Chapter 18 -- Neurological Emergencies
UPDATED ACTUAL Exam Questions and
CORRECT Answers
For any patient with an increase in intracranial pressure, the paramedic must:
A. take measures to lower blood pressure.
B. maintain an adequate blood pressure.
C. give glucose to prevent hypoglycemia.
D. avoid administering IV fluid boluses. - CORRECT ANSWER - B. maintain an adequate
blood pressure.
In contrast to syncope, a seizure:
A. is characterized by a quick return of orientation.
B. can occur when the patient is in any position.
C. is less commonly observed in older patients.
D. most often occurs when the patient is standing. - CORRECT ANSWER - B. can occur
when the patient is in any position.
Hyperventilating a patient who has increased intracranial pressure (ICP) will:
A. decrease ICP and maintain adequate cerebral perfusion.
B. constrict the cerebral vasculature and decrease cerebral perfusion.
C. dilate the cerebral vasculature and cause further increases in ICP.
D. increase the carbon dioxide in the brain through vasodilation. - CORRECT ANSWER -
B. constrict the cerebral vasculature and decrease cerebral perfusion.
A patient with a unilateral eyelid droop when smiling:
,A. may be experiencing Bell palsy.
B. likely has an intracerebral hemorrhage.
C. has a condition called miosis.
D. is experiencing transient cerebral ischemia. - CORRECT ANSWER - A. may be
experiencing Bell palsy.
You respond to the residence of a known heroin abuser. The patient, a 30-year-old man, is
unconscious and unresponsive. He is hypoventilating, bradycardic, and hypotensive.
Administration of 10 mg of naloxone has had no effect, and your transport time to the hospital is
approximately 30 minutes. You should:
A. hyperventilate him with high-flow oxygen to minimize tissue hypoxia.
B. administer 25 g of 50% dextrose and reassess his level of consciousness.
C. check his blood glucose level as your partner prepares to intubate.
D. transport at once and administer additional naloxone while en route. - CORRECT
ANSWER - C. check his blood glucose level as your partner prepares to intubate.
Apneustic breathing is characterized by:
A. extreme tachypnea and hyperpnea with a fruity or acetone breath odor.
B. a prolonged inspiratory phase with a shortened expiratory phase and bradypnea.
C. a gradual increase and decrease in breathing with periods of apnea.
D. an irregular respiratory pattern with unpredictable periods of apnea. - CORRECT
ANSWER - B. a prolonged inspiratory phase with a shortened expiratory phase and
bradypnea.
A stroke to the right cerebral hemisphere would MOST likely cause:
A. right-sided weakness and left side visual field loss.
, B. left-sided weakness and an absence of facial droop.
C. right-sided weakness and a right-sided facial droop.
D. left-sided weakness and a right side visual field loss. - CORRECT ANSWER - D. left-
sided weakness and a right side visual field loss.
Which of the following would MOST likely cause a sustained increase in intracranial pressure?
A. Frequent coughing
B. Bearing down
C. Projectile vomiting
D. Intracranial tumor - CORRECT ANSWER - D. Intracranial tumor
A neoplasm is MOST accurately defined as a(n):
A. damaged cell.
B. abnormal growth.
C. normal cell.
D. cancerous tumor. - CORRECT ANSWER - B. abnormal growth.
You are dispatched for a 44-year-old woman with a severe headache. You arrive to find the
patient lying on her sofa with a wet washcloth on her forehead. She tells you that she has a
history of migraine headaches and that this is one of her "typical" headaches. She also complains
of nausea and photophobia. Her blood pressure is 170/94 mm Hg, pulse rate is 120 beats/min and
regular, and respirations are 22 breaths/min with adequate depth. The MOST appropriate
treatment for this patient includes:
A. placing her in a Fowler position, administering oxygen, and transporting her to the hospital
for definitive care.
B. oxygen as tolerated, starting an IV line and administering onedansetron, and transporting
without lights and siren.
UPDATED ACTUAL Exam Questions and
CORRECT Answers
For any patient with an increase in intracranial pressure, the paramedic must:
A. take measures to lower blood pressure.
B. maintain an adequate blood pressure.
C. give glucose to prevent hypoglycemia.
D. avoid administering IV fluid boluses. - CORRECT ANSWER - B. maintain an adequate
blood pressure.
In contrast to syncope, a seizure:
A. is characterized by a quick return of orientation.
B. can occur when the patient is in any position.
C. is less commonly observed in older patients.
D. most often occurs when the patient is standing. - CORRECT ANSWER - B. can occur
when the patient is in any position.
Hyperventilating a patient who has increased intracranial pressure (ICP) will:
A. decrease ICP and maintain adequate cerebral perfusion.
B. constrict the cerebral vasculature and decrease cerebral perfusion.
C. dilate the cerebral vasculature and cause further increases in ICP.
D. increase the carbon dioxide in the brain through vasodilation. - CORRECT ANSWER -
B. constrict the cerebral vasculature and decrease cerebral perfusion.
A patient with a unilateral eyelid droop when smiling:
,A. may be experiencing Bell palsy.
B. likely has an intracerebral hemorrhage.
C. has a condition called miosis.
D. is experiencing transient cerebral ischemia. - CORRECT ANSWER - A. may be
experiencing Bell palsy.
You respond to the residence of a known heroin abuser. The patient, a 30-year-old man, is
unconscious and unresponsive. He is hypoventilating, bradycardic, and hypotensive.
Administration of 10 mg of naloxone has had no effect, and your transport time to the hospital is
approximately 30 minutes. You should:
A. hyperventilate him with high-flow oxygen to minimize tissue hypoxia.
B. administer 25 g of 50% dextrose and reassess his level of consciousness.
C. check his blood glucose level as your partner prepares to intubate.
D. transport at once and administer additional naloxone while en route. - CORRECT
ANSWER - C. check his blood glucose level as your partner prepares to intubate.
Apneustic breathing is characterized by:
A. extreme tachypnea and hyperpnea with a fruity or acetone breath odor.
B. a prolonged inspiratory phase with a shortened expiratory phase and bradypnea.
C. a gradual increase and decrease in breathing with periods of apnea.
D. an irregular respiratory pattern with unpredictable periods of apnea. - CORRECT
ANSWER - B. a prolonged inspiratory phase with a shortened expiratory phase and
bradypnea.
A stroke to the right cerebral hemisphere would MOST likely cause:
A. right-sided weakness and left side visual field loss.
, B. left-sided weakness and an absence of facial droop.
C. right-sided weakness and a right-sided facial droop.
D. left-sided weakness and a right side visual field loss. - CORRECT ANSWER - D. left-
sided weakness and a right side visual field loss.
Which of the following would MOST likely cause a sustained increase in intracranial pressure?
A. Frequent coughing
B. Bearing down
C. Projectile vomiting
D. Intracranial tumor - CORRECT ANSWER - D. Intracranial tumor
A neoplasm is MOST accurately defined as a(n):
A. damaged cell.
B. abnormal growth.
C. normal cell.
D. cancerous tumor. - CORRECT ANSWER - B. abnormal growth.
You are dispatched for a 44-year-old woman with a severe headache. You arrive to find the
patient lying on her sofa with a wet washcloth on her forehead. She tells you that she has a
history of migraine headaches and that this is one of her "typical" headaches. She also complains
of nausea and photophobia. Her blood pressure is 170/94 mm Hg, pulse rate is 120 beats/min and
regular, and respirations are 22 breaths/min with adequate depth. The MOST appropriate
treatment for this patient includes:
A. placing her in a Fowler position, administering oxygen, and transporting her to the hospital
for definitive care.
B. oxygen as tolerated, starting an IV line and administering onedansetron, and transporting
without lights and siren.
