Chapter 17 (Lecture/Quiz/eBook Quiz)
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?
9 - moderate dysfunction
Status epilepticus is characterized by:
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:
Recovery position and transport
Which of the following conditions would MOST likely affect the entire brain?
Respiratory failure or cardiopulmonary arrest
What criteria must be met for a patient to have status epilepticus?
Seizures that recur every few minutes or last longer than 30 minutes
A generalized (tonic-clonic) seizure is characterized by:
Severe twitching of all the body's muscles
Your patient answers your questions appropriately, although her eyes remain closed the entire time. She moves each extremity on command, although her left side is weaker than the right. You should assign a Glasgow Coma Scale (GCS) score of:
12
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:
8
Which of the following patients would MOST likely demonstrate typical signs of infection, such as a fever?
A 17-year-old male with anxiety
What is the difference between a stroke and a transient ischemic attack?
A TIA resolves completely within 24 hours of onset
When caring for a patient with documented hypoglycemia, you should be MOST alert for:
A seizure
Which of the following MOST accurately describes a simple partial seizure?
A seizure that begins in one extremity
Which of the following MOST accurately describes what the patient will experience during the postictal state that follows a seizure?
A seizure that begins in one extremity
Components of the Cincinnati Prehospital Stroke Scale include:
Arm drift, speech, and facial droop
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:
Ask his wife when she noticed the symptoms.
When assessing for arm drift of a patient with a suspected stroke, you should:
Ask the patient to close his or her eyes during the assessment
Interruption of cerebral blood flow may result from all of the following, EXCEPT:
Cerebral Vasodilation
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:
Assist ventilations, perform a rapid exam, and prepare for immediate transport
Muscle control and body coordination are controlled by the:
Cerebellum
Which of the following MOST accurately describes the cause of an ischemic stroke?
Blockage of a cerebral artery
The three major parts of the brain are the:
Cerebrum, cerebellum, and brain stem
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?
Cincinnati Prehospital Stroke Scale
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?
Complex partial
Which of the following MOST accurately describes what the patient will experience during the postictal state that follows a seizure?
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. Treatment should include:
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:
Dysarthria
The anterior aspect of the cerebrum controls:
Emotion
During the primary assessment of a semiconscious 70-year-old female, you should:
Ensure a patent airway and support ventilation as needed
A 40-year-old patient without a history of seizures experiences a generalized (tonic-clonic) seizure. The LEAST likely cause of this seizure is:
Epilepsy
A patient who is possibly experiencing a stroke is NOT eligible for thrombolytic (fibrinolytic) therapy if he or she:
Has bleeding within the brain
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?
He is currently not prescribed any medications
Which of the following findings should concern the EMT the MOST when assessing a patient who complains of a headache?
History of migraines
The MOST significant risk factor for a hemorrhagic stroke is:
Hypertension
Which of the following is a metabolic cause for a seizure?
Hypoglycemia
Which of the following mimics a stroke and also causes a seizure?
Hypoglycemia
Which of the following conditions is NOT a common cause of seizures?
Hypotension
Which of the following conditions would be the LEAST likely to mimic the signs and symptoms of a stroke?
Hypovolemia
What happens when blood flow to a particular part of the brain is cut off by a blockage, resulting in tissue damage?
Ischemic Stroke
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?
Left Hemisphere
Which of the following medications would indicate that a patient has a history of seizures?
Levetiracetam (Keppra)
What is the name of the condition when the patient forgets about the injured side after a stroke?
Neglect
A patient with an altered mental status is:
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 topiramate (Topamax). When obtaining further medical history from the girlfriend, it is MOST important to:
Obtain a description of how the seizure developed
Which of the following clinical signs is MOST suggestive of a ruptured aneurysm?
Sudden, severe headache
Which of the following symptoms would lead the EMT to believe that a patient's headache is caused by sinus congestion?
The pain is worse when bending over
The left cerebral hemisphere controls:
The right side of the body
Successful treatment of a stroke depends on whether:
Thrombolytic therapy is given within 3 hours of symptoms beginning
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:
Transport the child to the hospital and reassure the mother en route
A patient who is experiencing aphasia is:
Unable to produce or understand speech
The principal clinical difference between a stroke and hypoglycemia is that patients with hypoglycemia:
Usually have an altered mental status or decreased level of consciousness
When you are obtaining medical history from the family of a suspected stroke patient, it is MOST important to determine:
When the patient last appeared normal
