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acls > ASLS Pretest > Flashcards

ASLS Pretest Flashcards

1
Q

Hemorrhagic Stroke accounts for approximately what percent of all strokes?

a. <5%
b. 20%
c. 50%
d. 80%

A

b. 20%

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2
Q

Which of the following represents optimal management in patients with acute stroke in the prehospital and emergency-department settings?
a. keep head flat, give small sips of water, give 100% O2 via face mask.
B. Keep head flat, keep NPO, give O2 2-4 L via face mask
C. Elevate head of stretcher, keep NPO, give O2 2-4L via nasal cannula
D. Elevate head of stretcher, keep NPO, give 100% O2 via face mask

A

C. Elevate head of stretcher, keep NPO, give O2 2-4L via nasal cannula

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3
Q

A known diabetic woman has sudden right-sided weakness and EMS is called. Which respresents optimal management of this patient by EMS personnel?

a. administer IV D50 stat
b. Give hard candy or orange juice oraly
c. perform glucose fingerstick, give IV D50 if < 50
d. Administer IV D5W

A

C. Perform glucose fingerstick, give IV D50

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4
Q

The majority of ischemic strokes is caused by:

a. ventricular fibrillation
b. atrial fibrillation
c. Atherosclerotic occlusion
d. thromboembolism

A

d. thromboembolism

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5
Q

Which of the following is true regarding imaging the brain of a patient with acute stroke in the emergency department?
a. Noncontrast CT can determine how much brain tissue can still be saved
b. Noncontrast CT can rule out bleed, vizualize early ischemic stroke
C. Contrast CT is dangerous to recently infarcted brain tissue
D. contrast CT is necessary to better visualize a very early ischemic stroke

A

b. Noncontrast CT can rule out bleed, visualize early ischemic stroke

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6
Q

Symptoms of a brainstem syndrome include:

a. vomiting, vertigo, facial numbness, and gait ataxia
b. Aphasia, right visual field deficit, right hemiparesis
c. neglect, left visual field deficit, left hemiparesis
d. vomiting, severe headache, stiff neck

A

a. vomiting, vertigo, facial numbness, and gait ataxia

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7
Q

Which one of the following is correct regarding the use of intravenous t-PA in ischemic stroke patients?

a. It can only be given within 3 hours
b. It can be given based on history and exam, before CT scan
c. It reduces mortality by 30%
d. It should be given with a full aspirin

A

a. It can only be given within 3 hours

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8
Q

A 75-year-old man with known hypertension has sudden right-sided weakness and numbness. EMS Arrives to find his blood pressure (BP) is 250/150. The best action for EMS personnel to take is to monitor and record BP and:

a. Control BP with sublingual nitroglycerin until SBP < 185 and DBP < 110.
b. Administer nifedipine (Procardia) 10 mg SL
c. Administer Labetalol 15 mg IV
d. Do not administer any antihypertensive agent

A

d. Do not administer any antihypertensive agent

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9
Q

Paramedics arrive on scene to care for an 80-year-old man. Examination reveals pulse 90, respirations 16, BP left arm 190/110, and BP right arm 200/100. He is alert and repeats the phrase “You can’t teach an old dog new tricks” correctly. When asked to smile, his left lower face does not elevate. When holding out both arms with his eyes closed, he can barely lift his left arm and it drifts down in a few seconds. This patient’s likely stroke syndrome is:

a. Subarachnoid hemorrhage
b. Left hemisphere
c. Right hemisphere
d. Brainstem

A

C. Right Hemisphere

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10
Q

The most common cause of subarachnoid hemorrhage is:

a. Hypertension
b. Vessel Malformation
c. Aneurysm rupture
d. Bleeding abnormality

A

C. Aneurysm rupture

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11
Q

Double vision may occur as a part of which stroke syndrome?

a. Left brain
b. Right Brain
c. Cerebellum.
d. Brainstem

A

d. brainstem

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12
Q

Contraindications for the administration of intravenous t-PA in ischemic stroke patients include:

a. Blood glucose less than 50
b. Age over 90
c. Blood pressure 180/100
d. Taking aspirin within 24 hours of stroke onset

A

a. Blood glucose less than 50

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13
Q
  1. Which of the following statements regarding transient ischemic attacks (TIAs) is correct?
    a. Previous history of TIA is a contraindication to thrombolytic therapy
    b. If a TIA lasts 10 hours, it is rare for MRA to show evidence of acute ischemia
    c. Underlying causes of TIA and ischemic stroke are the same
    d. EMS and ED personnel should refer patients with suspected TIA to outpatient clinics rather than utilize emergency resources
A

c. Underlying causes of TIA and ischemic stroke are the same

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14
Q

The ischemic penumbra is

a. Damaged by hypertension
b. Damaged by hyperglycemia
c. Detected on CT scan
d. Detected on physical examination

A

b. damaged by hyperglycemia

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15
Q

Which of the following statements regarding stroke are true?

a. It is leading cause of death in the USA
b. Paramedics must be prepared to administer t-PA promptly in the field
c. It is the leading cause of disability in the USA
d. Approximately 2/3 of patients die who suffer an acute stroke

A

c. It is the leading cause of disability in the USA

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16
Q

Which of the following may mimic an ischemic stroke?

a. Hypoglycemia
b. Hypokalemia
c. Hypothyroidism
d. Tension Headache

A

a. Hypoglycemia

17
Q

The on-scene prehospital stroke examination consists of:

a. Speech, facial symmetry, arm strength
b. Speech, facial symmetry, reflexes
c. Speech, reflexes, arm strength
d. Reflexes, facial symmetry, arm strength

A

a. Speech, facial symmetry, arm strength

18
Q

Which of the following is a NOT a risk factor for ischemic stroke?

a. Cigarette smoking
b. Hypertension
c. Diabetes Mellitus
d. Emphysema

A

d. Emphysema

19
Q

Which Symptom suggests hemorrhagic stroke rather than ischemic stroke?

a. Left hemiparesis
b. Aphasia
c. Neck pain and stiffness
d. Gait and limb ataxia

A

c. Neck pain and stiffness

20
Q

EMS arrives on scene to care for a 71-year-old man who complained of sudden dizziness and falling to the right when trying to walk. On assessment, he is awake and alert and responds to appropriately to verbal stimuli. When asked to repeat a phrase, he says the words correctly without slurring. When asked to smile, he elevates both sides of his face without difficulty. When asked to hold out his arms extended, he raises both arms without drifting down, but the right arm moves awkwardly. The likely stroke syndrome is:

a. Left hemisphere
b. Right Hemisphere
c. Brainstem
d. Cerebellum

A

d. Cerebellum

acls (8 decks)

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