NREMT - National Registry of Emergency Medical Technicians Neurological Emergencies & Stroke Care 1

Question 1

A 62-year-old patient describes the sudden onset of 'the worst headache of my life,' with a stiff neck and sensitivity to light. This presentation is most suspicious for:

Accepted Answer

Subarachnoid hemorrhage from a ruptured aneurysm

Answer

Ischemic stroke affecting the frontal lobe

Answer

Hypertensive encephalopathy

Answer

Complex migraine with aura

Question 2

When transporting a conscious, hemodynamically stable stroke patient without respiratory distress, the most appropriate position is:

Accepted Answer

Semi-Fowler's with the head elevated 15–30 degrees

Answer

Supine with legs elevated 12 inches

Answer

Trendelenburg to maximize cerebral perfusion

Answer

Recovery position on the paralyzed side

Question 3

During an active generalized tonic-clonic seizure, the EMT's MOST important intervention is:

Accepted Answer

Protecting the patient's head and maintaining airway patency

Answer

Inserting a bite block between the patient's teeth to protect the airway

Answer

Firmly restraining the patient's limbs to prevent musculoskeletal injury

Answer

Immediately administering high-flow oxygen via non-rebreather mask

Question 4

A patient's blood pressure is 210/118 mmHg, heart rate is 44 bpm, and respirations are irregular. The patient is unresponsive with unequal pupils. These findings together are most consistent with:

Accepted Answer

Increasing intracranial pressure (Cushing's triad)

Answer

Severe hypoglycemic crisis

Answer

Anaphylactic shock with neurological involvement

Answer

Hypovolemic shock with compensatory response

Question 5

A patient tells you they experienced left-arm weakness and slurred speech that completely resolved on its own about 20 minutes ago. The patient now feels fine and refuses transport. The EMT's best course of action is to:

Accepted Answer

Encourage transport urgently, explaining that a TIA significantly raises the short-term risk of stroke

Answer

Allow refusal since symptoms have fully resolved and document accordingly

Answer

Monitor the patient on scene for another 30 minutes to confirm symptoms do not return

Answer

Contact medical control only if symptoms recur within the hour

Question 6

Using the AVPU scale, how would you classify a patient who moans and withdraws only when you apply a sternal rub, but does not respond to your voice?

Accepted Answer

Pain

Answer

Alert

Answer

Verbal

Answer

Unresponsive