You are called to assist an adult diabetic who was found unconscious in bed. On arrival, your patient is unresponsive with snoring respirations and cool, clammy skin. Your glucometer will not power up, so blood glucose analysis is impossible at the present time. Which of the following would be most appropriate after controlling the patient's airway and delivering high-flow oxygen therapy?

Correct Answer: B

Rationale: The correct answer is B because administering one amp of dextrose 50% (D50) intravenously is the most appropriate action for an unconscious diabetic patient with hypoglycemia. Here's the rationale: 1. Glucagon (Choice A) requires an intact liver glycogen store to be effective, which may not be the case in some diabetic patients. 2. Administering a glucose-containing IV fluid bolus (Choice C) may delay the delivery of glucose to the brain, which is critical in this emergency situation. 3. Transporting the patient to the hospital for blood glucose analysis (Choice D) would waste valuable time, as immediate glucose administration is crucial. Administering D50 intravenously provides a rapid source of glucose directly into the bloodstream, ensuring a quick increase in blood sugar levels to reverse hypoglycemia and improve the patient's condition.

Correct Answer: A

Rationale: The correct answer is A: 0.5 to 1 inch. After the endotracheal tube passes through the vocal cords, it should be advanced approximately 0.5 to 1 inch into the trachea before inflating the cuff. This ensures the cuff is positioned below the cords to prevent aspiration and secure ventilation. Choices B and C are too short of a distance, risking dislodgment or improper placement. Choice D is excessively far, potentially leading to endobronchial intubation. The recommended range of 0.5 to 1 inch provides a balance between securing the tube and minimizing complications.

Correct Answer: B

Rationale: The correct answer is B: Spontaneous pneumothorax. In this scenario, the presence of small pockets of air in the subcutaneous tissue of the chest indicates air escaping from the lung into the chest cavity, leading to pneumothorax. Spontaneous pneumothorax commonly presents with sudden chest pain and dyspnea, more prevalent in older individuals, like the patient described. Bacterial pneumonia (A) typically presents with fever, productive cough, and consolidation on lung auscultation. Dry pleurisy (C) refers to inflammation of the pleura without significant fluid accumulation, unlikely to cause subcutaneous emphysema. Chronic obstructive pulmonary disease (D) is characterized by progressive airflow limitation and is not directly associated with subcutaneous emphysema.

Correct Answer: B

Rationale: The correct answer is B: Respiratory acidosis. In this scenario, the patient's shallow and irregular respirations indicate hypoventilation, leading to carbon dioxide retention and decreased pH levels, causing respiratory acidosis. The low SpO2 level further supports inadequate oxygen exchange. Choices A, C, and D are incorrect as they do not align with the hypoventilation and CO2 retention observed in the patient. Option A (Respiratory alkalosis) would be characterized by increased respiratory rate and low CO2 levels. Option C (Metabolic acidosis) involves non-respiratory causes like kidney dysfunction. Option D (Metabolic alkalosis) results from excessive loss of acids like vomiting.

Correct Answer: A

Rationale: The correct answer is A: It reduces the release of chemical mediators from the mast cells. Epinephrine acts on adrenergic receptors to inhibit mast cell degranulation, reducing the release of histamine and other inflammatory mediators that contribute to anaphylaxis. This helps to prevent further systemic allergic reactions and stabilize the patient. Choice B is incorrect because while epinephrine does help reduce the overall inflammatory response by stabilizing mast cells, it is not the primary mechanism of action. Choice C is incorrect as epinephrine primarily causes an increase in heart rate through its positive inotropic and chronotropic effects on the heart, rather than peripheral vasoconstriction. Choice D is incorrect as while epinephrine does cause vasoconstriction, it is mainly focused on improving blood pressure and systemic vascular resistance rather than reducing itching.