CH.13-19 HW QUESTION (exam 3 study)

You are summoned to a grocery store for an elderly female patient found having a "fit" by store employees. Upon arrival, you are escorted to the side of an alert but mildly confused 81-year-old woman who is diaphoretic and appears exhausted. After 2-3 more minutes, she becomes more alert and informs you that she has a history of seizures and just had a generalized seizure. Despite your urging, she refuses transport to the hospital because "that's where people go to die." Your safest action would be to:

Advise medical direction of the situation.

You have been called for a seizure emergency. On scene, you find an adult female patient actively seizing with bystanders attempting to restrain her. You should:

Instruct the bystanders to release the patient while you protect her head with your hands.

While you are providing free blood pressure readings at a community health fair, you are taking the blood pressure of a mother of two young twin boys. One of the boys tells you that his twin brother suffers from seizures and asks what he can do if he sees his brother convulsing. Your response would be:

"Move any movable objects and furniture away from him."

As a general rule, a postictal patient should be placed on the stretcher and transported in which position?

Lateral recumbent

After a lengthy response time in a rural community, you arrive at the home of a 62-year-old female patient who is still seizing. Of the listed options, your immediate action would be to:

Assess the patient's airway and breathing.

You find a patient, who seized for approximately 2 minutes, supine on the kitchen floor. He responds to painful stimuli and has snoring respirations. Emergency Medical Responders are providing spine motion restriction precautions, and they report the patient's heart rate is 124 beats/min and his pulse oximetry is 89% on room air. The patient has cool and clammy skin. What should you do first?

Perform a jaw-thrust maneuver

A postictal patient is awake and can communicate with you, but has trouble answering your questions correctly. Given this presentation, the Emergency Medical Technician would recognize that:

The airway is open.

You are preparing to transport a 46-year-old male patient who has had multiple seizures throughout the morning, according to the family. Currently, he is on your stretcher and is postictal. He has a history of seizures for which he takes anticonvulsant medications. He also has diabetes and kidney failure. Of the equipment listed here, which is the most essential to have ready during transport of this patient?

Suction device

When obtaining a medical history from the family of a patient experiencing seizure, which of these questions is most important for the Emergency Medical Technician to ask first (select best answer)?

"Does he take his seizure medications as prescribed?"

While you are placing a 52-year-old female patient, whose complaint is a headache, on the stretcher, she begins to seize. Your immediate action would be to:

Raise the side rails and do not apply the straps very tightly.

How would you transport a patient experiencing a seizure who is strongly suspected of having a cervical spine cord injury?

With spine motion restriction precautions applied and a cervical collar in place

You are called to a residence to assess a child. The panicked parents state that their 3-year-old son was playing with his brother when he suddenly "blanked out" and would not respond to them for several seconds. When asked, they deny any convulsing-type movement as well as a history of medical problems. Based on this description, you would be suspicious that the patient experienced which type of seizure?

Absence

When performing the secondary assessment on a confused patient who was reportedly unresponsive just prior to your arrival, which of these findings would be most suggestive of a seizure?

Bleeding tongue

When an Emergency Medical Technician performs the secondary assessment on a postictal patient with a known history of seizures, which of these assessment findings would be of most concern?

New contusion noted to the forehead

You are caring for a postictal male patient with a known history of seizures. He is confused and cannot remember his 8-year-old son's name. His son tearfully asks you if his father will ever remember him. Your response would be:

"Although he is confused now, he should remember your name in a little bit."

You have been called to a public bus station for a behavioral emergency. On scene, you find a disheveled male in his forties sitting up against a wall. He is confused and incontinent. Bystanders state that he was just sitting on a bench watching people walk by, when suddenly he got up and began to stumble around, shouting obscenities, and then fell to the ground with his whole body shaking. From this description, the Emergency Medical Technician should be suspicious of which condition?

Generalized seizure

As you approach a female patient, she appears unresponsive, with her arms and legs jerking violently. On the prehospital care report, you would document that the patient was found in which phase of a generalized seizure?

Clonic

A female patient with a history of seizures has experienced a seizure in a public area and is now refusing further assessment and transport. As you leave, a witness to the entire event tells you that he thinks the patient is "crazy in the head" because immediately before she seized, she looked up toward the ceiling and kept repeating, "Do you see the birds?" As a knowledgeable Emergency Medical Technician, you should recognize that the bystander is describing which condition?

An aura

Friends of a male patient who experienced a generalized seizure while at a picnic are worried because he cannot remember the seizure. You should inform them that this is:

A normal finding that is common among those who suffer this type of seizure.

The initial phase of a generalized seizure experienced by some patients, in which they may experience an odd smell or something auditory, is called the:

aura

Status epilepticus is best differentiated from a generalized seizure by the:

Duration of the seizure.

The Emergency Medical Technician shows that she understands the danger posed by status epilepticus when she states:

"The longer the seizure continues, the greater the opportunity for permanent brain damage."

Which of these patients is most at risk for problems to the airway and breathing?

A 23-year-old female with a history of seizures who has been seizing for 24 minutes

Which of these patients would be classified as having status epilepticus?

A 57-year-old female at a group home who seized during the entire evening movie that was shown in the common living room, according to other group home residents

You arrive on scene and find Emergency Medical Responders with a seizing patient. Which of these questions should you ask first?

"How long has the patient been seizing?"

A patient has been actively seizing for 17 minutes. He is cyanotic with shallow and ineffective respirations. Which immediate care should you provide to this patient?

Attempt to open the airway and begin positive pressure ventilation

While you are transporting a 41-year-old woman who is not feeling well, she begins to seize. She has no history of seizures, and the seizure lasts approximately 90 seconds. After 30 seconds of being postictal and totally unresponsive, the woman suddenly seizes again for the remainder of the 12-minute transport. The Emergency Medical Technician should recognize that the patient is experiencing which emergency condition?

Status epilepticus

While taking an Emergency Medical Technician class, you come across a test question that asks you to define the pathophysiology of a seizure. Which answer would you select?

"A seizure occurs when there is a massive and uncoordinated electrical discharge in the brain."

Which of these patients should be categorized as the highest priority for transport?

A pregnant female with no history of seizures who is seizing

Which of these statements about seizures is true?

Seizures may be caused by a variety of medical conditions.

Which type of seizure occurs in children and is caused by a high core temperature?

Febrile

Which of these statements made by a patient who experienced a syncopal episode should concern the Emergency Medical Technician most?

"My chest felt really funny right before I passed out."

A patient who experienced an apparent syncopal episode refuses transport to the hospital. Prior to the patient signing a refusal, which of these statements should you make to the patient?

"Syncope may indicate a serious underlying condition, so please follow up with a doctor."

You have been called for a 57-year-old female patient who has "passed out." As you enter the patient's apartment, you find her supine on the living room floor with a cool washcloth on her forehead. She states that she was standing and talking on the telephone when everything went dark. When she came to, she was on the floor. What should you do next?

Complete the primary assessment, and then obtain vital signs while the patient is supine

Which of these statements made by a patient would reinforce your suspicion of syncope?

"Once I hit the floor, I was out for only a few seconds."

A man comes into your station and tells you that he was just diagnosed by his physician as having multiple syncopal episodes the previous week. More specifically, he asks you to explain why he keeps fainting. Which of these statements would be your best response?

"For some reason, there was a temporary decrease in the flow of blood to your brain."

You are dispatched to a mall, where you are met by bystanders who state that the patient was talking to a customer representative when she "passed out." You find an alert and oriented 55-year-old female patient lying supine on the tile floor. The patient tells you that the back of her head is hurting, her neck now hurts, and her arms and legs feel very weak. Which action should you perform first?

Take manual cervical spine motion restriction

Which of these is the best explanation of why a patient who experiences a syncopal episode often regains consciousness after falling?

The supine position allows better perfusion to the brain.

You are an Emergency Medical Technician who finds an adult male patient on his living room floor after the police department had to force the door open. The scene size-up reveals a very cluttered home that smells of urine. On an end table, you find a container of phenytoin (Dilantin) with the patient's name on it. When you pinch his shoulder, the patient responds by moaning and trying to remove your hand from his neck. Based on this information, which of these conditions would you suspect?

Seizure

You are called to a residence for seizure activity. On scene, the patient's daughter tells you that her father, who has diabetes, stated that he suddenly felt dizzy and then fell to the floor. Within a few seconds, he began asking what had happened and why he was on the floor. Based on this description, the Emergency Medical Technician should recognize which condition?

Syncopal episode

Which sign or symptom would be most helpful in determining that a patient had a syncopal episode rather than a seizure?

There was no period of confusion after the event.

You have been called to an alcoholic rehabilitation center for a 56-year-old male patient whose left arm suddenly began to shake uncontrollably. He is alert and oriented, and he is terrified that he cannot stop his arm from moving. Which type of seizure should you suspect?

Simple partial

You are transporting a patient who has a history of simple partial seizures. During transport, she experiences a simple partial seizure involving her right arm. Her pulse is 92, respirations are 14 breaths/min and adequate, blood pressure is 168/88 mmHg, and SpO2is 98%. Your primary concern would be:

Progression to a generalized seizure.

Which of these statements about seizures is true?

Simple partial seizures do not cause an alteration in mental status.

An 86-year-old male patient has experienced a sudden change in mental status and is repeatedly striking a fist against his leg. When you question him, he doesnot respond. This presentation is most consistent with which condition?

Seizure

A 72-year-old male patient with a history of elevated thyroid function and a brain tumor is experiencing a psychomotor seizure. When you enter the room, he is standing up and walking in a circle. He is awake but does not respond to your questions. Family members state that he has had three similar episodes over the past six months, which his physician diagnosed as complex partial seizures. Vital signs are pulse, 112; respirations, 16 breaths/min; blood pressure, 166/68 mmHg; and SpO2, 98%. Which action would be most appropriate in the care of this patient?

Proceed with a nonemergency transport

Which of these medications is most closely associated with a history of seizures?

Depakote

A 20-year-old patient is unresponsive with snoring respirations. She is in a public restroom and has no family or friends with her. After addressing the airway, breathing, and circulation, you begin the secondary assessment. Which of these signs most likely indicates the patient experienced a seizure?

urinary incontinence

The Emergency Medical Technician would recognize that a 49-year-old male patient has experienced a primary seizure when his wife states:

"He had seizures in the past, but they are not sure what causes them."

A 36-year-old male patient with diabetes and hypertension has experienced a secondary seizure. The patient responds to verbal stimuli with garbled speech, and his airway, breathing, and circulation are intact. Vital signs are pulse, 128; respirations, 20 breaths/min and adequate; blood pressure, 158/96 mmHg; and SpO2, 97% on room air. At this time, it is important that the Emergency Medical Technician:

Check the patient's blood sugar with a glucometer.

When treating a patient who has had a seizure, the most important aspect of providing care is to:

Assess for and manage any life-threatening condition found.

Regarding a generalized tonic-clonic seizure, which of these statements is true regarding the different stages?

The aura comes before a loss of consciousness.

You believe that a patient experienced a simple partial seizure. Which of these statements made by the patient would reinforce this suspicion?

"My left arm would not stop shaking. I did not know what was happening."

The Emergency Medical Technician would recognize a simple partial seizure when she observes:

Jerky muscular activity of a single extremity.

A complex partial (psychomotor) seizure can easily be mistaken for:

Alcohol intoxication.

You have been called for a 71-year-old male patient with seizure activity. When you reach the patient's side, you find him lying motionless on the floor of his bedroom with a family member performing chest compression-only CPR. In this situation, your immediate action would be to:

Ask the provider to stop CPR and feel for a carotid pulse.

A young male patient with a seizure history is postictal in his bed. His airway is patent, breathing labored, and radial pulse strong and fast. Vital signs are pulse, 140; respirations, 20 breaths/min; blood pressure, 158/92 mmHg; and SpO2, 96% on room air. At this time, which action would be most appropriate?

Place the patient in a lateral recumbent position

You are on the scene of a patient who just experienced a seizure. The patient is still in the postictal phase and is not fully oriented. Family members state that he has a history of diverticulitis, gastric ulcers, and diabetes. Your partner asks you if you think he should obtain a blood glucose level. Your response should be:

"Yes, that is a good idea since he has a history of diabetes."

You have been asked to speak to a group of new mothers regarding the emergency treatment of a fever. During your presentation, one of the mothers asks you what the link is between a fever and seizures. Your best response would be:

"The higher the child's temperature, the greater the decrease in the seizure threshold becomes."

Select all the statements that apply to pediatric seizures (but no more than three).

A) The magnitude and peak of the fever is most likely the cause of a febrile seizure.

B) They are most common in children as young as 3 to 6 months.

C) Febrile seizures are considered to be secondary seizures.

An 86-year-old male has experienced a seizure and is now lethargic and confused. His family states that the patient has a history of seizures and was sleeping in bed when the seizure was witnessed by his wife. He remains in bed with an intact airway, adequate breathing, and a rapid radial pulse. You also note him to be incontinent of urine. Appropriate care of this patient would include:

Considering oxygen and transport with him positioned on his left side.

A. F.A.S.T

To better fulfill the AHA's Stroke Chain of Survival goals, which assessment mnemonic was developed to better prepare the public and Emergency Medical Services to recognize stroke?

A. F.A.S.T

B. S.T.R.O.K.E. C. AEIOU-TIPPSS

D. RACE

B. Paralysis or weakness of the throat muscles

Patients with an altered mental status due to a stroke may not be able to control their own airways because of:

A. Enlargement and swelling of the epiglottis

B. Paralysis or weakness of the throat muscles

C. Hypersensitivity of the gag reflex

D. Increased oral secretions

C. Insulin

What does the first "I" in the AEIOU-TIPPSS mnemonic stand for?

A. Ischemia

B. Infection

C. Insulin

D. Influenza

A. The patient has likely experienced a stroke.

When the Emergency Medical Technician evaluates a patient with the Rapid Arterial Occlusion Evaluation stroke scale, the score is 4 points. This score would infer:

A. The patient has likely experienced a stroke.

B. A stroke has likely not occurred if the corresponding Glasgow Coma Scale score is 12 points or higher.

C. The patient has not likely experienced a stroke.

D. The stroke scale was incorrectly performed, as the minimum score is at least 5 points.

B. "How old are you?"

The EMT shows that he is performing the Los Angeles Prehospital Stroke Screen (LAPSS) correctly when he asks which of these questions.

A. "Did you lose control of your bladder?"

B. "How old are you?"

C. "Do you know where you are right now?"

D. "May I assess your pupils?"

B. Recognizing the signs of a stroke

When assessing a patient with a possible stroke, what is the priority?

A. Determining a family history of stroke

B. Recognizing the signs of a stroke

C. Identifying risk factors for stroke

D. Determining the type of stroke

A. A 48-year-old male whose symptoms started while watching the 6:00 p.m. news, at which time he dialed 911

Which of these patients would be most eligible to receive a fibrinolytic medication for stroke if no other contraindications are found?

A. A 48-year-old male whose symptoms started while watching the 6:00 p.m. news, at which time he dialed 911

B. An 81-year-old male who awoke with stroke symptoms after an 8-hour sleep

C. A 62-year-old female whose stroke symptoms started at 8:00 a.m. and disappeared half an hour later

D. A 37-year-old female diagnosed in the emergency department with a hemorrhagic stroke 2 hours after its onset

D. Large-vessel occlusion stroke

During a continuing education program, the lecturer is talking about the Rapid Arterial Occlusion Evaluation (RACE) scale as a newer tool the Emergency Medical Technician can use to help determine whether a neurologic problem is present. Which neurologic problem does the RACE scale address?

A. Structural versus metabolic cause of unresponsiveness

B. Stroke stemming from a smaller blood vessel above the circle of Willis

C. Seizures that are due to an organic cause versus metabolic cause

D. Large-vessel occlusion stroke

B. 4.5 hours after the diagnosis of stroke is officially made

For the patient with stroke to be eligible for a fibrinolytic agent, the therapy must be given within:

A. 3 hours of EMS arrival at the scene

B. 4.5 hours after the diagnosis of stroke is officially made

C. 4 hours of the first signs and/or symptoms started

D. 3.5 hours of the onset of stroke symptoms

C. 4.5

For the patient with stroke to be eligible for a fibrinolytic agent, the patient must be brought to the hospital emergency department within how many hours of the onset of stroke symptoms?

A. 6.0

B. 3.0

C. 4.5

D. 2.5

C. Fever

You have been called to a local daycare facility for a sick child. At the scene, panicked daycare workers inform you that the 4-year-old child was lethargic all morning and wanted to sleep. After resting for several minutes, she began to "shake all over." This lasted for approximately 30 seconds. Your assessment reveals the patient to be responsive to painful stimuli and breathing adequately. Her airway is open and her radial pulse is strong and bounding. Her skin is hot and moist to the touch, with no signs of cyanosis. You are told that the patient has no medical history. En route to the hospital, the patient's mental status improves. Based on this presentation and information, you assume that the seizure occurred secondary to:

A. Hypoglycemia

B. Hypoxia

C. Fever

D. Altered mental status

A. "The pain seems to get worse as the day goes on."

Which of these statements made by a patient suggests that he is suffering from a tension headache?

A. "The pain seems to get worse as the day goes on."

B. "The light really seems to bother my eyes when I get these headaches."

C. "I get so nauseated with the pain."

D. "The pain starts at the top of my head and spreads down my back."

A. Oxygen at 2 lpm via nasal cannula

A male patient is confused for no apparent reason. There are no life threats to his airway, breathing, or circulation, and his vital signs are pulse, 88; respirations, 16 breaths/min and adequate; blood pressure, 144/68 mmHg; and SpO Subscript 2, 93% on room air. When addressing the patient's oxygenation status, which of these treatments would be appropriate?

A. Oxygen at 2 lpm via nasal cannula

B. Oxygen at 15 lpm via a nonrebreather mask

C. Positive pressure ventilation with room air

D. Oxygen at 6 lpm via nasal cannula

B. Left lateral recumbent position

A 73-year-old female patient is responsive to painful stimuli and cannot move her arm or leg on one side of her body. You suspect she is having a stroke. What is the best transport position for this patient?

A. Supine with head elevated 30 degrees

B. Left lateral recumbent position

C. Prone with left arm and leg flexed

D. Supine with left arm and leg flexed

C. "Close your eyes and hold your arms straight out for 10 seconds."

Which one of these instructions to a patient with possible stroke indicates proper assessment for an arm drift?

A. "Grab my fingers and squeeze with both hands as hard as you can for 5 seconds, and I mean squeeze hard."

B. "Raise your hands above your head and close your eyes while counting backward from 20."

C. "Close your eyes and hold your arms straight out for 10 seconds."

D. "Hold out your arms and count to 10 while keeping your eyes open."

D. Infection

An elderly male patient with a history of chronic obstructive pulmonary disease, hypertension, and diabetes presents as lethargic and confused. His airway is patent, and breathing is adequate. His skin is hot and his radial pulse is strong, regular, and bounding. Vital signs are pulse, 112; respirations, 20 breaths/min; blood pressure, 108/64 mmHg; SpO Subscript 2, 94%; and temperature, 102.8degreesF. Also noted is swelling and erythema to his right lower leg. Given these assessment findings, the Emergency Medical Technician should suspect which condition is responsible for the patient's altered presentation?

A. Tachycardia

B. Hypoxia

C. Peripheral edema

D. Infection

B. SpO Subscript 2 95% with 2 lpm O Subscript 2 via nasal cannula

On scene, a confused 68-year-old female patient with possible stroke has a SpO Subscript 2 of 91% on room air. Regarding oxygen therapy and the adjunct by which to provide it, which of these represents the most desirable target SpO Subscript 2 reading for the amount of oxygen delivered?

A. SpO Subscript 2 98% with 12 lpm O Subscript 2 via nonrebreather mask

B. SpO Subscript 2 95% with 2 lpm O Subscript 2 via nasal cannula

C. SpO Subscript 2 100% with 15 lpm O Subscript 2 via nonrebreather mask

D. SpO Subscript 2 100% with 6 lpm O Subscript 2 via nasal cannula

B. Paralysis

Which of these conditions would the EMT recognize as most likely indicating a neurologic deficit?

A. Hypoglycemia

B. Paralysis

C. Constricted pupils

D. Headache

D. "Have you ever had a seizure?"

Which of these questions would the EMT ask when performing the Los Angeles Prehospital Stroke Screen?

A. "Do you take blood thinners?"

B. "Do you smoke cigarettes?"

C. "Are your hand grips weak?"

D. "Have you ever had a seizure?"

C. Agents in the bloodstream bust apart the cerebral clot that is causing the signs and symptoms

What is the pathophysiology underlying a transient ischemic attack (TIA) and its typically rapid resolution?

A. Vasodilation of the cerebral blood vessel that was constricted tightly enough to stop blood flow

B. Blood flow from nearby vascular beds start to perfuse those regions cut off by the TIA mini-stroke

C. Agents in the bloodstream bust apart the cerebral clot that is causing the signs and symptoms

D. Neurons from the areas surrounding the TIA's origin start to assume the functions of the brain region affected by the TIA

B. Aphasia

A 49-year-old male patient is unable to speak. You would document this finding as:

A. Apnea

B. Aphasia

C. Dysplegia

D. Dysarthria

A. 15.0

You are determining the Pediatric Glasgow Coma Scale (GCS) score for a 28-month-old female who was stung by a bee while playing in the backyard, the mother is unsure if she is allergic to stings. You note that the patient is alert. When asked, she tells you that she was stung on the bottom of her foot as she raises it up to show you. At this point in time her GCS score would be:

A. 15.0

B. 19.0

C. 14.0

D. 10.0

D. Providing a darkened environment during transport

A 30-year-old patient with a history of headaches has called 911 for a suspected migraine headache. She says the headache follows her usual pattern of headaches, the pain is a 10/10, and she is nauseated. Her vital signs are pulse, 108; respirations, 18 breaths/min; and blood pressure, 154/90 mmHg. Which of these treatments is indicated in the care of this patient?

A. 81 to 162 mg aspirin by mouth

B. Requesting orders for sublingual nitroglycerin

C. Emergent transport with lights and sirens

D. Providing a darkened environment during transport

C. "He has bad kidneys."

Assessment of a 56-year-old male patient reveals him to be responsive to verbal stimuli with garbled speech. Which of these statements made by the patient's wife suggests that the patient's problem may be toxic-metabolic?

A. "He had a stroke two years ago."

B. "He was diagnosed last year with Alzheimer disease."

C. "He has bad kidneys."

D. "He fell and hit his head yesterday."

A. "Oxygen should be administered at a minimal amount, just enough to get the SpO Subscript 2 at or greater than 94%."

Which of these statements indicates that the EMT understands the appropriate use of supplemental oxygen when caring for a patient with stroke?

A. "Oxygen should be administered at a minimal amount, just enough to get the SpO Subscript 2 at or greater than 94%."

B. "In the short time that we provide care to a patient with stroke, the benefits of high-concentration oxygen outweigh the risks."

C. "If positive pressure ventilation is required, it should be given with room air and not supplemental oxygen."

D. "Since stroke decreases oxygen delivery to the brain, high-concentration oxygen should always be geared toward achieving an SpO Subscript 2 as near to 100% as possible."

B. Right side of the brain

A patient with stroke cannot move his left arm or leg. Based on this presentation, the EMT should strongly suspect that the stroke has occurred in which part of the central nervous system.

A. Left side of the spinal cord

B. Right side of the brain

C. Right and left sides of the brain

D. Left side of the brain

B. "We noticed him acting oddly about 7:00 p.m."

You are treating an unresponsive patient. Which piece of information given to you by the patient's family is most important in relation to a possible stroke?

A. "He forgot to take his blood thinner last night."

B. "We noticed him acting oddly about 7:00 p.m."

C. "We think that he had too much to drink last night."

D. "He took some ibuprofen last night for a fever and cough."

D. Check the patient's blood glucose level (if local protocol allows)

You have determined that an alert elderly male patient has garbled speech and weakness to the right arm and leg. His vital signs and SpO Subscript 2 level are within normal limits. The family informs you that he has a history of heart problems and diabetes. Given this scenario, what should you do immediately?

A. Administer oxygen via a nasal cannula at 2 lpm

B. Attach the automated external defibrillator (AED)

C. Administer oral glucose or sugar water

D. Check the patient's blood glucose level (if local protocol allows)

A. Facial droop

With the Cincinnati Prehospital Stroke Scale, which of these patient parameters is assessed?

A. Facial droop

B. Blood glucose level

C. Age of the patient

D. Time of symptom onset

D. "What time did these signs start?"

An 82-year-old male patient presents with right-hand weakness and garbled speech. Which question should the EMT ask first to the patient or a reliable family member who is present?

A. "Does he take any blood thinners?"

B. "Is he allergic to anything?"

C. "Does he have a history of high blood pressure?"

D. "What time did these signs start?"

A. Start positive pressure ventilation

You have been called to a long-term care facility for a 77-year-old female patient who was found unresponsive in her wheelchair by staff. The nurse reports that the patient complained of a headache earlier in the day and was given 600 mg of Motrin. Your assessment shows the patient to be unresponsive with a patent airway, slow and irregular respirations, and a weak radial pulse. Her lips are cyanotic, and your partner reports these vital signs: pulse, 44; respirations, 6 breaths/min; and blood pressure, 228/116 mmHg. Which action should be your next priority?

A. Start positive pressure ventilation

B. Perform a prehospital stroke screen

C. Attach the pulse oximeter to get a SpO Subscript 2 reading

D. Check the patient's blood glucose level

B. Rapid transport to a stroke center

A 56-year-old patient is in bed and unable to speak. Family members state that he had a stroke in the past and has been bedridden since then, but has always been able to talk, until a few hours ago when his speech became garbled. They also state that the last stroke left him paralyzed on his left side. Your assessment reveals that the patient is unable to speak, but has an open airway, adequate respirations, and a strong radial pulse. Additionally, you note that he is unable to move his right arm. Vital signs are within normal limits. What would be an appropriate step in the care on this patient?

A. Suction the mouth and then place an NPA

B. Rapid transport to a stroke center

C. Administer positive pressure ventilation

D. Insert an oropharyngeal airway

B. Ask the patient to repeat a specific but common phrase

When using a stroke scale to assess a patient for abnormal speech, the EMT should:

A. Write questions on note cards for the patient to read

B. Ask the patient to repeat a specific but common phrase

C. Question family members about the patient's ability to talk

D. Observe verbal ability during assessment

D. Obstructive blood clot inside a blood vessel within the brain

Which of these is a good description of an ischemic stroke?

A. Blood accumulation within the brain tissue

B. Rupture of an artery within the brain

C. Simultaneous occurrence of stroke and heart attack

D. Obstructive blood clot inside a blood vessel within the brain

D. Had a medical episode that concerned their caregiver

BRUE evaluations are typically performed on infants who:

A. Have congenital carotid circulatory problems

B. Are at risk for unresolved events

C. Had an event that the EMT is unable to resolve

D. Had a medical episode that concerned their caregiver

D. Highly suggestive that a stroke may be occurring

Assessment of a 63-year-old female patient reveals a patent airway, adequate breathing, and strong radial pulse. She has no difficulty speaking and no facial droop, but exhibits a slight left arm drift and has a headache. The EMT should interpret these specific findings as:

A. Minimally suggestive that a stroke may be occurring

B. Not suggestive of a stroke

C. Moderately suggestive that a stroke may be occurring

D. Highly suggestive that a stroke may be occurring

B. Stroke typically results in weakness or paralysis to one side of the body.

When attempting to distinguish a spinal injury from a stroke, the EMT should remember that:

A. Stroke does not cause paralysis, while spinal injuries typically do.

B. Stroke typically results in weakness or paralysis to one side of the body.

C. Stroke usually causes weakness to all extremities; spinal injuries do not.

D. Spinal injuries often result in weakness to one side of the body.

B. "If one arm is weak, a stroke should be suspected."

Which of these statements made by your new EMT partner demonstrates an understanding of assessment findings related to stroke?

A. "For a stroke to be suspected, both arms must be equally weak."

B. "If one arm is weak, a stroke should be suspected."

C. "If one arm is weak, stroke should be suspected only if the blood pressure is also elevated."

D. "A stroke should be suspected only when one arm is paralyzed, not weak."

C. The pain was preceded by an aura

A 41-year-old female patient has called 911 for a headache. Which of these assessment findings should make the EMT suspicious that the patient has a migraine headache?

A. Bright light increases the patient's discomfort

B. Her blood pressure is 192/124 mmHg

C. The pain was preceded by an aura

D. She rates the pain as an 8/10