Chapter 17: Neurological Emergencies

Headache, vomiting, altered mental status, and seizures are all considered early signs of:

Increased intracranial pressure.

A patient with an altered mental status is:

Not thinking clearly or is incapable of being aroused.

Febrile seizures:

Are usually benign but should be evaluated.

The three major parts of the brain are the:

Cerebrum, cerebellum, and brain stem.

Hypoglycemia can mimic conditions such as:

Stroke.

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 MOST accurately describes a simple partial seizure?

A seizure that begins in one extremity.

A transient ischemic attack (TIA) occurs when:

A small clot in a cerebral artery causes temporary symptoms.

When blood flow to a particular part of the brain is cut off by a blockage inside a blood vessel, the result is:

An ischemic stroke.

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.

Which of the following MOST accurately describes what the patient will experience during the postictal state that follows a seizure?

Confusion and fatigue.

A patient whose speech is slurred and difficult to understand is experiencing:

Dysarthria.

During the primary assessment of a semiconscious 70-year-old female, you should:

Ensure a patent airway and support ventilation as needed.

The spinal cord exits the cranium through the:

Foramen magnum.

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.

Patients with a subarachnoid hemorrhage typically complain of a sudden severe:

Headache.

The MOST significant risk factor for a hemorrhagic stroke is:

Hypertension.

Which of the following conditions would be the LEAST likely to mimic the signs and symptoms of a stroke?

Hypovolemia.

You are dispatched to a residence for a 66-year-old male who, according to family members, has suffered a massive stroke. Your primary assessment reveals that the patient is unresponsive, apneic, and pulseless. You should:

Initiate CPR and attach an AED as soon as possible.

The mental status of a patient who has experienced a generalized seizure:

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

You are called to a home and find a 56-year-old woman supine in her bed. She appears alert, but has slurred speech. Her family tells you she has a history of TIAs and hypertension. You ask the patient, "What day is it today?" Her reply is, "Butterfly." Which area of the brain is likely affected?

Left hemisphere

Individuals with chronic alcoholism are predisposed to intracranial bleeding and hypoglycemia secondary to abnormalities in the:

Liver.

You arrive at the residence of a 33-year-old woman who is experiencing a generalized (tonic-clonic) seizure. She has a small amount of vomitus draining from the side of her mouth. After protecting her from further injury, you should:

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

The principal difference between a patient who has had a stroke and a patient with hypoglycemia almost always has to do with the:

Mental status.

Which of the following is a metabolic cause of a seizure?

Poisoning.

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.

When transporting a stable stroke patient with a paralyzed extremity, place the patient in a:

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:

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

Which of the following conditions would MOST likely affect the entire brain?

Respiratory failure or cardiopulmonary arrest.

When caring for a patient with documented hypoglycemia, you should be MOST alert for:

Seizure.

A transient ischemic attack (TIA) occurs when:

Signs and symptoms resolve spontaneously within 48 hours.

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, is breathing at a normal rate with adequate depth, and has an oxygen saturation of 96%. You should:

Suction her oropharynx and transport immediately.

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.

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.

The most basic functions of the body, such as breathing, blood pressure, and swallowing, are controlled by the:

Brain stem.

A patient who is possibly experiencing a stroke is NOT eligible for thrombolytic (fibrinolytic) therapy if he or she:

Has bleeding within the brain.

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 valproate (Depakote) for her seizures, but has not taken it in a few days. He also tells you that she has diabetes. In addition to administering oxygen, you should:

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

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.