EMT Chapter 17

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

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:

8

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

A 17-year-old male with anxiety

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

A. Confusion and fatigue

Components of the Cincinnati Prehospital Stroke Scale include:

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: list all of the patient's current medications. obtain a complete set of baseline vital signs. administer glucose to rule out hypoglycemia. ask his wife when she noticed the symptoms.

Ask his wife when she noticed the symptoms

When assessing for arm drift of a patient with a suspected stroke, you should: A. ask the patient to hold his or her arms up with the palms down. B. expect to see one arm slowly drift down to the patient's side. C. observe movement of the arms for approximately 2 minutes. 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 a simple partial seizure? A. A seizure that causes the patient to stare blankly B. A seizure that begins in one extremity C. A generalized seizure without incontinence D. A seizure that is not preceded by an aura

B. A seizure that begins in one extremity

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 is currently not prescribed any medications C. His wife states that this was his "usual" seizure D. He has experienced seizures since he was 20

B. He is currently not prescribed any medications

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

B. The pain is worse when bending over

What most MOST accurately describes the cause of an ischemic stroke?

Blockage of a cerebral artery

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

C. 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. call medical control and request permission to give the child aspirin. B. cover the child with wet towels and give oxygen via nasal cannula. C. transport the child to the hospital and reassure the mother en route. D. advise the mother to take her child to the doctor the following day.

C. transport the child to the hospital and reassure the mother en route.

Muscle control and body coordination are controlled by the: Cerebrum Cerebellum Brain stem Cerebral cortex

Cerebellum

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

Cerebral vasodilation

The three major parts of the brain are:

Cerebrum, cerebellum, brain stem

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

D. Ensure a patent airway and support ventilation as needed

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:Select one: A. oral glucose gel and transport. B. high-flow oxygen and transport. C. ventilatory assistance and transport. D. recovery position and transport.

D. recovery position and transport.

A patient whose speech is slurred and difficult to understand is experiencing:

Dysarthria

The anterior aspect of the cerebrum controls: Touch Emotion Movement Vision

Emotion

a 40 year old patient without a history of seizures experiences a generalized (tonic-clonic) seizure. The LEAST likely cause of this seizure is: Epilepsy Brain tumor Serious infection Intracranial bleeding

Epilepsy

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

Has bleeding within the brain

The MOST significant risk factor for a hemorrhagic stroke is:

Hypertension

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

Hypotension

Which of the following conditions would be the least likely to mimic the signs and symptoms of a stroke? Hypoglycemia A postictal state Hypovolemia Intracranial bleeding

Hypovolemia

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

Levetiracetam (Keppra)

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

Neck stiffness or pain

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

Severe twitching of all the body's muscles

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

Sudden, severe headache

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

The right side of the body

Successful treatment of a strike depends on whether:

Thrombolytic therapy is given within 3 hours of symptoms beginning

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

When the patient last appeared normal

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

a seizure

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: place a bite block in her mouth in case she has a seizure and transport at once. apply oxygen via a nonrebreathing mask, place her on her left side, and transport. assist ventilations, perform a rapid exam, and prepare for immediate transport. apply oxygen via nonrebreathing mask and transport her for a blood-alcohol test.

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. Treatment should include: assisting him with his migraine medication and transporting without lights and siren. placing him in a supine position and transporting with lights and siren to a stroke center. applying warm compresses to the back of his neck and transporting with lights and siren. dimming the lights in the back of the ambulance and transporting without lights and siren.

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

A patient with an altered mental status is:

not thinking clearly or is incapable of being aroused.

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: determine if the patient is a known alcohol abuser. obtain a description of how the seizure developed. determine when he was last seen by his physician. ask her how long the patient has been taking his medication.

obtain a description of how the seizure developed.

Status epilepticus is characterized by:

prolonged seizures without a return of consciousness.

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: always take oral medications to maintain normal blood glucose levels. do not present with slurred speech or weakness to one side of the body. are typically alert and attempt to communicate with health care providers. usually have an altered mental status or decreased level of consciousness.

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