Patient Assessment paramedic hocking
17. Your patient will MOST likely develop a good first impression of you if you: A) look and act professional and confident. B) tell him or her that everything will be okay. C) address him or her as "dear" or "honey." D) quickly determine his or her chief complaint.
Ans: A Complexity: Easy Ahead: History Taking Subject: Chapter 11 Page: 519 Feedback: History Taking, page 519
25. Pausing to consider something significant that you have just been told is called: A) reflection. B) interpretation. C) facilitation. D) clarification.
Ans: A Complexity: Easy Ahead: History Taking Subject: Chapter 11 Page: 522 Feedback: History Taking, page 522
. Your entire assessment of a patient should: A) appear to be a seamless process. B) yield a definitive field diagnosis. C) only focus on his or her complaint. D) not deviate at all from a strict format.
Ans: A Complexity: Easy Ahead: Introduction Subject: Chapter 11 Page: 500 Feedback: Introduction, page 500
56. Other than overall patient appearance, the patient's __________ is/are the MOST objective data for determining his or her status. A) vital signs B) medications C) chief complaint D) medical history
Ans: A Complexity: Easy Ahead: Secondary Assessment Subject: Chapter 11 Page: 542 Feedback: Secondary Assessment, page 542
63. What does pulse oximetry measure? A) The percentage of hemoglobin saturation B) The percentage of red blood cells in the blood C) The percentage of ratio of red blood cells to plasma D) The percentage of oxygen that reaches the cells
Ans: A Complexity: Easy Ahead: Secondary Assessment Subject: Chapter 11 Page: 546 Feedback: Secondary Assessment, page 546
65. The skin becomes _________ when red blood cell perfusion to the capillary beds of the skin is poor. A) pale B) flushed C) cyanotic D) mottled
Ans: A Complexity: Easy Ahead: Secondary Assessment Subject: Chapter 11 Page: 554 Feedback: Secondary Assessment, page 554
77. When assessing a patient's conjunctivae, you note they are injected. This means that the conjunctivae are: A) red. B) pale. C) yellow. D) cyanotic.
Ans: A Complexity: Easy Ahead: Secondary Assessment Subject: Chapter 11 Page: 558 Feedback: Secondary Assessment, page 558
84. S1, the first heart sound, represents: A) closure of the mitral and tricuspid valves. B) the sound heard at the end of diastole. C) closure of the aortic and pulmonic valves. D) the sound heard at the end of systole.
Ans: A Complexity: Easy Ahead: Secondary Assessment Subject: Chapter 11 Page: 567 Feedback: Secondary Assessment, page 567
93. Which of the following statements regarding ascites is correct? A) Ascites is a collection of fluid within the peritoneal cavity. B) Percussion of the abdomen will often yield hyperresonance. C) The most common cause of ascites is an acute splenic injury. D) The abdomen of a patient with ascites has a sunken appearance.
Ans: A Complexity: Easy Ahead: Secondary Assessment Subject: Chapter 11 Page: 570 Feedback: Secondary Assessment, page 570
92. A patient who is absolutely still and resists any movement should be suspected of having: A) peritonitis. B) kidney stones. C) a bowel obstruction. D) intra-abdominal bleeding.
Ans: A Complexity: Easy Ahead: Secondary Assessment Subject: Chapter 11 Page: 572 Feedback: Secondary Assessment, page 572
98. A pathologic fracture occurs when: A) normal forces are applied to abnormal bone structures. B) abnormal forces are applied to abnormal bone structures. C) normal forces are applied to normal bone structures. D) abnormal forces are applied to normal bone structures.
Ans: A Complexity: Easy Ahead: Secondary Assessment Subject: Chapter 11 Page: 574 Feedback: Secondary Assessment, page 574
11. On most runs, the two MOST important pieces of patient history information that you need to obtain initially are the: A) patient's name and chief complaint. B) chief complaint and patient's address. C) patient's name and family physician. D) chief complaint and the patient's sex.
Ans: A Complexity: Moderate Ahead: History Taking Subject: Chapter 11 Page: 519 Feedback: History Taking, page 519
47. The MOST effective way to obtain a medical history from a patient who is crying is to: A) place your hand on his or her shoulder (if appropriate for the patient) and reassure him or her that you are in control of the situation. B) tactfully advise the patient that you cannot effectively help him or her if he or she continues to cry. C) have one family member calm the patient as you gather the medical history from another family member. D) administer a sedative medication, which will calm the patient and facilitate your gathering of the medical history.
Ans: A Complexity: Moderate Ahead: History Taking Subject: Chapter 11 Page: 521 Feedback: History Taking, page 521
35. Your patient says, "I can't catch my breath." In response, you state, "That's very helpful. Let me think about that for a moment." This dialogue is an example of: A) reflection. B) clarification. C) facilitation. D) interpretation.
Ans: A Complexity: Moderate Ahead: History Taking Subject: Chapter 11 Page: 522 Feedback: History Taking, page 522
46. Which of the following statements regarding an intoxicated patient is correct? A) While the patient is trying to explain things to you, his or her anger can escalate faster than if he or she were not intoxicated. B) Although the intoxicated patient is a poor historian, his or her family members usually provide the information that you need. C) You should promptly transport the intoxicated patient, because attempting to obtain a medical history will be unsuccessful. D) The risk of an intoxicated patient's behavior turning violent is low because his or her cognitive skills are impaired significantly.
Ans: A Complexity: Moderate Ahead: History Taking Subject: Chapter 11 Page: 522 Feedback: History Taking, page 522
86. When auscultating heart sounds, you should place your stethoscope at the: A) fifth intercostal space, over the apex of the heart. B) second intercostal space, over the base of the heart. C) third or fourth intercostal space, in the midaxillary line. D) sternal border at the second or third intercostal space.
Ans: A Complexity: Moderate Ahead: Secondary Assessment Subject: Chapter 11 Page: 567 Feedback: Secondary Assessment, page 567
27. An empathetic attitude: A) is often offensive to the patient. B) puts you in your patient's shoes. C) will put your patient at ease quickly. D) allows you to feel sorry for the patient.
Ans: B Complexity: Easy Ahead: History Taking Subject: Chapter 11 Page: 520 Feedback: History Taking, page 520
24. Making your patient aware that you perceive something inconsistent with his or her behavior is called: A) clarification. B) confrontation. C) facilitation. D) interpretation.
Ans: B Complexity: Easy Ahead: History Taking Subject: Chapter 11 Page: 522 Feedback: History Taking, page 522
14. The history of present illness is defined as: A) the reason why the patient called EMS in the first place. B) a chronologic account of the patient's signs and symptoms. C) your perception of the severity of the patient's condition. D) a past medical problem that is causing the chief complaint.
Ans: B Complexity: Easy Ahead: History Taking Subject: Chapter 11 Page: 531 Feedback: History Taking, page 531` 15. Which of the following questions would be of LEAST pertinence when trying to determine a patient's current health status? A) "Are your mother and father still living?" B) "Are your immunizations up to date?" C) "Are you currently taking any prescription medicines?" D) "Do you have a history of any specific diseases in your family?"` Ans: A Complexity: Moderate Ahead: History Taking Subject: Chapter 11 Page: 532 Feedback: History Taking, page 532
8. You will MOST likely develop your field impression of a patient based on the: A) medications the patient is taking. B) chief complaint and patient history. C) results of your secondary assessment. D) patient's perception of his or her problem.
Ans: B Complexity: Easy Ahead: Introduction Subject: Chapter 11 Page: 502 Feedback: Introduction, page 502
55. __________ entails gently striking the surface of the body, typically where it overlies various body cavities. A) Palpation B) Percussion C) Inspection D) Auscultation
Ans: B Complexity: Easy Ahead: Secondary Assessment Subject: Chapter 11 Page: 542 Feedback: Secondary Assessment, page 542
57. The residual pressure in the circulatory system while the left ventricle is relaxing is called the: A) pulse pressure. B) diastolic pressure. C) systolic pressure. D) mean arterial pressure.
Ans: B Complexity: Easy Ahead: Secondary Assessment Subject: Chapter 11 Page: 545 Feedback: Secondary Assessment, page 545
82. Percussion of the chest produces ____________ if the pleural space is full of blood. A) a hollow sound B) a dull sound C) a high-pitched note D) hyperresonance
Ans: B Complexity: Easy Ahead: Secondary Assessment Subject: Chapter 11 Page: 565 Feedback: Secondary Assessment, page 565
89. Arterial pulses are a physical expression of: A) pressure in the vena cavae. B) left ventricular contraction. C) the diastolic blood pressure. D) right ventricular contraction.
Ans: B Complexity: Easy Ahead: Secondary Assessment Subject: Chapter 11 Page: 568 Feedback: Secondary Assessment, page 568
95. Abdominal guarding is MOST commonly encountered in patients with: A) acute renal failure. B) peritoneal irritation. C) intra-abdominal bleeding. D) chronic liver inflammation.
Ans: B Complexity: Easy Ahead: Secondary Assessment Subject: Chapter 11 Page: 572 Feedback: Secondary Assessment, page 572
80. Swollen lymph nodes in the anterior neck usually indicate: A) malignancy. B) an infection. C) viral replication. D) an allergic state.
Ans: B Complexity: Easy Ahead: Secondary Assessment Subject: Chapter 11 Pages: 560-561 Feedback: Secondary Assessment, pages 560-561
83. You would NOT expect to encounter decreased breath sounds in a patient with: A) opiate intoxication. B) cardiac tamponade. C) status asthmaticus. D) pulmonary edema.
Ans: B Complexity: Easy Ahead: Secondary Assessment Subject: Chapter 11 Pages: 564-566 Feedback: Secondary Assessment, pages 564-566
69. Changes in hair growth or loss of hair are LEAST suggestive of: A) diabetes. B) an infection. C) the aging process. D) radiation therapy.
Ans: B Complexity: Easy Ahead: Secondary Assessment Subject: Chapter 11 Page: 555 Feedback: Secondary Assessment, page 555
34. It would MOST likely be necessary to ask a patient a direct question if: A) he or she is elderly and has more than one medical complaint. B) he or she is not giving you usable facts about himself or herself. C) he or she is having chest pain and a heart attack must be ruled out. D) there are numerous family members and friends present at the scene.
Ans: B Complexity: Moderate Ahead: History Taking Subject: Chapter 11 Page: 518 Feedback: History Taking, page 518
21. EMS providers who read off a list of questions to the patient to fill in all the blanks on the run report: A) usually provide the most competent patient care. B) tend to make little or no eye contact with the patient. C) are in the best position to establish good patient rapport. D) are reassuring the patient that he or she is not being ignored.
Ans: B Complexity: Moderate Ahead: History Taking Subject: Chapter 11 Page: 519 Feedback: History Taking, page 519
100. Structural integrity of the pelvis should be assessed by: A) carefully rocking the pelvis back and forth. B) gently pushing in and down on the iliac crests. C) applying firm upward pressure to the pelvic wings. D) placing the patient on his or her side to elicit pain.
Ans: B Complexity: Moderate Ahead: Secondary Assessment Subject: Chapter 11 Page: 576 Feedback: Secondary Assessment, page 576
101. The diagnosis of a problem involving the shoulder can often be made by simply: A) assessing range of motion. B) noting the patient's posture. C) palpating for gross deformities. D) asking the patient to bend the elbow.
Ans: B Complexity: Moderate Ahead: Secondary Assessment Subject: Chapter 11 Page: 576 Feedback: Secondary Assessment, page 576
23. Paying attention, making eye contact, and repeating key information from the patient's answers are examples of: A) reflection. B) clarification. C) facilitation. D) interpretation.
Ans: C Complexity: Easy Ahead: History Taking Subject: Chapter 11 Page: 522 Feedback: History Taking, page 522
58. Blood pressure is the product of: A) stroke volume and heart rate. B) left ventricular ejection fraction and afterload. C) cardiac output and peripheral vascular resistance. D) right atrial preload and ventricular stroke volume.
Ans: C Complexity: Easy Ahead: Secondary Assessment Subject: Chapter 11 Page: 545 Feedback: Secondary Assessment, page 545
68. Poor skin turgor in an infant or child is MOST indicative of: A) shock. B) hypoxemia. C) dehydration. D) elastin deficiency.
Ans: C Complexity: Easy Ahead: Secondary Assessment Subject: Chapter 11 Page: 554 Feedback: Secondary Assessment, page 554
78. An opaque black area against the red reflex of the eye is indicative of: A) retinitis. B) conjunctivitis. C) cataracts. D) macular degeneration.
Ans: C Complexity: Easy Ahead: Secondary Assessment Subject: Chapter 11 Page: 557 Feedback: Secondary Assessment, page 557
73. A patient who complains of double vision has: A) ptosis. B) anisocoria. C) diplopia. D) hyperopia.
Ans: C Complexity: Easy Ahead: Secondary Assessment Subject: Chapter 11 Page: 558 Feedback: Secondary Assessment, page 558
85. The fourth heart sound (S4): A) is normal in 40% of the population. B) occurs immediately before the S2 sound. C) indicates increased pressure in the atria. D) represents increased left ventricular stretching.
Ans: C Complexity: Easy Ahead: Secondary Assessment Subject: Chapter 11 Page: 567 Feedback: Secondary Assessment, page 567
99. Clinical signs of an inflamed joint include all of the following, EXCEPT: A) redness. B) swelling. C) deformity. D) increased heat.
Ans: C Complexity: Easy Ahead: Secondary Assessment Subject: Chapter 11 Page: 574 Feedback: Secondary Assessment, page 574
30. Before asking a patient about any mental health issues, the paramedic should: A) speak privately with a family member or trusted friend. B) move the patient to the ambulance, where it is more private. C) ask questions relating to his or her physical health. D) perform a comprehensive head-to-toe assessment.
Ans: C Complexity: Moderate Ahead: History Taking Subject: Chapter 11 Page: 520 Feedback: History Taking, page 520
29. Which of the following questions will yield the LEAST reliable information when assessing a patient with abdominal pain? A) "In your opinion, how severe is the pain?" B) "Are you experiencing any other symptoms?" C) "Does the pain radiate to your chest or back?" D) "Have you ever experienced pain like this before?"
Ans: C Complexity: Moderate Ahead: History Taking Subject: Chapter 11 Page: 521 Feedback: History Taking, page 521
36. When assessing a patient who is under the influence of alcohol, it is MOST important to remember that: A) the amount of alcohol consumed is often overstated. B) the patient often gives a reliable and accurate history. C) alcohol can mask any number of signs and symptoms. D) suspicions of alcohol intoxication must be documented.
Ans: C Complexity: Moderate Ahead: History Taking Subject: Chapter 11 Page: 522 Feedback: History Taking, page 522
18. Working to ensure a patient's privacy, confidentiality, and comfort level will: A) make the patient feel comfortable in disclosing personal information to you. B) leave no doubt in the patient's mind that you are truly a professional caregiver. C) establish positive patient rapport and encourage honest, open communication. D) help you gain the trust of the patient's family more than the trust of the patient.
Ans: C Complexity: Moderate Ahead: History Taking Subject: Chapter 11 Page: 524 Feedback: History Taking, page 524
41. A patient who is overly talkative during your assessment: A) should be interrupted immediately. B) will not give a reliable medical history. C) may have abused methamphetamines. D) is usually an inherently antisocial person.
Ans: C Complexity: Moderate Ahead: History Taking Subject: Chapter 11 Page: 526 Feedback: History Taking, page 526
13. When a patient presents with two seemingly unrelated complaints, it is MOST important for the paramedic to determine: A) if the two complaints are related. B) when each of the complaints began. C) which complaint has a higher priority. D) the patient's past medical history.
Ans: C Complexity: Moderate Ahead: History Taking Subject: Chapter 11 Page: 530 Feedback: History Taking, page 530
28. When asking a patient if he or she uses illegal drugs, you will MOST likely get accurate information if you: A) remain professional and nonjudgmental. B) reassure the patient that you can be trusted and will not tell anyone. C) question the patient in the presence of a trusted family member. D) tell the patient that withholding such information from you is illegal.
Ans: A Complexity: Moderate Ahead: History Taking Subject: Chapter 11 Page: 523 Feedback: History Taking, page 523
37. If you suspect that a patient has been abused, it is MOST important that you: A) request law enforcement personnel if necessary. B) discreetly ask the patient if he or she was abused. C) contact medical control to make him or her aware. D) ask a family member about the possibility of abuse.
Ans: A Complexity: Moderate Ahead: History Taking Subject: Chapter 11 Page: 523 Feedback: History Taking, page 523
45. If a hostile family member suddenly leaves the room, especially in the middle of a conversation with him or her, you should: A) retreat to a place of safety and notify law enforcement personnel. B) ignore the family member's departure and continue to assess your patient. C) have your partner follow the person, while working to defuse the situation. D) ask the patient to follow the person in an attempt to reason with him or her.
Ans: A Complexity: Moderate Ahead: History Taking Subject: Chapter 11 Page: 527 Feedback: History Taking, page 527
53. Which of the following is NOT an effective way of obtaining a medical history from a patient who is totally deaf? A) Speaking slowly and slightly more loudly to the patient B) Using paper and pencil to write down your questions C) Addressing the patient face to face if he or she can read lips D) Using an interpreter who knows American Sign Language
Ans: A Complexity: Moderate Ahead: History Taking Subject: Chapter 11 Page: 528 Feedback: History Taking, page 528
42. When dealing with a patient who has multiple symptoms, the MOST effective way to develop an appropriate care plan is to: A) prioritize the patient's complaints. B) perform a complete head-to-toe exam. C) address all complaints simultaneously. D) assume that all complaints are linked.
Ans: A Complexity: Moderate Ahead: History Taking Subject: Chapter 11 Page: 530 Feedback: History Taking, page 530
32. It is appropriate to ask, "Would you say the pain is similar to or worse than with previous episodes?" when determining the _________ of a patient's pain. A) severity B) quality C) region D) progression
Ans: A Complexity: Moderate Ahead: History Taking Subject: Chapter 11 Page: 531 Feedback: History Taking, page 531
22. When transferring a geriatric patient from a hospital to an extended care facility, it is MOST important to: A) review the patient's transfer paperwork. B) document at least two full sets of vital signs. C) call a radio report to the extended care facility. D) presume that the patient will not wish to speak.
Ans: A Complexity: Moderate Ahead: History Taking Subject: Chapter 11 Pages: 524-525 Feedback: History Taking, pages 524-525
4. In prehospital care, the priorities of evaluation and treatment are based on: A) the degree of threat to the patient's life. B) your overall experience as a paramedic. C) the receiving physician's online orders. D) standard treatment guidelines and algorithms.
Ans: A Complexity: Moderate Ahead: Introduction Subject: Chapter 11 Page: 502 Feedback: Introduction, page 502
6. When determining whether a patient is sick, your MOST effective tool is often: A) a quick visual assessment. B) the patient's chief complaint. C) past medical history findings. D) the patient's baseline vital signs.
Ans: A Complexity: Moderate Ahead: Introduction Subject: Chapter 11 Page: 502 Feedback: Introduction, page 502
10. Which of the following statements regarding the patient assessment process is correct? A) The assessment process must be organized and systematic, yet flexible enough to allow you to maximize the amount of information you can gather. B) It is critical that you think of patient assessment as a static sequence of events that are carried out on every patient that you encounter. C) Expanding your questioning of a patient in order to elicit more information often confuses the patient and should be avoided if possible. D) As the patient interview unfolds, you must remain focused on the patient's chief complaint, as it is likely his or her most serious problem.
Ans: A Complexity: Moderate Ahead: Introduction Subject: Chapter 11 Pages: 502-503 Feedback: Introduction, pages 502-503
61. When using a tympanic device to obtain a patient's body temperature, you should: A) be aware of extrinsic factors that can skew the reading. B) hold the device in the patient's ear for 30 to 60 seconds. C) irrigate any wax from the ear with lukewarm water first. D) ensure that the patient is in a laterally recumbent position.
Ans: A Complexity: Moderate Ahead: Secondary Assessment Subject: Chapter 11 Page: 546 Feedback: Secondary Assessment, page 546
62. Which of the following factors would likely NOT skew a pulse oximetry reading? A) Hypertension B) Cold temperature C) Carbon monoxide D) Sickle cell disease
Ans: A Complexity: Moderate Ahead: Secondary Assessment Subject: Chapter 11 Page: 546 Feedback: Secondary Assessment, page 546
70. Which of the following are the MOST relevant initial questions to ask a patient who has a cerebral shunt? A) Where was the shunt placed and where does it drain? B) How long have you had the shunt and who placed it? C) Has the shunt ever had to be replaced, and if so, why? D) When was the shunt placed and do you have symptoms?
Ans: A Complexity: Moderate Ahead: Secondary Assessment Subject: Chapter 11 Page: 555 Feedback: Secondary Assessment, page 555
71. Examination of the head is MOST important when assessing a patient who: A) has an altered mental status. B) complains of nausea. C) has shortness of breath. D) presents with hemiparesis.
Ans: A Complexity: Moderate Ahead: Secondary Assessment Subject: Chapter 11 Page: 555 Feedback: Secondary Assessment, page 555
79. Frank blood or clear, watery fluid draining from the ear canal following head trauma is MOST suggestive of a(n): A) basilar skull fracture. B) orbital blowout fracture. C) fracture of the cribriform plate. D) ruptured tympanic membrane.
Ans: A Complexity: Moderate Ahead: Secondary Assessment Subject: Chapter 11 Page: 559 Feedback: Secondary Assessment, page 559
43. The MOST negative immediate consequence of providing inappropriate reassurance to your patient in the prehospital setting is: A) a lawsuit lodged against you by the patient or his or her family. B) the patient's choice not to share as much information with you. C) causing the patient's family members severe emotional distress. D) emotional distress when the physician tells the patient otherwise.
Ans: B Complexity: Moderate Ahead: History Taking Subject: Chapter 11 Page: 520 Feedback: History Taking, page 520
31. Which of the following is an example of a leading question? A) "On a scale of 1 to 10, what number would you assign your pain?" B) "Do you think that you are experiencing a cardiac emergency?" C) "Has anything like this ever happened to you before today?" D) "Does the pain stay in your chest or does it move anywhere else?"
Ans: B Complexity: Moderate Ahead: History Taking Subject: Chapter 11 Page: 521 Feedback: History Taking, page 521
38. Which of the following findings is LEAST indicative of abuse or domestic violence? A) Multiple injuries that are in various stages of healing B) A patient who refuses to allow a family member to speak for him or her C) Injuries that are inconsistent with the history that you are given D) A husband who towers over his wife and answers your questions for her
Ans: B Complexity: Moderate Ahead: History Taking Subject: Chapter 11 Page: 523 Feedback: History Taking, page 523
39. When asking questions pertaining to a patient's sexual history, it is important to remember that: A) you should inquire about the patient's HIV status. B) obtaining the history in a private setting is essential. C) a physical examination should be performed as well. D) the patient's sexual preference is especially relevant.
Ans: B Complexity: Moderate Ahead: History Taking Subject: Chapter 11 Page: 523 Feedback: History Taking, page 523
49. If your patient becomes seductive or makes sexual advances toward you, you should advise the patient that your relationship with him or her is strictly professional and then: A) continue providing care as usual. B) ensure that a witness is present at all times. C) ask your partner to assume care of the patient. D) threaten the patient with a sexual harassment lawsuit.
Ans: B Complexity: Moderate Ahead: History Taking Subject: Chapter 11 Page: 524 Feedback: History Taking, page 524
52. When your patient is a non-English-speaking person, his or her child is often able to function as an interpreter because: A) you can usually teach a child English quickly. B) children quickly absorb a new language in school. C) the child is usually not as scared as his or her parent is. D) most children of non-English-speaking parents speak English.
Ans: B Complexity: Moderate Ahead: History Taking Subject: Chapter 11 Page: 526 Feedback: History Taking, page 526
44. If a patient's family member is hostile and begins shouting at you, you should: A) remain professional and ignore the family member so that you can provide appropriate patient care. B) tell the person that if he or she continues to shout, you will not feel safe and will need to call law enforcement. C) have your partner physically remove the family member from the patient care area and continue your assessment. D) firmly tell the patient that his or her behavior is unacceptable and childish, and that he or she is worsening the situation.
Ans: B Complexity: Moderate Ahead: History Taking Subject: Chapter 11 Page: 527 Feedback: History Taking, page 527
51. When caring for a patient who is mentally challenged: A) it is highly unlikely that you will obtain a reliable medical history. B) you may have to obtain the medical history from a family member. C) your priority should be to transport the patient to a psychiatric facility. D) you should speak to the patient as though he or she is younger in age.
Ans: B Complexity: Moderate Ahead: History Taking Subject: Chapter 11 Page: 528 Feedback: History Taking, page 528
19. The paramedic should address a patient: A) by using the patient's formal name. B) as the patient wishes to be addressed. C) by the patient's first name whenever possible. D) in a manner that the paramedic deems most professional.
Ans: B Complexity: Moderate Ahead: History Taking Subject: Chapter 11 Pages: 519-520 Feedback: History Taking, pages 519-520
3. A key part of making your practice of prehospital care successful is for you to: A) let the patient guide the questions that you ask in order to build a cohesive rapport on which you can build. B) develop and cultivate your own style of assessment and an overall strategy for evaluating and providing care. C) approach every patient in the same fashion with the realization that patient assessment in the field is a static process. D) strictly adhere to your department's standard operating procedures so that they become a rote series of actions.
Ans: B Complexity: Moderate Ahead: Introduction Subject: Chapter 11 Page: 502 Feedback: Introduction, page 502
59. To obtain a heart rate in infants younger than 1 year of age, you should: A) apply a cardiac monitor. B) palpate the brachial artery. C) auscultate directly over the heart. D) count the pulse for a full minute.
Ans: B Complexity: Moderate Ahead: Secondary Assessment Subject: Chapter 11 Page: 545 Feedback: Secondary Assessment, page 545
64. Which of the following statements regarding your general survey of the patient is correct? A) Little information can be gained from the patient without a hands-on assessment. B) It is not uncommon for patients in severe pain to present with a quiet and still affect. C) The environment in which the patient is found is more significant than his or her appearance. D) The general patient survey begins as you perform the initial assessment of the patient.
Ans: B Complexity: Moderate Ahead: Secondary Assessment Subject: Chapter 11 Page: 547 Feedback: Secondary Assessment, page 547
75. The diameter of a patient's pupils and their reactivity to light provide information about the: A) amount of vitreous humor. B) status of cerebral perfusion. C) intactness of the first cranial nerve. D) level of carbon dioxide in the brain.
Ans: B Complexity: Moderate Ahead: Secondary Assessment Subject: Chapter 11 Page: 557 Feedback: Secondary Assessment, page 557
74. When assessing visual acuity in the prehospital setting, you should: A) use a Snellen chart. B) examine each eye in isolation. C) check both eyes simultaneously. D) remove any corrective lenses the patient is wearing.
Ans: B Complexity: Moderate Ahead: Secondary Assessment Subject: Chapter 11 Page: 558 Feedback: Secondary Assessment, page 558
50. A patient who gives the emergency department physician completely different information than he or she gave to you in the field: A) clearly trusts the physician more than you. B) will cause the physician to question your competence. C) may have an organic condition, such as a brain tumor. D) should be questioned as to why the information was different.
Ans: C Complexity: Moderate Ahead: History Taking Subject: Chapter 11 Pages: 527-528 Feedback: History Taking, pages 527-528
5. Which of the following is NOT a part of your overall job as a paramedic? A) Efficiently executing a patient care plan B) Quickly identifying your patient's problem C) Definitively diagnosing the patient's problem D) Establishing your priorities of patient care
Ans: C Complexity: Moderate Ahead: Introduction Subject: Chapter 11 Page: 502 Feedback: Introduction, page 502
9. When assessing any patient, the paramedic should remember that: A) the past medical history is of even greater importance if the patient has a traumatic injury. B) it is extremely common for patients with a medical complaint to have an underlying injury. C) some patients with a traumatic injury could also have an underlying medical component. D) the patient's underlying medical problem can usually be identified by a rapid assessment.
Ans: C Complexity: Moderate Ahead: Introduction Subject: Chapter 11 Page: 503 Feedback: Introduction, page 503
91. When examining the anterior abdomen of a patient who complains of abdominal pain: A) auscultate bowel sounds for at least 5 minutes. B) you should first percuss over the four quadrants. C) routinely palpate the least painful area(s) first. D) it is often necessary to administer analgesia first.
Ans: C Complexity: Moderate Ahead: Secondary Assessment Subject: Chapter 11 Page: 570 Feedback: Secondary Assessment, page 570
97. Assessment of the female genitalia: A) is not performed by the paramedic. B) is only necessary in pregnant patients. C) should be limited to inspection only. D) is a routine part of the physical exam.
Ans: C Complexity: Moderate Ahead: Secondary Assessment Subject: Chapter 11 Page: 573 Feedback: Secondary Assessment, page 573
12. After determining that the scene is safe, the FIRST step in approaching a patient is to: A) determine the chief complaint. B) ask the patient his or her name. C) ascertain the age of the patient. D) introduce yourself to the patient.
Ans: D Complexity: Easy Ahead: History Taking Subject: Chapter 11 Page: 519 Feedback: History Taking, page 519
48. Situational depression is: A) often characterized by violent bouts of rage. B) ongoing and does not appear to have a cause. C) a condition that usually requires inpatient care. D) a reaction to a stressful event in a patient's life.
Ans: D Complexity: Easy Ahead: History Taking Subject: Chapter 11 Page: 527 Feedback: History Taking, page 527
26. A working hypothesis of the nature of a patient's problem is called the: A) chief complaint. B) field impression. C) history of present illness. D) differential diagnosis.
Ans: D Complexity: Easy Ahead: History Taking Subject: Chapter 11 Page: 538 Feedback: History Taking, page 538
54. Objective patient information: A) is observed by the patient. B) is perceived by the patient. C) cannot be quantified. D) is based on fact or observation.
Ans: D Complexity: Easy Ahead: Secondary Assessment Subject: Chapter 11 Page: 539 Feedback: Secondary Assessment, page 539
60. A conscious patient's respiratory rate should be measured: A) by auscultating the lungs. B) by looking at the abdomen. C) with his or her prior knowledge. D) for a minimum of 30 seconds.
Ans: D Complexity: Easy Ahead: Secondary Assessment Subject: Chapter 11 Page: 545 Feedback: Secondary Assessment, page 545
67. Flushed skin is commonly seen as a result of all the following, EXCEPT: A) fever. B) heat exposure. C) superficial burns. D) vasoconstriction.
Ans: D Complexity: Easy Ahead: Secondary Assessment Subject: Chapter 11 Page: 554 Feedback: Secondary Assessment, page 554
72. Asymmetry of the face could indicate: A) oculomotor nerve injury. B) severe hyperglycemia. C) a spinal cord injury. D) facial nerve palsy.
Ans: D Complexity: Easy Ahead: Secondary Assessment Subject: Chapter 11 Page: 556 Feedback: Secondary Assessment, page 556
76. Asymmetry of the pupils: A) is a normal finding in up to 40% of the population. B) indicates a significant ocular or neurologic pathology. C) is normal when a light is shone into one of the pupils. D) must be correlated with the patient's overall presentation.
Ans: D Complexity: Easy Ahead: Secondary Assessment Subject: Chapter 11 Page: 557 Feedback: Secondary Assessment, page 557
90. Distention of the jugular veins indicates: A) a state of hypovolemia. B) left-sided heart failure. C) decreased venous pressure. D) increased venous capacitance.
Ans: D Complexity: Easy Ahead: Secondary Assessment Subject: Chapter 11 Page: 568 Feedback: Secondary Assessment, page 568
94. Which assessment technique usually yields the MOST significant diagnostic information during the abdominal exam? A) Percussion B) Auscultation C) Inspection D) Palpation
Ans: D Complexity: Easy Ahead: Secondary Assessment Subject: Chapter 11 Page: 571 Feedback: Secondary Assessment, page 571
81. All of the following are adventitious breath sounds, EXCEPT: A) rales. B) rhonchi. C) wheezes. D) vesicular sounds.
Ans: D Complexity: Easy Ahead: Secondary Assessment Subject: Chapter 11 Pages: 562, 564 Feedback: Secondary Assessment, pages 562, 564
20. Using casual nicknames can be especially problematic when: A) the patient is a male who was involved in an assault. B) assessing geriatric patients who fear losing their independence. C) the patient is critically ill or injured and is semiconscious. D) cultural differences exist between the patient and the paramedic.
Ans: D Complexity: Moderate Ahead: History Taking Subject: Chapter 11 Page: 520 Feedback: History Taking, page 520
40. If a patient does not respond to a question within a couple of seconds, he or she: A) must be assumed to have an altered mental status until proven otherwise. B) should immediately be asked another question to facilitate gathering data. C) should have the question repeated back to him or her using different terms. D) may be deciding if he or she can trust you enough to answer the question.
Ans: D Complexity: Moderate Ahead: History Taking Subject: Chapter 11 Page: 521 Feedback: History Taking, page 521
33. The mnemonic "OPQRST" is a tool that: A) is only effective when assessing a patient who is experiencing severe pain. B) allows the paramedic to reach a field diagnosis quickly and initiate treatment. C) is used commonly to rule out conditions that are immediately life threatening. D) offers an easy-to-remember approach to analyzing a patient's chief complaint.
Ans: D Complexity: Moderate Ahead: History Taking Subject: Chapter 11 Page: 531 Feedback: History Taking, page 531
2. Gathering a patient's medical history and performing a secondary assessment should occur: A) immediately after you form your visual general impression of the patient. B) shortly after making patient contact and determining his or her complaint. C) after initial treatment has been rendered and you are en route to the hospital. D) after life threats have been identified and corrected in the primary assessment.
Ans: D Complexity: Moderate Ahead: Introduction Subject: Chapter 11 Page: 502 Feedback: Introduction, page 502
7. You are in the BEST position to decide what, if any, care needs to be provided at the scene versus en route to the hospital once you: A) can qualify that a patient is indeed sick. B) determine how far away the hospital is. C) perform a detailed secondary assessment. D) are able to quantify how sick a patient is.
Ans: D Complexity: Moderate Ahead: Introduction Subject: Chapter 11 Page: 502 Feedback: Introduction, page 502
16. More often than not, the paramedic will form his or her general impression of a patient based on: A) baseline vital signs and SAMPLE history. B) a rapid, systematic head-to-toe assessment. C) conditions found in the primary assessment. D) the initial presentation and chief complaint.
Ans: D Complexity: Moderate Ahead: Primary Survey Subject: Chapter 11 Page: 509 Feedback: Primary Survey, page 509
66. A patient who does not respond to verbal or tactile stimuli is: A) lethargic. B) semiconscious. C) disoriented. D) unresponsive.
Ans: D Complexity: Moderate Ahead: Primary Survey Subject: Chapter 11 Page: 511 Feedback: Primary Survey, page 511
88. To appreciate the S2 sound: A) the patient should be sitting upright and leaning slightly backward. B) ask the patient to breathe normally and hold his or her breath on expiration. C) the patient should be supine with his or her body tilted to the right. D) ask the patient to breathe normally and hold his or her breath on inhalation.
Ans: D Complexity: Moderate Ahead: Secondary Assessment Subject: Chapter 11 Page: 567 Feedback: Secondary Assessment, page 567
87. A bruit indicates _________ blood flow and is MOST significant in the _________ arteries. A) turbulent, femoral B) laminar, carotid C) laminar, brachial D) turbulent, carotid
Ans: D Complexity: Moderate Ahead: Secondary Assessment Subject: Chapter 11 Page: 568 Feedback: Secondary Assessment, page 568
96. Visceral abdominal pain is: A) highly suggestive of a ruptured hollow abdominal organ. B) characterized by a localized area of abdominal tenderness or pain. C) commonly encountered in patients with cholecystitis or pancreatitis. D) often less localized on palpation and is poorly described by the patient.
Ans: D Complexity: Moderate Ahead: Secondary Assessment Subject: Chapter 11 Pages: 570, 572 Feedback: Secondary Assessment, pages 570, 572