ENPC Toxicological Emergencies

Question 1

Which antidote is indicated for acetaminophen toxicity in pediatric patients?

Accepted Answer

N-acetylcysteine (NAC)

Answer

N-acetylcysteine replenishes glutathione stores and prevents hepatotoxicity from acetaminophen overdose.

Question 2

A 4-year-old presents with miosis, bradycardia, excessive secretions, and bronchospasm after pesticide exposure. Which toxidrome does this represent?

Accepted Answer

Cholinergic

Answer

Organophosphate and carbamate pesticides inhibit acetylcholinesterase, producing the cholinergic toxidrome (SLUDGE/DUMBELS).

Question 3

What is the first-line antidote for opioid-induced respiratory depression in a pediatric patient?

Accepted Answer

Naloxone

Answer

Naloxone is a competitive opioid receptor antagonist that rapidly reverses opioid-induced respiratory depression and sedation.

Question 4

Which GI decontamination method is MOST appropriate for an alert 2-year-old who ingested an unknown substance 30 minutes ago?

Accepted Answer

Activated charcoal

Answer

Activated charcoal is most effective when given within 1 hour of ingestion in alert patients who can protect their airway.

Question 5

A teenager presents with hyperthermia, tachycardia, hypertension, agitation, and dilated pupils. Which toxidrome is most likely?

Accepted Answer

Sympathomimetic toxidrome

Answer

Sympathomimetic toxidrome from cocaine or amphetamines presents with hyperthermia, tachycardia, hypertension, agitation, and mydriasis.

ENPC - Emergency Nurse Practitioner Practice Test