Ch. 23 Flashcards
Which of the following statements regarding diabetic ketoacidosis is TRUE?
A) DKA is a complication of type 2 diabetes without ketoacidosis.
B) DKA is an extreme, life-threatening form of hyperthyroidism.
C) Hallmark signs of DKA include polyphagia, polyuria, and polydipsia.
D) DKA is a disease of glucose regulation and excess insulin production.
C) Hallmark signs of DKA include polyphagia, polyuria, and polydipsia.
Page Ref: 600
Objective: 23.7 Compare and contrast diabetic ketoacidosis (DKA) and hyperosmolar hyperglycemic state (HHS).
Which of the following is an action of insulin?
A) It increases the transfer of sugar from the stomach and small intestine to the bloodstream.
B) It increases the movement of sugar from the bloodstream to the cell.
C) It increases the circulating level of glucose in the blood.
D) It blocks the uptake of sugar by the body’s cells.
B) It increases the movement of sugar from the bloodstream to the cell.
Page Ref: 595
Objective: 23.1 Define key terms introduced in this chapter; 23.2 Describe the pathophysiology of type 1 and type 2 diabetes mellitus.
In diabetic ketoacidosis, which of the following may result?
A) Excessive urination, excessive thirst, and excessive hunger
B) Polyuria, polydipsia, polyphagia, and hyperactivity
C) Excessive insulin, excessive glucose, and excessive urination
D) Hyperactivity, excessive thirst, and polyuria
A) Excessive urination, excessive thirst, and excessive hunger
Page Ref: 600
Objective: 23.2 Describe the pathophysiology of type 1 and type 2 diabetes mellitus.
The condition in which there is an insufficient amount of sugar in the blood is called:
A) diabetic coma.
B) hypoglycemia.
C) hyperglycemia.
D) diabetic ketoacidosis.
B) hypoglycemia.
Page Ref: 599
Objective: 23.1 Define key terms introduced in this chapter.
The homeostatic function of the endocrine system is regulated by:
A) hormonal release.
B) baroreceptors.
C) nervous system stimulation.
D) voluntary control.
A) hormonal release.
Page Ref: 592
Objective: 23.2 Describe the pathophysiology of type 1 and type 2 diabetes mellitus.
Which of the following may result in hypoglycemia in the diabetic patient?
A) Failure to take insulin
B) Vigorous exercise
C) High fever
D) Overeating
B) Vigorous exercise
Page Ref: 601
Objective: 23.2 Describe the pathophysiology of type 1 and type 2 diabetes mellitus.
Diabetes mellitus is an endocrine disorder characterized by:
A) inadequate glucose production.
B) inadequate regulation of blood glucose.
C) excessive glucose production.
D) excessive catecholamine production.
B) inadequate regulation of blood glucose.
Page Ref: 592
Objective: 23.1 Define key terms introduced in this chapter.
The pancreas secretes two major hormones, including:
A) prolactin.
B) calcitonin.
C) aldosterone.
D) glucagon.
D) glucagon.
Page Ref: 593
Objective: 23.2 Describe the pathophysiology of type 1 and type 2 diabetes mellitus.
Your patient is a 25-year-old woman with a history of diabetes. She is confused, agitated, and verbally abusive to you, and she is very sweaty. Although she refuses to give a history of the present illness, you should suspect low blood glucose levels as the likely cause of her presentation. If this patient accepts treatment and transport, how often should you reassess her?
A) Every five minutes
B) Every 10 minutes
C) Every 15 minutes
D) Once
C) Every 15 minutes
Page Ref: 598
Objective: 23.12 Describe the reassessment of a patient with a diabetic emergency.
Which of the following blood glucose levels is considered normal for an adult?
A) 40 mg/dL
B) 80 mg/dL
C) 120 mg/dL
D) 150 mg/dL
B) 80 mg/dL
Page Ref: 599
Objective: 23.3 Given a patient’s blood glucose level, determine whether it is within normal limits.
What are the two endocrine hormones released by the pancreas?
A) Epinephrine and norepinephrine
B) Glucose and glycogen
C) Dopamine and neurontin
D) Insulin and glucagon
D) Insulin and glucagon
Page Ref: 593
Objective: 23.2 Describe the pathophysiology of type 1 and type 2 diabetes mellitus.
Which of the following is characteristic of a patient with hyperglycemia?
A) Use of excessive amounts of insulin or lack of adequate food intake
B) Slow onset, Kussmaul’s respirations, and acetone odor on breath
C) Cool, moist skin, agitated behavior, and increased heart rate
D) Sudden onset of altered mental status and combativeness
B) Slow onset, Kussmaul’s respirations, and acetone odor on breath
Page Ref: 599
Objective: 23.6 Compare and contrast the speed of onset and signs and symptoms of hypoglycemia and hyperglycemia.
When cells are unable to utilize glucose for fuel, they will slowly begin to use ________ as an energy source.
A) fats
B) insulin
C) pancreatic enzymes
D) carbohydrates
A) fats
Page Ref: 594
Objective: 23.2 Describe the pathophysiology of type 1 and type 2 diabetes mellitus.
The management of medical and trauma emergencies in diabetic patients is complicated by impaired:
A) cortisol production.
B) insulin depletion.
C) glucose homeostasis.
D) ketoacidosis.
C) glucose homeostasis.
Page Ref: 599
Objective: 23.9 List common complications of diabetes.
The patient with type 2 diabetes is MOST likely to control the condition with:
A) oral antihyperglycemic agents.
B) methimazole.
C) steroids.
D) insulin.
A) oral antihyperglycemic agents.
Page Ref: 598
Objective: 23.2 Describe the pathophysiology of type 1 and type 2 diabetes mellitus.
A patient is hypoglycemic and unconscious. You administer all of a 50 mL prefilled syringe of 50 percent dextrose, or:
A) 5 mg.
B) 50 mg.
C) 0.25 grams.
D) 25 grams.
D) 25 grams.
Page Ref: 601-602
Objective: 23.10 Given a scenario with a patient suffering a diabetic emergency, provide emergency medical care for the patient; 23.11 Identify indications and contraindications to the administration of oral glucose, intravenous dextrose, and intramuscular glucagon.
An unconscious patient is hypoglycemic and has no suitable intravenous site. What do you administer to this patient and by which route?
A) dextrose 25 percent IM
B) insulin SQ
C) glucagon IM
D) insulin IV
C) glucagon IM
Page Ref: 602
Objective: 23.10 Given a scenario with a patient suffering a diabetic emergency, provide emergency medical care for the patient; 23.11 Identify indications and contraindications to the administration of oral glucose, intravenous dextrose, and intramuscular glucagon.
The patient in a hyperosmolar hyperglycemic state is at risk for dehydration due to:
A) osmotic diuresis.
B) vasodilation.
C) sepsis.
D) hemorrhage.
A) osmotic diuresis.
Page Ref: 601
Objective: 23.7 Compare and contrast diabetic ketoacidosis (DKA) and hyperosmolar hyperglycemic state (HHS).
The dose of glucagon when given IM is:
A) 50 mg IV.
B) 5 mg IV.
C) 1 mg IM.
D) 10 mg IM.
C) 1 mg IM.
Page Ref: 602
Objective: 23.10 Given a scenario with a patient suffering a diabetic emergency, provide emergency medical care for the patient; 23.11 Identify indications and contraindications to the administration of oral glucose, intravenous dextrose, and intramuscular glucagon.
Which of the following statements regarding a hyperosmolar hyperglycemic state (HHS) relative to diabetic ketoacidosis (DKA) is TRUE?
A) Blood glucose in a patient with HHS is lower than in the patient with DKA.
B) There is a lack of ketone formation in a patient with HHS.
C) Alkalosis results from inadequate tissue perfusion in a patient with HHS.
D) Glucose is unavailable for metabolism in HHS.
B) There is a lack of ketone formation in a patient with HHS.
Page Ref: 600-601
Objective: 23.7 Compare and contrast diabetic ketoacidosis (DKA) and hyperosmolar hyperglycemic state (HHS).
Your patient is a 28-year-old man who is found unconscious, breathing deeply and rapidly with a weak, rapid pulse. The patient’s skin is warm with dry mucous membranes and you note a fruity odor to the breath. Treatment for this patient would EXCLUDE:
A) isotonic IV fluid administration.
B) high-flow oxygen by mask.
C) possible dextrose administration.
D) oral glucose.
D) oral glucose.
Page Ref: 602
Objective: 23.11 Identify indications and contraindications to the administration of oral glucose, intravenous dextrose, and intramuscular glucagon.
What is the recommendation of the American Diabetes Association for diabetic patients’ HbA1c levels?
A) Greater than or equal to 8.0 percent
B) 6.5 percent or less
C) 1.5 percent
D) 9 percent
B) 6.5 percent or less
Page Ref: 599
Objective: 23.3 Given a patient’s blood glucose level, determine whether it is within normal limits.
Which of the following statements regarding glucose use by the cells is TRUE?
A) The brain can convert to using fats for energy.
B) The brain requires insulin to absorb glucose.
C) Glycogen is stored in the pancreas for cellular use.
D) Brain cells require glucose to function.
D) Brain cells require glucose to function.
Page Ref: 595
Objective: 23.4 Recognize the brain’s particular sensitivity to decreased blood glucose levels.
The basis of the excessive urination characteristic of untreated diabetes is called:
A) facilitated elimination.
B) osmotic diuresis.
C) gluconeogenesis.
D) facilitated diffusion.
B) osmotic diuresis.
Page Ref: 601
Objective: 23.2 Describe the pathophysiology of type 1 and type 2 diabetes mellitus.