CH 10- Patient Assessment
Which of the following medical history questions would be of LEAST pertience in an acute situation?
"Does your mother have diabetes?"
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?"
Which of the following patient responses would establish the "E" in the SAMPLE history?
"I was mowing the lawn when the pain began"
Which of the following questions is used to determine a patient's chief complaint?
"What seems to be the matter?"
The normal respiratory rate for an adult should range from
12 to 20 breaths per minute
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
During a 30-minute transport of a stable patient, you should reassess him or her at least ________ times
2
When you assess capillary refill time in an infant, normal color to the tested area should return within
2 seconds
Normal respiratory rates should not exceed _______ breaths/min in toddlers and _______ breaths/min in infants
40, 60
A patient in unstable condition should be reassessed at least every
5 minutes
For an adult, the normal resting pulse should be between
60 and 100 beats/min
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
The rapid exam of a patient that occurs following the primary assessment should take no longer than
90 seconds
The goal of oxygen for most patients is an oxygen saturation of
94% to 99%
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
Which of the following scenarios does NOT involve the presence of any symptoms?
A 61-year-old female who is unconscious with facial cyanosis
Which of the following patients has signs of an altered mental status?
A patient with a head injury who is slow to answer questions
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
When should you take standard precautions during an EMS call?
Before exiting the ambulance and before actual patient contact
Which of the following factors would MOST likely cause a patient's pulse rate to be slower than normal?
Beta blocker medications
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
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
Which of the following pupillary changed would indicate depressed brain function?
Both pupils are sluggish with introduction of a bright light
Which of the following statements regarding stridor is correct?
It is a high-pitched, crowing upper airwar sound
What maneuver should be used to open the airway of an unresponsive patient with suspected trauma?
Jaw-thrust maneuver
For which the following patients is spinal immobilization clearly indicated?
Man with altered mental status after being exposed to blunt force trauma
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
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
Which of the following actions would NOT be performed during the scene size-up?
Rapidly assessing a patient's respiratory status
Which of the following situations or conditions warrants immediate transports?
Severe chest pain and cool, pale skin
Which of the following would the EMT likely NOT perform on a responsive patient with a headache and no apparent life-threating conditions?
Systematic head-to-toe examination
Which of the following statements regarding the mechanism of injury (MOI) is correct?
The MOIT may allow you to predict the severity of a patient's injuries
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
Which of the following occurs when a patient's respirations are shallow?
Tidal volume is markedly reduced
A 71-year-old female slipped on a rug and fell. She is conscious but confused and complains of severe pelvic pain. Her respirations are 22 breaths/min, and her heart rate is 120 beats/min. What should you do?
Treat her for possible shock
When is the MOST appropriate to consider requesting additional ambulances at an accident scene?
When you determine there are multiple patients
Which of the following statements regarding the secondary assessment is correct?
You may not have time to perform a secondary assessment if you must continually manage life threats that were identified during the primary assessment
Which of the following findings indicates that your patient has a patent airway?
ability to speak
Which of the following conditions would be the LEAST likely to cause an altered level of consciousness?
acute anxiety
An elderly patient has fallen and hit her head. You assess her level of consciousness as unresponsive using the AVPU scale. Your initial care should focus on
airway, breathing, and circulation
Treatment and transport priorities at the scene of a mass-casualty incident should be determined after
all the patients have been triaged
Palliating factors regarding a patient's pain involve those that
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
A 39-year-old male sustained a stab wound to the groin during during an altercation at a bar. As you approach the patient, you note that he conscious, 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
External bleeding from an extremity can usually be controlled by a combination of
applying direct pressure
Poor peripheral circulation will cause the skin to appear
ashen
You recieve 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
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
assist his ventilations
When palpating the carotid pulse of a responsive patient, you should
avoid compressing both carotid arteries simultaneously
An adult patient who is NOT experiencing difficulty breathing will
be able to speak in complete sentences without unusual pauses
When you shine a light into one pupil, the normal reaction of the other pupil should be to
become smaller
When auscultating the blood pressure in a patient's upper extremity, you should place the diaphragm (head) of the stethoscope over the _________ artery
brachial
When performing the secondary assessment on trauma patient, you note the prescence of Battle sign. This is defined as
bruising behind the ear
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
When you inspect a patient's pupils with a penlight, the pupils should normally react to the light by
constricting
When palpating a patient's pulse, you note that is is grossly irregular. You should
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
cyanosis
A patient's short-term memory is MOST likely intact if he or she correctly answers questions regarding
day and event
Cyanosis of the skin is caused by
decreased blood oxygen
Capnography is used to
determine how much carbon dioxide is being exhaled
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
When evaluating a patient with multiple complaints, the EMT's responsibility is to
determine which complaint poses the greatest threat to the patient's life
A patient with profuse sweating is referred to as being
diaphoretic
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
Upon arriving at a potentially unsafe scene, you should first
ensure that you are safe
A blood pressure cuff that is too small for patient's arm will give a
falsely high systolic and diastolic reading
A patient with high blood pressure would be expected to have skin that is
flushed and red
You should suspect that a patient is experiencing respiratory failure if he or she
has bradycardia and diminished muscle tone
Which of the following is an example of a symptom?
headache
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?
history taking
The goal of the primary assessment is to
identify and rapidly treat all life-threatening conditions
After performing a primary assessment, a rapid exam of the body should be performed to
identify less-obvious injuries that require immediate treatment
If you cannot palpate a pulse in an unresponsive patient, you should
immediately begin CPR
You respond to a call for a female pedestrian who has been struck by a car. As your partner maintains manual stabilization of her head, you perform a primary assessment. She is unconscious, has ineffective breathing, and has bloody secretions in her mouth. You should
immediately suction her oropharynx
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
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
In patients with deeply pigmented skin, changes in color may be apparent only in certain areas, such as the
lips or oral mucosa
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 and jaundiced. You should suspect
liver dysfunction
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
A decrease in blood pressure may indicate
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
The diastolic blood pressure represents the
minimum amount of pressure that is always present in the arteries
The chief complaint is MOST accurately defined as the
most serious thing the patient is concerned about
A 40-year-old male crashed his motorcyle 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
In infants and small children, skin color should be assessed on the
palms and soles
With regard to the assessment of a patient's cardiovascular status, capillary refill time is MOST reliable in
patients who are younger than 6 years of age
The systematic head-to-toe assessment should be performed on
patients with a significant MOI and unresponsive medical patients
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
You respond to the scene of a motor vehicle collision. Upon arrival, you find the driver, a young female, sitting on the curb. She is confused, is in obvious respiratory distress, and has pale, moist skin. As your partner manually stabilizes her head, you perform a primary assessment. After performing any immediate life-saving treatment, you should
perform a detailed head-to-toe exam and prepare for immediate transport
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 the infant's
peripheral circulation is decreased
Normal skin color, temperautre, and condition should be
pink, warm, and dry
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
When performing a rapid exam on a supine patient, what part of the body is typically assessed last?
posterior
A 50-year-old male presents with altered mental status. His wife tells you that he had a "small stroke" 3 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
A palpable pulse is created by
pressure waves through the arteries caused by cardiac contraction
During the primary assessment, circulation is evaluated by assessing
pulse quality, external bleeding, and skin condition
Observations made when forming a general impression of a patient would include all of the following, EXCEPT
pulse strength
In responsive patients who are older than 1 year of age, you should palpate the pulse at the ________ artery
radial
Pain that moves from its point of origin to another body location is said to be
radiating
When palpating a patient's pulse, you note that there is a short interval between pulsations. This indicates that the pulse is
rapid
If a patient develops difficulty breathing after your primary assessment, you should immediately
reevaluate his or her airway status
A pulse with consistent pattern is considered to be
regular
When performing a resassessment of your patient, you should first
repeat the primary assessment
When interviewing a patient, you can show him or her that you understand the situation by
repeating statements back to him or her
A patient who moves and cries out only when pinch his or her trapezius muscle is said to be
responsive to painful stimuli
The pulse oximeter is an assessment tool used to evalute the
saturation level of arterial blood
Which of following signs of respiratory distress is usually observed only pedriatric patients?
seesaw breathing
Clinical signs of labored breathing include all of the following EXCEPT
shallow chest movement
Jugular venous distention suggests a problem with blood returning to the heart if the patient is
sitting up at a 45 degree angle
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
Which of the following abnormal breath sounds indicates obstruction of the upper airway?
stridor
A crackling sound produced by air bubbles under the skin is called
subcutaneous emphysema
When assessing a patient's abdomen, you will evaluate for all of the following, EXCEPT
subcutaneous emphysema
After performing a head tilt-chin lift maneuver to open the airway of an unresponsive patient, you should
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
systolic blood pressure
The pressure exerted against the walls of the artery when left ventricle contracts is called the
systolic pressure
The pressure exerted against the walls of the artery when the left ventricle contracts is called the:
systolic pressure
As time progresses following a significant injury
the body's ability to compensate for shock decreases
You should avoid palpating a patient's pelvis if
the patient complains of pelvic pain
The "Golden Hour" begins when an injury occurs and ends when
the patient recieves definitive care
Reassessment is performed to determine all of the following EXCEPT
the reason why the patient called EMS
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
A properly sized blood pressure cuff should cover
two thirds the length from the armpit to the crease at the elbow
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
ventricles relaxing
When assessing motor function in a conscious patient's lower extremities, you should expect the patient to
wiggle his or her toes on command
Supplemental oxygen with assisted ventilation would MOST likely be administered to patients
with difficulty breathing and adequate tidal volume
A patient with spontaneous respirations is breathing
without assistance
