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Prehospital Emergency Care Practice Test: Handling Altered Mental Status, Stroke, and Headache
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A headache with altered mental status (AMS) can be a sign of infection, bleeding, or a tumor. Vomiting without diarrhea can indicate increased brain pressure. Dehydration can also cause AMS.  Some causes of AMS include: Brain bleed, Brain tumor, Hepatic encephalopathy, Obstructive hydrocephalus, Seizure, and Stroke.  A stroke, also known as a cerebrovascular accident (CVA) or brain attack, occurs when blood flow to the brain is blocked or a blood vessel in the brain bursts. This can cause lasting brain damage, long-term disability, or even death.  There are two main types of... Show more
Prehospital Emergency Care Practice Test: Handling Altered Mental Status, Stroke, and Headache
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25 Questions

1. Patients with an altered mental status due to a stroke may not be able to control their own airways because of:
2. Which of these statements made by your new EMT partner demonstrates an understanding of assessment findings related to stroke?
3. Assessment of a 56-year-old male patient reveals him to be responsive to verbal stimuli with garbled speech. Which of these statements made by the patient's wife suggests that the patient's problem may be toxic-metabolic?
4. Which of these patients would be most eligible to receive a fibrinolytic medication for stroke if no other contraindications are found?
5. A male patient has altered mental status secondary to a brain tumor. The EMT would classify the brain tumor as which type of cause?
6. For altered mental status to occur, which body system must be affected?
7. The EMT demonstrates she understands hemorrhagic stroke when she states:
8. A 78-year-old male patient was found lying on his bathroom floor. Emergency Medical Responders report that the patient is unresponsive, with unequal pupils, and vital signs are as follows: pulse, 78; respirations, 20 breaths/min and snoring; blood pressure, 210/106 mmHg; SpO2, 99%. The EMRs have applied oxygen by nonrebreather mask, and also report that the patient has a hematoma on the back of his head. What should you do first?
9. What does the first 'I' in the AEIOU-TIPPSS mnemonic stand for?
10. When the EMT evaluates a patient with the RACE stroke scale, the score is 3 points. This score would infer:
11. Which of these is a good description of an ischemic stroke?
12. You have been called for a patient who suddenly became confused. Which of these assessment findings should concern you most?
13. A male patient is confused and combative for no apparent reason. There are no life threats to his airway, breathing, or circulation, and his vital signs are pulse, 88; respirations, 16 breaths/min and adequate; blood pressure, 144/68 mmHg; and SpO2, 93% on room air. When addressing the patient's oxygenation status, which of these treatments would be appropriate?
14. You are treating an unresponsive patient. Which piece of information given to you by the patient's family is most important in relation to a possible stroke?
15. A 49-year-old male patient is unable to speak. You would document this finding as:
16. You have determined that an alert elderly male patient has garbled speech and weakness to the right arm and leg. His vital signs and SpO2 level are within normal limits. The family informs you that he has a history of heart problems and diabetes. Given this scenario, what should you do immediately?
17. The MEND exam for a stroke does not include which assessment parameter?
18. During a continuing education program, the lecturer is talking about the RACE scale as a newer tool the EMT can use to help determine whether a neurologic problem is present. Which neurologic problem does the RACE scale address?
19. Which one of these instructions to a patient with possible stroke indicates proper assessment for an arm drift?
20. When assessing a patient with stroke-like signs and symptoms, it is critical that the EMT also suspect and rule out which condition?
21. Which of these statements made by the EMT indicates a correct understanding of caring for someone with a headache?
22. An alert and oriented 69-year-old male patient has slight right-arm weakness but exhibits no deficits to the right leg. The EMT should consider this patient to be a:
23. You are called for a 69-year-old male patient with altered mental status. Assessment reveals that he is confused and has left-sided weakness. During transport, you note that the patient is now completely oriented and the weakness has resolved. Which condition would you suspect this patient has?
24. A 56-year-old patient is in bed and unable to speak. Family members state that he had a stroke in the past and has been bedridden since then, but has always been able to talk, until a few hours ago when his speech became garbled. They also state that the last stroke left him paralyzed on his left side. Your assessment reveals that the patient is unable to speak, but has an open airway, adequate respirations, and a strong radial pulse. Additionally, you note that he is unable to move his right arm. Vital signs are within normal limits. What would be an appropriate step in the care on this patient?
25. When a patient smiles, the left side of the face shows significantly less movement than the right side of the face. The EMT would describe this finding as:

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