You are on-scene with an adult patient exhibiting unusual activity and appears to be intoxicated. He is anxious and hyperactive. His heart rate and respirations are fast, but his blood pressure remains within normal range for his age. The patient denies alcohol or drug consumption but reports he has diabetes. His blood glucose level is found to be 54 milligrams per deciliter. How would hypoglycemia cause the patient to present with the above findings?

Correct Answer: A

Rationale: The correct answer is A because hypoglycemia triggers the release of epinephrine by the sympathetic nervous system, leading to liver glycogenolysis, which raises blood glucose levels. This explains the patient's fast heart rate and respirations. Choice B is incorrect because low blood sugar levels do not directly mimic alcohol intoxication. Choice C is incorrect because elevated heart rate and respirations are not due to increased glucose and fatty acid uptake by adipose tissue. Choice D is incorrect because the increase in heart rate and respirations is not a direct result of promoting glucagon production and release from the pancreas.

Correct Answer: D

Rationale: The correct answer is D: Colloid solution. Colloid solutions contain large molecules like proteins that are too large to pass through the capillary membrane, making them effective in increasing oncotic pressure within the blood vessels. Hypertonic solutions (A) have higher solute concentration, hypotonic solutions (B) have lower solute concentration, and crystalloid solutions (C) contain small molecules that can easily pass through the capillary membrane.

Correct Answer: C

Rationale: The correct answer is C: Sodium bicarbonate and calcium chloride. During cardiac arrest, the priority is to correct any metabolic acidosis (sodium bicarbonate) and replenish calcium stores (calcium chloride) to support myocardial function. Sodium bicarbonate helps with acid-base balance, while calcium chloride is crucial for cardiac muscle contraction. Choice A is incorrect as magnesium sulfate alone is not sufficient for cardiac arrest. Choice B is incorrect as amiodarone is used for arrhythmias, not asystole. Choice D is incorrect as administering potassium during cardiac arrest can worsen the situation, and dopamine is not recommended in this scenario.

Correct Answer: D

Rationale: The correct answer is D because spinal cord injury can exist without visible fractures on x-rays. Objective findings may not be present initially, making it imperative to consider further evaluation beyond imaging studies. Central cord syndrome (choice A) typically presents with specific symptoms such as motor weakness in the upper extremities, which may not align with the given scenario. While MRI (choice B) is valuable for detailed soft tissue evaluation, it may not always be necessary for diagnosis. CT scan (choice C) is useful for visualizing bony structures but may not capture subtle spinal cord injuries. Thus, choice D is the most appropriate as it emphasizes the importance of clinical assessment and the possibility of spinal cord injury without immediate radiographic evidence.

Correct Answer: D

Rationale: Step 1: Diaphragmatic breathing in an unconscious patient who has fallen indicates injury to the spine. Step 2: Diaphragmatic breathing occurs when the spinal cord is damaged at a higher level, affecting the phrenic nerve. Step 3: This is a reliable clinical sign of spinal cord injury that requires immediate medical attention. Summary: A: Incorrect. A normal lateral c-spine film does not definitively exclude injury as soft tissue injuries may not be visible. B: Incorrect. Vertebral injuries can occur without immediate signs of cord injury due to the protective nature of the spinal cord. C: Incorrect. Immobilization on a short spine board is not always necessary and should be based on clinical assessment.