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West Coast EMT Block 3
1. 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: a brain tumor
C: epilepsy ✅
D: intracranial bleeding
Rationale:
Epilepsy typically develops in younger individuals or those with a prior seizure history. In adults
over 30 with no history, seizures are more often due to acute problems such as infection, tumor,
trauma, or stroke.
2. 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
Rationale:
Aphasia results from injury to the language centers in the brain (usually the left hemisphere). It
affects the ability to produce or comprehend speech.
3. A patient who is possibly experiencing a stroke is NOT eligible for thrombolytic
(fibrinolytic) therapy if he or she:
A: has a GCS score that is less than 8
B: has had a prior heart attack
C: is older than 60 years of age
D: has bleeding within the brain ✅
Rationale:
Thrombolytics dissolve clots and are used for ischemic strokes. They are contraindicated in
hemorrhagic strokes because they worsen bleeding.
,4. A patient with an altered mental status is:
A: typically alert but is confused as to preceding events
B: usually able to be aroused with a painful stimulus
C: completely unresponsive to all forms of stimuli
D: not thinking clearly or is incapable of being aroused ✅
Rationale:
Altered mental status (AMS) refers to any change in cognitive function — confusion,
disorientation, or unresponsiveness — due to neurological or metabolic causes.
5. 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 ✅
Rationale:
The Cincinnati scale assesses facial droop, arm drift, and speech to quickly identify stroke
symptoms in the field.
6. Febrile seizures:
A: are usually benign but should be evaluated ✅
B: are also referred to as absence seizures
C: often result in permanent brain damage
D: occur when a child’s fever rises slowly
Rationale:
Febrile seizures occur in children due to rapid increases in body temperature. They are generally
short and self-limiting but require evaluation to rule out infection.
7. Individuals with chronic alcoholism are predisposed to intracranial bleeding and
hypoglycemia secondary to abnormalities in the:
A: pancreas
B: kidneys
C: brain
D: liver ✅
Rationale:
Liver dysfunction in alcoholics impairs clotting factor production and glucose regulation, leading
to bleeding risks and hypoglycemia.
,8. Muscle control and body coordination are controlled by the:
A: brain stem
B: cerebral cortex
C: cerebellum ✅
D: cerebrum
Rationale:
The cerebellum is responsible for balance, coordination, and fine motor control.
9. 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
Rationale:
Status epilepticus involves continuous or repeated seizures lasting >5 minutes without regaining
consciousness — a life-threatening emergency.
10. The most basic functions of the body, such as breathing, blood pressure, and
swallowing, are controlled by the:
A: brain stem ✅
B: cerebellum
C: cerebral cortex
D: cerebrum
Rationale:
The brain stem controls automatic functions — respiration, cardiac activity, and swallowing.
11. The MOST significant risk factor for a hemorrhagic stroke is:
A: hypertension ✅
B: diabetes mellitus
C: severe stress
D: heavy exertion
Rationale:
Chronic high blood pressure weakens arterial walls, making them prone to rupture and cause
bleeding.
, 12. The spinal cord exits the cranium through the:
A: foramen magnum ✅
B: cauda equina
C: foramen lamina
D: vertebral foramen
Rationale:
The foramen magnum is the large opening at the base of the skull through which the spinal cord
passes.
13. 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
Rationale:
These three parts coordinate higher functions (cerebrum), movement (cerebellum), and vital
functions (brain stem).
14. When assessing for arm drift of a patient with a suspected stroke, you should:
A: ask the patient to hold his or her arms up with the palms down
B: ask the patient to close his or her eyes during the assessment ✅
C: observe movement of the arms for approximately 2 minutes
D: expect to see one arm slowly drift down to the patient’s side
Rationale:
The test is done with eyes closed to prevent visual compensation, assessing for weakness on one
side.
15. When caring for a patient with documented hypoglycemia, you should be MOST alert
for:
A: an acute stroke
B: a seizure ✅
C: respiratory distress
D: a febrile convulsion