Chapter 9 PT asses

45.During a 30-minute transport of a stable patient, you should reassess him or her at least ________ times.

2

146.To obtain the pulse rate in most patients, you should count the number of pulses felt in a ______.

30-second

76.Normal respiratory rates should not exceed _______ breaths per minute in toddlers and _______ breaths per minute in infants.

40, 60

119.An unstable patient should be reassessed at least every

5 minutes.

87.For an adult, the normal resting pulse should be between

60 and 100 beats/min.

17.The rapid exam of a patient that occurs following the primary assessment should take no longer than

60 to 90 seconds.

64.In the adult, bradycardia is defined as a pulse rate less than _______ beats/min, and tachycardia is defined as a heart rate greater than _______ beats/min.

60, 100

20.Which of the following assessments would be the MOST useful in determining the possible cause of a patient's altered mental status?

Blood glucose level

7.Which of the following statements regarding the blood pressure is correct?

Blood pressure is usually not measured in children younger than 3 years of age.

40.At what point in the patient assessment process do you investigate the chief complaint?

History taking

49.Which of the following MOST accurately describes paradoxical movement of the chest wall?

Only one section of the chest rises on inspiration, while another area falls

61.When palpating a patient's pulse, you note that there is a short interval between pulsations. This indicates that the pulse is

Rapid

111.Which of the following would you NOT detect while determining your initial general impression of a patient?

Rapid heart rate

4.Which of the following actions would NOT be performed during the scene size-up?

Rapidly assessing a patient's respiratory status

116.When assessing your patient's pain, he says it started in his chest but has spread to his legs. This is an example of what part of the OPQRST mnemonic?

Region/radiation

71.A pulse with a consistent pattern is considered to be

Regular

142.What does the "P" on the AVPU scale represent?

Responsive to pain

36.You respond to a home where a 25-year-old woman is lying in bed. She is semiconscious but opens her eyes when you speak to her, and is lethargic. How do you rate her on the AVPU scale?

Responsive to verbal stimuli

33.__________ is used for asking questions about pain.

SAMPLE

35.What is the first concern when entering a scene?

Scene safety

42.In what phase of patient assessment do you determine MOI/NOI?

Scene size-up

41.When treating a 6-year-old, you note a brassy crowing sound, especially when she breathes in. What is this?

Stridor

73.Which of the following would the EMT likely NOT perform on a responsive patient with a headache and no apparent life-threatening conditions?

Systematic head-to-toe examination

81.The pressure exerted against the walls of the artery when the left ventricle contracts is called the

Systolic pressure

34.In an adult patient, a pulse rate that is greater than 100 beats/min is described as ________.

Tachycardia

14.Which of the following statements regarding the mechanism of injury (MOI) is correct?

The MOI may allow you to predict the severity of a patient's injuries.

136.____ is the measure of the amount of air that's moved into & out of the lungs in one breath.

Tidal volume

39.What is the purpose of the primary assessment?

To identify and begin to treat immediate life threats

162.In the _____ position, the patient sits leaning forward on outstretched arms with the head & chin thrust slightly forward.

Tripod

16.Palliating factors regarding a patient's pain involve those that

alleviate the pain.

134.With _____, the force of the injury occurs over a broad area, & the skin is usually not broken.

blunt trauma

82.When auscultating the blood pressure in a patient's upper extremity, you should place the diaphragm (head) of the stethoscope over the _________ artery.

brachial

95.For children younger than 1 year old, you should palpate the _____ artery when assessing the pulse.

brachial

155.When assessing breathing, you should obtain all of the following EXCEPT

breath odor

59.Which of the following is the MOST accurate guide to palpating a pulse?

place the tips of your index and long fingers over the pulse point

102.When performing the secondary assessment on a trauma patient, you note the presence of Battle sign. This is defined as

bruising behind the ear

137.The physical examination consists of all of the following EXCEPT

puncture

140.The initial assessment includes evaluation of all of the following EXCEPT

pupils

5.In responsive patients who are older than 1 year of age, you should palpate the pulse at the ________ artery.

radial

128.Pain that moves from its point of origin to another body location is said to be

radiating.

46.If a patient develops difficulty breathing after your primary assessment, you should immediately

reevaluate his or her airway status

10.When interviewing a patient, you can show him or her that you understand the situation by

repeating statements back to him or her.

97.The systematic head-to-toe assessment should be performed on

responsive medical patients and patients without a significant MOI.

153.In the absence of light, pupils will

dilate

130.External bleeding from an extremity can usually be controlled by a combination of

direct pressure and elevation.

166.Which of the following is NOT considered a sign?

dizziness

27.When approaching a 32-year-old male who is complaining of traumatic neck pain, you should

ensure that the patient can see you approaching him

92.A blood pressure cuff that is too small for a patient's arm will give a

falsely high systolic and diastolic reading

56.A patient with high blood pressure would be expected to have skin that is

flushed and red

67.Which of the following findings indicates that your patient has a patent airway?

forceful coughing

129.As you assess the head of a patient with a suspected spinal injury, your partner should

maintain stabilization of the head.

113.Assessment of an unconscious patient's breathing begins by

manually positioning the head.

90.End-tidal carbon dioxide (ETCO2) is defined as the

maximal concentration of CO2 at the end of an exhaled breath.

141.The best indicator of brain function is the patient's

mental status

8.The diastolic blood pressure represents the

minimum amount of pressure that is always present in the arteries.

25.The chief complaint is MOST accurately defined as the

most serious thing the patient is concerned about

101.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

responsive to painful stimuli.

109.You arrive at the scene of an "injured person." As you exit the ambulance, you see a man lying on the front porch of his house. He appears to have been shot in the head and is lying in a pool of blood. You should

retreat to a safe place and wait for law enforcement to arrive.

65.Which of the following signs of respiratory distress is seen MOST commonly in pediatric patients?

seesaw breathing

83.Which of the following situations or conditions warrants immediate transport?

severe chest pain and cool, pale skin

105.Clinical signs of labored breathing include all of the following, EXCEPT

shallow chest movement.

80.Jugular venous distention suggests a problem with blood returning to the heart if the patient is

sitting up at a 45° angle.

88.You respond to the residence of a 62-year-old male who is unresponsive. Your primary assessment reveals that he is apneic and pulseless. You should

start CPR and attach the AED as soon as possible.

114.Your 12-year-old patient can speak only two or three words without pausing to take a breath. He has a serious breathing problem known as

two- to three-word dyspnea.

1.Supplemental oxygen without assisted ventilation would MOST likely be administered to patients

with difficulty breathing and adequate tidal volume.

11.A patient with spontaneous respirations is breathing

without assistance.

85.Family histroy

"Does your mother have diabetes?"

98.Which of the following medical history questions would be of LEAST pertinence in an acute situation?

"Does your mother have diabetes?"

53.Which of the following questions would you ask a patient to ascertain the "M" in the SAMPLE history?

"How much Tylenol do you take each day?"

54.Which of the following patient responses would establish the "E" in the SAMPLE history?

"I was mowing the lawn when the pain began."

89.Which of the following questions is used to determine a patient's chief complaint?

"What seems to be the matter?"

143.The AED should be used on pediatric medical patients who are at least ____ year(s) old & who have been assessed to be unresponsive, apneic, & pulseless.

1

75.The normal respiratory rate for an adult should range from

12 to 20 breaths per minute.

62.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

13

117.In which of the following situations is a pertinent negative identified?

A 59-year-old man complains of crushing chest pain but denies shortness of breath.

13.Which of the following scenarios does NOT involve the presence of any symptoms?

A 61-year-old female who is unconscious with facial cyanosis

38.What is a pertinent negative?

A negative finding that requires no further care or intervention

147.In deeply pigmented skin, you should look for changes in color in areas of the skin that have less pigment, including

A) the sclera B) the conjunctiva C) the mucous membranes of the mouth =D) all of the above=

2.Which of the following conditions would be LEAST likely to cause an altered level of consciousness

Acute anxiety

94.Which of the following is the most effective method of assessing the quality of air movement in the lungs?

Auscultating breath sounds with a stethoscope

44.Which of the following devices would you use to measure a patient's ventilation, circulation, and metabolism?

Capnography

32.When responding to a 45-year-old man involved in a motorcycle accident who is unresponsive, where should you palpate for a pulse?

Carotid pulse *Check radial pulse in responsive adult patients. Carotid pulse in unresponsive adult patients. Brachial pulse in infants.

149.Which of the following is NOT considered a method for controlling external bleeding?

Cold water

152.An integral part of the rapid scan is evaluation using the mnemonic

DCAP-BTLS

132.The scene size-up consists of all of the following EXCEPT

Determining level of responsiveness

52.A patient with profuse sweating is referred to as being

Diaphoretic

48.When performing a rapid exam on a supine patient, what part of the body is typically assessed last?

Extremities

58.A 71-year-old female slipped on a rug and fell. She is conscious and alert and complains of severe pelvic pain. Her respirations are 22 breaths/min with adequate depth and her heart rate is 120 beats/min. Which of the following is NOT indicated for this patient?

Gentle palpation of the pelvis

43.What is the primary purpose of standard precautions?

Infection prevention

139.When considering the need for additional resources, which of the following is NOT a question you should ask?

Is it raining?

159.Which of the following questions should you ask yourself when dealing with a patient who is not answering your questions?

Is there a language problem?

6.An injured patient is assigned a total score of 9 on the GCS. He is assigned a score of 2 for eye opening, a score of 3 for verbal response, and a score of 4 for motor response. Which of the following clinical findings is consistent with his GCS score?

Opens eyes in response to pain, uses inappropriate words, withdraws from pain

154.____ cause the pupils to constrict to a pinpoint.

Opiates

115.How should you determine the pulse in an unresponsive 8-year-old patient?

Palpate the carotid pulse in the neck.

160.____ is an assessment tool used to evaluate the effectiveness of oxygenation

Pulse oximetry

156.Which of the following statements regarding assessment of the airway is TRUE?

The body will not be supplied the necessary oxygen if the airway is not managed

31.You are assessing a patient who fell off a ladder. He is conscious and alert and complaining of pain to his right side and shortness of breath. This is known as __________.

The chief complaint, The patient's reported primary issues constitute the chief complaint.

158.The MOST important thing to consider in patients with multiple injuries in various stages of healing is that

The patient might be a victim of abuse

157.Which of the following is NOT considered a type of breath sound?

Vibration

118.A decrease in the blood pressure may indicate

a loss of vascular tone.

148.All of the following are conditions not related to the body's circulation that may slow capillary refill EXCEPT

abdominal pain

21.An elderly patient has fallen and hit her head. Your initial care should focus on

airway, breathing, and circulation

18.Treatment and transport priorities at the scene of a mass-casualty incident should be determined after

all the patients have been triaged.

66.When using the pulse oximeter as part of your assessment of a patient, it is important to remember that

any situation that causes vasoconstriction or loss of red blood cells, such as anemia or bleeding, may result in an inaccurate or misleading value.

15.A 39-year-old male sustained a stab wound to the groin during an altercation at a bar. As you approach the patient, you note that he is conscious. He is screaming in pain and is attempting to control the bleeding, which is bright red and spurting from his groin area. You should

apply direct pressure to the wound.

106.Poor peripheral circulation will cause the skin to appear

ashen.

77.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

assess for a brachial pulse for 5 to 10 seconds

60.When palpating the carotid pulse of a responsive patient, you should

avoid compressing both carotid arteries simultaneously

165.The first set of vital signs that you obtain is called the

baseline vital signs

126.An adult patient who is NOT experiencing difficulty breathing will

be able to speak in complete sentences without unusual pauses.

28.When you shine a light into one pupil, the normal reaction of the other pupil should be to

become smaller

22.During an EMS call, you should take standard precautions

before exiting the ambulance and before actual patient contact

86.Which of the following factors would MOST likely cause a patient's pulse rate to be slower than normal?

beta-blocker medications

163.In an unresponsive adult patient, the primary location to assess the pulse is the ____ artery.

carotid

150.The ____ is the most serious thing that the patient is concerned about, the reason why they called 9-1-1

chief complaint

84.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

confirm this information with law enforcement personnel at the scene.

70.When you inspect a patient's pupils with a penlight, the pupils should normally react to the light by

constricting.

50.When palpating a patient's pulse, you note that it is grossly irregular. You should

count the pulse rate for a full minute to obtain an accurate reading

161.When examining the abdomen, you should palpate for all of the following EXCEPT

crepitation

144.When there are low levels of oxygen in the blood, the lips & mucous membranes appear blue or gray. This condition is called

cyanosis

55.A patient's short-term memory is MOST likely intact if he or she correctly answers questions regarding

date and event

96.Cyanosis of the skin is caused by

decreased blood oxygen

167.When blood pressure drops, the body compensates to maintain perfusion to the vital organs by

decreasing the blood flow to the skin & extremities

12.Capnography is used to

determine how much carbon dioxide is being exhaled.

123.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

determine if the patient has a medical alert bracelet or wallet card.

19.You should suspect that a patient is experiencing respiratory failure if he or she

has bradycardia and diminished muscle tone.

72.Which of the following is an example of a symptom?

headache

151.The four items used to assess the orientation of a patient's mental status include all of the following EXCEPT

history

120.The goal of the primary assessment is to

identify and rapidly treat all life-threatening conditions.

125.After performing a primary assessment, a rapid scan of the body should be performed in order to

identify less obvious injuries that require immediate transport.

145.Your first consideration when assessing a pulse is to determine

if one is present

3.If you cannot palpate a pulse in an unresponsive patient whose collapse was not witnessed, you should

immediately begin CPR.

164.Liver disease or dysfunction may cause ____, resulting in the patient's skin & sclera turning yellow.

jaundice

26.What maneuver should be used to open the airway of an unresponsive patient with suspected trauma?

jaw-thrust maneuver

23.In patients with deeply pigmented skin, changes in color may be apparent only in certain areas, such as the

lips or oral mucosa

103.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

liver dysfunction.

78.The goal of the systematic head-to-toe exam that is performed during the secondary assessment is to

locate injuries not found in the primary assessment

121.Normal skin color, temperature, and condition should be

pink, warm, and dry.

68.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

open his airway with the jaw-thrust maneuver.

127.In infants and small children, skin color should be assessed on the

palms and soles.

131.A full-body scan should be performed on

patients with a significant MOI and unresponsive medical patients.

135.With _____, the force of the injury occurs at a small point of contact between the skin & the object piercing the skin.

penetrating trauma

63.The MOST effective way to determine whether your patient's problem is medical or traumatic in origin is to

perform a careful and thorough assessment.

112.Your primary assessment of an elderly woman who fell reveals an altered level of consciousness and a large hematoma to her forehead. After protecting her spine and administering oxygen, you should

perform a rapid exam.

124.During your assessment of a 6-month-old male with vomiting and diarrhea, you note that his capillary refill time is approximately 4 seconds. From this information, you should conclude that his

peripheral circulation is decreased.

30.You are assessing a 72-year-old man with abdominal pain. The patient is sitting in a chair; he is conscious, alert, and calm. As you are talking to the patient, your partner discreetly directs your attention to a handgun, which is located on a nearby table. You should

position yourself in between the patient and the gun and ask your partner to request law enforcement assistance

99.A 50-year-old male presents with altered mental status. His wife tells you that he had a "small stroke" three years ago but has otherwise been in good health. The patient is responsive but unable to follow commands. After administering oxygen if needed, you should

prepare for immediate transport

9.A palpable pulse is created by

pressure waves through the arteries caused by cardiac contraction.

110.Findings such as inadequate breathing or an altered level of consciousness should be identified in the

primary assessment.

93.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 rapid and shallow. Your initial action should be to

provide assisted ventilation.

100.During the primary assessment, circulation is evaluated by assessing

pulse quality, external bleeding, and skin condition.

69.A crackling sound produced by air bubbles under the skin is called

subcutaneous emphysema

51.When assessing a patient's abdomen, you will evaluate for all of the following, EXCEPT

subcutaneous emphysema.

74.After performing a head tilt-chin lift maneuver to open the airway of an unresponsive patient who has a pulse, you should

suction as needed and insert an airway adjunct.

37.Which of the following would be used to describe the patient's pulse rate of 140 beats/min?

tachycardia

104.After the first 60 minutes of experiencing a significant injury

the body's ability to compensate for shock decreases.

138.When determining the initial general impression, you should note all of the following EXCEPT

the events leading up to the incident

57.You should gently palpate a patient's pelvis only if

the patient does not complain of pelvic pain.

47.The "Golden Hour" begins when an injury occurs and ends when

the patient receives definitive care

108.During the scene size-up, you should routinely determine all of the following, EXCEPT

the ratio of pediatric patients to adult patients.

24.Reassessment is performed to determine all of the following, EXCEPT

the reason why the patient called EMS

29.Which of the following statements regarding the secondary assessment is correct?

the secondary assessment should focus on a certain area or region of the body as determined by the chief complaint

122.A low ETCO2 reading, as measured by capnography, would MOST likely be observed if

there is an absence or decrease in the level of CO2 in the lungs.

79.When a patient's respirations are shallow

tidal volume is markedly reduced.

107.When assessing a 62-year-old female with crushing chest pain, you note that her pulse is rapid and irregular. You should administer supplemental oxygen if needed and then

transport at once and consider requesting a paramedic unit.

91.A properly sized blood pressure cuff should cover

two thirds the length from the armpit to the crease in the elbow.

133.Your primary safety concern is for

yourself