Chapter 9 QUIZ: Patient Assessment

Which of the following questions would you ask a patient to ascertain the "M" in the SAMPLE history? "Have you ever had any major surgeries?" "How much Tylenol do you take each day?" "When was the last time you ate a meal?" "How long have you had your chest pain?"

"How much Tylenol do you take each day?"

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: 14. 10. 13. 12.

13.

During a 30-minute transport of a stable patient, you should reassess him or her at least ________ times. 4 6 2 3

2

When you assess capillary refill time in an infant, normal color to the tested area should return within: 3 seconds. 1 second. 2 seconds. 4 seconds.

2 seconds.

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 50, 110 30, 130 40, 120

60, 100

In which of the following situations is a pertinent negative identified? A 56-year-old woman states that her chest hurts when she takes a deep breath. A 59-year-old man complains of crushing chest pain but denies shortness of breath. A 53-year-old man with dizziness also tells you that he has vomited three times. A 50-year-old woman states that nothing makes her chest pain better or worse.

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

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 Treating her for possible shock Rapid head-to-toe exam Application of a cervical collar

Gentle palpation of the pelvis

What part of the patient assessment process focuses on obtaining additional information about the patient's chief complaint and any medical problems he or she may have? Primary assessment Secondary assessment General impression History taking

History taking

Which of the following MOST accurately describes paradoxical movement of the chest wall? Multiple rib fractures that cause a marked deformity of the chest wall. One side of the chest wall moves opposite the direction of the other. Only one section of the chest rises on inspiration, while another area falls. A marked decrease in chest wall movement due to abdominal breathing.

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

When performing a rapid exam on a supine patient, what part of the body is typically assessed last? Anterior chest Abdomen Extremities Posterior

Posterior

Which of the following situations or conditions warrants immediate transport? Decreased ability to move an extremity Mild pain in the lower abdomen Severe chest pain and cool, pale skin Responsiveness and ability to follow commands

Severe chest pain and cool, pale skin

Which of the following abnormal breath sounds indicates obstruction of the upper airway? Stridor Rhonchi Crackles Rales

Stridor

Palliating factors regarding a patient's pain involve those that: alleviate the pain. worsen the pain. change the pain. initiate the pain.

alleviate the pain.

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. pulse oximetry is especially useful in patients who have cold extremities because vasoconstriction forces blood to the capillary beds. carbon monoxide has no effect on pulse oximetry readings because the pulse oximeter presumes that oxygen is saturating the hemoglobin. as long as the patient's oxygen saturation is greater than 95%, oxygen is usually not necessary, even if the patient is experiencing respiratory distress.

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

Poor peripheral circulation will cause the skin to appear: cyanotic. ashen. pink. flushed.

ashen.

When palpating the carotid pulse of a responsive patient, you should: firmly compress the artery because the pulse is often weak. avoid gentle pressure so that weak pulses can be detected. ensure that his or her head is in a hyperextended position. avoid compressing both carotid arteries simultaneously.

avoid compressing both carotid arteries simultaneously.

When auscultating the blood pressure in a patient's upper extremity, you should place the head of the stethoscope over the _________ artery. radial femoral apical brachial

brachial

When performing the secondary assessment on a trauma patient, you note the presence of Battle sign. This is defined as: bruising behind the ear. swelling to the orbital area. unequal pupils. fluid drainage from the nose.

bruising behind the ear.

When you inspect a patient's pupils with a penlight, the pupils should normally react to the light by: fluttering. constricting. enlarging. dilating.

constricting.

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. count the number of pulsations in 30 seconds and multiply by two. count the number of pulsations in 15 seconds and multiply by four. count the pulse rate for at least 30 seconds to ensure accuracy.

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

When assessing the skin of an unresponsive patient, you note that it has a bluish tint to it. This finding is called: flushing. pallor. cyanosis. mottling.

cyanosis.

Cyanosis of the skin is caused by: decreased blood oxygen. increased blood oxygen. venous vasoconstriction. peripheral vasodilation.

decreased blood oxygen.

Capnography is used to: assess how much oxygen is reaching the body's tissues. determine how much carbon dioxide is being exhaled. assess how much oxygen is bound to the hemoglobin. trend a patient's blood pressure and assess for shock.

determine how much carbon dioxide is being exhaled.

A patient with profuse sweating is referred to as being: diaphoretic. edematous. flushed. plethoric.

diaphoretic.

Upon arriving at a potentially unsafe scene, you should: remove all bystanders. move the patient to safety. ensure that you are safe. request another ambulance.

ensure that you are safe.

Upon arriving at the scene of a patient with difficulty breathing, you determine that the scene is safe. You enter the residence and find the patient sitting in a chair in respiratory distress. Your first action should be to: ask the patient what's wrong. assess the patient's airway status. obtain a set of baseline vital signs. introduce yourself to the patient.

introduce yourself to the patient.

A patient is sitting in a chair, leaning forward on his outstretched arms. His head and chin are thrust forward. This position indicates that he: is experiencing difficulty breathing. is experiencing severe back pain. has abdominal muscle spasms. has a decreased level of consciousness.

is experiencing difficulty breathing.

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: gallbladder disease. acute pancreatitis. renal insufficiency. liver dysfunction.

liver dysfunction.

The goal of the systematic head-to-toe exam that is performed during the secondary assessment is to: definitively rule out significant internal injuries. assess only the parts of the body that are injured. locate injuries not found in the primary assessment. detect and treat all non-life-threatening injuries.

locate injuries not found in the primary assessment.

A decrease in blood pressure may indicate: arterial constriction. loss of vascular tone. increased blood volume. forceful cardiac contraction.

loss of vascular tone.

As you assess the head of a patient with a suspected spinal injury, your partner should: maintain stabilization of the head. assess the rest of the body for bleeding. prepare the immobilization equipment. look in the ears for gross bleeding.

maintain stabilization of the head.

The diastolic blood pressure represents the: average pressure against the arterial walls during a cardiac cycle. difference in pressure between ventricular contraction and relaxation. minimum amount of pressure that is always present in the arteries. increased arterial pressure that occurs during ventricular contraction.

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

The systematic head-to-toe assessment should be performed on: all patients with traumatic injuries who will require EMS transport. stable patients who are able to tell you exactly what happened. patients with a significant MOI and unresponsive medical patients. responsive medical patients and patients without a significant MOI.

patients with a significant MOI and unresponsive medical patients.

Normal skin color, temperature, and condition should be: pale, cool, and moist. pink, warm, and moist. flushed, cool, and dry. pink, warm, and dry.

pink, warm, and dry.

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. inquire about his family history. perform a head-to-toe assessment. repeat the primary assessment.

prepare for immediate transport.

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

radial

Pain that moves from its point of origin to another body location is said to be: palliating. radiating. provoking. referred.

radiating.

If a patient develops difficulty breathing after your primary assessment, you should immediately: determine his or her respiratory rate. auscultate his or her breath sounds. begin assisting his or her breathing. reevaluate his or her airway status.

reevaluate his or her airway status.

A pulse with a consistent pattern is considered to be: weak. irregular. regular. strong.

regular.

When interviewing a patient, you can show him or her that you understand the situation by: using medical terminology whenever possible. interrupting him or her as needed for clarification. maintaining constant eye contact with him or her. repeating statements back to him or her.

repeating statements back to him or her.

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. responsive to verbal stimuli. completely unresponsive. conscious and alert.

responsive to painful stimuli.

Jugular venous distention suggests a problem with blood returning to the heart if the patient is: sitting up at a 45° angle. in a supine position. in a recumbent position. in a prone position.

sitting up at a 45° angle.

A crackling sound produced by air bubbles under the skin is called: subcutaneous emphysema. crepitus rhonchi. Korotkoff sounds.

subcutaneous emphysema.

After performing a head tilt-chin lift maneuver to open the airway of an unresponsive patient who has a pulse, you should: assess respiratory rate, depth, and regularity. place him or her in the recovery position. provide positive-pressure ventilatory assistance. suction as needed and insert an airway adjunct.

suction as needed and insert an airway adjunct.

When you use the palpation method to obtain a blood pressure, the measurement you obtain is the: diastolic blood pressure. pulse pressure. cardiac output pressure. systolic blood pressure.

systolic blood pressure.

The pressure exerted against the walls of the artery when the left ventricle contracts is called the: pulse pressure. blood pressure. diastolic pressure. systolic pressure.

systolic pressure.

When a patient's respirations are shallow: oxygenation occurs more efficiently. tidal volume is markedly reduced. chest rise will be easily noticeable. carbon dioxide elimination is increased.

tidal volume is markedly reduced.

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. conclude that the irregular pulse is normal based on her age. document your findings and perform a detailed assessment. apply the AED and analyze her cardiac rhythm.

transport at once and consider requesting a paramedic unit.

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: atria relaxing. ventricles relaxing. atria contracting. ventricles contracting.

ventricles relaxing.

When assessing motor function in a conscious patient's lower extremities, you should expect the patient to: identify different types of stimuli. wiggle his or her toes on command. note any changes in temperature. feel you touching the extremity.

wiggle his or her toes on command.