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Worksheetschapter 20
Total questions: 46
Worksheet time: 4hrs 50mins
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:
has a low blood glucose level.
has overdosed on her insulin.
is significantly hyperglycemic.
has a urinary tract infection.
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; hunger; abdominal pain; and deep, slow respirations.
warm, dry skin; irritability; bradycardia; and rapid respirations.
Diabetes is MOST accurately defined as a(n):
lack of insulin production in the pancreas.
disorder of glucose metabolism.
abnormally high blood glucose level.
mass excretion of glucose by the kidneys.
Diabetic ketoacidosis occurs when:
Insulin is not available in the body.
blood glucose levels rapidly fall
The pancreas produces excess insulin.
the cells rapidly metabolize glucose.
Excessive eating caused by cellular "hunger" is called:
polydipsia
dyspepsia.
dysphasia.
polyphagia.
Hemoglobin is:
the fluid portion of the blood that transports cells throughout the body.
found within the red blood cells and is responsible for carrying oxygen.
essential for the formation of clots, such as when vessel damage occurs.
a key component of the blood and is produced in response to an infection.
In general, oral glucose should be given to any patient who:
is unresponsive, even in the absence of a history of diabetes.
has a blood glucose level that is less than 100 mg/dL.
has documented hypoglycemia and an absent gag reflex.
has an altered mental status and a history of diabetes.
Patients with thrombophilia are at an increased risk for:
acute arterial rupture.
various cancers.
hemorrhagic stroke.
pulmonary embolism.
Patients with type 2 diabetes usually control their disease with all of the following, EXCEPT:
supplemental insulin.
tolbutamide (Orinase).
diet and exercise.
glyburide (Micronase).
Patients with uncontrolled diabetes experience polyuria because:
they drink excess amounts of water due to dehydration
high blood sugar levels cause permanent kidney damage
excess glucose in the blood is excreted by the kidneys.
low blood glucose levels result in cellular dehydration.
Proper procedure for administering oral glucose to a patient includes all of the following, EXCEPT:
ensuring the absence of a gag reflex.
assessing the patient's mental status.
requesting permission from medical control.
checking the medication's expiration date.
Symptomatic hypoglycemia will MOST likely develop if a patient:
misses one or two prescribed insulin injections.
markedly overeats and misses an insulin dose.
eats a regular meal followed by mild exertion.
takes too much of his or her prescribed insulin.
The normal blood glucose level is between:
80 and 120 mg/dL.
60 and 80 mg/dL.
160 and 200 mg/dL.
130 and 150 mg/dL.
To which of the following diabetic patients should you administer oral glucose?
A confused 55-year-old male with tachycardia and pallor
An unconscious 33-year-old male with cool, clammy skin
A semiconscious 40-year-old female without a gag reflex
A conscious 37-year-old female with nausea and vomiting
Type 1 diabetes:
is typically treated with medications such as metformin.
typically occurs in patients between 50 and 70 years of age.
is defined as a blood sugar level that is less than 120 mg/dL.
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
rate and depth of breathing.
patient's mental status.
presence of a medical identification tag.
rate of the patient's pulse.
When obtaining a SAMPLE history from a patient with diabetes who has an altered mental status, it would be MOST important to determine:
approximately how much water the patient drank that day.
if he or she has had any recent illnesses or excessive stress.
if there is a family history of diabetes or related conditions.
the name of the physician who prescribed his or her insulin.
Which of the following conditions is the diabetic patient at an increased risk of developing?
Blindness
Hepatitis B
Depression
Alcoholism
Which of the following signs or symptoms would the EMT MOST likely encounter in a patient with new-onset type 1 diabetes?
Total lack of appetite
Weight loss and polyuria
Low blood glucose level
Weight gain and edema
Which of the following statements regarding sickle cell disease is correct?
Because of their abnormal shape, red blood cells in patients with sickle cell disease are less apt to lodge in a blood vessel.
Sickle cell disease is an inherited blood disorder that causes the blood to clot too quickly.
In sickle cell disease, the red blood cells are abnormally shaped and are less able to carry oxygen.
The red blood cells of patients with sickle cell disease are round and contain hemoglobin.
Type 1 diabetes is a condition in which:
too much insulin is produced.
glucose utilization is impaired.
too much glucose enters the cell.
the body does not produce glucose.
A 45-year-old man with type 1 diabetes is found unresponsive. Which of the following questions is MOST important to ask his wife?
“Did he take his insulin today?”
“Has he seen his physician recently?”
“How long has he been a diabetic?”
“What kind of insulin does he take?”
A diabetic patient presents with a blood glucose level of 310 mg/dL and severe dehydration. The patient’s dehydration is the result of:
excretion of glucose and water from the kidneys.
a deficiency of insulin that causes internal fluid loss.
an infection that often accompanies hyperglycemia.
an inability to produce energy because of insulin depletion.
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
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.
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
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.
If the cells do not receive glucose, they will begin to metabolize:
fat
acid
sugar
ketones
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.
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.
When dealing with hematologic disorders, the EMT must be familiar with the composition of blood. Which of the following is NOT considered a hematologic disease?
Sickle cell disease
Hemophilia
Lou Gehrig’s disease
Thrombophilia
What are the two main components of blood?
Erythrocytes and hemoglobin
Cells and plasma
Platelets and neutrophils
Leukocytes and white blood cells
The assessment of a patient with a hematologic disorder is the same as it is with all other patients an EMT will encounter. 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.
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
List three signs and/or symptoms that can give you clues about the presence of diabetic ketoacidosis
(a)
Polyuria is
(a)
Polyphagia is
(a)
Polydispia is
(a)
Which of these is a notable symptom of hyperglycemia that can lead to ketoacidosis?
Polyuria
Anorexia
Dysphagia
Dysrhythmia
What are key signs of hypoglycemia?
Normal to shallow or rapid respirations, pallor/moist skin, AMS, normal to low BP
Fruity breath, fainting, normal respirations, normal BP
Rapid pulse, dry/warm skin. high BP, AMS
Normal mental status, rapid pulse, polyphagia
What is the name of respirations that are faster and deeper that occur as a result of DKA?
Biot respirations
Kussmaul respirations
Sighing respirations
Cheyne-Stokes respirations
What illness can result from continual fat metabolism and ketone production?
(a)
What's the difference between type 1 and type 2 diabetes?
Pick 2!
In type 1
the pancreas doesn't produce insulin;
In type 2
the pancreas produces less insulin/the body becomes resistant to it
In type 1
the pancreas produces too much insulin;
In type 2
the pancreas produces less insulin/the body uses too much insulin too quickly
Type 1 is typically first found in children; Type 2 is caused by obesity predisposition
Type 1 is typically first found in adolescence; Type 2 is caused by weight loss
AEIOU-TIPS
Alcohol
Epilepsy/Endocrine/[E_____]
I[_____]
Opiates/Other drugs
Uremia ([what is the other name for this condition?])
Trauma/Temp
Infection
Poisoning
S[____]
(a)
How does hemophilia effect the blood?
Decreased ability for the blood to form clots
Blood is more likely to clot
Lower number of hemoglobin carrying cells
Decreased blood oxygen level
What is the disorder in which the body's ability to maintain the viscosity and smooth flow of blood through the venous ands arterial systems?
Thrombophilia
Anemia
Hemophila
Sickle Cell diseases
