EMT Chapter 12
A 56-year-old male patient had a syncopal episode in church. Dispatch notes that he has an altered mental status, and bystanders are concerned about his breathing. As you approach the patient, you say hello and ask how he is feeling. He replies, "I'm fine, thanks." Which of the following would be the most appropriate statement about the patient's airway status? A. The patient evidently does not have a patent airway. B. The patient's altered mental status is threatening his airway. C. Because the patient is able to speak, the airway is patent. D. The patient's airway is most likely obstructed.
Because the patient is able to speak, the airway is patent.
A 30-year-old male has been struck by a vehicle at moderate speed and is now unconscious. You initiate a primary assessment and identify that he has blood in his airway, rapid and labored breathing, and absent breath sounds. You note that he is cyanotic. Which of these problems should be managed first? A. Absent lung sounds B. Inadequate ventilations C. Blood in the airway D. Diminished mental status
Blood in the airway
During the primary assessment of an unresponsive two-month-old infant, which pulse should be palpated? A. Carotid B. Umbilical C. Radial D. Brachial
Brachial
Your patient is a middle-aged man who appears to be in distress and is clutching his chest. These observations lead you to suspect which type of problem? A. Cardiac B. Choking C. Digestive D. Anaphylaxis
Cardiac
Which of the following best describes an EMS provider's "sixth sense"? A. General impression B. Diagnostic ability C. Scene safety D. Clinical judgment
Clinical judgment
Which of the following is the correct manner for checking for responsiveness in an apparently unresponsive infant? A. Rubbing the sternum with your knuckles B. Shaking the child C. Flicking the soles of the feet D. Pinching the earlobe
Flicking the soles of the feet
What is the first thing the EMT does during the primary assessment? A. Opens the airway B. Forms a general impression C. Assesses mental status D. Determines transport priority
Forms a general impression
Which term refers to the EMT's initial sense of the patient's condition, based on immediate assessment of the patient's environment, appearance, and chief complaint? A. Scene size-up B. Primary assessment C. Secondary assessment D. General impression
General impression
Which of the following represents the correct order of assessment for the EMT during the primary assessment from start to end? A. General impression, mental status, airway, breathing, circulation, patient priority B. Patient priority, general impression, mental status, airway, breathing, circulation C. Mental status, general impression, airway, breathing, circulation, patient priority D. None of the above
General impression, mental status, airway, breathing, circulation, patient priority
Which of the following is not true regarding a patient who has a mental status of less than alert? A. He requires high-concentration oxygen. B. His brain may not be getting enough oxygen. C. He may not have adequate blood circulation. D. He is in a state of rapid eye movement sleep.
He is in a state of rapid eye movement sleep.
Which of the following interventions should be performed with both responsive and unresponsive trauma patients? A. Head-tilt, chin-lift maneuver B. Manual stabilization of the head and neck C. Jaw-thrust maneuver D. High-concentration oxygen
Manual stabilization of the head and neck
Which of the following is not performed during the airway phase of the primary assessment? A. Suctioning B. Insertion of an oropharyngeal airway C. Obtaining the respiratory rate D. Head-tilt, chin-lift maneuver
Obtaining the respiratory rate
Which of the following conditions must be managed during the primary assessment? A. Internal injuries to the abdomen B. Capillary bleeding C. A fractured extremity D. Open chest wounds
Open chest wounds
Your patient is a 33-year-old man who has been ejected from his vehicle during a high-speed collision. During your primary assessment it is discovered that he is not moving, does not appear to have adequate respirations, and has suffered moderate external bleeding. Which of the following should be done first? A. Check the patient's carotid pulse. B. Begin bag-valve-mask ventilations. C. Control the bleeding with direct pressure. D. Open the airway.
Open the airway.
You have arrived on the scene at a high school football field where a 17-year-old male is lying on the ground. He is unresponsive and cyanotic, and he is making obvious respiratory effort without moving adequate amounts of air. Which of the following should be done first? A. Open the patient's airway using a manual maneuver. B. Insert a nasopharyngeal or oropharyngeal airway. C. Apply high-concentration oxygen by nonrebreather mask. D. Assist ventilations with a bag-valve-mask device and supplemental oxygen.
Open the patient's airway using a manual maneuver.
You are at the scene where a 19-year-old female college student has been drinking large quantities of alcohol throughout the evening. On your arrival, the patient is lying on her back with no signs of trauma; has vomited; and has slow, wet sounding respirations. Which of the following should you do next? A. Check for carotid and radial pulses. B. Open the patient's airway using a head-tilt, chin-lift maneuver C. Assist respirations with a bag-valve-mask device. D. Determine the respiratory rate.
Open the patient's airway using a head-tilt, chin-lift maneuver.
The mnemonic AVPU is used to evaluate which of the following? A. Patient's transport priority B. Patient's chief complaint C. Patient's level of responsiveness D. EMT's general impression of the patient's condition
Patient's level of responsiveness
Which of the following is the proper position for maintaining the airway in a child with a decreased level of consciousness? A. Using a cervical collar to keep the chin elevated B. Flexing the neck to place the chin on the chest; placing a folded towel under the back of the head if necessary C. Hyperextension of the neck; placing a pillow under the back if necessary D. Placing the head and neck in a neutral position; using a folded towel under the shoulders if necessary
Placing the head and neck in a neutral position; using a folded towel under the shoulders if necessary
If a patient is alert and breathing adequately but exhibits cyanotic skin, then which intervention is most appropriate? A.Assist the patient's ventilations with 100% oxygen. Synchronize your ventilations with the patient's own respirations so they are working together, not against each other. B.Provide oxygen based on the patient's need as determined by your examination, the patient's complaint and level of distress, and the pulse oximetry readings. C.Perform rescue breathing. D.Provide positive pressure ventilations with 100% oxygen.
Provide oxygen based on the patient's need as determined by your examination, the patient's complaint and level of distress, and the pulse oximetry readings.
Which of the following describes the chief complaint? A. Events immediately preceding the call for EMS B. Reason why the patient summoned EMS C. Overall impression of the patient's condition D. All of the above
Reason why the patient summoned EMS
Which of the following presentations would be considered normal during the breathing phase of the primary assessment? A. Respiratory rate of 16 with altered mental status B. Respiratory rate of 28 with adequate depth C. Respiratory rate of 6 with shallow depth D. Respiratory rate of 12 with adequate depth
Respiratory rate of 12 with adequate depth
How would you assess the mental status of an infant who appeared unresponsive? A.Ask the caregiver whether the infant is alert. B.Speak as a verbal stimulus and flick the feet as a painful stimulus. C.Shake the infant and shout. D.Do a light sternal rub to elicit a painful response.
Speak as a verbal stimulus and flick the feet as a painful stimulus.
Which of the following is the most reliable means of determining whether a patient has any immediately life-threatening conditions? A. Use of intuition B. Thorough scene size-up C. Systematic approach to assessment D. Obtaining a detailed medical history
Systematic approach to assessment
In the primary assessment, which of the following is not an acceptable method of assessing the patient's circulatory status? A. Looking for serious bleeding B. Assessing the patient's skin color C. Checking a radial pulse D. Taking a blood pressure reading
Taking a blood pressure reading
In EMS, which of the following best describes the term intervention? A. Creating a permanent record of patient care B. Decreasing the EMT's liability for negligence C. Determining if there is a problem D. Taking steps to correct a problem
Taking steps to correct a problem
Which of the following differences should be expected when assessing a pediatric patient, as compared to an adult patient? A. Capillary refill is not as reliable an indicator of circulatory status. B. The normal pulse rate is slower. C. The normal respiratory rate is faster. D. An adult's tongue is proportionally larger than that of a child and should always be considered as a potential airway obstruction.
The normal respiratory rate is faster.
Which of the following is a good indication of a partially occluded airway? A. The patient is alert. B. The patient is speaking clearly. C. The patient has snoring respirations. D. The patient is crying loudly.
The patient has snoring respirations.
A 13-year-old male has crashed an ATV. He was not wearing a helmet, and was found unconscious. His airway is patent and he is breathing adequately, but you hear rales in his chest and diminished lung sounds in his right chest. You assess this patient's priority for transport as high. What is one reason? A.The patient crashed an ATV. B.The patient was not wearing a helmet. C.The patient is unconscious. D.The patient's airway is patent.
The patient is unconscious.
During your assessment of a patient who is suspected of having had a stroke, you have to pinch his nail beds for him to respond. Which of the following would best categorize this patient's mental status? A.The patient is unresponsive. B.The patient responds to painful stimuli. C.The patient is alert. D.The patient responds to verbal stimuli.
The patient responds to painful stimuli.
Which of the following is true concerning the primary assessment? A. The primary assessment begins by just observing the patient as you enter the room. B. Manual airway maneuvers must be performed on all patients. C. External bleeding will be obvious as you enter the room and initially see the patient. D. The EMT should perform a sternal rub on all patients to test for response to painful stimuli.
The primary assessment begins by just observing the patient as you enter the room.
Which of the following is not assessed during the breathing phase of the primary assessment? A. The presence of respirations B. The respiratory rate C. The depth of respiration D. The pulse oximetry reading
The pulse oximetry reading
In EMS, what does mental status refer to? A. The patient's level of awareness of his surroundings B. The patient's general level of intelligence C. Any history of mental illness that the patient may have D. None of the above
The patient's level of awareness of his surroundings
Which of the following is the purpose of the primary assessment? A. To discover trends of improvement or deterioration in the patient's condition B. To detect and treat immediately life-threatening problems C. To find all of the patient's signs and symptoms D. To detect dangers to the patient and/or EMS crew
To detect and treat immediately life-threatening problems
Your patient is a 42-year-old woman who fell two feet from a ladder and is complaining of pain in her ankle. Which of the following are you unable to determine from the information given? A. Transport priority B. Chief complaint C. General impression D. Airway status
Transport priority
You are responding to a patient who has sustained a blunt-force blow to the side of the head. Which of the following would you use to determine the patient's mental status? A. Voice commands. B. A pulse reading C. Assessing the airway D. Determining priority for transport
Voice commands
Which of the following questions will most likely elicit your patient's chief complaint? A. Have you been drinking today? B. How have you been feeling lately? C. Do you have any medical problems? D. What made you call 911 this evening?
What made you call 911 this evening?
A patient with an open but endangered airway is: A. a patient telling you to step back. B. a patient choking on vomit. C. a patient lying faceup. D. a patient sobbing uncontrollably.
a patient lying faceup.
An unstable patient is: A. a patient who appears to be catatonic. B. a patient sitting up and breathing slowly. C. a patient who is responsive to commands. D. a patient with slightly depressed vital signs.
a patient who appears to be catatonic.
You are approaching a young adult male lying supine on the ground with his eyes closed. You should: A. expose his chest. B. feel for a pulse. C. ask him if he is okay. D. open his airway.
ask him if he is okay.
A 64-year-old male complained of chest pain. Minutes before your arrival, he lost consciousness and fell to the floor. As you approach, he is not responsive to your voice, and he does not respond when you gently shake him. You should next: A. question bystanders. B. open his airway manually. C. deliver two rescue breaths. D. assess for a carotid pulse.
assess for a carotid pulse.
An 18-year-old male has been involved in an altercation with another person. During the fight, he was stabbed in the thigh. As you approach, you note the patient to be awake with minor bleeding from a laceration on his leg. You should first: A. administer high-concentration oxygen. B. assess his airway. C. apply direct pressure to his leg wound. D. assess his radial pulse.
assess his airway.
A 66-year-old female has been found apneic and pulseless. You should immediately: A.begin chest compressions. B.initiate positive pressure ventilations. C.insert an OPA. D.open the patient's airway.
begin chest compressions.
As you interview a patient with a medical complaint, the reason why EMS was called is often referred to as the: A.SAMPLE history. B.mechanism of injury. C.chief complaint. D.physical examination.
chief complaint.
You arrive on the scene of an automobile collision and find one of the drivers suffering from multiple injuries and an altered level of consciousness. You should first: A. obtain a SAMPLE history for secondary assessment. B. complete a primary assessment. C. initiate immediate transport. D. complete a detailed physical examination.
complete a primary assessment.
You are approaching a 16-year-old male with bright red spurting blood coming from his leg. He is screaming and he begs you to help him. You should: A. assess his airway. B. apply oxygen. C. ask him to calm down. D. control the bleeding.
control the bleeding.
You are called to a scene of a fall and find the patient unconscious with a twisted leg. A general impression of this patient would be: A.deciding that the patient's fall was severe and injured the patient's leg. B.opening the patient's airway and suctioning the airway, if necessary. C.checking whether the patient has a pulse and is displaying signs of shock. D.determining whether the patient is breathing and that the level of breathing is adequate.
deciding that the patient's fall was severe and injured the patient's leg.
Generally, the sixth and last part of a primary assessment is: A. performing a scene size-up. B. assessing the patient's mental status. C. determining the priority of the patient for treatment and transport. D. forming a general impression of the patient.
determining the priority of the patient for treatment and transport.
During the primary assessment, an example of a life threat to circulation that must be managed right away would be: A.a throbbing headache. B.external arterial bleeding. C.nausea and stomach pain. D.very cold, pale skin.
external arterial bleeding.
When you report to your partner that the patient is a 46-year-old male trauma patient with leg pain, you have provided the: A. transport priority. B. primary assessment. C. secondary assessment. D. general impression.
general impression.
A 37-year-old female complains of dyspnea. You note that she has a patent airway but severe respiratory distress. She has tight wheezes and diminished air movement. She is cyanotic and confused. You should first: A. assess for a radial pulse. B. suction the airway. C. initiate positive pressure ventilations. D. apply supplemental oxygen.
initiate positive pressure ventilations.
What is a normal capillary refill time in a pediatric patient? A. 5 seconds B. 3 seconds C. less than 2 seconds D. 1 minute
less than 2 seconds
During the primary assessment, you would focus exclusively on: A.hazards of the scene. B.nature of illness. C.life threats. D.mechanism of injury.
life threats.
When performing a primary assessment on a patient, you are most commonly: A. taking the patient's medical history. B. packaging the patient for transport. C. conducting a detailed physical examination. D. looking for immediate life threats.
looking for immediate life threats.
You find a middle-aged unresponsive man lying prone on the ground near a ladder. You should: A. move the ladder out of the way. B. pick him up with a scoop stretcher. C. manually immobilize his head. D. roll him over to a supine position.
manually immobilize his head.
You are approaching an adult female lying supine on the ground with snoring respirations. You should: A. insert an oropharyngeal airway. B. open her airway with a jaw-thrust maneuver. C. insert a nasopharyngeal airway. D. ventilate with a bag-valve mask.
open her airway with a jaw-thrust maneuver.
A 45-year-old female is found unconscious. She is not breathing but has a pulse. You should next: A.initiate chest compressions. B.apply an AED. C.administer supplemental oxygen. D.perform rescue breathing.
perform rescue breathing.
You enter a room to find a 16-year-old female sitting upright in a chair with her back straight, leaning forward, and her arms supporting her. She is having a hard time talking to you. You should suspect: A. respiratory distress. B. allergic reaction. C. abdominal pain. D. chest discomfort.
respiratory distress.
A patient whose mental status can be described as verbal is able to: A. tell you his or her name, his or her location, and what day it is. B. talk spontaneously and respond to the EMT's questions. C. respond only to a stimulus such as the EMT rubbing his sternum with his knuckles. D. respond to speaking or shouting by opening the eyes.
respond to speaking or shouting by opening the eyes.
Mental status is the level of a patient's: A. responsiveness. B. pain threshold. C. verbal acuity. D. knowledge.
responsiveness.
During your primary assessment, you note blood in the patient's mouth and hear gurgling. You should next: A.suction the airway and clear any secretions. B.form a general impression of the patient. C.evaluate the patient's breathing. D.evaluate the patient's circulation.
suction the airway and clear any secretions.
You find a teenage male lying supine in his bedroom. You hear gurgling sounds from the patient's mouth and see vomit with pill fragments on the floor. You should: A. suction the airway. B. ventilate with oxygen. C. identify the pills. D. perform chest thrusts.
suction the airway.
A 56-year-old male has fallen off a 12-foot ladder. After ensuring scene safety and completing the scene size-up, you should next: A.assess baseline vital signs. B.assess the patient's airway. C.question bystanders. D.take manual cervical spine precautions.
take manual cervical spine precautions.
A 25-year-old male was shot in the leg. He has visibly lost a lot of blood, and when assessing this patient's circulation, you determine that this patient has life-threatening bleeding. You should control the bleeding and: A.open the patient's airway. B.suction the patient's airway. C.treat for shock. D.place an oral or nasal airway.
treat for shock.
You are conducting a primary assessment. You find that your patient will open the eyes when you call the patient's name, but does not acknowledge your presence. You determine that the patient's mental status is: A. "A" for alert. B. "U" for unresponsive. C. "P" for painful. D. "V" for verbal.
"V" for verbal.
For which of the following patients would capillary refill be a reliable sign of circulatory status? A. 50-year-old woman complaining of chest pain B. 3-year-old child with a fever and cough C. 92-year-old man complaining of weakness on his right side D. 24-year-old homeless man who has spent the night outside in the rain
3-year-old child with a fever and cough
Which of the following would be the best method to open the airway on an unresponsive trauma patient? A.Jaw-thrust maneuver B.Head-tilt, chin-lift maneuver C.Inserting an oropharyngeal airway D.Suctioning the airway
Jaw-thrust maneuver
Which of the following statements is TRUE about the primary assessment? A.You cannot gain enough information about the patient during the primary assessment to make a transport decision. B.You will assess each patient in A-B-C order: airway, breathing, and circulation. C.Life-threatening conditions that are identified during the primary assessment must be treated immediately as found. D.The main purpose of the primary assessment is to perform a head-to-toe physical examination to discover injuries.
Life-threatening conditions that are identified during the primary assessment must be treated immediately as found.
Which of the following findings is generally not used to assess an adult's circulation? A. Patient's capillary refill time B. Evaluation for bleeding C. Patient's skin color, temperature, and condition D. Patient's distal pulse rate
Patient's capillary refill time
Which of the following is not part of the general impression? A. Patient's facial expression B. Patient's age and sex C. Position in which the patient is found D. Patient's past medical history
Patient's past medical history
Which of the following acronyms may be used in assessing the patient's level of responsiveness? A.SAMPLE B.C-A-B C.AVPU D.ABC
AVPU
Which of the following patients is a high priority for transport? A. Adult male with sharp lower back pain B. Adult male with difficulty breathing C. Adult male with dull abdominal pain D. Adult male with a headache
Adult male with difficulty breathing
Which of the following indicates a possible circulatory problem? A. Rapid pulse B. Weak, thready pulse that is normal in rate C. Slow pulse D. All of the above
All of the above
Which of the following techniques is used when formulating the general impression? A. Detecting odors B. Listening for unusual sounds C. Looking for visual clues D. All of the above
All of the above
You check for a pulse in an unconscious 12-year-old patient. What would cause you concern? A. A pulse on the low or high side of normal B. A pulse above normal C. A pulse below normal D. Any pulse outside of normal
Any pulse outside of normal
Your patient is a 72-year-old female who has "twisted her ankle" coming down some steps. She is alert and complaining of pain in her right ankle, but she jokes about her "clumsiness." Which of the following should you do next? A. Determine the presence of a carotid pulse. B. Ask if the patient has pain anywhere beside her ankle. C. Administer high-concentration oxygen by nonrebreather mask. D. Take immediate manual control of the patient's cervical spine.
Ask if the patient has pain anywhere beside her ankle.
A 34-year-old male is unconscious in bed. Which of the following should be done first? A. Auscultate lung sounds. B. Assess respiratory rate. C. Assess circulation. D. Obtain baseline vital signs.
Assess circulation
During the primary assessment of a responsive adult patient, where should the pulse be checked? A. At the radial artery B. At the femoral artery C. At the carotid artery D. At the brachial artery
At the radial artery
