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

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

hypertension

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

8

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

A seizure that begins in one extremity

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.

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

D. when the patient last appeared normal.

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

He is currently not prescribed any medications

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

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? Select one: A. The headache began suddenly B. There is numbness in the extremities C. There is associated neck stiffness D. The pain is worse when bending over

The pain is worse when bending over

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.

a ruptured cerebral artery.

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.

are usually benign but should be evaluated.

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.

ask his wife when she noticed the symptoms.

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. expect to see one arm slowly drift down to the patient's side. C. ask the patient to hold his or her arms up with the palms down. D. observe movement of the arms for approximately 2 minutes.

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

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.

assist ventilations, perform a rapid exam, and prepare for immediate transport

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.

brain stem.

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

cerebellum.

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

cerebral vasodilation.

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.

cerebral vasodilation.

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

confusion and fatigue

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.

dimming the lights in the back of the ambulance and transporting without lights and siren.

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

dysarthria

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

ensure a patent airway and support ventilation as needed.

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.

ensure a patent airway and support ventilation as needed.

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

foramen magnum.

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

has bleeding within the brain.

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

hypovolemia

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.

is likely to improve over a period of 5 to 30 minutes.

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

liver.

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.

maintain her airway with manual head positioning, suction her airway to remove the vomitus, insert a nasopharyngeal airway, and administer high-flow oxygen.

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

memory

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.

monitor her airway and breathing status and assess her blood glucose level.

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

not thinking clearly or is incapable of being aroused.

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.

obtain a description of how the seizure developed.

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.

petit mal seizure.

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.

prolonged seizures without a return of consciousness.

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

recovery position and transport.

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″.

recumbent position with the paralyzed side down.

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.

repeat the arm drift test, but move the patient's arms into position yourself.

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

seizure

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.

suction her oropharynx and apply 100% oxygen.

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.

the normal body processes destroy a clot in a cerebral artery.

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

the right side of the body

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.

thrombolytic therapy is given within 3 hours after symptoms began.

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. call medical control and request permission to give the child aspirin. B. cover the child with wet towels and give oxygen via nasal cannula. 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.

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

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.

unable to produce or understand speech.

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.

usually have an altered mental status or decreased level of consciousness.