EMT Ch. 17 Quiz

The spinal cord exits the cranium through the: A. foramen lamina. B. vertebral foramen. C. foramen magnum. D. cauda equina.

foramen magnum

Which of the following symptoms would lead the EMT to believe that a patient's headache is caused by sinus congestion? A. The headache began suddenly B. The pain is worse when bending over C. There is numbness in the extremities D. There is associated neck stiffness

The pain is worse when bending over

The left cerebral hemisphere controls: A. the right side of the body. B. heart rate and pupil reaction. C. the right side of the face. D. breathing and blood pressure.

The right side of the body

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: A. 12 B. 13 C. 14 D. 15

12

What Glasgow Coma Scale (GCS) score would you assign to a patient who responds to painful stimuli, uses inappropriate words, and maintains his or her arms in a flexed position? A. 6 B. 8 C. 9 D. 10

8

Your patient opens his eyes, moans, and pulls away from you when you pinch his trapezius muscle. You should assign a Glasgow Coma Scale (GCS) score of: A. 9. B. 7. C. 8. D. 6.

8

Which of the following patients would MOST likely demonstrate typical signs of infection, such as a fever? A. A 3-month-old female who was born prematurely B. A 17-year-old male with anxiety C. A 35-year-old female in the later stages of AIDS D. An 88-year-old male with chronic renal problems

A 17-year-old male with anxiety

A patient whose speech is slurred and difficult to understand is experiencing: A. paraplegia. B. dysarthria. C. aphasia. D. dysphagia.

Dysarthria

Which of the following medications would indicate that a patient has a history of seizures? A. Enalapril (Vasotec) B. Levetiracetam (Keppra) C. Hydromorphone (Dilaudid) D. Metformin (Glucophage)

Levetiracetam (Keppra)

Febrile seizures: A. are usually benign but should be evaluated. B. are also referred to as petit mal seizures. C. occur when a child's fever progressively rises. D. often result in permanent brain damage.

are usually benign but should be evaluated

Components of the Cincinnati Prehospital Stroke Scale include: A. speech, pupil reaction, and memory. B. arm drift, memory, and grip strength. C. arm drift, speech, and facial droop. D. facial droop, speech, and pupil size.

arm drift, speech, and facial droop

A 58-year-old male presents with confusion, right-sided weakness, and slurred speech. His wife is present and is very upset. As your partner is applying oxygen, it is MOST important for you to: A. administer glucose to rule out hypoglycemia. B. ask his wife when she noticed the symptoms. C. obtain a complete set of baseline vital signs. D. list all of the patient's current medications.

ask his wife when she noticed the symptoms

The most basic functions of the body, such as breathing, blood pressure, and swallowing, are controlled by the: A. brain stem. B. cerebrum. C. cerebral cortex. D. cerebellum.

brain stem

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

cerebellum

The anterior aspect of the cerebrum controls: A. touch. B. emotion. C. movement. D. vision.

emotion

You are dispatched to a residence for a 66-year-old male who, according to family members, has suffered a massive stroke. Your primary assessment reveals that the patient is unresponsive, apneic, and pulseless. You should: A. assess the patient for a facial droop and hemiparesis. B. perform CPR for 5 minutes before applying the AED. C. obtain a blood glucose sample to rule out hypoglycemia. D. initiate cardiopulmonary resuscitation (CPR) and attach an automated external defibrillator (AED) as soon as possible.

initiate cardiopulmonary resuscitation (CPR) and attach an automated external defibrillator (AED) as soon as possible

The mental status of a patient who has experienced a typical seizure: A. typically does not improve, even after several minutes. B. is easily differentiated from that of acute hypoglycemia. C. is likely to improve over a period of 5 to 30 minutes D. progressively worsens over a period of a few hours.

is likely to improve over a period of 5 to 30 minutes

Individuals with chronic alcoholism are predisposed to intracranial bleeding and hypoglycemia secondary to abnormalities in the: A. kidneys. B. liver. C. brain. D. pancreas.

liver

Which of the following is NOT an assessment parameter included in the Cincinnati Prehospital Stroke Scale? A. speech B. memory C. arm drift D. facial droop

memory

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 phenytoin (Dilantin) for her seizures, but has not taken it in a few days. He also tells you that she has diabetes. In addition to applying high-flow oxygen, you should: A. administer one tube of oral glucose and prepare for immediate transport. B. give her small cups of water to drink and observe for further seizure activity. C. monitor her airway and breathing status and assess her blood glucose level. D. place her in the recovery position and transport her with lights and siren.

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

An absence seizure is also referred to as a: A. grand mal seizure. B. petit mal seizure. C. total body seizure. D. generalized motor seizure.

petit mal seizure

Status epilepticus is characterized by: A. profound tachycardia and total muscle flaccidity. B. an absence seizure that is not preceded by an aura. C. prolonged seizures without a return of consciousness. D. generalized seizures that last less than 5 minutes.

prolonged seizures without a return of consciousness

When transporting a stable stroke patient with unilateral paralysis, it is best to place the patient in a: A. recumbent position with the paralyzed side up. B. recumbent position with the paralyzed side down. C. sitting position with the head at a 45° to 90° angle. D. supine position with the legs elevated 6″ to 12″.

recumbent position with the paralyzed side down

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, and is breathing at a normal rate with adequate depth. You should: A. use a bag-mask device to assist her ventilations. B. insert an oral airway, apply oxygen, and transport. C. place her on her side and prepare for rapid transport. D. suction her oropharynx and apply 100% oxygen.

suction her oropharynx and apply 100% oxygen

A transient ischemic attack (TIA) occurs when: A. the normal body processes destroy a clot in a cerebral artery. B. signs and symptoms resolve spontaneously within 48 hours. C. medications are given to dissolve a cerebral blood clot. D. a small cerebral artery ruptures and causes minimal damage.

the normal body processes destroy a clot in a cerebral artery

The principal clinical difference between a stroke and hypoglycemia is that patients with hypoglycemia: A. are typically alert and attempt to communicate with health care providers. B. always take oral medications to maintain normal blood glucose levels. C. do not present with slurred speech or weakness to one side of the body. D. usually have an altered mental status or decreased level of consciousness.

usually have an altered mental status or decreased level of consciousness

When caring for a patient with documented hypoglycemia, you should be MOST alert for: A. a seizure. B. respiratory distress. C. an acute stroke. D. a febrile convulsion.

A seizure

Which of the following MOST accurately describes a simple partial seizure? A. A seizure that causes the patient to stare blankly B. A generalized seizure without incontinence C. A seizure that is not preceded by an aura D. A seizure that begins in one extremity

A seizure that begins in one extremity

When assessing for arm drift of a patient with a suspected stroke, you should: A. expect to see one arm slowly drift down to the patient's side. B. observe movement of the arms for approximately 2 minutes. C. ask the patient to hold his or her arms up with the palms down. D. ask the patient to close his or her eyes during the assessment.

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? A. Blockage of a cerebral artery B. Acute atherosclerotic disease C. Rupture of a cerebral artery D. Narrowing of a carotid artery

Blockage of a cerebral artery

Interruption of cerebral blood flow may result from all of the following, EXCEPT: A. cerebral vasodilation. B. an acute arterial rupture. C. an embolism. D. a thrombus.

Cerebral vasodilation

The three major parts of the brain are the: A. cerebrum, cerebellum, and brain stem. B. midbrain, cerebellum, and spinal cord. C. cerebellum, medulla, and occiput. D. brain stem, midbrain, and spinal cord.

Cerebrum, cerebellum, and brain stem

Which of the following MOST accurately describes what the patient will experience during the postictal state that follows a seizure? A. Confusion and fatigue B. A rapidly improving level of consciousness C. Hyperventilation and hypersalivation D. A gradually decreasing level of consciousness

Confusion and fatigue

During the primary assessment of a semiconscious 70-year-old female, you should: A. insert a nasopharyngeal airway and assist ventilations. B. ensure a patent airway and support ventilation as needed. C. ask family members if the patient has a history of stroke. D. immediately determine the patient's blood glucose level.

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: A. has a GCS score that is less than 8. B. has had a prior heart attack. C. has bleeding within the brain. D. is older than 60 years of age.

Has bleeding within the brain

A 30-year-old male experienced a generalized (tonic-clonic) seizure, which stopped before you arrived at the scene. The patient is conscious, is answering your questions appropriately, and refuses EMS transport. Which of the following would be the MOST compelling reason to disagree with his refusal of transport? A. His Glasgow Coma Scale (GCS) score is 15 B. He has experienced seizures since he was 20 C. He is currently not prescribed any medications D. His wife states that this was his "usual" seizure

He is currently not prescribed any medications

The MOST significant risk factor for a hemorrhagic stroke is: A. heavy exertion. B. hypertension. C. severe stress. D. diabetes mellitus.

Hypertension

Which of the following conditions is NOT a common cause of seizures? A. Poisoning or overdose B. Hypotension C. Acute hypoglycemia D. Acute alcohol withdrawal

Hypotension

Which of the following conditions would be the LEAST likely to mimic the signs and symptoms of a stroke? A. Intracranial bleeding B. Hypoglycemia C. Hypovolemia D. A postictal state

Hypovolemia

Which of the following clinical signs is MOST suggestive of a ruptured aneurysm? A. Unilateral hemiparesis B. Confusion and weakness C. Nasal discharge of blood D. Sudden, severe headache

Sudden, severe headache

Which of the following findings should concern the EMT the MOST when assessing a patient who complains of a headache? A. Sinus congestion B. Neck stiffness or pain C. History of migraines D. Slow onset of symptoms

Neck stiffness or pain

A patient with an altered mental status is: A. usually able to be aroused with a painful stimulus. B. typically alert but is confused as to preceding events. C. completely unresponsive to all forms of stimuli. D. not thinking clearly or is incapable of being aroused.

Not thinking clearly or is incapable of being aroused

You are caring for a 68-year-old man with sudden onset of left-sided paralysis and slurred speech. His airway is patent, his respirations are 14 breaths/min with adequate depth, and his oxygen saturation is 98%. Treatment for this patient should include: A. oral glucose gel and transport. B. ventilatory assistance and transport. C. high-flow oxygen and transport. D. recovery position and transport

Recovery position and transport

Which of the following conditions would MOST likely affect the entire brain? A. Blocked cerebral artery in the frontal lobe B. Respiratory failure or cardiopulmonary arrest C. Reduced blood supply to the left hemisphere D. Ruptured cerebral artery in the occipital lobe

Respiratory failure or cardiopulmonary arrest

You respond to a residence for a child who is having a seizure. Upon arrival at the scene, you enter the residence and find the mother holding her child, a 2-year-old male. The child is conscious and crying. According to the mother, the child had been running a high fever and then experienced a seizure that lasted approximately 3 minutes. You should: A. transport the child to the hospital and reassure the mother en route. B. advise the mother to take her child to the doctor the following day. C. call medical control and request permission to give the child aspirin. D. cover the child with wet towels and give oxygen via nasal cannula.

Transport the child to the hospital and reassure the mother en route

When you are obtaining medical history from the family of a suspected stroke patient, it is MOST important to determine: A. the patient's overall medication compliance. B. if the patient has been hospitalized before. C. when the patient last appeared normal. D. if there is a family history of a stroke.

When the patient last appeared normal

You are assessing a 49-year-old man who, according to his wife, experienced a sudden, severe headache and then passed out. He is unresponsive and has slow, irregular breathing. His blood pressure is 190/94 mm Hg and his pulse rate is 50 beats/min. His wife tells you that he has hypertension and diabetes. He has MOST likely experienced: A. a acute hypoglycemia. B. a ruptured cerebral artery. C. a complex partial seizure. D. an occluded cerebral artery.

a ruptured cerebral artery

Law enforcement has summoned you to a nightclub, where a 22-year-old female was found unconscious in an adjacent alley. Your primary assessment reveals that her respirations are rapid and shallow and her pulse is rapid and weak. She is wearing a medical alert bracelet that identifies her as an epileptic. There is an empty bottle of vodka next to the patient. You should: A. apply oxygen via a nonrebreathing mask, place her on her left side, and transport. B. apply oxygen via nonrebreathing mask and transport her for a blood-alcohol test. C. assist ventilations, perform a rapid exam, and prepare for immediate transport. D. place a bite block in her mouth in case she has a seizure and transport at once.

assist ventilations, perform a rapid exam, and prepare for immediate transport

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 and adequate. In addition to high-flow oxygen, further treatment should include: A. assisting him with his migraine medication and transporting without lights and siren. B. applying warm compresses to the back of his neck and transporting with lights and siren. C. dimming the lights in the back of the ambulance and transporting without lights and siren. D. placing him in a supine position and transporting with lights and siren to a stroke center.

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

A 40-year-old patient without a history of seizures experiences a generalized (tonic-clonic) seizure. The LEAST likely cause of this seizure is: A. epilepsy. B. a brain tumor. C. a serious infection. D. intracranial bleeding.

epilepsy

Which of the following conditions would be the LEAST likely to mimic the signs and symptoms of a stroke? A. hypovolemia B. a postictal state C. intracranial bleeding D. hypoglycemia

hypovolemia

You arrive at the residence of a 33-year-old woman who is experiencing a generalized seizure. She has a small amount of vomitus draining from the side of her mouth. After protecting her from further injury, you should: A. place a bite block in between her teeth, apply high-flow oxygen via a nonrebreathing mask, and consider inserting a nasopharyngeal airway. B. wait for the seizure to stop, manually open her airway, insert an oropharyngeal airway, and assess her oxygen saturation with the pulse oximeter. C. maintain her airway with manual head positioning, suction her airway to remove the vomitus, insert a nasopharyngeal airway, and administer high-flow oxygen. D. restrain her extremities to prevent her from injuring herself, suction her airway to remove the vomitus, and assist her ventilations with a bag-mask device.

maintain her airway with manual head positioning, suction her airway to remove the vomitus, insert a nasopharyngeal airway, and administer high-flow oxygen

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 carbamazepine (Tegretol). When obtaining further medical history from the girlfriend, it is MOST important to: A. determine when he was last seen by his physician. B. ask her how long the patient has been taking his medication. C. determine if the patient is a known alcohol abuser. D. obtain a description of how the seizure developed.

obtain a description of how the seizure developed

You are assessing the arm drift component of the Cincinnati Prehospital Stroke Scale on a 60-year-old woman. When she holds both of her arms out in front of her and closes her eyes, both of her arms immediately fall to her sides. You should: A. instruct the patient to keep her eyes open and then repeat the arm drift test. B. repeat the arm drift test and ensure that her palms are facing downward. C. defer this part of the test and assess her for facial droop and slurred speech. D. repeat the arm drift test, but move the patient's arms into position yourself.

repeat the arm drift test, but move the patient's arms into position yourself

A generalized (tonic-clonic) seizure is characterized by: A. severe twitching of all the body's muscles. B. a blank stare and brief lapse of consciousness. C. unconsciousness for greater than 30 minutes. D. a core body temperature of greater than 103°F (40°C).

severe twitching of all the body's muscles

Successful treatment of a stroke depends on whether: A. thrombolytic therapy is given within 3 hours after symptoms began. B. the stroke occurs within the left or right hemisphere of the brain. C. surgical intervention is performed to remove obstructive clots. D. medications are given to restore the function of infarcted cells.

thrombolytic therapy is given within 3 hours after symptoms began

A patient who is experiencing aphasia is: A. not able to swallow without choking. B. unable to produce or understand speech. C. usually conscious but has slurred speech. D. experiencing a right hemispheric stroke.

unable to produce or understand speech.