chapter 15 Neurological emergencies

Muscle control and body coordination are controlled by the:

cerebellum

The spinal cord exits the cranium through the:

foramen magnum.

Which of the following medications is NOT used to treat patients with a history of seizures?

hydromorphone (Dilaudid)

The MOST significant risk factor for a hemorrhagic stroke is:

hypertension

Status epilepticus is characterized by

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:

recumbent position with the paralyzed side down.

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?

8

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

blockage of a cerebral artery

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

a 17 y/0 male with depression and anxiety

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

a 17-year-old male with no past medical history.

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 ruptured cerebral artery

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

a seizure that begins in one extremity

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

a seizure.

The most basic functions of the body, such as breathing, blood pressure, and swallowing, are controlled by the:

brain stem

An area of swelling or enlargement in a weakened arterial wall is called:

an aneurysm

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

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

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:

assist ventilation perform a rapid exam, and prepare for immediate transport.

Which of the following MOST accurately describes what the patient will experience during the postictal state that follows a seizure?

confusion and fatigue

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:

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

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

dystharia

The anterior aspect of the cerebrum controls:

emotion.

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

ensure a patent airway and support ventilation as needed

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 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:

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:

liver

:Which of the following is NOT an assessment parameter included in the Cincinnati Prehospital Stroke Scale?

memory

Which of the following is NOT an assessment parameter included in the Cincinnati Prehospital Stroke Scale?

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:

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

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 carbamazepine (Tegretol). When obtaining further medical history from the girlfriend, it is MOST important to:

obtain a description of how the seizure developed

You are caring for a semiconscious man with left-sided paralysis. His airway is patent and his respirations are 14 breaths/min with adequate tidal volume. Treatment for this patient should include:

oxygen via nonrebreathing mask, left lateral recumbant position, and transport

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

poisoning

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:

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

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

severe hypovulemia

A generalized seizure is characterized by:

severe twitching of all the body's muscles

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

sudden, severe headache

A transient ischemic attack (TIA) occurs when:

the normal body processes destroy a clot in a cerebral artery

The left cerebral hemisphere controls

the right side of the body

A patient who is experiencing aphasia is

unable to produce or understand speech

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

When obtaining medical history information from the family of a suspected stroke patient, it is MOST important to determine:

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 ruptured cerebral artery.

A patient without a history of seizures experiences a sudden convulsion. The LEAST likely cause of this seizure is:

epilepsy.

Which of the following conditions would be the LEAST likely to mimic the signs and symptoms of a stroke?

hypovolemia