Practice Test Geeks(PSA) Prescribing Safety Assessment Practice Test
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Emergency Prescribing Flashcards

7 cards from real PSA practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.

Read the first 7 Emergency Prescribing flashcards as text

  1. A patient presents 4 hours after a large acetaminophen ingestion. The serum acetaminophen level is 250 mcg/mL. What is the specific antidote?

    Answer: N-acetylcysteine (NAC) IV (150mg/kg over 1 hour, then 50mg/kg over 4 hours, then 100mg/kg over 16 hours)

    N-acetylcysteine replenishes hepatic glutathione and is the antidote for acetaminophen overdose; the Rumack-Matthew nomogram guides initiation.

  2. A patient with chronic alcohol use disorder presents with a generalized tonic-clonic seizure. What is the drug of choice?

    Answer: Lorazepam 4mg IV (or diazepam 10mg IV)

    Benzodiazepines are first-line for alcohol withdrawal seizures because they enhance GABA-A receptor function, the mechanism disrupted by alcohol withdrawal.

  3. A patient taking atenolol intentionally overdoses and presents with HR 28 bpm, BP 72/40 mmHg, and bradycardia unresponsive to atropine. What is the specific antidote?

    Answer: Glucagon 5–10mg IV bolus followed by infusion 3–5mg/hr

    Glucagon is the antidote for beta-blocker toxicity, stimulating adenylate cyclase independently of blocked beta-receptors to increase cardiac output.

  4. A patient with TCA (amitriptyline) overdose develops QRS duration of 140ms and runs of ventricular tachycardia. What is the treatment?

    Answer: Sodium bicarbonate 1–2 mEq/kg IV bolus, repeat until QRS narrows or pH 7.50–7.55

    Sodium bicarbonate alkalinizes serum (increasing TCA protein binding) and overcomes sodium channel blockade, narrowing QRS and reducing dysrhythmia risk.

  5. A firefighter rescued from a structural fire presents with cherry-red skin, coma, and lactic acidosis with normal PaO2. What antidote should be given?

    Answer: Hydroxocobalamin (Cyanokit) 5g IV over 15 minutes

    Hydroxocobalamin is the first-line antidote for cyanide poisoning, directly binding cyanide ions to form cyanocobalamin excreted in urine.

  6. A patient on sertraline and tramadol develops hyperthermia (41.2°C), clonus, hyperreflexia, and agitation 2 hours after a tramadol dose increase. What is the diagnosis and management?

    Answer: Serotonin syndrome — stop serotonergic agents, cyproheptadine PO/NG, IV benzodiazepines, active cooling

    Serotonin syndrome from combined serotonergic drugs presents with the Hunter triad (clonus, hyperreflexia, hyperthermia) and is treated with cyproheptadine and benzodiazepines.

  7. A patient with methanol poisoning (formate acidosis, visual disturbance) is treated with fomepizole. What additional intervention may be required in severe cases?

    Answer: Hemodialysis to remove methanol and formate

    Hemodialysis efficiently removes methanol and its toxic metabolite formic acid and is indicated in severe acidosis, visual impairment, or very high methanol levels.