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Adams: Pharmacology: Connections to Nursing Practice
Chapter 78
Emergency Preparedness: Bioterrorism and Management of Poisoning
Learning Outcome 1
Discuss the role of professional nursing in emergency
preparedness and management of poisoning.
1. Which of the following are potential disasters? Select all that apply.
1. Biological agents
2. Chemical agents
3. Radiologic agents
4. Nuclear explosives
Answer: 1, 2, 3, 4
Rationale: Potential disasters can result from agents that are biological, chemical,
radiological, nuclear, or explosive in nature.
Cognitive Level: Analysis
Client Need: Safe, Effective Care Environment
Nursing Process: Assessment
Learning Outcome: 78-1
2. The most essential competency for nurses in this age of bioterrorism is:
1. Emergency preparedness.
2. Knowing the offending agent.
3. Managing mass casualties.
4. Teaching awareness of bioterrorism.
Answer: 1
Rationale:
1. Emergency preparedness has become an essential competency for all health care
professionals.
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2. While all three are important, the options are part of the overall competency of
emergency preparedness.
3. While all three are important, the options are part of the overall competency of
emergency preparedness.
4. While all three are important, the options are part of the overall competency of
emergency preparedness.
Cognitive Level: Analysis
Client Need: Safe, Effective Care Environment
Nursing Process: Planning
Learning Outcome: 78-1
3. The difference between the standard emergency triage known to nurses and the
current emergency triage of mass casualties is:
1. Previous emergencies are triaged with labels tagged to clients, such as easy to
complex.
2. Current emergencies focus on the clients with the best chance to live.
3. Previous emergencies never triaged mass casualties or biological agents.
4. Current emergencies triage women and children first.
Answer: 2
Rationale:
1. Clients are labeled, but not using terms of easy to complex.
2. Standard emergency triage may be reversed, focusing on patients with the best
chance to live.
3. Previous emergencies throughout history have dealt with mass casualties or
biologic agents.
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4. Current emergencies deal with clients who have the best chance to live, regardless
of age.
Cognitive Level: Analysis
Client Need: Safe, Effective Care Environment
Nursing Process: Assessment
Learning Outcome: 78-1
Learning Outcome 2
Discuss the purpose, function, and components of Strategic
National Stockpile.
4. Which of the following are components of the Strategic National Stockpile (SNS)?
Select all that apply.
1. Antibiotics
2. Chemical antidotes
3. Life-support medications
4. Intravenous administration equipment
Answer: 1, 2, 3, 4
Rationale: The Strategic National Stockpile (SNS) is a national repository of antibiotics,
chemical antidotes, antitoxin, antiviral agents, life-support medications, and intravenous
(IV) administration equipment. Additional equipment include airway maintenance
supplies and surgical material.
Cognitive Level: Application
Client Need: Safe, Effective Care Environment
Nursing Process: Planning
Learning Outcome: 78-2
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5. The government agency responsible for managing the SNS is the:
1. Department of Defense.
2. Joint Commission of Accreditation of Healthcare Organizations.
3. Department of Homeland Security.
4. Centers for Disease Control and Prevention.
Answer: 4
Rationale:
1. The Department of Defense is a government agency with a stake in emergencies
of mass casualties, but does not manage the SNS.
2. The Joint Commission of Accreditation of Healthcare Organizations is not a
government agency, but a regulatory agency of health care organizations.
3. The Department of Homeland Security is a government agency with a stake in
emergencies of mass casualties, but does not manage the SNS.
4. The CDC manages the Strategic National Stockpile to ensure immediate
availability and deployment of essentials to any state.
Cognitive Level: Knowledge
Client Need: Safe, Effective Care Environment
Nursing Process: Assessment
Learning Outcome: 78-2
6. The purpose of the push packages is:
1. To manage incoming equipment when a disaster occurs.
2. To provide information booklets to communities experiencing a disaster.
3. To transport appropriate personnel to disaster sites.
4. To maintain supplies available for emergencies within 12 hours.
Answer: 4
Rationale:
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1. Managing incoming equipment when a disaster occurs is not the purpose of push
packages.
2. Providing information booklets to communities experiencing a disaster is not the
purpose of push packages.
3. Transporting appropriate personnel to disaster sites is not the purpose of push
packages.
4. Push packages include preassembled caches of drugs, antidotes, and medical
supplies that broadly cover a nonspecific emergency for use in early hours. Stored
strategically, deployment can be accomplished within 12 hours.
Cognitive Level: Comprehension
Client Need: Safe, Effective Care Environment
Nursing Process: Intervention
Learning Outcome: 78-2
Learning Outcome 3
Identify the types of agents that might be used for a bioterrorist
attack.
7. Person-to-person spread occurs in which of the following bioterrorist agents? Select
all that apply.
1. Hemorrhagic fever
2. Plague
3. Anthrax
4. Botulism
Answer: 2
Rationale:
1. Viral hemorrhagic fevers result in circulatory system damage and hemorrhage.
The host can be the cotton rat or deer mouse, but some hemorrhagic fevers, such
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as Ebola or Marburg, have unknown hosts. It is treated with supportive therapy,
such as fluid and electrolytes, and management of complications.
2. Within 1–6 days after exposure, the patient would be infectious to everyone she
has come in contact with during that time.
3. Anthrax poisoning can occur by ingestion, absorption through an open wound on
the skin, or inhalation, the most dangerous route.
4. Botulism is caused by Clostridium botulinum, an organism that secretes a potent
toxin that paralyzes the muscles after a person is poisoned.
Cognitive level: Analysis
Client Need: Physiologic Integrity
Nursing Process: Evaluation
Learning Outcome: 78-3
8. The nurse explains to a group of concerned citizens that a biologic terrorism agent that
is especially dangerous because of its high contagion and prolonged incubation period
(allowing exposure to a large number of people during the early stages of the disease) is:
1. Anthrax.
2. Botulism.
3. Hemorrhagic fever.
4. Smallpox.
Answer: 4
Rationale:
1. Anthrax is not spread through human contact.
2. Botulism is not spread through human contact.
3. Hemorrhagic fever is not spread through human contact.
4. Personal contact is needed to spread smallpox, but only a few viral droplets
spread through the air or on contaminated objects are needed to produce the
disease. Humans are the only carriers.
Cognitive Level: Application
Client Need: Safe, Effective Care Environment
Nursing Process: Intervention
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Learning Outcome: 78-3
9. Which of the following medications is the primary antibiotic of choice for the
treatment of anthrax?
1. Ciprofloxacin
2. Vancomycin
3. Ampicillin
4. Erythromycin
Answer: 1
Rationale:
1. Ciprofloxacin (Cipro) is the primary antibiotic used, with a prophylaxis oral dose
of 500 mg every 12 hours for 60 days.
2. Anthrax may be treated with other antibiotics, such as penicillin, ampicillin,
vancomycin, and erythromycin, but vancomycin is not the primary antibiotic
used.
3. Anthrax may be treated with other antibiotics, such as penicillin, ampicillin,
vancomycin, and erythromycin, but ampicillin is not the primary antibiotic used.
4. Anthrax may be treated with other antibiotics, such as penicillin, ampicillin,
vancomycin, and erythromycin, but erythromycin is not the primary antibiotic
used.
Cognitive Level: Application
Client Need: Physiologic Integrity
Nursing Process: Intervention
Learning Outcome: 78-3
Learning Outcome 4
Compare and contrast the various chemical agents that can be
used as poisons.
10. Antidotes for nerve agent poisoning include:
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1. Acetylcysteine.
2. Atropine sulfate.
3. Protamine sulfate.
4. Methylprednisolone.
Answer: 2
Rationale:
1. Acetylcysteine is the antidote for Tylenol poisoning.
2. The antidote for nerve gas is the anticholinergic drug, atropine sulfate.
3. Protamine sulfate is the antidote for heparin poisoning.
4. Methylprednisolone is not an antidote.
Cognitive Level: Comprehension
Client Need: Physiologic Integrity
Nursing Process: Intervention
Learning Outcome: 78-4
11. A common intervention for clients exposed to gaseous chemical agents such as
cyanogen chloride, phosgene, and VX nerve agent is to:
1. Administer antibiotics intravenously.
2. Initiate emetic measures.
3. Apply sodium bicarbonate to skin lesions.
4. Expose clients to air or to administer oxygen.
Answer: 4
Rationale:
1. Administering antibiotics intravenously may be used for other chemical agents
that cause skin lesions.
2. Initiating emetic measures is prohibited with most chemical agents.
3. Applying sodium bicarbonate to skin lesions may be used for other chemical
agents that cause skin lesions.
4. All three gaseous chemical agents require some form of air-oxygen therapy or
fresh air.
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Cognitive Level: Analysis
Client Need: Physiologic Integrity
Nursing Process: Intervention
Learning Outcome: 78-4
12. Clients arrive in the Emergency Department complaining of difficulty breathing,
tearing from their eyes after a bomb exploded in a nearby store. The priority intervention
of the health care team initially should be to:
1. Complete a history and physical.
2. Identify the offending agent.
3. Notify local law enforcement.
4. Flush the skin and eyes with water.
Answer: 4
Rationale:
1. Completing a history and physical might be an intervention during the initial
period, but the priority is to remove the offending agent.
2. Identifying the offending agent might be an intervention during the initial period,
but the priority is to remove the offending agent.
3. Notifying local law enforcement might be an intervention during the initial
period, but the priority is to remove the offending agent.
4. The health care team should initially flush the skin and eyes with copious
amounts of water to flush the offending agent.
Cognitive Level: Application
Client Need: Physiologic Integrity
Nursing Process: Intervention
Learning Outcome: 78-4
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Learning Outcome 5
Explain the risks associated with ionizing radiation emitted
from a nuclear terrorist attack.
13. A client who has experienced whole-body radiation exposure is admitted to the
Emergency Department six hours after exposure with radiation sickness. On assessment,
the nurse would expect the client to report:
1. Hair loss.
2. Nausea and vomiting.
3. Bleeding from the gums and nose.
4. Bruises on skin not covered by her clothing.
Answer: 2
Rationale:
1. Hair loss is not an initial symptom of radiation sickness.
2. Radiation sickness occurs after exposure to ionizing radiation, and can last from
hours to days. Initial symptoms include nausea, vomiting, and diarrhea, with later
symptoms of weight loss, anorexia, fatigue, and suppression of the bone marrow.
3. Bleeding from the gums and nose is not an initial symptom of radiation sickness.
4. Bruises on the skin are not initial symptoms of radiation sickness.
Cognitive Level: Application
Client Need: Physiologic Integrity
Nursing Process: Assessment
Learning Outcome: 78-5
14. The danger from radiation exposure is primarily due to: (Select all that apply.)
1. Long-lasting effects of radiation exposure.
2. The amount of radiation exposure.
3. The distance from the initial incident.
4. The amount of cellular death from radiation exposure.
Answer: 1, 2, 3, 4
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Rationale: Radiation exposure can cause mass casualty deaths at the point of impact and
create residual ionizing radiation for miles around the site. Some radioisotopes emit
radiation for decades and even centuries. When exposed to large amounts of radiation, or
to small amounts over many decades, patients tend to develop certain malignancies
(cellular death) such as leukemia or thyroid cancer.
Cognitive Level: Analysis
Client Need: Safe, Effective Care Environment
Nursing Process: Planning
Learning Outcome: 78-5
15. Which of the following diagnoses is a direct affect from exposure to ionizing
radiation?
1. Type II diabetes
2. Hypertension
3. Leukemia
4. Gout
Answer: 3
Rationale:
1. Type II diabetes has no direct link to ionizing radiation.
2. Hypertension has no direct link to ionizing radiation.
3. When exposed to large amounts of radiation, or to small amounts over many
decades, patients tend to develop certain malignancies such as leukemia or thyroid
cancer.
4. Gout has no direct link to ionizing radiation.
Cognitive Level: Comprehension
Client Need: Safe, Effective Care Environment
Nursing Process: Evaluation
Learning Outcome: 78-5
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Learning Outcome 6
Describe the five general principles of treating acute poisoning.
16. Which of the five general principles for treating acute poisoning below would be
indicated for treating an external chemical agent? Select all that apply.
1. Topical decontamination
2. Prevention of absorption
3. Neutralization
4. Increase in the rate of excretion
5. Antidotes and symptomatic therapy
Answer: 1, 3
Rationale:
1. Topical decontamination and prevention of absorption are not indicated for
external exposure, as they relate to internal ingestion of poison.
2. Neutralization and increase in the rate of excretion are not indicated for external
exposure as they relate to internal ingestion of poison.
3. Antidotes and symptomatic therapy are not indicated for external exposure, as
they relate to internal ingestion of poison.
4. For external agents, treatment is topical decontamination and neutralization.
5. Antidotes and symptomatic therapy would not be indicated for treating an
external chemical agent.
Cognitive Level: Application
Client Need: Safe, Effective Care Environment
Nursing Process: Intervention
Learning Outcome: 78-6
17. At a local health fair, the community nurse is educating the public on poison-control
strategies. Which strategy should the nurse indicate to the public as most important to
follow?
1. Identification of household poisons
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2. Maintain a stockpile of selected antidotes.
3. Available Poison Control Hotline phone number
4. Prevention of potential household poisonings
Answer: 4
Rationale:
1. Identification of household poisons is important, but not the best strategy.
2. No storage of antidotes is indicated for the public.
3. An available Poison Control Hotline phone number is important to know, but not
the best strategy.
4. Educating the community about accidental poisoning is an important part of
community health nursing. Prevention is the first line of defense to minimize
poisonings.
Cognitive Level: Application
Client Need: Safe, Effective Care Environment
Nursing Process: Planning
Learning Outcome: 78-6
18. The five general principles used in the treatment of acute poisoning are:
1. Identification of poison, modification of lifestyle, health teaching,
decontamination, and increase in the rate of excretion.
2. Antidote therapy, decontamination, neutralization, prevention of absorption, and
increase in the rate of excretion.
3. Modification of lifestyle, health teaching, antidote therapy, symptomatic therapy,
absorbent administration, and dialysis.
4. Identification of poison, symptomatic therapy, neutralization, dialysis, and
absorbent administration.
Answer: 2
Rationale:
1. This includes components of the five general principles, but not all of them.
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2. The five general principles are topical decontamination, prevention of absorption,
neutralization, increase in the rate of excretion, and antidotes and symptomatic
therapy.
3. This includes components of the five general principles, but not all of them.
4. This includes components of the five general principles, but not all of them.
Cognitive Level: Analysis
Client Need: Safe, Effective Care Environment
Nursing Process: Planning
Learning Outcome: 78-6
Learning Outcome 7
Identify the drugs important in emergency preparedness and
management of poisoning.
19. The client is found at home unconscious with an empty bottle of diltiazem
(Cardizem) near the couch. The emergency response team prepares to administer which
of the following antidotes?
1. Pyridoxine
2. Calcium
3. Naloxone
4. Atropine
Answer: 2
Rationale:
1. Pyridoxine is the antidote for INH.
2. IV calcium is the antidote for Cardizem, a calcium channel blocker.
3. Naloxone is the antidote for opioids.
4. Atropine is the antidote for nerve gas.
Cognitive Level: Analysis
Client Need: Safe, Effective Care Environment
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Nursing Process: Intervention
Learning Outcome: 78-7
20. Which of the following agents would the nurse administer to prevent the absorption
of a poison that the client ingested?
1. Syrup of ipecac
2. furosemide (Lasix)
3. Sodium bicarbonate
4. Charcoal
Answer: 4
Rationale:
1. Do not give ipecac syrup. Though once considered routine procedure, this method
of poison management is now considered ineffective.
2. Administration of diuretic is used to increase in the rate of excretion.
3. Administration of acids or bases is used to neutralize the poison.
4. Prevention of absorption: administration of adsorbents (activated charcoal), whole
bowel irrigation, induction of vomiting, and gastric lavage.
Cognitive Level: Comprehension
Client Need: Physiologic Integrity
Nursing Process: Intervention
Learning Outcome: 78-7
21. The client was exposed to iodine-131. Which of the following medications would the
nurse administer to this client?
1. Potassium iodide orally
2. Penicillin intravenously
3. Anti-iodine vaccine intramuscularly
4. Antiviral nasal spray
Answer: 1
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Rationale:
1. The only recognized treatment available to counter the thyroid uptake of radiation
is ingestion of potassium iodine (KI) before or immediately after exposure.
2. Intravenous penicillin is not the treatment for iodine exposure.
3. There is no vaccine available.
4. Antiviral nasal spray is not the treatment for iodine exposure.
Cognitive Level: Application
Client Need: Physiologic Integrity
Nursing Process: Intervention
Learning Outcome: 78-7
Learning Outcome 8
Compare pharmacologic management of biological, chemical,
radiological, nuclear, and explosive agents in emergency
preparedness.
22. A group of concerned people ask the community nurse speaking at a local town hall
meeting if there is a vaccine for anthrax available and, if so, if they should get it. The
nurse’s best response would be:
1. “No vaccine has been made to prevent anthrax.”
2. “Yes, the vaccine is available, but is limited to select groups, such as the
military.”
3. “Yes, the vaccine is available, and you should ask your primary health care
provider for it.”
4. “Yes, the vaccine is available, but it has not been approved by the Food and Drug
Administration.”
Answer: 2
Rationale:
1. There is a vaccine available.
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2. The CDC recommends vaccination for only select populations: laboratory
personnel who work with anthrax, military personnel deployed to high-risk areas,
and those who deal with animal products imported from areas with a high
incidence of the disease.
3. There is an ongoing controversy regarding the safety of the anthrax vaccine and
whether it is truly effective in preventing the disease. Until these issues are
resolved, the availability of anthrax immunization will likely remain limited to
select groups.
4. The FDA has approved the vaccine.
Cognitive Level: Application
Client Need: Psychosocial Integrity
Nursing Process: Intervention
Learning Outcome: 78-8
23. The client is admitted to the critical care unit with acute poisoning of acetylsalicylic
acid (aspirin). The nurse knows that ion trapping will be the therapy of choice for this
medication, and thus prepares to:
1. Insert a nasogastric tube for lavage.
2. Administer sodium bicarbonate and furosemide (Lasix) intravenously.
3. Provide supportive therapy, as ion trapping would not be the therapy of choice for
aspirin overdose.
4. Hang a bag of 100 ml normal saline solution with 100 units regular insulin
adjusted to the client’s rising blood glucose levels.
Answer: 2
Rationale:
1. This treatment is not related to ion trapping.
2. Forced alkaline diuresis may be used to increase the excretion of acidic drugs like
salicylates and phenobarbital, and forced acid diuresis has been used to eliminate
amphetamines, quinine, and strychnine. When forced alkaline diuresis is
employed, a diuretic such as furosemide along with IV sodium bicarbonate will
make the urine more alkaline.
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3. While supportive therapy may be used, the known treatment is ion trapping.
4. This treatment would be used for hypoglycemia, and is not related to ion trapping.
Cognitive Level: Application
Client Need: Physiologic Integrity
Nursing Process: Intervention
Learning Outcome: 78-8
24. A mother and her 3-year-old child arrive in the Emergency Department after the
child had just ingested approximately 20 tablets of iron that were prescribed to the child’s
mother. The nurse immediately prepares a medication to reverse iron known as:
1. Pyridoxine (vitamin B6).
2. Fomepizole (Antizol).
3. Deferoxamine (Desferal).
4. Sodium bicarbonate.
Answer: 3
Rationale:
1. Pyridoxine (vitamin B6) is the antidote for isoniazid (INH).
2. Fomepizole (Antizol) is the antidote for methanol.
3. Deferoxamine (Desferal) is the antidote for iron overdose.
4. Sodium bicarbonate is the antidote for tricyclic antidepressants.
Cognitive Level: Knowledge
Client Need: Physiologic Integrity
Nursing Process: Intervention
Learning Outcome: 78-8
Learning Outcome 9
Discuss the management of poisoning through the poison
control center, including minimizing poison absorption and
enhancing poison removal.
25. Nursing interventions that enhance the removal of poisons include: (Select all that
apply.)
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1. Administering activated charcoal.
2. Preparing the client for dialysis.
3. Inserting a nasogastric tube.
4. Monitoring output.
Answer: 1, 2, 3, 4
Rationale:
1. All options may be used to enhance the removal of poisons. Charcoal works by
binding with the poison agent. The client might need dialysis for removal of lethal toxins
quickly. Inserting a nasogastric tube might be needed for lavage of stomach contents. The
client’s output should be monitored, noting the characteristics of urine for early
identification of rhabdomyolysis.
2. All options may be used to enhance the removal of poisons. Charcoal works by
binding with the poison agent. The client might need dialysis for removal of lethal toxins
quickly. Inserting a nasogastric tube might be needed for lavage of stomach contents. The
client’s output should be monitored, noting the characteristics of urine for early
identification of rhabdomyolysis.
3. All options may be used to enhance the removal of poisons. Charcoal works by
binding with the poison agent. The client might need dialysis for removal of lethal toxins
quickly. Inserting a nasogastric tube might be needed for lavage of stomach contents. The
client’s output should be monitored, noting the characteristics of urine for early
identification of rhabdomyolysis.
4. All options may be used to enhance the removal of poisons. Charcoal works by
binding with the poison agent. The client might need dialysis for removal of lethal toxins
quickly. Inserting a nasogastric tube might be needed for lavage of stomach contents. The
client’s output should be monitored, noting the characteristics of urine for early
identification of rhabdomyolysis.
Cognitive Level: Analysis
Client Need: Safe, Effective Care Environment
Nursing Process: Intervention
Learning Outcome: 78-9
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26. Nursing considerations during the administration of edetate calcium disodium
(CaEDTA) for lead poisoning are:
1. Restricting fluid intake until all doses are given.
2. discontinuing CaEDTA if urine output exceeds 100 ml/hour.
3. Encouraging the client to eat foods high in zinc, calcium, and iron.
4. Monitoring serum blood glucose, potassium, and calcium levels daily.
Answer: 3
Rationale:
1. Fluids should be increased to enhance urinary excretion of chelates.
2. Monitor intake and output ratio, since the drug is excreted almost exclusively via
the kidneys. Toxicity could develop if output is inadequate. Therapy should be
stopped if urine flow is markedly diminished or absent.
3. Eat foods rich in zinc, calcium, magnesium, iron, and calcium to prevent storage
of lead in the body.
4. Laboratory studies that require monitoring during therapy are serum creatinine,
calcium, and phosphorus before and during each course of therapy. Monitor
baseline and frequent blood urea nitrogen levels and ECG during therapy.
Cognitive Level: Application
Client Need: Physiologic Integrity
Nursing Process: Intervention
Learning Outcome: 78-9
27. The client was found by emergency personnel in his home after calling 911. He
admitted to taking 24 Tylenol tablets at once, stating “I just want to die.” An empty bottle
of Tylenol (acetaminophen) was found close by. He was brought to the Emergency
Department, and assessment and treatment were initiated. Which of the following
medications would most likely be administered to reverse the effects of Tylenol?
1. Naloxone (Narcan)
2. Atropine (Protopam)
3. Flumazenil (Romazicon)
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4. Acetylcysteine (Mucomyst)
Answer: 4
Rationale:
1. Narcan is the antidote for opioids.
2. Atropine is the antidote for carbonates and organophosphates.
3. Flumazenil is the antidote for benzodiazepines
4. Mucomyst is the antidote for Tylenol overdose.
Cognitive Level: Application
Client Need: Physiologic Integrity
Nursing Process: Intervention
Learning Outcome: 78-9
Learning Outcome 10
Apply the nursing process to care for patients who are receiving
drug therapy for poisoning or overdose.
28. An explosion at a restaurant occurred, causing several individuals to require
treatment at a nearby hospital. The clients arrived to the Emergency Department with
complaints of visual disturbances, burning of the eyes and skin, and loss of hearing. The
nurses prioritize care based on the nursing diagnosis of:
1. Deficient Knowledge related to exposure to unknown material.
2. Impaired Communication, risk for related to lack of knowledge about the
incident.
3. Ineffective Coping related to the unexpected incident.
4. Poisoning, risk for related to exposure to potential toxic substance.
Answer: 4
Rationale:
1. There is no evidence in the stem that identifies a knowledge deficit.
2. There is no evidence in the stem that indicates a communication problem.
3. There is not enough information in the stem to suggest ineffective coping.
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4. Speaks directly to the assessment of the explosion incident, and care would be
centered around the risk for poisoning.
Cognitive Level: Analysis
Client Need: Safe, Effective Care Environment
Nursing Process: Planning
Learning Outcome: 78-10
29. The nurse is speaking to a group of individuals as part of a trauma outreach program
on poison control. The nurse instructs the group that if a known poison has been ingested,
which of the following measures must be taken?
1. Administering syrup of ipecac if the ingestion is within 30 minutes
2. Having the person drink large amounts of water to flush the poison through the
gastrointestinal system
3. Notifying the local health agency and the Centers for Disease Control and
Prevention of the poison after the person has stabilized
4. Contacting the American Association of Poison Control Centers for the proper
immediate treatment
Answer: 4
Rationale:
1. Do not give ipecac syrup. Though once considered routine procedure, this method
of poison management is now considered ineffective.
2. Do not give milk or water unless directed to do so by the Poison Center. Though
once thought to dilute the poison, fluids can liquefy dry poison and send it more
rapidly to the small intestine.
3. These agencies are not routinely notified when a poisoning has been suspected.
4. Educating the community about accidental poisoning is an important part of
community health nursing. Keep the number of the local poison center close to
your phone. To find your local poison center number, call 1-800-222-1222.
Cognitive Level: Application
Client Need: Health Promotion
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Nursing Process: Implementation
Learning Outcome: 78-10
30. Which of the following vitamins or mineral supplements is a common potential toxic
substance?
1. Vitamin C
2. Zinc
3. Vitamin E
4. Iron
Answer: 4
Rationale:
1. Vitamin C is water-soluble, and rarely toxic.
2. Zinc is a mineral that is rarely a known toxic substance.
3. Vitamin E, although fat-soluble, can cause toxicity, but it is rare.
4. The most common dangerous substances can poison, such as medicines and iron
pills, antifreeze, cleaning products, windshield washer solution, furniture polish,
lighter fluid, lamp oil, kerosene, pesticides, carbon monoxide, and wild
mushrooms.
Cognitive Level: Comprehension
Client Need: Physiologic Integrity
Nursing Process: Assessment
Learning Outcome: 78-10
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