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.
A) pons and medulla.
B) brainstem and midbrain.
C) thalamus and hypothalamus.
D) cerebellum and cerebral cortex.
B) cerebral cortex.
C) occipital lobe of the brain.
D) reticular activating system.
D) Basal nuclei
B) limbic system.
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.
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.
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.
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.
A) normal cell.
B) new growth.
C) damaged cell.
D) cancerous tumor.
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.
A) 30° elevation of the head.
B) diazepam or lorazepam.
C) up to 325 mg of aspirin.
D) crystalloid fluid boluses.
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.
A) a fever.
C) a headache.
A) they convert to anaerobic metabolism.
B) they produce alkalotic waste products.
C) spontaneous intracerebral bleeding occurs.
D) the process of neuronal regeneration begins.
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.
A) acute hypovolemic shock.
B) hypertension and bradycardia.
C) mean arterial pressure increase.
D) increased intracranial pressure.
A) the heart rate acutely increases.
B) the brain becomes hypocarbic.
C) cerebral herniation may occur.
D) mean arterial pressure decreases.
A) 60 mm Hg
B) 75 mm Hg
C) 90 mm Hg
D) 95 mm Hg
A) Bearing down
B) Frequent coughing
C) Projectile vomiting
D) Intracranial tumor
D) Slow rise in intracranial pressure
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.
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.
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.
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.
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.
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A) systolic hypotension.
B) an increased diastolic blood pressure.
C) a widened pulse pressure.
D) tachycardia and tachypnea.
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.
A) opiate toxicity.
B) cerebral hypoxia.
C) a head injury.
D) an active seizure.
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.
A) has a condition called miosis.
B) may be experiencing Bell palsy.
C) likely has an intracerebral hemorrhage.
D) is experiencing transient cerebral ischemia.
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.
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.
A) left-sided weakness and a left-sided facial droop.
B) left-sided weakness and a right-sided facial droop.
C) right-sided weakness and a left-sided facial droop.
D) right-sided weakness and a right-sided facial droop.
A) Cerebral palsy
B) Multiple sclerosis
C) Parkinson disease
D) Alzheimer disease
A) one arm drifting downward and turning away from the body when the patient’s eyes are closed.
B) one arm drifting downward and turning toward the body when the patient’s eyes are closed.
C) one arm drifting downward and turning away from the body when the patient’s eyes are open.
D) both arms moving downward more than 3 inches in 30 seconds when the patient’s eyes are open.
A) rest, Parkinson disease
B) postural, Alzheimer disease
C) clonic, cerebral palsy
D) intention, multiple sclerosis
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A) the cause is not known.
B) the entire brain is affected.
C) a part of the brain is affected.
D) a postictal phase is not present.
A) an acoustic neuroma.
B) hemifacial spasm.
C) trigeminal neuralgia.
D) glossopharyngeal neuralgia.
A) stimulate the vagus nerve.
B) determine if the spinal cord is intact.
C) elicit a response to painful stimuli.
D) assess for an orbital skull fracture.
A) obtain a 12-lead ECG tracing and assess his pupils.
B) assist his ventilations and assess his oxygen saturation.
C) assess his blood glucose level and give high-flow oxygen.
D) apply oxygen via nonrebreathing mask and apply the ECG.
A) give high-flow oxygen, apply the cardiac monitor, start an IV line with normal saline, and administer 0.5 mg of atropine to treat his bradycardia.
B) hyperventilate with a bag-mask at 30 breaths/min, begin transcutaneous pacing, establish vascular access, and administer 25 g of 50% dextrose.
C) intubate after 30 seconds of preoxygenation, ventilate at a rate of 8 breaths/min, start an IV with normal saline, administer 50 g of 50% dextrose, and reassess.
D) assist ventilations, apply the cardiac monitor, start an IV line with normal saline, administer 12.5 g of 50% dextrose, and reassess his level of consciousness.
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A) positive-pressure ventilatory support.
B) rapid infusion of a crystalloid solution.
C) high-flow oxygen via nonrebreathing mask.
D) immediate transcutaneous cardiac pacing.
A) check his blood glucose level as your partner prepares to intubate.
B) transport at once and administer additional naloxone while en route.
C) administer 25 g of 50% dextrose and reassess his level of consciousness.
D) hyperventilate him with high-flow oxygen to minimize tissue hypoxia.
A) “Does your wife have a history of diabetes?”
B) “Is your wife allergic to aspirin or contrast dye?”
C) “When did your wife last see her physician?”
D) “When did you first notice your wife’s symptoms?”
A) consider him a candidate for fibrinolytic therapy if his symptoms began less than 12 hours ago.
B) rule out hypoglycemia by assessing his blood sugar, but suspect a right-sided ischemic stroke.
C) start an IV and administer crystalloid fluid boluses if his systolic blood pressure is less than 110 mm Hg.
D) suspect that he is experiencing a hemorrhagic stroke, begin immediate transport, and start an IV en route.
A) You should administer nitroglycerin or labetalol if her systolic blood pressure is greater than 150 mm Hg.
B) The patient will likely receive fibrinolytic therapy in the emergency department if no contraindications exist.
C) Although the patient is likely experiencing a TIA, you should treat her as though she is experiencing a stroke.
D) The patient’s signs and symptoms are likely the result of her blood sugar and will resolve with dextrose.
A) administering oxygen via nonrebreathing mask.
B) ensuring airway patency and adequate breathing.
C) evaluating his cardiac rhythm with the ECG monitor.
D) performing a rapid check of his blood glucose level.
A) administering oxygen as tolerated, establishing an IV line, padding the rails of the ambulance cot, and transporting without lights and siren.
B) establishing vascular access, administering diazepam or lorazepam to reduce her combativeness, and transporting to the closest hospital.
C) giving her high-flow oxygen, inserting an IO catheter in her proximal tibia, transporting, and observing for further seizure activity.
D) administering oxygen, restraining her to protect her from further injury, placing a bite block in her mouth in case she seizes again, and transporting.
C) simple partial
D) complex partial
A) place a bite block between his molars to prevent oral trauma, administer high-flow oxygen, and give lorazepam IM.
B) protect him from further injury by restraining him, attempt orotracheal intubation, establish an IV, and give Valium.
C) hyperventilate him with a bag-mask to eliminate excess carbon dioxide, establish vascular access, and give lorazepam.
D) open his airway and begin assisting his ventilations, establish an IV or IO line, and administer 5 to 10 mg of diazepam.
A) a seizure.
C) a vasovagal response.
D) acute hypoglycemia.
A) carefully assessing her pupils, administering oxygen, starting an IV and giving her morphine, and transporting.
B) placing her in a Fowler position, administering oxygen, and transporting her to the hospital for definitive care.
C) oxygen as tolerated, starting an IV line and administering ondansetron, and transporting without lights or siren.
D) administering high-flow oxygen, establishing vascular access, and administering nitroglycerin to lower her blood pressure.
A) acute sinusitis.
B) an intracranial neoplasm.
C) acute hemorrhagic stroke.
D) a ruptured cerebral artery.
A) provide supportive care and safely transport her to the hospital.
B) assist her with her prescribed insulin to lower her blood glucose.
C) advise her to take ibuprofen and to follow up with her physician.
D) conclude that she has peripheral neuropathy and give her fentanyl.
A) diazepam, 5 mg.
B) promethazine, 25 mg.
C) diphenhydramine, 25 mg.
D) ondansetron, 4 mg.
A) Kernig sign.
B) Grey Turner sign.
C) Cullen sign.
D) Brudzinski sign.
A) the movement of CSF in the brain exceeds the production of CSF.
B) the movement of CSF decreases, but the production of CSF does not.
C) CSF production increases, which causes increased pressure in the skull.
D) total CSF volume decreases, which leads to excessive cerebral edema.
A) Multiple sclerosis
B) Spina bifida
D) Cerebral palsy
A) hemiplegia, low-grade fever, hyperactivity, and a diffuse stabbing headache.
B) paralysis below the waist, high fever, a diffuse headache, and slurred speech.
C) high-grade fever, persistent localized headache, confusion, and focal impairment.
D) an absence of fever, severe localized headache, and vomiting without nausea.
A) Trochlear, oculomotor, abducens
B) Facial, accessory, glossopharyngeal
C) Accessory, olfactory, hypoglossal
D) Optic, trigeminal, glossopharyngeal
A) indicate increased intracranial pressure.
B) may be a normal variant in some patients.
C) are a sign of methamphetamine abuse.
D) are a sign of optic nerve compression.
A) dilates the blood vessels and can cause brain herniation.
B) lowers intracranial pressure and oxygenates the brain.
C) increases intracranial pressure, but oxygenates the brain.
D) causes vasoconstriction and can impair brain perfusion.
A) the patient is younger than 45 years of age.
B) the blood glucose is between 60 and 400 mg/dL.
C) at baseline, the patient is normally bedridden.
D) a bilateral facial droop is present during the exam.
A) is less commonly observed in older patients.
B) can occur when the patient is in any position.
C) most often occurs when the patient is standing.
D) is characterized by a quick return of orientation.
A) sustained and painful contraction of the eyelids.
B) involuntary unilateral myoclonic contractions of the face.
C) severe stabbing pain, usually to one side of the face.
D) neck muscle contraction, which twists the head to one side.