A patient presents in a thyroid storm from an exacerbation of hyperthyroidism. What are their expected labs?

The patient has been diagnosed with acute myocardial infarction. They are complaining of increasing chest pain and difficulty breathing. They appear very nervous, and there is noted tremors. The ECG shows atrial fibrillation at a rate of 148. This patient may be experiencing:

Regarding the diabetic ketoacidosis (DKA) patient, glucose should be decreased based on the following protocol?

A patient is receiving heparin after being diagnosed with a pulmonary embolus. After five days, they have developed heparin-induced thrombocytopenia. What clinical sign is expected initially?

Which of the following is associated with a poor prognosis in a patient with severe acute respiratory distress syndrome (ARDS)?

A 12-year-old patient has a current pH of 7.52. Their previous pH was 7.41, and their potassium (K⁺) was 4.7 mEq/L. The expected current K+ is approximately what?

A 13-year-old patient has a history of insulin-dependent diabetes and recently admitted to a local ICU. The family states that they have had a cold over the past week and have become more lethargic over the last 24 hours. Lab results are as follows: Na⁺ 150, Cl^– 103, glucose 504, WBC 12.3, bands 14%, leukocytes represent 68%. The most likely cause of this patient’s DKA state is:

A 14-year-old patient is currently being treated for diabetic ketoacidosis (DKA). There is a noted decrease in mental status with associated lethargy, and their Glasgow coma scale (GCS) score is now 7, dropping from the previous 14. The neurological changes would most likely indicate which situation?

A 15-year-old with a past medical history of diabetes mellitus presents very lethargic and only responsive to painful stimuli. They have been sick with a virus for the past couple of days. When reviewing their lab results, what would you expect to find?

A 6-year-old patient treated for diabetic ketoacidosis (DKA) is showing signs of deterioration. Which of the following assessment findings would confirm this suspicion?

A change in HCO3^– of 10 mEq/L, will change the pH __________ in the same direction?

A key component used in the management of both diabetic ketoacidosis (DKA) and hyperosmolar hyperglycemic state (HHS) is?

A patient being treated for acute pancreatitis has developed significant ascites. They now have diminished breath sounds in the left lower lobe. Current vital signs: BP 116/74, HR 108, RR 36/min, T 98.7°F. Based on the presentation what is suspected?

A patient diagnosed with congestive heart failure has received a total of 280mg of Lasix intravenously over the past eight hours. During an assessment of the patient, there is generalized muscle weakness, flat neck veins, and diminished deep tendon reflexes. Which additional assessment finding would help confirm a suspected diagnosis of hyponatremia?

A patient has received two units of packed red blood cells (PRBCs). The patient’s initial hemoglobin and hematocrit (H&H) was 6 g/dL and 18%. What is their expected H&H after receiving the two units?

A patient in initial shock most likely will suffer from which acid-base disorder?

A patient involved in a traumatic resuscitation has received five units of packed red blood cells rapidly. What should be of concern in this patient?

A patient is currently recovering after an abdominal aortic aneurysm (AAA) repair. Three days later, the patient’s nasogastric tube has been removed and they are eating an advancing diet. They start complaining of excruciating abdominal pain. The patient has a bowel movement that is large and dark red. What is the most likely cause of this pain?

A patient is ordered to have constant nasogastric tube suctioning. Based on this, what acid-base derangement is expected?

A patient presenting with Beck’s triad is most likely experiencing:

A patient presents with a blood glucose of 1087 mg/dL, and negative for ketone production. Their ABG shows a pH of 7.32. Which medication is anticipated to be administered first?

A patient underwent abdominal surgery for necrotizing pancreatitis. They have now presented with a diagnosis of a pancreatic fistula as a complication. What metabolic disorder would you most likely suspect to see with this patient?

A patient was recently started on enteral feedings at a long-term care facility. They are transferred to the local emergency room due to a change in their level of consciousness. Current lab values are: Na⁺ 150, BUN 80 mg/dL, serum glucose 870 mg/dL, and serum osmolality 377 mOsm/kg. What is the most likely cause of the abnormal serum osmolality?

A patient with a history of hypoparathyroidism is complaining of numbness and tingling around the mouth and in their toes. Which abnormal electrolyte finding is anticipated?

A patient experiencing an aplastic sickle cell crisis typically presents with pallor, tachycardia, weakness, and fatigue as well as:

A patient’s current hematocrit (Hct) is 58%, and serum sodium (Na⁺) is 156 mEq/L.  What is the most likely cause of these findings?

A pediatric patient is diagnosed with acute cardiac collapse secondary to myocarditis. Upon assessment, the following are noted: BP 72/38, HR 128, RR 34, urine output of 30 mL over the past 3 hours, CVP 12 mmHg, PAP 32/26 mmHg, PCWP 23 mmHg, CI 1.7 L/min/m2.  When evaluating this patient’s glomerular filtration rate (GFR), what laboratory value would be best utilized?

A post-traumatic injury patient has received six units of packed red blood cells. The patient’s 2,3-DPG is anticipated to change and has what effect on the oxyhemoglobin dissociation curve?

A shift to the right on the oxyhemoglobin dissociation curve is caused by?

A patient has a lactate reading of 4.8. What is another finding that would correlate with this?

A patient is suffering from septic shock. With regards to the pathophysiology of this disease process, which of the following would NOT be anticipated to be present in this patient?

After receiving a massive transfusion with packed red blood cells (PRBCs), the patient is experiencing cellular hypoxia secondary to what?

All of the following are triggers for sickle cell crisis except?

An effect to which of the following would NOT result in a shift on the oxyhemoglobin dissociation curve?

Beta-blockers are contraindicated in which of the following situations?

Bohr effect states?

Causes of metabolic alkalosis include all of the following EXCEPT?

Classify the pH disorder based on the following ABGs:

pH 7.37, PaCO₂ 58, HCO3^– 23, base deficit -2, PaO₂ 106

Classify the pH disorder based on the following ABGs:

pH 7.55, PaCO₂ 30, HCO3^– 25, PaO₂ 56

Dopamine’s alpha-adrenergic effects are related to?

Ecchymosis around the umbilicus is called what?

Fluid loss in an already dehydrated patient will most critically increase serum levels of which of the following?

For every 10 mmHg change in PaCO₂, the pH will change by ____________ in the opposite direction?

Identify the following ABG:

pH 7.28, PaCO₂ 20, HCO3^– 17, PaO₂ 80, BE -8

Identify the following formula:

CO₂ + H₂O ↔ H₂CO₃ ↔ HCO₃^– + H⁺

Identify the following pediatric patient’s ABG: pH 7.60, PaCO₂ 23, HCO3^– 35, PaO₂ 85.

Identify the medication with bronchodilating properties.

In a patient suffering from metabolic acidosis, what electrolyte becomes elevated due to the acid-base disorder?

Labs show the patient’s current lactate level is 6.3 mmol/L.  What does this value suggest?

Morphine has what other effect on the body besides analgesia?

Myoglobinuria, if left untreated, will result in what critical condition?

Non-cardio selective beta blockers could cause an increased risk of complications in which patient situation?

Protracted vomiting typically results in what acid-base imbalance?

Recommended minimum urinary output when caring for an adult patient should be?

The average blood volume for an adult is how many milliliters per kilogram (mL/kg)?

The crew is transporting a patient who presented with fatigue, anxiety, and a burning right upper quadrant abdominal pain. They have a significant past medical history of daily IV drug use, hypertension, and hypertriglyceridemia. Upon assessment, there is upper abdominal tenderness and a holosystolic murmur best heard at the lower left sternal border. Current vitals: BP 118/82, HR 118, RR 24, and T 102.5°F. Laboratory studies reveal an elevated white blood cell count, low sodium and chloride and a high sedimentation rate. Which of the following is this patient most at risk for?

The family of a witnessed cardiac arrest victim has been informed that the patient was not successfully resuscitated and has died.  The most appropriate communication with the family includes which of the following statements:

The main focus when treating a patient with disseminated intravascular coagulation (DIC) is to:

The patient is currently receiving a magnesium infusion due to hypomagnesemia (1.2 mEq/L initially). Upon assessment, which finding would alert to stop the infusion immediately?

The primary problem with disseminated intravascular coagulation (DIC) is?

The primary treatment in reversing malignant hyperthermia is what medication?

The primary treatment of rapidly evolving disseminated intravascular coagulation (DIC) is:

The sequela of sepsis can lead to multi-organ dysfunction. Which of the following organs is involved first?

The team is transporting a 2-year-old presenting with fever, hyperglycemia, and lethargy for the past three hours. Vital signs are as follows: BP 72/42, HR 146, and RR 32. Upon assessment, there is dry mucous membranes and capillary refill of 4 seconds. Current labs are: K⁺ 3.0 mEq/L, glucose 485 mg/dL. ABGs: pH 7.1, PaCO₂ 22, HCO3^– 17, PaO₂ 98. Which of the following types of fluids is most appropriate initially for this patient?

The team is transporting a patient who is complaining of severe epigastric pain that is radiating to their back. They have been vomiting consistently for the past 8 hours and cannot get relief from the pain. The patient does admit to greater than moderate use of alcohol on a daily basis but denies smoking or recreational drug use. Upon assessment, there is dry skin and mucous membranes. Upon palpation of the abdomen, there is distention and significant rebound tenderness. Vitals are as follows: BP 92/54, HR 128, RR 24. What is the next best action for this patient?

The team is transporting a patient who recently underwent a craniotomy to remove a tumor. They are currently awake, alert, and answering questions appropriately. There are no signs of neurologic deficits. Current vital signs: BP 112/76, HR 88, RR 18, O₂ @ 97% on 2 L/min of oxygen via nasal cannula, and blood sugar is 96 mg/dL. Since the craniotomy, they have been urinating approximately 50 mL/hr. Within the last couple of hours, urine output has increased to 350 mL/hr and has a specific gravity of 1.001. What is suspected based on this recent history?

The team is transporting a patient with a diagnosis of diabetic ketoacidosis (DKA). Current labs and ABGs are as follows:

Na⁺ 140, Cl^– 95, Albumin 3.5, K⁺ 2.4

pH 6.9, PaCO₂ 20, HCO³ 15, PaO₂ 80, base deficit -8

The patient has not received any fluid replacement. What is the relationship between pH and K⁺?

The patient is demonstrating an increase in venous oxygen saturation (SvO₂) and a decrease in oxygen consumption (VO₂) and pH. What type of shock do you suspect?

What does the following formula represent?

[Na⁺ – (Cl^– + HCO3^–) + K⁺]

What is the best treatment choice in someone with diabetes insipidus (DI)?

What is the drug of choice for a gastrointestinal (GI) bleed?

What is the following equation used to identify?

[1.34 x Hgb x (SaO₂)] + PaO₂ x 0.003

What is the leading cause of indirect acute respiratory distress syndrome (ARDS)?

What is the priority when treating respiratory acidosis?

What is the treatment choice in citrate toxicity?

When administering Albuterol to a 4-year-old, which of the following changes would NOT be anticipated with the administration?

When administering PRBCs, it is anticipated that hemoglobin (Hgb) and hematocrit (Hct) will increase how much with each unit administered?

When assessing a patient’s fractured elbow, damage to the radial and ulnar nerves would present as:

When calculating how PaCO₂ affects pH, for every 10 mmHg change in CO₂, the pH will change by __________ in the opposite direction?

When treating a pediatric patient with suspected diabetic ketoacidosis, what value can help differentiate the diagnosis of diabetic ketoacidosis (DKA) from a hyperosmolar hyperglycemic state (HHS)?

When treating rhabdomyolysis, giving large amounts of fluid and administering _______________ will help alleviate acidic urine.

Which condition would result in a left shift on the oxyhemoglobin dissociation curve?

Which lab finding would be anticipated with diabetes insipidus?

Which medication causes a decrease in pulmonary vascular resistance?

Which of the following ABGs would be suspected in a patient with a diagnosis of diabetic ketoacidosis (DKA)?

Which of the following blood gas results would have you preparing to intubate and ventilate the multisystem trauma patient?

Which of the following can be seen with hypocalcemia?

Which of the following conditions would put a patient at the LEAST amount of risk for acute respiratory distress syndrome (ARDS)?

Which of the following does not have bronchodilation effects?

Which of the following is not a treatment strategy when dealing with rhabdomyolysis and myoglobinuria?

Which of the following laboratory findings would be expected in a patient with a diagnosis of syndrome of inappropriate antidiuretic hormone (SIADH)?

Which of the following medications contains both nonselective beta-adrenergic and alpha1-adrenergic blocking effects?

Which type of medication blocks the renin-angiotensin-aldosterone (RAA) system to help with heart failure?

With a diagnosis of diabetes insipidus (DI), what lab findings would be anticipated?

With regards to the pathophysiology of sepsis, which of the following would be anticipated in a patient with a diagnosis of sepsis?

You are transporting a patient with a nasogastric tube (NGT) that was placed by the transferring facility. You look at the x-ray to confirm placement and note the following:

You are transporting an intoxicated patient who was involved in a motor vehicle collision and sustained a closed femur fracture. Which types of hypoxia-related problems may occur in flight?

____________ is a drug that has potent alpha effects and is used to increase systemic vascular resistance (SVR) in profound vasodilatory redistributive shock states such as sepsis and neurogenic shock.