Chapter 3 Flashcards by walter Maverick

What is the most appropriate initial assessment in a patient with altered mental status?
a) Check blood pressure
b) Assess for trauma
c) Evaluate airway, breathing, and circulation
d) Start IV access

c) Evaluate airway, breathing, and circulation

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AEIOU-TIPS is a useful mnemonic for assessing:
a) Chest pain
b) Stroke
c) Altered mental status
d) Seizures

c) Altered mental status

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Which of the following is most consistent with metabolic acidosis?
a) Bradypnea
b) Cheyne-Stokes respirations
c) Kussmaul respirations
d) Apnea

c) Kussmaul respirations

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A 40-year-old found unresponsive with pinpoint pupils likely has:
a) Stroke
b) Opioid overdose
c) Hyperglycemia
d) Hypovolemia

b) Opioid overdose

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Which assessment finding would most support a diagnosis of stroke?
a) Polyuria and dry mucous membranes
b) Unilateral facial droop and slurred speech
c) Generalized tonic-clonic movements
d) Diaphoresis and bradycardia

b) Unilateral facial droop and slurred speech

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In hypoglycemia, the brain is deprived of:
a) Insulin
b) Oxygen
c) Glucose
d) Electrolytes

c) Glucose

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What is the appropriate prehospital treatment for hypoglycemia with altered mental status?
a) High-flow oxygen
b) Oral glucose
c) Dextrose IV or glucagon IM
d) Atropine IV

c) Dextrose IV or glucagon IM

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Which term refers to a patient’s inability to recognize familiar people or places?
a) Aphasia
b) Dysarthria
c) Agnosia
d) Amnesia

c) Agnosia

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What is the classic triad of symptoms for Wernicke’s encephalopathy?
a) Fever, hypotension, tachycardia
b) Ataxia, confusion, ophthalmoplegia
c) Hypertension, bradycardia, irregular respirations
d) Seizure, headache, visual changes

b) Ataxia, confusion, ophthalmoplegia

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A patient presents with confusion, ataxia, and vertical nystagmus. You suspect:
a) Stroke
b) Alcohol intoxication
c) Wernicke’s encephalopathy
d) Hypoxia

c) Wernicke’s encephalopathy

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Which condition is most likely to cause rapid deterioration in a diabetic patient?
a) Hyperglycemia
b) Hypoglycemia
c) Hypertension
d) Hyperkalemia

b) Hypoglycemia

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A patient with hepatic encephalopathy will most likely present with:
a) High blood pressure and seizures
b) Asterixis and confusion
c) Abdominal pain and diarrhea
d) Dyspnea and tachycardia

b) Asterixis and confusion

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Which of the following may mimic stroke symptoms?
a) Subdural hematoma
b) COPD
c) UTI
d) Sinusitis

a) Subdural hematoma

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You are called for a seizure patient who is postictal. What should your initial focus be?
a) Start IV access
b) Determine seizure type
c) Protect airway and monitor breathing
d) Administer glucose

c) Protect airway and monitor breathing

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An elderly patient presents with altered mental status and fever. You should suspect:
a) Sepsis
b) Stroke
c) Epilepsy
d) CHF

a) Sepsis

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Which of the following is LEAST likely to cause altered mental status?
a) Hypoxia
b) Hypoglycemia
c) Hypothermia
d) Hypertension

d) Hypertension

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In patients with suspected drug overdose, what is the most important priority?
a) Identify the substance
b) Administer activated charcoal
c) Support airway, breathing, and circulation
d) Transport to a detox center

c) Support airway, breathing, and circulation

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A 32-year-old female presents with visual hallucinations, tachycardia, and dilated pupils. This suggests:
a) Benzodiazepine overdose
b) Opiate use
c) Sympathomimetic toxicity
d) Beta-blocker toxicity

c) Sympathomimetic toxicity

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Which lab value is most critical when assessing altered mental status?
a) Sodium
b) Hematocrit
c) Blood glucose
d) Calcium

c) Blood glucose

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Which of the following is most consistent with hyperosmolar hyperglycemic state (HHS)?
a) Rapid-onset unconsciousness
b) Severe dehydration and very high glucose
c) Kussmaul breathing and ketosis
d) Blood glucose <70 mg/dL

b) Severe dehydration and very high glucose

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You respond to a patient who is agitated and combative, with extreme diaphoresis and tachypnea. What should be your primary concern?
a) Panic attack
b) Excited delirium
c) Hypoglycemia
d) Stroke

b) Excited delirium

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Asterixis is best described as:
a) Eye fluttering
b) Flapping tremor of the hands
c) Pupil constriction
d) Slurred speech

b) Flapping tremor of the hands

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What is the most appropriate treatment for excited delirium?
a) Rapid cooling and IV fluids
b) Sedation and airway support
c) High-dose beta blockers
d) Sodium bicarbonate IV

b) Sedation and airway support

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A key difference between delirium and dementia is:
a) Delirium has gradual onset
b) Delirium involves fluctuating awareness
c) Dementia has hallucinations
d) Dementia is reversible

b) Delirium involves fluctuating awareness

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A stroke that affects speech and the right side of the body is likely located in the: a) Left hemisphere b) Brainstem c) Cerebellum d) Right hemisphere

a) Left hemisphere

A diabetic patient presents with polydipsia, polyuria, and deep rapid respirations. What should you suspect? a) Hypoglycemia b) DKA c) Stroke d) Hyperosmolar hyperglycemic state

b) DKA

Which condition is characterized by the loss of ability to express speech? a) Aphasia b) Agnosia c) Dysarthria d) Asterixis

a) Aphasia

The prehospital treatment for suspected narcotic overdose includes: a) Diphenhydramine and oxygen b) Glucagon c) Naloxone d) Activated charcoal

c) Naloxone

A patient experiencing a syncopal episode should first be evaluated for: a) Hypoglycemia b) Cardiac dysrhythmia c) Seizure activity d) Stroke

b) Cardiac dysrhythmia

Which mental status is typical in the postictal phase? a) Violent agitation b) Unconsciousness c) Confusion and fatigue d) Alertness and restlessness

c) Confusion and fatigue

A 50-year-old with a history of alcohol use presents confused, ataxic, and has nystagmus. You suspect: a) Stroke b) Wernicke’s encephalopathy c) Bell’s palsy d) Hepatic encephalopathy

b) Wernicke’s encephalopathy

A patient with expressive aphasia likely has damage in which brain region? a) Wernicke’s area b) Brainstem c) Broca’s area d) Occipital lobe

c) Broca’s area

Seizures due to alcohol withdrawal typically occur within: a) 1–2 hours b) 6–8 hours c) 12–24 hours d) 48–72 hours

d) 48–72 hours

What is the most life-threatening complication of hepatic encephalopathy? a) Hypotension b) Seizures c) Cerebral edema d) Hypoglycemia

c) Cerebral edema

A seizure that lasts more than 5 minutes is termed: a) Focal seizure b) Grand mal c) Status epilepticus d) Tonic seizure

c) Status epilepticus

Your patient presents with pinpoint pupils, respiratory depression, and unresponsiveness. What is your first intervention? a) IV access b) Naloxone c) BVM ventilation d) Oral glucose

c) BVM ventilation

Which is the MOST important diagnostic tool when evaluating a patient with altered mental status? a) ECG b) Blood glucose check c) Vital signs d) Neurological exam

b) Blood glucose check

Which of the following is a reversible cause of altered mental status? a) Stroke b) Subarachnoid hemorrhage c) Hypoglycemia d) Dementia

c) Hypoglycemia

A patient who is awake but unable to respond verbally may be experiencing: a) Apraxia b) Dysarthria c) Expressive aphasia d) Receptive aphasia

c) Expressive aphasia

A diabetic patient with deep, rapid respirations and fruity breath odor likely has: a) Sepsis b) DKA c) HHS d) Stroke

b) DKA

What is the key distinguishing feature of delirium? a) Gradual memory loss b) Hallucinations c) Fluctuating consciousness d) Personality changes

c) Fluctuating consciousness

A seizure patient is awake but confused. What phase is this? a) Aura b) Tonic c) Postictal d) Clonic

c) Postictal

The most common cause of altered mental status in elderly patients is: a) Stroke b) UTI c) Head trauma d) Electrolyte imbalance

b) UTI

Which of the following is an early sign of increased intracranial pressure (ICP)? a) Unequal pupils b) Irregular breathing c) Vomiting d) Bradycardia

c) Vomiting

A GCS of 8 or less usually indicates: a) Stroke b) Minor head injury c) Need for intubation d) Seizure activity

c) Need for intubation

A patient who responds only to painful stimuli would have a GCS of: a) 3 b) 6 c) 8 d) 10

c) 8

A 65-year-old diabetic patient with slurred speech and right-sided weakness most likely has: a) Seizure b) Stroke c) Hyperglycemia d) Bell’s palsy

b) Stroke

Which of the following best describes receptive aphasia? a) Difficulty writing words b) Impaired comprehension of speech c) Slurred and garbled speech d) Repeating the same word

b) Impaired comprehension of speech

The most important goal in managing status epilepticus is: a) Prevent aspiration b) Determine the cause c) Stop the seizure d) Monitor vital signs

c) Stop the seizure

A diabetic patient with AMS and blood glucose of 38 mg/dL needs: a) IV normal saline b) IM glucagon or IV dextrose c) Oxygen and fluids d) Naloxone

b) IM glucagon or IV dextrose

Which brain lobe is primarily responsible for vision? a) Frontal b) Temporal c) Occipital d) Parietal

c) Occipital

In a patient with a suspected stroke, what is the prehospital priority? a) Administer aspirin b) Rapid glucose check and transport to stroke center c) Administer naloxone d) Monitor vital signs only

b) Rapid glucose check and transport to stroke center

A patient presents with AMS, dry skin, and poor turgor. Which condition is most likely? a) Hypoglycemia b) Hyperglycemia c) Hepatic encephalopathy d) Stroke

b) Hyperglycemia

Decorticate posturing indicates damage to the: a) Brainstem b) Midbrain c) Cortex d) Cerebellum

b) Midbrain

Which of the following typically presents with slow onset AMS in the elderly? a) Stroke b) Subdural hematoma c) Seizure d) Myocardial infarction

b) Subdural hematoma

Which sign is most likely to be present in hepatic encephalopathy? a) Miosis b) Bradycardia c) Asterixis d) Tachypnea

c) Asterixis

What does the 'P' in AEIOU-TIPS stand for? a) Pulmonary embolism b) Psychogenic causes c) Poisoning d) Pneumonia

c) Poisoning

A patient who is alert but disoriented to time and place has a GCS verbal score of: a) 5 b) 4 c) 3 d) 2

b) 4

Which of the following signs is associated with increased ICP? a) Hypertension with bradycardia b) Hypotension and tachycardia c) Hyperglycemia and bradypnea d) Dilated pupils with fast HR

a) Hypertension with bradycardia

A patient with pinpoint pupils and respiratory depression most likely overdosed on: a) Cocaine b) Benzodiazepines c) Opioids d) Alcohol

c) Opioids

A patient with hepatic failure presents with confusion. What toxin is likely responsible? a) Glucose b) Ammonia c) Bilirubin d) Acetone

b) Ammonia

When using the Cincinnati Prehospital Stroke Scale, what is NOT included? a) Facial droop b) Arm drift c) Speech d) Grip strength

d) Grip strength

Which of the following is most consistent with psychogenic AMS? a) Hallucinations b) Hypoglycemia c) Asterixis d) Seizures

a) Hallucinations

A 72-year-old male presents with AMS and fever. What is your top concern? a) Stroke b) Sepsis c) Hyperglycemia d) Cardiac ischemia

b) Sepsis

Which condition presents with involuntary flapping motions of the hands? a) Seizure b) Asterixis c) Delirium d) Syncope

b) Asterixis

Rebound hyperglycemia after treatment with insulin is called: a) HHS b) Somogyi effect c) Dawn phenomenon d) DKA

b) Somogyi effect

A blood glucose level of 700 mg/dL with dehydration suggests: a) DKA b) Hypoglycemia c) Hyperosmolar hyperglycemic state (HHS) d) Insulin overdose

c) Hyperosmolar hyperglycemic state (HHS)

A 35-year-old is confused, diaphoretic, and tachycardic. You find blood sugar 38 mg/dL. You should: a) Administer IV fluids b) Give naloxone c) Administer oral glucose or D50 IV d) Transport without treatment

c) Administer oral glucose or D50 IV

What finding differentiates HHS from DKA? a) Ketones b) Vomiting c) Glucose levels d) Respiratory rate

a) Ketones

The limbic system of the brain primarily controls: a) Movement b) Emotion c) Speech d) Vision

b) Emotion

Which of the following is an indication for naloxone? a) Hypoglycemia b) Decreased respiratory drive c) Bradycardia d) Vomiting

b) Decreased respiratory drive

What is a common finding in a patient with benzodiazepine overdose? a) Agitation b) Tachypnea c) Sedation and hypotonia d) Hypertension

c) Sedation and hypotonia

In the setting of trauma, AMS is most commonly due to: a) Spinal shock b) Blood loss c) Head injury d) Rib fractures

c) Head injury

Which of the following is a primary assessment priority in a patient with AMS? a) Cardiac monitoring b) Neurological history c) Blood glucose level d) Head-to-toe exam

c) Blood glucose level

A 28-year-old found with bizarre behavior and hallucinations may have: a) Syncope b) Psychosis c) Stroke d) Hypoxia

b) Psychosis

Which brain structure regulates vital functions such as breathing and heart rate? a) Cerebrum b) Brainstem c) Cerebellum d) Thalamus

b) Brainstem

What is a primary cause of seizure in patients with a history of epilepsy? a) Brain tumor b) Alcohol withdrawal c) Missed medication d) Stroke

c) Missed medication

A patient with AMS and asterixis likely has dysfunction in which organ? a) Kidney b) Brain c) Liver d) Pancreas

c) Liver

Which of the following is NOT part of the AEIOU-TIPS mnemonic? a) Infection b) Overdose c) Trauma d) Intoxication

d) Intoxication

What is the best initial treatment for AMS caused by hypoglycemia? a) Oxygen b) IV fluids c) Dextrose d) Naloxone

c) Dextrose

A patient presents with muscle twitching, confusion, and positive Chvostek’s sign. Suspect: a) Hyperkalemia b) Hypocalcemia c) Hyponatremia d) Hypermagnesemia

b) Hypocalcemia

What medication is administered intramuscularly for severe hypoglycemia when IV access is not available? a) D10 b) Glucagon c) Insulin d) Naloxone

b) Glucagon

What neurological finding is common in hepatic encephalopathy? a) Ataxia b) Myoclonus c) Asterixis d) Aphasia

c) Asterixis

Which brain lobe controls voluntary muscle movements? a) Parietal b) Temporal c) Frontal d) Occipital

c) Frontal

A tonic-clonic seizure followed by a confused state is known as: a) Status epilepticus b) Simple seizure c) Postictal state d) Partial seizure

c) Postictal state

The Monroe-Kellie doctrine refers to: a) Pulmonary perfusion ratios b) Intracranial pressure dynamics c) Spinal cord compression patterns d) Hepatic pressure regulation

b) Intracranial pressure dynamics

What is the first intervention for a hypoglycemic patient with AMS and no IV access? a) Oral glucose b) Glucagon IM c) Transport without intervention d) Oxygen only

b) Glucagon IM

Which metabolic abnormality is most associated with seizures? a) Hypernatremia b) Hypoglycemia c) Hyperchloremia d) Hypercalcemia

b) Hypoglycemia

A diabetic patient with tachypnea, polyuria, and Kussmaul respirations likely has: a) HHS b) DKA c) Hypernatremia d) Hepatic encephalopathy

b) DKA

Which brain region processes auditory information? a) Occipital lobe b) Parietal lobe c) Frontal lobe d) Temporal lobe

d) Temporal lobe

What does the 'S' in AEIOU-TIPS stand for? a) Seizure b) Stroke c) Syncope d) Shock

a) Seizure

A patient who cannot understand spoken language may have damage to: a) Broca’s area b) Wernicke’s area c) Frontal lobe d) Brainstem

b) Wernicke’s area

What hormone imbalance is seen in hepatic encephalopathy? a) High cortisol b) High insulin c) Low glucagon d) High ammonia

d) High ammonia

Which finding supports a diagnosis of HHS over DKA? a) Blood glucose 450 b) Ketones in urine c) Slow, shallow breathing d) Serum ketone absent

d) Serum ketone absent

A confused diabetic with glucose of 35 mg/dL should be treated with: a) Insulin b) IM glucagon or IV D50 c) Normal saline d) Oxygen only

b) IM glucagon or IV D50

A patient with syncope, slow cap refill, and thready pulse is likely experiencing: a) Neurogenic shock b) Cardiogenic shock c) Hypovolemia d) Seizure

c) Hypovolemia

What GCS score would be assigned to a patient who moans to pain, opens eyes to pain, and flexes arms abnormally? a) 6 b) 7 c) 8 d) 9

b) 7

Which organ system failure can lead to uremic encephalopathy? a) Cardiac b) Hepatic c) Renal d) Respiratory

c) Renal

Which lobe is responsible for interpreting sensory input? a) Temporal b) Occipital c) Parietal d) Frontal

c) Parietal

What is the immediate danger in status epilepticus? a) Bradycardia b) Hypoxia c) Hyperglycemia d) Dehydration

b) Hypoxia

Chapter 3 Flashcards

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