Chapter 35 Syncope
1. Ménière’s ’disease presents with the following triad of symptoms:
A. Vertigo, nystagmus, hearing loss
B. Vertigo, tinnitus, hearing loss
C. Vertigo, syncope, hearing loss
D. None of the above
ANS: B
The exact cause of Ménière’s disease is unknown. However, the symptoms are associated with increased
fluid and pressure in the labyrinth. Ménière’s disease commonly involves a triad of symptoms: severe
vertigo, tinnitus, and hearing loss. The vertigo is transient but recurrent. The tinnitus and hearing loss may
also be intermittent and/or recurrent but often become worse over time. A sensation of ear fullness may
precede an episode. During the episode, vertigo is often debilitating and is associated with nausea and
vomiting. The tinnitus and hearing loss are usually unilateral.
2. . You are an emergency room clinician that assisted with CPR on a 20-year-old trauma patient.
The CPR was unsuccessful, the patient expired, and you need to explain this to the family in the waiting
room. Upon telling the mother about the death of her son, she becomes dizzy and faints. What is the most
likely cause for the woman fainting?
A. Cardiogenic shock
B. Vasovagal response
C. Syncope due to hypoxia
D. Dizziness and vertigo
ANS: B
Neurocardiogenic syncope, also called vasovagal syncope, is a common cause of dizziness and fainting. It is
due to a sudden decrease in blood pressure and heart rate after prolonged standing, with stress, or from
dehydration. It is a result of sympathetic sensitivity, causing a reflexive response that suddenly causes
bradycardia and venous dilation. Hypotension and dizziness result.
3. During the taking of the health history, a patient tells the nurse that it feels like the room is
spinning around me. The nurse would document this finding as:
a. Vertigo. b. Syncope. c. Dizziness.
d. Seizure activity. ANS: A
True vertigo is rotational spinning caused by a neurologic dysfunction or a problem in the
vestibular apparatus or the vestibular nuclei in the brainstem. Syncope is a sudden loss of
strength or a temporary loss of consciousness. Dizziness is a lightheaded, swimming sensation. Seizure
activity is characterized by altered or loss of consciousness, involuntary muscle movements, and sensory
disturbances.
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1. Ménière’s ’disease presents with the following triad of symptoms:
A. Vertigo, nystagmus, hearing loss
B. Vertigo, tinnitus, hearing loss
C. Vertigo, syncope, hearing loss
D. None of the above
ANS: B
The exact cause of Ménière’s disease is unknown. However, the symptoms are associated with increased
fluid and pressure in the labyrinth. Ménière’s disease commonly involves a triad of symptoms: severe
vertigo, tinnitus, and hearing loss. The vertigo is transient but recurrent. The tinnitus and hearing loss may
also be intermittent and/or recurrent but often become worse over time. A sensation of ear fullness may
precede an episode. During the episode, vertigo is often debilitating and is associated with nausea and
vomiting. The tinnitus and hearing loss are usually unilateral.
2. . You are an emergency room clinician that assisted with CPR on a 20-year-old trauma patient.
The CPR was unsuccessful, the patient expired, and you need to explain this to the family in the waiting
room. Upon telling the mother about the death of her son, she becomes dizzy and faints. What is the most
likely cause for the woman fainting?
A. Cardiogenic shock
B. Vasovagal response
C. Syncope due to hypoxia
D. Dizziness and vertigo
ANS: B
Neurocardiogenic syncope, also called vasovagal syncope, is a common cause of dizziness and fainting. It is
due to a sudden decrease in blood pressure and heart rate after prolonged standing, with stress, or from
dehydration. It is a result of sympathetic sensitivity, causing a reflexive response that suddenly causes
bradycardia and venous dilation. Hypotension and dizziness result.
3. During the taking of the health history, a patient tells the nurse that it feels like the room is
spinning around me. The nurse would document this finding as:
a. Vertigo. b. Syncope. c. Dizziness.
d. Seizure activity. ANS: A
True vertigo is rotational spinning caused by a neurologic dysfunction or a problem in the
vestibular apparatus or the vestibular nuclei in the brainstem. Syncope is a sudden loss of
strength or a temporary loss of consciousness. Dizziness is a lightheaded, swimming sensation. Seizure
activity is characterized by altered or loss of consciousness, involuntary muscle movements, and sensory
disturbances.
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