chapter 13 emt
You are transporting a patient who was injured as he was jogging along a road and was struck by a car. The patient has a GCS score of 10 with a respiratory rate of 30/min and a blood pressure of 78 systolic. The heart rate is 124/min. What is the patient's total revised trauma score?
9
your 64-year-old patient is complaining of chest pain radiating to his left jaw. What part of the OPQRST would this information apply to?
R
A large puncture wound or laceration to the neck must be immediately sealed with an occlusive dressing to prevent: A. an air embolus. B. C-spine injury. C. airway compromise. D. infection or cellulitis.
a
During your ride-along time as an EMT student, you are called for a female patient with a severe headache that occurred suddenly and now radiates into her neck and jaw. She said that this occurred after she fell backwards and struck her head on the ground about 2 hours ago. Learning that the pain started 2 hours ago would be what part of the OPQRST history? A. T B. R C. S D. Q
a
If your trauma patient had an initial GCS score of 13, and now has a score of 10, what does this imply? A. The patient is deteriorating. B. The patient is improving. C. Someone miscalculated the first GCS score as the maximum score one can receive is 10. D. The patient is still stable.
a
The mnemonic used to assess a patient's mental status is: A. AVPU. B. PEARL. C. DCAP-BTLS. D. OPQRST.
a
Tracheal deviation found during the general impression or primary examination may indicate a/an: A. tension pneumothorax. B. airway blockage. C. flail segment. D. serious injury to the heart.
a
Which of the following assessment findings would be considered a critical finding in an unresponsive medical patient? A. Facial drooping B. Tachypnea C. Equal pupils D. Tachycardia
a
Which of the following components is NOT used during the evaluation of the Revised Trauma Score? A. Heart rate B. Respiratory rate C. Systolic blood pressure D. Motor, verbal, eye responses
a
Which of the following is NOT a reason to perform a reassessment of the patient? A. Transport time to the hospital of less than 10 minutes B. To adjust the emergency care as needed C. For identifying any missed injuries or conditions D. To detect any change in the patient's condition
a
Which of the following is TRUE regarding crowing and stridor? A. Both are commonly associated with swelling of the airway. B. Airway adjuncts should be used in a child with suspected infection of the epiglottis. C. They are usually relieved by proper positioning of the airway and airway adjuncts. D. Both are rattling sounds produced on exhalation.
a
Which of the following is recognized as one of the four main components or phases of patient assessment? A. Primary assessment B. Vital signs C. Transport D. Rapid trauma assessment
a
Which of the following statements is TRUE regarding the secondary assessment for an unresponsive medical patient? A. It is very similar to the secondary assessment for a trauma patient with a significant mechanism of injury. B. It is the same as the secondary exam for a responsive medical patient. C. It is very similar to the modified secondary assessment for a trauma patient with no significant mechanism of injury. D. All secondary assessments are conducted in the same way.
a
You are assessing a 58-year-old male who was in a high-speed collision. He was not wearing his seatbelt and has a deep laceration on his forehead and neck pain. It is not clear whether there was a period of unconsciousness before your arrival on the scene. What is the patient's treatment priority, and which hospital should he be taken to? A. High priority and trauma center 10 miles away B. Low priority and nearest hospital 7 miles away C. High priority and nearest hospital 7 miles away D. Low priority and trauma center 10 miles away
a
You are at the scene of a patient with a significant mechanism of injury. After you complete your primary assessment, you find that the patient responds to painful stimuli with decorticate posturing. You also note blood in the hypopharynx, unequal chest wall motion, and a penetration injury to the leg with moderate bleeding. According to these findings, what would be your transport decision? A. High priority B. No priority C. Low priority D. Medium priority
a
Your patient was injured in a construction accident and is complaining of pain to the pelvic region. Upon inspection, you note gross deformities to the pelvis. How should you continue to assess the pelvis? A. Do not palpate the pelvis. B. Auscultate the pelvis at the normal locations. C. Palpate the pelvis for instability by placing your hands over the iliac crests. D. Palpate the pelvis only by applying downward pressure over the symphysis pubis.
a
For which of the following patients should the EMT initiate their assessment and management by determining the status of the circulatory system? A. A patient with severe dyspnea B. A patient with an altered mental status C. A patient suspected to be in cardiac arrest D. A patient with an obvious brain injury from head trauma
a pt suspected to be in cardiac arrest
You are working with a new EMT and while on scene with an unresponsive medical patient, your partner asks you when he should obtain vitals. What would you tell him?
after the rapid secondary assessment
An airway that is open can also be called: A. positional. B. patent. C. obstructed. D. occluded.
b
The pulse oximeter is failing to read properly, and the patient is complaining of dyspnea, abdominal pain, and nausea and is becoming more and more anxious. What should the EMT do? A. Repeat the SAMPLE and OPQRST history. B. Administer high-concentration oxygen. C. Administer low-concentration oxygen. D. Provide four baby aspirins for the patient to chew and swallow, and then begin rapid transport.
b
What is the first phase of patient assessment that the EMT should do at each and every patient encounter? A. Rapid trauma assessment B. Scene size-up C. Primary survey D. History and physical exam
b
What is the order in which you should perform a secondary assessment for a stable trauma patient who is responsive? A. History, vitals, and modified secondary assessment B. Modified secondary assessment, vitals, history C. Vitals, modified secondary assessment, and history D. Modified secondary assessment, history, and vitals
b
What would be considered a significant mechanism of injury for an infant? A. Fussiness while trying to feed from a bottle B. A fall greater than 10 feet C. A low-impact motor vehicle collision (MVC) in which the infant was restrained in a car safety seat D. A laceration to a finger
b
When assessing the patient, paying attention to his mood, speech, posture, and motor activity would be MOST relevant to which body system? A. Respiratory B. Neurological C. Musculoskeletal D. Cardiovascular
b
Which of the following BEST describes establishing manual in-line stabilization? A. Applying a cervical collar to the patient's neck. B. Bringing the patient's head into a neutral in-line position and holding it there. C. Securing the patient to a KED with a cervical collar in place. D. Securing the patient to a backboard with a cervical collar in place.
b
Which of the following BEST outlines the sequences for completing the reassessment phase by the EMT while en route to the hospital? A. Repeat the primary assessment, repeat the secondary assessment, and assess vitals. B. Repeat the primary assessment, reassess the vitals, repeat the secondary assessment, assess effectiveness of interventions, and note trends in the patient's condition. C. Assess the vitals, repeat the primary and secondary assessments, and note the effectiveness of the interventions. D. Repeat the primary and secondary assessments, obtain vital signs, note trends in the patient's condition, and reassess the effectiveness of the interventions.
b
Which of the following circulation assessment findings best describes a hemorrhage that the EMT should manage immediately? A. Venous bleed from the antecubital fossa following a failed IV cannulation B. Heavy venous/arterial bleeding from the thigh due to a penetration injury C. Dark red hemorrhage from the proximal tibia due to an open fracture D. Bright red hemorrhage from the temporal scalp from a fall injury
b
You are assessing a 35-year-old female patient who fell and struck her head while skiing. She is confused about the day of the week, and she does not remember falling, although a witness says that she collided with a tree. She was wearing a helmet at the time, according to bystanders. On the basis of what you know already, what is her priority? A. Potentially stable B. Unstable C. Stable D. Potentially unstable
b
Your patient is a 54-year-old male with a history of diabetes who is currently unresponsive. You have initiated high-flow oxygen and started transport. His initial vitals were pulse 68, respirations 14, and B/P 102/70, with a BGL of 425 mg/dL. Given this, how often will you repeat the vital signs while transporting? A. Only if mental status changes B. Every 5 minutes C. Once during transport D. Every 15 minutes
b
As soon as the patient's airway is opened, which of the following is NOT part of what the EMT should consider doing NEXT? A. Determine the need for early oxygen therapy. B. Determine if the breathing is adequate or inadequate. C. Determine the need for spinal immobilization. D. Determine the need for mechanical ventilation.
c
For infants and children, significant mechanisms of injury include: A. any indication of physical abuse. B. a fall of 3 feet when the child was accidently dropped by a parent. C. a vehicle collision in which the patient was unrestrained. D. laceration to a finger from pinching it in a door.
c
Forming a general impression of the patient includes which of the following? A. Ascertaining whether law enforcement is needed on scene B. Assessing the vital signs C. Obtaining the chief complaint D. Determining the need and type of PPE for the call
c
Of the following, which would NOT be included in the assessment of vitals during a secondary assessment? A. Capillary refill B. Skin characteristics C. Blood glucose level (BGL) assessment D. Pupil assessment
c
The range of a normal respiratory rate for an adult patient is between: A. 6 and 18 per minute. B. 12 and 20 per minute. C. 8 and 24 per minute. D. 14 and 28 per minute.
c
When discussing the reassessment phase, the EMT would likely say that it: A. is performed every 15 minutes on the unstable patient. B. is done only if the EMT actually provided some intervention. C. is performed continuously, until arrival at the hospital. D. is only performed on patients for whom a physical exam was performed.
c
Which of the following is LEAST directly related to checking the effectiveness of interventions you have performed on a trauma patient? A. Making sure that the patient's airway is still patent with the OPA inserted B. Checking whether the pressure dressing is adequately controlling the bleeding C. Obtaining a blood pressure and a pulse rate D. Ensuring that bone or joint injuries are adequately immobilized
c
Which of the following is TRUE about the inspection of the abdomen in a patient who sustained blunt abdominal trauma? A. If the patient is minimally responsive, you will see no indication of pain on palpation of an abdominal injury. B. A distended and firm abdomen is normal for a patient in good physical condition. C. Discoloration around the navel and in the flank area usually appears several hours after the injury. D. Palpate the abdominal quadrants closest to the painful area first.
c
Which of the following patients would receive a modified secondary assessment rather than a rapid secondary assessment? A. A patient who has blood in the airway and is unresponsive B. A patient with acute abdominal pain C. A patient with a laceration to the finger D. A patient with absent alveolar breath sounds
c
While on scene with a trauma patient, your EMT partner asks you whether she should request ALS backup. The presence of what clinical finding would cause you to have your partner summon ALS? A. Abdominal tenderness B. Presence of pedal and carotid pulses C. Occluded airway D. Blood glucose level of 120 mg/dL
c
You are conducting a primary assessment on a patient who has suffered an emergency. Although the patient is not spontaneously conscious, you note that when you call his name loudly he will open his eyes and then respond. Given this, you determine that his mental status is: A. "A" for alert. B. "U" for unresponsive. C. "V" for verbal. D. "P" for painful.
c
You arrive on scene for a patient who is trapped in a car after an MVC. From the ambulance, you can see the male patient slumped over the steering wheel with blood coming from a large head laceration. There is also smoke billowing from under the hood. What should you do first? A. Put pressure on the head laceration. B. Open the airway. C. Complete a full scene size-up. D. Establish inline stabilization.
c
An unresponsive medical patient requires airway management. Which of the following is TRUE regarding airway control of the unresponsive medical patient? A. The EMT will be forced to use the modified jaw lift on this medical patient. B. An airway adjunct should always be used to keep the airway on an unresponsive patient open. C. Manual airway maneuvers are not necessary if the patient is a medical patient. D. Manual airway maneuvers helps to prevent the tongue and epiglottis from blocking the airway of an unresponsive patient.
d
At what point would the EMT consider the administration of oxygen to a patient with abdominal pain? A. Only if the pulse oximeter drops to 96 percent B. If the patient stated that the abdominal pain has lasted over 6 hours C. Only if the transport time to the hospital is greater than 30 minutes D. If the pulse oximeter dropped below 94 percent
d
Given the time constraints that EMTs often face as they assess and care for patients, the reassessment of the patient is usually completed: A. after patient care has been transferred to the hospital staff. B. upon arrival at the hospital. C. immediately after the primary survey D. while in the ambulance.
d
If the EMT is preparing to assess the characteristics of the skin, what location is the LEAST reliable location to use? A. Mucous membranes lining the eyelids B. Mucous membranes under the tongue C. Mucous membranes in the mouth D. At the base of the nail beds of the hands
d
Of the patients listed which would you consider to be most unstable? A. An alert 54-year-old male who has some chest tightness for the past hour B. A 45-year-old female who thinks she is having an exercise-induced asthma attack but has clear breath sounds C. A 62-year-old male who says he has weakness in his right leg that comes and goes D. An unconscious 29-year-old female who has very shallow breathing
d
What is the highest numerical value assigned to the best motor response when computing the GCS? A. 3 points B. 5 points C. 4 points D. 6 points
d
When you report to your partner that the patient is a 46-year-old conscious male patient with leg pain, you have determined the: A. secondary assessment. B. primary assessment. C. transport priority. D. chief complaint.
d
Which of the following assessment findings would be considered critical during the primary assessment? A. Bleeding from an amputated finger B. Heart rate of 112/min C. Nasal flaring D. Sonorous breath sounds
d
Why may the EMT have to change the general impression of the patient on the basis of information learned during the primary or secondary assessment? A. The EMS service has a short transport time and may not be able to complete the primary survey before arriving at the hospital. B. Once the general impression has been formed, the EMT should never change it, as this will cause a delay in patient care. C. Once formed by the EMT, the general impression can be changed only by a provider with a higher certification level. D. An intoxicated patient may present as a medical patient but actually also have a traumatic injury.
d
you are called to the scene for a female patient who was ejected from a car she was riding in when it collided with another car. The driver of the other vehicle was killed in the accident. Your patient is visibly shaken, but only has minor injuries visible. What will you do regarding protecting this patient's spine?
d
Which of the following clinical findings is consistent with a patient who is struggling to breathe? A. Symmetrical movement of the chest during inhalation and exhalation B. Pink tone of the skin around the nail beds C. A breathing rate of 12 to 20 breaths per minute D. Excessive abdominal muscle use
excessive abdominal muscle use
When assessing a patient using the major body systems approach, which body system is typically not included in the assessment?
genitourinary
You are conducting the primary assessment of a 52-year-old man who was in a car crash. When checking the airway, breathing, and circulation, you are looking for:
immediate threats to life
during your assessment of the extremities of a critical trauma patient, which of the following should be of greatest concern? major bleeding, inability to properly place a splint on the patient, gross angulation of a fracture, severe pain to the patient.
major bleeding
What does the EMT know about the modified medical assessment of a stable patient?
the EMT knows that it is directed by the patient's complaints
