West Coast EMT Block Exam #3
A 30-year-old male experienced a generalized (tonic-clonic) seizure, which stopped before you arrived at
the scene. The patient is conscious, is answering your questions appropriately, and refuses EMS
transport. Which of the following would be the MOST compelling reason to disagree with his refusal of
transport?
Select one:
A. His Glasgow Coma Scale (GCS) score is 15
B. His wife states that this was his "usual" seizure
C. He has experienced seizures since he was 20
D. He is currently not prescribed any medications - (correct Answer) - D. He is currently not prescribed
any medications
A patient who is possibly experiencing a stroke is NOT eligible for thrombolytic (fibrinolytic) therapy if he
or she:
Select one:
A. has had a prior heart attack.
B. has bleeding within the brain.
C. has a GCS score that is less than 8.
D. is older than 60 years of age. - (correct Answer) - B. has bleeding within the brain.
A patient whose speech is slurred and difficult to understand is experiencing:
Select one:
A. paraplegia.
B. dysphagia.
C. dysarthria.
D. aphasia. - (correct Answer) - C. dysarthria.
A patient with an altered mental status is:
Select one:
,A. typically alert but is confused as to preceding events.
B. not thinking clearly or is incapable of being aroused.
C. usually able to be aroused with a painful stimulus.
D. completely unresponsive to all forms of stimuli. - (correct Answer) - B. not thinking clearly or is
incapable of being aroused.
During the primary assessment of a semiconscious 70-year-old female, you should:
Select one:
A. insert a nasopharyngeal airway and assist ventilations.
B. ask family members if the patient has a history of stroke.
C. immediately determine the patient's blood glucose level.
D. ensure a patent airway and support ventilation as needed. - (correct Answer) - D. ensure a patent
airway and support ventilation as needed.
Interruption of cerebral blood flow may result from all of the following, EXCEPT:
Select one:
A. an embolism.
B. cerebral vasodilation.
C. a thrombus.
D. an acute arterial rupture. - (correct Answer) - B. cerebral vasodilation.
The left cerebral hemisphere controls:
Select one:
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. - (correct Answer) - D. the right side of the body.
The MOST significant risk factor for a hemorrhagic stroke is:
Select one:
A. diabetes mellitus.
B. hypertension.
,C. heavy exertion.
D. severe stress. - (correct Answer) - B. hypertension.
The three major parts of the brain are the:
Select one:
A. midbrain, cerebellum, and spinal cord.
B. brain stem, midbrain, and spinal cord.
C. cerebellum, medulla, and occiput.
D. cerebrum, cerebellum, and brain stem. - (correct Answer) - D. cerebrum, cerebellum, and brain stem.
When assessing for arm drift of a patient with a suspected stroke, you should:
Select one:
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. - (correct Answer) - A. ask the patient
to close his or her eyes during the assessment.
When caring for a patient with documented hypoglycemia, you should be MOST alert for:
Select one:
A. a seizure.
B. respiratory distress.
C. an acute stroke.
D. a febrile convulsion. - (correct Answer) - A. a seizure.
When you are obtaining medical history from the family of a suspected stroke patient, it is MOST
important to determine:
Select one:
A. if the patient has been hospitalized before.
B. if there is a family history of a stroke.
C. when the patient last appeared normal.
D. the patient's overall medication compliance. - (correct Answer) - C. when the patient last appeared
, normal.
Which of the following conditions would be the LEAST likely to mimic the signs and symptoms of a
stroke?
Select one:
A. Intracranial bleeding
B. A postictal state
C. Hypoglycemia
D. Hypovolemia - (correct Answer) - D. Hypovolemia
Which of the following conditions would MOST likely affect the entire brain?
Select one:
A. Respiratory failure or cardiopulmonary arrest
B. Ruptured cerebral artery in the occipital lobe
C. Blocked cerebral artery in the frontal lobe
D. Reduced blood supply to the left hemisphere - (correct Answer) - A. Respiratory failure or
cardiopulmonary arrest
Which of the following MOST accurately describes a simple partial seizure?
Select one:
A. A generalized seizure without incontinence
B. A seizure that causes the patient to stare blankly
C. A seizure that begins in one extremity
D. A seizure that is not preceded by an aura - (correct Answer) - C. A seizure that begins in one extremity
Which of the following MOST accurately describes what the patient will experience during the postictal
state that follows a seizure?
Select one:
A. A gradually decreasing level of consciousness
B. A rapidly improving level of consciousness
C. Hyperventilation and hypersalivation
D. Confusion and fatigue - (correct Answer) - D. Confusion and fatigue
A 30-year-old male experienced a generalized (tonic-clonic) seizure, which stopped before you arrived at
the scene. The patient is conscious, is answering your questions appropriately, and refuses EMS
transport. Which of the following would be the MOST compelling reason to disagree with his refusal of
transport?
Select one:
A. His Glasgow Coma Scale (GCS) score is 15
B. His wife states that this was his "usual" seizure
C. He has experienced seizures since he was 20
D. He is currently not prescribed any medications - (correct Answer) - D. He is currently not prescribed
any medications
A patient who is possibly experiencing a stroke is NOT eligible for thrombolytic (fibrinolytic) therapy if he
or she:
Select one:
A. has had a prior heart attack.
B. has bleeding within the brain.
C. has a GCS score that is less than 8.
D. is older than 60 years of age. - (correct Answer) - B. has bleeding within the brain.
A patient whose speech is slurred and difficult to understand is experiencing:
Select one:
A. paraplegia.
B. dysphagia.
C. dysarthria.
D. aphasia. - (correct Answer) - C. dysarthria.
A patient with an altered mental status is:
Select one:
,A. typically alert but is confused as to preceding events.
B. not thinking clearly or is incapable of being aroused.
C. usually able to be aroused with a painful stimulus.
D. completely unresponsive to all forms of stimuli. - (correct Answer) - B. not thinking clearly or is
incapable of being aroused.
During the primary assessment of a semiconscious 70-year-old female, you should:
Select one:
A. insert a nasopharyngeal airway and assist ventilations.
B. ask family members if the patient has a history of stroke.
C. immediately determine the patient's blood glucose level.
D. ensure a patent airway and support ventilation as needed. - (correct Answer) - D. ensure a patent
airway and support ventilation as needed.
Interruption of cerebral blood flow may result from all of the following, EXCEPT:
Select one:
A. an embolism.
B. cerebral vasodilation.
C. a thrombus.
D. an acute arterial rupture. - (correct Answer) - B. cerebral vasodilation.
The left cerebral hemisphere controls:
Select one:
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. - (correct Answer) - D. the right side of the body.
The MOST significant risk factor for a hemorrhagic stroke is:
Select one:
A. diabetes mellitus.
B. hypertension.
,C. heavy exertion.
D. severe stress. - (correct Answer) - B. hypertension.
The three major parts of the brain are the:
Select one:
A. midbrain, cerebellum, and spinal cord.
B. brain stem, midbrain, and spinal cord.
C. cerebellum, medulla, and occiput.
D. cerebrum, cerebellum, and brain stem. - (correct Answer) - D. cerebrum, cerebellum, and brain stem.
When assessing for arm drift of a patient with a suspected stroke, you should:
Select one:
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. - (correct Answer) - A. ask the patient
to close his or her eyes during the assessment.
When caring for a patient with documented hypoglycemia, you should be MOST alert for:
Select one:
A. a seizure.
B. respiratory distress.
C. an acute stroke.
D. a febrile convulsion. - (correct Answer) - A. a seizure.
When you are obtaining medical history from the family of a suspected stroke patient, it is MOST
important to determine:
Select one:
A. if the patient has been hospitalized before.
B. if there is a family history of a stroke.
C. when the patient last appeared normal.
D. the patient's overall medication compliance. - (correct Answer) - C. when the patient last appeared
, normal.
Which of the following conditions would be the LEAST likely to mimic the signs and symptoms of a
stroke?
Select one:
A. Intracranial bleeding
B. A postictal state
C. Hypoglycemia
D. Hypovolemia - (correct Answer) - D. Hypovolemia
Which of the following conditions would MOST likely affect the entire brain?
Select one:
A. Respiratory failure or cardiopulmonary arrest
B. Ruptured cerebral artery in the occipital lobe
C. Blocked cerebral artery in the frontal lobe
D. Reduced blood supply to the left hemisphere - (correct Answer) - A. Respiratory failure or
cardiopulmonary arrest
Which of the following MOST accurately describes a simple partial seizure?
Select one:
A. A generalized seizure without incontinence
B. A seizure that causes the patient to stare blankly
C. A seizure that begins in one extremity
D. A seizure that is not preceded by an aura - (correct Answer) - C. A seizure that begins in one extremity
Which of the following MOST accurately describes what the patient will experience during the postictal
state that follows a seizure?
Select one:
A. A gradually decreasing level of consciousness
B. A rapidly improving level of consciousness
C. Hyperventilation and hypersalivation
D. Confusion and fatigue - (correct Answer) - D. Confusion and fatigue
