ASLS Post-test + New Questions Flashcards
- The most common cause of intracerebral hemorrhage is:
a. Vessel malformation
b. Brain tumor
c. Aneurysm rupture
d. Chronic hypertension
d. Chronic hypertension
- The MEND Exam:
a. Is the ideal on-scene assessment tool for prehospital personnel
b. Is too time consuming for use as a routine assessment tool for nurses
c. Enhances communication between prehospital and hospital personnel
d. Is best used when assessing patients with diffuse brain dysfunction
c. Enhances communication between prehospital and hospital personnel
- Which one of the following statements is correct regarding the use of
intravenous t-PA in ischemic stroke patients?
a. Paramedics must be prepared to administer it in the field
b. If used appropriately, it decreases risk of disability by 30%
c. It is most beneficial within 3 hours, but may be given within 5 hours
d. It is most beneficial if given to patients with minor symptoms
b. If used appropriately, it decreases risk of disability by 30%
- EMS arrives on scene to care for a 56-year-old woman who complained of
sudden headache, dizziness, and falling to the left when trying to walk. On
assessment, she is lethargic but responds appropriately to verbal stimuli.
When asked to repeat a phrase, she says the words correctly without slurring.
When asked to smile, she elevates both sides of her face without difficulty.
When asked to hold out her arms extended, she raises both arms without
drifting down, but the left arm moves awkwardly. The likely stroke syndrome is:
a. Hemorrhage in cerebellum
b. Ischemic stroke in right hemisphere
c. Subarachnoid hemorrhage
d. Ischemic stroke in left hemisphere
a. Hemorrhage in cerebellum
A patient has sudden weakness of the left arm and leg. Paramedics find the
patient’s blood pressure (BP) to be 250/150 mm Hg. The appropriate action for
the paramedics is to monitor BP and:
a. Administer labetalol 15 mg IV
b. Administer nifedipine 10 mg SL
c. Administer nitroglycerine SL
d. Do not administer any antihypertensive agent
d. Do not administer any antihypertensive agent
- Symptoms of a cerebellar stroke include:
a. Motor weakness
b. Aphasia
c. Dyscoordination
d. Sensory loss
c. Dyscoordination
- Which pairing is correct?
a. Left brain dysfunction – double vision
b. Right brain dysfunction – neglect (left hemi-inattention)
c. Subarachnoid hemorrhage – inappropriate speech
d. Brainstem dysfunction – visual field deficit
b. Right brain dysfunction – neglect (left hemi-inattention)
- Paramedics arrive on scene to care for a 74-year-old woman. Examination
reveals pulse 90, respirations 18, BP left arm 200/100, and BP right arm
190/100. She is awake and alert, but says “dog tricks” when asked to repeat
the phrase “You can’t teach an old dog new tricks.” When asked to smile, her
right lower face does not elevate. When holding out both arms with her eyes
closed, she can barely lift her right arm and it drifts down in a few seconds.
The likely stroke syndrome is:
a. Subarachnoid hemorrhage
b. Left hemisphere
c. Right hemisphere
d. Brainstem
b. Left hemisphere
- The ischemic penumbra is:
a. Brain tissue with permanent damage
b. Unaffected by the use of t-PA
c. Damaged by lowering blood pressure
d. Visualized on CT scan of the brain
c. Damaged by lowering blood pressure
- Which of the following is true?
a. Stroke is the leading cause of death in the USA
b. It is best to start controlling stroke risk factors after age 40
c. IV t-PA decreases the risk of death from stroke
d. Stroke incidence increases with age
d. Stroke incidence increases with age
- Which of the following is NOT typical of subarachnoid hemorrhage?
a. Neck stiffness
b. Nausea and vomiting
c. Depressed consciousness
d. Gradual onset of symptoms
d. Gradual onset of symptoms
12. Which of the following is most likely to present as depressed consciousness without focal neurologic deficit? a. Seizure b. Brain tumor c. Drug overdose d. Migraine
c. Drug overdose
- The optimal IV solution for patients with acute stroke is:
a. Lactated Ringers
b. D5W
c. Normal Saline
d. ½ Normal Saline
c. Normal Saline
- The majority of ischemic strokes is caused by:
a. Thromboembolism
b. Atherosclerotic occlusion
c. Aneurysmal rupture
d. Acute hypertension
a. Thromboembolism
- In a patient suspected of having an acute stroke, which one of the following is
the best way to differentiate between an ischemic or hemorrhagic cause?
a. The history
b. The neurologic examination
c. Blood pressure values
d. A CT scan of the brain
d. A CT scan of the brain
- Which of the following is NOT a risk factor for ischemic stroke?
a. Cocaine use
b. Brain tumor
c. Excessive alcohol use
d. Hypercoagulable state
b. Brain tumor
- Ischemic stroke accounts for approximately what percent of all strokes?
a. 20%
b. 50%
c. 80%
d. > 95%
c. 80%
- Contraindications for thrombolytic therapy in acute stroke patients include:
a. History of TIA one week ago
b. History of brain hemorrhage 5 years ago
c. History of heart attack 1 year ago
d. Taking warfarin with subtherapeutic INR of 1.2
b. History of brain hemorrhage 5 years ago
- Optimal management of patients with acute stroke in the prehospital and
emergency-department (ED) settings includes:
a. Keep patient NPO, including no oral liquids or medications
b. Administer high-flow oxygen via face mask
c. Keep patient’s head flat to improve blood flow to the penumbra
d. Administer low-flow oxygen even if oxygen saturation is > 95%
a. Keep patient NPO, including no oral liquids or medications
- EMS transports a 64-year-old man to the hospital for complaint of sudden
difficulty speaking and right-arm weakness that resolves after 20 minutes. In
the emergency department (ED), his neurologic examination is normal. The
appropriate action for ED personnel to take is:
a. Discharge him with advice to call his doctor for an appointment as soon
as possible.
b. Admit him to the hospital for a rapid evaluation to determine the cause of
his event
c. Discharge him with advice to begin aspirin 325 mg per day for stroke
prevention
d. Advise him his risk of disability will be decreased if he receives IV t-PA
therapy
b. Admit him to the hospital for a rapid evaluation to determine the cause of
his event
What are one of the 8 D’s?
Delivery
Your patient is an 85 y/o male in a nursing home complaining of left arm weakness and LOC 2 weeks after a fall… what is his condition?
Subdural Hematoma
Stroke affects?
800,000 people a year
What is the function of the cerebellum?
Its the Coordination Center
What is the best way to determine if someone has a focal neurological deficit?
primary assessment
