Chapter 19 Study Plan

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Which of the following blood glucose levels is considered normal for an​ adult? A. 80​ mg/dL B. 40​ mg/dL C. 180​ mg/dL D. 150​ mg/dL

A. 80​ mg/dL

Which of the following is characteristic of a patient with​ hyperglycemia? A. A​ "fruity" odor of the breath B. Sudden onset of altered mental status C. Use of excessive amounts of insulin or lack of adequate food intake D. ​Cool, moist​ skin, agitated​ behavior, and increased heart rate

A. A​ "fruity" odor of the breath

Which of the following is the medical name of a stroke that is defined as the death or injury of brain tissue that has been deprived of​ oxygen? A. Cerebral vascular accident B. Carotid vessel aneurysm C. Cerebral vascular aneurysm D. Carotid vascular accident

A. Cerebral vascular accident A cerebral vascular accident​ (CVA) is the medical term for a stroke.

Which of the following is NOT a sign or symptom of​ stroke? A. Chest pain B. Vomiting C. Seizure D. Sudden impairment of vision

A. Chest pain

Which of the following is a standardized test to evaluate a conscious patient for possible​ stroke? A. Cincinnati Prehospital Stroke Scale B. Michigan TIA Assessment C. The​ Numbness-Aphasia-Paralysis (NAP) Test D. The Functional Analysis Stroke Test

A. Cincinnati Prehospital Stroke Scale

Which of the following is the LEAST important question in obtaining the history of a seizure patient in the prehospital​ setting? A. Does the patient have a family history of​ seizures? B. How did the patient behave during the​ seizure? C. What was the patient doing before the​ seizure? D. Did the patient lose control of his​ bladder?

A. Does the patient have a family history of​ seizures?

Your patient is a​ 19-year-old female who is 7 months pregnant. She just experienced a seizure. Although she has no previous history of seizures or any other medical​ condition, she was just diagnosed with​ pregnancy-induced hypertension. Which of the following is the most likely cause of the​ seizure? A. Eclampsia B. Hypoglycemia C. Trauma D. Any of the above

A. Eclampsia

Which of the following is a typical cause of seizures in children 6 months to 3 years of​ age? A. Fever B. Asthma C. Administration of glucose to a hyperglycemic patient D. Chest pain

A. Fever

Which of the following is a type of stroke in which a blood vessel in the brain has​ ruptured? A. Hemorrhagic B. Occlusive C. Ischemic D. Aneurysm

A. Hemorrhagic A hemorrhagic stroke is one in which a blood vessel ruptures and results in a​ space-occupying hematoma. Not only does this reduce distal blood​ flow, but the pressure buildup can cause ICP damage. Although an aneurysm frequently leads to​ bleeding, it can exist as simply a ballooning of the vessel. Ischemic and occlusive strokes occur because the vessel has been blocked.

Which of the following categories should be assigned to a patient who presents with an acute change in his or her mental​ status? A. High priority B. Delayed candidate C. Moderate priority D. Low priority

A. High priority Every patient with a disturbance to the​ airway, breathing, or circulation or an acute change in mental status should be considered as a high priority for transport.

Which of the following terms BEST describes a type of stroke caused by a blood vessel in the brain that has been​ blocked, causing distal cells to begin to​ die? A. Ischemic B. Hemorrhagic C. Vasodilatory D. Aneurysm

A. Ischemic An ischemic stroke occurs when the cerebral artery is blocked by a clot or other foreign matter. The resulting diminishment or cessation of distal blood flow results in cellular ischemia and death if perfusion is not returned rapidly. A hemorrhagic stroke occurs as a result of bleeding. An aneurysm occurs due to blood seeping into the middle layers of a blood vessel.

Which of the following is characterized by​ sudden, temporary loss of consciousness caused by insufficient blood flow to the​ brain, with return of consciousness almost immediately on becoming​ supine? A. Syncope B. Transient ischemic attack​ (TIA) C. Concussion D. Reversible ischemic neurological disorder​ (RIND)

A. Syncope Syncope is a neurological condition characterized by the​ sudden, temporary loss of consciousness caused by insufficient blood flow to the​ brain, with recovery of consciousness almost immediately on becoming supine. Nearly half of all Americans will experience at least one episode of syncope during their lifetime. TIAs can cause neurological deficit but rarely cause unconsciousness. Concussion can cause unconsciousness but is not caused by interruption of blood flow to the brain.

Which of the items below is NOT part of the Cincinnati Prehospital Stroke​ Scale? A. Test for equal grip strength. B. Have the patient repeat a simple sentence. C. Test the patient for arm droop or lack of movement. D. Ask the patient to smile.

A. Test for equal grip strength.

Which of the following stroke screening methods relies on speech as one of the screening​ criteria? A. The Cincinnati Prehospital Stroke Scale B. Speech is not a criterion for any common stroke screening system C. The Los Angeles Prehospital Stroke Screen​ (LAPSS) D. Both the Cincinnati Prehospital Stroke Scale and the Los Angeles Prehospital Stroke Screen

A. The Cincinnati Prehospital Stroke Scale The Cincinnati Prehospital Stroke Scale utilizes speech as one of its criteria. During the​ test, the patient is asked to say a​ simple, familiar​ saying, and the ability to clearly do so is evaluated.

Which of the following may result in hypoglycemia in the diabetic​ patient? A. Vomiting after eating a meal B. Lack of exercise C. Failure to take insulin or oral diabetes medications D. Overeating

A. Vomiting after eating a meal

Which of the following is one of the most common characteristics of a​ stroke? A. Weakness on one side of the body B. Projectile vomiting C. Sudden onset of bizarre behavior D. ​Sudden, severe headache

A. Weakness on one side of the body

For the​ EMT, which of the following is the most important question to ask of a diabetic patient or his family​ members? A. When was the last time you had something to​ eat? B. Do you have a fruity taste in your​ mouth? C. Do you have a family history of​ diabetes? D. What kind of insulin do you​ take?

A. When was the last time you had something to​ eat?

Many factors that cause dizziness and syncope are generally related to​ the: A. brain. B. nervous system. C. lungs. D. kidneys.

A. brain.

The reticular activating system​ (RAS) is responsible​ for: A. consciousness. B. urinary output. C. blood glucose levels. D. hormone levels.

A. consciousness. The RAS is a series of neurological circuits in the brain that are responsible for consciousness. Although blood glucose​ levels, hormone​ levels, and urinary output all can affect​ consciousness, the RAS is the system that is responsible for it.

The basic primary fuel for the cell​ is: A. glucose. B. glucagon. C. oxygen. D. carbon dioxide.

A. glucose. Cellular​ metabolism, also known as cellular​ respiration, is the process in​ which, normally, molecules of glucose are broken down to produce energy for the body. There are two types of cellular​ metabolism: aerobic and anaerobic. Although oxygen is a necessary component in aerobic​ metabolism, it is not the primary fuel. Carbon dioxide is a byproduct of metabolism. Glucagon is a hormone.

A seizure that occurs spontaneously from an unknown cause is​ called: A. idiopathic. B. hypoxic. C. hypoglycemic. D. toxinic.

A. idiopathic.

The islets of Langerhans are located in​ the: A. pancreas. B. rear of the thyroid. C. kidneys. D. anterior neck.

A. pancreas. Component of the endocrine​ system, the islets of Langerhans are located in the pancreas and make insulin for the body. The kidneys are the location of the thyroid gland. The anterior neck houses the thyroid gland.

Treatment of someone with a seizure disorder includes all of the following ​except: A. placing a bite block in the​ patient's mouth so he does not bite his tongue. B. loosening restrictive clothing. C. placing the patient on the floor or ground. D. removing objects that might harm the patient.

A. placing a bite block in the​ patient's mouth so he does not bite his tongue.

A​ 16-year-old female has altered mental status. Her blood glucose is 40​ mg/dl. This finding tells you​ that: A. the patient is hypoglycemic. B. the patient is hyperglycemic. C. the​ patient's blood glucose is normal. D. the glucometer has malfunctioned.

A. the patient is hypoglycemic. A blood glucose level below 60​ mg/dl indicates hypoglycemia. Modern glucometers are typically very​ reliable, and the​ patient's altered mental status would help to confirm your finding.

TIA is a commonly accepted abbreviation​ for: A. transient ischemic attack. B. telephoned in advance. C. tube in airway. D. transported in ambulance.

A. transient ischemic attack. TIA is the medical abbreviation for​ "transient ischemic​ attack."

When a patient tells you that it feels as though the room is going round and​ round, the specific term for this symptom​ is: A. vertigo. B. petit mal seizure. C. dizziness. D. ataxia.

A. vertigo. The sensation that the room is spinning is called vertigo. Stroke patients sometimes complain of this sensation. Although the term​ "dizziness" can typically be used to describe​ vertigo, vertigo is the more specific term.​ Ataxia, or uncoordinated muscle​ movement, can result from vertigo. A petit mal seizure usually results in a brief loss of awareness.

Which of the following readings on the glucometer would be of concern to the​ EMT? A. 108​ mg/dl B. 150​ mg/dl C. 98​ mg/dl D. 118​ mg/dl

B. 150​ mg/dl A blood glucose level over about 140​ mg/dl indicates hyperglycemia and therefore would be concerning. That​ said, high blood glucose levels are rarely life threatening until they reach much higher levels.

The signs and symptoms of a transient ischemic attack​ (TIA) may last up​ to: A. 30 minutes. B. 24 hours. C. 6 hours. D. 1 hour.

B. 24 hours.

A patient who is experiencing a transient ischemic attack​ (TIA) may develop MOST of the same symptoms as a patient who is suffering a stroke. The key difference is that the signs and symptoms of a TIA usually disappear​ within: A. two to four weeks. B. 24 hours. C. two to three days. D. one week.

B. 24 hours. Patients who experience a TIA develop most of the same signs and symptoms as those who are experiencing a stroke. The key difference between a stroke and a TIA is that the signs and symptoms of a TIA disappear without any obvious permanent neurological deficits. The signs and symptoms of the TIA will typically resolve within one to two hours after the​ onset; however, they may last up to 24 hours.

A patient who demonstrates any one of the three symptoms from the Cincinnati Prehospital Stroke Scale has​ a(n) ________% chance of having an acute stroke. A. 50 B. 70 C. 80 D. 60

B. 70

What is​ epilepsy? A. A condition caused by congenital brain abnormalities that causes seizures only twice a year. B. A condition in which a person has multiple seizures usually controlled by medication. C. A condition in which a person has general seizures that start in childhood. D. A condition in which a person has an aura followed by seizure usually controlled by medication.

B. A condition in which a person has multiple seizures usually controlled by medication.

Which of the following is within the​ EMT's scope of practice for the treatment of the diabetic​ patient? A. Assisting the patient with the administration of his insulin B. Administration of oral glucose C. Rectal administration of glucose D. Both A and B

B. Administration of oral glucose

Which of the following is the cause of most​ strokes? A. A ruptured cerebral artery due to hypertension B. Blockage of an artery supplying part of the brain C. A ruptured cerebral artery due to an aneurysm D. A spasm in an artery supplying part of the brain

B. Blockage of an artery supplying part of the brain

Which of the following is MOST likely to cause an altered mental​ status? A. Hypertension B. Hypoxia C. Dizziness D. Headache

B. Hypoxia Although any of these factors can influence mental​ status, hypoxia should always be considered first as the possible cause of altered mental status.

Your patient is a​ 59-year-old female with a sudden onset of slurred speech and weakness on her right side. Which of the following measures is​ appropriate? A. Test the​ patient's sensation with a series of​ pinpricks, beginning at the feet and working upward. B. Immediately transport the patient to a hospital with specialized treatment for stroke patients. C. Administer oral glucose and then assess the​ patient's blood sugar. D. Keep the patient in a supine position.

B. Immediately transport the patient to a hospital with specialized treatment for stroke patients.

Which statement below is NOT true about​ seizures? A. A generalized seizure affects the entire brain. B. Many seizures are followed by an aura. C. A partial seizure affects one​ part, or one​ side, of the brain. D. The most common seizure that EMTs are likely to be called on is a​ tonic-clonic seizure.

B. Many seizures are followed by an aura.

A patient who loses the ability to speak or feel sensations is experiencing what type of​ deficit? A. Hemorrhagic B. Neurological C. Urinary D. Muscular

B. Neurological A neurological deficit is one that causes a change in the​ patient's mental status or other neurological finding and is caused by some type of disturbance or injury to the neurological system itself.

Which of the following findings from the SAMPLE and OPQRST history of a seizure patient is of GREATEST concern to the​ EMT? A. The patient has a history of diabetes. B. The patient stopped taking his antiseizure medicine. C. The patient is being treated for hypertension. D. The patient does not have a history of epilepsy.

B. The patient stopped taking his antiseizure medicine. Although all the information is​ relevant, a patient who is on medicine for seizures has an active condition that is being treated to keep the seizures from recurring. If the patient stops taking that​ medicine, the seizures will start to break through again and may lead to a status epilepticus situation.

You have arrived on the scene of a call for a possible stroke. On your​ arrival, the patient denies signs and​ symptoms, is alert and​ oriented, and moves all extremities well. Her husband states that before you arrived the patient could not move her right arm and the left side of her face seemed to be​ "slack." Which of the following has most likely​ occurred? A. The patient is suffering from aphasia. B. The patient suffered a transient ischemic attack. C. The patient has had a subarachnoid hemorrhage. D. The patient suffered a stroke.

B. The patient suffered a transient ischemic attack.

To which of the following hypoglycemic seizure patients should the EMT administer oral​ glucose? A. The seizure patient who is still in the tonic phase B. The postictal patient who can manage his or her own airway C. The actively seizing patient D. The postictal patient who has sonorous breathing

B. The postictal patient who can manage his or her own airway The EMT cannot administer oral glucose to a patient who cannot manage his or her own airway. Oral glucose can be given when the patient is in the postictal phase and is able to manage his or her own airway.

Many diabetics today have an insulin pump. Which of the following statements about insulin pumps is NOT​ true? A. They are about the size of an MP3 player or a pager. B. They are usually worn around the ankle. C. They have a catheter that enters into the abdomen. D. They are usually worn on the belt.

B. They are usually worn around the ankle.

The condition in which there is an insufficient amount of sugar in the blood is​ called: A. hyperglycemia. B. hypoglycemia. C. diabetic ketoacidosis. D. diabetic coma.

B. hypoglycemia.

A hormone called insulin is secreted by​ the: A. gallbladder found in the pancreas. B. islets of Langerhans in the pancreas. C. islets of Langerhans in the liver. D. None of the above.

B. islets of Langerhans in the pancreas

If you suspect that your unresponsive patient suffered a syncopal episode but he did not regain consciousness within a few​ moments, then: A. you should administer an ammonia ampoule. B. it is likely something more serious than a syncopal episode. C. you should perform a sternal rub. D. you should administer oral glucose.

B. it is likely something more serious than a syncopal episode. The definition of syncope includes rapid recovery of consciousness​ (usually less than a​ minute) once the patient is in a supine position and blood flow to the brain improves. If a patient does not spontaneously regain consciousness within a few​ moments, the EMT should consider that something more serious caused the unconsciousness. You should not administer anything orally to an unconscious patient. Take great care with noxious or painful​ stimuli, as they can cause harm in the patient.

You respond to a​ 32-year-old female who is having a seizure. You arrive on the scene to find the patient​ drowsy, confused, and complaining of a headache. This patient is demonstrating​ the: A. tonic phase. B. postictal phase. C. aura phase. D. clonic phase.

B. postictal phase.

A​ 26-year-old female complains of six hours of vomiting and diarrhea. She is dizzy and lightheaded but feels better while lying down. If you were to take her blood pressure and pulse after sitting her​ up, you would expect​ the: A. pulse to drop and blood pressure to increase. B. pulse to increase and blood pressure to drop. C. pulse to increase and blood pressure to increase. D. pulse to drop and blood pressure to drop.

B. pulse to increase and blood pressure to drop. Postural changes in a hypovolemic patient will result in an increase in pulse rate and a drop in blood pressure.

A prolonged generalized seizure or two or more seizures without the patient regaining consciousness in between are known​ as: A. postictal stasis. B. status epilepticus. C. clonic infinitus. D. petit corpus.

B. status epilepticus. Status epilepticus is a​ life-threatening prolonged seizure or consecutive seizures without the patient regaining consciousness in between.

The medical term for fainting​ is: A. dehydration. B. syncope. C. altered RAS status. D. vertigo.

B. syncope.

Which of the following are the MOST important treatment elements to consider in transporting a patient with possible​ stroke, seizures,​ coma, or​ headache? A. Maintaining a state of hyperoxia to reduce swelling B. ​Airway, oxygen, and glucose levels C. Medication levels D. The administration of antiemetics

B. ​Airway, oxygen, and glucose levels Your treatment must remain focused on assessing and maintaining the​ patient's airway,​ oxygen, and glucose levels. Rapid identification and early notification to your receiving facility are also key in achieving successful recovery from strokes and other neurological impairments.

What is the cause of most​ strokes?

Blockage of an artery supplying part of the brain

Which of the following refers to difficulty in speaking or understanding speech as a result of a​ stroke? A. Ataxia B. Ischemia C. Aphasia D. Hemiparesis

C. Aphasia

Which is NOT one of the steps in managing a patient experiencing dizziness and​ syncope? A. Lay the patient flat. B. Loosen any tight clothing around the neck. C. Apply cold packs to the​ patient's head. D. Administer oxygen.

C. Apply cold packs to the​ patient's head.

Which of the following is a probable cause of​ dizziness? A. External otitis B. Aphasia C. Blood loss D. Ataxia

C. Blood loss Blood loss is a probable cause of dizziness. Aphasia is an inability to speak. Ataxia refers to a loss of muscle​ coordination, as in difficulty walking. Although otitis media​ (inner ear​ infection) typically causes​ dizziness, external otitis is not a cause of dizziness.

Which of the following would be an acceptable substitute for the administration of commercially prepared oral glucose​ solution? A. Having the patient eat something high in​ protein, such as a deli sandwich B. Diet soda C. Cake icing D. Having the patient eat a banana

C. Cake icing

Which of the following is the most common cause of seizures in​ adults? A. Withdrawal from alcohol B. Head trauma C. Failure to take prescribed medication D. Fever

C. Failure to take prescribed medication

A​ 50-year-old female patient has been found unconscious and unresponsive. She is breathing rapidly and is diaphoretic. Her vital signs are P​ 130, R​ 30, BP​ 140/80. Which of the following conditions would most likely explain these​ findings? A. High blood pressure B. TIA C. Hypoglycemia D. ​Beta-blocker overdose

C. Hypoglycemia Given the​ patient's signs and​ symptoms, the most likely probable cause is diabetes. Diaphoresis and tachycardia are common findings associated with low blood sugar. A TIA can cause altered mental status but rarely results in frank unconsciousness. A​ beta-blocker overdose would result in a slow heart rate and would be far less common than hypoglycemia.

A​ 19-year-old male is found combative after a prolonged asthma attack. Which of the following reasons would best explain the altered mental status in this​ patient? A. Overdose of asthma medications B. Acute psychosis C. Hypoxia D. Fear and anxiety

C. Hypoxia In a patient with a prolonged asthma​ attack, any altered mental status should be assumed to be the result of hypoxia. Although​ fear, anxiety and even overdose could explain this​ finding, each of these explanations is significantly less likely than hypoxia. Psychosis would not be a likely explanation.

Which of the following conditions may be mimicked by​ hypoglycemia? A. Heart attack B. Respiratory distress C. Intoxication D. All of the above

C. Intoxication

Which of the following is an action of​ insulin? A. It increases the transfer of sugar from the stomach and small intestine to the bloodstream. B. It increases the circulating level of glucose in the blood. C. It increases the movement of sugar from the bloodstream to the cell. D. It blocks the uptake of sugar by the​ body's cells.

C. It increases the movement of sugar from the bloodstream to the cell.

Your patient is a​ 19-year-old male who was reportedly unconscious for a brief time. You learn that he regained consciousness in about 30 seconds. You find no evidence of drowsiness or neurological deficits. Which of the following is MOST likely the​ cause? A. Stroke B. Hyperglycemia C. Syncope D. Status epilepticus

C. Syncope On the basis of the​ findings, syncope is the most likely​ cause, as other conditions would likely have a much longer recovery time. Although a seizure would also explain these​ findings, status epilepticus would involve a prolonged seizure​ (longer than 10​ minutes), which does not appear to be the case in this scenario. Hyperglycemia frequently causes altered mental status but not for brief periods. Stroke does not usually lead to unconsciousness.

Which of the following BEST describes status​ epilepticus? A. A seizure that occurs without a known cause B. A period of drowsiness following​ tonic-clonic seizures C. Two or more seizures with​ tonic-clonic activity without an intervening period of consciousness D. A seizure involving convulsions on only one side of the body

C. Two or more seizures with​ tonic-clonic activity without an intervening period of consciousness

A​ 69-year-old female complains of​ acute-onset slurred speech. She also notes difficulty moving her right arm. She has no history of diabetes and was feeling fine before the onset. You should suspect​ that: A. the patient had a transient ischemic attack the day before. B. electrical activity in the brain has caused the cells to conduct nerve impulses. C. at least a portion of the​ patient's brain is not receiving an adequate blood supply. D. the amount of glucose in the brain is more than sufficient to support cellular function.

C. at least a portion of the​ patient's brain is not receiving an adequate blood supply. There could be several reasons for the​ patient's slurred​ speech, but the most likely explanation is that her brain is not receiving an adequate blood supply. The symptoms that she demonstrates indicate ischemia from a stroke. Although hypoglycemia is​ possible, a lack of diabetes makes this less likely.

Which of the following substances specifically nourishes the brain to enable​ consciousness? A. carbon dioxide B. water C. glucose D. oxygen

C. glucose Although water and oxygen are necessary for the brain to maintain​ consciousness, glucose specifically provides nourishment. Carbon dioxide is the byproduct of the metabolism that transforms glucose into energy.

Your patient is a​ 70-year-old man whose wife called EMS because her husband began exhibiting unusual behavior. Upon your arrival you introduce yourself to the​ patient, who​ responds, "Not until nine​ o'clock." This phenomenon is BEST described​ as: A. expressive aphasia. B. unresponsive to verbal stimuli. C. receptive aphasia. D. disorientation to time.

C. receptive aphasia

Your DKA patient has rapid breathing and a fruity odor on his breath. This is likely due​ to: A. acute hypoglycemia. B. the rapid onset of symptoms. C. the presence of ketones. D. too much insulin.

C. the presence of ketones. Ketones are a byproduct product of the acidosis associated with DKA and often cause rapid breathing and a fruity odor. DKA is caused by a lack of insulin and extremely high blood glucose levels.

Emergency medical care of the unresponsive patient who has a nontraumatic brain injury may​ include: A. placing the unresponsive patient in the Trendelenburg position. B. applying​ low-concentration oxygen by face mask. C. ventilating the patient who has inadequate breathing. D. placing the unresponsive patient in the prone position.

C. ventilating the patient who has inadequate breathing. Hypoxia is one of the most common causes of death associated with brain injury. If any patient displays ventilatory​ inadequacy, the EMT will need to immediately institute​ positive-pressure ventilations with oxygen. Remember that if the patient is breathing​ inadequately, supplemental oxygen is not enough.​ Positive-pressure ventilations must be initiated.​ Brain-injured patients should not be positioned prone or in Trendelenburg position.

With advances in​ clot-busting (thrombolytic)​ drugs, the patient has a window of​ ________ hours to receive treatment. A. 4 B. 6 C. 5 D. 3

D. 3

When assessing a patient for a possible​ stroke, which of the following three functions should be tested by the​ EMT? A. ​Memory, ability to​ speak, and ability to track movement with the eyes B. Ability to​ walk, control of facial​ muscles, and balance C. Ability to​ walk, ability to hold both arms in an extended position for 10​ seconds, and ability to name common objects D. Control of facial​ muscles, ability to​ speak, and ability to hold both arms in an extended position for 10 seconds

D. Control of facial​ muscles, ability to​ speak, and ability to hold both arms in an extended position for 10 seconds

Which of the following is LEAST important for the patient who has stopped seizing before the​ EMT's arrival at the​ scene? A. Suctioning B. Checking for mechanism of injury C. Administering oxygen D. Determining when the patient was last transported to the hospital for seizures

D. Determining when the patient was last transported to the hospital for seizures

If the blood sugar level is very​ high, which of the following may​ result? A. Polyuria and hyperactivity B. Excessive​ insulin, excessive​ glucose, and excessive urination C. ​Hyperactivity, excessive​ thirst, and polyuria D. Excessive​ urination, excessive​ thirst, and excessive hunger

D. Excessive​ urination, excessive​ thirst, and excessive hunger

Following a period of confusion and​ disorientation, your patient has weakness and loss of movement in his right arm and right leg. Which of the following is the MOST likely​ explanation? A. He is probably postictal from a seizure. B. He has likely suffered a stroke in both hemispheres. C. He is probably hypoglycemic. D. He has likely suffered a stroke in his left hemisphere.

D. He has likely suffered a stroke in his left hemisphere. Although there could be several​ causes, the most accurate explanation is that the patient has likely suffered a stroke in his left hemisphere. Although seizures and hypoglycemia can cause similar neurological​ symptoms, the most likely explanation is stroke.

A severe headache is more common with what kind of​ stroke? A. Occlusive B. Transient C. Ischemic D. Hemorrhagic

D. Hemorrhagic Severe headache is more common with hemorrhagic strokes and may be due to a ruptured blood vessel.

Which of the following is the role of glucose in the​ body? A. It is an essential building block for body​ tissues, such as muscle and bone. B. It assists the pancreas in the manufacture of insulin. C. It allows the body to use insulin. D. It provides energy for brain cells and other cells in the body.

D. It provides energy for brain cells and other cells in the body.

Compared to​ hypoglycemia, which of the following is true of​ hyperglycemia? A. Its onset is more sudden. B. Its onset is preceded by an​ aura, such as hallucinations or detecting unusual odors. C. It is more easily treated in the prehospital environment than hypoglycemia. D. Its onset is more gradual.

D. Its onset is more gradual.

Your patient is a​ 21-year-old female with a history of epilepsy. She is having a convulsion upon your arrival. Which of the following should you​ do? A. Place a tongue depressor or spoon in the back of the mouth to prevent the patient from swallowing her tongue. B. Insert a bite​ block, cloth,​ wallet, or similar item between the​ patient's teeth to prevent her from biting her tongue. C. Restrain the​ patient's extremities to prevent injury from flailing of the arms and legs.

D. Move furniture and other objects away from the patient to prevent injury.

Your patient is a​ 44-year-old male with a history of diabetes. He is lying on the living room​ floor, unresponsive to all stimuli. He has a respiratory rate of 12 breaths per​ minute, heart rate of 112 beats per​ minute, and is pale and sweaty. Which of the following should you do to treat this​ patient? A. Encourage the​ patient's family to administer his insulin. B. Apply oral glucose solution to a tongue depressor and insert it between the​ patient's cheek and gums. C. Place the patient in the recovery position to protect the airway and place oral glucose solution under the​ patient's tongue. D. Place the patient in the recovery​ position, administer​ oxygen, and monitor his airway status.

D. Place the patient in the recovery​ position, administer​ oxygen, and monitor his airway status.

Your patient is an unresponsive​ 30-year-old male wearing a​ Medic-Alert bracelet indicating that he is a diabetic. The​ patient's coworkers came by his house to check on him when he did not show up for work and did not call in sick. Your assessment does not clearly indicate to you whether the patient may be hypoglycemic or hyperglycemic. Which of the following should you do​ next? A. Administer oral​ glucose, as it will not cause additional harm in​ hyperglycemia, but may prevent brain damage if the patient is hypoglycemic. B. Use the​ patient's glucometer to check his blood sugar level. C. Use your glucometer to check his blood sugar before taking any further action. D. Protect the​ patient's airway, administer​ oxygen, and consider assessing the​ patient's blood glucose per local protocol.

D. Protect the​ patient's airway, administer​ oxygen, and consider assessing the​ patient's blood glucose per local protocol.

Most of the diabetic emergencies that you will be called to deal with will be related to hypoglycemia.​ However, occasionally you will experience an instance of hyperglycemia. In the list​ below, which item is NOT likely to be a sign or symptom of​ hyperglycemia? A. Nausea B. Excessive urination C. Chronic thirst D. Reduced rate of breathing

D. Reduced rate of breathing

The most common medical emergency for the diabetic is​ hypoglycemia, or low blood sugar. Which one of the factors below is NOT a cause of​ hypoglycemia? A. Vomits a meal B. Takes too much insulin C. Overexercises or overexerts himself D. Reduces sugar intake by eating too much

D. Reduces sugar intake by eating too much

After a period of syncope lasting 30​ seconds, your patient is now reporting a​ "fluttering" in his chest and generalized weakness. Which of the following is​ necessary? A. Having the patient sign a refusal and not transporting B. Administration of oral glucose C. Rapid transport to the hospital with lights and siren D. Requesting ALS to support the​ patient's care

D. Requesting ALS to support the​ patient's care Because the cause of the​ patient's symptoms may be​ cardiac, paramedics would be indicated to perform an ECG. Urgent transport is not​ indicated, given the current findings. Because there are no signs of​ hypoglycemia, oral glucose is not indicated.​ However, the patient should be transported and should not sign off.

Normal consciousness is regulated by a series of neurologic circuits in the brain that comprise the reticular activating system​ (RAS). The RAS has simple requirements to function properly. Which one of the following items is NOT one of those​ requirements? A. Water B. Glucose C. Oxygen D. Sodium

D. Sodium

Which of the following is the most critical piece of equipment to have immediately available for the seizure patient who has just stopped​ convulsing? A. Glucometer B. Bite block C. Cervical collar D. Suction

D. Suction

A​ 62-year-old male complains of weakness on one side of his body and slurred speech. After you arrive and evaluate the​ patient, you notice that the symptoms are beginning to subside. What is the likely cause of the​ patient's condition? A. Subdural hematoma B. Status epilepticus C. Acute coronary syndrome D. Transient ischemic attack

D. Transient ischemic attack When a patient has symptoms of a stroke and they begin to subside within the first​ day, this is referred to as a transient ischemic attack​ (TIA). Subdural hematomas can sometimes show periods of improvement but typically worsen quickly. Status epilepticus would be a prolonged seizure.

Which of the following would be an appropriate description of the reticular activating​ system? A. React and move center B. Feed or breed center C. Vegetative and thought center D. Wake and sleep center

D. Wake and sleep center The RAS is often referred to as the wake and sleep center or the​ on/off center because it determines whether the patient remains awake and aware of his or her surroundings or not. The RAS is continuously transmitting impulses about the​ patient's surroundings to the brain for constant stimulation and response.

Hyperglycemia is often due​ to: A. forgetting to eat. B. an insulin overdose. C. too much insulin. D. a lack of insulin.

D. a lack of insulin. Hyperglycemia is usually due to a lack of insulin. Without​ insulin, sugar cannot be transported out of the bloodstream to most cells.

A​ 45-year-old male presents agitated and confused. Your assessment identifies an oxygen saturation of​ 90%. You should​ next: A. administer oral glucose. B. conduct a Cincinnati Prehospital stroke examination. C. Restrain the patient for safety. D. administer oxygen.

D. administer oxygen. Oxygen therapy should be guided by the level of oxygen saturation in the blood ​(SpO2​ reading) and presenting signs and​ symptoms, not by a predetermined oxygen​ concentration, liter​ flow, or device. If the SpO2 is​ 94% or lower or the patient shows signs of respiratory​ distress, hypoxia,​ hypoxemia, or poor​ perfusion, administer oxygen via nasal cannula at 2 to 4 lpm to maintain an SpO2 reading of​ 94% or more.

DKA patients are prone​ to: A. hypertension. B. bradycardia. C. hypoglycemia. D. dehydration.

D. dehydration. DKA patients often have an increased urinary​ output, leading to dehydration.

Many stroke patients are candidates for thrombolytic drugs. One of the most important things that an EMT can do to optimize the care of a stroke patient who is a candidate for the drugs​ is: A. transport the patient to a Level I Trauma Center. B. do a thorough physical exam of the patient. C. transport to the closest hospital since the patient must go to the operating room as soon as possible. D. determine the exact time of onset of symptoms.

D. determine the exact time of onset of symptoms.

There are two types of​ seizures; if your patient is having a seizure that affects only one body part and does not cause her to lose​ consciousness, it is called​ a: A. ​tonic-clonic seizure. B. postictal seizure. C. generalized seizure. D. partial seizure.

D. partial seizure.

A patient is considered to be in status epilepticus​ if: A. a patient with a history of​ medication-controlled seizures experiences a generalized seizure. B. the patient has two or more seizures consecutively with a period of responsiveness between them. C. the patient remains unresponsive after the seizure. D. the patient suffers two seizures without regaining consciousness in between.

D. the patient suffers two seizures without regaining consciousness in between. A patient is considered to be in status epilepticus if he or she is seizing for over five minutes or having seizures that occur consecutively without a period of responsiveness between them.

Which of the following BEST describes the term​ "hemiparesis"? A. Bilateral paralysis B. Bilateral weakness C. ​One-sided paralysis D. ​One-sided weakness

D. ​One-sided weakness Hemiparesis is a term that used to describe​ one-sided weakness. Hemiparalysis would describe​ one-sided paralysis.

Which of the following statements is TRUE about paralysis caused by​ stroke? A. It is difficult to distinguish stroke from spinal​ injury, as both can cause paralysis to both legs. B. It is common for both sides of the body to be paralyzed from stroke. C. It is a good sign when patients experience only weakness in the​ extremities, as they will not deteriorate further. D. ​Typically, paralysis from strokes affects only one side of the body.

D. ​Typically, paralysis from strokes affects only one side of the body. Motor function and fine sensory interpretation are controlled by the side of the brain opposite from the side of the body it innervates.​ Thus, if a patient has had a stroke in the right hemisphere of the​ brain, there will likely be findings on the left side of the body.

During your primary assessment you find your patient has an altered mental status. What could this indicate?

Failing respiratory system

For the reticular activating system​ (RAS) to work​ correctly, what three substances are​ needed?

Oxygen to perfuse brain​ tissue, glucose to nourish brain​ tissue, and water to keep the brain hydrated

What is NOT a sign of a hypoglycemic diabetic​ emergency?

Slow heart rate

What does NOT correctly compare the signs and symptoms of hypoglycemia and​ hyperglycemia?

The hypoglycemic patient is usually complaining of a​ headache, whereas the hyperglycemic patient is not.

You have arrived on the scene of a call for a possible stroke. On your​ arrival, the patient denies signs and​ symptoms, is alert and​ oriented, and moves all extremities well. Her husband states that before you arrived the patient could not move her right arm and the left side of her face seemed to be​ "slack." Which of the following has most likely​ occurred?

The patient suffered a transient ischemic attack.

When someone is experiencing​ hypoglycemia, the body attempts to compensate by using the​ fight-or-flight mechanism of the autonomic nervous system. What is NOT one of the​ fight-or-flight responses?

The skin is hot and dry.

Your patient is waking up from a​ seizure; it was the​ patient's first seizure ever. When you ask what​ happened, the patient tells you she had the smell of fresh mown grass just before she seized. This sensation is known as​ a(n):

aura

As an​ EMT, you will be called on frequently to treat diabetic emergencies. Diabetic emergencies are usually caused​ by:

poor management of the​ patient's diabetes.


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