A 57-year-old-patient takes Metformin for a medical problem. The patient reportsdrinking too many beers and having too much food to eat today and this is the reason fornot feeling well. “The pills aren’t doing me any good” the patient claims. Most likely themedical condition the patient is referring to is:

You are called to a farmhouse on a sunny spring afternoon. Upon arrival, a frantic mother tells you that her 3-year-old daughter was playing in the yard, accidentally stepped on a hornets’ nest, and was stung repeatedly. The patient is alert, screaming and crying, and can follow her mother’s commands. Her arms and legs are swollen and show the marks of several stings. Her body is covered in hives. Her vital signs are blood pressure 90/40, pulse 110, respiratory rate 24, and oxygen saturation 99 percent. Her lung sounds are clear and equal bilaterally. Her mother states she put “nox-a-sting” on the bites but the bites only seemed to get worse. What condition is the patient suffering from?

Your EMS team has extricated a 70-year-old patient from the vehicle after it went off theroad at a high rate of speed and hit a tree. The patient has an altered mental status andis unable to provide a medical history. You are concerned that a cardiac problem mayhave precipitated the incident, but you must also rule out:

An unresponsive 80-year-old patient has been ill for 4 days. Diet was normal untilyesterday when the patient became very lethargic. There is a history of diabetes andhypertension. Respirations are 32 and deep, pulse is 120. The skin is warm and dry andthere is a sweet, fruity odor near the patient. Your FIRST impression of this patient is:

Which of the following assessment findings suggest a gastrointestinal bleed?

Following assessment of an unresponsive patient, you have determined the patient is ahigh priority. After you have addressed the life-threatening problems, what do you donext?

A 10-year-old is found unresponsive in the school playground. The children tell you abee stung the child about 10 minutes ago. The skin is mottled with red patches, thepulse is very rapid and weak, and you can barely hear any air movement duringrespirations. Identify what condition you believe to be the current problem.

You are called to care for an elderly patient. The patient takes insulin for diabetes andthe family reports there has been no trauma. The patient has been getting worse for aweek, and is now unconscious. During assessment you find the patient to be breathing 6times per minute, the pulse is 130, and BP is 78/54. Identify the most importantintervention while awaiting ALS arrival.

Your neurological emergency patient opens his eyes to voice command, uttersincomprehensible sounds, and can localize pain. What is his Glasgow Coma Scalescore?

A 16 year old female awoke this morning with severe abdominal pain. She states, “I have not had a period in two months and the pain started this morning.” Vital signs are BP 90/70, P 130, R 28, skin pale and cool. What should you suspect?