Table 4.
Altered Mental Status: Post-Test
| 1. An elderly male presents with a depressed level of consciousness. You detect what you believe is alcohol on his breath. In the first 10 minutes of the patient's arrival to the emergency department which of the following would be your lowest priority? |
| A) Connect the patient to an intravenous catheter and a cardiac monitor |
| B) Obtain a toxicology screen |
| C) Assess airway and breathing; supply supplemental oxygen if needed |
| D) Obtain a rectal temperature |
| E) Obtain a finger stick |
| 2. An agitated 25 year old presents to the emergency department with sinus tachycardia of 120. All of the following are diagnoses that need to be considered except: |
| A) Cocaine intoxication |
| B) Encephalitis |
| C) Severe hypothermia |
| D) Post-ictal state after a generalized tonic–clonic seizure |
| E) Hypoglycemia |
| 3. You (a third year medical student) are alone with an unconscious patient on the medical wards. The following would by a correct sequence for approaching the patient: |
| A) Airway, Breathing, Circulation Assessment – Assess Responsiveness – Call for Help – Check Glucose |
| B) Airway, Breathing, Circulation Assessment – Assess Responsiveness–Check Glucose – Call for Help |
| C) Call for Help – Airway, Breathing, Circulation Assessment – Check Glucose – Assess Responsiveness |
| D) Assess Responsiveness – Call for Help – Airway, Breathing, Circulation Assessment – Check Glucose |
| E) Check Glucose – Assess Responsiveness – Call for Help – Airway, Breathing, Circulation Assessment |
| 4. You are now evaluating an elderly unconscious woman. Which of the following bedside diagnostic tests would be least likely to reveal the cause of the patient's altered mental status? |
| A) Finger stick |
| B) Rectal temperature |
| C) Pulse oximetry |
| D) Hematocrit |
| E) Pupil exam |
| 5. You are now evaluating an elderly unconscious woman. Which of the following physical exam findings is not a classic set of findings for an etiology of altered sensorium? |
| A) Pin point pupils |
| B) Sweaty skin and tachycardia |
| C) Calf swelling and tachycardia |
| D) Asterixis |
| E) Dry skin and full bladder |
| 6. Which of the following causes of altered mental status is most rapidly reversible? |
| A) Urosepsis |
| B) Cocaine intoxication |
| C) Hepatic encephalopathy |
| D) Opiate overdose |
| E) Intracranial bleed |
| 7. Which of the following is an incorrect action for a patient who is actively having a seizure? |
| A) Insert an oral airway |
| B) Check glucose (finger stick) |
| C) Administer a benzodiazepine (e.g., lorazepam) |
| D) Provide supplemental oxygen |
| E) Keep the patient away from sharp objects |
| 8. Which of the following is true about the history in a patient with altered mental status? |
| A) Treatment should not be started without a complete medical history |
| B) The patient's medical records are not typically helpful |
| C) A history of recent medication adjustments should be elicited |
| D) Patients with altered mental status generally provide an accurate and detailed history |
| E) Knowledge of the patient's baseline mental status is generally not be helpful |
| Answer key: 1) B 2) C 3) D 4) D 5) C 6) D 7) A 8) C |