Question 1

When an EMT performs the secondary assessment on a postictal seizure patient with a known history of seizures, what assessment finding would be of most concern?

Accepted Answer

A)  Confused mental status 
B)  Heart rate of 136 
C)  Loss of bowel and bladder control 
D)  Bruise on the forehead

Question 2

How would you transport a seizure patient who may have a spinal-cord injury?

Accepted Answer

A)  Supine on the stretcher with straps loosely applied 
B)  In the lateral recumbent position with a cervical collar in place 
C)  Immobilized on a spine board with a cervical collar in place 
D)  Semi-sitting position with a cervical collar in place

Question 3

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

Accepted Answer

A)  Snoring respirations 
B)  Urinary incontinence 
C)  Altered mental status 
D)  Constricted pupils

Question 4

You are dispatched to a local mall and are met by bystanders who state that the patient was talking to a customer representative and "passed out." You find an alert and oriented 55-year-old female lying supine on the tile floor. The patient tells you that the back of her head is hurting. Which one of the following actions should you perform first?

Accepted Answer

A)  Open her airway with a jaw-thrust. 
B)  Obtain a full set of vital signs. 
C)  Take manual in-line spinal stabilization. 
D)  Assess the back of the patient's head for injury.

Question 5

The EMT would recognize that a 49-year-old male has suffered a primary seizure when his wife states:

Accepted Answer

A)  "He has never had a seizure before, this is the first seizure." 
B)  "He had seizures in the past, but they are not sure what causes them." 
C)  "The doctors said that his seizure come from one spot in his brain." 
D)  "His arms and legs were jerking and he would not talk to me."

Question 6

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:

Accepted Answer

A)  "I do not know. We will have to let the doctor help him first." 
B)  "I am not sure, but at least your mother remembers your name." 
C)  "Although he is confused now, he should remember your name in a little bit." 
D)  "I do not feel comfortable in telling you yes, since there is a chance he may not."

Question 7

Which one of the following signs and symptoms would be most helpful in determining that a patient had a syncopal episode rather than a seizure?

Accepted Answer

A)  The extremities twitched, but only for a few moments. 
B)  There was no period of confusion after the event. 
C)  The patient has never had a seizure before. 
D)  The patient complained of headache before the event.

Question 8

You are an EMT who finds an adult male on his living room floor. 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, you should suspect which one of the following conditions?

Accepted Answer

A)  Syncope 
B)  Allergic reaction 
C)  Behavioral emergency 
D)  Seizure

Question 9

After a lengthy response, you arrive at the home of a 62-year-old female who is still seizing. Your immediate action would be to:

Accepted Answer

A)  assess the patient's airway and breathing. 
B)  determine if the patient has a seizure history. 
C)  determine the total duration of the seizure. 
D)  move her to the ambulance for assessment and transport.

Question 10

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 14 and adequate, blood pressure 168/88 mmHg, and SpO₂ at 98%. Your primary concern would be:

Accepted Answer

A)  administering oxygen by nonrebreather. 
B)  loss of bowel or bladder control. 
C)  placing the arm tightly in a sling to prevent injury. 
D)  progression to a generalized seizure.

Question 11

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

Accepted Answer

A)  Provide high-concentration oxygen. 
B)  Insert an oropharyngeal airway. 
C)  Start positive pressure ventilation. 
D)  Place in a side-lying position.

Question 12

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 suddenly began to stumble around, shouting obscenities, and then fell to the ground spitting and shaking. From this description, the EMT should be suspicious of what condition?

Accepted Answer

A)  Generalized seizure 
B)  Alcohol intoxication 
C)  Absence seizure 
D)  Syncopal episode

Question 13

A young boy 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:

Accepted Answer

A)  "Move any movable objects and furniture away from him." 
B)  "Hold him securely to the floor until he stops seizing or the EMTs arrive." 
C)  "Insert a spoon into his mouth to keep him from swallowing his tongue." 
D)  "Call 911 if the seizure lasts more than 5 minutes or if he loses control of his bladder."

Question 14

You are by the side of an alert but confused 41-year-old woman who is diaphoretic and appears exhausted. She informs you that she has a history of seizures and just had a generalized seizure. Despite your urging, she refuses transport to the hospital. Your safest action would be to:

Accepted Answer

A)  transport her despite her refusal to consent. 
B)  advise medical direction of the situation. 
C)  contact law enforcement so transport is legal. 
D)  recognize a seizure history and have patient sign a refusal form.

Question 15

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

Accepted Answer

A)  "Syncope indicates a serious underlying condition, so please follow up with a doctor." 
B)  "The most common cause of syncope is diabetes, so follow up with your doctor." 
C)  "People who experience a syncopal episode are not allowed to drive unless they go on medication." 
D)  "Syncope is not dangerous and affects almost everyone, but it is still important to follow up with your doctor."

Question 16

A 72-year-old male with a history of depressed thyroid function and a brain tumor is suffering a psychomotor seizure. As you enter the room, you find him to be 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, blood pressure 166/68, and SpO₂ at 98%. Which one of the following actions would be most appropriate in the care of this patient?

Accepted Answer

A)  Determine if a durable power of attorney exits. 
B)  Restrain the patient and apply high-concentration oxygen. 
C)  Proceed with a nonemergency transport. 
D)  Insert a nasopharyngeal airway to ensure airway patency.

Question 17

While placing a 52-year-old female on the stretcher, she begins to seize. Your immediate action would be to:

Accepted Answer

A)  quickly move her to the ambulance for rapid transport. 
B)  perform a jaw-thrust maneuver and insert an oropharyngeal airway. 
C)  loosely apply the straps and raise the side rails. 
D)  remove her from the stretcher and place her on the ground.

Exam 19: Seizures and Syncope