Lesson 20 In-Class Quiz & Self-Assessment

A 50-year-old man with diabetes has an altered mental status and is unable to tell you when he last ate or took his insulin. Your glucometer keeps malfunctioning, and you are unable to determine his blood glucose level. Which of the following clinical signs would MOST likely lead you to the correct diagnosis? Select one: A. Deep and rapid breathing B. Rapid and weak pulse C. Restlessness and irritability D. Hypotension and tachycardia

A. Deep and rapid breathing

Before administering oral glucose gel, what instructions should you provide? Select one: A. Let it dissolve in your mouth. B. Swallow it immediately. C. Hold it under your tongue. D. Take a sip of water.

A. Let it dissolve in your mouth.

A 66-year-old woman experienced a sudden onset of difficulty breathing. She has a history of type 2 diabetes and deep vein thrombosis (DVT). On the basis of her medical history, which of the following should the EMT suspect? Select one: A. Pulmonary embolism B. Severe hypoglycemia C. Congestive heart failure D. Diabetic ketoacidosis

A. Pulmonary embolism

A 72-year-old male presents with a sudden onset of slurred speech that began 4hours ago. Vital signs are BP 180/102, P 68 and irregular, and R 16. What should you suspect? Select one: A. Stroke B. Hypoglycemia C. Postictal state D. Ketoacidosis

A. Stroke

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

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

A generalized (tonic-clonic) seizure is characterized by: Select one: A. severe twitching of all the body's muscles. B. a core body temperature of greater than 103°F (40°C). C. a blank stare and brief lapse of consciousness. D. unconsciousness for greater than 30 minutes.

A. 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: Select one: A. 13 B. 12 C. 14 D. 15

B. 12

A 64-year-old female has weakness in her right arm and leg. You note a facial droop. Vital signs are BP 160/100, P 62 and irregular, R 16, and SpO2 95%. What should you do? Select one: A. Position her in the lateral recumbent position. B. Transport immediately. C. Administer oxygen. D. Call for an ALS intercept.

B. Transport immediately.

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

B. recovery position and transport.

A 60-year-old male is unable to move his left arm and leg. He has expressive aphasia and facial droop. Which question is the most important to ask the patient's family? Select one: A. "Has he ever had a stroke or heart attack?" B. "Does he have a history of high blood pressure?" C. "When did you last see him normal?" D. "Did he lose consciousness before you arrived?"

C. "When did you last see him normal?"

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

C. A seizure that begins in one extremity

A 58-year-old male presents with confusion, right-sided weakness, and slurred speech. His airway is patent, and his breathing is adequate. His wife is present and is very upset. Which of the following has the MOST immediate priority? Select one: A. Administering glucose to rule out hypoglycemia B. Obtaining a complete set of baseline vital signs C. Asking his wife when she noticed the symptoms D. Documenting all of his current medications

C. Asking his wife when she noticed the symptoms

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

C. Hypovolemia

A 52-year-old female is unresponsive and supine seizure. She has blood-tinged food particles and emesis in her mouth. What should you do? Select one: A. Suction her airway with a rigid catheter. B. Administer oxygen via nonrebreathing mask. C. Immediately position her on her side. D. Insert a nasopharyngeal airway.

C. Immediately position her on her side.

A 75-year-old male with type 1 diabetes presents with chest pain and a general feeling of weakness. He tells you that he took his insulin today and ate a regular meal approximately 2 hours ago. You should treat this patient as though he is experiencing: Select one: A. an acute stroke. B. hyperglycemia. C. a heart attack. D. hypoglycemia

C. a heart attack.

Insulin functions in the body by: Select one: A. metabolizing glucose to make energy. B. producing new glucose as needed. C. enabling glucose to enter the cells. D. increasing circulating blood glucose.

C. enabling glucose to enter the cells.

A 42-year-old male is found unresponsive on his couch by a neighbor. During your assessment, you find no signs of trauma, and the patient's blood glucose level is 75 mg/dL. His blood pressure is 168/98 mm Hg, his heart rate is 45 beats/min and bounding, and his respirations are 8 breaths/min and irregular. The patient is wearing a medical alert bracelet that states he has hemophilia. You should: Select one: A. administer high-flow oxygen, perform a detailed secondary assessment at the scene, and transport promptly. B. suspect that he has internal bleeding and is in shock, administer high-flow oxygen, and transport at once. C. suspect that he has intracranial bleeding, assist his ventilations, and transport rapidly to an appropriate hospital. D. administer oxygen via a nonrebreathing mask, apply oral glucose in between his cheek and gum, and transport.

C. suspect that he has intracranial bleeding, assist his ventilations, and transport rapidly to an appropriate hospital.

A 32-year-old female complains of abdominal pain, weakness, and vomiting. She lost her only bottle of insulin yesterday. What blood glucose level are you most likely to obtain? Select one: A. 50mg/dL B. 80mg/dL C. 160 mg/dL. D. 440 mg/dL

D. 440 mg/dL

An 18-year-old male with a history of sickle cell disease complains of abdominal pain. It started 3 hours ago while playing soccer. Vital signs are BP 104/72, P 102, R20, and temp 98.8. What should you do? Select one: A. Provide treatment for shock. B. Advise him to go home, rest, and drink fluids. C. Initiate active cooling measures. D. Administer oxygen via nonrebreathing mask.

D. Administer oxygen via nonrebreathing mask.

A 29-vear-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 seems 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: Select one: 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. placing him in a supine position and transporting with lights and siren to a stroke center. D. dimming the lights in the back of the ambulance and transporting without lights and siren.

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