These CCRN practice questions target toxicology. The complete CCRN deck holds 1000 flashcards, 30 of them dedicated to this topic. Study the free samples below, then unlock the whole collection for a one-time $7.
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A patient ingested an unknown amount of acetaminophen 6 hours ago. The level returns above the treatment line on the Rumack-Matthew nomogram. What is the priority intervention and the golden window for maximum efficacy?
Show answer →Priority: Administer N-acetylcysteine (NAC). The golden window is within 8 hours of ingestion to prevent hepatotoxicity. NAC restores glutathione stores, allowing the detoxification of the toxic metabolite NAPQI. Exam Tip: If the ingestion time is unknown or >24h, the nomogram is not used; treat empirically if APAP is detectable or AST/ALT are elevated.
A patient is 36 hours post-acetaminophen ingestion. They report RUQ pain and labs show AST 2,500 U/L and INR 2.1. Which stage of toxicity is this patient in?
Show answer →Stage 2 (24–72 hours). This stage is characterized by the onset of liver injury, elevated transaminases, and RUQ pain. Stage 1 (0-24h) is often asymptomatic or mild GI upset. Stage 3 (72-96h) is the peak of liver failure (jaundice, encephalopathy, coagulopathy). Stage 4 (>4 days) is the recovery phase or progression to multi-organ failure. Exam Tip: Focus on the 24-72 hour window for the rise of enzymes.
After successful reversal of a Methadone overdose with Naloxone, the patient becomes somnolent and bradypneic again 60 minutes later. What is the physiological rationale and the required nursing intervention?
Show answer →The half-life of Naloxone (30–90 mins) is significantly shorter than the half-life of Methadone or extended-release opioids. As Naloxone dissociates from mu-receptors, the remaining opioid re-occupies them (re-sedation). Action: Resume Naloxone via continuous infusion (start at 2/3 of the dose that successfully reversed the patient per hour) and monitor for at least 24 hours.
Which specific opioid is an exception to the classic pinpoint pupil (miosis) presentation and is associated with a risk of seizures?
Show answer →Meperidine (Demerol). It can cause mydriasis (dilated pupils) due to its atropine-like structure. Its metabolite, normeperidine, is a CNS stimulant that can cause tremors, hyperreflexia, and seizures, especially in patients with renal impairment. CCRN Tip: Naloxone reverses respiratory depression but does NOT prevent normeperidine-induced seizures.
A patient in the ICU for alcohol withdrawal is receiving a Dexmedetomidine infusion for agitation. What is a critical limitation of this medication in the management of AWS?
Show answer →Dexmedetomidine (Precedex) is an alpha-2 agonist that provides sedation and reduces sympathetic outflow (tachycardia/hypertension), but it has NO GABAergic activity. Therefore, it does NOT prevent alcohol withdrawal seizures or Delirium Tremens. Exam Tip: AACN may test this as a distractor. Dexmedetomidine is an adjunct, never a monotherapy. The patient still requires benzodiazepines or phenobarbital to address the underlying GABA/NMDA imbalance and prevent seizures.
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Try 30 free CCRN cards firstThe full CCRN deck contains 1000 flashcards, and 30 of them focus on toxicology. This page shows 5 free samples.
Our CCRN deck dedicates 30 of 1000 cards (3%) to toxicology — always cross-check the official AACN exam outline for the current blueprint weighting.
Yes — the samples on this page are free, and the CCRN preview page has 30 more free cards. Full access to all 1000 cards is a one-time $7.
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Pathology
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