Chapter 11
When a penlight is shined into one eye, the opposite eye should:
constrict
When you are faced with a language barrier and are unable to find someone at the scene to translate, what would be the best way to proceed?
contact a telephone translation company
To adequately assess the patient's respirations, the EMT should:
count the number of respirations over 30 seconds and multiply by 2.
As a paramedic interviews a patient, which statement reflects the use of confrontation during active listening?
"You state you do not use any illicit drugs, but your pupils are dilated and sensitive to light"
The average range for an adult's respirations would be:
12 to 20 bpm
The normal range for an adult's respirations would be:
12 to 20 bpm
What is the longest amount of time a patient should go without a vital sign reassessment?
15 minutes
In American culture, at what distance does intimate space generally begin?
18 inches
You are testing orthostatic vital signs on a patient. You have just taken the vital signs while the patient was lying supine and just assisted the patient to a standing position. You should wait how long before taking the next set of vital signs?
2 min
What is the normal range of EtCO2?
35-45 mm Hg
The emergency medical technician (EMT) should provide assisted ventilation to an adult breathing at a rate greater than:
40 breaths per minute
A mnemonic or memory aid that is used to help the EMS provider remember the information that must be included in a patient history would be:
SAMPLE
An acronym used to help you remember information to include in your patient's history is:
SAMPLE
A bluish gray color to the skin is referred to as:
cyanosis
Regarding skin color, inadequate oxygenation may be indicated by:
cyanosis
As you interview the patient about his history and injuries or medical problems, the reason why the ambulance was called is often called the:
chief complaint
You are treating a patient with the following vital signs: Blood pressure: 150/92, Pulse: 98, Respirations: 16, SpO2: 96 percent. The EMT knows that this patient has:
hypertension
Which of the following is a reason for decreased EtCO2 levels?
hyperventilation
You are treating a patient that was just involved in an unrestrained motor vehicle collision. The patient is alert and has NO obvious injuries. The patient's vital signs are: BP: 80/60, HR: 148, RR: 22, SpO2: 94 percent. You know that this patient is exhibiting signs of:
hypo perfusion (shock)
You are treating a patient complaining of general tiredness. You take the patient's vital signs while lying flat and then you take the vital signs again when the patient is standing. You are testing:
orthostatic vital signs
Which should the EMT perform first prior to obtaining a pulse oximetry reading on a patient?
remove nail polish
What steps are necessary in order to build a good rapport with your elderly patients?
respect their dignity and do not rush them
Vital signs
respiratory rate, heart rate, temperature, pulse, skin, pupils, pulse oximetry and blood pressure
Only slight chest movement or abdominal wall motion is an indication of:
shallow breathing
Which one of the following indicates an abnormal quality of respirations?
shallow breathing
Blood pressure can fall drastically due to:
spinal injury
The amount of pressure that is exerted on the arteries when the left ventricle contracts is called the:
systolic blood pressure
The reason that a patient calls EMS is known as:
the chief complaint
Sonorous breath sounds are typically the result of:
the tongue partially blocking the upper airway
Dilated pupils may be a sign of:
the use of cocaine
You are treating an 85-year-old patient who has a history of chronic obstructive pulmonary disease. The patient requires oxygen via nasal cannula 24 hours a day. The patient presents with a right ankle that is extremely swollen, and cannot bear any weight. While taking the patient's vital signs, you note his capillary refill time to be 4 seconds. You know:
this finding is probably normal for the patient based on his history.
What would be an example of pertinent past medical history for a cardiac patient?
two prior heart attacks
When a patient is suffering from constriction of the bronchioles, the breath sound MOST likely heard on auscultation would be:
wheezing
If you are unable to bring a scene under control, your first priority should be:
your own safety
What is the most significant concern when dealing with an intoxicated patient?
your own safety
The EMT arrives at the patient's home and determines the patient is having pain with ambulation. Which question should the EMT use to obtain the most information?
"Which activities that you do make it worse?"
A tilt test is the common name for:
an orthostatic vital sign test
When assessing your patient's pupils, suspect stroke or a head injury if:
one pupil reacts but the other does not
Your adolescent patient is unconscious. The BEST place to check a pulse in this patient is:
carotid
Before providing care to any patient, the EMT must:
gain patient consent
A capillary refill time of 3 seconds in an asymptomatic elderly man is an indicator of:
normalcy
Which of the following is true regarding an adult patient breathing greater than 40 breaths per minute?
Respiratory muscle fatigue will develop.
The normal resting pulse for a 10-year-old child is:
75 to 118 bpm
Glucose reading
80-120
Which statement concerning palpating a blood pressure is MOST accurate?
A palpated systolic blood pressure is slightly lower than that taken by auscultation.
Jaundice
A yellowing of the skin and eyes
Which of the following statements concerning capillary refill is MOST accurate?
Capillary refill time alone does not provide sufficient information to determine shock.
Dilated
Cardiac arrest (pupils will also be fixed), drug use such as LSD, amphetamines, or cocaine
Nonreactive
Cardiac arrest, brain injury, eye drops, or drug intoxication or overdose
Constricted
Central nervous system disorder or narcotics use
What would be the best way to proceed when faced with collecting information from a patient who is also suffering from a progressive neurological disease such as dementia or from delirium when no family members or care providers are present?
Do not spend too much time collecting a history
The EMT is assessing a patient who presents with shortness of breath and auscultates crackles in the bilateral lung bases. Which statement explains this occurrence?
Fluid surrounding and filling the alveoli
The EMT arrives on the scene and discovers an adult patient with a respiratory rate of 22 breaths per minute. The EMT places the pulse oximetry probe on the patient's finger. Which result indicates a need for supplemental oxygen administration?
O2 92%
The evaluation of a patient's symptoms, such as chest pain, may be accomplished by using the mnemonic:
OPQRST
What does a sudden increase in EtCO2 during a cardiac arrest most likely indicate?
ROSC
Wet or moist
Shock, heat emergency, or diabetic emergency
Abnormally dry
Spinal injury, dehydration, heat stroke, poisoning, or hypothyroidism
Unequal
Stroke, head injury, artificial eye (occasionally a normal finding), eye drops, or eye trauma
You have just performed a tilt test on your patient. Which of the following outcomes would indicate a positive result?
The pulse increases by 15 bpm, and the systolic BP decreases by 15 mmHg.
pallor
Vasoconstriction, blood loss, shock, heart attack, fright, anemia, fainting, or emotional distress
Which of the following initial patient questions is worded in an appropriate format?
What seems to be the problem?
You are dispatched to a residence for a 72-year-old man having difficulty breathing. On your arrival, you are led into the kitchen, where the patient is sitting in the tripod position in apparent respiratory distress. Your history should begin with which of the following questions?
What seems to be the problem?
Noisy respirations such wheezing, rhonchi, or crackles and absent breath sounds may be further evaluated by:
auscultation
As an EMT, you will be measuring breathing, pulse, skin, pupils, and blood pressure. The FIRST set of measurements you take are known as:
baseline vital signs
During your patient assessment, you ask your EMT partner to obtain a set of vitals after applying oxygen. If this is the first set of vitals, what are they called?
baseline vital signs
The properly placed sphygmomanometer cuff should:
be centered over the brachial artery
You arrive at a scene to treat a pediatric patient who fell and struck his head. On arrival, you are led to the patient, who is sitting on the living room floor playing with a toy. The patient seems frightened and alarmed by your presence. One of the easiest things you can do to alleviate this fear is to:
bend down and get on the Childs level
mottling of the skin
blotchiness that indicates poor perfusion due to vasoconstriction
You are assessing a 9-month-old patient who is unconscious. You know that the BEST pulse to palpate in a patient this age is the:
brachial
A heart rate of less than 60 beats per minute is called:
bradycardia
You arrive at a chaotic scene. The EMT should initially attempt to:
bring order to the environment
A reliable indicator of perfusion in children less than 6 years of age is:
capillary refill
Which condition can cause the pulse oximeter not to display a value?
cardiac arrest
You should be especially careful when palpating this pulse, because excess pressure can cut off circulation to the brain.
carotid
The amount of pressure on the arterial walls when the left ventricle is at rest is called the:
diastolic blood pressure
You are treating a stable elderly patient for nausea and vomiting. At a minimum, how often should you reassess the patient's vital signs during your 30-minute transport to the hospital?
every 15 minutes
The EMT is providing care to a patient who sustained multiple injuries in a fall. The patient's level of consciousness is decreasing. How often should the EMT take thepatient's vital signs?
every 5 minutes
You are treating an unstable elderly patient for findings consistent with a stroke. At a minimum, how often should you reassess the patient's vital signs while transporting her to the stroke center 20 minutes away?
every 5 minutes
What does capnometry measure?
exhaled CO2
If you are obtaining a pedal pulse, you are palpating the:
foot
Which condition will cause the pulse oximeter to produce an erroneous reading?
hypothermia
The BEST places to assess skin color in adults are in the mucous membranes of the mouth and eyelids and:
in the nail beds
When assessing a patient's blood pressure with a sphygmomanometer cuff:
inflate the cuff to 30 mmHg above the point where you can no longer feel a pulse.
Asking a bystander who witnessed the patient fall to the ground is a method of:
investigating the chief complaint
A palpable pulse that presents with a chaotic rhythm and no predictable pattern is called:
irregularly irregular
The EMT responds to a call for a patient with increased weakness and falling. The patient has end-stage liver disease. Which integumentary assessment finding would the EMT expect to notice in the patient?
jaundice
In infants and children, retraction of the skin, muscles, and other tissues around the clavicle and between the ribs indicates:
labored breathing
Which of the following is TRUE about blood pressure?
low blood pressure indicates that there is not enough pressure in the arteries to keep the organs supplied adequately with blood
The paramedic is assessing the skin color of a patient who presents with shock due to blood pooling in the extremities. Which description should be included in thedocumentation?
mottling
Your patient is very lethargic and NOT acting right. During your assessment, you note that the patient has bilateral pinpoint pupils. This finding is MOST likely due to:
narcotic use
If you are in an excessively noisy environment, you may wish to check your patient's blood pressure by:
palpation
You are attempting to assess the pulse of an elderly man, and you note that you are unable to determine an accurate rate because the pulse disappears whenever the patient inhales. This is called:
pluses paradoxus
You note that the patient's pulse seems to weaken during inhalation. You would report this finding as:
pluses paradoxus
The device that is used to measure the level of hemoglobin that is saturated with oxygen is known as a:
pulse oximeter
The difference between the systolic and diastolic blood pressures is called:
pulse pressure