Chapter 17 Questions

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

A. 8

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

B. cerebral vasodilation

Your patient opens his eyes when you say his name, is making incomprehensible sounds, and withdraws when you pinch his earlobe. What is his GCS score? A. 9 B. 8 C. 11 D. 12

A. 9

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

A. a seizure

When assessing for arm drift of a patient with a suspected stroke, you should: A. ask the patient to close his or her eyes during the assessment. B. observe movement of the arms for approximately 2 minutes. C. ask the patient to hold his or her arms up with the palms down. 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 41-year-old man presents with slow, irregular breathing; hypotension; and dilated pupils. These signs MOST likely indicate dysfunction of the: A. brain stem. B. hypothalamus. C. cerebrum. D. cerebellum.

A. brain stem

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

A. cerebrum, cerebellum, and brain stem

A 56-year-old man experienced a sudden, severe headache and then became unresponsive. He has a history of high blood pressure. The MOST likely cause of his condition is a(n): A. hemorrhagic stroke. B. acute ischemic stroke. C. severe migraine headache. D. transient ischemic attack.

A. hemorrhagic stroke

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

A. hypertension

A patient with an altered mental status is: 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 painful stimulus

A. not thinking clearly or is incapable of being aroused

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: A. recovery position and transport. B. ventilatory assistance and transport. C. high-flow oxygen and transport. D. oral glucose gel and transport.

A. recovery position and transport

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

B. A seizure that begins in one extremity

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

B. dysarthria

The MOST important reason for promptly transporting a stroke patient to the hospital is because: A. a transient ischemic attack can be ruled out. B. medications may be given to reverse the stroke. C. the clot in the coronary artery may be dissolved. D. he or she needs close blood pressure monitoring.

B. medications may be given to reverse the stroke

Unlike an ischemic stroke, a transient ischemic attack is characterized by all of the following, EXCEPT: A. symptoms that resolve within 24 hours. B. symptoms that persist for longer than 24 hours. C. weakness or paralysis to one side of the body. D. an acute onset of confusion and slurred speech.

B. symptoms that persist for longer than 24 hours

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

B. the right side of the body

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

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

Which of the following are components of the Cincinnati Prehospital Stroke Scale? A. Arm drift, blood pressure, speech B. Speech, pupil response, arm drift C. Facial symmetry, speech, arm drift D. Pupil response, facial droop, speech

C. Facial symmetry, speech, arm drift

If a patient complains of a severe migraine, how should she be transported? A. In a brightly lit ambulance so she can see while her vision is impaired B. With loud sirens so she can get to the hospital as soon as possible C. Without lights and sirens D. This patient should not be transported.

C. Without lights and sirens

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

C. has bleeding within the brain

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

C. hypovolemia

When you are obtaining medical history 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. when the patient last appeared normal

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

D. Confusion and fatigue

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

D. He is currently not prescribed any medications

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

D. Respiratory failure or cardiopulmonary arrest

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

D. The pain is worse when bending over

An acute ischemic stroke is caused by: A. a ruptured cerebral artery. B. increased intracranial pressure. C. an acute rise in a person's blood pressure. D. a blocked cerebral artery.

D. a blocked cerebral artery

A patient with a suspected stroke presents with slurred speech that is difficult for you to understand. This is referred to as: A. aphasia. B. dysphasia. C. dysphagia. D. dysarthria.

D. dysarthria

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

D. ensure a patent airway and support ventilation as needed

A type of seizure that is characterized by severe twitching of all the body's muscles and lasts for several minutes or longer is called a(n): A. partial seizure. B. absence seizure. C. tonic-clonic seizure. D. generalized seizure.

D. generalized seizure