EMS Ch 17 JB

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

hypertension.

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: Select one: A. 7. B. 9. C. 8. D. 6.

8.

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

He is currently not prescribed any medications

Which of the following is a metabolic cause of a seizure? Select one: A. Brain tumor B. Poisoning C. Head trauma D. Massive stroke

Poisoning

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. The pain is worse when bending over D. There is associated neck stiffness

The pain is worse when bending over

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

are usually benign but should be evaluated.

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

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

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

cerebrum, cerebellum, and brain stem.

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

ensure a patent airway and support ventilation as needed.

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

foramen magnum.

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: Select one: A. assess the patient for a facial droop and hemiparesis. B. perform CPR for 5 minutes before applying the AED. C. obtain a blood glucose sample to rule out hypoglycemia. D. initiate CPR and attach an AED as soon as possible.

initiate CPR and attach an AED as soon as possible.

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

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: Select one: A. 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. 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. place a bite block in between her teeth, apply high-flow oxygen via a nonrebreathing mask, and consider inserting a nasopharyngeal airway. D. maintain her airway with manual head positioning, suction her airway to remove the vomitus, insert a nasopharyngeal airway, and administer high-flow oxygen.

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

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: Select one: A. place her in the recovery position and transport her with lights and siren. B. monitor her airway and breathing status and assess her blood glucose level. C. administer one tube of oral glucose and prepare for immediate transport. D. give her small cups of water to drink and observe for further seizure activity.

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

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

not thinking clearly or is incapable of being aroused.

When transporting a stable stroke patient with a paralyzed extremity, place the patient in a: Select one: A. recumbent position with the paralyzed side down. B. supine position with the legs elevated 6 feet to 12 feet. C. recumbent position with the paralyzed side up. D. sitting position with the head at a 45° to 90° angle.

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: Select one: A. repeat the arm drift test and ensure that her palms are facing downward. B. repeat the arm drift test, but move the patient's arms into position yourself. C. defer this part of the test and assess her for facial droop and slurred speech. D. instruct the patient to keep her eyes open and then repeat the arm drift test.

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

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: Select one: A. insert an oral airway, apply oxygen, and transport. B. suction her oropharynx and transport immediately. C. administer one tube of oral glucose and transport. D. assist her ventilations with a bag-valve mask.

suction her oropharynx and transport immediately.

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. when the patient last appeared normal. D. if the patient has been hospitalized before.

when the patient last appeared normal.

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

C. recovery position and transport.