Question 1
Question
A 19-year-old male complains 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:
Answer
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contact medical control and administer oral glucose.
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assist him with his insulin injection and reassess him.
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request a paramedic ambulance to administer IV glucose.
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transport only with close, continuous monitoring en route.
Question 2
Question
A 28-year-old female patient 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 has progressively worsened over the last 24 to 36 hours. On the basis of this patient's clinical presentation, you should suspect that she:
Answer
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is significantly hyperglycemic.
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has a low blood glucose level.
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has a urinary tract infection.
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has overdosed on her insulin.
Question 3
Question
A 29-year-old female presents with confusion and disorientation. Her respirations are rapid and shallow and her pulse is 120 beats/min and thready. She is markedly diaphoretic and has an oxygen saturation of 89%. You should:
Question 4
Question
A 30-year-old female presents with severe acute pain to the left upper quadrant of her abdomen. During your assessment, she tells you that she has sickle cell disease. You should suspect that:
Answer
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her spleen is enlarged because of red blood cell engorgement.
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the pain in her abdomen is referred pain from an enlarged liver.
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she has gastrointestinal bleeding due to large blood vessel rupture.
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she is experiencing an aplastic crisis and needs a blood transfusion.
Question 5
Question
A 37-year-old female 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 reads 320 mg/dL. If this patient's condition is not promptly treated, she will MOST likely develop:
Question 6
Question
A 42-year-old male is found unresponsive on his couch by a neighbor. During your assessment, you find no signs of trauma and the patient's blood glucose level is 75 mg/dL. His blood pressure is 168/98 mm Hg, his heart rate is 45 beats/min and bounding, and his respirations are 8 breaths/min and irregular. The patient is wearing a medical alert bracelet that states he has hemophilia. You should:
Answer
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administer oxygen via a nonrebreathing mask, apply oral glucose in between his cheek and gum, and transport.
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suspect that he has internal bleeding and is in shock, administer high-flow oxygen, and transport at once.
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administer high-flow oxygen, perform a detailed secondary assessment at the scene, and transport promptly.
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suspect that he has intracranial bleeding, assist his ventilations, and transport rapidly to an appropriate hospital.
Question 7
Question
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:
Answer
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hypoglycemia.
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an acute stroke.
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hyperglycemia.
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a heart attack.
Question 8
Question
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:
Answer
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open and maintain her airway and assess breathing.
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quickly assess for the presence of a medical identification tag.
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administer 100% oxygen via a nonrebreathing mask.
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administer oral glucose between her cheek and gum.
Question 9
Question
An acute accelerated drop in the hemoglobin level, which is caused by red blood cells breaking down at a faster rate than normal, occurs during a(n) __________ crisis.
Answer
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aplastic
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hemolytic
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vaso-occlusive
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splenic sequestration
Question 10
Question
Assessment of a patient with hypoglycemia will MOST likely reveal:
Answer
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sunken eyes.
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hyperactivity.
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warm, dry skin.
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combativeness.
Question 11
Question
Classic signs and symptoms of hypoglycemia include:
Answer
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warm, dry skin; irritability; bradycardia; and rapid respirations.
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cool, clammy skin; weakness; tachycardia; and rapid respirations.
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cold, clammy skin; bradycardia; hunger; and deep, rapid respirations.
Question 12
Question
Common signs and symptoms of diabetic coma include all of the following, EXCEPT:
Answer
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warm, dry skin.
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cool, clammy skin.
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rapid, thready pulse.
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acetone breath odor.
Question 13
Question
Diabetes is MOST accurately defined as a/an:
Answer
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disorder of carbohydrate metabolism.
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abnormally high blood glucose level.
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mass excretion of glucose by the kidneys.
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lack of insulin production in the pancreas.
Question 14
Question
Diabetic coma is a life-threatening condition that results from:
Answer
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hyperglycemia, ketoacidosis, and dehydration.
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hypoglycemia, excess insulin, and dehydration.
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hypoglycemia, dehydration, and ketoacidosis.
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hyperglycemia, excess insulin, and ketoacidosis.
Question 15
Question
Diabetic ketoacidosis occurs when:
Answer
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blood glucose levels rapidly fall.
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the cells rapidly metabolize glucose.
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the pancreas produces excess insulin.
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insulin is not available in the body.
Question 16
Question
During your assessment of a 19-year-old male, you are told that he is being treated with factor VIII. This indicates that:
Question 17
Question
Excessive eating caused by cellular “hunger” is called:
Answer
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polyphagia.
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polydipsia.
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dysphasia.
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dyspepsia.
Question 18
Question
Glipizide, a non–insulin-type medication, is another name for:
Answer
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Glucophage.
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Glucotrol.
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Micronase.
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Diabinese.
Question 19
Question
Glutose is a trade name for:
Answer
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glucotrol.
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oral glucose.
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micronase.
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glucophage.
Question 20
Answer
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the fluid portion of the blood that transports cells throughout the body.
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essential for the formation of clots, such as when vessel damage occurs.
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found within the red blood cells and is responsible for carrying oxygen.
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a key component of the blood and is produced in response to an infection.
Question 21
Question
Hypoglycemic crisis tends to develop more often and more severely in children because:
Answer
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they have larger glucose stores than adults do.
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they do not always eat correctly and on schedule.
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their cells do not uptake glucose as fast as adults' do.
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their low activity levels cause rapid glucose depletion.
Question 22
Question
In contrast to insulin shock, diabetic coma:
Answer
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is rapidly reversible if oral glucose is given.
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commonly results in excess water retention.
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can only be corrected in the hospital setting.
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is a rapidly developing metabolic disturbance.
Question 23
Question
Insulin functions in the body by:
Answer
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producing new glucose as needed.
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enabling glucose to enter the cells.
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increasing circulating blood glucose.
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metabolizing glucose to make energy.
Question 24
Question
Insulin shock will MOST likely develop if a patient:
Answer
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takes too much of his or her prescribed insulin.
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markedly overeats and misses an insulin dose.
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eats a regular meal followed by mild exertion.
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misses one or two prescribed insulin injections.
Question 25
Question
Ketone production is the result of:
Answer
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acidosis when blood glucose levels are low.
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blood glucose levels higher than 120 mg/dL.
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fat metabolization when glucose is unavailable.
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rapid entry of glucose across the cell membrane.
Question 26
Question
Kussmaul respirations are an indication that the body is:
Answer
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attempting to eliminate acids from the blood.
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trying to generate energy by breathing deeply.
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severely hypoxic and is eliminating excess CO2.
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compensating for decreased blood glucose levels.
Question 27
Question
Patients with thrombophilia are at an increased risk for:
Answer
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various cancers.
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hemorrhagic stroke.
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acute arterial rupture.
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pulmonary embolism.
Question 28
Question
Patients with type 2 diabetes usually control their disease with all of the following, EXCEPT:
Answer
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diet and exercise.
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tolbutamide (Orinase).
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glyburide (Micronase).
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supplemental insulin.
Question 29
Question
Patients with uncontrolled diabetes experience polyuria because:
Answer
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they drink excess amounts of water due to dehydration.
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excess glucose in the blood is excreted by the kidneys.
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low blood glucose levels result in cellular dehydration.
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high blood sugar levels cause permanent kidney damage.
Question 30
Question
Proper procedure for administering oral glucose to a patient includes all of the following, EXCEPT:
Answer
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assessing the patient's mental status.
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ensuring the absence of a gag reflex.
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checking the medication's expiration date.
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requesting permission from medical control.
Question 31
Question
The normal blood glucose level, as measured by a glucometer, is between:
Answer
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60 and 80 mg/dL.
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80 and 120 mg/dL.
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130 and 150 mg/dL.
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160 and 200 mg/dL.
Question 32
Question
The signs and symptoms of insulin shock are the result of:
Answer
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increased blood glucose levels.
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fat metabolism within the cells.
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decreased blood glucose levels.
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prolonged and severe dehydration.
Question 33
Question
To which of the following diabetic patients should you administer oral glucose?
Answer
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an unconscious 33-year-old male with cool, clammy skin
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a conscious 37-year-old female with nausea and vomiting
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a semiconscious 40-year-old female without a gag reflex
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a confused 55-year-old male with tachycardia and pallor
Question 34
Question
Type 1 diabetes:
Answer
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is typically treated with medications such as metformin (Glucophage).
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is a condition in which no insulin is produced by the body.
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typically occurs in patients between 50 and 70 years of age.
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is defined as a blood sugar level that is less than 120 mg/dL.
Question 35
Question
When assessing an unconscious diabetic patient, the primary visible difference between hyperglycemia and hypoglycemia is the:
Answer
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patient's mental status.
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rate of the patient's pulse.
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presence of a medical identification tag.
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rate and depth of breathing.
Question 36
Question
When obtaining a SAMPLE history from a patient with diabetes, it would be MOST important to determine:
Answer
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if he or she has had any recent illnesses or excessive stress.
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approximately how much water the patient drank that day.
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if there is a family history of diabetes or related conditions.
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the name of the physician who prescribed his or her insulin.
Question 37
Question
Which of the following conditions is the diabetic patient at an increased risk of developing?
Answer
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blindness
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depression
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alcoholism
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hepatitis B
Question 38
Question
Which of the following statements regarding diabetic coma is correct?
Answer
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Diabetic coma can be prevented by taking smaller insulin doses.
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Diabetic coma typically develops over a period of hours or days
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Patients with low blood glucose levels are prone to diabetic coma.
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Diabetic coma rapidly progresses once hyperglycemia develops.
Question 39
Question
Which of the following statements regarding glucose is correct?
Answer
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Most cells will function normally without glucose.
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Blood glucose levels decrease in the absence of insulin.
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The brain requires glucose as much as it requires oxygen.
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The brain requires insulin to allow glucose to enter the cells.
Question 40
Question
Which of the following statements regarding sickle cell disease is correct?
Answer
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Sickle cell disease is an inherited blood disorder that causes the blood to clot too quickly.
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In sickle cell disease, the red blood cells are abnormally shaped and are less able to carry oxygen.
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The red blood cells of patients with sickle cell disease are round and contain hemoglobin A.
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Because of their abnormal shape, red blood cells in patients with sickle cell disease are less apt to lodge in a blood vessel.
Question 41
Question
You are treating a 40-year-old male with a documented blood sugar reading of 300 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:
Answer
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oxygen.
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glucagon.
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insulin.
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dextrose.
Question 42
Question
You respond to a movie theater for a 70-year-old male 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:
Answer
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administering one to two tubes of oral glucose.
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applying a nonrebreathing mask at 15 L/min.
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assisting the patient with his diabetic medication.
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performing a rapid exam and obtaining vital signs.
Question 43
Question
You respond to a residence for a patient who is “not acting right.” As you approach the door, the patient, a 35-year-old male, begins shouting profanities at you and your partner while holding a baseball bat. The man is confused and diaphoretic, and is wearing a medical identification bracelet. You should:
Answer
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calm him down so you can assess him.
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be assertive and talk the patient down.
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contact medical control for instructions.
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retreat at once and call law enforcement.