emergency care ch 21

1. Which of the following is not a sign of a hypoglycemic diabetic emergency?
a. Combativeness
b. Slow heart rate
c. Anxiety
d. Cold, clammy skin
1. b. Slow heart rate

2. 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. Flushed, hot, dry skin and a “fruity” odor of the breath
c. Cool, moist skin, agitated behavior, and increased heart rate
d. Sudden onset of altered mental status
2. b. Flushed, hot, dry skin and a “fruity” odor of the breath

3. 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:
a. determine the exact time of onset of symptoms.
b. transport the patient to a Level I Trauma Center.
c. do a thorough physical exam of the patient.
d. transport to the closest hospital since the patient must go to the operating room as soon as possible.
3. a. determine the exact time of onset of symptoms.

4. What are the three items that make up the Cincinnati Prehospital Stroke Scale?
a. Ask the patient to smile, hold his arms out straight in front of him with his eyes closed, and ask him to
say the alphabet backward.
b. Ask the patient to look up, hold his arms straight out by his side with his eyes closed, and ask him to
repeat a sentence to see if he can remember it.
c. Ask the patient to smile. tilt his head back with his eyes closed, and ask him to say a sentence such as, ”
The sky is blue in Cincinnati.” to see if he can say Cincinnati.
d. Ask the patient to smile, hold his arms straight out in front of him with his eyes closed, and ask him to
say a sentence to see if it is clear.
4. d. Ask the patient to smile, hold his arms straight out in front of him with his eyes closed, and ask him to say a
sentence to see if it is clear.

5. As an EMT, you will be called on frequently to treat diabetic emergencies. Diabetic emergencies are
usually caused by:
a. poor management of the patient’s diabetes.
b. falls.
c. hypoxia.
d. pancreatitis.
5. a. poor management of the patient’s diabetes.

6. Which of theb following is a typical cause of seizures in children 6 months to 3 years of age?
a. Administration of glucose to a hyperglycemic patient
b. Fever
c. Asthma
d. Chest pain
6. b. Fever

7. 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, heart rate of 112 beats
per minute, and is pale and sweaty. Which of the following should you do to treat this patient?
a. Encourage the patient’s family to administer his insulin.
b. Apply oral glucose solution to a tongue depressor and insert it between the patient’s cheek and gums.
c. Place the patient in the recovery position to protect the airway and place oral glucose solution under the
patient’s tongue.
d. Place the patient in the recovery position, administer oxygen, and monitor his airway status.
7. d. Place the patient in the recovery position, administer oxygen, and monitor his airway status.

8. Which of the following is the most common cause of seizures in adults?
a. Failure to take prescribed medication
b. Withdrawal from alcohol
c. Fever
d. Head trauma
8. a. Failure to take prescribed medication

9. 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?
a. Chronic thirst
b. Excessive urination
c. A reduced rate of breathing
d. Nausea
9. c. A reduced rate of breathing

10. A hormone called insulin is secreted by the:
a. Islets of Langerhans in the liver.
b. gallbladder found in the pancreas.
c. Islets of Langerhans in the pancreas.
d. None of the above
10. c. Islets of Langerhans in the pancreas.

11. During your primary assessment you find your patient has an altered mental status. This could indicate
which of the following?
a. Failing respiratory system
b. Problems with the RAS due to hypertension
c. The need for suctioning of the airway
d. The need to complete a secondary assessment
11. a. Failing respiratory system

12. 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, you
should suspect which of the following as the likely cause of the patient’s presentation?
a. Failure to take her insulin
b. A nondiabetic-related problem, such as a head injury or mental illness
c. Failure to intake sufficient sugar
d. Excessive intake of foods high in sugar, such as soda or candy
12. c. Failure to intake sufficient sugar

13. Which of the following blood glucose levels is considered normal for an adult?
a. 80 mg/dL
b. 40 mg/dL
c. 180 mg/dL
d. 150 mg/dL
13. a. 80 mg/dL

14. A 14-year-old female is found unconscious in the bathroom just before lunch. Several girls say they saw
her shoot up earlier in the day and the school resource officer has found a syringe in her backpack. The
patient has cool and clammy skin, snoring respirations, and she vomited before she slumped to the floor.
What might be the cause of her altered mental status?
a. Fainting spell
b. Hypoglycemia
c. Hypotension due to pregnancy
d. Injectable illegal drugs
14. b. Hypoglycemia

15. Which of the following is the correct position of transport for a stroke patient with left-sided paralysis, a
decreased level of consciousness, and an inability to maintain his or her airway?
a. Supine
b. Lying on the right side
c. Semi-sitting
d. Lying on the left side
15. d. Lying on the left side

16. 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:
a. aura phase.
b. clonic phase.
c. postictal phase.
d. tonic phase.
16. c. postictal phase.

17. A patient who demonstrates any one of the three symptoms from the Cincinnati Prehospital Stroke
Scale has a ______ percent chance of having an acute stroke.
a. 50
b. 60
c. 70
d. 80
17. c. 70

18. Which of the following would be an acceptable substitute for the administration of commercially
prepared oral glucose solution?
a. Having the patient drink a glass of milk
b. Diet soda
c. Having the patient eat something high in protein, such as a deli sandwich
d. Cake icing
18. d. Cake icing

19. For the reticular activating system to work correctly, what three substances are needed?
a. Oxygen to perfuse brain tissue, insulin to nourish brain tissue, and sodium to keep the brain hydrated
b. Oxygen to perfuse brain tissue, insulin to nourish brain tissue, and water to keep the brain hydrated
c. Oxygen to perfuse brain tissue, glucose to nourish brain tissue, and sodium to keep the brain hydrated
d. Oxygen to perfuse brain tissue, glucose to nourish brain tissue, and water to keep the brain hydrated
19. d. Oxygen to perfuse brain tissue, glucose to nourish brain tissue, and water to keep the brain hydrated

20. Which of the following is NOT a common sign or symptom of stroke?
a. Chest pain
b. Vomiting
c. Sudden impairment of vision
d. Seizure
20. a. Chest pain

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