EMT - Chapter 17: Neurologic Emergencies - Questions (MFD)

The MOST significant risk factor for a hemorrhagic stroke is: a) severe stress. b) heavy exertion. c) diabetes mellitus. d) hypertension.

D

A patient who is possibly experiencing a stroke is NOT eligible for thrombolytic (fibrinolytic) therapy if he or she: a) has bleeding within the brain. b) is older than 60 years of age. c) has had a prior heart attack. d) has a GCS score that is less than 8.

A

A patient with an altered mental status is: a) not thinking clearly or is incapable of being aroused. b) completely unresponsive to all forms of stimuli. c) typically alert but is confused as to preceding events. d) usually able to be aroused with a painful stimulus.

A

A transient ischemic attack (TIA) occurs when: a) the normal body processes destroy a clot in a cerebral artery. b) signs and symptoms resolve spontaneously within 48 hours. c) medications are given to dissolve a cerebral blood clot. d) a small cerebral artery ruptures and causes minimal damage.

A

Febrile seizures: a) are usually benign but should be evaluated. b) are also referred to as petit mal seizures. c) occur when a child's fever progressively rises. d) often result in permanent brain damage.

A

Successful treatment of a stroke depends on whether: a) thrombolytic therapy is given within 3 hours after symptoms began. b) the stroke occurs within the left or right hemisphere of the brain. c) surgical intervention is performed to remove obstructive clots. d) medications are given to restore the function of infarcted cells.

A

The most basic functions of the body, such as breathing, blood pressure, and swallowing, are controlled by the: a) brain stem. b) cerebrum. c) cerebral cortex. d) cerebellum.

A

The three major parts of the brain are the: a) cerebrum, cerebellum, and brain stem. b) brain stem, midbrain, and spinal cord. c) cerebellum, medulla, and occiput. d) midbrain, cerebellum, and spinal cord.

A

Which of the following conditions would be the LEAST likely to mimic the signs and symptoms of a stroke? a) hypovolemia b) a postictal state c) intracranial bleeding d) hypoglycemia

A

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

B

A patient who is experiencing aphasia is: a) not able to swallow without choking. b) unable to produce or understand speech. c) usually conscious but has slurred speech. d) experiencing a right hemispheric stroke.

B

An absence seizure is also referred to as a: a) grand mal seizure. b) petit mal seizure. c) total body seizure. d) generalized motor seizure.

B

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

B

Individuals with chronic alcoholism are predisposed to intracranial bleeding and hypoglycemia secondary to abnormalities in the: a) kidneys. b) liver. c) brain. d) pancreas.

B

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? a) 6 b) 8 c) 9 d) 10

B

When transporting a stable stroke patient with unilateral paralysis, it is best to place the patient in a: a) recumbent position with the paralyzed side up. b) recumbent position with the paralyzed side down. c) sitting position with the head at a 45° to 90° angle. d) supine position with the legs elevated 6″ to 12″.

B

Which of the following is NOT an assessment parameter included in the Cincinnati Prehospital Stroke Scale? a) speech b) memory c) arm drift d) facial droop

B

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) acute hypoglycemia. b) a ruptured cerebral artery. c) a complex partial seizure. d) an occluded cerebral artery.

B

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

C

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

C

Muscle control and body coordination are controlled by the: a) cerebral cortex. b) cerebrum. c) cerebellum. d) brain stem.

C

Status epilepticus is characterized by: a) profound tachycardia and total muscle flaccidity. b) an absence seizure that is not preceded by an aura. c) prolonged seizures without a return of consciousness. d) generalized seizures that last less than 5 minutes.

C

The left cerebral hemisphere controls: a) breathing and blood pressure. b) the right side of the body. c) the right side of the face. d) heart rate and pupil reaction.

C

The mental status of a patient who has experienced a typical seizure: a) typically does not improve, even after several minutes. b) is easily differentiated from that of acute hypoglycemia. c) is likely to improve over a period of 5 to 30 minutes. d) progressively worsens over a period of a few hours.

C

The spinal cord exits the cranium through the: a) foramen lamina. b) vertebral foramen. c) foramen magnum. d) cauda equina.

C

When obtaining medical history information from the family of a suspected stroke patient, it is MOST important to determine: a) if the patient has been hospitalized before. b) if there is a family history of a stroke. c) when the patient last appeared normal. d) the patient's overall medication compliance.

C

Which of the following MOST accurately describes what the patient will experience during the postictal state that follows a seizure? a) hyperventilation and hypersalivation b) a gradually decreasing level of consciousness c) confusion and fatigue d) a rapidly improving level of consciousness

C

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) 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. d) place her in the recovery position and transport her with lights and siren.

C

You arrive at the residence of a 33-year-old woman who is experiencing a generalized 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 in between her teeth, apply high-flow oxygen via a nonrebreathing mask, and consider inserting a nasopharyngeal airway. b) wait for the seizure to stop, manually open her airway, insert an oropharyngeal airway, and assess her oxygen saturation with the pulse oximeter. c) maintain her airway with manual head positioning, suction her airway to remove the vomitus, insert a nasopharyngeal airway, and administer high-flow oxygen. d) restrain her extremities to prevent her from injuring herself, suction her airway to remove the vomitus, and assist her ventilations with a bag-mask device.

C

A patient whose speech is slurred and difficult to understand is experiencing: a) aphasia. b) dysphagia. c) paraplegia. d) dysarthria.

D

Interruption of cerebral blood flow may result from all of the following, EXCEPT: a) an embolism. b) an acute arterial rupture. c) a thrombus. d) cerebral vasodilation.

D

The principal clinical difference between a stroke and hypoglycemia is that patients with hypoglycemia: a) are typically alert and attempt to communicate with health care providers. b) always take oral medications to maintain normal blood glucose levels. c) do not present with slurred speech or weakness to one side of the body. d) usually have an altered mental status or decreased level of consciousness.

D

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

D

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: a) instruct the patient to keep her eyes open and then repeat the arm drift test. b) repeat the arm drift test and ensure that her palms are facing downward. c) defer this part of the test and assess her for facial droop and slurred speech. d) repeat the arm drift test, but move the patient's arms into position yourself.

D

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, and is breathing at a normal rate with adequate depth. You should: a) use a bag-mask device to assist her ventilations. b) insert an oral airway, apply oxygen, and transport. c) place her on her side and prepare for rapid transport. d) suction her oropharynx and apply 100% oxygen.

D

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: a) assess the patient for a facial droop and hemiparesis. b) perform CPR for 5 minutes before applying the AED. c) obtain a blood glucose sample to rule out hypoglycemia. d) initiate cardiopulmonary resuscitation (CPR) and attach an automated external defibrillator (AED) as soon as possible.

D

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

D