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HESI RN · HESI Pharmacology · Drug toxicology

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Showing all 5 practice questions with expert explanatory rationales.

Question 1 of 5

Delirium tremens:

A. Occurs in approximately 60 per cent of patients withdrawing from alcohol

B. Has a mortality of 5-10 per cent

C. Benzodiazepines are contraindicated

D. Phenytoin should be administered prophylactically to prevent convulsions

Expert Explanatory Rationale

Correct Answer: Has a mortality of 5-10 per cent

Question 2 of 5

3,4-Methylenedioxy-N-methylamphetamine (MDMA or ecstasy):(Select one that does not apply)

A. Has agonist properties at the 5HT2 receptor

B. Has mixed hallucinogenic and stimulant properties

C. Occasionally causes hyperpyrexia

D. All the above

Expert Explanatory Rationale

Correct Answer: All the above

Question 3 of 5

The following are clinical signs consistent with heroin (diamorphine) intoxication:(Select one that does not apply)

A. Slurred speech

B. Rapid respiratory rate

C. Hypothermia

D. Pinpoint pupils

Expert Explanatory Rationale

Correct Answer: Rapid respiratory rate

Question 4 of 5

Specific causes of death which are positively related to smoking include:

A. Ischaemic heart disease

B. Cancer of the oesophagus

C. Emphysema

D. All the above

Expert Explanatory Rationale

Correct Answer: All the above

Question 5 of 5

An 18-year-old woman is admitted 4 hours after taking 50 paracetamol and 50 x 300 mg aspirin tablets. The following statements are correct:

A. She is likely to be in a grade IV coma

B. Stomach washout is indicated

C. Acetylcysteine should be administered

D. If petechiae and subconjunctival haemorrhages are present, fresh frozen plasma should be administered immediately

Expert Explanatory Rationale

Correct Answer: Acetylcysteine should be administered

Option C: Acetylcysteine should be administered as it is the specific antidote for paracetamol overdose, which can lead to hepatotoxicity. Given the significant ingestion of paracetamol, timely administration of acetylcysteine is crucial to prevent liver damage and improve outcomes.

Option A: She is unlikely to be in a grade IV coma solely based on the ingestion of paracetamol and aspirin. Coma grading depends on multiple factors, including neurological assessment and other clinical signs, which are not specified here.

Option B: Stomach washout is not indicated in this scenario. Gastric decontamination is generally not recommended after 4 hours post-ingestion of paracetamol, as the drug is likely absorbed by that time.

Option D: Fresh frozen plasma should not be administered immediately unless there are significant coagulopathy issues. The presence of petechiae and subconjunctival hemorrhages does not automatically necessitate this intervention without further assessment of coagulation status.

Takeaways: Acetylcysteine is the antidote for paracetamol overdose and should be administered promptly to prevent liver damage; timely intervention is critical in managing such cases, as outlined in MedlinePlus on acetaminophen overdose.

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