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ALTERED MENTAL STATUS CHANGE (AMS)

Total questions: 10

Worksheet time: 7mins

Name
Class
Date
1.

Using the algorithm provided here , which of the following are presented in a veteran with an altered mental status?

(Select all that apply)

a)

Agitation

b)

Confusion

c)

Drowsiness

d)

Gait disturbance

e)

Abnormal behavior

2.

The veteran is displaying behavior that is a change from baseline , he is alert and responsive to commands.

At this time, is this veteran stable or unstable?

a)

Stable

b)

Unstable

3.

The veteran continues to demonstrate behavior that is a change from baseline .

You must identify a reversible cause.

According to the algorithm, which of the following will you identify?

a)

Hemoglobin

b)

Last po intake

c)

Finger stick Blood Sugar

(FSBS)

d)

Weight

4.

The veteran was demonstrating behavior that was a change from baseline. You performed a FSBS and results is 68 mg/dL

According to the AMS & Hypoglycemia algorithms, which of the following will you perform next?

(Select all that apply)

a)

Call for 2nd license for constant observation

b)

Give 1/2 cup of fruit juice

c)

Call provider

d)

Administer 4 units of Aspart insulin and await further orders

5.

The veteran was demonstrating behavior that was considered a change in baseline. FSBS is 110 mg/dL. Provider has been called. Which of the following orders will you anticipate ?

a)

Sodium levels

b)

Drug Screening

c)

Ammonia levels

d)

Hematocrit

e)

UA/C&S

6.

The veteran was demonstrating agitation and gait disturbance. He does not respond to painful stimuli and unable to obey commands. FSBS is 110 mg/dL. He appears to be leaning to his left side in his chair and left corner of his mouth is drooping. Which of the following algorithms will you add at this time ?

a)

Fever

b)

STROKE

c)

Hypoglycemia

d)

Hyperglycemia

7.

The veteran is demonstrating confusion and while you transfer him to his bed he feels hot to the touch.

Oral temperature is 103 degrees, FSBS is 110 mg/dL

Which of the following algorithms will you add at this time?

(Please select 2 )

a)

Fever

b)

Hypoglycemia

c)

Seizure

d)

Respiratory Distress

8.

The veteran is demonstrating abnormal behavior in the dining hall. He previously could follow a simple command and presently he has LOC. Temperature and FSBS are WNL.

According to the algorithm which of the following are your next actions?

a)

Call for 2nd license for constant observation

b)

Call 9-911 and X2555 CODE BLUE

c)

Call for code cart & AED

d)

Confirm Code status

e)

Administer 1 cup of milk

9.

The veteran tells you that he is experiencing blurred vision . FSBS is 110 mg/dL. Vital signs are abnormal with SBP 88 mm/Hg, RR 26 breaths per minute and pulse rate is 55 irregular. .

Which of the following actions will you take ?

(Select all that apply)

a)

Recheck VS in 15 minutes

b)

Call 9-911 and X 2555 CODE BLUE

c)

Call for 2nd license for constant observation

d)

Call for code cart & AED

e)

Assume patient is a DNR

10.

What does the acronym B.E.F.A.S.T represent ?

a)

Balance , Eyes, forward, Arms, Time

b)

Bilateral, Ears, Face, Leg weakness, Speech difficulty, today

c)

Balance, Eyes, Facial Droop, Arm Weakness, Speech difficulty, Time to call

d)

Brain. Eyes, Facial Droop, Arm Strength, Speech improved, Time to call