Question 1

A male patient has altered mental status secondary from a brain tumor. The EMT would classify the brain tumor as what type of cause?

Accepted Answer

A)  Central 
B)  Structural 
C)  Metabolic 
D)  Internal 
A)  Central 
B)  Structural 
C)  Metabolic 
D)  Internal B

Question 2

An alert and oriented 69-year-old male has slight right-arm weakness but exhibits no deficits to the right leg. The EMT should consider the patient a:

Accepted Answer

A)  non-priority transport since no paralysis exists. 
B)  priority only if the patient also has a low blood glucose level. 
C)  non-priority since he is alert and oriented. 
D)  priority for transport to a hospital with a stroke center. 
A)  non-priority transport since no paralysis exists. 
B)  priority only if the patient also has a low blood glucose level. 
C)  non-priority since he is alert and oriented. 
D)  priority for transport to a hospital with a stroke center. D

Question 3

On scene, a confused 68-year-old female with possible stroke has an SpO₂ of 91% on room air. Which one of the following indicates the most appropriate and beneficial type of oxygen therapy for this patient?

Accepted Answer

A)  SpO₂ 98% with 12 lpm O₂ via nonrebreather 
B)  SpO₂ 95% with 2 lpm O₂ via nasal cannula 
C)  SpO₂ 100% with 15 lpm O₂ via nonrebreather 
D)  SpO₂ 97% with 4 lpm O₂ via nasal cannula 
A)  SpO₂ 98% with 12 lpm O₂ via nonrebreather 
B)  SpO₂ 95% with 2 lpm O₂ via nasal cannula 
C)  SpO₂ 100% with 15 lpm O₂ via nonrebreather 
D)  SpO₂ 97% with 4 lpm O₂ via nasal cannula B

Question 4

When assessing a patient with a suspected stroke, the order of the exam would be:

Accepted Answer

A)  primary assessment, facial droop, arm drift. 
B)  level of consciousness, facial droop, arm drift, airway. 
C)  abnormal speech, facial droop, arm drift, primary assessment. 
D)  secondary assessment, primary assessment, stroke exam. 
A)  primary assessment, facial droop, arm drift. 
B)  level of consciousness, facial droop, arm drift, airway. 
C)  abnormal speech, facial droop, arm drift, primary assessment. 
D)  secondary assessment, primary assessment, stroke exam.

Question 5

For altered mental status to occur, what body system must be affected?

Accepted Answer

A)  Cardiovascular 
B)  Respiratory 
C)  Central nervous 
D)  Endocrine 
A)  Cardiovascular 
B)  Respiratory 
C)  Central nervous 
D)  Endocrine

Question 6

You have been called to a long-term care facility for a 77-year-old female 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 her to be unresponsive with a patent airway, slow and irregular respirations, and a weak radial pulse. Her lips are cyanotic and your partner reports the following vital signs: pulse 44, respirations 6, and blood pressure 228/116 mmHg. Which one of the following should you do next?

Accepted Answer

A)  Start positive pressure ventilation. 
B)  Check the patient's blood glucose level. 
C)  Attach the pulse oximeter to get an SpO₂ reading. 
D)  Perform either a Cincinnati or Los Angeles Prehospital Stroke Screen. 
A)  Start positive pressure ventilation. 
B)  Check the patient's blood glucose level. 
C)  Attach the pulse oximeter to get an SpO₂ reading. 
D)  Perform either a Cincinnati or Los Angeles Prehospital Stroke Screen.

Question 7

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

Accepted Answer

A)  81 mg aspirin by mouth 
B)  Providing a darkened environment 
C)  Emergent transport 
D)  Requesting orders for sublingual nitroglycerin 
A)  81 mg aspirin by mouth 
B)  Providing a darkened environment 
C)  Emergent transport 
D)  Requesting orders for sublingual nitroglycerin

Question 8

Your patient is a 78-year-old male who was found lying on his bathroom floor. Emergency Medical Responders report that the patient is unresponsive with unequal pupils, and vital signs are as follows: pulse 78, respirations 20 and snoring, blood pressure 210/106, SpO₂ at 99%. The EMRs have applied oxygen by nonrebreather, and also report that the patient has a hematoma on the back of his head. Which one of the following should you do first?

Accepted Answer

A)  Replace the nonrebreather with a nasal cannula. 
B)  Quickly apply a cervical collar. 
C)  Ensure an open airway with a jaw-thrust maneuver. 
D)  Lift the patient onto the stretcher for transport. 
A)  Replace the nonrebreather with a nasal cannula. 
B)  Quickly apply a cervical collar. 
C)  Ensure an open airway with a jaw-thrust maneuver. 
D)  Lift the patient onto the stretcher for transport.

Question 9

What condition places the patient at greatest risk for an acute neurological deficit?

Accepted Answer

A)  Acute myocardial infarction (AMI) 
B)  Transient ischemic attack (TI
A)  
C)  Chronic obstructive pulmonary disease (COP
D)  
D)  New onset of Type II diabetes 
A)  Acute myocardial infarction (AMI) 
B)  Transient ischemic attack (TI
A)  
C)  Chronic obstructive pulmonary disease (COP
D)  
D)  New onset of Type II diabetes

Question 10

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

Accepted Answer

A)  Supine with head elevated 30 degrees 
B)  Left lateral recumbent position 
C)  Supine with left arm and leg flexed 
D)  Prone with left arm and leg flexed 
A)  Supine with head elevated 30 degrees 
B)  Left lateral recumbent position 
C)  Supine with left arm and leg flexed 
D)  Prone with left arm and leg flexed

Question 11

A 41-year-old female has called 911 for a headache. What assessment finding should make the EMT suspicious that the patient is suffering from a vascular headache?

Accepted Answer

A)  Bright light increases the patient's discomfort. 
B)  The patient has pain throughout her entire head. 
C)  Her blood pressure is 192/124 mmHg. 
D)  She rates the pain as an 8/10. 
A)  Bright light increases the patient's discomfort. 
B)  The patient has pain throughout her entire head. 
C)  Her blood pressure is 192/124 mmHg. 
D)  She rates the pain as an 8/10.

Question 12

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

Accepted Answer

A)  "The pain starts at the top of my head and spreads down my back." 
B)  "I get so nauseated with the pain." 
C)  "The light really seems to bother my eyes when I get these headaches." 
D)  "The pain seems to get worse as the day goes on." 
A)  "The pain starts at the top of my head and spreads down my back." 
B)  "I get so nauseated with the pain." 
C)  "The light really seems to bother my eyes when I get these headaches." 
D)  "The pain seems to get worse as the day goes on."

Question 13

A male patient suddenly found himself unable to talk and with profound weakness to his right arm and leg. Currently he is responsive to verbal stimuli and has the following vital signs: pulse 88, respirations 14 and adequate, and blood pressure 210/80. When transporting this patient to the hospital, what position should you place him?

Accepted Answer

A)  Immobilized to a long board 
B)  Left lateral recumbent 
C)  Prone with head elevated 
D)  Supine with feet elevated 
A)  Immobilized to a long board 
B)  Left lateral recumbent 
C)  Prone with head elevated 
D)  Supine with feet elevated

Question 14

When assessing a patient for a facial droop, the EMT should:

Accepted Answer

A)  palpate the face one side at a time. 
B)  gently lift and then let go of the skin over the cheeks. 
C)  ask the patient to show you his teeth or smile. 
D)  observe the patient's ability to turn his head to the right and then to the left. 
A)  palpate the face one side at a time. 
B)  gently lift and then let go of the skin over the cheeks. 
C)  ask the patient to show you his teeth or smile. 
D)  observe the patient's ability to turn his head to the right and then to the left.

Question 15

A 82-year-old male presents with right-hand weakness and garbled speech. Which of the following questions should the EMT ask first?

Accepted Answer

A)  "Is he allergic to anything?" 
B)  "Does he take any blood thinners?" 
C)  "Does he have a history of high blood pressure?" 
D)  "What time did these signs start?" 
A)  "Is he allergic to anything?" 
B)  "Does he take any blood thinners?" 
C)  "Does he have a history of high blood pressure?" 
D)  "What time did these signs start?"

Question 16

A patient who is responsive to painful stimuli has a patent airway, inadequate respirations at 28 per minute, and a strong radial pulse with skin that is warm and dry. The patient is not moving his right arm or leg and is incontinent of urine. Which one of the following should the EMT do first?

Accepted Answer

A)  Insert an oropharyngeal airway. 
B)  Administer oxygen by nonrebreather mask. 
C)  Administer positive pressure ventilation. 
D)  Check the blood glucose level. 
A)  Insert an oropharyngeal airway. 
B)  Administer oxygen by nonrebreather mask. 
C)  Administer positive pressure ventilation. 
D)  Check the blood glucose level.

Question 17

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

Accepted Answer

A)  37-year-old female diagnosed in the emergency department with a hemorrhagic stroke 2 hours after onset 
B)  48-year-old male whose symptoms started while watching the 6 p.m. news at which time he dialed 911 
C)  81-year-old male who awoke with stroke symptoms after an 8-hour sleep 
D)  62-year-old female whose stroke symptoms started at 8 a.m. and disappeared half an hour later 
A)  37-year-old female diagnosed in the emergency department with a hemorrhagic stroke 2 hours after onset 
B)  48-year-old male whose symptoms started while watching the 6 p.m. news at which time he dialed 911 
C)  81-year-old male who awoke with stroke symptoms after an 8-hour sleep 
D)  62-year-old female whose stroke symptoms started at 8 a.m. and disappeared half an hour later

Question 18

Which statement shows that the EMT has an accurate understanding of altered mental status?

Accepted Answer

A)  "It describes any change away from a normal state of mental function." 
B)  "It applies only when the patient is not responsive to verbal or painful stimuli." 
C)  "It should only be suspected when the patient is on medications that can cause confusion." 
D)  "It is any mental state for a person with diabetes or other serious chronic disease." 
A)  "It describes any change away from a normal state of mental function." 
B)  "It applies only when the patient is not responsive to verbal or painful stimuli." 
C)  "It should only be suspected when the patient is on medications that can cause confusion." 
D)  "It is any mental state for a person with diabetes or other serious chronic disease."

Question 19

Bystanders state that a 72-year-old woman complained of chest pain and dizziness just before she fell down a flight of stairs. She is alert but confused and states that she feels nauseated and may vomit. How should the EMT position this patient for transport?

Accepted Answer

A)  Left lateral recumbent position on a long spine board 
B)  Supine with her head turned to one side 
C)  Fully immobilized to a long spine board 
D)  Semi-Fowler's with a cervical collar in place 
A)  Left lateral recumbent position on a long spine board 
B)  Supine with her head turned to one side 
C)  Fully immobilized to a long spine board 
D)  Semi-Fowler's with a cervical collar in place

Question 20

Which one of the following statements made by the EMT indicates a correct understanding of caring for someone with a headache?

Accepted Answer

A)  "Unless the patient has some sort of past medical history, a headache is not a true emergency." 
B)  "If a patient calls 911 for a headache, it is most likely a life-threatening condition." 
C)  "Assessment is essential in determining if a patient's headache represents a life-threatening condition." 
D)  "In general, a headache is only considered serious if the pain is felt throughout the entire head." 
A)  "Unless the patient has some sort of past medical history, a headache is not a true emergency." 
B)  "If a patient calls 911 for a headache, it is most likely a life-threatening condition." 
C)  "Assessment is essential in determining if a patient's headache represents a life-threatening condition." 
D)  "In general, a headache is only considered serious if the pain is felt throughout the entire head."

Exam 18: Altered Mental Status, Stroke, and Headache

A male patient has altered mental status secondary from a brain tumor. The EMT would classify the brain tumor as what type of cause?

An alert and oriented 69-year-old male has slight right-arm weakness but exhibits no deficits to the right leg. The EMT should consider the patient a:

On scene, a confused 68-year-old female with possible stroke has an SpO₂ of 91% on room air. Which one of the following indicates the most appropriate and beneficial type of oxygen therapy for this patient?

When assessing a patient with a suspected stroke, the order of the exam would be:

For altered mental status to occur, what body system must be affected?

What condition places the patient at greatest risk for an acute neurological deficit?

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

A 41-year-old female has called 911 for a headache. What assessment finding should make the EMT suspicious that the patient is suffering from a vascular headache?

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

When assessing a patient for a facial droop, the EMT should:

A 82-year-old male presents with right-hand weakness and garbled speech. Which of the following questions should the EMT ask first?

A patient who is responsive to painful stimuli has a patent airway, inadequate respirations at 28 per minute, and a strong radial pulse with skin that is warm and dry. The patient is not moving his right arm or leg and is incontinent of urine. Which one of the following should the EMT do first?

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

Which statement shows that the EMT has an accurate understanding of altered mental status?

Bystanders state that a 72-year-old woman complained of chest pain and dizziness just before she fell down a flight of stairs. She is alert but confused and states that she feels nauseated and may vomit. How should the EMT position this patient for transport?

Which one of the following statements made by the EMT indicates a correct understanding of caring for someone with a headache?

Emergency Medical Care Systems, Research, and Public Health

Workforce Safety and Wellness of the Emt

Medical, Legal, and Ethical Issues

Documentation

Communication

Lifting and Moving Patients

Anatomy, Physiology, and Medical Terminology

Pathophysiology

Life Span Development

Airway Management, Artificial Ventilation, and Oxygenation

Baseline Vital Signs, Monitoring Devices, and History Taking

Scene Size-Up

Patient Assessment

Pharmacology Medication and Administration

Shock and Resuscitation

Respiratory Emergencies

Cardiovascular Emergencies

Seizures and Syncope

Acute Diabetic Emergencies

Anaphylactic Reactions

Toxicologic Emergencies

Abdominal, Hematologic, Gynecologic, Genitourinary, and Renal Emergencies

Environmental Emergencies

Submersion Incidents: Drowning and Diving Emergencies

Behavioral Emergencies

Trauma Overview: the Trauma Patient and the Trauma System

Bleeding and Soft Tissue Trauma

Burns

Musculoskeletal Trauma and Nontraumatic Fractures

Head Trauma

Spinal Column and Spinal Cord Trauma

Eye, Face, and Neck Trauma

Chest Trauma

Abdominal and Genitourinary Trauma

Multisystem Trauma and Trauma in Special Patient Populations

Obstetrics and Care of the Newborn

Pediatrics

Geriatrics

Patients With Special Challenges

The Combat Veteran

Ambulance Operations and Air Medical Response

Gaining Access and Patient Extrication

Hazardous Materials

Multiple-Casualty Incidents and Incident Management

Ems Response to Terrorism Involving Weapons of Mass Destruction

ALS-Assist Skills

Advanced Airway Management

Filters