Chapter 17 Quiz - Neurological Emergencies

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

A. not thinking clearly or is incapable of being aroused.

The left cerebral hemisphere controls: Select one: A. the right side of the body. B. heart rate and pupil reaction. C. the right side of the face. D. breathing and blood pressure.

A. the right side of the body.

You are performing a Glasgow Coma Scale on a patient who opens her eyes in response to pain, is confused in her responses to questions, and has abnormal flexion. What is this patient's GCS score and corresponding state of dysfunction? A. 9 - moderate dysfunction B. 3 - severe dysfunction C. 12 - mild dysfunction D. 6 - severe dysfunction

A. 9 - moderate dysfunction

What is the difference between a stroke and a transient ischemic attack? A. A TIA resolves completely within 24 hours of onset. B. A TIA affects a limited portion of the brain. C. A TIA involves surges of electrical activity in the brain. D. A TIA has longer-lasting effects than a stoke.

A. A TIA resolves completely within 24 hours of onset.

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? Select one: A. He is currently not prescribed any medications B. His wife states that this was his "usual" seizure C. He has experienced seizures since he was 20 D. His Glasgow Coma Scale (GCS) score is 15

A. He is currently not prescribed any medications

Which of the following is a metabolic cause for a seizure? A. Hypoglycemia B. Head trauma C. Brain tumor D. High fever

A. Hypoglycemia

Which of the following mimics a stroke and also causes a seizure? A. Hypoglycemia B. Postictal state C. Meningitis D. Migraine headache

A. Hypoglycemia

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

A. Hypovolemia

What happens when blood flow to a particular part of the brain is cut off by a blockage, resulting in tissue damage? A. Ischemic stroke B. Status epilepticus C. Hemorrhagic stroke D. Seizure

A. Ischemic stroke

What is the name of the condition when the patient forgets about the injured side after a stroke? A. Neglect B. Ataxia C. Hemiparesis D. Aphasia

A. Neglect

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

A. The pain is worse when bending over

When assessing for arm drift of a patient with a suspected stroke, you should: Select one: 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. observe movement of the arms for approximately 2 minutes. D. expect to see one arm slowly drift down to the patient's side.

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

A patient whose speech is slurred and difficult to understand is experiencing: Select one: A. dysarthria. B. aphasia. C. paraplegia. D. dysphagia.

A. dysarthria.

When you are obtaining medical history from the family of a suspected stroke patient, it is MOST important to determine: Select one: A. when the patient last appeared normal. B. if there is a family history of a stroke. C. the patient's overall medication compliance. D. if the patient has been hospitalized before.

A. when the patient last appeared normal.

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

B. A seizure that begins in one extremity

You are examining a patient whose signs include lip smacking, jerking of the left arm, and agitation. Based on these signs, what type of seizure is this patient experiencing? A. Status epilepticus B. Complex partial C. Generalized D. Simple partial

B. Complex partial

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

B. has bleeding within the brain.

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

C. Confusion and fatigue

You are dispatched to a home where you find a 70-year-old man. He is exhibiting facial drooping and, when you ask him to tell you what day it is, he says "January." Which part of the brain is most likely to have been affected? A. Right hemisphere B. Cerebellum C. Left hemisphere D. Brain stem

C. Left hemisphere

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

C. cerebral vasodilation.

The three major parts of the brain are the: Select one: A. cerebellum, medulla, and occiput. B. midbrain, cerebellum, and spinal cord. C. cerebrum, cerebellum, and brain stem. D. brain stem, midbrain, and spinal cord.

C. cerebrum, cerebellum, and brain stem.

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 breaths/min with adequate depth, and his oxygen saturation is 98%. Treatment for this patient should include: Select one: A. oral glucose gel and transport. B. high-flow oxygen and transport. C. recovery position and transport. D. ventilatory assistance and transport.

C. recovery position and transport.

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: Select one: A. cover the child with wet towels and give oxygen via nasal cannula. B. call medical control and request permission to give the child aspirin. C. transport the child to the hospital and reassure the mother en route. D. advise the mother to take her child to the doctor the following day.

C. transport the child to the hospital and reassure the mother en route.

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: Select one: A. 7. B. 9. C. 6. D. 8.

D. 8.

What criteria must be met for a patient to have status epilepticus? A. Multiple seizures with normal consciousness between each event B. The presence of incontinence during the seizure C. A seizure that was preceded by an aura D. A seizure lasting more than 30 minutes

D. A seizure lasting more than 30 minutes

You are treating a patient who is exhibiting slurred speech, facial droop, and an inability to move his left arm. Which neurologic examination emphasizes these possible stroke signs? A. Glasgow Coma Scale B. 3-Item Stroke Severity Scale C. Chicago Prehospital Stroke Scale D. Cincinnati Prehospital Stroke Scale

D. Cincinnati Prehospital Stroke Scale

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

D. Respiratory failure or cardiopulmonary arrest

When caring for a patient with documented hypoglycemia, you should be MOST alert for: Select one: A. a febrile convulsion. B. respiratory distress. C. an acute stroke. D. a seizure.

D. a seizure.

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

D. ensure a patent airway and support ventilation as needed.

The MOST significant risk factor for a hemorrhagic stroke is: Select one: A. heavy exertion. B. severe stress. C. diabetes mellitus. D. hypertension.

D. hypertension.