poison control centers have immediate access to huge databases that contain detailed information on thousands of poisons. They can provide important information on poison-specific antidotes or treatment guidelines.

Front 71

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?

Back 71

Perform a rapid physical examination of the patient.CORRECT. The patient is unresponsive. Although an overdose is suspected, you must not get tunnel vision that this is the only possibility. You must take the time to rule out any other possibilities. You must perform a rapid physical exam after correcting issues with the airway, breathing, and circulation, then look for any other life-threatening injuries whenever the patient is unresponsive.

Front 72

penis.

Back 72

yup

Front 73

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?

Back 73

Contact medical control.CORRECT. The top priority in this patient after maintaining an adequate airway is to consult with medical control for further definitive steps to take in the patient care treatment of this patient.

Front 74

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:

Back 74

carbon monoxide poisoning.CORRECT. Given the cold weather and multiple patients, it is most likely that the campers are overcome by carbon monoxide poisoning. Carbon monoxide poisoning occurs in camping when campers leave on gas heaters in enclosed spaces such as campers and tents that do not get adequate ventilation.

Front 75

When a poison attaches to the chemical structure of activated charcoal, which of the following BEST describes this mechanism of action?

Back 75

Adsorption Page Ref: 579Objective: 21.6

Front 76

Smoke inhalation can result in all of the following except:

Back 76

lung contusion.CORRECT. Smoke inhalation is a serious problem associated with fire scenes. Smoke inhalation is often associated with thermal burns as well as with the effects of chemical poisons within the smoke. The smoke from any fire source contains many poisonous substances. Modern building materials and furnishings often contain plastics and other synthetics that release toxic fumes when they burn or are overheated. It is possible for the substances found in smoke to burn the skin, irritate the eyes, injure the airway, cause respiratory arrest, and, in some cases, cause cardiac arrest. Lung contusion is bruising of the lung tissues caused by blunt force trauma to the chest cavity.

Front 77

The drug ecstasy is classified as what type of drug?

Back 77

HallucinogenCORRECT. Hallucinogens such as LSD, PCP, and certain types of mushrooms are mind-affecting drugs that act on the nervous system to produce an intense state of excitement or a distortion of the user's perceptions. This class of drugs has few legal uses. They are often eaten or dissolved in the mouth and absorbed through the mucous membranes. A newer hallucinogen is ecstasy, also known as XTC, X, or MDMA (because it is methylenedioxymethamphetamine). Often taken at rave parties with other drugs, this hallucinogen also has the stimulant properties of uppers.

Front 78

Your patient is a 2-year-old conscious male who has swallowed a small quantity of bleach. Which of the following findings should you evaluate the patient for?

Back 78

Irritation in and around the mouthCORRECT. Mild exposure to bleach can result in coughing, eye irritation, and sore throat. Common signs and symptoms include a liquid or powder (bleach) on the patient's skin, burns, itching, irritation, and redness. A small quantity of bleach being ingested will not cause dilated pupils, irregular pulse, and respiratory depression.

Front 79

When a chemical substance is taken for reasons other than therapeutic use, this action is called:

Back 79

substance abuse.CORRECT. Substance abuse is a term that indicates a chemical substance is being taken for other than therapeutic (medical) reasons.