Chapter 9- Patient Assessment
A 50-year-old male is found unconscious in his car. There were no witnesses to the event. When gathering medical history information for this patient, the EMT should: A. determine if the patient has a medical alert bracelet or wallet card. B. ask law enforcement officials if they are familiar with the patient. C. defer SAMPLE history questions until you arrive at the hospital. D. wait for family members to arrive before asking any questions.
A
A palpable pulse is created by: A. pressure waves through the arteries caused by cardiac contraction. B. the pressure that is caused when venous blood returns to the heart. C. the pressure of circulating blood against the walls of the arteries. D. electrical conduction in the heart producing ventricular contraction.
A
A patient with high blood pressure would be expected to have skin that is: A) flushed and red. B) mottled and cool. C) pale and moist. D) cyanotic and dry.
A
A patient's short-term memory is MOST likely intact if he or she correctly answers questions regarding:Select one: A. date and event. B. event and person. C. time and place. D. person and place.
A
A properly sized blood pressure cuff should cover: A) two thirds the length from the armpit to the crease at the elbow. B) one half the length between the armpit and the crease at the elbow. C) one third the length from the armpit to the crease at the elbow. D) the entire upper arm between the armpit and the crease at the elbow.
A
After performing a head tilt-chin lift maneuver to open the airway of an unresponsive patient, you should next: A. suction as needed and insert an airway adjunct. B. assess pulse. C. place him or her in the recovery position. D. provide positive-pressure ventilatory assistance.
A
As you assess the head of a patient with a suspected spinal injury, your partner should: A. maintain stabilization of the head. B. look in the ears for gross bleeding. C. prepare the immobilization equipment. D. assess the rest of the body for bleeding.
A
Capnography is used to: A) determine how much carbon dioxide is being exhaled. B) assess how much oxygen is bound to the hemoglobin. C) trend a patient's blood pressure and assess for shock. D) assess how much oxygen is reaching the body's tissues.
A
Clinical signs of labored breathing include all of the following, EXCEPT: A. shallow chest movement. B. use of accessory muscles. C. supraclavicular retractions. D. gasping attempts to breathe
A
If you cannot palpate a pulse in an unresponsive patient that has an unknown down time, you should: A. immediately begin cardiopulmonary resuscitation (CPR). B. assess for adequate breathing. C. palpate at another pulse site. D. attach an automated external defibrillator (AED) at once.
A
In patients with deeply pigmented skin, changes in color may be apparent only in certain areas, such as the: A. lips or oral mucosa. B. forehead and face. C. back of the neck. D. dorsum of the hand.
A
The chief complaint is MOST accurately defined as the: A. most serious thing the patient is concerned about. B. the first condition that you discover. C. gross physical signs that you detect on assessment. D. condition that exacerbates an underlying problem.
A
The full-body scan of a patient that occurs following the primary assessment should: A. assess head to toe for hidden injuries and abnormalities. B. always be done in the ambulance. C. take no more than 15 seconds. D. never be performed prehospital.
A
The increase in the work of breathing is reported as: A. labored breathing. B. troubled breathing. C. obstructed breathing.
A
What maneuver should be used to open the airway of an unresponsive patient with suspected trauma? A. jaw-thrust maneuver B. head tilt-chin lift C. head tilt-neck lift D. tongue-jaw lift
A
When approaching a 32-year-old male who is complaining of traumatic neck pain, you should: A. ensure that the patient can see you approaching him. B. stand behind him and immediately stabilize his head. C. assess his mental status by having him move his head. D. approach him from behind and ask him not to move.
A
When palpating the carotid pulse of a responsive older patient, you should: A. avoid compressing both carotid arteries simultaneously. B. ensure that his or her head is in a hyperextended position. C. avoid gentle pressure so that weak pulses can be detected. D. firmly compress the artery because the pulse is often weak.
A
Which of the following signs of respiratory distress is seen MOST commonly in pediatric patients? A. seesaw breathing B. pursed-lip breathing C. slow respirations D. accessory muscle use
A
You respond to the residence of a 62-year-old male who is unresponsive. Your primary assessment reveals that he is pulseless and apneic. You should: A. start CPR and attach the AED as soon as possible. B. notify dispatch and request a paramedic ambulance. C. ask the family if the patient has a terminal disease. D. perform CPR and transport the patient immediately.
A
A 40-year-old male crashed his motorcycle into a tree. He is semiconscious, has snoring respirations, and has a laceration to the forearm with minimal bleeding. You should: A) apply a cervical collar and suction his airway. B) open his airway with the jaw-thrust maneuver. C) apply a pressure dressing to the patient's arm. D) tilt the patient's head back and lift up on his chin.
B
A full-body scan should be performed on: A. responsive medical patients and patients without a significant MOI. B. all patients who will require EMS transport. C. you never assess your patients. D. stable patients who are able to tell you exactly what happened.
B
During a 30-minute transport of a stable patient, you should reassess him or her at least ________ times. A. 4 B. 2 C. 6 D. 3
B
Palpating the carotid pulse is not recommended in infants because: A. a decrease in cerebral perfusion may occur. B. you may inadvertently compress the trachea. C. the pulse rate is usually too fast to count. D. the carotid artery is more anterior in infants.
B
The diastolic blood pressure represents the: A) average pressure against the arterial walls during a cardiac cycle. B) minimum amount of pressure that is always present in the arteries. C) increased arterial pressure that occurs during ventricular contraction. D) difference in pressure between ventricular contraction and relaxation.
B
The pulse oximeter is an assessment tool used to evaluate the: A. amount of exhaled carbon dioxide. B. effectiveness of oxygenation. C. percentage of red blood cells. D. saturation level of venous blood.
B
When assessing the skin of an unconscious patient, you note that it has a bluish tint to it. This finding is called: A. flushing. B. cyanosis. C. pallor. D. mottling.
B
When you use the palpation method to obtain a blood pressure, the measurement you obtain is the: A. pulse pressure. B. systolic blood pressure. C. diastolic blood pressure. D. cardiac output pressure.
B
Which of the following abnormal breath sounds indicates obstruction of the upper airway? A) Rales B) Stridor C) Crackles D) Rhonchi
B
Which of the following factors would MOST likely cause a patient's pulse rate to be slower than normal? A) Anxiety or severe stress B) Beta-blocker medications C) Internal bleeding from trauma D) Lack of a regular exercise routine
B
Which of the following findings indicates that your patient has a patent airway?Select one: a. Audible breathing b. Forceful coughing c. Inspiratory stridor d. Unresponsiveness
B
Which of the following pupillary changes would indicate depressed brain function? A. Both pupils dilate when a bright light is removed. B. Both pupils dilate with introduction of a bright light. C. Both pupils constrict when a bright light is introduced. D. Both pupils react briskly to light instead of sluggishly.
B
While evaluating a patient with chest pain, your partner tells you that the patient's blood pressure is 140/94 mm Hg. The lower number represents the pressure from the: A. atria contracting. B. ventricles relaxing. C. ventricles contracting. D. atria relaxing.
B
You are dispatched to the county jail for an inmate who is "sick." When you arrive, you find the patient, a 33-year-old male, unresponsive. His airway is patent and his respirations are slow and shallow. Your initial action should be to: A. request a paramedic unit. B. provide assisted ventilation. C. assess his blood pressure. D. apply a pulse oximeter.
B
A 29-year-old male with a head injury opens his eyes when you speak to him, is confused as to the time and date, and is able to move all of his extremities on command. His Glasgow Coma Scale (GCS) score is: A) 10. B) 12. C) 13. D) 14.
C
The rapid exam of a patient that occurs following the primary assessment should take no longer than: A. 120 to 180 seconds. B. 90 to 120 seconds. C. 60 to 90 seconds. D. 30 seconds.
C
Treatment and transport priorities at the scene of a mass-casualty incident should be determined after: A. the number of patients is known. B. area hospitals have been notified. C. all the patients have been triaged. D .a physician arrives at the scene.
C
Upon arriving at a potentially unsafe scene, you should: A. move the patient to safety. B. remove all bystanders. C. ensure that you are safe. D. request another ambulance.
C
When you inspect a patient's pupils with a penlight, the pupils should normally react to the light by: A. fluttering. B. dilating. C. constricting. D. enlarging.
C
Which of the following is the MOST accurate guide to palpating a pulse? A. Avoid compressing the artery against a bone or solid structure. B. Use your thumb to increase the surface area that you are palpating. C. Place the tips of your index and long fingers over the pulse point. D. Apply firm pressure to the artery with your ring and little fingers.
C
Which of the following is the MOST effective method of assessing the quality of air movement in the lungs? A) Evaluating the patient's chest for cyanosis B) Applying a pulse oximeter and monitoring the SpO2 C) Auscultating breath sounds with a stethoscope D) Looking for the presence of accessory muscle use
C
Which of the following patient responses would establish the "E" in the SAMPLE history? A. "I was in the hospital a week ago." B. "The chest pain started about 45 minutes ago." C. "I was mowing the lawn when the pain began." D. "I am not having any difficulty breathing."
C
Which of the following situations or conditions warrants immediate transport? A. mild pain in the lower abdomen B. decreased ability to move an extremity C. severe chest pain and cool, pale skin D. responsiveness and ability to follow commands
C
Which of the following statements regarding stridor is correct? A) It is a whistling sound heard in the lower airway. B) It is caused by incorrect airway positioning. C) It is a high-pitched, crowing upper airway sound. D) It suggests the presence of fluid in the lungs.
C
You are unable to find a radial pulse on a patient from a motor vehicle crash. You should: A. apply the pulse oximeter. B. begin chest compressions. C. attempt to find the carotid pulse.
C
A 40-year-old male presents with pain to the right upper quadrant of his abdomen. He is conscious and alert with stable vital signs. During your assessment, you note that his skin and sclera are jaundiced. You should suspect: A. renal insufficiency. B. acute pancreatitis. C. gallbladder disease. D. liver dysfunction
D
A crackling sound produced by air bubbles under the skin is called: A) crepitus B) rhonchi. C) Korotkoff sounds. D) subcutaneous emphysema.
D
A decrease in the blood pressure may indicate: A. forceful cardiac contraction. B. increased blood volume. C. arterial constriction. D. a loss of vascular tone.
D
A patient who does not respond to your questions but moves or cries out when his or her trapezius muscle is pinched, is said to be: A. conscious and alert. B. completely unresponsive. C. responsive to verbal stimuli. D. responsive to painful stimuli.
D
A patient with profuse sweating is referred to as being: A. moist. B. mottled. C. flushed. D. diaphoretic.
D
An elderly patient has fallen and hit her head. You assess her level of consciousness as unresponsive using the AVPU scale. Your initial care should focus on: A. obtaining baseline vital signs. B. gathering medical history data. C. providing immediate transport. D. airway, breathing, and circulation.
D
If a patient develops difficulty breathing after your primary assessment, you should immediately: A. determine his or her respiratory rate. B. auscultate his or her breath sounds. C. begin assisting his or her breathing. D. reevaluate his or her airway status.
D
In which of the following situations is a pertinent negative identified? A. A 50-year-old woman states that nothing makes her chest pain better or worse. B. A 53-year-old man with dizziness also tells you that he has vomited three times. C. A 56-year-old woman states that her chest hurts every time she takes a deep breath. D. A 59-year-old man complains of crushing chest pain but denies shortness of breath.
D
Jugular venous distention suggests a problem with blood returning to the heart if the patient is: A. in a right lateral position. B. in a recumbent position. C. in a supine position. D. sitting up at a 45° angle.
D
Pain that moves from its point of origin to another body location is said to be: A. provoking. B. referred. C. palliating. D. radiating.
D
Supplemental oxygen via nonrebreathing mask should be administered to patients: A. who are semiconscious with shallow respirations. B. with rapid respirations and a reduced tidal volume. C. who have accessory muscle use and slow breathing. D. with difficulty breathing and adequate tidal volume.
D
The systematic head-to-toe assessment should be performed on: A) stable patients who are able to tell you exactly what happened. B) all patients with traumatic injuries who will require EMS transport. C) responsive medical patients and patients without a significant MOI. D) patients with a significant MOI and unresponsive medical patients
D
Upon assessment of your patient, you notice that he has cool, sweaty skin. This finding is best described as which of the following? A. Symptom B. Diagnosis C. Complaint D. Sign
D
When taking blood pressure, the cuff should be inflated to what point? A. Until the gauge reads 200 mmHg B. Until the patient says it hurts C. Until the Velcro starts to crackle D. 30 mmHg beyond the point where the pulse disappears
D
When you shine a light into one pupil, the normal reaction of the other pupil should be to: A. become larger. B. dilate. C. not react. D. become smaller.
D
Which of the following statements regarding the secondary assessment is correct? A. During the secondary assessment, the EMT's only focus should be on taking the patient's vital signs and obtaining a SAMPLE history. B. The secondary assessment must always be performed en route to the hospital, regardless of the severity of the patient's condition. C. A secondary assessment should be performed, even if you must forgo the management of life threats that were identified in the primary assessment. D. The secondary assessment should focus on a certain area or region of the body as determined by the chief complaint in a stable awake patient.
D
While en route to the scene of a shooting, the dispatcher advises you that the caller states that the perpetrator has fled the scene. You should: A. ask the dispatcher if he or she knows the location of the perpetrator. B. only request law enforcement personnel if the scene is unsafe upon your arrival. C. proceed to the scene as usual but exercise extreme caution upon arrival. D. confirm this information with law enforcement personnel at the scene.
D
With regard to the assessment of a patient's cardiovascular status, capillary refill time is MOST reliable in: A. children who are older than 6 years of age. B. patients who are significantly hypotensive. C. patients with decreased peripheral perfusion. D. children who are younger than 6 years of age.
D
You receive a call to a daycare center for an unresponsive 8-month-old infant. Upon arrival, you perform an assessment and determine that the infant is not breathing. Your next action should be to: A) open the airway and give two rescue breaths. B) begin chest compressions and request backup. C) immediately transport the child to the hospital. D) assess for a brachial pulse for 5 to 10 seconds.
D
You receive a call to a local daycare center for an unresponsive 8-month-old infant. Upon arrival, you perform an assessment and determine that the infant is unresponsive. You should next: A. begin chest compressions and request backup. B. assess for a carotid pulse for 10 to 15 seconds. C. immediately transport the child to the hospital. D. assess for the presence of a brachial pulse.
D
You should gently palpate a patient's pelvis only if: A. you note severe gross deformity to the pelvic area after MOI. B. The patient is screaming in pain about their pelvis form a 30 foot fall C. you never palpate the pelvis of any patient. D. the patient does not complain of pelvic pain.
D
You should suspect that a patient is experiencing respiratory failure if he or she: A. has an increased heart rate and retractions. B. is anxious, tachycardic, and leaning forward. C. is restless and is working hard to breathe. D. has bradycardia and diminished muscle tone.
D
