EMT Chapter 19 Endocrine and Hematologic Emergencies

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

A. Weight loss and polyuria

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. a heart attack.

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.

B. 80 and 120 mg/dL.

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

B. Pale, cool, and clammy skin

Kussmaul respirations are an indication that the body is: A. trying to generate energy by breathing deeply B. attempting to eliminate acids from the blood C. compensating for decreased blood glucose levels D. severely hypoxic and is eliminating excess CO2

B. attempting to eliminate acids from the blood.

The onset of hypoglycemia can occur within: A. seconds B. minutes C. hours D. days

B. minutes.

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

C. The brain requires glucose as much as it requires oxygen.

Classic signs and symptoms of hypoglycemia include: A. cold, clammy skin; bradycardia; hunger; and deep, rapid respirations. B. warm, dry skin; hunger; abdominal pain; and deep, slow respirations. C. cool, clammy skin; weakness; tachycardia; and rapid respirations. D. warm, dry skin; irritability; bradycardia; and rapid respirations.

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

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.

C. ensuring the absence of a gag reflex.

Ketone production is the result of: A. rapid entry of glucose across the cell membrane. B. acidosis when blood glucose levels are low. C. fat metabolization when glucose is unavailable. D. blood glucose levels higher than 120 mg/dL.

C. fat metabolization when glucose is unavailable.

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

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

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

D. Blindness

The main function of the endocrine system is to _________. A. produce glandular secretions. B. regulate glucose and calcium. C. regulate blood flow. D. maintain homeostasis.

D. maintain homeostasis

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. calm him down so you can assess him. C. be assertive and talk the patient down. D. retreat at once and call law enforcement.

D. retreat at once and call law enforcement.

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: A. irreversible renal failure. B. hypoxia and overhydration. C. severe insulin shock. D. acidosis and dehydration.

A. irreversible renal failure.

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.

A. is caused by resistance to insulin at the cellular level.

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.

A. open and maintain her airway and assess breathing.

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

A. rate and depth of breathing.

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.

A. insulin.

Symptomatic hypoglycemia will MOST likely develop if a patient: A. takes too much of his or her prescribed insulin. B. eats a regular meal followed by mild exertion. C. markedly overeats and misses an insulin dose. D. misses one or two prescribed insulin injections.

A. takes too much of his or her prescribed insulin.

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

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

Excessive eating caused by cellular "hunger" is called: A. dyspepsia. B. polydipsia. C. polyphagia. D. dysphasia.

C. polyphagia.

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

B. diabetic ketoacidosis

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

B. milligrams per deciliter

Common signs and symptoms of severe hyperglycemia include all of the following, EXCEPT: A. warm, dry skin B. rapid, thready pulse C. cool, clammy skin D. acetone breath odor

C. cool, clammy skin.

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? A. Pulmonary embolism B. Diabetic ketoacidosis C. Congestive heart failure D. Severe hypoglycemia

A. Pulmonary embolism

The accumulation of ketones and fatty acids in blood tissue can lead to a dangerous condition in diabetic patients known as: A. diabetic ketoacidosis B. insulin shock C. HHNC D. hypoglycemia

A. diabetic ketoacidosis.

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

A. erythrocytes and leukocytes

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

A. he has hemophilia A.

Normal blood glucose levels range from _____ mg/dL. A. 80 and 120 mg/dL. B. 60 and 80 mg/dL. C. 160 and 200 mg/dL. D. 30 and 150 mg/dL.

A. 80 to 120

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

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

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.

B. children cannot store excess glucose as effectively as adults.