Chapter 18 Neurological Emergencies

Your patient answers your questions appropriately, although her eyes remain closed the entire time. She moves each extremity on command, although her left side is weaker than the right. You should assign a Glasgow Coma Scale (GCS) score of:

12

Which of the following patients would MOST likely demonstrate typical signs of infection, such as a fever?

A 17-year-old male with anxiety

Which of the following MOST accurately describes a simple partial seizure?

A seizure that begins in one extremity

Interruption of cerebral blood flow may result from all of the following, EXCEPT:

A. cerebral vasodilation. Correct B. an acute arterial rupture. C. an embolism. D. a thrombus.

A 58-year-old male presents with confusion, right-sided weakness, and slurred speech. His airway is patent and his breathing is adequate. His wife is present and is very upset. Which of the following has the MOST immediately priority?

Asking his wife when she noticed the symptoms

Which of the following findings should concern the EMT the MOST when assessing a patient who complains of a headache?

Neck stiffness or pain

Which of the following is a metabolic cause of a seizure?

Poisoning

Which of the following conditions is NOT a common cause of seizures?

Poisoning or overdose Acute hypoglycemia Hypotension (correct) Acute alcohol withdrawal

Components of the Cincinnati Prehospital Stroke Scale include:

arm drift, speech, and facial droop.

When assessing for arm drift of a patient with a suspected stroke, you should:

ask the patient to close his or her eyes during the assessment

Which of the following MOST accurately describes the cause of an ischemic stroke?

blockage of a cerebral artery

Muscle control and body coordination are controlled by the: cerebral cortex. cerebrum. brain stem. cerebellum.

cerebellum

A 29-year-old male complains of a severe headache and nausea that has gradually worsened over the past 12 hours. He is conscious, alert, and oriented and tells you that his physician diagnosed him with migraine headaches. He further tells you that he has taken numerous different medications, but none of them seem to help. His blood pressure is 132/74 mm Hg, his pulse is 110 beats/min and strong, and his respirations are 20 breaths/min. Treatment should include:

dimming the lights in the back of the ambulance and transporting without lights and siren.

During the primary assessment of a semiconscious 70-year-old female, you should:

ensure a patent airway and support ventilation as needed.

A patient who is possibly experiencing a stroke is NOT eligible for thrombolytic (fibrinolytic) therapy if he or she:

has bleeding within the brain.

A 40-year-old patient without a history of seizures experiences a generalized (tonic-clonic) seizure. The LEAST likely cause of this seizure is:

intracranial bleeding. a serious infection. epilepsy. Correct a brain tumor.

Individuals with chronic alcoholism are predisposed to intracranial bleeding and hypoglycemia secondary to abnormalities in the:

liver

You arrive at a local grocery store approximately 5 minutes after a 21-year-old female stopped seizing. She is confused and disoriented; she keeps asking you what happened and tells you that she is thirsty. Her brother, who witnessed the seizure, tells you that she takes valproate (Depakote) for her seizures, but has not taken it in a few days. He also tells you that she has diabetes. In addition to administering oxygen, you should:

monitor her airway and breathing status and assess her blood glucose level.

You arrive at a grocery store shortly after a 35-year-old male stopped seizing. Your assessment reveals that he is confused and incontinent of urine. The patient's girlfriend tells you that he has a history of seizures and takes topiramate (Topamax). When obtaining further medical history from the girlfriend, it is MOST important to:

obtain a description of how the seizure developed.

An absence seizure is also referred to as a:

petit mal seizure

When caring for a patient with documented hypoglycemia, you should be MOST alert for:

seizure

You are caring for a 70-year-old female with signs and symptoms of an acute stroke. She is conscious, has secretions in her mouth, is breathing at a normal rate with adequate depth, and has an oxygen saturation of 96%. You should:

suction her oropharynx and transport immediately.

Which of the following clinical signs is MOST suggestive of a ruptured aneurysm?

sudden, severe headache

A patient who is experiencing aphasia is:

unable to produce or understand speech.

The principal clinical difference between a stroke and hypoglycemia is that patients with hypoglycemia:

usually have an altered mental status or decreased level of consciousness.