Chapter 17 - Endocrine & Hematologic Emergencies

Question 1

A 19-year-old man has a chief complaint 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. In addition to administering oxygen, you should:
Select one:
A. request a paramedic ambulance to administer IV glucose.
B. contact medical control and administer oral glucose.
C. transport only with close, continuous monitoring en route.
D. assist him with his insulin injection and reassess him.

Answer 1

B. contact medical control and administer oral glucose.

Question 2

A 28-year-old woman 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 her condition has progressively worsened over the last 24 to 36 hours. On the basis of this patient's clinical presentation, you should suspect that she:
Select one:
A. is significantly hyperglycemic.
B. has a urinary tract infection.
C. has overdosed on her insulin.  
D. has a low blood glucose level.

Answer 2

A. is significantly hyperglycemic.

Question 3

A 37-year-old woman with a history of diabetes presents with excessive urination and weakness of 2 days' duration. You apply 100% oxygen and assess her blood glucose level, which is 320 mg/dL. If this patient's condition is not promptly treated, she will MOST likely develop:
Select one:
A. severe insulin shock.
B. complete renal failure. 
C. hypoxia and overhydration.
D. acidosis and dehydration.

Answer 3

D. acidosis and dehydration.

Question 4

A 75-year-old man 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:
Select one:
A. an acute stroke.
B. hyperglycemia.
C. a heart attack.
D. hypoglycemia.

Answer 4

C. a heart attack.

Question 5

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

Answer 5

C. diabetic ketoacidosis

Question 6

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

Answer 6

A. combativeness.

Question 7

During assessment of an unconscious patient with diabetes, the primary visible difference between hyperglycemia and hypoglycemia is the:
Select one:
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.

Answer 7

C. rate and depth of breathing.

Question 8

Excessive eating caused by cellular “hunger” is called:
Select one:
A. dyspepsia.  
B. polydipsia.
C. polyphagia.
D. dysphasia.

Answer 8

C. polyphagia.

Question 9

Hypoglycemic crisis tends to develop more often and more severely in children because:
Select one:
A. their cells do not uptake glucose as fast as those of adults.
B. they do not always eat correctly and on schedule.
C. they have larger glucose stores than adults do.
D. their low activity levels cause rapid glucose depletion.

Answer 9

B. they do not always eat correctly and on schedule.

Question 10

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

Answer 10

B. erythrocytes and leukocytes

Question 11

You respond to a movie theater for a 70-year-old man 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:
Select one:
A. performing a rapid exam and obtaining vital signs.
B. administering one to two tubes of oral glucose.
C. assisting the patient with his diabetic medication.
D. applying a nonrebreathing mask at 15 L/min.

Answer 11

D. applying a nonrebreathing mask at 15 L/min.