Chapter 20 - Endocrine & Hematologic Emergencies

Question 1

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:

Select one:

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

Answer 1

A. irreversible renal failure.

Question 2

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?

Select one:

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

Answer 2

A. Pulmonary embolism

Question 3

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:

Select one:

A. a heart attack.
B. an acute stroke.
C. hyperglycemia.
D. hypoglycemia.

Answer 3

A. a heart attack.

Question 4

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:

Select one:

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.

Answer 4

A. open and maintain her airway and assess breathing.

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. diabetic ketoacidosis
B. hyperosmolar hyperglycemic nonketotic coma
C. hyperglycemic crisis
D. hypoglycemic crisis

Answer 5

A. diabetic ketoacidosis

Question 6

A patient with hypoglycemia will often present with which of the following signs/symptoms?

Select one:

A. Pale, cool, and clammy skin
B. Warm, red, and dry skin
C. Hypertension
D. Deep, rapid respirations

Answer 6

A. Pale, cool, and clammy skin

Question 7

Classic signs and symptoms of hypoglycemia include:

Select one:

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.

Answer 7

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

Question 8

During your assessment of a 19-year-old male, you are told that he is being treated with factor VIII. This indicates that:

Select one:

A. he has hemophilia A.
B. he has a thrombosis.
C. his blood clots too quickly.
D. he has thrombophilia.

Answer 8

A. he has hemophilia A.

Question 9

Excessive eating caused by cellular “hunger” is called:

Select one:

A. dyspepsia.
B. polydipsia.
C. polyphagia.
D. dysphasia.

Answer 9

C. polyphagia.

Question 10

In contrast to type 1 diabetes, type 2 diabetes:

Select one:

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.

Answer 10

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

Question 11

The proper procedure for administering oral glucose to a patient includes all of the following, EXCEPT:

Select one:

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.

Answer 11

C. ensuring the absence of a gag reflex.

Question 12

Symptomatic hypoglycemia will MOST likely develop if a patient:

Select one:

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.

Answer 12

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

Question 13

The EMT should assess for hypoglycemia in small children with a severe illness or injury because:

Select one:

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.

Answer 13

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

Question 14

The main function of the endocrine system is to _________.

Select one:

A. produce glandular secretions
B. regulate blood flow
C. regulate glucose and calcium
D. maintain homeostasis

Answer 14

D. maintain homeostasis

Question 15

The normal blood glucose level is between:

Select one:

A. 30 and 150 mg/dL.
B. 80 and 120 mg/dL.
C. 160 and 200 mg/dL.
D. 60 and 80 mg/dL.

Answer 15

B. 80 and 120 mg/dL.

Question 16

The two main types of cells contained in blood are called _________.

Select one:

A. transport and clotting
B. platelets and plasma
C. hemoglobin A and S
D. erythrocytes and leukocytes

Answer 16

D. erythrocytes and leukocytes

Question 17

Which of the following conditions is the diabetic patient at an increased risk of developing?

Select one:

A. Depression
B. Alcoholism
C. Hepatitis B
D. Blindness

Answer 17

D. Blindness

Question 18

Which of the following statements regarding glucose is correct?

Select one:

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.

Answer 18

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

Question 19

Which of the following statements regarding sickle cell disease is correct?

Select one:

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.

Answer 19

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

Question 20

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:

Select one:

A. insulin.
B. oxygen.
C. dextrose.
D. glucagon.

Answer 20

A. insulin.