Ch 22: Diabetic emergencies

Question 1

Your patient is waking up from a​ seizure; it was the​ patient’s first seizure ever. When you ask what​ happened, the patient tells you she had the smell of fresh mown grass just before she seized. This sensation is known as​ a(n):

Answer 1

aura

Question 2

Which of the following is the most common cause of seizures in​ adults?

Answer 2

Failure to take prescribed medication

Question 3

You respond to a​ 32-year-old female who is having a seizure. You arrive on the scene to find the patient​ drowsy, confused, and complaining of a headache. This patient is demonstrating​ the:

Answer 3

postictal phase

Question 4

Your patient is a​ 25-year-old female 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, which of the following should you suspect as the likely cause of the​ patient’s presentation?

Answer 4

Failure to intake sufficient sugar

Question 5

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Part 1
Your patient is a​ 59-year-old female with a sudden onset of slurred speech and weakness on her right side. Which of the following measures is​ appropriate?

Answer 5

Immediately transport the patient to a hospital with specialized treatment for stroke patients.

Question 6

Which of the following is NOT a sign of a hypoglycemic diabetic​ emergency?

Answer 6

Slow heart rate

Question 7

The signs and symptoms of a transient ischemic attack​ (TIA) may last up​ to:

Answer 7

24 hours

Question 8

Treatment of someone with a seizure disorder includes all of the following​:

Answer 8

-removing objects that might harm the patient.

-placing the patient on the floor or ground.

-loosening restrictive clothing.

Question 9

If the blood sugar level is very​ high, which of the following may​ result?

Answer 9

Excessive​ urination, excessive​ thirst, and excessive hunger

Question 10

A hormone called insulin is secreted by​ the:

Answer 10

islets of Langerhans in the pancreas.

Question 11

The death of brain tissue due to deprivation of oxygen because of a blocked or ruptured artery in the brain is known as which of the​ following?

Answer 11

Stroke

Question 12

For the reticular activating system​ (RAS) to work​ correctly, what three substances are​ needed?

Answer 12

Oxygen to perfuse brain​ tissue, glucose to nourish brain​ tissue, and water to keep the brain hydrated

Question 13

Which of the following is a typical cause of seizures in children 6 months to 3 years of​ age?

Answer 13

Fever

Question 14

Which of the following is the MOST critical piece of equipment to have immediately available for the seizure patient who has just stopped​ convulsing?

Answer 14

Suction

Question 15

What is​ epilepsy?

Answer 15

A condition in which a person has multiple seizures usually controlled by medication

Question 16

Your patient is a​ 19-year-old female who is 7 months pregnant. She just experienced a seizure. Although she has no previous history of seizures or any other medical​ condition, she was just diagnosed with​ pregnancy-induced hypertension. Which of the following is the most likely cause of the​ seizure?

Answer 16

Eclampsia

Question 17

Many stroke patients are candidates for thrombolytic drugs. One of the most important things that an EMT can do to optimize the care of a stroke patient who is a candidate for the drugs​ is:

Answer 17

determine the exact time of onset of symptoms.

Question 18

Which of the following is the role of glucose in the​ body?

Answer 18

It provides energy for brain cells and other cells in the body.

Question 19

Which of the following is the cause of most​ strokes?

Answer 19

Blockage of an artery supplying part of the brain

Question 20

Which of the following is one of the most common characteristics of a​ stroke?

Answer 20

Weakness on one side of the body

Question 21

Which of the following is characteristic of a patient with​ hyperglycemia?

Answer 21

A​ “fruity” odor of the breath

Question 22

With advances in​ clot-busting (thrombolytic)​ drugs, the patient has a window of​ ________ hours to receive treatment.

Answer 22

​3-4.5

Question 23

Your patient is a​ 70-year-old man whose wife called EMS because her husband began exhibiting unusual behavior. Upon your arrival you introduce yourself to the​ patient, who​ responds, “Not until nine​ o’clock.” This phenomenon is BEST described​ as:

Answer 23

receptive aphasia.

Question 24

Compared to​ hypoglycemia, which of the following is TRUE of​ hyperglycemia?

Answer 24

Its onset is more gradual.

Question 25

Which of the following may result in hypoglycemia in the diabetic​ patient?

Answer 25

Vomiting after eating a meal

Question 26

Normal consciousness is regulated by a series of neurologic circuits in the brain that compose the reticular activating system​ (RAS). The RAS has simple requirements to function properly. Which of the following items are requirements?

Answer 26

water glucose oxygen

Question 27

When someone is experiencing​ hypoglycemia, the body attempts to compensate by using the​ fight-or-flight mechanism of the autonomic nervous system. Which of the following is NOT one of the​ fight-or-flight responses?

Answer 27

The skin is hot and dry.

Question 28

Which of the following is a standardized test to evaluate a conscious patient for possible​ stroke?

Answer 28

Cincinnati Prehospital Stroke Scale

Question 29

The most common medical emergency for the diabetic is​ hypoglycemia, or low blood sugar. Which of the factors below is NOT a cause of​ hypoglycemia?

Answer 29

Reduces sugar intake by eating too much

Question 30

Which of the items below is part of the Cincinnati Prehospital Stroke​ Scale?

Answer 30

Test the patient for arm droop or lack of movement. Ask the patient to smile. Have the patient repeat a simple sentence.

Question 31

The medical term for fainting​ is:

Answer 31

syncope

Question 32

During your primary​ assessment, you find your patient has an altered mental status. This could indicate which of the​ following?

Answer 32

Failing respiratory system

Question 33

Which of the following blood glucose levels is considered normal for an​ adult?

Answer 33

80​ mg/dL

Question 34

Your patient is a​ 44-year-old male with a history of diabetes. He is lying on the living room​ floor, unresponsive to all stimuli. He has a respiratory rate of 12 breaths per minute and heart rate of 112 beats per​ minute, and is pale and sweaty. Which of the following should you do to treat this​ patient?

Answer 34

Place the patient in the recovery​ position, administer​ oxygen, and monitor his airway status.

Question 35

There are two types of​ seizures; if your patient is having a seizure that affects only one body part and does not cause her to lose​ consciousness, it is called​ a:

Answer 35

partial seizure.

Question 36

Which of the following is the LEAST important question in obtaining the history of a seizure patient in the prehospital​ setting?

Answer 36

Does the patient have a family history of​ seizures?

Question 37

Which of the following is an action of​ insulin?

Answer 37

It helps the movement of sugar from the bloodstream to the cell.

Question 38

Looking at the following​ list, which of the items does NOT correctly compare the signs and symptoms of hypoglycemia and​ hyperglycemia?

Answer 38

The hypoglycemic patient usually complains of a​ headache, whereas the hyperglycemic patient does not.

Question 39

When assessing a conscious patient for a possible stroke using the Cincinnati Prehospital Stroke​ Scale, which of the following three functions should be tested by the​ EMT?

Answer 39

Control of facial​ muscles, ability to​ speak, and ability to hold both arms in an extended position for 10 seconds

Question 40

Your patient is an unresponsive​ 30-year-old male wearing a​ Medic-Alert bracelet indicating that he is a diabetic. The​ patient's coworkers came by his house to check on him when he did not show up for work and did not call in sick. Your assessment does not clearly indicate to you whether the patient may be hypoglycemic or hyperglycemic. Which of the following should you do​ next?

Answer 40

Apply oxygen and begin transport without taking further action.

Question 41

Most of the diabetic emergencies that you will be called to deal with will be related to hypoglycemia.​ However, occasionally you will experience an instance of hyperglycemia. In the list​ below, which item is NOT likely to be a sign or symptom of​ hyperglycemia?

Answer 41

Reduced rate of breathing

Question 42

For the​ EMT, which of the following is the most important question to ask of a diabetic patient or his family​ members?

Answer 42

When was the last time you had something to​ eat?

Question 43

A patient who demonstrates any one of the three symptoms from the Cincinnati Prehospital Stroke Scale has​ a(n) ________% chance of having an acute stroke.

Answer 43

70

Question 44

Which of the following is within the​ EMT's scope of practice for the treatment of the diabetic​ patient?

Answer 44

Administration of oral glucose

Question 45

The condition in which there is an insufficient amount of sugar in the blood is​ called:

Answer 45

hypoglycemia.

Question 46

Your patient is a​ 21-year-old female with a history of epilepsy. She is having a convulsion upon your arrival. Which of the following should you​ do?

Answer 46

Move furniture and other objects away from the patient to prevent injury.

Question 47

A seizure that occurs spontaneously from an unknown cause is​ called:

Answer 47

idiopathic.

Question 48

Which of the following is NOT a sign or symptom of​ stroke?

Answer 48

Chest pain

Question 49

Many diabetics today have an insulin pump. Which of the following statements about insulin pumps is NOT​ true?

Answer 49

They are usually worn around the ankle.

Question 50

Which of the following refers to difficulty in using words or understanding speech as a result of a​ stroke?

Answer 50

Aphasia

Question 51

Which of the following statements about seizures is NOT​ true?

Answer 51

Many seizures are followed by an aura.

Question 52

You have arrived on the scene of a call for a possible stroke. On your​ arrival, the patient denies signs and​ symptoms, is alert and​ oriented, and moves all extremities well. Her husband states that before you arrived the patient could not move her right arm and the left side of her face seemed to be​ "slack." Which of the following has most likely​ occurred?

Answer 52

The patient suffered a transient ischemic attack.

Question 53

Which is NOT one of the steps in managing a patient experiencing dizziness and​ syncope?

Answer 53

Apply cold packs to the​ patient's head.

Question 54

Which of the following is LEAST important for the patient who has stopped seizing before the​ EMT's arrival at the​ scene?

Answer 54

Requesting advanced life support

Question 55

Many factors that cause dizziness and syncope are generally related to​ the:

Answer 55

brain

Question 56

Which of the following conditions may be mimicked by​ hypoglycemia?

Answer 56

Intoxication

Question 57

Which of the following BEST describes status​ epilepticus?

Answer 57

Two or more seizures with​ tonic-clonic activity without an intervening period of consciousness