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Prehospital Emergency Care Practice Test: Handling Seizures and Syncope
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Syncope and seizures are two of the most common differential diagnoses for transient loss of consciousness.  Syncope is characterized by a sudden, complete loss of consciousness, with rapid recovery. Syncope, or fainting, is caused by low blood pressure resulting in an insufficient supply of blood, and therefore oxygen, to the brain. Some symptoms of syncope include: Orthostatic hypotension, Simple faints, Episodes that only occur in the recumbent position, and Syncope induced by strong emotional stimuli.  Seizures can be epileptic or non-epileptic. Some symptoms of seizures include: A... Show more
Prehospital Emergency Care Practice Test: Handling Seizures and Syncope
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25 Questions

1. A 36-year-old male patient with diabetes and hypertension has experienced a secondary seizure. The patient responds to verbal stimuli with garbled speech, and his airway, breathing, and circulation are intact. Vital signs are pulse, 128; respirations, 20 breaths/min and adequate; blood pressure, 158/96 mmHg; and SpO2, 97% on room air. At this time, it is important that the EMT:
2. Status epilepticus is best differentiated from a generalized seizure by the:
3. You are an EMT who finds an adult male patient on his living room floor after the police department had to force the door open. The scene size-up reveals a very cluttered home that smells of urine. On an end table, you find a container of phenytoin (Dilantin) with the patient's name on it. When you pinch his shoulder, the patient responds by moaning and trying to remove your hand from his neck. Based on this information, which of these conditions would you suspect?
4. The EMT shows that she understands the danger posed by status epilepticus when she states:
5. You are summoned to a grocery store for a female patient found having a 'fit' by store employees. Upon arrival, you are escorted to the side of an alert but mildly confused 41-year-old woman who is diaphoretic and appears exhausted. After 2-3 more minutes, she becomes more alert and informs you that she has a history of seizures and just had a generalized seizure. Despite your urging, she refuses transport to the hospital. Your safest action would be to:
6. Which of these medications is most closely associated with a history of seizures?
7. The initial phase of a generalized seizure experienced by some patients, in which they may experience an odd smell or something auditory, is called the:
8. You are caring for a postictal male patient with a known history of seizures. He is confused and cannot remember his 8-year-old son's name. His son tearfully asks you if his father will ever remember him. Your response would be:
9. You are called to a residence for seizure activity. On scene, the patient's daughter tells you that her father, who has diabetes, stated that he suddenly felt dizzy and then fell to the floor. Within a few seconds, he began asking what had happened and why he was on the floor. Based on this description, the EMT should recognize which condition?
10. While you are placing a 52-year-old female patient, whose complaint is a headache, on the stretcher, she begins to seize. Your immediate action would be to:
11. A female patient with a history of seizures has experienced a seizure in a public area and is now refusing further assessment and transport. As you leave, a witness to the entire event tells you that he thinks the patient is 'crazy in the head' because immediately before she seized, she looked up toward the ceiling and kept repeating, 'Do you see the birds?' As a knowledgeable EMT, you should recognize that the bystander is describing which condition?
12. The EMT would recognize that a 49-year-old male patient has experienced a primary seizure when his wife states:
13. While you are transporting a 41-year-old woman who is not feeling well, she begins to seize. She has no history of seizures, and the seizure lasts approximately 90 seconds. After 30 seconds of being postictal and totally unresponsive, the woman suddenly seizes again for the remainder of the 12-minute transport. The EMT should recognize that the patient is experiencing which emergency condition?
14. You are dispatched to a local mall, where you are met by bystanders who state that the patient was talking to a customer representative when she 'passed out.' You find an alert and oriented 55-year-old female patient lying supine on the tile floor. The patient tells you that the back of her head is hurting, her neck now hurts, and her arms and legs feel very weak. Which action should you perform first?
15. You are preparing to transport a 46-year-old male patient who has had multiple seizures throughout the morning, according to the family. Currently, he is on your stretcher and is postictal. He has a history of seizures for which he takes anticonvulsant medications. He also has diabetes and kidney failure. Of the equipment listed here, which is the most essential to have ready during transport of this patient?
16. You believe that a patient experienced a simple partial (focal motor) seizure. Which of these statements made by the patient would reinforce this suspicion?
17. When treating a patient who has had a seizure, the most important aspect of providing care is to:
18. A patient has been actively seizing for 17 minutes. He is cyanotic with shallow and ineffective respirations. Which immediate care should you provide to this patient?
19. Which of these statements about seizures is true?
20. You are transporting a patient who has a history of simple partial seizures. During transport, she experiences a simple partial seizure involving her right arm. Her pulse is 92, respirations are 14 breaths/min and adequate, blood pressure is 168/88 mmHg, and SpO2 is 98%. Your primary concern would be:
21. The EMT would recognize a simple partial seizure when she observes:
22. You have been called for a 71-year-old male patient with seizure activity. When you reach the patient's side, you find him lying motionless on the floor of his bedroom with a family member performing chest compression-only CPR. In this situation, your immediate action would be to:
23. You have been called for a 57-year-old female patient who has 'passed out.' As you enter the patient's apartment, you find her supine on the living room floor with a cool washcloth on her forehead. She states that she was standing and talking on the telephone when everything went dark. When she came to, she was on the floor. What should you do next?
24. Which of these patients should be categorized as the highest priority for transport?
25. Regarding a generalized tonic-clonic seizure, which of these statements is true regarding the different stages?

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