Registered Practical Nurse (RPN) Practice Test

In the case of an adolescent client with tremors and ataxia after sniffing glue, what substance does the nurse suspect?

1. Acetone

2. Toluene

3. Carbon monoxide

4. Formaldehyde

The correct answer is: Toluene

The correct answer is toluene. Toluene is a solvent often found in products such as glues, paints, and nail polish removers. Inhalation of toluene can lead to neurological symptoms, including tremors and ataxia, due to its effects on the central nervous system. As a highly volatile substance, toluene is commonly associated with "sniffing" behaviors among adolescents, which can result in acute toxicity, characterized by these motor function issues. Acetone, while also a solvent, is less commonly linked to the significant neurotoxic effects observed with toluene. Carbon monoxide primarily affects oxygen transport in the blood and usually presents with symptoms like headaches, dizziness, and confusion rather than tremors and ataxia. Formaldehyde exposure can cause respiratory distress and irritation rather than the neurological symptoms described in this case. Therefore, toluene is the most plausible substance to be suspected in this scenario due to its specific association with the symptoms and the behavior of sniffing glue.