Chapter 10 Patient Assessment
The goal of oxygenation for most patients is an oxygen saturation of: 100% 94% to 99% 90% to 94% 88% to 90%
94% to 99%
In which of the following situations is a pertinent negative identified A 50-year-old woman states that nothing makes her chest pain better or worse A 53 year old man with dizziness also tells you that he has vomited three times 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 59 year old man complains of crushing chest pain but denies shortness of breath
Which of the following patients have signs of altered mental status? A patient with an acute allergic reaction and dizziness A diabetic patient with nausea and severe lightheadedness A patient with a head injury who is slow to answer questions A patient who overdosed and tells you he tried to kill himself
A patient with a head injury who is slow to answer questions
Which of the following findings indicates that your patient has a patent airway? Audible breathing Ability to speak Inspiratory stridor Unresponsiveness
Ability to speak
15. Which of the following conditions would be least likely to cause an altered level of consciousness? Drug overdose Inadequate perfusion Acute anxiety Poisoning
Acute anxiety
When using the pulse oximeter as part of your assessment of a patient, it is important to remember that: A pulse oximeter 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 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
Any situation that causes vasoconstriction or loss of red blood cells, such as anemia or bleeding, may result in an inaccurate or misleading value
You receive a call to a daycare center for an unresponsive 8 month old infant. Upon arrival, you perform an assessment and determine that the infant is not breathing. Your next action should be to: Open the airway and give two rescue breaths Begin chest compressions and request backup Immediately transport the child to the hospital Assess for a brachial pulse for 5 to 10 seconds
Assess for a brachial pulse for 5 to 10 seconds
Which of the following is the most effective method of assessing the quality of air movement in the lungs? Evaluate the patient's chest for cyanosis Applying a pulse oximeter and monitor the SpO2 Auscultating breath sounds with a stethoscope Looking for the presence of accessory muscle use
Auscultating breath sounds with a stethoscope
Which of the following factors would most likely cause a patient's pulse rate to be slower than normal? Anxiety or severe distress Beta blocker medications Internal bleeding from trauma Lack of regular exercise routine
Beta blocker medications
Which of the following statements regarding blood pressure is correct? The systolic pressure represents ventricular relaxation Blood pressure falls early in patients with hypo perfusion Blood pressure is the most reliable indicator of perfusion Blood pressure is usually not measured in children younger than 3 years of age
Blood pressure is usually not measured in children younger than 3 years of age
Which of the following pupillary changes would indicate depressed brain function? Both pupils dilate when a bright light is removed Both pupils constrict when a bright light is introduced Both pupils react briskly to light instead of sluggishly Both pupils are sluggish with an introduction of a bright light
Both pupils are sluggish with an introduction of a bright light
When palpating a patient's pulse, you note that it is grossly irregular. You should: Count the pulse rate for at least 30 seconds to ensure accuracy Count the number of pulsations in 15 seconds and multiply by four Count the number of pulsations in 30 seconds and multiply by 2 Count the pulse rate for a full minute to obtain an accurate reading
Count the pulse rate for a full minute to obtain an accurate reading
The chief complaint is MOST accurately defined as the: A. gross physical signs that you detect on assessment. B. most serious thing the patient is concerned about. C. condition that exacerbates an underlying problem. D. most life-threatening condition that you discover.
D. most life-threatening condition that you discover.
A patient's short term memory is most likely intact if they correctly answer questions regarding: Time and place Day and event Event and person Person and place
Day and event
Capnography is used to: 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 Assess how much oxygen is reaching the body's tissues
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: Wait for family members to arrive before asking any questions Defer SAMPLE history questions until you arrive at the hospital Determine if the patient has a medical alert bracelet or wallet card Ask law enforcement officials if they are familiar with the patient
Determine if the patient has a medical alert bracelet or wallet card
When evaluating a patient with multiple complains, the EMTs responsibility is to: Direct his or her attention to the most obvious signs and symptoms Determine which compliant poses the greatest threat to the patient's life Definitively rule out serious causes of each of the patient's complaints Assess each complaining based on the patients perception of its seriousness
Determine which compliant poses the greatest threat to the patient's life
When approaching a 32 year old male who is complaining of traumatic next pain, you should Ensure that the patient can see you approaching him Approaching him from behind and ask him not to move Stand behind him and immediately stabilize his head Assess his mental status by having him move his head
Ensure that the patient can see you approaching him
A blood pressure cuff that is too small for a patient's arm will give a: Falsely low systolic and diastolic reading Falsely high systolic but low diastolic reading Falsely high systolic and diastolic reading Falsely low systolic but high diastolic reading
Falsely high systolic and diastolic reading
A patient with high blood pressure would be expected to have skin that is: Flushed and red Mottled and cool Pale and moist Cyanotic and dry
Flushed and red
You should suspect that a patient is experiencing respiratory failure if he or she: Is restless and is working hard to breathe Has an increased heart rate and retractions Has bradycardia and diminished muscle tone Is anxious, has tachycardia, and leaning forward
Has bradycardia and diminished muscle tone
The goal of the primary assessment is to: Determine if the patients problem is medical or traumatic Identify the patients that require transport to trauma center Determine the need to perform a head-to-toe assessment Identify and rapidly treat all life threatening conditions
Identify and rapidly treat all life threatening conditions
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: Assist her breathing with a bag-valve mask Quickly insert an oropharyngeal airway Assess the rate and quality of her pulse Immediately suction her oropharynx
Immediately suction her oropharynx
Upon arriving at the scene of a patient with difficult breathing, you determine that the scene is fafe. 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 Obtain a set of baseline vital signs Assess the patient's airway status Introduce yourself to the patient
Introduce yourself to the patient
Which of the following statements regarding stridor is correct? It is a whistling sound heard in the lower airway It is caused by incorrect airway position It is high-pitched, crowing upper airway sound It suggests the presence of fluid in the lungs
It is high-pitched, crowing upper airway sound
The goal of the systematic head-to-toe exam that is performed during the secondary assessment is to: Detect and treat all non-life threatening injuries Assess only the parts of the body that are injured Definitely rule out significant internal injuries Locate injuries not found in the primary assessment
Locate injuries not found in the primary assessment
For which of the following patients is spinal immobilization clearly indicated? A woman who fell from a standing position and has a deformed shoulder Man with an arrow impaled in his leg and no pulse distal to the injury Man with altered mental status after being exposed to blunt force trauma Woman in a minor motor vehicle collision who complains of severe knee pain
Man with altered mental status after being exposed to blunt force trauma
The diastolic blood pressure represents the: Average pressure against the arterial walls during a cardiac cycle Minimum amount of pressure that is always present in the arteries Increased arterial pressure that is always present in the arteries Difference in pressure between ventricular contraction and relaxation
Minimum amount of pressure that is always present in the arteries
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 GSC? Eyes remain closed, make incomprehensible sounds, exhibit abnormal extension. Opens eyes in response to pain, uses inappropriate words, withdraws from pain. Opens eyes in response to voice, makes incomprehensible sounds, localizes pain. Opens eyes spontaneously, is confused when spoken to, exhibits abnormal flexion.
Opens eyes in response to pain, uses inappropriate words, withdraws from pain.
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 Patients who are significantly hypotensive Patients who are exposed to cold temperatures Patients who are older than 70 years of age
Patients who are younger than 6 years of age
The systemic head-to-toe assessment should be performed on: Stable patients who are able to tell you exactly what happened All patients with traumatic injuries who will require EMS transport Responsive medical patients and patients without a sign MOI Patients with a significant MOI and unresponsive medical patients
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 Established the patient's medical history early Take note of the patient's general appearance Ask if bystanders are familiar with the patient
Perform a careful and thorough assessment
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: Immediately cease all patient care, carefully back out of the residence, and request law enforcement assistance Direct your partner to move the gun to a safe area and then advise the patient that his weapon has been secured Document the presence of the weapon, including its specific location, and continue your assessment of the patient Position yourself in between the patient and the gun and ask your partner to request law enforcement assistance
Position yourself in between the patient and the gun and ask your partner to request law enforcement assistance
A palpable pulse is created by The pressure of circulating blood against walls of the veins The pressure that is caused when venous blood returns to the heart Pressure waves through the arteries caused by cardiac contraction Electrical conduction in the heart producing contraction of the atria
Pressure waves through the arteries caused by cardiac contraction
Observations made when forming a general impression of a patient would include all of the following except Appearance Pulse strength Race and gender Level of distress
Pulse strength
Which of the following actions would not be performed during the scene size up? Asking a neighbor to secure the patient dog Rapidly assessing a patient's respiratory status Notifying the dispatcher to send the fire personal
Rapidly assessing a patient's respiratory status
When performing a reassessment of your patient, you should first: Obtain updated vital signs Reassess your interventions Repeat the primary assessment Confirm medical history findings
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 Using medical terminology whenever possible Maintaining constant eye contact with him or her Interrupting him or her as needed for clarification
Repeating statements back to him or her
The pulse oximeter is an assessment tool used to evaluate the: Quantity of red blood cells Level of carbon dioxide Saturation level of arterial blood Amount of exhaled carbon dioxide
Saturation level of arterial blood
Which of the following situations or conditions warrants immediate transport Mild pain in the lower abdomen Severe chest pain and cool, pale skin Decreased ability to move an extremity Ability to follow commands
Severe chest pain and cool, pale skin
Clinical signs of labored breathing includes all of the following EXCEPT: Shallow chest movement Use of accessory muscles Supraclavicular retractions Gasping attempts to breath
Shallow chest movement
A crackling sound produced by air bubbles under the skin is called: Crepitus Rhonchi Korotkoff sounds Subcutaneous emphysema
Subcutaneous emphysema
When assessing a patient's abdomen, you will evaluate for all of the following except: Subcutaneous emphysema Open wounds or eviscerations Gross bleeding and tenderness Rigidity and obvious bleeding
Subcutaneous emphysema
After performing a head-tilt-chin lift maneuver to open the airway of an unresponsive patient who has a pulse you should: Place him in the recovery potions Provide positive-pressure ventilatory assistance Assess respiratory rate, depth, and regularity Suction as needed and insert airway adjunct
Suction as needed and insert airway adjunct
Which of the following would the EMT likely NOT perform on a responsive patient with a headache and no apparent life threatening conditions? Focused secondary assessment Assessment of oxygen saturation Systematic head-to-toe examination Noninvasive blood pressure monitoring
Systematic head-to-toe examination
The pressure exerted against the walls of the artery when the ventricle contracts is called the: Apical pulse Systolic pressure Diastolic pressure Pulse pressure
Systolic pressure
Which of the following statements regarding the mechanism of injury (MOI) is correct? A nonsignificant Moi rules out the possibility of serious trauma The MOI may allow you to predict the severity of a patient's injuries The exact location of a patient's injuries can be determined by the MOI A significant MOI usually results in patient death or permanent disability
The MOI may allow you to predict the severity of a patient's injuries
As time progresses following a significant injury: The patient's blood pressure elevated significantly The patient's injuries will most likely be irresponsible Most patients will die secondary to internal bleeding The blood's ability to compensate for shock decreases
The blood's ability to compensate for shock decreases
You should avoid palpating a patient's pelvis if: The pelvis does not appear deformed The patient complains of pelvic pain The MOI suggests trauma to the pelvis The patients in older than 50 years of age
The patient complains of pelvic pain
The "Golden Hour" beings when an injury occurs and ends when: The patients receives definitive care The patient is admitted to the ICU You depart the scene for the hospital You arrive at the emergency department
The patients receives definitive care
Reassessment is performed to determine all of the following except: The reason why the patient called EMS The patient's response to your treatment Whether or not the patient is deteriorating. The nature of any newly identified problems
The reason why the patient called EMS
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 The secondary assessment should be performed on route to the hospital, regardless of the severity of the patient's condition A secondary assessment should always be performed, even if you must continually manage life threats that were identified in the primary assessment During the secondary assessment, the EMT's primary focus should be on taking the patient's vitals
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? Chest rise will be easily noticeable Tidal volume is markedly reduced Oxygenation occurs more efficiently Carbon dioxide elimination is increased
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? Transport her on her left side Transport her in a sealed position Treat her for possible shock Gently palpate her pelvis
Treat her for possible shock
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 Atria contracting Ventricles relaxing Ventricles contracting
Ventricles relaxing
Supplemental oxygen without assisted ventilation would most likely be administered to patients Who are semiconscious with shallow respirations With rapid respirations and a reduced tidal volume Who have accessory muscle use and slow breathing With difficulty breathing and adequate tidal volume
With difficulty breathing and adequate tidal volume
Which of the following statements regarding the secondary assessment is correct? If your general impression of a patient does not reveal any obvious life threats, you should proceed directly to the secondary assessment The purpose of the secondary assessment is to systematically examine every patient from head to toe You may not have time to perform a secondary assessment if you must continually manage life threats A focused secondary assessment would be the most appropriate approach for a patient who experienced significant trauma to multiple body systems
You may not have time to perform a secondary assessment if you must continually manage life threats
If a patient develops difficulty breathing after your primary assessment, you should immediately: Determine his or her respiratory rate Begin assisting his or her breathing Reevaluate his airway status Auscultate his or her breath sounds
auscultating breath sounds with a stethoscope
Which of the following does not involve the presence of any symptoms? a. A 44 year old male with abdominal pain and severe dizziness b. A 49 year old female with blurred vision and ringing in the ears c. A 55 year old male with a severe headache and 2 days of nausea d. A 61 year old female who is conscious with facial cyanosis
d. A 61 year old female who is conscious with facial cyanosis
A 40 year old male presents with pain to the right paper 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: acute pancreatitis. gallbladder disease liver dysfunction. renal insufficiency.
liver dysfunction.
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: apply the AED and analyze her cardiac rhythm. transport at once and consider requesting a paramedic unit. document your findings and perform a detailed assessment. conclude that the irregular pulse is normal based on her age.
transport at once and consider requesting a paramedic unit.
A patient with spontaneous respirations is breathing: without assistance. without difficulty. at a normal rate. with shallow depth.
without assistance.
