Chapter 19 TEST

A patient who demonstrates any one of the three symptoms from the Cincinnati Prehospital Stroke Scale has​ a(n) ________% chance of having an acute stroke. A. 70 B. 60 C. 50 D. 80

A. 70

Your patient is a​ 19-year-old female who is 7 months pregnant. She just experienced a seizure. She has no previous history of seizures or any other medical condition. Which of the following is the MOST likely cause of the​ seizure? A. Eclampsia B. Congenital brain defects C. Hypoglycemia D. Trauma

A. Eclampsia

A patient with a history of seizures experiences a seizure for no apparent reason. What is the likely​ cause? A. Failure to take prescribed medication B. Fever C. Withdrawal from alcohol D. Head trauma

A. Failure to take prescribed medication

What statement BEST distinguishes type 1 from type 2​ diabetes? A. In type 1​ diabetes, the pancreas does not secrete insulin​ normally, but in type 2​ diabetes, the​ body's cells fail to use insulin properly. B. Type 1 is typically far less severe than type 2. C. In type 1​ diabetes, too much insulin is the​ problem, and in type 2​ diabetes, too little insulin is the problem. D. Type 1 diabetes is known as​ non-insulin-dependent diabetes, and type 2 diabetes is known as​ insulin-dependent diabetes.

A. In type 1​ diabetes, the pancreas does not secrete insulin​ normally, but in type 2​ diabetes, the​ body's cells fail to use insulin properly.

For the reticular activating system​ (RAS) to work​ correctly, what three substances are​ needed? A. Oxygen to perfuse brain​ tissue, glucose to nourish brain​ tissue, and water to keep the brain hydrated B. Oxygen to perfuse brain​ tissue, glucose to nourish brain​ tissue, and sodium to keep the brain hydrated C. Oxygen to perfuse brain​ tissue, insulin to nourish brain​ tissue, and water to keep the brain hydrated D. Oxygen to perfuse brain​ tissue, insulin to nourish brain​ tissue, and sodium to keep the brain hydrated

A. Oxygen to perfuse brain​ tissue, glucose to nourish brain​ tissue, and water to keep the brain hydrated

Your patient is an unresponsive​ 30-year-old male wearing a​ Medic-Alert bracelet indicating that he is a diabetic. The​ patient's coworkers came by his house to check on him when he did not show up for work and did not call in sick. Your assessment does not clearly indicate to you whether the patient may be hypoglycemic or hyperglycemic. Which of the following should you do​ next? A. Protect the​ patient's airway, administer​ oxygen, and consider assessing the​ patient's blood glucose per local protocol. B. Use your glucometer to check his blood sugar before taking any further action. C. Use the​ patient's glucometer to check his blood sugar level. D. Administer oral​ glucose, as it will not cause additional harm in​ hyperglycemia, but may prevent brain damage if the patient is hypoglycemic.

A. Protect the​ patient's airway, administer​ oxygen, and consider assessing the​ patient's blood glucose per local protocol.

Most of the diabetic emergencies that you will be called to deal with will be related to hypoglycemia.​ However, occasionally you will experience an instance of hyperglycemia. In the list​ below, which item is NOT likely to be a sign or symptom of​ hyperglycemia? A. Reduced rate of breathing B. Excessive urination C. Chronic thirst D. Nausea

A. Reduced rate of breathing

Which of the items below is NOT part of the Cincinnati Prehospital Stroke​ Scale? A. Test for equal grip strength. B. Ask the patient to smile. C. Test the patient for arm droop or lack of movement. D. Have the patient repeat a simple sentence.

A. Test for equal grip strength.

Which of the following BEST describes status​ epilepticus? A. Two or more seizures with​ tonic-clonic activity without an intervening period of consciousness B. A seizure involving convulsions on only one side of the body C. A period of drowsiness following​ tonic-clonic seizures D. A seizure that occurs without a known cause

A. Two or more seizures with​ tonic-clonic activity without an intervening period of consciousness

Which of the following may result in hypoglycemia in the diabetic​ patient? A. Vomiting after eating a meal B. Lack of exercise C. Failure to take insulin or oral diabetes medications D. Overeating

A. Vomiting after eating a meal

The condition in which there is an insufficient amount of sugar in the blood is​ called: A. hypoglycemia. B. hyperglycemia. C. diabetic ketoacidosis. D. diabetic coma.

A. hypoglycemia.

A dose of oral glucose gel in a​ toothpaste-type tube​ is: A. one tube. B. a quarter of a tube. C. half a tube. D. dependent on the​ patient's glucose level.

A. one tube.

The medical term for fainting​ is: A. syncope. B. dehydration. C. altered RAS status. D. vertigo.

A. syncope.

The​ insulin-glucose relationship has been described as a​ "lock and​ key" mechanism​ because: A. without the insulin​ "key," glucose cannot enter the locked cells. B. insulin is the​ "key" to unlocking cells storing glucose. C. without the glucose​ "key," insulin cannot enter the locked cells. D. glucose is the​ "key" to unlocking cells storing insulin.

A. without the insulin​ "key," glucose cannot enter the locked cells.

Which of the following blood glucose levels is considered normal for an​ adult? A. 180​ mg/dL B. 80​ mg/dL C. 40​ mg/dL D. 150​ mg/dL

B. 80​ mg/dL

What is​ epilepsy? A. A condition in which a person has an aura followed by a seizure and that is usually controlled by medication. B. A condition in which a person has multiple seizures and that is usually controlled by medication. C. A condition in which a person has general seizures that start in childhood. D. A condition caused by congenital brain abnormalities that causes seizures only once or twice a year.

B. A condition in which a person has multiple seizures and that is usually controlled by medication.

Which of the following refers to difficulty in speaking or understanding speech as a result of a​ stroke? A. Ischemia B. Aphasia C. Hemiparesis D. Ataxia

B. Aphasia

When assessing a patient for a possible​ stroke, which of the following three functions should be tested by the​ EMT? A. ​Memory, ability to​ speak, and ability to track movement with the eyes B. Control of facial​ muscles, ability to​ speak, and ability to hold both arms in an extended position for 10 seconds C. Ability to​ walk, ability to hold both arms in an extended position for 10​ seconds, and ability to name common objects D. Ability to​ walk, control of facial​ muscles, and balance

B. Control of facial​ muscles, ability to​ speak, and ability to hold both arms in an extended position for 10 seconds

During your primary​ assessment, you find your patient has an altered mental status. This could indicate which of the​ following? A. The need for suctioning of the airway B. Failing respiratory system C. Problems with the RAS due to hypertension D. The need for rapid transport

B. Failing respiratory system

Compared to​ hypoglycemia, which of the following is true of​ hyperglycemia? A. Its onset is more sudden. B. Its onset is more gradual. C. It is more easily treated in the prehospital environment than hypoglycemia. D. Its onset is preceded by an​ aura, such as hallucinations or detecting unusual odors.

B. Its onset is more gradual.

The typical steps of managing a diabetic emergency​ are: A. Assist the patient in accepting​ glucose, prepare to administer oral​ glucose, primary​ assessment, secondary​ assessment, and reassessment. B. Primary​ assessment, secondary​ assessment, prepare to administer oral​ glucose, assist the patient in accepting​ glucose, and reassessment. C. Prepare to administer oral​ glucose, assist the patient in accepting​ glucose, primary​ assessment, secondary​ assessment, and reassessment. D. Primary​ assessment, prepare to administer oral​ glucose, assist the patient in accepting​ glucose, secondary​ assessment, and reassessment.

B. Primary​ assessment, secondary​ assessment, prepare to administer oral​ glucose, assist the patient in accepting​ glucose, and reassessment.

The death of brain tissue due to deprivation of oxygen because of a blocked or ruptured artery in the brain is known as which of the​ following? A. Aphasia B. Stroke C. Transient ischemic attack D. Seizure

B. Stroke

You have arrived on the scene of a call for a possible stroke. On your​ arrival, the patient denies signs and​ symptoms, is alert and​ oriented, and moves all extremities well. Her husband states that before you​ arrived, the patient could not move her right arm and the left side of her face seemed to be​ "slack." Which of the following has most likely​ occurred? A. The patient has had a subarachnoid hemorrhage. B. The patient suffered a transient ischemic attack. C. The patient suffered a stroke. D. The patient is suffering from aphasia.

B. The patient suffered a transient ischemic attack.

Which of the following is one of the most common characteristics of a​ stroke? A. ​Sudden, severe headache B. Weakness on one side of the body C. Sudden onset of bizarre behavior D. Projectile vomiting

B. Weakness on one side of the body

Your patient is waking up from a​ seizure; it was the​ patient's first seizure ever. When you ask what​ happened, the patient tells you she had the smell of fresh mown grass just before she seized. This sensation is known​ as: A. the clonic phase. B. an aura. C. the postictal phase. D. the tonic phase.

B. an aura.

There are two types of​ seizures; if your patient is having a seizure that affects only one area of her body and does not cause her to lose​ consciousness, it is called​ a: A. generalized seizure. B. partial seizure. C. postictal seizure. D. ​tonic-clonic seizure.

B. partial seizure.

You respond to a​ 32-year-old female who is having a seizure. You arrive on the scene to find the patient​ drowsy, confused, and complaining of a headache. This patient is demonstrating​ the: A. aura phase. B. postictal phase. C. tonic phase. D. clonic phase.

B. postictal phase.

Which is NOT one of the steps in managing a patient experiencing dizziness and​ syncope? A. Loosen any tight clothing around the neck. B. Lay the patient flat. C. Apply cold packs to the​ patient's head. D. Administer oxygen.

C. Apply cold packs to the​ patient's head.

Which of the following is the cause of most​ strokes? A. A spasm in an artery supplying part of the brain B. A ruptured cerebral artery due to hypertension C. Blockage of an artery supplying part of the brain D. A ruptured cerebral artery due to an aneurysm

C. Blockage of an artery supplying part of the brain

Which of the following is NOT a sign or symptom of​ stroke? A. Seizure B. Vomiting C. Chest pain D. Sudden impairment of vision

C. Chest pain

Which of the following is LEAST important for the patient who has stopped seizing before the​ EMT's arrival at the​ scene? A. Suctioning B. Checking for mechanism of injury C. Determining when the patient was last transported to the hospital for seizures D. Administering oxygen

C. Determining when the patient was last transported to the hospital for seizures

Which of the following is the LEAST important question in obtaining the history of a seizure patient in the prehospital​ setting? A. What was the patient doing before the​ seizure? B. How did the patient behave during the​ seizure? C. Does the patient have a family history of​ seizures? D. Did the patient lose control of his​ bladder?

C. Does the patient have a family history of​ seizures?

Your patient is a​ 59-year-old female with a sudden onset of slurred speech and weakness on her right side. Which of the following measures is​ appropriate? A. Test the​ patient's sensation with a series of​ pinpricks, beginning at the feet and working upward. B. Administer oral glucose and then assess the​ patient's blood sugar. C. Immediately transport the patient to a hospital with specialized treatment for stroke patients. D. Withhold oxygen unless the patient exhibits signs of profound hypoxia.

C. Immediately transport the patient to a hospital with specialized treatment for stroke patients.

Which statement below is NOT true about​ seizures? A. The most common seizure that EMTs are likely to be called on is a​ tonic-clonic seizure. B. A partial seizure affects one​ part, or one​ side, of the brain. C. Many seizures are followed by an aura. D. A generalized seizure affects the entire brain.

C. Many seizures are followed by an aura.

Your patient is a​ 44-year-old male with a history of diabetes. He is lying on the living room​ floor, unresponsive to all stimuli. He has a respiratory rate of 12 breaths per​ minute, heart rate of 112 beats per​ minute, and is pale and sweaty. Which of the following should you do to treat this​ patient? A. Place the patient in the recovery position to protect the airway and place oral glucose solution under the​ patient's tongue. B. Apply oral glucose solution to a tongue depressor and insert it between the​ patient's cheek and gums. C. Place the patient in the recovery​ position, administer​ oxygen, and monitor his airway status. D. Encourage the​ patient's family to administer his insulin.

C. Place the patient in the recovery​ position, administer​ oxygen, and monitor his airway status.

The most common medical emergency for the diabetic is​ hypoglycemia, or low blood sugar. Which one of the factors below is NOT a cause of​ hypoglycemia? A. Overexercises or overexerts himself B. Vomits a meal C. Reduces sugar intake by eating too much D. Takes too much insulin

C. Reduces sugar intake by eating too much

Which of the following is NOT a sign of a hypoglycemic diabetic​ emergency? A. Combativeness B. Anxiety C. Slow heart rate D. ​Cold, clammy skin

C. Slow heart rate

Normal consciousness is regulated by a series of neurologic circuits in the brain that comprise the reticular activating system​ (RAS). The RAS has simple requirements to function properly. Which one of the following items is NOT one of those​ requirements? A. Oxygen B. Water C. Sodium D. Glucose

C. Sodium

Looking at the following​ list, which of the items does NOT correctly compare the signs and symptoms of hypoglycemia and​ hyperglycemia? A. Hyperglycemic patients often have​ warm, red, dry​ skin, whereas hypoglycemic patients have​ cold, pale,​ moist, or clammy skin. B. Hyperglycemia usually has a slower onset than hypoglycemia. C. The hypoglycemic patient is usually complaining of a​ headache, whereas the hyperglycemic patient is not. D. The hyperglycemic patient often has acetone​ breath, whereas the hypoglycemic patient does not.

C. The hypoglycemic patient is usually complaining of a​ headache, whereas the hyperglycemic patient is not.

When someone is experiencing​ hypoglycemia, the body attempts to compensate by using the​ fight-or-flight mechanism of the autonomic nervous system. Which one of the statements below is NOT one of the​ fight-or-flight responses? A. The heart pumps faster. B. Blood vessels constrict. C. The skin is hot and dry. D. Breathing accelerates.

C. The skin is hot and dry.

Patients displaying altered mental status were lost for several hours in a desert area without food and water and temperatures in the high 90s. You would expect their altered mental status to be​ from: A. hypoglycemia. B. hyperglycemia. C. dehydration. D. hypoxia.

C. dehydration.

Many stroke patients are candidates for thrombolytic drugs. One of the most important things that an EMT can do to optimize the care of a stroke patient who is a candidate for the drugs​ is: A. do a thorough physical exam of the patient. B. transport the patient to a Level I Trauma Center. C. determine the exact time of onset of symptoms. D. transport to the closest hospital.

C. determine the exact time of onset of symptoms.

The Cincinnati Prehospital Stroke Scale assesses​ for: A. agitated emotional​ response, facial​ droop, and abnormal speech. B. arm​ drift, leg​ lift, and facial droop. C. facial​ droop, arm​ drift, and abnormal speech. D. abnormal​ speech, lack of pattern​ recognition, and lack of facial recognition.

C. facial​ droop, arm​ drift, and abnormal speech.

A seizure that occurs spontaneously from an unknown cause is​ called: A. hypoglycemic. B. ​tonic-clonic. C. idiopathic. D. hypoxic.

C. idiopathic.

A hormone called insulin is secreted by​ the: A. gallbladder found in the pancreas. B. kidneys. C. islets of Langerhans in the pancreas. D. islets of Langerhans in the liver.

C. islets of Langerhans in the pancreas.

Your patient is a​ 70-year-old man whose wife called EMS because her husband began exhibiting unusual behavior. Upon your​ arrival, you introduce yourself to the​ patient, who​ responds, "Not until nine​ o'clock," but shows no actual understanding of what you just said. This phenomenon is BEST described​ as: A. expressive aphasia. B. disorientation to time. C. receptive aphasia. D. unresponsive to verbal stimuli.

C. receptive aphasia.

You are called to a scene at which multiple patients are seizing at the same time. The likely cause​ is: A. hypoglycemia. B. hypoxia. C. something environmental at the scene. D. metabolic.

C. something environmental at the scene.

Some EMS systems allow administration of intranasal glucagon to patients who are A. combative because their​ fight-or-flight response. B. intolerant of the taste of oral glucose. C. unable to safely swallow oral glucose. D. responsive and alert.

C. unable to safely swallow oral glucose.

Which of the following is the most critical piece of equipment to have immediately available for the seizure patient who has just stopped​ convulsing? A. Cervical collar B. Suctioning equipment C. Bite block D. Glucometer

C. Suctioning equipment

The signs and symptoms of a transient ischemic attack​ (TIA) may last up​ to: A. 1 hour. B. 30 minutes. C. 6 hours. D. 24 hours.

D. 24 hours.

With advances in​ clot-busting (thrombolytic)​ drugs, the patient has a window of​ ________ hours to receive treatment. A. 5 B. 4 C. 6 D. 3

D. 3

What is a sign of sepsis becoming​ systemic? A. Lowered respiratory rate B. Lowered heart rate C. High blood pressure D. Altered mental status

D. Altered mental status

Which of the following is characteristic of a patient with​ hyperglycemia? A. ​Cool, moist​ skin, agitated​ behavior, and increased heart rate B. Sudden onset of altered mental status C. Use of excessive amounts of insulin or lack of adequate food intake D. A​ "fruity" odor of the breath

D. A​ "fruity" odor of the breath

If the blood sugar level is very​ high, which of the following may​ result? A. ​Hyperactivity, excessive​ thirst, and polyuria B. Excessive​ insulin, excessive​ glucose, and excessive urination C. Polyuria and hyperactivity D. Excessive​ urination, excessive​ thirst, and excessive hunger

D. Excessive​ urination, excessive​ thirst, and excessive hunger

Your patient is a​ 21-year-old female with a history of epilepsy. She is having a convulsion upon your arrival. Which of the following should you​ do? A. Restrain the​ patient's extremities to prevent injury from flailing of the arms and legs. B. Insert a bite​ block, cloth,​ wallet, or similar item between the​ patient's teeth to prevent her from biting her tongue. C. Place a tongue depressor or spoon in the back of the mouth to prevent the patient from swallowing her tongue. D. Move furniture and other objects away from the patient to prevent injury.

D. Move furniture and other objects away from the patient to prevent injury.

A patient complains of dizziness followed by brief syncope of several seconds. Regardless of this​ patient's history, it is likely that the dizziness and syncope are related to interference with the function of the​ patient's: A. kidneys. B. peripheral nervous system. C. lungs. D. brain.

D. brain.

Treatment of someone with a seizure disorder includes all of the following​ EXCEPT: A. placing the patient on the floor or ground. B. loosening restrictive clothing. C. removing objects that might harm the patient. D. placing a bite block in the​ patient's mouth so he does not bite his tongue.

D. placing a bite block in the​ patient's mouth so he does not bite his tongue.

In​ hyperglycemia, increasing blood sugar levels starve the cells of the body​ for: A. oxygen. B. insulin. C. fats. D. sugar.

D. sugar.

One of the criteria for administering oral glucose is the patient having a history of diabetes. The point at which you would typically ask about whether the patient has a history of diabetes is​ when: A. gathering a history of the present episode. B. performing a primary assessment. C. reassessing the patient. D. taking the SAMPLE history.

D. taking the SAMPLE history.