Chapter 19

106.In contrast to insulin shock, diabetic coma A. is rapidly reversible if oral glucose is given.B. commonly results in excess water retention.C. can only be corrected in the hospital setting.D. is a rapidly developing metabolic disturbance.

can only be corrected in the hospital setting.

41.A patient who is---------- may have Kussmaul respirations and sweet, fruity breath.

hyperglycemia

104.Diabetic coma is a life-threatening condition that results in A. hypoglycemia, excess insulin, and dehydration.B. hyperglycemia, ketoacidosis, and dehydration.C. hypoglycemia, dehydration, and ketoacidosis.D. hyperglycemia, excess insulin, and ketoacidosis.

hyperglycemia, ketoacidosis, and dehydration.

42.A patient with dry and warm skin indicates ...?

hyperglycemia.

43.A patient in symptomatic------------ is more critical and more likely to suffer from permanent problems than the condition of a patient with hyperglycemia or diabetic ketoacidosis.

hypoglycemia

92.When obtaining a SAMPLE history from a patient with diabetes, it would be MOST important to determine A.if he or she has had any recent illnesses or excessive stress. B.approximately how much water the patient drank that day. C.if there is a family history of diabetes or related conditions. D.the name of the physician who prescribed his or her insulin.

if he or she has had any recent illnesses or excessive stress.

85.A 54-year-old golfer collapsed on the 17th green at the golf course. His friend said he wasn't feeling well after the eighth hole, but insisted on walking and finishing out the game. His skin is pale, cool, and diaphoretic, and he provides incoherent answers to your questions. An initial blood glucose measurement indicates 65 mg/dL. The patient loses consciousness and a second blood glucose level reads 48 mg/dL. You should

call for, or rendezvous with, an ALS unit, ensure a patent airway, and provide high-flow oxygen.

57.Diabetes mellitus is a metabolic disorder in which the hormone ______ is missing or ineffective A. estrogenB. adrenalineC. insulinD. epinephrine

insulin

102.Diabetic ketoacidosis occurs when A. blood glucose levels rapidly fall.B. the cells rapidly metabolize glucose.C. the pancreas produces excess insulin.D. insulin is not available in the body.

insulin is not available in the body.

64.Oral diabetic medications do NOT include A. micronase B. glucotrol C. januvia D insulin

insulin medication

6.You are treating a 40-year-old male with a documented blood sugar reading of 480 mg/dL. The patient is semiconscious and breathing shallowly, and is receiving assisted ventilation from your partner. You should recognize that definitive treatment for this patient includes A. insulin.B. oxygen.C. dextrose.D. glucagon.

insulin.

84.A patient with hypoglycemia or hyperglycemia may appear to be A. having a heart attack B. perfectly normal C. intoxicated D. having a stroke

intoxicated

10.A 37-year-old female with a history of diabetes presents with excessive urination and weakness of 2 days' duration. Her blood glucose level reads 320 mg/dL. If this patient's condition is not promptly treated, she will MOST likely develop - hypoxia and overhydration. - severe insulin shock. - acidosis and dehydration. - irreversible renal failure.

irreversible renal failure.

95.Type I diabetes

is a condition in which no insulin is produced by the body.

29.In which condition are you most likely to encounter a vasoocclusive crisis? - Symptomatic hypoglycemia - Sickle cell disease - Hemophilia - Thrombophilia

- Sickle cell disease A vasoocclusive crisis is caused by sickle-shaped red blood cells that obstruct blood flow to a portion of the body.

44.what are the contraindications to oral glucose

are an inability to swallow and unconsciousness.

60.The patient with diabetic ketoacidosis (DKA) will generally have a fingerstick glucose level higher than A. 100 mg?dL B. 200 mg/dL C. 300 mg/dL D. 400 mg/dL

400 mg/dL

3.The normal blood glucose level is between A. 30 and 150 mg/dL. B. 80 and 120 mg/dL. C. 160 and 200 mg/dL. D. 60 and 80 mg/dL

80 and 120 mg/dL.

54.Which of the following is a normal glucose level in an adult? 20 mg/dL 80 mg/dL 140 mg/dL 200 mg/dL

80 mg/dL

31.The normal glucose range in non-fasting children and adults is ____________. 60-80 mg/dL 80-120 mg/dL 120-200 mg/dL 550-600 mg/dL

80-120 mg/dL

90.To which of the following diabetic patients should you administer oral glucose? A.an unconscious 33-year-old male with cool, clammy skin B.a conscious 37-year-old female with nausea and vomiting C.a semiconscious 40-year-old female without a gag reflex D.a confused 55-year-old male with tachycardia and pallor

A confused 55-year-old male with tachycardia and pallor

What are the two main components of blood? Erythrocytes and hemoglobin Cells and plasma Leukocytes and white blood cells Platelets and neutrophils

Answer: B Rationale: The blood is made up of two main components: cells and plasma. The cells in the blood include red blood cells (erythrocytes), white blood cells (leukocytes), and platelets. These cells are suspended in a straw-colored fluid called plasma.

A 45-year-old man with type 1 diabetes is found unresponsive. Which of the following questions is MOST important to ask his wife? a "Did he take his insulin today?" b "How long has he been a diabetic?" c "Has he seen his physician recently?" d "What kind of insulin does he take?"

Answer: A Rationale: All of these questions are important to ask the spouse of an unconscious diabetic. However, it is critical to ask if the patient took his insulin. This will help you differentiate hypoglycemic crisis from hyperglycemic crisis. For example, if the patient took his insulin and did not eat, or accidentally took too much insulin, you should suspect hypoglycemic crisis. If the patient did not take his insulin, you should suspect hyperglycemic crisis.

Which one of the following is NOT an appropriate treatment for EMTs to provide to a patient who has a hematologic disorder? Analgesics for pain Support of symptoms High-flow oxygen therapy at 12 to 15 L/min Rapid transport

Answer: A Rationale: Although analgesics would benefit a patient suffering from a hematologic disorder, the administration of such medications is not in the scope of practice for the EMT. ALS providers would have to be present to provide this emergency care.

If the cells do not receive glucose, they will begin to metabolize: fat. acid. sugar. ketones.

Answer: A Rationale: If the body's cells do not receive glucose, they will begin to metabolize the next most readily available substance—fat. Fat metabolism results in the production of ketoacids, which are released into the bloodstream (hence the term "ketoacidosis").

A diabetic patient presents with a blood glucose level of 310 mg/dL and severe dehydration. The patient's dehydration is the result of: a excretion of glucose and water from the kidneys. b a deficiency of insulin that causes internal fluid loss. c an infection that often accompanies hyperglycemia. d an inability to produce energy because of insulin depletion.

Answer: A Rationale: In severe hyperglycemia, the kidneys excrete excess glucose from the body. This process requires a large amount of water to accomplish; therefore, water is excreted with the glucose, resulting in dehydration.

Patients with diabetic ketoacidosis experience polydipsia because: they are dehydrated secondary to excessive urination. the cells of the body are starved due to a lack of glucose. fatty acids are being metabolized at the cellular level. hyperglycemia usually causes severe internal water loss.

Answer: A Rationale: Severe hyperglycemia—which leads to diabetic ketoacidosis—causes the body to excrete large amounts of glucose and water. As a result, the patient becomes severely dehydrated, which leads to excessive thirst (polydipsia).

A 19-year-old diabetic male was found unresponsive on the couch by his roommate. After confirming that the patient is unresponsive, you should: suction his oropharynx. manually open his airway. administer high-flow oxygen. begin assisting his ventilations

Answer: B Rationale: Immediately after determining that a patient is unresponsive, your first action should be to manually open his or her airway (eg, head tilt-chin lift, jaw-thrust). Use suction as needed to clear secretions from the patient's mouth. After manually opening the airway and ensuring it is clear of obstructions, insert an airway adjunct and then assess the patient's breathing.

Which combination of factors would MOST likely cause a hypoglycemic crisis in a diabetic patient? Eating a meal and taking insulin Skipping a meal and taking insulin Eating a meal and not taking insulin Skipping a meal and not taking insulin

Answer: B Rationale: The combination that would most likely cause a hypoglycemic crisis is skipping a meal and taking insulin. The patient will use up all available glucose in the bloodstream and become hypoglycemic. Left untreated, hypoglycemic crisis may cause permanent brain damage or even death.

Type 1 diabetes is a condition in which: 1.too much insulin is produced. 2.glucose utilization is impaired. 3.too much glucose enters the cell. 4.the body does not produce glucose.

Answer: B Rationale: Type 1 diabetes is a disease in which the pancreas fails to produce enough insulin (or none at all). Insulin is a hormone that promotes the uptake of sugar from the bloodstream and into the cells. Without insulin, glucose utilization is impaired because it cannot enter the cell.

What breathing pattern would you MOST likely encounter in a patient with diabetic ketoacidosis (DKA)? Slow and shallow Shallow and irregular Rapid and deep Slow and irregular

Answer: C Rationale: Kussmaul respirations—a rapid and deep breathing pattern seen in patients with DKA—indicates that the body is attempting to eliminate ketones via the respiratory system. A fruity or acetone breath odor is usually present in patients with Kussmaul respirations.

When dealing with hematologic disorders, the EMT must be familiar with the composition of blood. Which of the following is considered a hematologic disease? Sickle cell disease Hemophilia Lou Gehrig's disease Both A and B

Answer: D Rationale: Hematology is the study and prevention of blood-related diseases, such as sickle cell disease and hemophilia.

In contrast to a hyperglycemic crisis, a hypoglycemic crisis: rarely presents with seizures. presents over a period of hours to days. should not routinely be treated with glucose. usually responds immediately after treatment.

Answer: D Rationale: Hypoglycemic crisis usually responds immediately following treatment with glucose. Patients with hyperglycemic crisis generally respond to treatment gradually, within 6-12 hours following the appropriate treatment. Seizures can occur with both hyperglycemic crisis and hypoglycemic crisis, but are more common in patients with hypoglycemic crisis.

The assessment of a patient with a hematologic disorder is the same as it is with all other patients an EMT will encounter. The EMT must perform a scene size-up, primary assessment, history taking, secondary assessment, and reassessment. In addition to obtaining a SAMPLE history, EMTs should ask which of the following questions? Have you had a crisis before? When was the last time you had a crisis? How did your crisis resolve? All of the above

Answer: D Rationale: SAMPLE is the mnemonic used in taking the history of all patients. In addition to asking the SAMPLE, EMTs should also ask about past crises.

A woman called EMS because her 12-year-old son, who had been experiencing excessive urination, thirst, and hunger for the past 36 hours, has an altered mental status and is breathing fast. You should be MOST suspicious for: low blood sugar. hypoglycemia. hypoglycemic crisis. hyperglycemic crisis.

Answer: D Rationale: The child is experiencing a hyperglycemic crisis secondary to severe hyperglycemia. Hyperglycemic crisis is characterized by a slow onset; excessive urination (polyuria), thirst (polydipsia), and hunger (polyphagia). Other signs include rapid, deep breathing with a fruity or acetone breath odor (Kussmaul respirations); a rapid, thready pulse; and an altered mental status.

14.Which of the following conditions is the diabetic patient at an increased risk of developing? - Blindness - Hepatitis B - Depression - Alcoholism

Blindness

49.what organs can rapidly sustain permanent damage when the body's glucose level is too low? Brain Heart Kidney Liver

Brain

63.What condition increases a patient's risk for developing thrombophilia A. diabetes B. sickle cell disease C. cirrhosis of the liver D. cancer

Cancer

30.Kussmaul respirations

Deep, rapid breathing; usually the result of an accumulation of certain acids when insulin is not available in the body

48.what is the most common metabolic disease of childhood? Diabetes mellitus type 1 Diabetes mellitus type 2 Ketoacidosis Hyperosmolar hyperglycemic nonketotic syndrome

Diabetes mellitus type 1

53.Which of the following is the most common metabolic disease of childhood? Diabetes mellitus type 1 Diabetes mellitus type 2 Ketoacidosis Hyperosmolar hyperglycemic nonketotic syndrome

Diabetes mellitus type 1

28.In ________, there are fewer insulin receptors, so insulin resistance develops. - Diabetes mellitus type 1 - Diabetes mellitus type 2 - HHNS - Ketoacidosis

Diabetes mellitus type 2

105.Which of the following statements regarding diabetic coma is correct? A. Diabetic coma can be prevented by taking smaller insulin doses.B. Diabetic coma typically develops over a period of hours or days.C. Patients with low blood glucose levels are prone to diabetic coma.D. Diabetic coma rapidly progresses once hyperglycemia develops.

Diabetic coma typically develops over a period of hours or days.

35.polyphagia

Excessive eating; in diabetes, the inability to use glucose properly can cause a sense of hunger.

34.polydipsia

Excessive thirst that persists for long periods, despite reasonable fluid intake; often the result of excessive urination.

47.What is released when the concentration of glucose drops in the blood? Insulin Epinephrine Glucagon Dopamine

Glucagon

99.Metformin, a non-insulin medication, is another name for

Glucophage.

45.Diabetes is a metabolic disorder in which the body's ability to metabolize what is impaired? Protein Fats Glucose Electrolytes

Glucose

62.The sweet or fruity odor on the breath of a patient is commonly found in what condition? A. hypoglycemia B. hyperglycemia C. hemophilia D. thrombophilia

Hyperglycemia

7.Which of the following statements regarding sickle cell disease is correct? - In sickle cell disease, the red blood cells are abnormally shaped and are less able to carry oxygen. - Sickle cell disease is an inherited blood disorder that causes the blood to clot too quickly. - The red blood cells of patients with sickle cell disease are round and contain hemoglobin. - Because of their abnormal shape, red blood cells in patients with sickle cell disease are less apt to lodge in a blood vessel.

In sickle cell disease, the red blood cells are abnormally shaped and are less able to carry oxygen.

65.Which of the following is a contraindication to the administration of oral glucose? A. inability to swallow B. history of diabetic ketoacidosis C. active infection D. recent abdominal surgery

Inability to swallow

66.______ is the hormone that is normally produced by the pancreas that enables glucose to enter the cells. A. insulin B. adrenaline C. estrogen D. epinephrine

Insulin

46.What is the function of insulin in the body? It prevents glucose from oversaturating cells. It enables glucose in the blood to enter cells. It regulates oxygen flow to the cells. It regulates chemical production in the endocrine glands.

It enables glucose in the blood to enter cells.

61.Where is glycogen stored in the body? A. liver B. brain C. pancreas D. heart

Liver

15.A patient with hypoglycemia will often present with which of the following signs/symptoms? - Deep, rapid respirations - Warm, red, and dry skin - Hypertension - Pale, cool, and clammy skin

Pale, cool, and clammy skin

5.A 66-year-old woman experienced a sudden onset of difficulty breathing. She has a history of type 2 diabetes and deep vein thrombosis (DVT). On the basis of her medical history, which of the following should the EMT suspect? - Diabetic ketoacidosis - Congestive heart failure - Severe hypoglycemia - Pulmonary embolism

Pulmonary embolism

72._____ is/are a potentially life-threatening complication of hypoglycemia A. Kussmaul respirations B. hypotension C. seizures D. polydipsia

Seizures

37.Presentations of Hypoglycemia include

Seizures, altered mental status, misdiagnosis of neurologic dysfunction, and relationship to airway management

52.In which condition are you most likely to encounter a vasoocclusive crisis? Symptomatic hypoglycemia Sickle cell disease Hemophilia Thrombophilia

Sickle cell disease

32.Patients experiencing a sickle cell crisis should receive which of the following treatments to help improve perfusion? Bandaging to stop bleeding Oral glucose to boost nutrition Supplemental oxygen to hypersaturate the remaining hemoglobin All of these answers are correct.

Supplemental oxygen to hypersaturate the remaining hemoglobin

39.You are treating a 36-year-old patient displaying the following signs and symptoms: rapid, shallow respirations; pale, cool, clammy skin; tachycardia; weakness on the left side of the body; and confusion and irritability. What should you suspect? Symptomatic hyperglycemia Symptomatic hypoglycemia Vasoocclusive crisis DKA

Symptomatic Hypoglycemia

4.Which of the following statements regarding glucose is correct? A) The brain requires insulin to allow glucose to enter the cells. B) Blood glucose levels decrease in the absence of insulin. C) Most cells will function normally without glucose. D) The brain requires glucose as much as it requires oxygen

The brain requires glucose as much as it requires oxygen.

36.polyuria

The passage of an unusually large volume of urine in a given period; in diabetes, this can result from the wasting of glucose in the urine.

50.The condition in which blood clots as a result of an abnormality of the system of coagulation is called what? Hemophilia Sickle cell disease Thrombosis Thrombophilia

Thrombophilia

51.what type of diabetes is classified as an autoimmune disorder? Type 1 diabetes Type 2 diabetes Sickle cell disease Acidosis

Type 1 diabetes

93.Which of the following signs or symptoms would the EMT MOST likely encounter in a patient with new-onset type 1 diabetes? a. Low blood glucose level b. Total lack of appetite c. Weight loss and polyuria d. Weight gain and edema

Weight loss and polyuria

8.A 75-year-old male with type 1 diabetes presents with chest pain and a general feeling of weakness. He tells you that he took his insulin today and ate a regular meal approximately 2 hours ago. You should treat this patient as though he is experiencing A. a heart attack.B. an acute stroke.C. hyperglycemia.D. hypoglycemia.

a heart attack.

109.You are treating a 20-year-old male with a history of diabetes. The patient states that he is not feeling well. His vital signs are stable; however, he is confused and his skin is cool and clammy. You attempt to obtain a blood glucose reading with your glucometer; however, it reads "error" after three attempts. After administering 100% oxygen, you should

administer oral glucose as needed and transport.

75.Always suspect hypoglycemia in any patient with A. Kussmaul respirations. B. an altered mental status C. nausea and vomiting D. stridor

an altered mental status

81.Signs and symptoms associated with hypoglycemia include A. blood transfusions B. analgesics for pain C. intravenous (IV) therapy D. decontamination

anxious or combative behavior

40.You respond to a movie theater for a 70-year-old male who is confused. His wife tells you he has type 2 diabetes but refuses to take his pills. Your assessment reveals that the patient is diaphoretic, tachycardic, and tachypneic. Initial management for this patient should include 1. administering one to two tubes of oral glucose. 2. applying a nonrebreathing mask at 15 L/min 3. assisting the patient with his diabetic medication. 4. performing a rapid exam and obtaining vital signs.

applying a nonrebreathing mask at 15 L/min.

78.When obtaining the medical history of a patient with a sickle cell crisis, you should A. determine the patient's level of consciousness B. ask the patient about recent illnesses or stress C. take the patient's vital signs D. avoid asking about previous sickle cell crisis

ask the patient about recent illnesses or stress

24.A 31-year-old male with a history of diabetes had a seizure that stopped prior to EMS arrival. He is unresponsive and has rapid, shallow breathing. His pulse is rapid and weak and his skin is cyanotic. The EMT should

assist the patient's ventilations with a bag-valve mask.

89.Kussmaul respirations are an indication that the body is

attempting to eliminate acids from the blood.

86.Type 1 diabetes is considered to be a(n) _______ problem, in which the body becomes allergic to its own tissues and literally destroys them.

autoimmune

101.Assessment of a patient with hypoglycemia will MOST likely reveal A. sunken eyes.B. hyperactivity.C. warm, dry skin.D. combativeness.

bizarre behavior.

17.The EMT should assess for hypoglycemia in small children with a severe illness or injury because A. children overproduce insulin during severe illness or injury.B. children cannot store excess glucose as effectively as adults.C. illness or injury causes the pancreas to produce less insulin.D. a child's cells do not uptake glucose as rapidly as adults' do.

children cannot store excess glucose as effectively as adults.

21.A 19-year-old male complains of "not feeling right." His insulin and a syringe are on a nearby table. The patient says he thinks he took his insulin and cannot remember whether he ate. He is also unable to tell you the time or what day it is. The glucometer reads "error" after several attempts to assess his blood glucose level. You should A. contact medical control and administer oral glucose.B. assist him with his insulin injection and reassess him.C. request a paramedic ambulance to administer IV glucose.D. transport only with close, continuous monitoring en route.

contact medical control and administer oral glucose.

87.Common signs and symptoms of severe hyperglycemia include all of the following, EXCEPT

cool, clammy skin.

12.Classic signs and symptoms of hypoglycemia include - cold, clammy skin; bradycardia; hunger; and deep, rapid respirations. - cool, clammy skin; weakness; tachycardia; and rapid respirations. - warm, dry skin; irritability; bradycardia; and rapid respirations. - warm, dry skin; hunger; abdominal pain; and deep, slow respirations.

cool, clammy skin; weakness; tachycardia; and rapid respirations.

82.Hospital interventions for hemophilia may include all of the following EXCEPT A. blood transfusion B. analgesics for pain C. intravenous (IV) therapy D. all of the above E decontamination

decontamination others are correct. A. blood transfusion B. analgesics for pain C. intravenous (IV) therapy

100.The signs and symptoms of insulin shock are the result of A. increased blood glucose levels.B. fat metabolism within the cells.C. decreased blood glucose levels.D. prolonged and severe dehydration.

decreased blood glucose levels.

27.During your assessment of a 70-year-old woman, she tells you that she takes blood-thinning medication and has to wear compression stockings around her legs. This information should make you suspect that she has 1. hemophilia 2. sickle-cell disease 3. deep vein thrombosis. 4. severe hyperglycemia.

deep vein thrombosis

2.A patient with an altered mental status; high blood glucose levels; and deep, rapid breathing may have a condition known as __________. A. diabetic ketoacidosis B. hyperosmolar hyperglycemic nonketotic coma C. hyperglycemic crisis D. hypoglycemic crisis

diabetic ketoacidosis

97.Diabetes is MOST accurately defined as a/an A. disorder of carbohydrate metabolism.B. abnormally high blood glucose level.C. mass excretion of glucose by the kidneys.D. lack of insulin production in the pancreas.

disorder of carbohydrate metabolism.

96.Insulin functions in the body by A. producing new glucose as needed.B. enabling glucose to enter the cells.C. increasing circulating blood glucose.D. metabolizing glucose to make energy.

enabling glucose to enter the cells.

18.Proper procedure for administering oral glucose to a patient includes all of the following, EXCEPT A. checking the medication's expiration date.B. assessing the patient's mental status.C. ensuring the absence of a gag reflex.D. requesting permission from medical control.

ensuring the absence of a gag reflex.

20.The two main types of cells contained in blood are called _________. - platelets and plasma - transport and clotting - erythrocytes and leukocytes - hemoglobin A and S

erythrocytes and leukocytes

88.Ketone production is the result of

fat metabolization when glucose is unavailable.

55.When the body's cells do not receive the glucose they require, the body resorts to burning _____ A. fatsB. proteinsC. blood cellsD. ketones

fats

71.Without _____, or with very low levels, brain cells rapidly suffer permanent damage. A. epinephrine B. ketones C. bicarbonate D. glucose

glucose

16.During your assessment of a 19-year-old male, you are told that he is being treated with factor VIII. This indicates that - he has thrombophilia. - his blood clots too quickly. - he has a thrombosis. - he has hemophilia A.

he has hemophilia A.

26.A 75-year-old male with type 1 diabetes presents with chest pain and a general feeling of weakness. He tells you that he took his insulin today and ate a regular meal approximately 2 hours ago. You should treat this patient as though he is experiencing A. hypoglycemia. B. an acute stroke. C. hyperglycemia. D. a heart attack.

heart attack

13.In contrast to type 1 diabetes, type 2 diabetes A. is caused by resistance to insulin at the cellular level.B. is commonly diagnosed in children and young adults.C. is caused by a complete lack of insulin in the body.D. occurs when antibodies attack insulin-producing cells.

is caused by resistance to insulin at the cellular level.

22.A 28-year-old female patient is found to be responsive to verbal stimuli only. Her roommate states that she was recently diagnosed with type 1 diabetes and has had difficulty controlling her blood sugar level. She further tells you that the patient has been urinating excessively and has progressively worsened over the last 24 to 36 hours. On the basis of this patient's clinical presentation, you should suspect that she A. is significantly hyperglycemic.B. has a low blood glucose level.C. has a urinary tract infection.D. has overdosed on her insulin

is significantly hyperglycemic.

80.When reassessing the diabetic patient after administration of oral glucose, watch for all of the following EXCEPT A. warm, dry skin B. slow pulse C. Kussmaul respirations D. anxious or combative behavior

joint pain

79.A DVT is a worrisome risk for patients who have had A. gallbladder surgery B. alcoholism C. pneumonia D. joint replacement surgery

joint replacement surgery

68.When fat is used as an immediate energy source, _____ and fatty acids are formed as waste products. A. dextrose B. sucrose C. ketons D. bicarbonate

ketones

77.Determination of hyperglycemia or hypoglycemia should be A. made before transport of the patient B. made before administration of oral glucose C. determined by a urine glucose test D. based on your knowledge of the signs and symptoms of each condition

made before transport of the patient

11.The main function of the endocrine system is to _________. - produce glandular secretions - regulate glucose and calcium - regulate blood flow - maintain homeostasis

maintain homeostasis

38.The purpose of the endocrine system is to send ______________ throughout the body to control its function. oxgyen particles messages carbon dioxide

messages

73.Blood glucose levels are measured in A micrograms per deciliter B. milligrams per deciliter C. milliliters per decigram D. microliters per decigram

milligrams per deciliter

70.The onset of hypoglycemia can occure within A. seconds B. minutes C. hours D. days

minutes

19.A man finds his 59-year-old wife unconscious on the couch. He states that she takes medications for type 2 diabetes. He further tells you that his wife has been ill recently and has not eaten for the past 24 hours. Your assessment reveals that the patient is unresponsive. You should A. open and maintain her airway and assess breathing.B. assess for the presence of a medical identification tag.C. administer 100% oxygen via a nonrebreathing mask.D. administer oral glucose between her cheek and gum.

open and maintain her airway and assess breathing.

76.The most important step in caring for the unresponsive diabetic patient is to A. give oral glucose immediately B. perform a focused assessment C. open the airway D. obtain a SAMPLE history

open the airway

108.Glutose is a trade name for A. glucotrol.B. oral glucose.C. micronase.D. glucophage.

oral glucose.

58.Emergency care of a patient with hematologic disorder includes all of the following EXCEPT A. rapid transport for patients with an altered mental status B. providing supportive and symptomatic care C. oxygen at 4 L/min for patients with inadequate breathing D. placing patients in a position of comfort

oxygen at 4 L/min for patients with inadequate breathing

59.Insulin is produced by the

pancreas

9.Excessive eating caused by cellular "hunger" is called A) dysphasia. B) polydipsia.(thursty) C) dyspepsia. D) polyphagia.(hungry)

polyphagia.

67.The term for excessive urination is A. polyuria B. polydipsia C. polyphagia D. polyphony

polyuria

56.A sickle-cell related issue that results in unintentional clot formation is known as a(n) A. hemolytic crisisB. aplastic crisisC. spelic sequestration crisisD. vasoocclusive crisis

vasoocclusive crisis

23.A 29-year-old female presents with confusion and disorientation. Her respirations are rapid and shallow and her pulse is 120 beats/min and thready. She is markedly diaphoretic and has an oxygen saturation of 89%. You should A. transport immediately.B. administer oral glucose.C. provide ventilatory support.D. treat her for hyperglycemia.

provide ventilatory support.

33.Patients with thrombophilia are at an increased risk for various cancers. hemorrhagic stroke. acute arterial rupture. pulmonary embolism.

pulmonary embolism

91.When assessing an unresponsive diabetic patient, the primary visible difference between hyperglycemia and hypoglycemia is the A. rate of the patient's pulse. B. patient's mental status. C. rate and depth of breathing. D. presence of a medical identification tag.

rate and depth of breathing

94.You respond to a residence for a patient who is "not acting right." As you approach the door, the patient, a 35-year-old male, begins shouting profanities at you and your partner while holding a baseball bat. The man is confused and diaphoretic, and is wearing a medical identification bracelet. You should a. contact medical control for instructions. b. retreat at once and call law enforcement. c. calm him down so you can assess him. d. be assertive and talk the patient down.

retreat at once and call law enforcement.

69.An African American patient complaining of severe, generalized pain may have undiagnosed A. sickle cell disease B. type 1 diabetes C. thrombopenia D. hemophilia

sickle-cell disease

98.Patients with type II diabetes usually control their disease with all of the following, EXCEPT A. diet and exercise.B. tolbutamide (Orinase).C. glyburide (Micronase).D. supplemental insulin.

supplemental insulin.

25.A 42-year-old male is found unresponsive on his couch by a neighbor. During your assessment, you find no signs of trauma and the patient's blood glucose level is 75 mg/dL. His blood pressure is 168/98 mm Hg, his heart rate is 45 beats/min and bounding, and his respirations are 8 breaths/min and irregular. The patient is wearing a medical alert bracelet that states he has hemophilia. You should A. administer oxygen via a nonrebreathing mask, apply oral glucose in between his cheek and gum, and transport. B. suspect that he has internal bleeding and is in shock, administer high-flow oxygen, and transport at once. C. administer high-flow oxygen, perform a detailed secondary assessment at the scene, and transport promptly. D. suspect that he has intracranial bleeding, assist his ventilations, and transport rapidly to an appropriate hospital

suspect that he has intracranial bleeding, assist his ventilations, and transport rapidly to an appropriate hospital.

83.Because hyperglycemia is a complex metabolic condition that usually develops over time and involves all the tissues of the body, correcting this condition may A. be accomplished quickly through the use of oral glucose B. require rapid infusion of IV fluid to prevent permanent brain damage C. take many hours in a hospital setting D. include a reduction in the amount of insulin normally taken by the patient

take many hours in a hospital setting

1.Symptomatic hypoglycemia will MOST likely develop if a patient A. irreversible renal failure .B. hypoxia and overhydration. C. severe insulin shock. D. acidosis and dehydration.

takes too much of his or her prescribed insulin.

107.Insulin shock will MOST likely develop if a patient - takes too much of his or her prescribed insulin. - misses one or two prescribed insulin injections. - eats a regular meal followed by mild exertion. - markedly overeats and misses an insulin dose

takes too much of his or her prescribed insulin.

103.Insulin shock tends to develop more often and more severely in children because A. they have larger glucose stores than adults do.B. they do not always eat correctly and on schedule.C. their cells do not uptake glucose as fast as adults' do.D. their low activity levels cause rapid glucose depletion.

they do not always eat correctly and on schedule.

74.Diabetic ketoacidosis may develop as a result of A. too little insulin B. too much insulin C. overhydration D. metabolic alkalosis

too little insulin