EMT Block 3 exam

Status epilepticus is characterized by:

A. profound tachycardia and total muscle flaccidity.

B. prolonged seizures without a return of consciousness.

C. generalized seizures that last less than 5 minutes.

D. an absence seizure that is not preceded by an aura.

B. prolonged seizures without a return of consciousness

An area of swelling or enlargement in a weakened arterial wall is called:

A. atherosclerosis.

B. a thrombus.

C. an aneurysm.

D. an embolism.

C. an aneurysm

The spinal cord exits the cranium through the:

A. cauda equina.

B. foramen lamina.

C. vertebral foramen.

D. foramen magnum.

D. foramen magnum

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?

A. Asking his wife when she noticed the symptoms

B. Administering glucose to rule out hypoglycemia

C. Obtaining a complete set of baseline vital signs

D. Documenting all of his current medications

A. asking the wife when she noticed the symptoms

Components of the Cincinnati Prehospital Stroke Scale include:

A. arm drift, speech, and facial droop.

B. arm drift, memory, and grip strength.

C. speech, pupil reaction, and memory.

D. facial droop, speech, and pupil size.

A. arm drift, speech, and facial droop

A generalized (tonic-clonic) seizure is characterized by:

A. a core body temperature of greater than 103°F (40°C).

B. severe twitching of all the body's muscles.

C. unconsciousness for greater than 30 minutes.

D. a blank stare and brief lapse of consciousness

B. severe twitching of all the body's muscles

The mental status of a patient who has experienced a generalized seizure:

A. is easily differentiated from that of acute hypoglycemia.

B. progressively worsens over a period of a few hours.

C. typically does not improve, even after several minutes.

D. is likely to improve over a period of 5 to 30 minutes.

D. is likely to improve over a period of 5 to 30 minutes

Muscle control and body coordination are controlled by the:

A. cerebrum.

B. cerebral cortex.

C. brain stem.

D. cerebellum.

D. cerebellum

When you are obtaining medical history from the family of a suspected stroke patient, it is MOST important to determine:

A. if the patient has been hospitalized before.

B. if there is a family history of a stroke.

C. the patient's overall medication compliance.

D. when the patient last appeared normal.

D. when the patient last appeared normal

Which of the following medications would indicate that a patient has a history of seizures?

A. Hydromorphone (Dilaudid)

B. Levetiracetam (Keppra)

C. Enalapril (Vasotec)

D. Metformin (Glucophage)

B. Levetiracetam (Keppra)

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

A. Hypovolemia

B. Intracranial bleeding

C. A postictal state

D. Hypoglycemia

A. Hypovolemia

A patient whose speech is slurred and difficult to understand is experiencing:

A. dysarthria.

B. aphasia.

C. dysphasia.

D. dysphagia.

A. dysarthria

The MOST significant risk factor for a hemorrhagic stroke is:

A. diabetes mellitus.

B. hypertension.

C. heavy exertion.

D. severe stress.

B. hypertension

Which of the following is a metabolic cause of a seizure?

A. Massive stroke

B. Poisoning

C. Head trauma

D. Brain tumor

B. Poisoning

A patient who is experiencing aphasia is:

A. not able to swallow without choking.

B. experiencing a right hemispheric stroke.

C. unable to produce or understand speech.

D. usually conscious but has slurred speech.

C. unable to produce or understand speech

You are assessing a 49-year-old man who, according to his wife, experienced a sudden, severe headache and then passed out. He is unresponsive and has slow, irregular breathing. His blood pressure is 190/94 mm Hg, and his pulse rate is 50 beats/min. His wife tells you that he has hypertension and diabetes. He has MOST likely experienced:

A. a ruptured cerebral artery.

B. acute hypoglycemia.

C. an occluded cerebral artery.

D. a complex partial seizure.

A. a ruptured cerebral artery

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:

A. administer one tube of oral glucose and transport.

B. assist her ventilations with a bag-valve mask.

C. insert an oral airway, apply oxygen, and transport.

D. suction her oropharynx and transport immediately.

D. suction her oropharynx and 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:

A. applying warm compresses to the back of his neck and transporting with lights and siren.

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

C. placing him in a supine position and transporting with lights and siren to a stroke center.

D. assisting him with his migraine medication and transporting without lights and siren.

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

The frontal lobe of the brain controls:

A. touch.

B. vision.

C. movement.

D. emotion.

D. emotion

A transient ischemic attack (TIA) occurs when:

A. a small cerebral artery ruptures and causes minimal damage.

B. a small clot in a cerebral artery causes temporary symptoms.

C. medications are given to dissolve a cerebral blood clot.

D. signs and symptoms resolve spontaneously within 48 hours.

B. a small clot in a cerebral artery causes temporary symptoms

Which of the following patients would MOST likely demonstrate typical signs of infection, such as a fever?

A. A 17-year-old male with anxiety

B. A 3-month-old female who was born prematurely

C. An 88-year-old male with chronic renal problems

D. A 35-year-old female in the later stages of AIDS

A. A 17 year old male with anxiety

The left cerebral hemisphere controls:

A. breathing and blood pressure.

B. the right side of the body.

C. the right side of the face.

D. heart rate and pupil reaction.

B. the right side of the body

During the primary assessment of a semiconscious 70-year-old female, you should:

A. ask family members if the patient has a history of stroke.

B. insert a nasopharyngeal airway and assist ventilations.

C. ensure a patent airway and support ventilation as needed.

D. immediately determine the patient's blood glucose level.

C. ensure a patent airway and support ventilation as needed

Successful treatment of a stroke depends on whether:

A. the stroke occurs within the left or right hemisphere of the brain.

B. surgical intervention is performed to remove obstructive clots.

C. medications are given to restore the function of infarcted cells.

D. thrombolytic therapy is given within 3 hours of symptoms beginning.

D. thrombolytic therapy is given within 3 hours of symptoms beginning

Interruption of cerebral blood flow may result from all of the following, EXCEPT:

A. cerebral vasodilation.

B. an embolism.

C. a thrombus.

D. an acute arterial rupture.

A. cerebral vasodilation

When caring for a patient with documented hypoglycemia, you should be MOST alert for:

A. a seizure.

B. a febrile convulsion.

C. respiratory distress.

D. an acute stroke.

A. a seizure

Which of the following is characteristic of a focal-onset aware seizure?

A. Absence of breathing

B. Generalized twitching of all muscles

C. Normal level of consciousness

D. No change in vision, smell, or taste

C. normal level of consciousness

The most basic functions of the body, such as breathing, blood pressure, and swallowing, are controlled by the:

A. brain stem.

B. cerebrum.

C. cerebellum.

D. cerebral cortex.

A. brain stem

Which of the following conditions would MOST likely affect the entire brain?

A. Reduced blood supply to the left hemisphere

B. Ruptured cerebral artery in the occipital lobe

C. Blocked cerebral artery in the frontal lobe

D. Respiratory failure or cardiopulmonary arrest

D. respiratory failure or cardiopulmonary arrest

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:

A. high-flow oxygen and transport.

B. ventilatory assistance and transport.

C. recovery position and transport.

D. oral glucose gel and transport.

C. recovery position and transport

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

A. A seizure that causes the patient to stare blankly

B. A seizure that is not preceded by an aura

C. A generalized seizure without incontinence

D. A seizure that begins in one extremity

D. a seizure that begins in one extremity

Febrile seizures:

A. are usually benign but should be evaluated.

B. occur when a child's fever rises slowly.

C. are also referred to as absence seizures.

D. often result in permanent brain damage.

A. are usually benign but should be evaluated

You arrive at a grocery store shortly after a 35-year-old male stopped seizing. Your assessment reveals that he is confused and incontinent of urine. The patient's girlfriend tells you that he has a history of seizures and takes topiramate (Topamax). When obtaining further medical history from the girlfriend, it is MOST important to:

A. obtain a description of how the seizure developed.

B. ask her how long the patient has been taking his medication.

C. determine when he was last seen by his physician.

D. determine if the patient is a known alcohol abuser.

A. obtain a description of how the seizure developed

When assessing for arm drift of a patient with a suspected stroke, you should:

A. expect to see one arm slowly drift down to the patient's side.

B. observe movement of the arms for approximately 2 minutes.

C. ask the patient to hold his or her arms up with the palms down.

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

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

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?

A. His Glasgow Coma Scale (GCS) score is 15.

B. His wife states that this was his "usual" seizure.

C. He has experienced seizures since he was 20.

D. He is currently not prescribed any medications.

D. he is currently not prescribed any medications

A 40-year-old patient without a history of seizures experiences a generalized (tonic-clonic) seizure. The LEAST likely cause of this seizure is:

A. a serious infection.

B. epilepsy.

C. a brain tumor.

D. intracranial bleeding.

B. epilepsy

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:

A. 15

B. 14

C. 12

D. 13

C. 12

Law enforcement has summoned you to a nightclub, where a 22-year-old female was found unconscious in an adjacent alley. Your primary assessment reveals that her respirations are rapid and shallow and her pulse is rapid and weak. She is wearing a medical alert bracelet that identifies her as an epileptic. There is an empty bottle of vodka next to the patient. You should:

A. place a bite block in her mouth in case she has a seizure and transport at once.

B. apply oxygen via a nonrebreathing mask, place her on her left side, and transport.

C. assist ventilations, perform a rapid exam, and prepare for immediate transport.

D. apply oxygen via nonrebreathing mask and transport her for a blood-alcohol test.

C. assist ventilations, perform a rapid exam, and prepare for immediate transport

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:

A. place a bite block in between her teeth, apply high-flow oxygen via a nonrebreathing mask, and consider inserting a nasopharyngeal airway.

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. 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.

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

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

The principal clinical difference between a stroke and hypoglycemia is that patients with hypoglycemia:

A. usually have an altered mental status or decreased level of consciousness.

B. do not present with slurred speech or weakness to one side of the body.

C. always take oral medications to maintain normal blood glucose levels.

D. are typically alert and attempt to communicate with health care providers.

A. usually have an altered mental status or decreased level of consciousness