1
West Coast EMT Block Exam #3 | Questions &
Answers (Rated A+)
SECTION 1: NEUROLOGIC EMERGENCIES (Questions 1-30)
Brain Anatomy & Function
Q1. The most basic functions of the body, such as breathing, blood pressure, and swallowing, are
controlled by the:
A) Cerebellum
B) Cerebrum
C) Brain stem
D) Cerebral cortex
✔✔ Answer ✔✔ C - Brain stem
Explanation: The brain stem controls autonomic functions including respiration, heart rate, blood
pressure, and swallowing. The cerebellum controls coordination, while the cerebrum handles higher
functions.
Q2. The spinal cord exits the cranium through the:
A) Foramen magnum
B) Cauda equina
C) Vertebral foramen
D) Foramen lamina
✔✔ Answer ✔✔ A - Foramen magnum
Explanation: The foramen magnum is the large opening at the base of the skull through which the spinal
cord passes to connect with the brain stem.
Q3. The three major parts of the brain are the:
A) Cerebellum, medulla, and occiput
B) Cerebrum, cerebellum, and brain stem
C) Brain stem, midbrain, and spinal cord
D) Midbrain, cerebellum, and spinal cord
✔✔ Answer ✔✔ B - Cerebrum, cerebellum, and brain stem
Explanation: The three main divisions of the brain are the cerebrum (higher functions), cerebellum
(coordination), and brain stem (basic life functions).
Q4. Muscle control and body coordination are controlled by the:
A) Brain stem
B) Cerebral cortex
,2
C) Cerebellum
D) Cerebrum
✔✔ Answer ✔✔ C - Cerebellum
Explanation: The cerebellum is responsible for fine motor control, balance, coordination, and posture.
Q5. The left cerebral hemisphere controls:
A) Heart rate and pupil reaction
B) The right side of the face
C) Breathing and blood pressure
D) The right side of the body
✔✔ Answer ✔✔ D - The right side of the body
Explanation: Motor function is contralateral - the left hemisphere controls the right side of the body, and
vice versa.
Stroke (Cerebrovascular Accident)
Q6. A patient who is possibly experiencing a stroke is NOT eligible for thrombolytic (fibrinolytic)
therapy if he or she:
A) Has had a prior heart attack
B) Has bleeding within the brain
C) Has a GCS score less than 8
D) Is older than 60 years of age
✔✔ Answer ✔✔ B - Has bleeding within the brain
Explanation: Thrombolytics are contraindicated in hemorrhagic stroke because they would worsen
intracranial bleeding. They are only for ischemic strokes.
Q7. The MOST significant risk factor for a hemorrhagic stroke is:
A) Diabetes mellitus
B) Hypertension
C) Heavy exertion
D) Severe stress
✔✔ Answer ✔✔ B - Hypertension
Explanation: Chronic high blood pressure weakens blood vessel walls, making them prone to rupture,
which causes hemorrhagic stroke.
Q8. Interruption of cerebral blood flow may result from all of the following, EXCEPT:
A) An embolism
B) Cerebral vasodilation
C) A thrombus
D) An acute arterial rupture
✔✔ Answer ✔✔ B - Cerebral vasodilation
Explanation: Vasodilation increases blood flow; it does not interrupt it. Embolism, thrombus, and rupture
all disrupt cerebral circulation.
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Q9. A transient ischemic attack (TIA) occurs when:
A) A small cerebral artery ruptures and causes minimal damage
B) Medications are given to dissolve a cerebral blood clot
C) A small clot in a cerebral artery causes temporary symptoms
D) Signs and symptoms resolve spontaneously within 48 hours
✔✔ Answer ✔✔ C - A small clot in a cerebral artery causes temporary symptoms
*Explanation: A TIA is a "mini-stroke" where symptoms resolve within 24 hours (usually minutes to
hours) due to temporary blockage that dissolves on its own.*
Q10. Components of the Cincinnati Prehospital Stroke Scale include:
A) Arm drift, memory, and grip strength
B) Speech, pupil reaction, and memory
C) Facial droop, speech, and pupil size
D) Arm drift, speech, and facial droop
✔✔ Answer ✔✔ D - Arm drift, speech, and facial droop
Explanation: The CPSS assesses three signs: facial droop (ask patient to smile), arm drift (ask patient to
close eyes and hold arms out), and speech (ask patient to say a simple sentence).
Q11. When assessing for arm drift of a patient with a suspected stroke, you should:
A) Ask the patient to close his or her eyes during the assessment
B) Expect to see one arm slowly drift down to the patient's side
C) Observe movement of the arms for approximately 2 minutes
D) Ask the patient to hold his or her arms up with the palms down
✔✔ Answer ✔✔ A - Ask the patient to close his or her eyes during the assessment
Explanation: Eyes closed eliminates visual compensation, allowing detection of subtle unilateral
weakness.
Q12. 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
✔✔ Answer ✔✔ C - Unable to produce or understand speech
Explanation: Aphasia is a language disorder affecting speech production (Broca's area) or comprehension
(Wernicke's area), typically from left hemisphere stroke.
Q13. 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 a history of high blood pressure
B) When the patient was last seen normal
C) The patient's past medical history
D) If the patient has diabetes
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✔✔ Answer ✔✔ B - When the patient was last seen normal
*Explanation: This determines the time of onset, which is critical for thrombolytic therapy eligibility
(typically within 3-4.5 hours of symptom onset).*
Q14. When transporting a stable stroke patient with a paralyzed extremity, place the patient in a:
A) Supine position with the legs elevated
B) Recumbent position with the paralyzed side down
C) Sitting position with the head at 45-90 degrees
D) Recumbent position with the paralyzed side up
✔✔ Answer ✔✔ B - Recumbent position with the paralyzed side down
Explanation: Positioning the paralyzed side down allows the functional side to be free for assessment and
helps protect the airway.
Seizures
Q15. A 30-year-old male experienced a generalized (tonic-clonic) seizure, which stopped before you
arrived. The patient is conscious, answering 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 GCS score is 15
B) His wife states this was his "usual" seizure
C) He has experienced seizures since he was 20
D) He is currently not prescribed any medications
✔✔ Answer ✔✔ D - He is currently not prescribed any medications
Explanation: Patients with seizure history who are not taking prescribed medications are at high risk for
recurrent seizures and require evaluation.
Q16. Status epilepticus is characterized by:
A) Generalized seizures that last less than 5 minutes
B) An absence seizure that is not preceded by an aura
C) Prolonged seizures without a return of consciousness
D) Profound tachycardia and total muscle flaccidity
✔✔ Answer ✔✔ C - Prolonged seizures without a return of consciousness
Explanation: Status epilepticus is a medical emergency defined as continuous seizure activity lasting
more than 5 minutes, or two or more seizures without full recovery of consciousness between them.
Q17. 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
✔✔ Answer ✔✔ D - Is likely to improve over a period of 5 to 30 minutes
*Explanation: The postictal state typically lasts 5-30 minutes, during which the patient gradually regains
normal mental status.*
West Coast EMT Block Exam #3 | Questions &
Answers (Rated A+)
SECTION 1: NEUROLOGIC EMERGENCIES (Questions 1-30)
Brain Anatomy & Function
Q1. The most basic functions of the body, such as breathing, blood pressure, and swallowing, are
controlled by the:
A) Cerebellum
B) Cerebrum
C) Brain stem
D) Cerebral cortex
✔✔ Answer ✔✔ C - Brain stem
Explanation: The brain stem controls autonomic functions including respiration, heart rate, blood
pressure, and swallowing. The cerebellum controls coordination, while the cerebrum handles higher
functions.
Q2. The spinal cord exits the cranium through the:
A) Foramen magnum
B) Cauda equina
C) Vertebral foramen
D) Foramen lamina
✔✔ Answer ✔✔ A - Foramen magnum
Explanation: The foramen magnum is the large opening at the base of the skull through which the spinal
cord passes to connect with the brain stem.
Q3. The three major parts of the brain are the:
A) Cerebellum, medulla, and occiput
B) Cerebrum, cerebellum, and brain stem
C) Brain stem, midbrain, and spinal cord
D) Midbrain, cerebellum, and spinal cord
✔✔ Answer ✔✔ B - Cerebrum, cerebellum, and brain stem
Explanation: The three main divisions of the brain are the cerebrum (higher functions), cerebellum
(coordination), and brain stem (basic life functions).
Q4. Muscle control and body coordination are controlled by the:
A) Brain stem
B) Cerebral cortex
,2
C) Cerebellum
D) Cerebrum
✔✔ Answer ✔✔ C - Cerebellum
Explanation: The cerebellum is responsible for fine motor control, balance, coordination, and posture.
Q5. The left cerebral hemisphere controls:
A) Heart rate and pupil reaction
B) The right side of the face
C) Breathing and blood pressure
D) The right side of the body
✔✔ Answer ✔✔ D - The right side of the body
Explanation: Motor function is contralateral - the left hemisphere controls the right side of the body, and
vice versa.
Stroke (Cerebrovascular Accident)
Q6. A patient who is possibly experiencing a stroke is NOT eligible for thrombolytic (fibrinolytic)
therapy if he or she:
A) Has had a prior heart attack
B) Has bleeding within the brain
C) Has a GCS score less than 8
D) Is older than 60 years of age
✔✔ Answer ✔✔ B - Has bleeding within the brain
Explanation: Thrombolytics are contraindicated in hemorrhagic stroke because they would worsen
intracranial bleeding. They are only for ischemic strokes.
Q7. The MOST significant risk factor for a hemorrhagic stroke is:
A) Diabetes mellitus
B) Hypertension
C) Heavy exertion
D) Severe stress
✔✔ Answer ✔✔ B - Hypertension
Explanation: Chronic high blood pressure weakens blood vessel walls, making them prone to rupture,
which causes hemorrhagic stroke.
Q8. Interruption of cerebral blood flow may result from all of the following, EXCEPT:
A) An embolism
B) Cerebral vasodilation
C) A thrombus
D) An acute arterial rupture
✔✔ Answer ✔✔ B - Cerebral vasodilation
Explanation: Vasodilation increases blood flow; it does not interrupt it. Embolism, thrombus, and rupture
all disrupt cerebral circulation.
,3
Q9. A transient ischemic attack (TIA) occurs when:
A) A small cerebral artery ruptures and causes minimal damage
B) Medications are given to dissolve a cerebral blood clot
C) A small clot in a cerebral artery causes temporary symptoms
D) Signs and symptoms resolve spontaneously within 48 hours
✔✔ Answer ✔✔ C - A small clot in a cerebral artery causes temporary symptoms
*Explanation: A TIA is a "mini-stroke" where symptoms resolve within 24 hours (usually minutes to
hours) due to temporary blockage that dissolves on its own.*
Q10. Components of the Cincinnati Prehospital Stroke Scale include:
A) Arm drift, memory, and grip strength
B) Speech, pupil reaction, and memory
C) Facial droop, speech, and pupil size
D) Arm drift, speech, and facial droop
✔✔ Answer ✔✔ D - Arm drift, speech, and facial droop
Explanation: The CPSS assesses three signs: facial droop (ask patient to smile), arm drift (ask patient to
close eyes and hold arms out), and speech (ask patient to say a simple sentence).
Q11. When assessing for arm drift of a patient with a suspected stroke, you should:
A) Ask the patient to close his or her eyes during the assessment
B) Expect to see one arm slowly drift down to the patient's side
C) Observe movement of the arms for approximately 2 minutes
D) Ask the patient to hold his or her arms up with the palms down
✔✔ Answer ✔✔ A - Ask the patient to close his or her eyes during the assessment
Explanation: Eyes closed eliminates visual compensation, allowing detection of subtle unilateral
weakness.
Q12. 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
✔✔ Answer ✔✔ C - Unable to produce or understand speech
Explanation: Aphasia is a language disorder affecting speech production (Broca's area) or comprehension
(Wernicke's area), typically from left hemisphere stroke.
Q13. 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 a history of high blood pressure
B) When the patient was last seen normal
C) The patient's past medical history
D) If the patient has diabetes
, 4
✔✔ Answer ✔✔ B - When the patient was last seen normal
*Explanation: This determines the time of onset, which is critical for thrombolytic therapy eligibility
(typically within 3-4.5 hours of symptom onset).*
Q14. When transporting a stable stroke patient with a paralyzed extremity, place the patient in a:
A) Supine position with the legs elevated
B) Recumbent position with the paralyzed side down
C) Sitting position with the head at 45-90 degrees
D) Recumbent position with the paralyzed side up
✔✔ Answer ✔✔ B - Recumbent position with the paralyzed side down
Explanation: Positioning the paralyzed side down allows the functional side to be free for assessment and
helps protect the airway.
Seizures
Q15. A 30-year-old male experienced a generalized (tonic-clonic) seizure, which stopped before you
arrived. The patient is conscious, answering 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 GCS score is 15
B) His wife states this was his "usual" seizure
C) He has experienced seizures since he was 20
D) He is currently not prescribed any medications
✔✔ Answer ✔✔ D - He is currently not prescribed any medications
Explanation: Patients with seizure history who are not taking prescribed medications are at high risk for
recurrent seizures and require evaluation.
Q16. Status epilepticus is characterized by:
A) Generalized seizures that last less than 5 minutes
B) An absence seizure that is not preceded by an aura
C) Prolonged seizures without a return of consciousness
D) Profound tachycardia and total muscle flaccidity
✔✔ Answer ✔✔ C - Prolonged seizures without a return of consciousness
Explanation: Status epilepticus is a medical emergency defined as continuous seizure activity lasting
more than 5 minutes, or two or more seizures without full recovery of consciousness between them.
Q17. 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
✔✔ Answer ✔✔ D - Is likely to improve over a period of 5 to 30 minutes
*Explanation: The postictal state typically lasts 5-30 minutes, during which the patient gradually regains
normal mental status.*
