chapter 17 review
Your patient opens his eyes when you say his name, is making incomprehensible sounds, and withdraws when you pinch his earlobe. What is his GCS score? A) 9 B) 8 C) 11 D) 12
A) The Glasgow Coma Scale gives a score of 3 to a patient who opens his or her eyes in response to speech. "Incomprehensible sounds" has a score of 2, and "withdraws to pain" has a score of 4. When added together, this patient's GCS score is 9.
A 56-year-old man experienced a sudden, severe headache and then became unresponsive. He has a history of high blood pressure. The MOST likely cause of his conditions is a(n): A. Hemorrhagic stroke B. Acute Ischemic stroke C. Severe migraine headache D. Transient ischemic attack
A. Hemorrhagic stroke
A 41-year-old man presents with slow, irregular breathing; hypotension; and dilated pupils. These signs MOST likely indicate dysfunction of the: A. Brain Stem B. Hypothalmus C. Cerebrum D. Cerebellum
A. The brain stem is responsible for functions such as breathing, blood pressure, and pupil constriction. Brain stem dysfunction would result in abnormal finding with these functions
The MOST important reason for promptly transporting a stroke patient to the hospital is: A) a transient ischemic attack can be ruled out. B) medications may be given to reverse the stroke. C) the clot in the coronary artery may be dissolved. D) he or she needs close blood pressure monitoring.
B) Fibrinolytic medications (clot busters) have been shown to reverse the symptoms of a stroke by dissolving the clot that is blocking the cerebral artery. However, for the patient to be eligible for this therapy, it must be initiated within 3 hours after the onset of symptoms. For this reason, prompt transport of the stroke patient is critical.
Unlike an ischemic stroke, a transient ischemic attack is characterized by all of the following, EXCEPT: A) symptoms that resolve within 24 hours. B) symptoms that persist for longer than 24 hours. C) weakness or paralysis to one side of the body. D) an acute onset of confusion and slurred speech.
B) Signs and symptoms of a transient ischemic attack (TIA) are usually identical to those of an acute ischemic stroke (eg, hemiparesis, slurred speech, confusion, facial droop). Unlike the ischemic stroke, however, the symptoms of a TIA usually resolve within 24 hours.
Which of the following are components of the Cincinnati Prehospital Stroke Scale? A) Arm drift, blood pressure, speech B) Speech, pupil response, arm drift C) Facial symmetry, speech, arm drift D) Pupil response, facial droop, speech
C) The three components of the Cincinnati Prehospital Stroke Scale are facial symmetry, speech, and arm drift. Both sides of the patient's face should move symmetrically (equally) when he or she smiles. The patient's speech should be easily understandable and without slurring. The patient should be able to hold both arms out in front of his or her body—with eyes closed and palms up—without one arm drifting down to his or her side.
If a patient complains of a severe migraine, how should she be transported? A) In a brightly lit ambulance so she can see while her vision is impaired B) With loud sirens so she can get to the hospital as soon as possible C) Without lights and sirens D) This patient should not be transported.
C) Treatment of a migraine headache is supportive; however, you should always assess the patient for other signs and symptoms that might indicate a more serious condition. Applying high-flow oxygen, if tolerated, may help ease the patient's condition. When possible, provide a darkened and quiet environment because patients are sensitive to light and sound. Do not use lights and sirens during transport.
A patient with a suspected stroke presents with slurred speech that is difficult for you to understand. This is referred to as: A) aphasia. B) dysphasia. C) dysphagia. D) dysarthria.
D) Dysarthria is defined as slurred, poorly articulated speech; it is common in stroke patients. Dysphasia is defined as difficulty speaking; the patient's speech may or may not be slurred. Aphasia is the inability to speak. Dysphagia is defined as difficulty swallowing.
A type of seizure that is characterized by severe twitching of all the body's muscles and lasts for several minutes or longer is called a(n): A) partial seizure. B) absence seizure. C) tonic-clonic seizure. D) generalized seizure.
D) Generalized seizures are characterized by generalized severe twitching of all of the body's muscles; they often last for several minutes or longer. An absence seizure is characterized by a blank stare; generalized muscle twitching is absent.
An acute ischemic stroke is caused by: A. A ruptured cerebral artery B. increased intracranial pressure C. An acute rise in a person's blood pressure D. A blocked cerebral artery
D. A blocked cerebral artery