EMT Practice Questions

Hypoglycemia → Rapid onset

Hyperglycemia → Gradual onset

Diabetic ketoacidosis → Rapid, deep breathing

Type I diabetes → Insulin dependence

Each diabetic condition has hallmark characteristics that EMS providers must recognize quickly.

Hypoglycemia → Rapid onset:

Hypoglycemia (low blood glucose) typically develops suddenly, often within minutes, especially in patients who have taken insulin without adequate food intake.

NREMT materials emphasize that hypoglycemia presents with “rapid onset of symptoms such as altered mental status, sweating, and tachycardia.”

Hyperglycemia → Gradual onset:

Hyperglycemia (high blood glucose) develops slowly over hours to days due to insufficient insulin or illness.

EMS education standards describe hyperglycemia as having a “gradual onset with progressive symptoms such as polyuria, polydipsia, and dehydration.”

Diabetic Ketoacidosis (DKA) → Rapid, deep breathing:

DKA is a severe complication of hyperglycemia, primarily in Type I diabetics, and is characterized by Kussmaul respirations (rapid, deep breathing).

NREMT content identifies “deep, rapid respirations (Kussmaul breathing)” as a key sign of DKA due to metabolic acidosis.

Type I Diabetes → Insulin dependence:

Type I diabetes is defined by the body’s inability to produce insulin, requiring lifelong insulin therapy.

NREMT standards state that “patients with Type I diabetes are insulin dependent.”

Exact Extracts:

“Hypoglycemia typically has a rapid onset of symptoms.”

“Hyperglycemia develops more gradually over time.”

“Ketoacidosis is characterized by deep, rapid respirations (Kussmaul respirations).”

“Type 1 diabetics are insulin dependent.”

The correct answers are

B.  

C.  

F.  

This question is testing recognition of increased intracranial pressure (ICP), specifically the classic findings known as Cushing’s triad and abnormal breathing patterns.

Why B and C are correct (Cushing’s Triad):

Cushing’s triad is a hallmark of increased ICP and includes:

Hypertension (widening pulse pressure)

Bradycardia

Irregular respirations

NREMT-aligned trauma guidelines state:

“Increasing intracranial pressure may present with hypertension and bradycardia.”

These are late and critical signs of brain herniation risk.

Why F is correct (Cheyne-Stokes respirations):

Cheyne-Stokes respirations are:

An abnormal breathing pattern (alternating periods of apnea and rapid breathing)

Associated with brain injury and increased ICP

Guidelines emphasize:

“Irregular breathing patterns such as Cheyne-Stokes may indicate brain injury.”

Why the other options are incorrect:

A.  

Tachycardia: Typically seen in shock, not increased ICP.

D.  

Hypotension: Suggests shock; ICP usually causes hypertension.

E.  

Kussmaul respirations: Associated with metabolic acidosis (e.g., diabetic ketoacidosis), not ICP.

Exact Extracts:

“Cushing’s triad includes hypertension, bradycardia, and irregular respirations.”

“Irregular respirations such as Cheyne-Stokes are associated with brain injury.”

“These findings indicate increasing intracranial pressure and possible herniation.”

For pediatric BLS with two rescuers, current AHA Guidelines (2020) recommend:

Two-thumb encircling hands technique: Most effective for infants; provides consistent depth and control.

Compression ratio of 15:2: Enhances ventilation without compromising perfusion.

Compression depth: 1/3 of chest or approximately one-half the chest ' s depth.

CPR begins if pulse < 60 bpm with signs of poor perfusion, not at 72 bpm. Rate of 180/min is excessive; ideal rate is 100–120/min.

Pulmonary edema is caused by fluid accumulation in the alveoli, impairing gas exchange. It is typically due to:

Left-sided heart failure: Blood backs up into the pulmonary circulation

Hypertensive crisis: Increases hydrostatic pressure in the lungs

Anaphylaxis causes vasodilation and bronchospasm, not fluid overload. Increased oncotic pressure would retain fluid in capillaries — the opposite of edema.