CEN Neurological Emergencies Exam (2025-
2026) Questions with correct Answers
To quickly evaluate a child's neurological status, all of the following
standard evaluations can be used EXCEPT:
a. The Epworth Scale.
b. The AVPU scale.
c. The Glasgow Coma Scale.
d. Pupillary responses to light. - Correct Answers -A. The Epworth Scale is a
measure of sleepiness and is not part of the standard evaluation of a
child's neurological exam. The AVPU and Glasgow Coma scales can be
used to evaluate a child's neuro status. Pupillary size and response should
also be checked.
The National Institute of Neurological Disorders and Stokes (NINDS) has set
the goal for immediate general assessment by a stroke team or emergency
physician as:
a. Within 1 minute of arrival.
b. Within 10 minutes of arrival.
c. Within 30 minutes of arrival.
d. Within 60 minutes of arrival. - Correct Answers -B. The goal for general
assessment by an ED or stroke team physician is within 10 minutes of
arrival to the ED. Within the same 10 minutes, an urgent CT without
contrast should also be ordered.
A 44-year-old man is brought to the emergency department by his wife with
complaints of tingling in his hand and a metallic taste in his mouth. During
assessment, he is alert and oriented but anxious. He is unaware of a
repetitive chewing motion that he is making with his mouth. What is this
patient likely experiencing?
a. Partial or focal seizures
b. Generalized absence seizures
c. Grand mal seizures
d. Status epilepticus - Correct Answers -A. Partial or focal seizures are
typified by focused motor activity and disturbances in vision, hearing, smell
or taste. Numbness or tingling may be a symptom. In a simple partial
seizure, the patient's mental status usually will not be affected. One of the
most characteristic symptoms is the presence of some pattern of movement
such as chewing, hand patting, grimacing, or lip smacking.
An 8-year-old boy is brought to the emergency department by his father who
states that the child tends to "zone out" when he is stressed. The father
states that the child tells him that he does not remember anything during
those times. The father reports that the child tends to grimace during these
periods but denies any pain after the episodes.
Immediately after, the father says that the child is awake and alert. The
,father reports
, that his younger brother had similar episodes as a child. This child should
be evaluated for which of the following?
a. Partial or focal seizures
b. Generalized absence seizures
c. Grand mal seizures
d. Status epilepticus - Correct Answers -B. Generalized absence seizures
occur primary in young children and are characterized by abrupt cessation of
activity with occasional momentary loss of consciousness. Automatism such
as chewing, hand patting, grimacing or lip smacking may be noted. These
absence seizures may run in families. Typically, the child will appear to be
normal after the seizure.
A 23-year-old patient is brought to the emergency department by EMS
personnel. The paramedic reports a series of consecutive seizures that were
reported by the patient's wife and that have continued during transport. The
patient has not regained consciousness during transport. The patient's
temperature is 100 degrees F, blood pressure is 152/100 and pulse is 120.
The wife reports that the patient has a history of seizures but has never had
an episode like this. Appropriate interventions include all of the following
EXCEPT:
a. Monitor the patient's airway and prepare for intubation if necessary.
b. Prepare to give a sedative.
c. Protect the patient from injury by restraining the patient's arms and legs.
d. Prepare to give anticonvulsant medication. - Correct Answers -C.
Although the patient must be protected from injury, restraining the patient
may cause injury and prevent the patient from being rolled to his side
should he vomit. The stretcher should be in low position with side rails up.
The side rails should be padded if possible.
The National Institute of Neurological Disorders and Stokes (NINDS) has set
the goal for initiation of fibrinolytic therapy in appropriate patients as:
a. Within 1 hour of hospital arrival.
b. Within 3 hours of hospital arrival.
c. Within 4 hours of hospital arrival.
d. Within 6 hours of hospital arrival. - Correct Answers -A. NINDS
recommends a goal for initiation of fibrinolytic therapy within 1 hour of
arrival to the ED. NINDS also recommends a goal of door-to-admission time
of 3 hours.
Signs and symptoms of stroke may include all of following EXCEPT:
a. Sudden weakness or numbness of the face, arm or leg.
b. Sudden confusion.
c. Sudden headache with no known cause.
d. Hypotension. - Correct Answers -D. Hypotension is typically not a
sign of acute stroke. Hypertension, extremity weakness or numbness,
confusion and sudden headache are all symptoms of stroke.
When evaluating the 68-year-old stroke patient for fibrinolytic therapy, the
2026) Questions with correct Answers
To quickly evaluate a child's neurological status, all of the following
standard evaluations can be used EXCEPT:
a. The Epworth Scale.
b. The AVPU scale.
c. The Glasgow Coma Scale.
d. Pupillary responses to light. - Correct Answers -A. The Epworth Scale is a
measure of sleepiness and is not part of the standard evaluation of a
child's neurological exam. The AVPU and Glasgow Coma scales can be
used to evaluate a child's neuro status. Pupillary size and response should
also be checked.
The National Institute of Neurological Disorders and Stokes (NINDS) has set
the goal for immediate general assessment by a stroke team or emergency
physician as:
a. Within 1 minute of arrival.
b. Within 10 minutes of arrival.
c. Within 30 minutes of arrival.
d. Within 60 minutes of arrival. - Correct Answers -B. The goal for general
assessment by an ED or stroke team physician is within 10 minutes of
arrival to the ED. Within the same 10 minutes, an urgent CT without
contrast should also be ordered.
A 44-year-old man is brought to the emergency department by his wife with
complaints of tingling in his hand and a metallic taste in his mouth. During
assessment, he is alert and oriented but anxious. He is unaware of a
repetitive chewing motion that he is making with his mouth. What is this
patient likely experiencing?
a. Partial or focal seizures
b. Generalized absence seizures
c. Grand mal seizures
d. Status epilepticus - Correct Answers -A. Partial or focal seizures are
typified by focused motor activity and disturbances in vision, hearing, smell
or taste. Numbness or tingling may be a symptom. In a simple partial
seizure, the patient's mental status usually will not be affected. One of the
most characteristic symptoms is the presence of some pattern of movement
such as chewing, hand patting, grimacing, or lip smacking.
An 8-year-old boy is brought to the emergency department by his father who
states that the child tends to "zone out" when he is stressed. The father
states that the child tells him that he does not remember anything during
those times. The father reports that the child tends to grimace during these
periods but denies any pain after the episodes.
Immediately after, the father says that the child is awake and alert. The
,father reports
, that his younger brother had similar episodes as a child. This child should
be evaluated for which of the following?
a. Partial or focal seizures
b. Generalized absence seizures
c. Grand mal seizures
d. Status epilepticus - Correct Answers -B. Generalized absence seizures
occur primary in young children and are characterized by abrupt cessation of
activity with occasional momentary loss of consciousness. Automatism such
as chewing, hand patting, grimacing or lip smacking may be noted. These
absence seizures may run in families. Typically, the child will appear to be
normal after the seizure.
A 23-year-old patient is brought to the emergency department by EMS
personnel. The paramedic reports a series of consecutive seizures that were
reported by the patient's wife and that have continued during transport. The
patient has not regained consciousness during transport. The patient's
temperature is 100 degrees F, blood pressure is 152/100 and pulse is 120.
The wife reports that the patient has a history of seizures but has never had
an episode like this. Appropriate interventions include all of the following
EXCEPT:
a. Monitor the patient's airway and prepare for intubation if necessary.
b. Prepare to give a sedative.
c. Protect the patient from injury by restraining the patient's arms and legs.
d. Prepare to give anticonvulsant medication. - Correct Answers -C.
Although the patient must be protected from injury, restraining the patient
may cause injury and prevent the patient from being rolled to his side
should he vomit. The stretcher should be in low position with side rails up.
The side rails should be padded if possible.
The National Institute of Neurological Disorders and Stokes (NINDS) has set
the goal for initiation of fibrinolytic therapy in appropriate patients as:
a. Within 1 hour of hospital arrival.
b. Within 3 hours of hospital arrival.
c. Within 4 hours of hospital arrival.
d. Within 6 hours of hospital arrival. - Correct Answers -A. NINDS
recommends a goal for initiation of fibrinolytic therapy within 1 hour of
arrival to the ED. NINDS also recommends a goal of door-to-admission time
of 3 hours.
Signs and symptoms of stroke may include all of following EXCEPT:
a. Sudden weakness or numbness of the face, arm or leg.
b. Sudden confusion.
c. Sudden headache with no known cause.
d. Hypotension. - Correct Answers -D. Hypotension is typically not a
sign of acute stroke. Hypertension, extremity weakness or numbness,
confusion and sudden headache are all symptoms of stroke.
When evaluating the 68-year-old stroke patient for fibrinolytic therapy, the
