CLMS CERTIFICATION EXAM 2 2026 TEST
PAPER SOLVED QUESTIONS AND SOLUTIONS
◉ Frost Bite Management. Answer: The goal of management is to
restore normal body temperature. Constrictive clothing and jewelry
that could impair circulation are removed. Wet clothing is removed
as rapidly as possible. If the lower extremities are involved, the
patient should not be allowed to ambulate.
Controlled yet rapid rewarming is instituted. Frozen extremities are
usually placed in a 37°C to 40°C (98.6°F to 104°F) circulating bath
for 30- to 40-minute spans. This treatment is repeated until
circulation is effectively restored. Early rewarming appears to
decrease the amount of ultimate tissue loss. During rewarming, an
analgesic for pain is given as prescribed, because the rewarming
process may be very painful. To avoid further mechanical injury, the
body part is not handled. Massage is contraindicated.
Once rewarmed, the part is protected from further injury and is
elevated to help control swelling. Sterile gauze or cotton is placed
between affected fingers or toes to prevent maceration, and a bulky
dressing is placed on the extremity
◉ What is Frostbite. Answer: Frostbite is trauma from exposure to
freezing temperatures and freezing of the intracellular fluid and
fluids in the intercellular spaces. It results in cellular and vascular
damage. Frostbite can result in venous stasis and thrombosis. Body
parts most frequently affected by frostbite include the feet, hands,
,nose, and ears. Frostbite ranges from first degree (redness and
erythema) to fourth-degree (full-depth tissue destruction).
◉ Nonfatal Drowning. Answer: Nonfatal drowning is defined as
survival for at least 24 hours after submersion that caused a
respiratory arrest. The most common consequence is hypoxemia
◉ Ingested Poisons. Answer: Swallowed poisons may be corrosive.
Corrosive poison includes alkaline and acid agents that can cause
tissue destruction after coming in contact with mucous membranes.
Control of the airway, ventilation, and oxygenation are essential.
Efforts are made to determine what substance was ingested; the
amount; the time since ingestion; signs and symptoms, such as pain
or burning sensations, any evidence of redness or burn in the mouth
or throat, pain on swallowing or an inability to swallow, vomiting, or
drooling; age and weight of the patient; and pertinent health history
Gastric Lavage
Activated Charcoal
◉ Gastric Lavage Use in Ingested Poisons. Answer: Gastric lavage for
the patient who is obtunded is only useful within 1 hour of
ingestion, for sustained-release substances, or massive life-
threatening amounts of a substance; however, complications of
aspiration and stomach or esophageal perforation outweigh its
, usefulness. If performed, gastric aspirate is saved and sent to the
laboratory for testing (toxicology screens).
◉ Activated Charcoal Use in Ingested Poisons. Answer: Activated
charcoal administration if the poison is one that is absorbed by
charcoal; given orally or by nasogastric tube, it is effective in small
intermittent doses to decrease vomiting. It should be diluted as a
slurry so that it is easier to drink or pass through the nasogastric
tube. Activated charcoal absorbs most commonly ingested poisons
except corrosives, heavy metals and hydrocarbons, iron, and lithium
◉ Potassium Administration. Answer: People should take oral
preparations with or after meals; this decreases gastric irritation.
They should not crush controlled-release or extended-release
tablets. It is necessary to mix oral liquids, powders, and effervescent
tablets in at least 120 mL of water, juice, or carbonated beverage to
disguise the taste.
Intravenous (IV) potassium chloride is indicated when a patient
cannot take an oral preparation or has severe hypokalemia. The
nurse measures the serum potassium level and establishes that
urine output is adequate before starting IV potassium therapy. It is
essential to never give undiluted drug by the IV route or give it by
the IV push route.
◉ Alcohol Withdrawl Treatments. Answer: The goals of
management are to give adequate sedation and support to allow the
patient to rest and recover without danger of injury or peripheral
PAPER SOLVED QUESTIONS AND SOLUTIONS
◉ Frost Bite Management. Answer: The goal of management is to
restore normal body temperature. Constrictive clothing and jewelry
that could impair circulation are removed. Wet clothing is removed
as rapidly as possible. If the lower extremities are involved, the
patient should not be allowed to ambulate.
Controlled yet rapid rewarming is instituted. Frozen extremities are
usually placed in a 37°C to 40°C (98.6°F to 104°F) circulating bath
for 30- to 40-minute spans. This treatment is repeated until
circulation is effectively restored. Early rewarming appears to
decrease the amount of ultimate tissue loss. During rewarming, an
analgesic for pain is given as prescribed, because the rewarming
process may be very painful. To avoid further mechanical injury, the
body part is not handled. Massage is contraindicated.
Once rewarmed, the part is protected from further injury and is
elevated to help control swelling. Sterile gauze or cotton is placed
between affected fingers or toes to prevent maceration, and a bulky
dressing is placed on the extremity
◉ What is Frostbite. Answer: Frostbite is trauma from exposure to
freezing temperatures and freezing of the intracellular fluid and
fluids in the intercellular spaces. It results in cellular and vascular
damage. Frostbite can result in venous stasis and thrombosis. Body
parts most frequently affected by frostbite include the feet, hands,
,nose, and ears. Frostbite ranges from first degree (redness and
erythema) to fourth-degree (full-depth tissue destruction).
◉ Nonfatal Drowning. Answer: Nonfatal drowning is defined as
survival for at least 24 hours after submersion that caused a
respiratory arrest. The most common consequence is hypoxemia
◉ Ingested Poisons. Answer: Swallowed poisons may be corrosive.
Corrosive poison includes alkaline and acid agents that can cause
tissue destruction after coming in contact with mucous membranes.
Control of the airway, ventilation, and oxygenation are essential.
Efforts are made to determine what substance was ingested; the
amount; the time since ingestion; signs and symptoms, such as pain
or burning sensations, any evidence of redness or burn in the mouth
or throat, pain on swallowing or an inability to swallow, vomiting, or
drooling; age and weight of the patient; and pertinent health history
Gastric Lavage
Activated Charcoal
◉ Gastric Lavage Use in Ingested Poisons. Answer: Gastric lavage for
the patient who is obtunded is only useful within 1 hour of
ingestion, for sustained-release substances, or massive life-
threatening amounts of a substance; however, complications of
aspiration and stomach or esophageal perforation outweigh its
, usefulness. If performed, gastric aspirate is saved and sent to the
laboratory for testing (toxicology screens).
◉ Activated Charcoal Use in Ingested Poisons. Answer: Activated
charcoal administration if the poison is one that is absorbed by
charcoal; given orally or by nasogastric tube, it is effective in small
intermittent doses to decrease vomiting. It should be diluted as a
slurry so that it is easier to drink or pass through the nasogastric
tube. Activated charcoal absorbs most commonly ingested poisons
except corrosives, heavy metals and hydrocarbons, iron, and lithium
◉ Potassium Administration. Answer: People should take oral
preparations with or after meals; this decreases gastric irritation.
They should not crush controlled-release or extended-release
tablets. It is necessary to mix oral liquids, powders, and effervescent
tablets in at least 120 mL of water, juice, or carbonated beverage to
disguise the taste.
Intravenous (IV) potassium chloride is indicated when a patient
cannot take an oral preparation or has severe hypokalemia. The
nurse measures the serum potassium level and establishes that
urine output is adequate before starting IV potassium therapy. It is
essential to never give undiluted drug by the IV route or give it by
the IV push route.
◉ Alcohol Withdrawl Treatments. Answer: The goals of
management are to give adequate sedation and support to allow the
patient to rest and recover without danger of injury or peripheral
