Self Assessment 20

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:

a heart attack.

Which of the following MOST accurately describes a focal-onset aware seizure?

A seizure that begins in one extremity

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:

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

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?

440 mg/dL

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?

"When did you last see him normal?"

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

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, R 20, and temp 98.8. What should you do?

Administer oxygen via nonrebreathing mask.

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 immediately priority?

Asking his wife when she noticed the symptoms

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?

Deep and rapid breathing

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

Hypovolemia

A 52-year-old female is unresponsive and supine after a seizure. She has blood-tinged food particles and emesis in her mouth. What should you do?

Immediately position her on her side.

Before administering oral glucose gel, what instructions should you provide?

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?

Pulmonary embolism

A 72-year-old male presents with a sudden onset of slurred speech that began 4 hours ago. Vital signs are BP 180/102, P 68 and irregular, and R 16. What should you suspect?

Stroke

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?

Transport immediately.

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 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:

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

Insulin functions in the body by:

enabling glucose to enter the cells.

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.

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

A generalized (tonic-clonic) seizure is characterized by

severe twitching of all the body's muscles.