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Free NREMT practice questionsFree Paramedic practice questions · Medical/Obstetrics/Gynecology

1 free Paramedic practice questions: Stroke & TIA

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Question 1 of 1

A 66-year-old patient has sudden left facial droop and slurred speech that began 25 minutes ago. The patient is alert, speaks in full sentences, and is breathing comfortably. The blood glucose level is 102 mg/dL. The vital signs are BP 158/88, P 76, R 16, and SpO₂ 97% on room air. Which oxygen therapy is most appropriate for this patient?

Show the answer and rationale

Correct answer · No supplemental oxygen

This stroke patient does not need oxygen. The SpO₂ is 97% on room air, so the patient is not hypoxic. Oxygen only helps when the blood is not fully saturated. In a saturated patient, the hemoglobin is already carrying all the oxygen it can, so extra oxygen adds nothing. Too much oxygen can also narrow blood vessels and cause free radical injury in the penumbra, the brain tissue at risk around the stroke. Stroke protocols give oxygen for an SpO₂ below 94% or for an airway problem. Document the last known well time, the stroke scale findings, and the glucose of 102 mg/dL. Get this patient to a stroke center fast.

Why the others are wrong

Nasal cannula at 4 liters per minute: Many protocols default to oxygen on stroke calls, so a nasal cannula is a common reflex. This patient's SpO₂ is 97% on room air, already above the 94% that would call for oxygen. A nasal cannula at 4 L/min adds oxygen the blood does not need and risks hyperoxic injury to the penumbra.

NRB at 15 liters per minute: An NRB at 15 L/min is for a patient in respiratory failure or severe hypoxia who needs as much oxygen as possible. This patient breathes 16 times a minute, comfortably, with an SpO₂ of 97%. There is no oxygen problem to correct.

CPAP: for a patient in respiratory distress from pulmonary edema or a COPD flare who is working hard to breathe. This patient is breathing comfortably at 16 with no distress. Nothing about this patient's breathing calls for positive pressure.

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