Neurologic Emergencies Ch 18 Part 1

Front 1

The peripheral nervous system is responsible for:

A) memory, understanding, and thought processes.

B) feeling and autonomic sensory and motor functions.

C) thought, perception, and voluntary motor functions.

D) sending messages to and receiving messages from the brain.

Back 1

D) sending messages to and receiving messages from the brain.

Front 2

Components of the diencephalon include the:

A) pons and medulla.

B) brainstem and midbrain.

C) thalamus and hypothalamus.

D) cerebellum and cerebral cortex.

Back 2

C) thalamus and hypothalamus.

Front 3

A person's level of consciousness is regulated by the:

A) diencephalon.

B) cerebral cortex.

C) occipital lobe of the brain.

D) reticular activating system.

Back 3

D) reticular activating system.

Front 4

What portion of the brainstem regulates respiratory rate and depth?

A) Pons

B) Medulla

C) Midbrain

D) Basal nuclei

Back 4

A) Pons

Front 5

Emotions such as rage and anger are generated in the:

A) thalamus.

B) limbic system.

C) hypothalamus.

D) diencephalon.

Back 5

B) limbic system

Front 6

Among other functions, the medulla oblongata:

A) directly regulates body temperature.

B) controls blood pressure and heart rate.

C) communicates with the pituitary gland.

D) sends messages to move skeletal muscles

Back 6

B) controls blood pressure and heart rate.

Front 7

A loss of balance and equilibrium suggests injury to the:

A) midbrain.

B) cerebrum.

C) thalamus.

D) cerebellum.

Back 7

D) cerebellum.

Front 8

A synapse is:

A) a cluster of sensory nerve cells.

B) the body's main neurotransmitter.

C) a slight gap between nerve cells.

D) the point where a nerve cell terminates

Back 8

C) a slight gap between nerve cells.

Front 9

Chemicals that relay electrically conducted signals from one neuron to another are called:

A) hormones.

B) endorphins.

C) catecholamines.

D) neurotransmitters.

Back 9

D) neurotransmitters.

Front 10

When a neuron generates an electrical impulse, it first sends the signal:

A) along its axon to the axon terminal.

B) to the cell's nucleus via a dendrite.

C) via neurotransmitters at the synapse.

D) to the cell's dendrites simultaneously.

Back 10

A) along its axon to the axon terminal.

Front 11

Myelin functions by:

A) allowing the neuron to send its signal consistently along the axon without losing its electricity.

B) insulating the neuron, thus decreasing the speed of electrical conduction between two neurons.

C) covering the neurons in the body that do not require rapid conduction of an electrical impulse.

D) briefly delaying the conduction of an electrical impulse between the synaptic cleft and dendrite.

Back 11

A) allowing the neuron to send its signal consistently along the axon without losing its electricity.

Front 12

A neoplasm is MOST accurately defined as a:

A) normal cell.

B) new growth.

C) damaged cell.

D) cancerous tumor.

Back 12

B) new growth.

Front 13

In contrast to a benign neoplasm, a malignant neoplasm:

A) is relatively easy to remove surgically.

B) can metastasize to other parts of the body.

C) results in death in the vast majority of cases.

D) remains within a capsule and grows minimally

Back 13

B) can metastasize to other parts of the body.

Front 14

Prehospital treatment for a patient with a suspected stroke may include all of the following, EXCEPT:

A) 30° elevation of the head.

B) diazepam or lorazepam.

C) up to 325 mg of aspirin.

D) crystalloid fluid boluses.

Back 14

C) up to 325 mg of aspirin.

Front 15

Common reality is defined as:

A) one person's perception of his or her surroundings.

B) a perceived thought that is not based on reality.

C) minimal shared reality between two individuals.

D) sensory stimulation that can be confirmed by others.

Back 15

D) sensory stimulation that can be confirmed by others.

Front 16

The MOST common sign of an infectious disease is the presence of:

A) a fever.

B) seizures.

C) a headache.

D) tachycardia.

Back 16

A) a fever.

Front 17

When neurons are deprived of oxygen and glucose:

A) they convert to anaerobic metabolism.

B) they produce alkalotic waste products.

C) spontaneous intracerebral bleeding occurs.

D) the process of neuronal regeneration begins

Back 17

A) they convert to anaerobic metabolism.

Front 18

All of the following are examples of acute cerebrovascular emergencies, EXCEPT:

A) embolic blockage of a cerebral artery.

B) accumulation of atherosclerotic plaque.

C) rupture of a cerebral arterial aneurysm.

D) stroke secondary to thrombus rupture.

Back 18

B) accumulation of atherosclerotic plaque

Front 19

The MOST immediate and significant complication associated with a hemorrhagic stroke is:

A) acute hypovolemic shock.

B) hypertension and bradycardia.

C) mean arterial pressure increase.

D) increased intracranial pressure.

Back 19

D) increased intracranial pressure.

Front 20

As intracranial pressure rises:

A) the heart rate acutely increases.

B) the brain becomes hypocarbic.

C) cerebral herniation may occur.

D) mean arterial pressure decreases.

Back 20

C) cerebral herniation may occur.

Front 21

What is the cerebral perfusion pressure of a patient with a mean arterial pressure of 80 mm Hg and an intracranial pressure of 5 mm Hg?

A) 60 mm Hg

B) 75 mm Hg

C) 90 mm Hg

D) 95 mm Hg

Back 21

B) 75 mm Hg

Front 22

Which of the following would MOST likely cause a sustained increase in intracranial pressure?

A) Bearing down

B) Frequent coughing

C) Projectile vomiting

D) Intracranial tumor

Back 22

D) Intracranial tumor

Front 23

Which of the following would have the MOST negative effect on the outcome of a patient with an intracranial hemorrhage?

A) Hypotension

B) Tachycardia

C) Hypertension

D) Slow rise in intracranial pressure

Back 23

A) Hypotension

Front 24

For any patient with an increase in intracranial pressure, the paramedic must:

A) avoid administering IV fluid boluses.

B) give glucose to prevent hypoglycemia.

C) maintain an adequate blood pressure.

D) take measures to lower blood pressure.

Back 24

C) maintain an adequate blood pressure.

Front 25

Hyperventilating a patient who has increased intracranial pressure (ICP) will:

A) dilate the cerebral vasculature and cause further increases in ICP.

B) constrict the cerebral vasculature and decrease cerebral perfusion.

C) increase the carbon dioxide levels in the brain through vasodilation.

D) decrease ICP and maintain adequate cerebral perfusion.

Back 25

B) constrict the cerebral vasculature and decrease cerebral perfusion.

Front 26

Management for a patient with a neurologic emergency begins by:

A) ensuring that the patient's airway remains patent.

B) taking deliberate actions to ensure personal safety.

C) determining the degree of neurologic impairment.

D) protecting the patient from further injury or harm.

Back 26

B) taking deliberate actions to ensure personal safety

Front 27

Decerebrate posturing:

A) is characterized by abnormal flexion of the arms and extension of the lower extremities.

B) is considered less severe than decorticate posturing, because it indicates that the brainstem is intact.

C) is an early clinical finding, because it occurs with minimal increases in intracranial pressure.

D) is a more severe finding than decorticate posturing, as it indicates damage in or near the brainstem.

Back 27

D) is a more severe finding than decorticate posturing, as it indicates damage in or near the brainstem.

Front 28

All of the following cranial nerves are responsible for airway control, EXCEPT the:

A) abducens.

B) trigeminal.

C) hypoglossal.

D) glossopharyngeal.

Back 28

A) abducens.

Front 29

Patients with trismus often require:

A) premedication with lidocaine before being intubated.

B) hyperventilation to reduce severe intracranial pressure.

C) sedation or chemical paralysis to facilitate airway control.

D) immediate tracheal intubation before the airway swells shut.

Back 29

C) sedation or chemical paralysis to facilitate airway control.

Front 30

n contrast to patients in shock, patients with increased intracranial pressure MOST often experience:

A) systolic hypotension.

B) an increased diastolic blood pressure.

C) a widened pulse pressure.

D) tachycardia and tachypnea.

Back 30

C) a widened pulse pressure.

Front 31

What type of tremor occurs when a body part is placed in a particular position and required to maintain that position for a long period of time?

A) Rest

B) Postural

C) Intention

D) Jacksonian

Back 31

B) Postural

Front 32

Apneustic breathing is characterized by:

A) an irregular respiratory pattern with unpredictable periods of apnea.

B) a gradual increase and decrease in breathing with periods of apnea.

C) extreme tachypnea and hyperpnea with a fruity or acetone breath odor.

D) a prolonged inspiratory phase with a shortened expiratory phase and bradypnea.

Back 32

D) a prolonged inspiratory phase with a shortened expiratory phase and bradypnea.

Front 33

An adult who opens her eyes in response to verbal stimuli, is disoriented, and pushes your hand away when you palpate a painful area has a Glasgow Coma Scale score of:

A) 9.

B) 10.

C) 11.

D) 12.

Back 33

D) 12.

Front 34

Common causes of trismus in an unresponsive patient include all of the following, EXCEPT:

A) opiate toxicity.

B) cerebral hypoxia.

C) a head injury.

D) an active seizure.

Back 34

A) opiate toxicity.

Front 35

A patient with a Glasgow Coma Scale score of 8 or less:

A) may require definitive airway control.

B) has moderate neurologic dysfunction.

C) is often able to localize his or her pain.

D) is likely experiencing brain herniation.

Back 35

A) may require definitive airway control

Front 36

A patient with a unilateral eyelid droop when smiling:

A) has a condition called miosis.

B) may be experiencing Bell palsy.

C) likely has an intracerebral hemorrhage.

D) is experiencing transient cerebral ischemia.

Back 36

B) may be experiencing Bell palsy.

Front 37

A patient who is experiencing agnosia:

A) has neuronal dysfunction between the temporal and frontal lobe.

B) may call a knife a fork when he or she is asked to name the object.

C) is probably experiencing an ischemic stroke in the cerebellar area.

D) cannot use a pencil secondary to dysfunction of the occipital lobe.

Back 37

B) may call a knife a fork when he or she is asked to name the object.

Front 38

A patient who is unable to use a common object is said to be:

A) agnosic.

B) aphasic.

C) atonic.

D) apraxic.

Back 38

D) apraxic.

Front 39

Which of the following is an example of receptive aphasia?

A) A patient with slurred speech is able to tell you his or her name.

B) You hand a patient a pencil and he or she tries to cut paper with it.

C) You ask a patient who the president is and he or she says, “January.”

D) A patient responds with “no” when asked if he or she has hypertension.

Back 39

C) You ask a patient who the president is and he or she says, “January.”

Front 40

The involuntary, rhythmic movement of the eyes is called:

A) nystagmus.

B) hyperopia.

C) anisocoria.

D) dysphagia.

Back 40

A) nystagmus.