1
TOXICOLOGY & POISONING NURSING EXAM PRACTICE
EXAMINATION – 100 QUESTIONS WITH ANSWERS AND
RATIONALES (2026 VERSION)
Exam Introduction
This examination evaluates the nurse’s knowledge and clinical judgment in
toxicology and poisoning management, including:
• Recognition of common toxins and poisons
• Assessment and monitoring of poisoned patients
• Emergency interventions for ingestion, inhalation, dermal, or injection
exposures
• Antidote administration and pharmacologic management
• Prevention strategies and patient education
• Understanding toxicokinetics and toxicodynamics
This exam is designed for nursing students, clinical nurses, and exam preparation,
focusing on safe and evidence-based care for toxicology cases.
Exam Instructions
• Total Questions: 100
• Question Type: Multiple Choice (A–D)
• Each question includes:
o Correct answer
o Detailed rationale
Question 1
,2
A patient is admitted with acetaminophen overdose. Which
laboratory test is most important to assess?
A. Liver function tests (AST, ALT)
B. Serum creatinine
C. Complete blood count
D. Blood glucose
Correct Answer: A. Liver function tests (AST, ALT)
Rationale:
Acetaminophen toxicity primarily affects the liver. Elevated AST
and ALT levels indicate hepatocellular injury and guide antidote
therapy (N-acetylcysteine).
Question 2
Which antidote is used for acetaminophen poisoning?
A. Naloxone
B. N-acetylcysteine (NAC)
C. Atropine
D. Deferoxamine
Correct Answer: B. N-acetylcysteine (NAC)
Rationale:
NAC replenishes glutathione, detoxifying the toxic metabolite of
acetaminophen and preventing liver damage.
,3
Question 3
A patient presents after ingesting a large amount of aspirin.
Which acid-base imbalance is expected?
A. Metabolic acidosis
B. Respiratory acidosis
C. Metabolic alkalosis
D. Respiratory alkalosis
Correct Answer: A. Metabolic acidosis
Rationale:
Salicylate toxicity causes metabolic acidosis due to
accumulation of organic acids and respiratory alkalosis from
hyperventilation may also occur in early toxicity.
Question 4
Which intervention is most important for a patient with
ingested corrosive poison (e.g., strong acid)?
A. Induce vomiting immediately
B. Provide supportive care and airway protection
C. Give milk or neutralizing agents orally
D. Administer activated charcoal
, 4
Correct Answer: B. Provide supportive care and airway
protection
Rationale:
Vomiting or neutralizing agents can worsen injury. Protecting
airway and supportive care are priorities.
Question 5
A nurse suspects opioid overdose. Which sign is most
characteristic?
A. Pinpoint pupils and respiratory depression
B. Tachycardia and mydriasis
C. Hyperthermia and agitation
D. Hypertension and flushing
Correct Answer: A. Pinpoint pupils and respiratory depression
Rationale:
Classic opioid toxicity presents with CNS depression, respiratory
depression, and miosis (pinpoint pupils).
Question 6
Which antidote is used for opioid overdose?
A. Flumazenil
B. Naloxone
TOXICOLOGY & POISONING NURSING EXAM PRACTICE
EXAMINATION – 100 QUESTIONS WITH ANSWERS AND
RATIONALES (2026 VERSION)
Exam Introduction
This examination evaluates the nurse’s knowledge and clinical judgment in
toxicology and poisoning management, including:
• Recognition of common toxins and poisons
• Assessment and monitoring of poisoned patients
• Emergency interventions for ingestion, inhalation, dermal, or injection
exposures
• Antidote administration and pharmacologic management
• Prevention strategies and patient education
• Understanding toxicokinetics and toxicodynamics
This exam is designed for nursing students, clinical nurses, and exam preparation,
focusing on safe and evidence-based care for toxicology cases.
Exam Instructions
• Total Questions: 100
• Question Type: Multiple Choice (A–D)
• Each question includes:
o Correct answer
o Detailed rationale
Question 1
,2
A patient is admitted with acetaminophen overdose. Which
laboratory test is most important to assess?
A. Liver function tests (AST, ALT)
B. Serum creatinine
C. Complete blood count
D. Blood glucose
Correct Answer: A. Liver function tests (AST, ALT)
Rationale:
Acetaminophen toxicity primarily affects the liver. Elevated AST
and ALT levels indicate hepatocellular injury and guide antidote
therapy (N-acetylcysteine).
Question 2
Which antidote is used for acetaminophen poisoning?
A. Naloxone
B. N-acetylcysteine (NAC)
C. Atropine
D. Deferoxamine
Correct Answer: B. N-acetylcysteine (NAC)
Rationale:
NAC replenishes glutathione, detoxifying the toxic metabolite of
acetaminophen and preventing liver damage.
,3
Question 3
A patient presents after ingesting a large amount of aspirin.
Which acid-base imbalance is expected?
A. Metabolic acidosis
B. Respiratory acidosis
C. Metabolic alkalosis
D. Respiratory alkalosis
Correct Answer: A. Metabolic acidosis
Rationale:
Salicylate toxicity causes metabolic acidosis due to
accumulation of organic acids and respiratory alkalosis from
hyperventilation may also occur in early toxicity.
Question 4
Which intervention is most important for a patient with
ingested corrosive poison (e.g., strong acid)?
A. Induce vomiting immediately
B. Provide supportive care and airway protection
C. Give milk or neutralizing agents orally
D. Administer activated charcoal
, 4
Correct Answer: B. Provide supportive care and airway
protection
Rationale:
Vomiting or neutralizing agents can worsen injury. Protecting
airway and supportive care are priorities.
Question 5
A nurse suspects opioid overdose. Which sign is most
characteristic?
A. Pinpoint pupils and respiratory depression
B. Tachycardia and mydriasis
C. Hyperthermia and agitation
D. Hypertension and flushing
Correct Answer: A. Pinpoint pupils and respiratory depression
Rationale:
Classic opioid toxicity presents with CNS depression, respiratory
depression, and miosis (pinpoint pupils).
Question 6
Which antidote is used for opioid overdose?
A. Flumazenil
B. Naloxone
