Emergency Care Exam Questions And Answers 100% Verified 2024/2025

Emergency Care Exam Questions And Answers 100% Verified 2024/2025 A 3-year-old boy is brought to the emergency department by his father because of possible poisoning. He was found in the garage with furniture polish on his cheeks, mouth, and clothes. The father saw him coughing but denies choking or vomiting. On examination, the boy is active with normal vital signs. Which of the following is the next best step? A. Consult pulmonology B. Give activated charcoal C. Obtain chest x-ray D. Perform gastric lavage - answerC Hydrocarbon toxicity can result from ingestion of furniture polish. A transient and mild CNS depression is commonly noted after hydrocarbon ingestion or inhalation. Aspiration is characterized by coughing, which usually is the first clinical finding. It is important to obtain a chest radiograph. Standard mechanical ventilation, high-frequency ventilation, and ECMO have all been used to manage the respiratory failure and ARDS associated with severe hydrocarbon-induced pneumonitis. A 19-year-old farmer presents to the ED with vomiting, diarrhea, diaphoresis, wheezing, and excessive tearing. Vital signs are BP 150/100 mm Hg, HR 36 beats per minute, RR 28 breaths per minute, and T 98.6°F. Which of the following is the most appropriate initial step in management? A. Atropine B. Decontamination C. Endotracheal intubation D. High-dose insulin - answerB This patient is exhibiting signs and symptoms consistent with cholinergic toxicity secondary to organophosphate poisoning. Management of organophosphate poisoning should begin with decontamination. There are two keys to definitive treatment in patients with organophosphate poisoning. The first is to temporize the life-threatening signs and symptoms of cholinergic toxicity. Atropine is a competitive inhibitor of acetylcholine at muscarinic receptors. The goal of treatment with atropine is to titrate to the drying of bronchial secretions. Pralidoxime (2-PAM) is the definitive antidote to organophosphate poisoning. SLUDGE mnemonic: Salivation, Lacrimation, Urination, Diarrhea, GI cramps and Emesis. Patients will also demonstrate diaphoresis, pupillary miosis, bradycardia, muscular fasciculations, paralysis, agitation, seizures, or even coma. When prescribing metronidazole which of the following should patients be specifically instructed to avoid? A. Dairy products B. Ethanol C. Excessive water intake D. Leafy green vegetables - answerB Metronidazole is used in the treatment of various parasitic and bacterial infections, but patients should be specifically instructed to avoid alcohol intake, as even a small amount of alcohol ingestion during metronidazole therapy may result in intense vomiting, also known as a disulfiram-like reaction A 7-year-old boy presents to the emergency department with an ankle injury. He fell while playing on equipment at a nearby playground. There is pain, swelling, and ecchymosis over the medial malleolus. An ankle X-ray is obtained and shows a fracture along the growth plate and into the epiphysis of the tibia. Which of the following is the most likely diagnosis? A. Greenstick fracture B. Salter-Harris type II fracture C. Salter-Harris type III fracture D. Torus fracture - answerC Salter-Harris type III fractures are intra-articular injuries that involve the physis and the epiphysis. These are often unstable fractures and are managed based on size and degree of displacement. Consultation with an orthopedic surgeon is recommended. A 35-year-old woman with a prior history of suicidal ideations is brought to the Emergency Department approximately 10 hours after ingesting an unknown quantity of acetaminophen and ibuprofen. She is complaining of nausea and abdominal pain. Her blood pressure is 150/80 mm Hg, heart rate is 90, respiratory rate is 18, and temperature is 36.8C. Physical examination reveals diffuse abdominal pain. What is the most appropriate next step in management? A. Administer glutathione B. Administer N-acetylcysteine C. Arrange for hemodialysis D. Determine acetaminophen level - answerB Risk of severe hepatotoxicity increases if the patient is not treated with N-acetylcysteine (NAC) within the first 8 hours after ingestion. If the patient presents after 8 hours from the time of the ingestion, a loading dose of NAC at the initial dose of 140 mg/kg should be administered without delay. Acetaminophen level as well as transaminases must be determined, but therapy should not be delayed while awaiting the results of the laboratory studies. A 42-year-old man with a history of hypertension presents to the emergency department by ambulance after his wife called 911 out of concern for a possible overdose. The patient is confused and unable to answer questions upon arrival. His blood pressure is 80/50 mm Hg, heart rate is 45 beats/minute, and respiratory rate is 12 breaths/minute. Electrocardiogram findings include a prolonged PR interval. His glucose is 60 mg/dL. Which of the following is the most likely explanation? A. Acetaminophen overdose B. Beta-blocker overdose C. Calcium-channel blocker overdose D. Opioid overdose - answerB