Quiz Questions

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A 68-year-old African American man comes into the ED 30 minutes after the acute onset of left-sided facial droop and blurred vision. His son brought him to the ED and is sitting in a chair next to the patient. The patient cannot recall the date and is unsure where he is. He has a history of diabetes and hypertension but no prior stroke. Blood pressure is 173/98 mm Hg; temperature is normal.

1. List two reasons why it might have been better for the patient if his son had called 911 instead of driving him to the ED.

2. Getting a CT scan taken and interpreted is a critical step in deciding which treatment is appropriate for the patient. According to the NINDS protocol, getting the CT scan should be done in less than which of the following times?

1. 2 hours
2. 60 minutes
3. 45 minutes
4. 30 minutes

3. The patient is scanned and the scan shows no hemorrhage. Does he qualify for fibrinolytic therapy?

1. Yes
2. No
3. More diagnostics need to be taken.

4. Which step needs to be taken before therapy is administered?

1. Specialist needs to assess the patient using the fibrinolytic checklist.
2. 12-lead ECG needs to be done.
3. Glucose should be administered.
4. Consultation with another specialist is required.

5. According to the NINDS protocol, from the time the patient came into the ED, when should fibrinolytic therapy begin?

1. within 25 min
2. within 45 min
3. within 1 hr
4. within 2 hrs

6. The patient's blood pressure is monitored every 15 min for 2 hrs, then every 30 min for 6 hrs, and finally every hr for 16 hrs. His blood pressure is 185/110. Which medication would be recommended for him?

1. Labetalol 20 mg IV for 1–2 min
2. Labetalol 10 mg IV for 1–2 min
3. Nicardipine 5 mg/hr IV infusion
4. Sodium nitroprusside 0.5 µg/kg per IV infusion

7. The most common cause of a subarachnoid hemorrhage is

1. Cerebral aneurysm
2. AV malformation
3. Chronic hypertension
4. Atrial fibrillation

Quiz Questions

1. Answer:
   1. EMS responders can take the patient to a hospital with a stroke unit, rather than one without advanced stroke care.
   2. EMS responders can notify the hospital that the patient is coming; hospital personnel can then be ready to move quickly with assessment and treatment.
2. Answer: C. 45 minutes. It should be obtained within 25 minutes.
3. Answer: A. Yes
4. Answer: A. Specialist needs to assess patient using the fibrinolytic checklist.
5. Answer: C. within 1 hr
6. Answer: B. Labetalol 10 mg IV for 1–2 min
7. Answer: A. Cerebral aneurysm