EMT Quiz 19

While treating a seizing​ patient, it is LEAST important for the EMT to​ determine:

A.* the cause of the seizure. This is the correct answer. B. if the area is free from objects that may injure the patient. C. if the patient is breathing adequately. D. if the airway is patent.

You have been called to a public bus station for a behavioral emergency. On scene you find a disheveled male in his forties sitting up against a wall. He is confused and incontinent. Bystanders state that he suddenly began to stumble​ around, shouting​ obscenities, and then fell to the ground spitting and shaking. From this​ description, the EMT should be suspicious of what​ condition?

. Alcohol intoxication B. Syncopal episode C.* Generalized seizure This is the correct answer. D. Absence seizure

You have been called to an alcoholic rehabilitation center for a​ 56-year-old male patient whose left arm suddenly began to shake uncontrollably. He is alert and​ oriented, and he is terrified that he cannot stop his arm from moving. What type of seizure should you​ suspect?

A. Generalized B. Psychomotor C. Complex partial D.* Simple partial

Which patient would benefit the most from an ALS​ intercept?

. A​ 24-year-old female who is complaining of pain and swelling in the right wrist after a bystander attempted to restrain her during a seizure B. A​ 55-year-old postictal female with an SpO 2 2 of​ 95% on 2 lpm of oxygen C.* A​ 22-year-old postictal male who is lethargic with a blood glucose level of 46​ mg/dL This is the correct answer. D. An​ 18-year-old male with a history of seizures who is lethargic but well oriented and refuses transport Since hypoglycemia may trigger a​ seizure, assess the blood glucose level​ (BGL) by using a glucose meter if protocol permits. If the blood glucose is less than 60​ mg/dL, you may suspect that the seizure is due to a low blood glucose level. Contact medical direction and request an ALS backup if the patient remains unresponsive or if you are unable to administer oral glucose because of the​ patient's inability to maintain an airway.

You are called to a residence to assess a child. The panicked parents state that their​ 3-year-old son was playing with his brother when he suddenly​ "blanked out" and would not respond to them for several seconds. When​ asked, they deny any​ convulsing-like movement as well as a history of medical problems. Based on this​ description, you would be suspicious of what type of​ seizure?

. Grand mal B. Simple partial C. Febrile D.* Absence This is the correct answer.

Which type of seizure primarily occurs in children and is caused by a​ fever?

. Idiopathic B. Hypoglycemic C. Eclamptic D.* Febrile

A young male with a seizure history is postictal in his bed. His airway is​ patent, breathing labored and​ forced, and radial pulse strong and fast. Vital signs are pulse​ 140, respirations​ 20, blood pressure​ 158/92 mmHg, and SpO2​ 96% on room air. At this​ time, what action would be most​ appropriate?

. Insert an oropharyngeal airway. B. Provide​ high-concentration oxygen. C.* Place in a​ side-lying position. This is the correct answer. D. Start positive pressure ventilation.

You are dispatched to a local mall and are met by bystanders who state that the patient was talking to a customer representative and​ "passed out." You find an alert and oriented 55 dash -year dash -old female lying supine on the tile floor. The patient tells you that the back of her head is hurting. Which one of the following actions should you perform​ first?

. Open her airway with a jaw dash -thrust. B. Obtain a full set of vital signs. C. Assess the back of the​ patient's head for injury. D.* Take manual in dash -line spinal stabilization.

What type of seizure is most commonly found in children aged 6 months to 6​ years?

. Primary seizures B. Complex partial seizures C.* Febrile seizure This is the correct answer. D. Simple partial seizures

What may a syncopal patient do after becoming supine that a seizure patient typically does NOT​ do?

. Suffer arrhythmias B.* Become responsive This is the correct answer. C. Experience paralysis D. Stop breathing

As you approach a female​ patient, she appears unresponsive with her arms and legs jerking violently. On the prehospital care​ report, you would document that the patient was found in what phase of a generalized​ seizure?

. Tonic B.* Clonic This is the correct answer. C. Absence D. Syncopal

One common neurologic sign of a postictal patient​ is:

. a compromised airway. B. inadequate circulation. C. inadequate breathing. D.* disorientation.

The initial part of a generalized seizure experienced by some patients is called​ the:

. clonic phase. B. syncopal stage. C. postictal state. D.* aura.

After a lengthy​ response, you arrive at the home of a​ 62-year-old female who is still seizing. Your immediate action would be​ to:

. determine the total duration of the seizure. B.* assess the​ patient's airway and breathing. This is the correct answer. C. move her to the ambulance for assessment and transport. D. determine if the patient has a seizure history.

Seizure patients who are in the postictal state and are displaying signs of severe hypoxia should be treated with oxygen using​ a:

. nonrebreather mask at 8 lpm. B. nasal cannula at 10 lpm. C.* nonrebreather mask at 15 lpm. This is the correct answer. D. nasal cannula at 4 lpm.

Status epilepticus is best differentiated from a generalized seizure by​ the:

. preexisting seizure history. B. presence of an aura prior to seizing. C. length of the postictal period. D.* duration of the seizure.

A person who remains unconscious for 15 minutes after a generalized seizure is said to​ be:

. preictal. B. in status epilepticus. C.* postictal. This is the correct answer. D. in a secondary seizure. The postictal state is the recovery phase. The​ patient's mental status is altered and may range from complete unresponsiveness to confusion and disorientation. The mental status progressively improves over time. The patient is exhausted and weak. A headache and temporary weakness in one side of the body​ (hemiparesis) may be present. The postictal phase generally lasts from 10 to 30 minutes but could last much longer. A patient who suffers generalized motor seizures that last more than 5 minutes or seizures that occur consecutively without a period of responsiveness between them is considered to be in status epilepticus. This is a dire medical emergency that requires aggressive airway​ management, positive pressure ventilation with supplemental​ oxygen, and immediate transport to a medical facility. The longer the delay in​ treatment, the greater is the chance that the patient will suffer permanent brain damage. Secondary or reactive seizures do not result from a genetic cause but occur as the result of an insult to the​ body, such as​ fever, infection,​ hypoxia, hypoglycemia,​ hyperglycemia, drug​ intoxication, drug​ withdrawal, eclampsia in​ pregnancy, degenerative brain​ diseases, or imbalances in the electrolytes in the body.

A postictal patient is awake but has trouble answering your questions correctly. Given this​ presentation, the EMT would recognize​ that:

. the patient has a seizure history. B.* the airway is open. This is the correct answer. C. ​high-concentration oxygen is indicated. D. another seizure is coming.

When treating a patient who has had a​ seizure, the most important aspect of providing care is​ to:

A.* assess for and manage any​ life-threatening condition found. This is the correct answer. B. provide​ high-concentration oxygen to ensure adequate oxygenation of the brain. C. identify the type and duration of​ seizure, as well as a history of seizures. D. ensure that the patient does not bite his or her tongue.

You are by the side of an alert but confused​ 41-year-old woman who is diaphoretic and appears exhausted. She informs you that she has a history of seizures and just had a generalized seizure. Despite your​ urging, she refuses transport to the hospital. Your safest action would be​ to:

. transport her despite her refusal to consent. B.* advise medical direction of the situation. This is the correct answer. C. recognize a seizure history and have patient sign a refusal form. D. contact law enforcement so transport is legal.

Pediatric absence​ seizures:

. usually progress to​ tonic-clonic seizures by the age of 20. B. are usually precipitated by congenital tumors. C.* do not typically require emergency care. This is the correct answer. D. are normally cause for significant concern.

When obtaining a medical history from the family of a seizure​ patient, what question is most important for the EMT to ask​ first?

. ​"How long has he had his seizure​ condition?" B. ​"Was he grunting and breathing hard during the​ seizure?" C.* ​"Does he take his seizure medications as​ prescribed?" This is the correct answer. D. ​"Why do you think that his tongue is​ bleeding?"

Which patient statement reinforces your suspicion of​ syncope?

. ​"I have had a​ low-grade fever for the past three​ days." B.* ​"Once I hit the​ floor, I was only out for a few​ seconds." This is the correct answer. C. ​"I think that I may have had a​ seizure." D. ​"I was lying on the bed when I passed​ out."

Which​ statement, made by a patient who experienced a syncopal​ episode, should MOST concern the​ EMT?

. ​"The doctor told me to get out of bed​ slowly, but I​ didn't." B. ​"I seemed to get very warm just before passing​ out." C. ​"I remember feeling faint right before I passed​ out." D.* ​"My chest felt funny right before I passed​ out."

You have been called for a​ 47-year-old female who has​ "passed out." As you enter the​ patient's apartment, you find her supine on the living room floor with a cool wash cloth on her forehead. She states that she was standing and talking on the telephone when everything went dark. When she came​ to, she was on the floor. What should be your first​ action?

.* Assess and obtain vital signs while she is supine. This is the correct answer. B. Move her to the ambulance for immediate transport. C. Immediately sit her upright. D. Insert a nasopharyngeal airway.

When performing the secondary assessment on a confused​ patient, which one of the following signs would be most suggestive of a​ seizure?

.* Bleeding tongue This is the correct answer. B. Bruises to the arms C. Warm skin D. Pinpoint pupils

A​ 72-year-old male with a history of depressed thyroid function and a brain tumor is suffering a psychomotor seizure. As you enter the​ room, you find him to be standing up and walking in a circle. He is awake but does not respond to your questions. Family members state that he has had three similar episodes over the past six​ months, which his physician diagnosed as complex partial seizures. Vital signs are pulse​ 112, respirations​ 16, blood pressure​ 166/68, and SpO2 at​ 98%. Which one of the following actions would be most appropriate in the care of this​ patient?

.* Proceed with a nonemergency transport. This is the correct answer. B. Insert a nasopharyngeal airway to ensure airway patency. C. Restrain the patient and apply​ high-concentration oxygen. D. Determine if a durable power of attorney exits

Which statement related to the pathophysiology of seizures is​ CORRECT?

.* ​"A seizure occurs when there is a massive and uncoordinated electrical discharge in the​ brain." This is the correct answer. B. ​"All seizures are caused by​ epilepsy, which describes a problem somewhere in the​ body." C. ​"A seizure condition describes a muscle problem that causes the arms and legs to​ jerk." D. ​"A seizure occurs when the heart beats​ irregularly, causing a decreased amount of oxygen minus −rich blood to reach the​ brain."

Which statement about seizures is​ TRUE?

.* ​"Seizures may be caused by a variety of medical​ conditions." This is the correct answer. B. ​"If the cause of a seizure is​ unknown, it is classified as status​ epilepticus." C. ​"Patients who have seizures are at increased risk for​ stroke." D. ​"All seizures are caused by some form of brain​ injury."

A patient who suffered an apparent syncopal episode refuses transport to the hospital. Prior to the patient signing a​ refusal, you should make which one of the following​ statements?

.* ​"Syncope indicates a serious underlying​ condition, so please follow up with a​ doctor." This is the correct answer. B. ​"People who experience a syncopal episode are not allowed to drive unless they go on​ medication." C. ​"Syncope is not dangerous and affects almost​ everyone, but it is still important to follow up with your​ doctor." D. ​"The most common cause of syncope is​ diabetes, so follow up with your​ doctor."

You are to transport a​ 46-year-old male who has had multiple seizures throughout the morning.​ Currently, he is on your stretcher and is postictal. He has a history of seizures for which he takes anticonvulsant medications. He also suffers from diabetes and kidney failure. Of the equipment listed​ below, which one is most essential to have ready during transport of this​ patient?

A. Oral glucose B.** Suction device This is the correct answer. C. Automated external defibrillator D. Padded tongue blade

It is important that the EMT recognize that a complex partial​ (psychomotor) seizure can easily be mistaken for​ a(n):

A.* alcohol intoxication. This is the correct answer. B. asthma exacerbation. C. ​left-sided stroke. D. absence​ (petit mal) seizure.

An EMT would recognize a focal motor seizure when he​ observes:

A.* jerky muscular activity of a single extremity. This is the correct answer. B. abrupt personality changes including fits of rage. C. repetitive actions like lip smacking or finger rolling. D. blank staring which begins and ends abruptly

While placing a​ 52-year-old female on the​ stretcher, she begins to seize. Your immediate action would be​ to:

A.* loosely apply the straps and raise the side rails. This is the correct answer. B. perform a​ jaw-thrust maneuver and insert an oropharyngeal airway. C. remove her from the stretcher and place her on the ground. D. quickly move her to the ambulance for rapid transport.

What is the BEST explanation of why a patient who experiences a syncopal episode regains consciousness after​ falling?

A. *** The supine position allows more blood to perfuse the brain. This is the correct answer. B. The act of falling causes the heart rate to decrease. C. The trauma of falling causes the blood glucose level to increase. D. The seizure stops once the patient is supine.

You arrive on the scene of a​ 24-year-old male seizure patient and find his wife performing CPR. What should your first action​ be?

A. Apply oxygen. B. Apply the AED. C. Take over providing compressions. D.* Verify the pulse. Because seizure activity may mimic a heart attack and can result in short periods of​ apnea, you may find a bystander performing CPR on the patient on your arrival. Quickly verify a pulse​ first, and immediately stop any unnecessary care. Some cardiac arrests are preceded by seizure activity because of a lack of oxygen and blood to the brain. You should proceed with​ CPR, application of the automated external defibrillator​ (AED), and emergency care for cardiac arrest if no pulse is found.

Which patient medication is most consistent with a history of​ seizures?

A. Celexa B.* Depakote This is the correct answer. C. Xopenex D. Prozac

Which statement about seizures is​ true?

A. Complex partial seizures involve both cerebral hemispheres. B. Generalized seizures last longer than partial seizures. C. The cause of most seizures is easily identified. D.* Simple partial seizures do not cause an alteration in mental status.

A​ 20-year-old patient is unresponsive with snoring respirations. She is in a public restroom with no family or friends with her. After addressing the​ airway, breathing, and​ circulation, you begin the secondary assessment. Which one of the following signs best indicates the patient experienced a​ seizure?

A. Constricted pupils B.* Urinary incontinence This is the correct answer. C. Snoring respirations D. Altered mental status

An​ 86-year-old male has had a sudden change in mental status and is repeatedly striking a fist against his leg. When you question​ him, he does not respond. This presentation is most consistent with what​ condition?

A. Dementia B. Stroke C. Delirium D.* Seizure

What question would be most appropriate to ask the parent of a​ 4-year-old child who had a generalized seizure but no history of previous​ seizures?

A. Does the child have a history of a brain​ tumor? B.* Did the child have a​ fever? This is the correct answer. C. Did the child take his seizure​ medication? D. Does the child have a history of heart​ disease? Febrile​ seizures, caused by high​ fever, are most common in children between 6 months and 6 years of age. About 5 percent of children who have a fever will develop febrile seizures. These secondary or reactive generalized seizures are often very short and may not require emergency​ care; however, always assume that the seizures are serious. The diagnosis cannot be made without a medical evaluation. Lacking a history of​ seizures, the child would not be on seizure medicine at all. Children also rarely have a history of heart​ disease, and a seizure resulting from a tumor would typically present as a focal seizure initially.

You are treating a known​ epileptic, who is in her second trimester of​ pregnancy, for a generalized seizure. Your​ patient's seizure is normal for her​ condition, and on your​ arrival, she is​ postictal, regaining​ consciousness, and reluctant to be transported. What should you​ do?

A. Place her on oxygen at 2 lpm. B.* Point out to her that the seizure may have compromised her fetus and she is a high priority for transport and further care. This is the correct answer. C. Have her sign a release. D. Notify​ children's services of the endangerment. The seizure patient should be categorized as a priority for transport if any of the following​ occurs: the patient remains unresponsive after the​ seizure; the​ airway, breathing, or circulation is inadequate after the seizure​ activity; a second generalized motor seizure occurs without a period of responsiveness between the seizure​ episodes; a generalized motor seizure lasts more than 5​ minutes; the patient is​ pregnant, has a history of​ diabetes, or is​ injured; the seizure has occurred in​ water, such as a swimming pool or​ lake; there is evidence of head trauma leading to the​ seizure; there is no history of epilepsy or other seizure​ disorder; or the seizure is the result of drug or alcohol withdrawal.

A female patient with a history of seizures has suffered a seizure in a public area and is now refusing further assessment and transport. As you​ leave, a witness to the entire event tells you that he thinks the patient is​ "crazy in the​ head" because right before she​ seized, she looked up toward the ceiling and kept​ repeating, "Do you see the​ birds?" As a knowledgeable​ EMT, you should recognize that the bystander is describing what​ condition?

A. Postictal confusion B. Side effects of seizure medications C. Syncopal episode D.* An aura This is the correct answer.

Which of the following statements is CORRECT when discussing a seizure that is unusually long in​ duration?

A. Prolonged seizures mean that the patient has a history of seizures. B.* Prolonged seizures can be life threatening. This is the correct answer. C. Patients with prolonged seizures should be suspected of being off their​ anti-seizure medication. D. Patients with prolonged seizures have a history of​ epilepsy, and often require no medical care.

You find an adult male on his living room floor. The scene​ size-up reveals a very cluttered home that smells of urine. On an end​ table, you find a container of phenytoin​ (Dilantin) with the​ patient's name on it. When you pinch his​ shoulder, the patient responds by moaning and trying to remove your hand from his neck. On the basis of this​ information, you should suspect which one of the following​ conditions?

A. Syncope B. Behavioral emergency C. Allergic reaction D.* Seizure

You are transporting a patient who has a history of simple partial seizures. During transport she experiences a simple partial seizure involving her right arm. Her pulse is​ 92, respirations 14 and​ adequate, blood pressure​ 168/88 mmHg, and SpO2 at​ 98%. Your primary concern would​ be:

A. administering oxygen by nonrebreather. B. placing the arm tightly in a sling to prevent injury. C. loss of bowel or bladder control. D.* progression to a generalized seizure.

A​ 36-year-old diabetic male with hypertension has suffered a secondary seizure. The patient responds to verbal stimuli with garbled speech and his​ airway, breathing, and circulation are intact. Vital signs​ are: pulse​ 128, respirations 20 and​ adequate, blood pressure​ 158/96 mmHg, and SpO2​ 97% on room air. At this​ time, it is important that the​ EMT:

A. administer​ high-concentration oxygen. B. administer oral glucose. C. position the patient supine on the stretcher and transport. D.* check the​ patient's blood sugar.

You have been called for a​ 71-year-old male with seizure activity. At the​ patient's side, you find him lying motionless on the floor of his bedroom with a family member performing chest compression only CPR. In this​ situation, your immediate action would be​ to:

A. take over CPR and attach the automated external defibrillator. B. open the airway and begin positive pressure ventilation. C. continue CPR and call for advanced life support assistance. D.* stop CPR and feel for a carotid pulse.

Friends of a male patient who suffered a generalized seizure are worried because he cannot remember the seizure. You should inform them that this is​ a(n):

A. unrelated event to the seizure and may indicate a more serious medical problem. B. important piece of information that warrants immediate transport to the hospital. C. concern since most people can remember the seizure. D.* normal finding common among those who suffer this type of seizure.

A man comes into your station and tells you that he was just diagnosed by his physician as having a syncopal episode the previous week. More​ specifically, he asks you to explain why he fainted. Which one of the statements that follow would be your best​ response?

A. ​"A small clot formed in a blood vessel in your​ brain, but was quickly broken down by the​ body." B.* ​"For some​ reason, there was a temporary decrease in the flow of blood to your​ brain." This is the correct answer. C. ​"A syncopal episode is a small seizure that runs its course very​ quickly." D. ​"Your blood sugar most likely dropped very​ quickly, causing you to​ faint."

As a general​ rule, a postictal patient should be placed on the stretcher and transported in what​ position?

A. ​Semi-Fowler's B.* Lateral recumbent This is the correct answer. C. Prone D. Supine

How would you transport a seizure patient who may have a​ spinal-cord injury?

A.* Immobilized on a spine board with a cervical collar in place This is the correct answer. B. Supine on the stretcher with straps loosely applied C. Semi minus −sitting position with a cervical collar in place D. In the lateral recumbent position with a cervical collar in place

A patient has been actively seizing for 17 minutes. He is cyanotic with shallow respirations. What immediate care should you provide to this​ patient?

A.* Open the airway and begin positive pressure ventilation. This is the correct answer. B. Determine if he has a history of seizures. C. Apply the automated external defibrillator. D. Place him in the lateral recumbent position.

While you are transporting a 41 dash -year dash -old woman who is not feeling​ well, she begins having a generalized tonic dash -clonic seizure. She has no history of seizures. The seizure lasts approximately 90 seconds. After 30 seconds of being postictal and​ unresponsive, the woman seizes again for the remainder of the 12 dash -minute transport. You recognize which one of the following​ conditions?

A.* Status epilepticus This is the correct answer. B. ​Partial-motor seizure C. ​Hypoglycemic-induced seizures D. Undiagnosed epilepsy

You arrive on scene and find Emergency Medical Responders with a seizing patient. What question should the EMT ask​ first?

A.* ​"How long has the patient been​ seizing?" This is the correct answer. B. ​"Did the patient lose control of his​ bladder?" C. ​"Do you know what medications the patient is​ taking?" D. ​"What are the​ patient's vital​ signs?"

You believe that a patient suffered a simple partial​ (focal motor) seizure. What statement made by the patient would reinforce this​ suspicion?

A.* ​"My left arm would not stop shaking. I did not know what was​ happening." This is the correct answer. B. ​"I cannot remember anything that happened. I must have passed​ out!" C. ​"I think that I may have lost control of my bladder and bit my​ tongue." D. ​"I remember my arms and legs​ shaking, and then I​ can't remember anything​ else!"

Which one of the following patients should be classified as suffering from status​ epilepticus?

A.* ​57-year-old female who seized during the entire news program This is the correct answer. B. ​16-year-old male experiencing a partial motor seizure for 7 minutes C. ​89-year-old who seized immediately upon getting out of bed D. ​19-year-old female who briefly seized but has been postictal for 20 minutes

What do untrained bystanders sometimes attempt to do to the actively seizing patient prior to EMS​ arrival?

A.** Place a spoon in the​ patient's mouth to keep him from swallowing his tongue. This is the correct answer. B. Place the patient on a couch or chair so he does not fall down. C. Put a pillow under the​ patient's back to keep him from rolling over. D. Give the patient a sip of water to stop the seizure.

You are caring for a postictal male patient with a known history of seizures. He is confused and cannot remember his​ 8-year-old son's name. His son tearfully asks you if his father will ever remember him. Your response would​ be:

A.** ​"Although he is confused​ now, he should remember your name in a little​ bit." This is the correct answer. B. ​"I do not feel comfortable in telling you​ yes, since there is a chance he may​ not." C. ​"I do not know. We will have to let the doctor help him​ first." D. ​"I am not​ sure, but at least your mother remembers your​ name."