BCEN Toxicology 3

Question 1

A patient presents with altered mental status, miosis, bradycardia, and excessive salivation after pesticide exposure. Which intervention is the highest priority?

Accepted Answer

Administer atropine to dry secretions and protect airway

Answer

In organophosphate poisoning, atropine is the priority to reverse muscarinic effects, especially secretions that threaten airway patency.

Question 2

Which urine color change is associated with significant rhabdomyolysis from drug toxicity?

Accepted Answer

Tea-colored or brown urine

Answer

Tea-colored or brown urine indicates myoglobinuria from rhabdomyolysis, a serious complication requiring aggressive IV fluid resuscitation.

Question 3

A patient on warfarin presents with supratherapeutic INR of 9.5 and active major bleeding. What is the MOST appropriate treatment?

Accepted Answer

Administer 4-factor prothrombin complex concentrate and vitamin K

Answer

4-factor PCC provides immediate reversal of warfarin effect for life-threatening bleeding, while IV vitamin K ensures sustained reversal.

Question 4

A patient presents with hypotension, bradycardia, and hyperglycemia after suspected calcium channel blocker overdose. Which treatment is appropriate for refractory shock?

Accepted Answer

High-dose insulin euglycemic therapy

Answer

High-dose insulin euglycemic therapy improves myocardial function in calcium channel blocker toxicity by enhancing carbohydrate metabolism in cardiac cells.

Question 5

Which symptom cluster correctly describes the anticholinergic toxidrome?

Accepted Answer

Mydriasis, tachycardia, dry skin, urinary retention

Answer

The anticholinergic toxidrome is remembered as 'hot as a hare, dry as a bone, red as a beet, blind as a bat, mad as a hatter' — mydriasis, tachycardia, dry skin, urinary retention.

(BCEN) Board of Certification of Emergency Nursing Practice Test

(BCEN) Board of Certification of Emergency Nursing Practice Test

BCEN Toxicology 3