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Flashcards in Chapter 11 Deck (46):
1

When assessing a patient with a possible stroke, the priority of care is:

a. identifying risk factors for stroke.
b. determining if there is a family history of stroke.
c. recognizing the signs of a stroke.
d. determining the type of stroke.

a. identifying risk factors for stroke.
b. determining if there is a family history of stroke.
c. recognizing the signs of a stroke.
d. determining the type of stroke.

Answer: c
Objective: 11-5
Reference: 375

2

Which of the following is the best answer to the question, “Are all stroke patients paralyzed on one side of their bodies?”

a. “Yes. Both the arm and leg on the same side is always be paralyzed.”
b. “No. Some patients suffering a stroke will show no signs of paralysis at all.”
c. “No. Paralysis can occur on both sides of the body of different limbs.”
d. “No. Some stroke patients may have only slight weakness on one side of their bodies.”

a. “Yes. Both the arm and leg on the same side is always be paralyzed.”
b. “No. Some patients suffering a stroke will show no signs of paralysis at all.”
c. “No. Paralysis can occur on both sides of the body of different limbs.”
d. “No. Some stroke patients may have only slight weakness on one side of their bodies.”

Answer: d
Objective: 11-4
Reference: 375

3

When assessing a patient for abnormal speech, you should:

a. ask the patient stick his tongue straight out.
b. ask the patient to repeat a common phrase.
c. see if one side of the patient’s mouth is drooping.
d. write questions on note cards for the patient to read.

a. ask the patient stick his tongue straight out.
b. ask the patient to repeat a common phrase.
c. see if one side of the patient’s mouth is drooping.
d. write questions on note cards for the patient to read.

Answer: b
Objective: 11-4
Reference: 375

4

When assessing a patient for a facial droop, you should:

a. palpate the face one side at a time.
b. gently lift and then let go of the skin over the cheeks.
c. ask the patient to show you his teeth or to smile.
d. observe the patient’s ability to turn his head to the right and then to the left.

a. palpate the face one side at a time.
b. gently lift and then let go of the skin over the cheeks.
c. ask the patient to show you his teeth or to smile.
d. observe the patient’s ability to turn his head to the right and then to the left.

Answer: c
Objective: 11-5
Reference: 375

5

Which of the following instructions to a possible stroke patient describes the proper procedure for assessing an arm drift?

a. “Hold your arms up over your head for 20 seconds.”
b. “Grab my fingers with both hands and squeeze as hard as you can.”
c. “Raise your hands above your head and close your eyes.”
d. “Hold your arms straight out for 10 to 15 seconds.”

a. “Hold your arms up over your head for 20 seconds.”
b. “Grab my fingers with both hands and squeeze as hard as you can.”
c. “Raise your hands above your head and close your eyes.”
d. “Hold your arms straight out for 10 to 15 seconds.”

Answer: d
Objective: 11-5
Reference: 374

6

Which of the following questions is critical for establishing a window of treatment for a patient who is weak and dizzy and may have suffered a stroke?

a. “Does your father have a history of heart problems or stroke?”
b. “What time did the weakness and dizziness start?”
c. “What medications do you take?”
d. “Do you have any pain in your arms or legs?”

a. “Does your father have a history of heart problems or stroke?”
b. “What time did the weakness and dizziness start?”
c. “What medications do you take?”
d. “Do you have any pain in your arms or legs?”

Answer: b
Objective: 11-5
Reference: 373, 376

7

Which of the following pieces of information is assessed by the Cincinnati Prehospital Stroke Scale?

a. Blood glucose level
b. Presence or absence of facial droop
c. Duration of symptoms
d. Age of the patient

a. Blood glucose level
b. Presence or absence of facial droop
c. Duration of symptoms
d. Age of the patient

Answer: b
Objective: 11-5
Reference: 376

8

You have assessed a patient and found a patent airway, adequate breathing, and a strong radial pulse. The patient is having no difficulty speaking and no facial droop, but exhibits a slight left arm drift. You should interpret these findings as:

a. not suggestive of a stroke.
b. suggestive of a stroke only if the patient’s blood pressure is also elevated.
c. suggestive of a stroke only if the patient’s pupils are not equal.
d. suggestive that a stroke may be occurring.

a. not suggestive of a stroke.
b. suggestive of a stroke only if the patient’s blood pressure is also elevated.
c. suggestive of a stroke only if the patient’s pupils are not equal.
d. suggestive that a stroke may be occurring.

Answer: d
Objective: 11-5
Reference: 375

9

Which of the following statements shows that the speaker has an accurate understanding of assessment findings related to stroke?

a. “For a stroke to be suspected, both arms must be equally weak.”
b. “If one arm is weak, a stroke should be suspected.”
c. “A stroke should be suspected only when one arm is paralyzed, not just weak.”
d. “If one arm is weak, stroke should be suspected only if the patient’s blood pressure is also elevated.”

a. “For a stroke to be suspected, both arms must be equally weak.”
b. “If one arm is weak, a stroke should be suspected.”
c. “A stroke should be suspected only when one arm is paralyzed, not just weak.”
d. “If one arm is weak, stroke should be suspected only if the patient’s blood pressure is also elevated.”

Answer: b
Objective: 11-5
Reference: 374, 375

10

You have been called for a 63-year-old woman with slurred speech and right arm weakness. On arrival, the patient informs you that the slurred speech and weakness have resolved. Since your assessment reveals no deficits, you would tell the patient:

a. “It would be best to start taking one baby aspirin every day; this will decrease the chance of this happening again.”
b. “Sometimes seizures present this way; call your doctor in the morning to schedule an appointment.”
c. “If this happens again, wait 10 minutes to see if you are okay. If the symptoms don’t go away, call 911.”
d. “You really need to be evaluated in the hospital. You could be at risk for a future stroke.”

a. “It would be best to start taking one baby aspirin every day; this will decrease the chance of this happening again.”
b. “Sometimes seizures present this way; call your doctor in the morning to schedule an appointment.”
c. “If this happens again, wait 10 minutes to see if you are okay. If the symptoms don’t go away, call 911.”
d. “You really need to be evaluated in the hospital. You could be at risk for a future stroke.”

Answer: d
Objective: 11-5
Reference: 375, 380

11

Your assessment reveals a drooling 48-year-old male to have gurgling speech and left arm paralysis. Which of the following would be your priority?

a. Suction the patient’s airway.
b. Protect the patient’s left arm.
c. Determine the patient’s risk factors for stroke.
d. Monitor the patient’s blood pressure.

a. Suction the patient’s airway.
b. Protect the patient’s left arm.
c. Determine the patient’s risk factors for stroke.
d. Monitor the patient’s blood pressure.

Answer: a
Objective: 11-5
Reference: 377

12

Which of the following events best describes an ischemic stroke?

a. An artery in the brain has ruptured.
b. Blood has collected throughout the brain tissue.
c. A heart attack has occurred at the same time as a stroke.
d. A blood clot has obstructed a blood vessel in the brain.

a. An artery in the brain has ruptured.
b. Blood has collected throughout the brain tissue.
c. A heart attack has occurred at the same time as a stroke.
d. A blood clot has obstructed a blood vessel in the brain.

Answer: d
Objective: 11-5
Reference: 370

13

Which of the following statements indicates that the speaker understands hemorrhagic strokes?

a. “They occur when clots form in blood vessels in the brain.”
b. “They occur when a blood vessel in the brain ruptures.”
c. “Their signs and symptoms generally resolve within 24 hours.”
d. “They can sometimes be treated by clot-destroying medications.”

a. “They occur when clots form in blood vessels in the brain.”
b. “They occur when a blood vessel in the brain ruptures.”
c. “Their signs and symptoms generally resolve within 24 hours.”
d. “They can sometimes be treated by clot-destroying medications.”

Answer: b
Objective: 11-5
Reference: 371

14

The signs and symptoms of a transient ischemic attack (TIA):

a. are temporary and resolve within 24 hours.
b. can persist for a few days before they resolve.
c. are mild but permanent.
d. are severe and permanent.

a. are temporary and resolve within 24 hours.
b. can persist for a few days before they resolve.
c. are mild but permanent.
d. are severe and permanent.

Answer: a
Objective: 11-5
Reference: 371

15

Which of the following statements indicates that the speaker an accurate understanding of altered mental status?

a. “It describes any abnormal change in a person’s level of awareness.”
b. “It occurs only when a patient is not responsive to verbal or painful stimuli.”
c. “It should be suspected only when a patient is on medications that can cause confusion.”
d. “It is any mental state in a person with diabetes.”

a. “It describes any abnormal change in a person’s level of awareness.”
b. “It occurs only when a patient is not responsive to verbal or painful stimuli.”
c. “It should be suspected only when a patient is on medications that can cause confusion.”
d. “It is any mental state in a person with diabetes.”

Answer: a
Objective: 11-1
Reference: 356

16

Your patient is a 78-year-old male who was found lying on the beginner slope. The patient is unresponsive with unequal pupils and vital signs as follows: pulse 78, respirations 20 and deep. The patient has a hematoma on the back of his head. Which one of the following would you do first?

a. Find a witness to tell you how the person got there.
b. Apply a cervical collar.
c. Ensure an open airway using the jaw-thrust maneuver.
d. Look for a medic alert tag.

a. Find a witness to tell you how the person got there.
b. Apply a cervical collar.
c. Ensure an open airway using the jaw-thrust maneuver.
d. Look for a medic alert tag.

Answer: c
Objective: Supplemental
Reference: 373

17

Your patient is unresponsive. Which piece of information given to you by the patient’s family is most important in relation to the treatment of a possible stroke?

a. “He forgot to take his blood thinner last night.”
b. “We think he had too much to drink last night.”
c. “We noticed him acting oddly about 7 p.m. last night.”
d. “He took some ibuprofen last night for a fever and cough.”

a. “He forgot to take his blood thinner last night.”
b. “We think he had too much to drink last night.”
c. “We noticed him acting oddly about 7 p.m. last night.”
d. “He took some ibuprofen last night for a fever and cough.”

Answer: c
Objective: 11-6
Reference: 373

18

The benefit of the Cincinnati Prehospital Stroke Scale is that it:

a. enables you to identify patients at risk for stroke.
b. enables you to identify the type of stroke a patient is having.
c. helps you predict the likelihood a patient will die from a stroke.
d. helps you identify the probability that your patient is having a stroke.

a. enables you to identify patients at risk for stroke.
b. enables you to identify the type of stroke a patient is having.
c. helps you predict the likelihood a patient will die from a stroke.
d. helps you identify the probability that your patient is having a stroke.

Answer: d
Objective: 11-6
Reference: 376

19

You have been called for a seizure emergency. You find an adult female actively seizing with a bystander attempting to place a spoon between her teeth. The bystander tells you that he is trying to keep the person from biting her tongue. Which one of the following would be an appropriate response?

a. Tell the bystander to continue trying to get the spoon in place.
b. Turn the patient onto her side to facilitate the drainage of oral secretions.
c. Instruct the bystander to restrain the patient while you put the spoon in place.
d. Tell the bystander that a padded tongue blade works better.

a. Tell the bystander to continue trying to get the spoon in place.
b. Turn the patient onto her side to facilitate the drainage of oral secretions.
c. Instruct the bystander to restrain the patient while you put the spoon in place.
d. Tell the bystander that a padded tongue blade works better.

Answer: b
Objective: 11-4
Reference: 380

20

A young boy tells you that his twin brother suffers from seizures and asks what he can do if he sees his brother convulsing. You should give him which one of the following instructions?

a. “Move any moveable objects and furniture away from him.”
b. “Hold him firmly against the floor until he stops seizing or until the EMTs arrive.”
c. “Insert a spoon into his mouth to keep him from swallowing his tongue.”
d. “Call EMS only if the seizure lasts more than 10 minutes or he loses control of his bladder.”

a. “Move any moveable objects and furniture away from him.”
b. “Hold him firmly against the floor until he stops seizing or until the EMTs arrive.”
c. “Insert a spoon into his mouth to keep him from swallowing his tongue.”
d. “Call EMS only if the seizure lasts more than 10 minutes or he loses control of his bladder.”

Answer: a
Objective: 11-4
Reference: 380

21

As a general rule, a seizing patient should be transported in what position?

a. Supine
b. Semi-Fowler’s
c. Lateral recumbent
d. Trendelenburg (shock position)

a. Supine
b. Semi-Fowler’s
c. Lateral recumbent
d. Trendelenburg (shock position)

Answer: c
Objective: 11-4
Reference: 380

22

After a delayed response, you arrive in the lodge and find a 62-year-old female is still seizing. Which one of the following should you do first?

a. Assess her airway and breathing.
b. Determine if she has a seizure history.
c. Ascertain the duration of the seizure.
d. Move her to the aid room for further assessment and then transport her to the hospital.

a. Assess her airway and breathing.
b. Determine if she has a seizure history.
c. Ascertain the duration of the seizure.
d. Move her to the aid room for further assessment and then transport her to the hospital.

Answer: a
Objective: 11-4
Reference: 380

23

You are called the lodge to assess a 3-year-old boy. The parents state that their son was playing with his brother and “blanked out” and “stared off into space” for several seconds. They deny any convulsing-like movement. Based on this description, you would suspect what type of seizure?

a. A febrile seizure
b. A simple partial seizure
c. A grand mal seizure
d. An absence seizure

a. A febrile seizure
b. A simple partial seizure
c. A grand mal seizure
d. An absence seizure

Answer: d
Objective: 11-4
Reference: 364

24

When performing a secondary assessment on a confused patient, which of the following signs is most suggestive of a seizure?

a. Bruises on the arms
b. A bitten tongue
c. Pinpoint pupils
d. A slow heart rate

a. Bruises on the arms
b. A bitten tongue
c. Pinpoint pupils
d. A slow heart rate

Answer: b
Objective: 11-4
Reference: 373

25

You have been called to the lodge for a behavioral emergency. When you arrive, you find a disheveled male in his forties sitting up against a wall. He is confused and incontinent. Bystanders state that he suddenly began to stumble around and then fell to the ground and was grunting and shaking. From this description, you would be suspicious of what condition?

a. A generalized seizure
b. A diabetic reaction
c. An absence seizure
d. A syncopal episode

a. A generalized seizure
b. A diabetic reaction
c. An absence seizure
d. A syncopal episode

Answer: a
Objective: 11-4
Reference: 364

26

Status epilepticus is best differentiated from a generalized seizure by:

a. the duration of the seizure.
b. the length of the postictal period.
c. the presence of an aura prior to seizing.
d. a pre-existing history of seizures.

a. the duration of the seizure.
b. the length of the postictal period.
c. the presence of an aura prior to seizing.
d. a pre-existing history of seizures.

Answer: a
Objective: 11-4
Reference: 365

27

During the initial part of a generalized seizure, some patients experience a(n):

a. syncopal stage.
b. aura.
c. clonic phase.
d. postictal state.

a. syncopal stage.
b. aura.
c. clonic phase.
d. postictal state.

Answer: b
Objective: 11-4
Reference: 364

28

Which of the following statements indicates that the speaker understands the danger posed by status epilepticus?

a. “Status epilepticus is an extremely dangerous condition because the patient can go into shock from blood loss.”
b. “Patients who do not have a history of seizures are at greater risk for status epilepticus.”
c. “The longer the seizure continues, the greater the likelihood of permanent brain damage.”
d. “Status epilepticus indicates that the patient’s medications have reached toxic levels in the body.”

a. “Status epilepticus is an extremely dangerous condition because the patient can go into shock from blood loss.”
b. “Patients who do not have a history of seizures are at greater risk for status epilepticus.”
c. “The longer the seizure continues, the greater the likelihood of permanent brain damage.”
d. “Status epilepticus indicates that the patient’s medications have reached toxic levels in the body.”

Answer: c
Objective: 11-4
Reference: 365

29

Which of the following statements concerning the pathophysiology of seizures is correct?

a. A seizure occurs when the heart beats irregularly, causing a decreased amount of oxygen-rich blood to reach the brain.
b. All seizures are caused by epilepsy, a term that describes a problem somewhere in the body.
c. A seizure condition is a muscle problem that causes the arms and legs to jerk.
d. A seizure occurs when there is an electrical disturbance in the brain.

a. A seizure occurs when the heart beats irregularly, causing a decreased amount of oxygen-rich blood to reach the brain.
b. All seizures are caused by epilepsy, a term that describes a problem somewhere in the body.
c. A seizure condition is a muscle problem that causes the arms and legs to jerk.
d. A seizure occurs when there is an electrical disturbance in the brain.

Answer: d
Objective: 11-4
Reference: 363

30

In the mnemonic AEIOU-TIPS, the A stands for:

a. ADHD and alcohol.
b. alcohol and acidosis.
c. acidosis and anemia.
d. abscess and acidosis.

a. ADHD and alcohol.
b. alcohol and acidosis.
c. acidosis and anemia.
d. abscess and acidosis.

Answer: b
Objective: 11-2
Reference: 361, 377

31

In the mnemonic AEIOU-TIPS, the E stands for:

a. epilepsy, environment, and electrolyte imbalance.
b. edema, electrolyte imbalance, and endocarditis.
c. epilepsy, echovirus, and environment.
d. electrolyte imbalance, environment, and echovirus.

a. epilepsy, environment, and electrolyte imbalance.
b. edema, electrolyte imbalance, and endocarditis.
c. epilepsy, echovirus, and environment.
d. electrolyte imbalance, environment, and echovirus.

Answer: a
Objective: 11-2
Reference: 361, 378

32

In the mnemonic AEIOU-TIPS, the first I stands for:

a. impetigo.
b. infantile neuroaxonal dystrophy.
c. insulin.
d. interstitial cystitis.

a. impetigo.
b. infantile neuroaxonal dystrophy.
c. insulin.
d. interstitial cystitis.

Answer: c
Objective: 11-2
Reference: 361, 378

33

In the mnemonic AEIOU-TIPS, the O stands for:

a. osteosarcoma and oxygen.
b. oxygen and overdose.
c. overdose and oliguria.
d. overdose and otitis.

a. osteosarcoma and oxygen.
b. oxygen and overdose.
c. overdose and oliguria.
d. overdose and otitis.

Answer: b
Objective: 11-2
Reference: 361, 379

34

In the mnemonic AEIOU-TIPS, the U stands for:

a. urticaria.
b. usher syndrome.
c. ulcers.
d. uremia.

a. urticaria.
b. usher syndrome.
c. ulcers.
d. uremia.

Answer: d
Objective: 11-2
Reference: 361, 379

35

In the mnemonic AEIOU-TIPS, the T stands for:

a. thyroiditis and thrombophlebitis.
b. trauma and tumors.
c. thrombophlebitis and tinnitus.
d. trauma and thrombophlebitis.

a. thyroiditis and thrombophlebitis.
b. trauma and tumors.
c. thrombophlebitis and tinnitus.
d. trauma and thrombophlebitis.

Answer: b
Objective: 11-2
Reference: 361, 379

36

In the mnemonic AEIOU-TIPS, the second I stands for:

a. insomnia.
b. impetigo.
c. interstitial cystitis.
d. infection.

a. insomnia.
b. impetigo.
c. interstitial cystitis.
d. infection.

Answer: d
Objective: 11-2
Reference: 361, 380

37

In the mnemonic AEIOU-TIPS, the P stands for:

a. parathyroid disorders and Parkinson’s disease.
b. parathyroid disorders and psychiatric conditions.
c. Parkinson’s disease and peripheral nerve disorder.
d. poisoning and psychiatric conditions.

a. parathyroid disorders and Parkinson’s disease.
b. parathyroid disorders and psychiatric conditions.
c. Parkinson’s disease and peripheral nerve disorder.
d. poisoning and psychiatric conditions.

Answer: d
Objective: 11-2
Reference: 361, 380

38

In the mnemonic AEIOU-TIPS, the S stands for:

a. steroids, seizure, and sinusitis.
b. seizure, stroke, and syncope.
c. Sjogren’s syndrome, seizure, and sinusitis.
d. sickle cell anemia, Sjogren’s syndrome, and steroids.

a. steroids, seizure, and sinusitis.
b. seizure, stroke, and syncope.
c. Sjogren’s syndrome, seizure, and sinusitis.
d. sickle cell anemia, Sjogren’s syndrome, and steroids.

Answer: b
Objective: 11-2
Reference: 361, 380

39

The part of the brain that is responsible for emotion, thought, speech, integration, and memory is the:

a. brain stem.
b. cerebellum.
c. cerebrum.
d. thalamus.

a. brain stem.
b. cerebellum.
c. cerebrum.
d. thalamus.

Answer: c
Objective: Supplemental
Reference: 356-357

40

The part of the brain that controls basic functions necessary for life is the:

a. brain stem.
b. cerebellum.
c. cerebrum.
d. thalamus.

a. brain stem.
b. cerebellum.
c. cerebrum.
d. thalamus.

Answer: a
Objective: Supplemental
Reference: 356

41

The part of the brain that controls balance and coordination is the:

a. brain stem.
b. cerebellum.
c. cerebrum.
d. thalamus.

a. brain stem.
b. cerebellum.
c. cerebrum.
d. thalamus.

Answer: b
Objective: Supplemental
Reference: 356

42

Insulin:

a. is a catalyst for driving glucose into cells.
b. increases the level of glucose circulating in the blood.
c. makes glucose work better as an energy source.
d. increases the transfer of sugar from the stomach and small intestine to the bloodstream.

a. is a catalyst for driving glucose into cells.
b. increases the level of glucose circulating in the blood.
c. makes glucose work better as an energy source.
d. increases the transfer of sugar from the stomach and small intestine to the bloodstream.

Answer: a
Objective: 11-3
Reference: 358

43

The primary problem in Type II diabetes is that:

a. sugars cannot be easily digested in the stomach and small intestine.
b. cells exhibit resistance to insulin.
c. insufficient insulin is produced.
d. too much insulin is produced.

a. sugars cannot be easily digested in the stomach and small intestine.
b. cells exhibit resistance to insulin.
c. insufficient insulin is produced.
d. too much insulin is produced.

Answer: b
Objective: 11-3
Reference: 367

44

Which of the following actions may result in hypoglycemia in a diabetes patient?

a. Failure to take insulin or an oral diabetes medication
b. Lack of exercise
c. Missing a meal
d. Overeating

a. Failure to take insulin or an oral diabetes medication
b. Lack of exercise
c. Missing a meal
d. Overeating

Answer: c
Objective: 11-3
Reference: 367

45

Hyperglycemia:

a. has a more gradual onset than hypoglycemia.
b. is preceded by an aura, such as hallucinations or detecting unusual odors.
c. has a more rapid onset than hypoglycemia.
d. is more easily treated in prehospital environments than is hypoglycemia.

a. has a more gradual onset than hypoglycemia.
b. is preceded by an aura, such as hallucinations or detecting unusual odors.
c. has a more rapid onset than hypoglycemia.
d. is more easily treated in prehospital environments than is hypoglycemia.

Answer: a
Objective: 11-3
Reference: 369

46

Glucose:

a. assists the pancreas in the manufacture of insulin.
b. is an energy source for brain cells and other cells in the body.
c. is an essential building block for body tissues such as muscle and bone.
d. allows the body to use insulin.

a. assists the pancreas in the manufacture of insulin.
b. is an energy source for brain cells and other cells in the body.
c. is an essential building block for body tissues such as muscle and bone.
d. allows the body to use insulin.

Answer: b
Objective: 11-3
Reference: 365