Deck 22: Toxicologic Emergencies

Question 1

Regarding poisonings, the EMT recognizes which of the following as true?

A) A poison is any substance that impairs a person's health by its chemical action.
B) All toxins are poisonous when in contact with the human body.
C) The majority of poisonings are intentional and result in homicide or suicide.
D) The number one cause of poisoning in the United States is medications.

Answer 1

A

Question 2

You have been called for a 13-year-old boy who was caught sniffing glue by his parents. The boy is lethargic and confused and complaining of "burning" in his mouth and nose, as well as nausea and vomiting. Based on the clinical presentation and mechanism of illness, how has this poison affected the boy's brain?

A) Absorbing through the small intestine into the bloodstream and then on to the brain
B) Directly contacting the brain by crossing the mucous membranes of the mouth and nose
C) Crossing from the lungs into the bloodstream and then circulating to the brain
D) Absorbing fumes through the skin, nose, and eyes and then on to the brain

Answer 2

C

Question 3

A 31-year-old female was stung by a hornet while golfing. Your assessment reveals her to be confused with stridorous respirations. Her skin is warm and flushed and covered with hives. A stinger is located on the back of her neck. Based on this information, the EMT would recognize that the route of poisoning suffered by this patient would be:

A) absorption.
B) anaphylactic.
C) topical.
D) injection.

Answer 3

D

Question 4

A 44-year-old patient was found unresponsive at home. Based on his mental status and the fact that he was burning a kerosene heater in an enclosed room, you suspect carbon monoxide poisoning. Based on this information, which route of exposure would the EMT recognize as responsible for the poisoning?

A) Nasal-oral
B) Inhalation
C) Ingestion
D) Absorption

Question 5

You have assessed a 25-year-old female who states that she took a large amount of antidepressants and other medications in an effort to end her life. The primary assessment reveals no life-threatening conditions. Why is it important to get her medical history at this time, rather than later on in the assessment or during transport?

A) Patients are generally scared early on and more truthful with information.
B) Further assessment may not be needed if there is no past medical history.
C) The police on scene will need the information prior to transport from the scene.
D) The patient may become confused and be unable to provide information.

Question 6

A confused female patient states that she was intoxicated and accidentally drank a glass of household bleach. When transporting this patient, which of the following complications would you continually assess for?

A) Vomiting
B) Chest pain
C) Headache
D) Diaphoresis

Question 7

The EMT's first priority when managing a patient that has been exposed to a poisonous substance is:

A) identify the poison.
B) induce vomiting.
C) perform a primary assessment.
D) administer activated charcoal.

Question 8

You have been called for an unresponsive patient. On scene, hysterical family members direct you to an unresponsive 32-year-old woman who is lying on the bedroom floor. Her husband says that she left a note saying that she wanted to kill herself and took an unspecified poison. Assessment reveals a green-colored liquid in her mouth and respirations that are rapid, shallow, and gurgling. Her pulse is weak and her skin is cool and dry with cyanosis to her fingertips. Your immediate action would be to:

A) start positive pressure ventilation.
B) extricate and provide care en route to the hospital.
C) open the airway and suction.
D) read the note for clues to what she took.

Question 9

A 53-year-old female has intentionally ingested a large amount of Valium. The EMT would recognize that the medication is being absorbed into the body through what structure?

A) Stomach
B) Esophagus
C) Large intestine
D) Small intestine

Question 10

Which of the following statements regarding antidotes is correct?

A) "There are many antidotes for a large number of poisons and toxic substances."
B) "An antidote will neutralize or counteract the effects of a poison or toxic substance."
C) "Antidotes are beneficial because they will remove the poison from the body."
D) "An antidote can only be given in the emergency department by the physician or nurse."

Question 11

You have been summoned to a residence for a child who ingested a liquid pesticide. On scene, worried parents inform you that their 4-year-old son and some friends were playing in the garage and apparently found some pesticide, which their son says he tasted. Assessment indicates that he is alert, oriented, and crying and has some white powder around his mouth. After performing the initial assessment and finding no life-threatening conditions, which of the following questions or statements is it imperative that the EMT make?

A) "Do you think this was an intentional act?"
B) "I need to see the other children."
C) "Are all of his shots up to date?"
D) "These chemicals need to be put out of reach."

Question 12

A frantic mother called 911 because she found her 18-month-old daughter playing with a bottle of drain cleaner. When assessing this patient, which of the following provides the strongest evidence that the child did indeed ingest some of the liquid?

A) Persistent crying
B) Burns to her mouth
C) Garbled speech
D) Elevated heart rate

Question 13

A confused and lethargic patient reports that she took a large number of antianxiety pills because she was angry with her husband. Her airway is patent and her breathing is adequate. Her pulse is normal and skin is warm and dry. During your reassessment, she reports that she is now dizzy and feels extremely nauseated. The EMT would immediately:

A) perform a jaw-thrust maneuver.
B) place her in a lateral recumbent position.
C) prepare the suction device.
D) check her vital signs.

Question 14

A 44-year-old male had a pesticide splashed into his eyes. Aside from local irritation and damage to the eyes, he also suffered systemic complications since the pesticide entered and was circulated throughout his body. When completing the prehospital care report, the EMT would note the route of exposure as:

A) absorption.
B) visual.
C) injection.
D) topical.

Question 15

Which of the following correctly identifies the routes by which a poison can enter the human body?

A) Exposure, Ingestion, Inhalation, Injection
B) Topical, Inhalation, Nasal-Oral, Absorption
C) Ingestion, Inhalation, Injection, Absorption
D) Inhalation, Injection, Nasal-Oral, Visual

Question 16

The most common route by which a poison enters the body is:

A) inhalation.
B) ingestion.
C) exposure.
D) topical.

Question 17

You have been called to a residence for a 14-year-old male who states that he intentionally took some medication to kill himself. Assessment indicates that he is alert, oriented, and has an open airway and adequate breathing. Given the situation, it is imperative that the EMT's next action be:

A) ask the patient if he feels nauseated.
B) determine what was taken.
C) check the radial pulse and skin.
D) inquire why the patient took the medication.

Question 18

An 11-year-old boy with a history of mild mental retardation has possibly ingested the leaves of a household plant. His mother states that she found him eating the leaves, then immediately called 911. You note that the plant has been overturned and is missing a considerable number of leaves. Assessment reveals the boy to be lethargic and confused and complaining of abdominal pain, accompanied by nausea and vomiting. His airway is patent and his respirations are adequate. Which assessment finding would be most suggestive that the plant leaves have been absorbed into the body?

A) Confusion and lethargy
B) Nausea and vomiting
C) Abdominal pain
D) Leaves missing from the plant

Question 19

When assessing a patient who has been exposed to a poisonous substance, it is essential to recognize:

A) vomiting indicates that the poison has not yet been absorbed into the body.
B) the signs and symptoms of toxic exposure will vary depending on the specific poison.
C) the route of entry into the body will determine the signs and symptoms.
D) absorption into the body has not occurred if the signs of illness are not apparent within 15 minutes.

Question 20

The grandfather of an alert and oriented 2-year-old girl found her on the floor playing with pills from his open bottle of Digoxin (heart medication that slows the rate). He cannot remember how many pills were in the bottle, but he thinks that some are missing and she may have eaten them thinking that they were candy. Assessment reveals her airway to be open and breathing adequate. Her pulse is appropriate for a child her age and her skin warm and dry. Her grandfather is not sure of how long ago she may have taken the pills. Given the assessment findings, the EMT would assume:

A) not enough Digoxin was taken to harm the child.
B) the child apparently did not take any Digoxin.
C) the child must have spit the pills out before swallowing them.
D) the Digoxin pills have yet to absorb into the body.

Question 21

You are transporting a patient who overdosed on medications from a community emergency department (ED) to a large medical center for continued care. In the ED, the patient received two doses of activated charcoal. When performing your reassessment of the patient, which of the following findings would be most concerning?

A) Dark black stool
B) Nausea
C) Red colored stool
D) Diarrhea

Question 22

Medical direction has ordered the administration of activated charcoal to an adult patient who has overdosed on several unspecified medications. Prior to administering the medication, the EMT must:

A) shake the medication thoroughly to mix it.
B) determine if the patient has a prescription for the medication.
C) determine if the patient has a history of diabetes.
D) ask the patient if he has had diarrhea over the past two weeks.

Question 23

You are preparing to administer activated charcoal to a patient who has ingested a poison. The activated charcoal authorized by your medical director also contains a cathartic. What statement would you make to the patient regarding this additive?

A) "You may experience diarrhea after taking the charcoal."
B) "This charcoal will most likely give you a slight headache."
C) "The additive in the charcoal may cause you to vomit."
D) "If you have a heart condition, I cannot give you this medication."

Question 24

A worker at a chemical plant was working on a high-pressure tank containing chlorine gas when the valve broke, filling the room with chlorine gas and throwing the patient forcefully against the wall. He was unresponsive and trapped in the room for 10 minutes, until being pulled out by firefighters. As he is brought to your location, he appears unresponsive. Your first action in caring for this patient would be to:

A) assess breathing and auscultate breath sounds.
B) open the airway using the head-tilt, chin-lift.
C) determine the presence or absence of a pulse.
D) take in-line manual spinal stabilization.

Question 25

An 18-year-old female has eaten a poisonous mushroom. Medical direction has ordered you to administer activated charcoal. Immediately following administration, the patient vomits the medication. She remains alert and oriented with no current life threats to the airway, breathing, or circulation. Your next action would be to:

A) administer a glass of milk.
B) place the patient supine.
C) reassess and continue transport.
D) re-administer the activated charcoal.

Question 26

For which of the following patients would activated charcoal be indicated?

A) 24-year-old female who was sniffing glue and is now complaining of a headache
B) 17-year-old male who drank bleach 30 minutes ago
C) 27-year-old who intentionally took a large amount of Tylenol 45 minutes ago
D) 53-year-old female who took an overdose of antidepressants earlier in the day

Question 27

Medical direction has ordered the administration of activated charcoal to a 3-year-old boy. What dose would be most appropriate?

A) 100 mg
B) 1 gram/kilogram
C) 50 grams
D) 0.5 mg/kilogram

Question 28

The family of a 31-year-old female reports that she has taken an overdose of her father's diabetes medication. Assessment reveals her to be unresponsive, laying on the floor with snoring respirations. Her pulse is rapid and her skin is cool to the touch. She has no history of diabetes but is allergic to penicillin. It is believed that she took the medication within the past hour. Your initial intervention in caring for this patient would be to:

A) administer activated charcoal.
B) induce vomiting.
C) perform a jaw-thrust maneuver.
D) administer milk.

Question 29

You have been called to a railroad yard for an unknown emergency. As you arrive on scene, you find a tanker car with two men lying on the ground next to it. The only other person around is a security guard who saw the collapsed men on a video camera and called 911 immediately. He has an automated external defibrillator (AED) at his side. Your initial action would be to:

A) quickly retrieve the patients and move them to safety.
B) take manual in-line spinal stabilization and assess the ABCs on each.
C) remain at a safe distance and call for assistance.
D) determine what chemical the tanker contains and assess the leaks.

Question 30

A middle-aged male with behavioral problems states that he drank some "chemicals" to kill the bugs in his body. The patient is alert and oriented and shows no life-threatening conditions to the airway, breathing, or circulation. At this point, which of the following questions would be most appropriate to ask?

A) "Have you thrown up?"
B) "When did you drink it?"
C) "What exactly did you drink?"
D) "Are you taking other medications?"

Question 31

A 42-year-old patient weighs 154 pounds (70 kg). How much activated charcoal would you administer to him?

A) 70 grams
B) 100 grams
C) 154 grams
D) 500 grams

Question 32

An alert and oriented 5-year-old child drank some ammonia that was placed in a cup. He is very scared and complaining of abdominal pain, and he states that he has not vomited. Assessment shows ammonia around and in his mouth as well as on his breath. He has an open airway and is breathing adequately. His pulse and skin show no abnormalities. Appropriate care for this patient would include:

A) rinsing his face and mouth with water.
B) inducing vomiting.
C) applying positive pressure ventilation.
D) administering activated charcoal.

Question 33

A 14-year-old female has taken an excessive amount of Tylenol with codeine. Family states that they were asleep when they heard a crash and found her at the bottom of the stairs. When they asked her if she was okay, she told them that her boyfriend broke up with her and she saw no point in going on, therefore she took the overdose. As you arrive by the patient's side, you note that she is responsive to verbal stimuli and breathing shallowly. Your first action would be to:

A) open the airway with the head-tilt, chin-lift.
B) determine exactly how much medication she took.
C) start positive pressure ventilation with oxygen.
D) take manual in-line spinal stabilization.

Question 34

Medical command has ordered you to administer activated charcoal to a patient who ingested a large amount of poison. When looking in your medical kit, which of the following medications would you prepare and administer?

A) Nitrostat
B) Actidose
C) Glyburide
D) Ecotrin

Question 35

After determining that a patient intentionally overdosed on blood pressure medications, which of the following questions would be most appropriate?

A) "Why did you take so many?"
B) "How many did you take?"
C) "Were you confused about the proper dose?"
D) "Are you on other medications?"

Question 36

A patient who has ingested a toxic substance is to receive activated charcoal. The EMT knows that the charcoal will benefit the patient by:

A) coating the small intestine, limiting absorption.
B) neutralizing the poison in the bloodstream.
C) adsorbing the poisonous substance in the stomach.
D) causing vomiting, thus removing the poison from the body.

Question 37

Which of the following instructions given to another EMT would be most appropriate when managing a patient who ingested numerous household cleaners in an attempt to kill himself?

A) "I need you to write down all of the cleaners he may have taken so we can let the hospital know."
B) "Let's gather up all of the containers of the chemicals he may have taken and take them with us."
C) "We need to pour a sample of each cleaner that he may have taken into containers and take them with us."
D) "Before we leave, please call the hospital and tell them what he took so that they will know."

Question 38

Which of the following statements made by an EMT indicates a safe and accurate understanding of inhalation poisonings?

A) "The onset of signs and symptoms associated with an inhalation poisoning are typically rapid."
B) "Inhalation poisonings affect the lungs and do not circulate systemically throughout the body."
C) "It is probably safe for you to enter a scene of an inhalation emergency if you do not smell anything."
D) "Most inhalation poisonings are easily identified by residue or burns around the patient's mouth."

Question 39

Firefighters have pulled a 62-year-old male from a bedroom that was on fire. According to the firefighters, he was smoking in bed and fell asleep. They found him supine on the floor. Assessment reveals him to be responsive to painful stimuli with soot in his airway. He is breathing rapidly, but has no evidence of burns to his body. His pulse is 124 beats per minute, respirations are 24, blood pressure is 146/90 mmHg, and SpO₂ 95%. After providing the appropriate care, what question would be the most important to ask the firefighters prior to transport?

A) "How did the fire start?"
B) "How long was he trapped in the room?"
C) "What materials were burning in the room?"
D) "How fast was he breathing when you found him?"

Question 40

Which of the following actions indicate that the EMT is correctly administering activated charcoal to a patient who has ingested a toxic substance?

A) The charcoal is mixed with milk.
B) Sugar is added to make it taste better.
C) The charcoal is squirted into the mouth.
D) The patient drinks it through a straw.

Question 41

At the scene of an industrial accident, you are presented with a male patient who was exposed to a powerful pesticide in powder form. The patient states that he was moving sacks of the pesticide when one broke open. In the process, his face and arms were covered with the powder. At the present time, he is complaining of difficulty breathing and burning of his skin on his face and arms. You note that some of the pesticide still remains on these areas of the body. Your first action in caring for this patient would be to:

A) apply oxygen through a nonrebreather mask.
B) brush off the remaining pesticide.
C) flush the pesticide with copious amounts of water.
D) obtain vital signs and medical history.

Question 42

You are assessing a young male patient who was found in an alley by sanitation workers. Assessment reveals the patient to respond to painful stimuli by opening his eyes, but then closes them once you stop pinching the muscles on his neck. His airway is open and his breathing is shallow. His skin is cool and diaphoretic and his pupils are constricted and do not react to light. Based on these assessment findings, the EMT would be suspicious of:

A) stroke or hypoglycemia.
B) narcotic overdose.
C) traumatic assault.
D) methamphetamine overdose.

Question 43

You are by the side of a young female college student who is unresponsive. Friends say that she is not a heavy drinker, but tonight she drank an excessive amount of alcohol. She responds to painful stimuli and has snoring respirations. Her respiratory rate is 8 breaths per minute and her radial pulse is weak. Your immediate action would be to:

A) apply oxygen via a nonrebreather mask.
B) administer positive pressure ventilation.
C) determine if drugs are also involved.
D) perform the head-tilt, chin-lift maneuver.

Question 44

A 17-year-old male was stung by an unidentified insect. On scene, the sting site to his right forearm showed some redness and mild swelling. During the reassessment, which statement made by the patient would indicate that venom from the sting is absorbing into the bloodstream?

A) "The bite seems to be hurting worse now."
B) "I think that my arm is more swollen."
C) "The area around the bite feels numb."
D) "I feel sick to my stomach and dizzy."

Question 45

On arrival to a parking lot tailgate, you observe a crowd around a young man who is seizing. As you get equipment from the ambulance and make your way to the patient, his friends tell you that the patient has been up all night "partying" by drinking alcohol and smoking "crack" cocaine. At the patient's side, you note that he is no longer seizing, but he is unresponsive and has snoring respirations. His respirations are labored at 16 per minute and his radial pulse is strong. His skin is cool and diaphoretic. Friends also inform you that he is a diabetic and about an hour ago they heard him say that he thought his blood sugar was going low. Which of the following interventions would be included in your care?

A) Open the airway, provide oxygen, and administer oral glucose.
B) Open the airway, check the blood glucose level, and administer oral glucose.
C) Insert an oral airway, provide positive pressure ventilation, and administer oral glucose.
D) Open the airway, provide oxygen, and give rapid transport to the hospital.

Question 46

A 49-year-old alcoholic patient has fallen down a flight of stairs after consuming two-fifths of cheap whiskey. He presents with confused and slurred speech and the smell of alcohol on his breath. Family states that he is "hopeless" and has been drinking more and more every night. They also say that he must be more drunk than usual because he usually does not slur his speech. Assessment reveals his airway to be open, breathing adequate, and circulation intact. He has a bruise from the fall to the left side of his head and he is complaining of pain to his left wrist. Given these assessment findings, the EMT would be most concerned about the:

A) amount of alcohol consumed.
B) bruise to the head.
C) possible wrist fracture.
D) lack of family support.

Question 47

You are responding to a drug-related emergency. While en route, the dispatcher informs you that the patient has overdosed on an unspecified narcotic. Which of the following statements made to your partner indicates an understanding of overdoses with narcotic drugs?

A) "We will have to be careful because narcotic overdoses can cause hallucinations, and the patient may be violent."
B) "When performing the primary assessment, we need to be alert for respiratory depression."
C) "If the patient is conscious, we will have to ask about chest pain since narcotics can increase the heart's workload."
D) "We need to look at the pupils. If they are dilated, the patient has indeed taken a narcotic."

Question 48

You have been called to a residence for a 31-year-old patient complaining of confusion, nausea, vomiting, and a headache. He states that this started this morning and has been getting worse all day. Despite lying in bed and resting all day, he is more fatigued than before. Which of the following statements made by the patient would the EMT recognize as most important in relation to the patient's present complaint?

A) "I just turned the furnace on last night."
B) "I tried some raw seafood last week."
C) "My wife is taking penicillin, to which I am allergic."
D) "I have not been sleeping well the past few nights."

Question 49

The EMT is transporting a patient with the diagnosis of Wernicke-Korsakoff syndrome. As such, the EMT would recognize that the patient has a past medical history of:

A) alcoholism.
B) drug abuse.
C) pancreatic failure.
D) liver failure.

Question 50

A 32-year-old female calls 911 stating that she injected herself with some heroin 15 minutes ago. She has never tried heroin and she is now scared about what she has done. Assessment reveals her to be alert but confused to the date and time. Her airway is open and she is breathing 14 times a minute. Her pulse is moderate in strength and her skin is warm and dry. Which of the following would be appropriate in her care?

A) Monitor her and transport.
B) Place a warm pack to the injection site.
C) Administer activated charcoal.
D) Apply a tourniquet below the site of injection.

Question 51

A 44-year-old male was using an industrial drain cleaning solvent to clean the drains in his house. The solvent ate through the pipes on the second floor, spilling into the walls and filling the house with fumes. He was in the house for several minutes prior to getting himself out. The primary assessment reveals him to be alert and oriented with a patent airway. He is complaining of dizziness and has rapid respirations. His radial pulse is fast and strong, and his skin is warm and pink. What action should the EMT take first?

A) Insert a nasopharyngeal airway.
B) Start positive pressure ventilation.
C) Administer supplemental oxygen.
D) Provide rapid transport in a semi-Fowler's position.

Question 52

Following a large wedding, health authorities announce that some of the food was contaminated with salmonella. Consequently, your EMS service receives notice that there may be a significant number of calls involving food poisoning. A new EMT asks you how to treat those with food poisoning. You would reply:

A) "After assessing the patient, the administration of activated charcoal can be effective if there are no obvious contraindications."
B) "The primary role of EMS in this situation is merely to transport to the hospital."
C) "If the patient has a fever, we can administer a medication to make him or her vomit to get the food out of his or her system."
D) "You should treat the patient based on his or her signs and symptoms, just like any other ingested poison."

Question 53

You have arrived at a home where the parents found their 13-year-old son in the garage inhaling propane from the family grill. Your assessment reveals him to be alert and oriented with an open airway. His breathing is labored, and his pulse is rapid for his age. When conducting the secondary assessment, which of the following findings or information would be of the greatest concern to the EMT?

A) Chemical burn to the right hand
B) Abdominal pain and diarrhea
C) Wheezing localized to the left lung
D) Suicide attempt two years ago

Question 54

A patient working at an ice plant is trapped in a room filled with sulfur dioxide. You don a self-contained breathing apparatus and entered the room, finding the patient unresponsive on the floor. The room remains filled with the gas. Your immediate priority in caring for this patient is to:

A) assess the airway, breathing, and circulation.
B) remove him from the immediate environment.
C) start positive pressure ventilation.
D) loosen all tight-fitting clothing.

Question 55

On the scene of a drug-related emergency, a 22-year-old patient tells you that he has been taking amphetamines because he likes the way that they make him feel. Over the past two days, he has been taking more and more and today he feels as though his heart is racing. He also tells you that he recognizes he has a problem and wants to get help. When you are assessing the patient, which of the following signs or symptoms would provide further evidence that the patient indeed has been abusing amphetamines?

A) Increased blood pressure
B) Auditory hallucinations
C) Constricted pupils
D) Fatigue and prolonged sleep

Question 56

You have been called for a young female who overdosed on several drugs. Which of the following is it most essential that the EMT perform while caring for this patient?

A) Identify and correct loss of vital function.
B) Identify the drug(s) and amount taken.
C) Determine if she has a history of drug abuse.
D) Identify medical conditions that may be worsened by the drug(s).

Question 57

While he is changing the battery on a truck, acid from the battery splashed into a 66-year-old male's right eye. He complains of burning pain to his right eye and he is having a hard time keeping it open. He is alert and oriented and has no problems with his airway, breathing, or circulation. Your next action would be to:

A) cover both eyes and provide immediate and rapid transport.
B) rinse the eye with a mixture of sterile water and activated charcoal.
C) place a cold pack to the eye and immediately transport to the hospital.
D) irrigate the eye with tap water for a minimum of 20 minutes.

Question 58

A patient has overdosed on an unknown amount of unspecified drugs. On scene, you find her to be conscious but confused and extremely nauseated and she vomits twice. Examination of the vomitus reveals the fragments of different pills. Her past medical history includes diabetes and alcoholism. En route to the hospital, she vomits again and suddenly becomes unresponsive. Your first action would be to:

A) get another set of vitals.
B) contact medical command.
C) position her on her side.
D) check her blood sugar.

Question 59

A patient who is agitated and hyperactive with dilated pupils and tachypnea has most likely ingested:

A) heroin.
B) hallucinogens.
C) methadone.
D) crack cocaine.

Question 60

You have been called for a 46-year-old male who just smoked crack cocaine. In reviewing his past medical history, which of the following conditions would be most of most concern to the EMT?

A) Alcoholism
B) Migraine headaches
C) Heart disease
D) Diabetes

Question 61

You have been called for a 41-year-old female who is confused. Her husband states that she is an alcoholic who has been in and out of rehab for the past five years. Assessment reveals her airway to be open and breathing adequate. Her pulse is regular and strong. Which of the following findings would cause the EMT to classify and treat this patient as a high priority?

A) Blood pressure 108/72 mmHg and complaint of nausea
B) Smell of alcohol on breath and complaint of headache
C) Complaint of nausea with a temperature of 101.6°F
D) Irritable and uncooperative with your effort to treat her

Question 62

You have been called for an alcoholic patient experiencing a medical emergency. On scene, a home health nurse informs you that the patient is experiencing delirium tremens. As an EMT, you recognize which of the following?

A) The patient is extremely intoxicated and in danger of dying.
B) This is a life-threatening condition requiring rapid transport.
C) The patient is in the early stages of alcohol withdrawal.
D) There is little to be done except encouragement and supportive care.

Question 63

You are en route for a possible heroin overdose. As an EMT, you would recognize heroin as what type of drug?

A) Sedative
B) Morphine derived
C) Psychedelic
D) Depressant

Question 64

A patient informs you that he smoked marijuana all night and now he has great anxiety and tremors to both hands. The EMT would recognize marijuana as a(n):

A) hallucinogen.
B) cannabis product.
C) appetite stimulant.
D) sedative.

Question 65

The EMT accurately understands alcoholism when he states:

A) "The diagnosis of alcoholism is applied to a person who drinks hard liquor, not beer or wine."
B) "Surprisingly, in its late stages, those with alcoholism are very functional and able to hold down a job and maintain good family relations."
C) "Alcohol is classified as a drug on which the addict becomes psychologically dependent, not physically dependent."
D) "Aside from the excessive amounts of alcohol, much of the health deterioration that accompanies alcoholism comes from malnutrition."

Question 66

You are called to an alcoholic crisis center to transport a patient experiencing delirium tremens. When assessing the patient, which signs or symptoms would the EMT associate with this condition?

A) Seizure activity, memory impairment, tachycardia, tremors
B) Constricted pupils, hypothermia, confusion, hypotension
C) Loss of memory, hallucinations, fever, dilated pupils
D) High fever, seizure activity, sweating, restlessness

Question 67

You have been called for a "drunk" male patient at a halfway house known to provide living quarters to those with drug and alcohol problems. Residents tell you that the patient is a heavy drinker and must have had too much last night. This morning he was found "passed out" with alcohol on his breath. Quick assessment of the scene reveals the patient to be prone on a dirty bed in a room littered with liquor containers. Aside from the alcohol, which of the following scene clues would be most significant to the EMT?

A) Glucometer on the table
B) Smell of urine in the room
C) Dried vomit on the floor
D) Bugs and insects in the room

Question 68

When performing a "talk down," which of the following statements would appropriately be included?

A) "Can you tell me how many rats there are and the color of them?"
B) "Do you see what happens when you take these drugs?"
C) "Please ignore the rats and tell me exactly what you took."
D) "You are seeing rats because of the drug; this will not last forever."

Question 69

Which of the following complaints would the EMT expect from a person who has just used crack cocaine?

A) "I have chest pain."
B) "My heart feels slow."
C) "I see spiders."
D) "My nose feels raw."

Question 70

For which of the following patients would you be most concerned about exposure to cyanide?

A) Auto mechanic working near exhaust fumes
B) Coal miner working long hours in a mine
C) Worker who paints cars in an auto body shop
D) Firefighter battling a smoky structure fire

Question 71

This is the third day that a patient is in withdrawal from alcohol. If called to care for this patient, the EMT would recognize the need for:

A) restraints.
B) positive pressure ventilation.
C) warm blankets.
D) seizure precautions.

Question 72

Which of the following is characteristic of carbon monoxide?

A) It generally takes several days for a toxic level to accumulate in the body.
B) Its symptoms mimic the flu, but it tends to cause a higher fever than the flu.
C) It is an odorless gas that can kill a person by causing severe hypoxia.
D) It is a tasteless gas that is produced by household appliances like electric furnaces.

Question 73

You are suspicious of food poisoning in a 51-year-old male with nausea, vomiting, diarrhea, and fever. He is alert and oriented with no life threats to his airway, breathing, or circulation. His vital signs are: pulse 124, respirations 20, blood pressure 198/98, and SpO₂ 93% on room air. He states a history of COPD and hypertension, for which he did not take his medications today. In this situation, which of the following would be appropriate?

A) Oxygen at 2 lpm through a nasal cannula
B) Encourage water by mouth for rehydration
C) Take the blood pressure pill that he missed earlier
D) Follow up with his family doctor

Question 74

Which of the following statements indicates that the EMT understands the condition of withdrawal?

A) "Withdrawal is typically not a life-threatening situation and is easily managed by EMS."
B) "Withdrawal indicates that a patient is addicted to a drug and is presently overdosed on that drug(s)."
C) "Withdrawal from drugs or alcohol can be just as serious a medical emergency as an overdose."
D) "Withdrawal is a term that is applied to the cessation of street drugs to which the patient is addicted, not prescription drugs."

Question 75

A drug addict informs you that he has been taking Oxycontin and now requires more and more of the drug to take his chronic back pain away. The EMT would recognize this patient as experiencing:

A) overdose.
B) dependence.
C) tolerance.
D) adverse reaction.

Question 76

You have been called to an alcoholic rehabilitation center. On scene, one of the counselors tells you that the patient is a 44-year-old woman who just came to the center this morning. He continues on by stating that she has not had any alcohol for 24 hours and is now sweating profusely and has an elevated heart rate and blood pressure. Based on this information, the EMT would recognize that the patient is:

A) physically dependent on alcohol.
B) experiencing delirium tremens.
C) psychologically dependent on alcohol.
D) experiencing alcohol tolerance.

Question 77

For which of the following patients is a "talk down" indicated?

A) 26-year-old who took LSD and is panicked because spiders are after him
B) 18-year-old who is having a "bad trip" after taking PCP for the first time
C) 59-year-old whose heart is racing after trying cocaine
D) 47-year-old who is a chronic alcoholic and is demanding help

Question 78

Which of the following patients would the EMT recognize as a drug abuser?

A) A 41-year-old male who tried marijuana for the first time
B) A 39-year-old female who takes pain medications even though she is not in pain
C) A 46-year-old female who used cocaine for 10 years but has not used it in 5 years
D) A 56-year-old male who accidentally took an additional dose of blood pressure medication

Question 79

You have been called to a party by friends of a 14-year-old female with a decreased level of consciousness. On scene, the partygoers state that they were "huffing" when she suddenly complained of a headache and then passed out. In reference to the term "huffing," you would recognize this as:

A) injecting drugs intravenously.
B) inhaling fumes or vapors.
C) smoking methamphetamine.
D) sampling multiple prescription drugs.

Question 80

A 16-year-old male has been inhaling paint fumes to "feel good." His grandmother called 911 when she found him doing this in the basement and he told her he was having a hard time breathing. He is alert and oriented, with a patent airway and adequate breathing. His radial pulse is strong and skin warm and dry. Your partner reports mild wheezing in both lungs. Vital signs are: pulse 92, respirations 20, blood pressure 148/62, and SpO₂ 96% on room air. He has no medical history. Appropriate initial care would include:

A) positive pressure ventilation with supplemental oxygen.
B) oxygen by nasal cannula at 8 liters per minute.
C) breathing treatment with a metered-dose inhaler.
D) high-concentration oxygen through a nonrebreather mask.