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Hypoglycemia and acute ischemic stroke can present similarly because:
• A:both oxygen and glucose are needed for brain function.
• B:the majority of stroke patients have a history of diabetes.
• C:the most common cause of a stroke is hypoglycemia.
• D:they are both caused by low levels of glucose in the blood. - Answer-• A:both
oxygen and glucose are needed for brain function.
Reason: Although stroke and hypoglycemia are two distinctly different conditions,
their signs and symptoms are often similar. This is because the brain requires both
oxygen and glucose to function normally. An acute ischemic stroke is caused by a
lack of oxygen to a part of the brain due to a blocked cerebral artery, whereas
hypoglycemia (low blood glucose level) deprives the entire brain of glucose. In
either case, the patient presents with signs of impaired brain function (ie, slurred
speech, weakness, altered mental status). Both conditions may lead to permanent
brain damage or death if not treated promptly.
You are called to a local park for an ill person. It is a hot day and the humidity is
high. When you arrive, a bystander directs you to the patient, a young male who is
,semiconscious. His skin is flushed, hot, and moist. Your FIRST action in the
management of this patient should be to:
• A:begin rapid cooling measures.
• B:ensure an open airway.
• C:administer high-flow oxygen.
• D:move him to a cool area. - Answer-You selected D; This is correct!
Reason:Your first action in a heat-related emergency is to move the patient to a
cooler environment. Once you have moved the patient to a cooler place, you
should begin your assessment and treat the patient accordingly. Remember, you
must FIRST prevent further harm to the patient.
A known diabetic female is found unresponsive. Her respirations are rapid and
shallow; her skin is cool, clammy, and pale; and her pulse is rapid and weak.
Which of the following would BEST explain the likely cause of her condition?
• A:Failure to take insulin
• B:Insulin overdose
• C:Excessive eating
• D:High blood sugar - Answer-The correct answer is B;
Reason:The patient has classic signs of insulin shock, a condition caused by a low
blood glucose level (hypoglycemia). Common causes of insulin shock include
insulin overdose (accidental or intentional), failure to eat (or not eating enough),
and excessive exertion. The patient's symptoms are not consistent with diabetic
ketoacidosis (DKA), a condition that results from a high blood glucose level
(hyperglycemia). Signs of DKA include deep, rapid breathing with a fruity or
acetone breath odor (Kussmaul respirations), and warm, dry skin. Unlike insulin
,shock, which can result from an insulin overdose, DKA can occur if a patient fails
to take his or her insulin or takes too little.
When dealing with an emotionally disturbed patient, you should be MOST
concerned with:
• A:gathering all of the patient's medications.
• B:safely transporting to the hospital.
• C:whether the patient could harm you.
• D:obtaining a complete medical history. - Answer-You selected C; This is correct!
Reason: When managing any patient with an emotional or psychiatric crisis, your
primary concern is your own safety. Safely transporting the patient to the hospital
is your ultimate goal. If possible, you should attempt to obtain a medical history
and should take any of the patient's prescribed medications to the hospital.
However, this should not supercede your own safety or interfere with safely
transporting the patient.
You are at the scene where a man panicked while swimming in a small lake. Your
initial attempt to rescue him should include:
• A:rowing a small raft to the victim.
• B:reaching for the victim with a long stick.
• C:throwing a rope to the victim.
, • D:swimming to the victim to rescue him. - Answer-You selected B; This is correct!
Reason: General rules to follow when attempting to rescue a patient from the
water include "reach, throw, row, and then go." In this case, you should attempt to
reach the victim by having him grab hold of a large stick or similar object. If this is
unsuccessful, throw the victim a rope or flotation device (if available). If these are
not available, row to the patient in a small raft (if available). Going into the water
to retrieve the victim is a last resort. The rescuer must be a strong swimmer
because patients who are in danger of drowning are in a state of blind panic and
will make every attempt to keep themselves afloat, even if it means forcing the
rescuer underwater.
How should you classify a patient's nature of illness if he or she has a low blood
glucose level, bizarre behavior, and shallow breathing?
• A:Behavioral emergency
• B:Altered mental status
• C:Respiratory emergency
• D:Cardiac compromise - Answer-The correct answer is B;
Reason: The nature of illness (NOI) is the medical equivalent to mechanism of
injury (MOI). Altered mental status should be the suspected NOI in any patient
with any fluctuation in level of consciousness, which can range from bizarre
behavior to complete unresponsiveness. Causes of an altered mental status
include hypo- or hyperglycemia, head trauma, stroke, behavioral crises, drug
overdose, and shock, among others.