EMT - Chapter 18 - Altered Mental Status, Stroke & Headache

18.11.9 The MEND exam for a stroke does not include which assessment​ parameter? A. BGL assessment B. Cranial nerve function C. Mental status D. Motor and sensory function of the limbs

A. BGL assessment

18.03.4 You have been called to the house of a young adult male patient who is unresponsive. The man lives by​ himself, so no family is present. In trying to determine the origin of the​ patient's altered mental​ status, which of these would most likely provide the best​ information, assuming it is available to​ you? A. Examination of patient medications​ (prescribed and​ recreational) B. Interpretation of physical assessment findings C. Observation of the living conditions in the house D. Contact with medical direction

A. Examination of patient medications​ (prescribed and​ recreational)

18.02.3 An elderly male patient with a history of​ COPD, hypertension, and diabetes presents as lethargic and confused. His airway is​ patent, and breathing is adequate. His skin is hot and his radial pulse is​ strong, regular, and bounding. Vital signs are​ pulse, 112;​ respirations, 20​ breaths/min; blood​ pressure, 108/64​ mmHg; SpO2,​ 94%; and​ temperature, 102.8°F. Also noted is swelling to his right lower leg. Given these assessment​ findings, the EMT should suspect which condition is responsible for the​ patient's altered​ presentation? A. Infection B. Peripheral edema C. Tachycardia D. Hypoxia

A. Infection

18.05.1 What does the first​ "I" in the​ AEIOU-TIPPSS mnemonic stand​ for? A. Insulin B. Infection C. Ischemia D. Influenza

A. Insulin

18.08.1 Which of these is a good description of an ischemic​ stroke? A. Obstructive blood clot inside a blood vessel within the brain B. Rupture of an artery within the brain C. Simultaneous occurrence of stroke and heart attack D. Blood accumulation within the brain tissue

A. Obstructive blood clot inside a blood vessel within the brain

18.01.1 Which of these conditions would the EMT recognize as most likely signaling a neurologic​ deficit? A. Paralysis B. Constricted pupils C. Headache D. Hypoglycemia

A. Paralysis

18.12.11 An alert and oriented​ 69-year-old male patient has slight​ right-arm weakness but exhibits no deficits to the right leg. The EMT should consider this patient to be​ a: A. Priority for transport to a hospital with a stroke center B. ​Non-priority since he is alert and oriented C. Priority only if the patient also has a low blood glucose level D. ​Non-priority transport since no paralysis exists

A. Priority for transport to a hospital with a stroke center

18.12.9 A patient who is responsive only to painful stimuli has a patent​ airway, inadequate respirations at 28​ breaths/min and​ irregular, and a strong radial pulse with skin that is warm and dry. The patient is not moving his right arm or leg and is incontinent of urine. What is the priority for the EMT at this​ time? A. Check the blood glucose level B. Administer positive pressure ventilation C. Administer oxygen by nonrebreather mask D. Insert an oropharyngeal airway

B. Administer positive pressure ventilation

18.09.2 What is the pathophysiology underlying a TIA and its typically rapid​ resolution? A. Blood flow from nearby vascular beds start to perfuse those regions cut off by the TIA​ mini-stroke B. Agents in the bloodstream bust apart the cerebral clot that is causing the signs and symptoms C. Vasodilation of the cerebral blood vessel that was constricted tightly enough to stop blood flow D. Neurons from the areas surrounding the​ TIA's origin start to assume the functions of the brain region affected by the TIA

B. Agents in the bloodstream bust apart the cerebral clot that is causing the signs and symptoms

18.01.2 A​ 49-year-old male patient is unable to speak. You would document this finding​ as: A. Dysplegia B. Aphasia C. Apnea D. Dysarthria

B. Aphasia

18.11.2 When assessing a patient for a facial​ droop, the EMT​ should: A. Palpate the face one side at a time B. Ask the patient to show you his teeth or smile C. Observe the​ patient's ability to turn his head to the right and then to the left D. Gently lift and then let go of the skin over the cheeks

B. Ask the patient to show you his teeth or smile

18.03.11 For altered mental status to​ occur, which body system must be​ affected? A. Cardiovascular B. Central nervous C. Respiratory D. Endocrine

B. Central nervous

18.06.2 To better fulfill the​ AHA's Stroke Chain of Survival​ goals, which assessment mnemonic was developed to better prepare the public and EMS to recognize​ stroke? A. ​AEIOU-TIPPSS B. F.A.S.T C. RACE D. S.T.R.O.K.E.

B. F.A.S.T

18.03.6 You have been called for a patient who suddenly became confused. Which of these assessment findings should concern you​ most? A. Pupils fully dilated and sluggishly reactive to light B. Heart rate of 180​ beats/min but regular C. Blood glucose level of 72​ mg/dL D. Blood pressure of​ 110/72 mmHg

B. Heart rate of 180​ beats/min but regular

18.11.4 Assessment of a​ 63-year-old female patient reveals a patent​ airway, adequate​ breathing, and strong radial pulse. She has no difficulty speaking and no facial​ droop, but exhibits a slight left arm drift and has a headache. The EMT should interpret these specific findings​ as: A. Moderately suggestive that a stroke may be occurring B. Highly suggestive that a stroke may be occurring C. Minimally suggestive that a stroke may be occurring D. Not suggestive of a stroke

B. Highly suggestive that a stroke may be occurring

18.11.10 A patient is alert and​ oriented, with a blood pressure of​ 228/110 mmHg, a heart rate of 82​ beats/min, respirations of 20​ breaths/min and​ adequate, and a pulse oximeter reading of​ 96% on room air. The patient complains of a bad headache that started suddenly. The patient has equal grips and good lower leg function. The blood glucose is 68​ mg/dL, and pupils are​ reactive, although the patient has trouble maintaining a horizontal gaze when asked to do so. He has a history of​ seizures, hypertension, and atrial fibrillation. Given these assessment​ findings, which one meets a criterion for the MEND stroke screening tool that suggests the patient may be experiencing a​ stroke? A. Hypertensive blood pressure B. Horizontal gaze abnormality C. Sudden onset of a bad headache D. History of seizures and atrial fibrillation

B. Horizontal gaze abnormality

18.12.13 Patients with an altered mental status due to a stroke may not be able to control their own airways because​ of: A. Increased oral secretions B. Paralysis or weakness of the throat muscles C. Enlargement and swelling of the epiglottis D. Hypersensitivity of the gag reflex

B. Paralysis or weakness of the throat muscles

18.03.1 When assessing a patient with a suspected​ stroke, the order of the exam would​ be: A. Abnormal​ speech, facial​ droop, arm​ drift, primary​ assessment, and then secondary assessment B. Primary​ assessment, then secondary assessment including a stroke scale C. Secondary​ assessment, primary​ assessment, stroke​ exam, and then SAMPLE history D. Level of​ consciousness, facial​ droop, arm​ drift, airway, and then secondary assessment

B. Primary​ assessment, then secondary assessment including a stroke scale

18.03.10 You have been called to a​ long-term care facility for a​ 77-year-old female patient who was found unresponsive in her wheelchair by staff. The nurse reports that the patient complained of a headache earlier in the day and was given 600 mg of Motrin. Your assessment shows the patient to be unresponsive with a patent​ airway, slow and irregular​ respirations, and a weak radial pulse. Her lips are​ cyanotic, and your partner reports the following vital​ signs: pulse,​ 44; respirations, 6​ breaths/min; and blood​ pressure, 228/116 mmHg. Which action should be your next​ priority? A. Check the​ patient's blood glucose level B. Start positive pressure ventilation C. Perform a prehospital stroke screen D. Attach the pulse oximeter to get a SpO2 reading

B. Start positive pressure ventilation

18.09.1 Which of these conditions places the patient at the greatest risk for an acute neurologic​ deficit? A. Acute myocardial infarction​ (AMI) B. Transient ischemic attack​ (TIA) C. New onset of type 2 diabetes​ (NIDDM) D. Chronic obstructive pulmonary disease​ (COPD)

B. Transient ischemic attack​ (TIA)

18.05.2 Your partner is using the​ AEIOU-TIPPSS mnemonic to assess for common causes of altered mental status in a geriatric patient. During this​ process, your partner forgets what the​ "T" stands for. You would remind him that it​ means: A. Tachycardia B. Trauma C. Tumor D. Toxicology

B. Trauma

18.11.6 The EMT shows that he is performing the Los Angeles Prehospital Stroke Screen​ (LAPSS) correctly when he asks which of these​ questions? A. ​"Did you lose control of your​ bladder?" B. ​"How old are​ you?" C. ​"Do you know where you are right​ now?" D. ​"May I assess your​ pupils?"

B. ​"How old are​ you?"

18.07.3 Which of these statements made by your new EMT partner demonstrates an understanding of assessment findings related to​ stroke? A. ​"If one arm is​ weak, stroke should be suspected only if the blood pressure is also​ elevated." B. ​"If one arm is​ weak, a stroke should be​ suspected." C. ​"A stroke should be suspected only when one arm is​ paralyzed, not​ weak." D. ​"For a stroke to be​ suspected, both arms must be equally​ weak."

B. ​"If one arm is​ weak, a stroke should be​ suspected."

18.01.3 Which of these statements shows that the EMT has an accurate understanding of altered mental​ status? A. ​"It applies only when the patient is not responsive to verbal or painful​ stimuli." B. ​"It describes any change away from a normal state of mental​ function." C. ​"It should be suspected only when the patient is on medications that can cause​ confusion." D. ​"It is any mental state experienced by a person with diabetes or other serious chronic​ disease."

B. ​"It describes any change away from a normal state of mental​ function."

18.11.7 The EMT shows that he recognizes the benefit of using the Cincinnati Prehospital Stroke Scale or Los Angeles Prehospital Stroke Screen when he makes which of these​ statements? A. ​"The screening allows the EMT to differentiate the type of stroke a patient is​ having." B. ​"The screening helps to identify​ stroke, even when it is not the​ patient's chief​ complaint." C. ​"The screening allows the EMT to identify the patient at risk for​ stroke." D. ​"The screen is very predictive in determining whether the patient will die from​ stroke."

B. ​"The screening helps to identify​ stroke, even when it is not the​ patient's chief​ complaint."

18.12.16 You are treating an unresponsive patient. Which piece of information given to you by the​ patient's family is most important in relation to a possible​ stroke? A. ​"He took some ibuprofen last night for a fever and​ cough." B. ​"We noticed him acting oddly about 7​ p.m." C. ​"He forgot to take his blood thinner last​ night." D. ​"We think that he had too much to drink last​ night."

B. ​"We noticed him acting oddly about 7​ p.m."

18.11.11 During a continuing education​ program, the lecturer is talking about the RACE scale as a newer tool the EMT can use to help determine whether a neurologic problem is present. Which neurologic problem does the RACE scale​ address? A. Seizures that are due to an organic cause versus metabolic cause B. ​Large-vessel occlusion stroke C. Structural versus metabolic cause of unresponsiveness D. Stroke stemming from a smaller blood vessel above the circle of Willis

B. ​Large-vessel occlusion stroke

18.12.6 For the patient with stroke to be eligible for a fibrinolytic​ agent, the patient must be brought to the hospital emergency department within how many hours of the onset of stroke​ symptoms? A. 3 B. 24 C. 2 D. 6

C. 2

18.11.1 When using a stroke scale to assess a patient for abnormal​ speech, the EMT​ should: A. Question family members about the​ patient's ability to talk B. Write questions on note cards for the patient to read C. Ask the patient to repeat a specific but common phrase D. Observe verbal ability during assessment

C. Ask the patient to repeat a specific but common phrase

18.12.2 You have determined that an alert elderly male patient has garbled speech and weakness to the right arm and leg. His vital signs and SpO2 level are within normal limits. The family informs you that he has a history of heart problems and diabetes. Given this​ scenario, what should you do​ immediately? A. Administer oxygen via a nasal cannula at 2 lpm B. Administer oral glucose or sugar water C. Check the​ patient's blood glucose level​ (if local protocol​ allows) D. Attach the automated external defibrillator​ (AED)

C. Check the​ patient's blood glucose level​ (if local protocol​ allows)

18.03.9 A​ 78-year-old male patient was found lying on his bathroom floor. Emergency Medical Responders report that the patient is​ unresponsive, with unequal​ pupils, and vital signs are as​ follows: pulse,​ 78; respirations, 20​ breaths/min and​ snoring; blood​ pressure, 210/106​ mmHg; SpO2,​ 99%. The EMRs have applied oxygen by nonrebreather​ mask, and also report that the patient has a hematoma on the back of his head. What should you do​ first? A. Replace the nonrebreather mask with a nasal cannula B. Lift the patient onto the stretcher for transport C. Ensure an open airway with a​ jaw-thrust maneuver D. Quickly apply a cervical collar

C. Ensure an open airway with a​ jaw-thrust maneuver

18.11.3 With the Cincinnati Prehospital Stroke​ Scale, which of these patient parameters is​ assessed? A. Age of the patient B. Time of symptom onset C. Facial droop D. Blood glucose level

C. Facial droop

18.04.2 Which past medical condition identified during the SAMPLE history could be a metabolic cause of an altered mental status in an elderly male​ patient? A. Hemorrhagic stroke B. Brain abscess C. Kidney failure D. Brain tumor

C. Kidney failure

18.12.18 A male patient suddenly found himself unable to talk and with profound weakness to his right arm and leg. Currently he is responsive to verbal stimuli and has the following vital​ signs: pulse,​ 88; respirations 14​ breaths/min and​ adequate; and blood​ pressure, 210/80 mmHg. When transporting this patient to the​ hospital, in which position should you place​ him? A. Prone with head elevated B. Supine with feet elevated C. Left lateral recumbent D. Immobilized to a long board

C. Left lateral recumbent

18.12.10 A​ 73-year-old female patient is responsive to painful stimuli and cannot move her arm or leg on one side of her body. You suspect she is having a stroke. What is the best transport position for this​ patient? A. Supine with head elevated 30 degrees B. Supine with left arm and leg flexed C. Left lateral recumbent position D. Prone with left arm and leg flexed

C. Left lateral recumbent position

18.12.12 When transporting an alert but nonverbal patient with stroke and a blood pressure of​ 210/110 mmHg, the EMT​ should: A. Touch the patient only when absolutely​ necessary, such as when obtaining vital signs B. Dim the lights and remain out of the​ patient's sight to avoid unnecessary stimulation C. Make an effort to explain everything that is happening or being done while trying to help the patient feel at ease D. Remain in the​ patient's sight but avoid talking or stimulating the patient

C. Make an effort to explain everything that is happening or being done while trying to help the patient feel at ease

18.03.8 You have just arrived by the side of a​ 46-year-old male patient who receives dialysis for​ end-stage renal failure. He is positioned in his living room​ recliner, unresponsive with snoring​ respirations, and appears to have ineffective ventilations. What is your priority intervention at this​ time? A. Find out when he last received dialysis B. Inquire when the symptoms started C. Manually open the airway D. Provide mechanical ventilations

C. Manually open the airway

18.12.19 A male patient is confused and combative for no apparent reason. There are no life threats to his​ airway, breathing, or​ circulation, and his vital signs are​ pulse, 88;​ respirations, 16​ breaths/min and​ adequate; blood​ pressure, 144/68​ mmHg; and​ SpO2, 93% on room air. When addressing the​ patient's oxygenation​ status, which of these treatments would be​ appropriate? A. Oxygen at 6 lpm via nasal cannula B. Positive pressure ventilation with room air C. Oxygen at 2 lpm via nasal cannula D. Oxygen at 15 lpm via a nonrebreather mask

C. Oxygen at 2 lpm via nasal cannula

18.03.7 A​ middle-aged male patient collapsed while shopping and now responds to verbal stimuli with confused speech. The primary assessment indicates no immediate​ life-threatening conditions. His pulse is​ 96, respirations 16​ breaths/min, blood pressure​ 158/88 mmHg, SpO2​ 98% on room​ air, and blood glucose level 79​ mg/dL. The patient is carrying a vial of nitroglycerin in his jacket pocket. What should you do next after determining the patient priority​ status? A. Administer sublingual nitroglycerin B. Administer oral glucose C. Perform a secondary assessment D. Provide oxygen via nasal cannula at 2 lpm

C. Perform a secondary assessment

18.12.5 For the patient with stroke to be eligible for a fibrinolytic​ agent, the therapy must be given​ within: A. 4 hours after the diagnosis of stroke is officially made B. 4 hours of the first signs​ and/or symptoms started C. 3 hours of EMS arrival at the scene D. 3 hours of the onset of stroke symptoms

D. 3 hours of the onset of stroke symptoms

18.12.4 Which of these patients would be most eligible to receive a fibrinolytic medication for stroke if no other contraindications are​ found? A. A​ 37-year-old female diagnosed in the emergency department with a hemorrhagic stroke 2 hours after its onset B. An​ 81-year-old male who awoke with stroke symptoms after an​ 8-hour sleep C. A​ 62-year-old female whose stroke symptoms started at 8 a.m. and disappeared half an hour later D. A​ 48-year-old male whose symptoms started while watching the 6 p.m.​ news, at which time he dialed 911

D. A​ 48-year-old male whose symptoms started while watching the 6 p.m.​ news, at which time he dialed 911

18.12.14 When assessing a patient with​ stroke-like signs and​ symptoms, it is critical that the EMT also suspect and rule out which​ condition? A. Narcotic overdose B. Syncope C. Shock D. Hypoglycemia

D. Hypoglycemia

18.03.5 When performing a secondary assessment on an elderly male patient who is confused and​ combative, which of these assessment findings should be of most concern to the​ EMT? A. Pulse oximeter reading of​ 94% on room air B. Respirations of 20​ breaths/min C. Bruising to the back of the hand D. Pulse of 164

D. Pulse of 164

18.07.1 When assessing a patient with a possible​ stroke, what is the​ priority? A. Determining the type of stroke B. Identifying risk factors for stroke C. Determining a family history of stroke D. Recognizing the signs of a stroke

D. Recognizing the signs of a stroke

18.12.20 On​ scene, a confused​ 68-year-old female patient with possible stroke has a SpO2 of​ 91% on room air. Regarding oxygen therapy and the adjunct by which to provide​ it, which of these represents the most desirable target SpO2 reading for the amount of oxygen​ delivered? A. SpO2​ 100% with 15 lpm O2 via nonrebreather mask B. SpO2​ 98% with 12 lpm O2 via nonrebreather mask C. SpO2​ 100% with 6 lpm O2 via nasal cannula D. SpO2​ 95% with 2 lpm O2 via nasal cannula

D. SpO2​ 95% with 2 lpm O2 via nasal cannula

18.13.1 A​ 41-year-old female patient has called 911 for a headache. Which of these assessment findings should make the EMT suspicious that the patient has a migraine​ headache? A. Her blood pressure is​ 192/124 mmHg B. Bright light increases the​ patient's discomfort C. She rates the pain as an​ 8/10 D. The pain was preceded by an aura

D. The pain was preceded by an aura

18.11.12 When the EMT evaluates a patient with the RACE stroke​ scale, the score is 3 points. This score would​ infer: A. The patient has not likely experienced a stroke B. The stroke scale was incorrectly​ performed, as the minimum score is at least 5 points C. A stroke has likely not occurred if the corresponding GCS score is 12 points or higher D. The patient has likely experienced a stroke

D. The patient has likely experienced a stroke

18.10.1 You are called for a​ 69-year-old male patient with altered mental status. Assessment reveals that he is confused and has​ left-sided weakness. During​ transport, you note that the patient is now completely oriented and the weakness has resolved. Which condition would you suspect this patient​ has? A. Low blood sugar B. Stroke C. Syncope D. Transient ischemic attack

D. Transient ischemic attack

18.14.1 Which of these statements made by the EMT indicates a correct understanding of caring for someone with a​ headache? A. ​"Unless the patient has some sort of past medical​ history, a headache is not a true​ emergency." B. ​"In general, a headache is considered serious only if the pain is felt throughout the entire​ head." C. ​"If a patient calls 911 for a​ headache, it is most likely a​ life-threatening condition." D. ​"Assessment is essential in determining if a​ patient's headache represents a​ life-threatening condition."

D. ​"Assessment is essential in determining if a​ patient's headache represents a​ life-threatening condition."

18.11.5 Which of these questions would the EMT ask when performing the Los Angeles Prehospital Stroke​ Screen? A. ​"Do you take blood​ thinners?" B. ​"Are your hand grips​ weak?" C. ​"Do you smoke​ cigarettes?" D. ​"Have you ever had a​ seizure?"

D. ​"Have you ever had a​ seizure?"

18.07.2 While you are teaching a public awareness class about​ stroke, a participant asks you if all patients with stroke are paralyzed on one side of their bodies. Your reply would​ be: A. ​"Yes. Both the arm and the leg must be paralyzed for the health professional to recognize a​ stroke." B. ​"Yes. To be diagnosed with a​ stroke, the arm​ and/or the leg must be very weak and​ paralyzed." C. ​"No. Some patients suffering stroke will show no signs or​ symptoms, but all still must be​ evaluated." D. ​"No. Some stroke patients may have only slight weakness to one side of their​ bodies."

D. ​"No. Some stroke patients may have only slight weakness to one side of their​ bodies."

18.12.17 A​ 56-year-old patient is in bed and unable to speak. Family members state that he had a stroke in the past and has been bedridden since​ then, but has always been able to​ talk, until a few hours ago when his speech became garbled. They also state that the last stroke left him paralyzed on his left side. Your assessment reveals that the patient is unable to​ speak, but has an open​ airway, adequate​ respirations, and a strong radial pulse.​ Additionally, you note that he is unable to move his right arm. Vital signs are within normal limits. What would be an appropriate step in the care on this​ patient? A. Rapid transport to a stroke center B. Administer positive pressure ventilation C. Insert an oropharyngeal airway D. Suction the mouth and then place an NPA

A. Rapid transport to a stroke center

18.07.4 A patient with stroke cannot move his left arm or leg. Based on this​ presentation, the EMT should strongly suspect that the stroke has occurred in which part of the central nervous​ system? A. Right side of the brain B. Left side of the spinal cord C. Right and left sides of the brain D. Left side of the brain

A. Right side of the brain

18.12.8 Assessment reveals a drooling​ 48-year-old male patient to have gurgling speech and​ left-arm paralysis. The​ EMT's immediate priority treatment is​ to: A. Suction the airway B. Determine the time of onset C. Protect the left arm D. Determine risk factors for stroke

A. Suction the airway

18.03.3 You have gathered and written down all of the​ medications, including narcotic pain​ medications, that a confused​ 46-year-old male patient currently takes. The patient is placed on the stretcher for transport. At this​ time, how would you handle the​ medications? A. Transport them with the patient B. Give them to a family member C. Return them to their original places D. Turn them over to the police

A. Transport them with the patient

18.11.8 Which one of these instructions to a patient with possible stroke indicates proper assessment for an arm​ drift? A. ​"Close your eyes and hold your arms straight out for 10​ seconds." B. ​"Raise your hands above your head and close your eyes while counting backward from​ 20." C. ​"Hold out your arms and count to 10 while keeping your eyes​ open." D. ​"Grab my fingers and squeeze with both hands as hard as you can for 5​ seconds, and I mean squeeze​ hard."

A. ​"Close your eyes and hold your arms straight out for 10​ seconds."

18.08.2 The EMT demonstrates she understands hemorrhagic stroke when she​ states: A. ​"It occurs when a blood vessel ruptures and bleeds within the​ brain." B. ​"Its signs and symptoms generally resolve within 24​ hours." C. ​"It can sometimes be treated by​ clot-destroying medications." D. ​"It occurs when clots form in blood vessels within the​ brain."

A. ​"It occurs when a blood vessel ruptures and bleeds within the​ brain."

18.04.1 You are obtaining the past medical history from the family of an elderly patient with an altered mental status who suffered sudden onset of​ right-side weakness. Which of these statements made by the​ patient's family member should you recognize as increasing the​ patient's risk of​ stroke? A. ​"She has an irregular​ heartbeat." B. ​"She takes an aspirin every​ morning." C. ​"Her blood pressure runs​ low." D. ​"She has a history of​ migraines."

A. ​"She has an irregular​ heartbeat."

18.12.3 When a patient​ smiles, the left side of the face shows significantly less movement than the right side of the face. The EMT would describe this finding​ as: A. ​Left-side facial droop B. ​Left-side facial paralysis C. ​Right-side facial droop D. ​Right-side facial paralysis

A. ​Left-side facial droop

18.14.2 A patient with a headache informs you that his physician has diagnosed him with cluster headaches. He states that his current pain feels just like the last cluster headache that he suffered. The primary assessment reveals no life threats. His vital signs are​ pulse, 104;​ respirations, 16​ breaths/min; blood​ pressure, 124/68​ mmHg; and​ SpO2, 98%. You note no neurologic deficits. Based on this​ information, what is indicated in the treatment of this​ patient? A. Massage the​ patient's neck and obtain a refusal for transport if the pain is alleviated B. Immediately transport the patient to the hospital for possible stroke C. Place the patient on the cot and allow him to assume a position of comfort D. Administer supplemental oxygen at 15 liters per minute

C. Place the patient on the cot and allow him to assume a position of comfort

18.14.3 A​ 30-year-old patient with a history of migraine headaches has called 911 for a suspected migraine headache. She says the headache follows her usual pattern of​ headaches, the pain is a​ 10/10, and she is nauseated. Her vital signs are​ pulse, 108;​ respirations, 18​ breaths/min; and blood​ pressure, 154/90 mmHg. Which of these treatments is indicated in the care of this​ patient? A. Requesting orders for sublingual nitroglycerin B. 81 to 162 mg aspirin by mouth C. Providing a darkened environment during transport D. Emergent transport with lights and sirens

C. Providing a darkened environment during transport

18.07.5 A patient has an altered mental status accompanied by loss of motor function on one side of the body. The EMT must suspect which condition as the cause of this​ presentation? A. Syncope B. Seizure C. Stroke D. Hypoglycemia

C. Stroke

18.03.2 When attempting to distinguish a spinal injury from a​ stroke, the EMT should remember​ that: A. Stroke does not cause​ paralysis, while spinal injuries typically do B. Spinal injuries often result in weakness to one side of the body C. Stroke typically results in weakness or paralysis to one side of the body D. Stroke usually causes weakness to all​ extremities; spinal injuries do not

C. Stroke typically results in weakness or paralysis to one side of the body

18.02.2 A male patient has altered mental status secondary to a brain tumor. The EMT would classify the brain tumor as which type of​ cause? A. Central B. Internal C. Structural D. Metabolic

C. Structural

18.02.1 Assessment of a​ 56-year-old male patient reveals him to be responsive to verbal stimuli with garbled speech. Which of these statements made by the​ patient's wife suggests that the​ patient's problem may be​ toxic-metabolic? A. ​"He was diagnosed last year with​ Alzheimer's disease." B. ​"He had a stroke two years​ ago." C. ​"He has bad​ kidneys." D. ​"He fell and hit his head​ yesterday."

C. ​"He has bad​ kidneys."

18.12.1 Which question would it be critical that the EMT ask the family of a patient who cannot speak and is suspected of having a​ stroke? A. ​"Does your mother have any pain in her arms or​ legs?" B. ​"Which medications is your mother​ taking?" C. ​"What time did the weakness and dizziness​ start?" D. ​"Does your mother have a history of heart​ problems?"

C. ​"What time did the weakness and dizziness​ start?"

18.06.1 Rapid recognition of stroke signs and symptoms by the public is part of which assessment​ system? A. S.T.R.O.K.E. assessment B. ​AEIOU-TIPPSS C. ​AHA's Stroke Chain of Survival D. RACE exam

C. ​AHA's Stroke Chain of Survival

18.10.2 Which one of these describes the typical signs and symptoms of a transient ischemic attack​ (TIA)? A. ​Persistent, with most TIAs lasting more than 1 hour but less than 24 hours B. Severe and debilitating C. ​Temporary, with many TIAs lasting less than 15 minutes D. ​Mild, but permanent

C. ​Temporary, with many TIAs lasting less than 15 minutes

18.12.21 Which of these statements indicates that the EMT understands the appropriate use of supplemental oxygen when caring for a patient with​ stroke? A. ​"Since stroke decreases oxygen delivery to the​ brain, high-concentration oxygen should always be geared toward achieving an SpO2 as near to​ 100% as​ possible." B. ​"If positive pressure ventilation is​ required, it should be given with room air and not supplemental​ oxygen." C. ​"In the short time that we provide care to a patient with​ stroke, the benefits of​ high-concentration oxygen outweigh the​ risks." D. ​"Oxygen should be administered at a minimal​ amount, just enough to get the SpO2 at or greater than​ 94%."

D. ​"Oxygen should be administered at a minimal​ amount, just enough to get the SpO2 at or greater than​ 94%."

18.13.2 Which of these statements made by a patient suggests that he is suffering from a tension​ headache? A. ​"The light really seems to bother my eyes when I get these​ headaches." B. ​"I get so nauseated with the​ pain." C. ​"The pain starts at the top of my head and spreads down my​ back." D. ​"The pain seems to get worse as the day goes​ on."

D. ​"The pain seems to get worse as the day goes​ on."

18.12.15 An​ 82-year-old male patient presents with​ right-hand weakness and garbled speech. Which question should the EMT ask first to the patient or a reliable family member who is​ present? A. ​"Does he take any blood​ thinners?" B. ​"Is he allergic to​ anything?" C. ​"Does he have a history of high blood​ pressure?" D. ​"What time did these signs​ start?"

D. ​"What time did these signs​ start?"

18.12.7 You have been called for a​ 63-year-old woman with slurred speech and​ right-arm weakness. On​ arrival, the patient informs you that the slurred speech and weakness have resolved. Since your assessment reveals no​ deficits, the patient insists on signing a refusal of treatment form. Which of these statements should you make prior to having her sign the​ form? A. ​"If this happens​ again, wait 10 minutes to see if you are okay. If the symptoms​ persist, call​ 911." B. ​"It would be best to start taking one baby aspirin every​ day; this will decrease the chance of this happening​ again." C. ​"Sometimes seizures present this​ way; call your doctor in the morning to schedule an​ appointment." D. ​"You really need to be evaluated in the hospital. You are at significant risk for a future​ stroke, which may be debilitating or even​ fatal."

D. ​"You really need to be evaluated in the hospital. You are at significant risk for a future​ stroke, which may be debilitating or even​ fatal."