Chapter 18 Questions

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 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) ask the patient to hold his or her arms up with the palms down C) observe movement of the arms for approximately 2 mins 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

Which of the following MOST accurately describes the cause of an ischemic stroke? A) blockage of a cerebral artery B) acute atherosclerotic disease C) narrowing of a carotid artery D) rupture of a cerebral artery

A) blockage of a cerebral artery

A 41 year old man presents with slo, irregular breathing; hypotension; and dilated pupils. These signs MOST likely indicate dysfunction of the: A) brainstem B) hypothalamus C) cerebrum D) cerebellum

A) brainstem

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 old C) has a GCS score that is less than 8 D) has had a prior heart attack

A) has bleeding within the brain

A 56 year old man experienced a sudden, severe headache and then becomes 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 stroke

A) hemorrhagic stroke

Which of the following findings should concern the EMT the MOST when assessing a patient who complains of a headache? A) neck stiffness or pain B) sinus congestion C) history of migraines D) slow onset of symptoms

A) neck stiffness or pain

A 40 year old patient without a history of seizures experiences a generalized (tonic-clonic) seizure. The LEAST likely cause of this seizure is: A) a brain tumor B) epilepsy C) intracranial bleeding D) a serious infection

B) epilepsy

The spinal cord exits the cranium through the: A) vertebral foramen B) foramen magnum C) cauda equina D) foramen lamina

B) foramen magnum

The MOST important reason for promptly transporting a stroke patient to the hospital is: 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) mediations may be given to reverse the stroke

Which of the following conditions would MOST likely affect the entire brain? A) blocked cerebral artery in the frontal lobe B) respiratory failure or cardiopulmonary arrest C) ruptured cerebral artery in the occipital lobe D) reduced blood supply to the left hemisphere

B) respiratory failure or cardiopulmonary arrest

Which of the following clinical signs is MOST suggestive of a ruptured aneurysm? A) nasal discharge of blood B) sudden, severe headache C) unilateral hemiparesis D) confusion and weakness

B) sudden, severe headache

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

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) unable to produce or understand speech

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

C) a seizure

Febrile seizures: A) occur when a child's fever rises slowly B) are also referred to as absence seizures C) are usually benign but should be evaluated D) often result in permanent brain damage

C) are usually benign but should be evaluated

Components of the Cincinnati Prehospital Stroke Scale include: A) arm drift, memory, and grip strength B) speech, pupil reaction, and memory C) arm drift, speech, and facial droop D) facial droop, speech, and pupil size

C) arm drift, speech, and facial droop

Muscle control and body coordination are controlled by the: A) cerebrum B) cerebral cortex C) cerebellum D) brain stem

C) cerebellum

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

Individuals with chronic alcoholism are predisposed to intracranial bleeding and hypoglycemia secondary to abnormalities in the: A) brain B) kidneys C) liver D) pancreas

C) liver

A patient with an altered mental status is: A) typically alert but is confused as to preceding events B) completely unresponsive to all forms of stimuli C) no thinking clearly or is incapable of being aroused D) usually able to be aroused with a painful stimulus

C) not thinking clearly or is incapable of being aroused

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

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

The most basic functions of the body, such as breathing, blood pressure, and swallowing, are controlled by the: A) cerebral cortex B) cerebrum C) cerebellum D) brain stem

D) brain stem

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

D) cerebrum, cerebellum, and brain stem

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

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

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

D) hypertension

Which of the following is characteristic of a focal-onset aware seizure? A) generalized twitching of all muscles B) absence of breathing C) no change in vision, smell, or taste D) normal level of consciousness

D) normal level of consciousness

Status epileptics is characterized by: A) an absence seizure that is not preceded by an aura B) profound tachycardia and total muscle flaccidity C) generalized seizures that last less than 5 mins D) prolonged seizures without a return of consciousness

D) prolonged seizures without a return of consciousness