10 free AEMT practice questions: Neurologic Emergencies: Stroke, Seizure, and Altered Mental Status
These are real questions from the same bank the app draws from. Each one is written to the NREMT AEMT content specifications and kept inside the AEMT scope of practice. Pick an answer and you get the full rationale, including why the other three options are wrong.
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Question 1 of 10
A 73-year-old patient has sudden left arm weakness and facial droop. Breathing is unlabored at 16 per minute and the SpO₂ reads 97% on room air. What is the correct oxygen decision?
Show the answer and rationale
Correct answer · Give no supplemental oxygen and monitor the reading
Oxygen in stroke is a correction, not a comfort measure. This patient is already carrying a normal saturation, so adding oxygen has nothing to offer here. Keep the probe on, watch the number, and treat it if it drops below the threshold.
Why the others are wrong
Apply a nonrebreather at 15 liters per minute: A nonrebreather is for a patient who is genuinely short of oxygen. Applying one to a saturation of 97% treats the equipment list instead of the patient.
Apply a nasal cannula at 4 liters per minute: A low-flow cannula is still supplemental oxygen, and this patient does not have a saturation that calls for it.
Begin assisted ventilation with a BVM: Assisted ventilation is for inadequate breathing. This patient is moving air at a normal rate with an adequate saturation.
Question 2 of 10
A 4-year-old patient has been actively seizing for 8 minutes with no break in the movement. Which term describes this presentation?
Show the answer and rationale
Correct answer · Status epilepticus
Status epilepticus is a seizure that keeps going past five minutes, or seizures that come one after another without the patient waking up in between. Eight continuous minutes clears that line. The name matters because it moves the call from watch and protect to a true emergency with a hospital that needs to know you are coming.
Why the others are wrong
A simple febrile seizure: A febrile seizure in a child is usually brief and stops on its own. A seizure running past five minutes has left that category behind.
A postictal state: The postictal state is the recovery period after the seizure stops. This patient is still seizing.
A focal seizure: involves one part of the body with the patient often aware. This is generalized and continuous.
Question 3 of 10
A 34-year-old patient has been seizing continuously for 11 minutes. The airway is being managed with positioning and suction, and the blood glucose reads 96. The emergency department is 7 minutes away. A paramedic unit can meet the ambulance in 14 minutes. Which action is correct?
Show the answer and rationale
Correct answer · Continue supportive care and transport to the emergency department
An AEMT does not carry the medication that stops this seizure, so the only question is which set of hands reaches the patient first. The hospital is 7 minutes out and the paramedic is 14, which makes the intercept slower than the destination it was meant to beat. Keep the airway open, keep suction going, and drive.
Why the others are wrong
Stage on scene and wait for the paramedic unit to arrive: Waiting on scene stops the clock in the worst possible place, since the patient gains nothing during the delay and the hospital is closer than the help you are waiting for.
Request an order from medical direction to give a sedative: Benzodiazepines are not on the national AEMT medication list, and an order cannot add a drug to a scope that does not include it.
Meet the paramedic unit and transfer care at that point: An intercept is worth requesting only when it genuinely beats the hospital. Here it arrives 7 minutes after you could have delivered the patient.
Question 4 of 10
A 6-year-old patient is having a generalized seizure on a tile floor with furniture nearby. Which action best describes appropriate care during the active seizure?
Show the answer and rationale
Correct answer · Move objects away and pad the area around the head
During the seizure itself your work is environmental. Clear the hard things the patient could strike, get something soft under the head, and let the seizure run its course while you watch the clock. Holding a seizing patient down can injure the very limbs you are trying to protect, and nothing belongs in the mouth.
Why the others are wrong
Hold the arms and legs still to prevent injury: Restraining the movement fights muscle contractions strong enough to injure joints, and it does nothing to shorten the seizure.
Place a bite block between the teeth to protect the tongue: Putting anything between the teeth risks broken teeth, an obstructed airway, and a bitten finger. The tongue is not swallowed during a seizure.
Lift the patient onto the cot and secure the straps: Moving a seizing patient onto a cot is both unsafe and unnecessary while the seizure is happening. Protect where the patient is and move them afterward.
Question 5 of 10
A 29-year-old patient who is 34 weeks pregnant has a generalized seizure with no seizure history. The vital signs after the seizure are BP 178/112, P 102, R 18, and SpO₂ 96% on room air. Which combination of actions is most appropriate?
Show the answer and rationale
Correct answer · Left lateral positioning, a quiet cabin, and rapid obstetric transport
A seizure late in pregnancy with a pressure that high is eclampsia until an obstetric team says otherwise. Rolling the patient onto the left side takes the uterus off the big vein returning blood to the heart, and keeping the lights down and the cabin quiet reduces the stimulation that can set off another seizure. The definitive treatment is a hospital with obstetrics, so the transport is rapid and the notification goes out early.
Why the others are wrong
Supine positioning, oxygen by nonrebreather, and routine transport: Lying flat on the back lets the uterus compress the vena cava, and routine transport misreads how time sensitive this patient is.
Seated positioning, a fluid bolus, and transport to the nearest clinic: Sitting the patient up does not relieve the compression, and a clinic cannot deliver the definitive care an eclamptic patient needs.
Left lateral positioning, bright lighting, and a repeat blood pressure: Left lateral positioning is right, but bright lighting is the opposite of what reduces stimulation, and rechecking a pressure is not a substitute for moving.
Question 6 of 10
A 52-year-old patient collapsed without warning while jogging and woke up on the sidewalk within seconds. There is no chest pain now and the neurologic exam is normal. Which action best fits this history?
Show the answer and rationale
Correct answer · Acquire a 12-lead ECG and transport on the cardiac monitor
Fainting during exertion with no warning is the pattern that points at the heart rather than at a simple faint. A normal exam afterward is expected and it does not clear anything, because the rhythm that dropped this patient may have already corrected itself. Get the tracing, keep the monitor on during transport, and let the hospital sort the cause.
Why the others are wrong
Release the patient to a family member after a normal exam: A normal exam after a cardiac syncope is the rule rather than the exception, so releasing the patient sends home the one presentation most likely to repeat fatally.
Give a fluid bolus and recheck a standing blood pressure: A fluid challenge treats a volume problem. Nothing in this history suggests dehydration, and orthostatic testing does not evaluate an exertional collapse.
Treat the event as vasovagal and transport without a monitor: A vasovagal faint usually comes with warning and happens while upright and still, not during exertion, so labeling it that way ignores the red flag.
Question 7 of 10
Two adults in a home with a running generator report headache, nausea, and confusion. Both have a SpO₂ of 98% on room air. How should the oxygen saturation readings be interpreted?
Show the answer and rationale
Correct answer · They may be falsely high and do not exclude poisoning
A standard pulse oximeter cannot tell the difference between hemoglobin carrying oxygen and hemoglobin carrying carbon monoxide, so it counts both and shows you a comfortable number. Two people sick in the same house with a generator running is the finding that should drive this call. Move them to fresh air, give high-concentration oxygen, and transport.
Why the others are wrong
They confirm adequate oxygen delivery to the tissues: The reading looks reassuring for exactly the wrong reason, since the device is counting the molecule that is blocking oxygen delivery as though it were oxygen.
They are inaccurate because both patients are confused: Confusion does not make a probe read wrong. The problem is what the device measures, not the patient's mental status.
They indicate the symptoms come from a shared illness: Multiple people sick at once does raise infection as a thought, but the generator makes an exposure the far more urgent explanation to act on.
Question 8 of 10
An 82-year-old patient has become progressively more confused over the past four days with reduced appetite and no focal weakness. The vital signs are BP 106/64, P 108, R 22, and T 100.8 degrees Fahrenheit. Which cause does the tempo of this decline most support?
Show the answer and rationale
Correct answer · An infection such as a urinary tract infection
How fast the change happened narrows the list before you touch the patient. Stroke, seizure, overdose, and cardiac events arrive suddenly, while infection, metabolic problems, and medication effects build over days. An older adult with a slow slide into confusion, a low-grade fever, and a fast heart rate is showing you an infection, and a bladder infection does this constantly with none of the usual complaints.
Why the others are wrong
An acute ischemic stroke in the posterior circulation: A stroke arrives suddenly. Four days of gradual decline does not fit that timeline, and there are no focal findings to support it.
A structural bleed producing rising intracranial pressure: A bleed producing rising pressure declares itself over hours with worsening headache and falling responsiveness, not over days with poor appetite.
A postictal state following an unwitnessed seizure: A postictal state clears within minutes to tens of minutes. A four-day decline is far outside that window.
Question 9 of 10
EMS is called for a 74-year-old patient found on the bathroom floor at 09:15 with right-sided weakness and slurred speech, unable to say when the symptoms began. A family member reports last speaking with the patient by phone at 06:30, when the patient sounded normal. What is the patient's last known well time for stroke treatment decisions?
Show the answer and rationale
Correct answer · 06:30, the last time the patient was observed behaving normally
Last known well is defined as the last time someone actually observed the patient behaving normally, not the time the patient was found or the time symptoms were noticed. Here that is 06:30, the last phone call when the patient sounded normal. The gap before the patient was found does not change that definition. This time is one of the two pieces of information, along with the glucose reading, that only the AEMT reliably gathers and that the receiving stroke team depends on for treatment decisions.
Why the others are wrong
09:15, the time the patient was found on the floor with symptoms present: 09:15 is when the patient was found with symptoms already present, not the last time the patient was observed acting normally; using it as the last known well overstates how recently the patient was confirmed normal.
An averaged time halfway between the phone call at 06:30 and the discovery at 09:15: Last known well is an actual observed time, not an estimate or an average between two other times; averaging invents a data point nobody witnessed.
The time EMS personnel first confirmed the deficits during their assessment on scene: The time EMS confirmed the deficits on scene marks when the symptoms were verified, not when the patient was last observed at neurologic baseline, and it plays no role in the last known well determination.
Question 10 of 10
The AEMT is transporting a 61-year-old patient with a witnessed onset of right-sided arm weakness and slurred speech 35 minutes ago. Ten minutes into transport, the patient's speech is clear and arm strength has returned to normal. The patient asks to be taken home instead of to the hospital. What should the AEMT do?
Show the answer and rationale
Correct answer · Continue transport and notify the hospital
A stroke-like deficit that resolves completely within minutes to hours is a transient ischemic attack, and every transient ischemic attack is still an emergency because roughly one-third of these patients go on to have a stroke soon afterward, so transport and hospital notification must continue even though the deficit has resolved.
Why the others are wrong
Return the patient home as requested: A student who takes the resolved deficit as proof nothing serious happened may agree to take the patient home, missing that a resolved deficit is still a warning sign of a stroke risk soon after.
Cancel the response and clear the scene: A student who treats the resolved weakness as a false alarm may want to clear the scene entirely, but a transient ischemic attack still requires hospital evaluation even without an ongoing deficit.
Downgrade to non-emergency transport: A student who thinks the resolved deficit lowers urgency may downgrade the transport priority, but the elevated risk of a stroke following a transient ischemic attack keeps this a time-critical transport.
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Take the free AEMT diagnosticMore free AEMT practice questions by topic
Airway, Respiration & Ventilation
Cardiology & Resuscitation
Trauma
Medical/Obstetrics/Gynecology
- IV Therapy and Fluid Administration
- Medication Administration Routes
- Diabetic Emergencies and Glucometry
- Respiratory Emergencies and Nebulized Medications
- Obstetric and Gynecologic Emergencies
- Neurologic Emergencies: Stroke, Seizure, and Altered Mental Status
- Endocrine Emergencies Beyond Diabetes
- Gastrointestinal, Renal, and Genitourinary Emergencies
- Toxicology and Overdose Management
- Sepsis and Systemic Infection
EMS Operations
- AEMT Scope of Practice and Medical Direction
- Specialized Transport Considerations
- Scene Safety, Personal Protection, and Infection Control
- Multiple Casualty Incidents, Triage, and Incident Command
- Documentation, Communication, and Confidentiality
- Ambulance Operations and Equipment Readiness
- Responder Wellness and Resilience