Chapter 20 EMT

A 28-year-old female 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 states tells you that the patient has been urinating excessively and has progressively worsened over the last 24-36 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

A. is significantly hyperglycemic

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

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

Diabetes is MOST accurately defined as a(n):
A. mass excretion of glucose by the kidneys
B. lack of insulin production in the pancreas
C. disorder of glucose metabolism
D. abnormally high blood glucose level

C. disorder of glucose metabolism

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

B. insulin is not available in the body

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

C. polyphagia

Hemoglobin is:
A. essential for the formation of clots, such as when vessel damage occurs
B. the fluid portion of the blood that transports cells throughout the body
C. a key component of the blood that is produced in response to an infection
D. found within the red blood cells and is responsible for carrying oxygen

D. found within the red blood cells and is responsible for carrying oxygen

In general, oral glucose should be given to any patient who:
A. is unresponsive, even in the absence of a history of diabetes
B. has an altered mental status and a history of diabetes
C. has documented hypoglycemia and an absent gag reflex
D. has a blood glucose level that is less than 100 mg/dL

B. has an altered mental status and a history of diabetes

Patients with thrombophilia are at an increased risk for:
A. various cancers
B. pulmonary embolism
C. acute arterial rupture
D. hemorrhagic stroke

C. acute arterial rupture

Patients with type 2 diabetes usually control their disease with all of the following, EXCEPT:
A. tolbutamide (orinase)
B. glyburide (micronase)
C. supplemental insulin
D. diet & exercise

C. supplemental insulin

Patients with uncontrolled diabetes experience polyuria because:
A. low blood glucose levels result in cellular dehydration
B. excess glucose in the blood is excreted by the kidneys
C. high blood sugar levels cause permanent kidney damage
D. they drink excess amounts of water due to dehydration

B. excess glucose in the blood is excreted by the kidneys

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

C. ensuring the absence of a gag reflex

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

C. takes too much of his or her prescribed insulin

The normal blood glucose level is between:
A. 80-120 mg/dL
B. 60-80 mg/dL
C. 130-150 mg/dL
D. 160-200 mg/dL

A. 80-120 mg/dL

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 confused 55-year-old male with tachycardia and pallor
C. a semiconscious 40-year-old female without a gag reflex
D. a conscious 37-year-old female with nausea and vomiting

B. a confused 55-year-old male with tachycardia and pallor

Type 1 diabetes:
A. is typically treated with medications such as metformin
B. typically occurs in patients between 50-70 years of age
C. is defined as a blood sugar level that is less than 120 mg/dL
D. is a condition in which no insulin is produced by the body

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

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. presence of a medical identification tag
D. rate and depth of breathing

D. rate and depth of breathing

When obtaining a SAMPLE history from a patient with diabetes who has an altered mental status, it would be MOST important to determine:
A. the name of the physician who prescribed their insulin
B. if they have had any recent illness or excessive stress
C. approximately how much water the patient has drank that day
D. if there is a family history of diabetes or related conditions

B. if they have had any recent illness or excessive stress

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

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. low blood glucose level
C. weight gain and edema
D. total lack of appetite

A. weight loss and polyuria

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

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