(2) Chapter 17: Neurologic (QUIZ)

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

Postictal state

A period following a seizure that typically includes labored respirations and altered mental status

Aura

A sense of warning experienced prior to an event

Aneurysm

A swelling or enlargement of part of an artery resulting from weakness of the arterial wall

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

A. A seizure that begins in one extremity

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

A. Ask the patient to close his or her eyes during the assessment

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

A. Cerebral vasodilation

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. He is currently not prescribed any medications B. His GCS score is 15 C. His wife state that this was his "usual" seizure D. He has experienced seizure since he was 20

A. He is currently not prescribed any medications

The MOST significant risk factor for a hemorrhagic stroke is: A. Hypertension B. Diabetes C. Severe stress D. Heavy exertion

A. Hypertension

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

A. Hypovolemia

A patient with an altered mental status is: A. Not thinking clearly or is incapable of being aroused B. Usually able to be aroused with a painful stimulus C. Completely unresponsive to all stimulus D. Typically alert but is confused as to preceding events

A. Not thinking clearly or is incapable of being aroused

You are assessing the arm-drift component of the Cincinnati prehospital stoke 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. Repeat the arm drift test, but move the patient's arms into position yourself B. Defer this part of the test and assess her for facial droop and slurred speech C. Instruct the patient to keep her eyes open and then repeat the arm drift test D. Repeat the arm drift test and ensure that her palms are facing downward

A. Repeat the arm drift test, but move the patient's arms into position yourself

Hypoglycemia can mimic conditions such as: A. Stroke B. Myocardial infarction C. High fever D. Cystic fibrosis

A. Stroke

Aphasia

An inability to produce or understand speech

When caring for a patient with documented hypoglycemia, you should be most alert for: A. Respiratory distress B. A seizure C. Febrile convulsion D. An acute stroke

B. A seizure

The most basic functions of the body, such as breathing, blood pressure, and swallowing, are controlled by the: A. Cerebellum B. Brain stem C. Cerebrum D. Cerebral cortex

B. Brain stem

A patient whose speech is slurred and difficult to understand is experiencing: A. Paraplegia B. Dysarthria C. Aphasia D. Dysphagia

B. Dysarthria

A patient who is possibly experiencing a stroke is NOT eligible for thrombolytic (fibrinolytic) therapy if he or she: A. Is older than 60 years of age B. Has bleeding in the brain C. Has had a prior heart attack D. Has a GCS score that is less than 8

B. Has bleeding in the brain

You are called to a home and find a 56-year-old woman supine in her bed. She appears alert, but has slurred speech. Her family tells you she has a history of TIAs and hypertension. You ask the patient, "What day is it today?" Her reply is, "butterfly." Which area of the brain is likely affected? A. Occipital lobe B. Left hemisphere C. Right hemisphere D. Cerebellum

B. Left hemisphere

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/min with adequate depth, and his O2 sat is 98%. Treatment for the patient should include: A. Oral glucose gel and transport B. Recovery position and transport C. Ventilatory assistance and transport D. High-flow oxygen and transport

B. Recovery position and transport

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) place her in the recovery position and transport her with lights and siren. C) monitor her airway and breathing status and assess her blood glucose level. D) 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.

A transient ischemic attack (TIA) occurs when: A. Signs and symptoms resolve spontaneously within 48 hours B. Medications are given to dissolve a cerebral blood clot C. A small clot in a cerebral artery causes temporary symptoms D. A small cerebral artery ruptures and causes minimal damage

C. A small clot in a cerebral artery causes temporary symptoms

When the blood flow to a particular part of the brain is cut off by a blockage inside a blood vessel, the result is: A. A cerebral embolism B. Atherosclerosis C. An ischemic stroke D. A hemorrhagic stroke

C. An ischemic stroke

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

C. Confusion and fatigue

During the primary assessment of a semiconscious 70-year-old female, you should: A. Insert and NPA and assist ventilations B. Ask family members if the patient has a history of stroke C. Ensure a patent airway and support ventilation as necessary D. Immediately determine the patient's blood glucose level

C. Ensure a patent airway and support ventilation as necessary

Headache, vomiting, altered mental status, and seizures are all considered early signs of: A. Increased extracranial pressure B. Decrease intracranial pressure C. Increased intracranial pressure D. Decreased extracranial pressure

C. Increased intracranial pressure

You arrive at the residence of a 33-year-old woman who is experiencing a generalized (tonic-clonic) 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 between her teeth, apply high-flow oxygen via a nonrebreathing mask, and consider inserting an NPA B. Restrain her extremities to prevent her from injuring herself, suction her airway, and assist her ventilations with a BVM C. Maintain her airway with manual head positioning, suction her airway, insert an NPA, and administer high-flow oxygen D. Wait for the seizure to stop, manually open her airway, insert an OPA, and assess her O2 sat with a pulse ox

C. Maintain her airway with manual head positioning, suction her airway, insert an NPA, and administer high-flow oxygen

The principle difference between a patient who has had a stroke and a patient with hypoglycemia almost always has to do with the: A. Blood pressure B. Pupillary response C. Mental status D. Capillary refill time

C. Mental status

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

C. Respiratory failure or cardiopulmonary arrest

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

C. The pain is worse when bending over

Patients with subarachnoid hemorrhage typically complain of a sudden severe:

Headache

When transporting a stable patient with a paralyzed extremity, place the patient:

In a recumbent position with the paralyzed side down

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:

Initiate CPR and attach an AED as soon as possible

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 O2 sat of 96%

Suction her airway and transport immediately

The left cerebral hemisphere controls:

The right side of the body

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:

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:

When the patient last appeared normal

The three major parts of the brain are:

cerebrum, cerebellum, brain stem

Hemiparesis

weakness on one side of the body