Chapter 11. Baseline Vital Signs EMT 111

When a penlight is shined into one​ eye, the opposite eye​ should: A. dilate. B. constrict. C. remain fixed. D. develop nystagmus.

constrict.

To adequately assess the​ patient's respirations, the EMT​ should: A. count the number over 20 seconds and multiply by 2. B. count the number of respirations over 15 seconds and multiply by 10. C. count the number of respirations over 30 seconds and multiply by 2. D. count the number of respirations over 45 seconds and divide by 3.

count the number of respirations over 30 seconds and multiply by 2.

What is the longest amount of time a patient should go without a vital sign​ reassessment? A. 1 hour B. 10 minutes C. 15 minutes D. 5 minutes

15 minutes

When measuring the blood​ pressure, the EMT would inflate the cuff to this many points above where the pulse disappears. A. 50 mmHg B. 70 mmHg C. 30 mmHg D. 10 mmHg

30 mmHg

An acronym used to help you remember information to include in your​ patient's history​ is: A. ​DCAP-BTLS. B. OPQRST. C. AVPU. D. SAMPLE.

SAMPLE.

Question Help 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: A. SOAP. B. SAMPLE. C. AVPU. D. ​DCAP-BTLS.

SAMPLE.

Your adolescent patient is unconscious. The BEST place to check a pulse in this patient​ is: A. brachial. B. dorsalis. C. carotid. D. radial.

carotid.

A bluish gray color to the skin is referred to​ as: A. flush. B. diaphoresis. C. mottling. D. cyanosis.

cyanosis.

Regarding skin​ color, inadequate oxygenation may be indicated​ by: A. jaundice. B. flushing. C. pallor. D. cyanosis.

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: A. mechanism of injury. B. SAMPLE history. C. chief complaint. D. physical exam.

chief complaint.

When taking your​ patient's history, you should first determine his or​ her: A. vital signs. B. insurance information. C. demographic information. D. chief complaint.

chief complaint.

An example of an associated sign would be when the patient with a severe headache tells you​ he: A. was receiving treatment for the headache by his primary care physician. B. is allergic to certain drugs. C. has taken aspirin for his problem. D. has been vomiting.

has been vomiting.

You are assessing a​ 10-month-old infant who is acting​ lethargic, in the​ parents' judgment. His vital signs​ are: HR 140 and RR​ 32, his capillary refill is 2​ seconds, and his color is good. With this​ information, you know​ that: A. his respiratory rate is high. B. his BP is low. C. his vital signs are normal. D. his heart rate is high.

his vital signs are normal.

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: A. orthopnea. B. hypertension. C. bradycardia. D. tachycardia.

hypertension.

When assessing your​ patient's pupils, suspect stroke or a head injury​ if: A. neither pupil reacts. B. both pupils are dilated. C. both pupils are constricted. D. one pupil reacts but the other does not.

one pupil reacts but the other does not.

You are treating a patient complaining of general tiredness. You take the patients vital signs while lying flat and then you take the vital signs again when the patient is standing. You are​ testing: A. aortic insufficiency. B. cardiac tamponade. C. orthostatic vital signs. D. hypotensive crisis.

orthostatic vital signs.

You note that the​ patient's pulse seems to weaken during inhalation. You would report this finding​ as: A. cardiac regurgitation. B. pulsus paradoxus. C. aortic stenosis. D. cardiac tamponade.

pulsus paradoxus.

An adult pulse rate of 110 beats per minute is​ considered: A. slow. B. normal. C. moderate. D. rapid.

rapid.

Only slight chest movement or abdominal wall motion is an indication​ of: A. labored breathing. B. normal breathing. C. noisy breathing. D. shallow breathing.

shallow breathing

Because of disease and environmental​ considerations, measurement of capillary refill time in the adult​ patient: A. is typically shorter for the elderly. B. should be used as only one tool in circulatory assessment. C. is typically shorter for men. D. cannot be relied upon.

should be used as only one tool in circulatory assessment.

You just asked your elderly patient to describe the pain in her chest. You note that the patient seems to be taking a long time to answer your question so you​ should: A. simply move onto another question as the patient is unable to answer your question. B. slow your talking speed down as it is obvious that this patient cannot understand and you need to talk at a really slow pace. C. keep revising the question and asking it differently until the patient can easily answer you. D. simply wait for the patient to respond as they might be forming their response.

simply wait for the patient to respond as they might be forming their response.

The amount of pressure that is exerted on the arteries when the left ventricle contracts is called​ the: A. diastolic blood pressure. B. mean arterial pressure. C. systolic blood pressure. D. pulse pressure.

systolic blood pressure.

All of the following are TRUE regarding taking a​ patient's blood​ pressure, EXCEPT: A. taking a blood pressure requires a sphygmomanometer and a stethoscope. B. the blood pressure cuff should cover​ two-thirds of the upper​ arm, elbow to shoulder. C. there should be no clothing under the cuff. D. center the bladder of the cuff over the brachial artery.

taking a blood pressure requires a sphygmomanometer and a stethoscope.

The reason that a patient calls EMS is known​ as: A. the primary exam. B. the chief complaint. C. method of injury​ (MOI). D. patient history.

the chief complaint.

Absence of a radial pulse may indicate all of the following​ EXCEPT: A. that the heart has stopped beating. B. that the blood pressure is extremely low. C. the patient is not breathing. D. that an artery has been injured.

the patient is not breathing.

Sonorous breath sounds are typically the result​ of: A. the tongue partially blocking the upper airway. B. an obstruction at the level of the larynx. C. constriction of the bronchioles. D. fluid in the upper airway.

the tongue partially blocking the upper airway.

Dilated pupils may be a sign​ of: A. the use of cocaine. B. a central nervous system disorder. C. the use of narcotics. D. early brain injury.

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 tripped over a rug in his house but caught himself from falling. The patient thinks that he sprained his ankle during the event. His right ankle is extremely​ swollen, and he cannot bear any weight on it. While taking the​ patient's vital​ signs, you note his capillary refill time to be 4 seconds. You​ know: A. this finding is probably normal for the patient based on his history. B. the patient has lost a significant amount of blood. C. the patient is not being perfused and therefore needs blood administered quickly. D. the patient sustained a significant trauma and needs immediate transport to a level 1 trauma facility.

this finding is probably normal for the patient based on his history.

You take your trauma​ patient's blood pressure every five minutes. This is​ called: A. vital signs stacking. B. clinical documentation. C. validating. D. trending.

trending

When a patient is suffering from constriction of the​ bronchioles, the breath sound MOST likely heard on auscultation would​ be: A. snoring. B. wheezing. C. crowing. D. gurgling.

wheezing.

If you are unable to bring a scene under​ control, your first priority should​ be: A. your own safety. B. removing the patient from the scene. C. calling for additional resources. D. bringing bystanders under submission.

your own safety.

A tilt test is the common name​ for: A. an orthostatic vital sign test. B. a syncope test. C. lumbar traction. D. a chemical stress test.

an orthostatic vital sign test.

You are treating a patient that is complaining of sudden onset of shortness of breath. The patient was working in the garden when he was stung by a bee and shortly thereafter the difficulty in breathing began. The​ patient's vital signs​ are: BP:​ 160/90, HR:​ 160, RR:​ 34, SpO2​: 89 percent. The EMT knows that the​ patient's vital signs and history are MOST consistent with​ a/an: A. anaphylactic reaction. B. diabetic problem. C. heart attack. D. stroke.

anaphylactic reaction

If you are obtaining a pedal​ pulse, you are palpating​ the: A. foot. B. upper arm. C. wrist. D. pelvis.

foot.

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? A. 10 minutes B. 5 minute C. 15 minutes D. 1 minutes

5 minute

The typical physiologic range for a pulse rate in a​ disease- and​ injury-free adult at rest​ is: A. 70 to 80 beats per minute. B. 80 to 100 beats per minute. C. 50 to 60 beats per minute. D. 60 to 80 beats per minute.

60 to 80 beats per minute.

What is the normal respiratory rate for an​ adult? A. 8 to 16 breaths per minute. B. 15 to 30 breaths per minute. C. 8 to 24 breaths per minute. D. 25 to 50 breaths per minute.

8 to 24 breaths per minute.

Which of the choices is TRUE regarding the difference between a sign and a​ symptom? A. A condition that must be described by the patient is a symptom. B. Information obtained during baseline vitals assessment are symptoms. C. Any objective physical evidence that you can​ see, hear,​ feel, or smell is a symptom. D. A vague complaint that cannot be specifically described is a sign.

A condition that must be described by the patient is a symptom

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? A. Do not spend much time collecting a history. B. Write the questions down. C. Be​ patient, and give the person additional time to respond. D. Deliberately ask redundant questions to try to ascertain the truth.

A. Do not spend much time collecting a history.

You have just performed a tilt test on your patient. Which of the following outcomes would indicate a positive​ result? A. The pulse increases by 15​ bpm, and the systolic BP decreases by 15 mmHg. B. The pulse increases by 5​ bpm, and the systolic BP increases by 10 mmHg. C. The pulse decreases by 5​ bpm, and the systolic BP increases by 5 mmHg. D. The pulse increases by 15​ bpm, and the systolic BP remains constant.

A. The pulse increases by 15​ bpm, and the systolic BP decreases by 15 mmHg.

You are treating a patient who awoke to his carbon monoxide detector alarming. The patient is complaining of shortness of breath and a headache. You apply the pulse oximeter and you note the reading to be 99 percent SpO2. You​ should: A. apply oxygen via NRBM at 15 lpm as the pulse oximeter reading is not accurate due to the carbon monoxide. B. apply a nasal cannula at 2 lpm. C. reassure the patient and have him breathe into a paper bag as the event has sent him into a panic attack. D. administer aspirin for the​ patient's headache and allow the patient to refuse.

A. apply oxygen via NRBM at 15 lpm as the pulse oximeter reading is not accurate due to the carbon monoxide.

Noisy respirations such​ wheezing, rhonchi, or crackles and absent breath sounds may be further evaluated​ by: A. auscultation. B. vital sign assessment. C. sphygmomanometry. D. assisted ventilations.

A. auscultation.

You are dispatched to a residence for a​ 16-year-old female complaining of severe abdominal pain. On your​ arrival, the parents tell you that she was having​ "cramps" the day before and the condition progressively worsened overnight and then suddenly increased prior to their call. The patient is alert and oriented and her vitals are BP​ 90/70, pulse​ 110, respirations​ 20; her skin is warm and dry. Your primary exam reveals tenderness and guarding in the left lower quadrant but is otherwise​ unremarkable; you do NOT believe she has a fever. As you begin the patient​ interview, she responds quietly and you frequently cannot hold eye contact. Based on the information​ provided, what would your NEXT step​ be? A. Call medical direction. B. Transport the patient to the hospital while monitoring vitals. C. Start high flow oxygen and transport. D. Ask the parents to step out of the room and repeat the interview.

Ask the parents to step out of the room and repeat the interview.

You are dispatched to a residence for a​ 16-year-old female complaining of severe abdominal pain. On your​ arrival, the parents tell you that she was having​ "cramps" the day before and the condition progressively worsened overnight and then suddenly increased prior to their call. The patient is alert and oriented and her vitals are BP​ 90/70, pulse​ 110, respirations​ 20; her skin is warm and dry. Your primary exam reveals tenderness and guarding in the left lower quadrant but is otherwise​ unremarkable; you do NOT believe she has a fever. As you begin the patient​ interview, she responds quietly and you frequently cannot hold eye contact. Based on the information​ provided, what would your NEXT step​ be? A. Transport the patient to the hospital while monitoring vitals. B. Start high flow oxygen and transport. C. Ask the parents to step out of the room and repeat the interview. D. Call medical direction.

Ask the parents to step out of the room and repeat the interview.

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? A. 45 seconds B. 2 minutes C. 3 minutes D. 5 minutes

B. 2 minutes

A capillary refill time of 3 seconds in an asymptomatic elderly male is an indicator​ of: A. cyanosis. B. normalcy. C. high blood pressure. D. hypoperfusion.

B. normalcy.

When investigating the​ patient's chief​ complaint, pay close attention to statements family members may​ make, such​ as: A. she has always been a diabetic. B. she just does not seem to be herself today. C. she has been taking medicine for her ulcers. D. she always walks the dog in the morning.

B. she just does not seem to be herself today.

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? A. 5 minutes B. 10 minutes C. 15 minutes D. 1 minute

C. 15 minutes

Which of the following would likely present with breath sounds that are similar on both​ sides? A. Tension pneumothorax B. A collapsed lung C. Wheezing D. Hemothorax

C. Wheezing

You notice your EMT partner is taking a blood pressure without a stethoscope. This method is referred to​ as: A. pulsatile pressure. B. finger pressure. C. palpation. D. ​non-steth pressure.

C. palpation.

Which condition can cause the pulse oximeter not to display a​ value? A. Heart attack B. Traumatic brain injury C. High blood pressure D. Cardiac arrest

Cardiac arrest

You should be especially careful when palpating this​ pulse, because excess pressure can cut off circulation to the brain. A. Carotid B. Brachial C. Femoral D. Temporal

Carotid

What should you do after collecting baseline vital signs and available patient history and arriving at a field diagnosis for your unresponsive medical​ patient? A. Refine your patient history. B. Treat the patient symptomatically. C. Verify your rapid assessment. D. Devise a management plan.

Devise a management plan

Monitoring devices used by the EMT include each of the​ following, EXCEPT: A. pulse oximeter. B. ECG monitor. C. glucose meter. D. Blood pressure cuff.

ECG monitor.

Which condition will cause the pulse oximeter to produce an erroneous​ reading? A. Tachycardia B. ​High-flow oxygen C. Emphysema D. Hypothermia

Hypothermia

Which of the following is TRUE about blood​ pressure? A. An early sign of hypoperfusion​ (shock) to watch for is a drop in blood pressure. B. Low blood pressure indicates that there is not enough pressure in the arteries to keep the organs supplied adequately with blood. C. High blood pressure can occur after a spinal cord injury in which the blood vessels in the body constrict. D. Low blood pressure can result in the rupture or damage of​ arteries, such as those in the brain.

Low blood pressure indicates that there is not enough pressure in the arteries to keep the organs supplied adequately with blood.

The evaluation of a​ patient's symptoms, such as chest​ pain, may be accomplished by using the​ mnemonic: A. SAMPLE. B. OPQRST. C. AVPU. D. ​DCAP-BTLS.

OPQRST.

​Periodically, parents may interfere with the treatment of a child. If this​ happens, what should the EMT​ do? A. Separate the parents from the child. B. Delay care of the patient until placed in the ambulance. C. Ignore the parents. D. Firmly rebuff the parents.

Separate the parents from the child.

In the OPQRST​ mnemonic, the S stands for A. Signs B. Severity C. Systolic D. Symptoms

Severity

The pressure wave generated by each individual contraction of the left ventricle is​ called: A. diastolic blood pressure. B. a pulse. C. pulse pressure. D. systolic blood pressure.

a pulse.

What term describes a weak rapid pulse assessed at the​ wrist? A. Bounding B. Thready C. Hypoperfusion D. Tachycardic

Thready

Which of the following initial patient questions is worded in an appropriate​ format? A. Were you walking when the pain​ started? B. Are you having trouble​ breathing? C. Are you having abdominal​ pain? D. What seems to be the​ problem?

What seems to be the​ problem?

You are dispatched to a residence for a​ 72-year-old male 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? A. How long have you been short of​ breath? B. What seems to be the​ problem? C. How long have you been​ dyspneic? D. Did you exert yourself prior to becoming short of​ breath?

What seems to be the​ problem?

Which of the following is a good example of appropriate language use when taking a​ history? A. So does the pain usually radiate dorsally or​ laterally? B. How long have you had this abdominal​ guarding? C. When was your most recent​ stroke? D. Have you ever had an​ MI?

When was your most recent​ stroke?

What is the most significant concern when dealing with an intoxicated​ patient? A. Collecting an accurate history B. Your own safety C. Performing a physical exam D. Ascertaining an accurate chief complaint

Your own safety

Pulsus paradoxus is defined​ as: A. a change in the​ patient's heart rate from sitting position to a standing position. B. a decrease in the strength of the pulse during the inspiratory phase of the patient. C. an increase in the pulse strength during the expiratory phase of the patient. D. a change in the​ heart's rhythm.

a decrease in the strength of the pulse during the inspiratory phase of the patient.

Pulsus paradoxus is defined​ as: A. an increase in the pulse strength during the expiratory phase of the patient. B. a change in the​ heart's rhythm. C. a decrease in the strength of the pulse during the inspiratory phase of the patient. D. a change in the​ patient's heart rate from sitting position to a standing position.

a decrease in the strength of the pulse during the inspiratory phase of the patient.

Arterial pressure exerted by the blood when the left ventricle contracts is​ detected: A. as the first sound heard when pressure in the​ B/P cuff is slowly released. B. when sounds of the pulse disappear during deflation of the​ B/P cuff. C. by a stethoscope as the diastolic reading. D. by the difference between the systolic and diastolic pressure.

as the first sound heard when pressure in the​ B/P cuff is slowly released.

In checking a​ patient's blood pressure for the FIRST time utilizing a noninvasive blood pressure​ monitor, it is BEST​ to: A. use a wrist or finger blood pressure monitor. B. use a noninvasive blood pressure monitor. C. initiate invasive blood pressure monitoring. D. auscultate a manual blood pressure first.

auscultate a manual blood pressure first.

The FIRST blood pressure the EMT takes should be done​ by: A. auscultation method using a sphygmomanometer and stethoscope. B. using a noninvasive automatic blood pressure machine. C. assessing the​ B/P after you have begun transporting the patient to the hospital to make sure you do not delay transport. D. using the palpation method as it is quicker.

auscultation method using a sphygmomanometer and stethoscope.

As an​ EMT, you will be measuring​ breathing, pulse,​ skin, pupils, and blood pressure. The FIRST set of measurements you take are known​ as: A. initial vital signs. B. ongoing vital signs. C. baseline vital signs. D. primary vital signs.

baseline vital signs.

The properly placed sphygmomanometer cuff​ should: A. cover the entire upper arm. B. fit loosely until inflated. C. have a bladder that overlaps slightly. D. be centered over the brachial artery.

be centered over the brachial artery.

A heart rate of less than 60 beats per minute is​ called: A. bradycardia. B. tachycardia. C. synchronous rate. D. sinus rhythm.

bradycardia.

You arrive at a chaotic scene. The EMT should initially attempt​ to: A. physically restrain anyone who is not complying with your orders. B. bring order to the environment. C. shout loudly at the people to be quiet. D. have law enforcement arrest everyone at the scene but the patient.

bring order to the environment.

A reliable indicator of perfusion in children less than six years of age​ is: A. pulse rate. B. pupil size. C. skin color. D. capillary refill.

capillary refill.

Your infant patient is breathing 44 times a minute with a strong cry and you are going to administer oxygen. The MOST appropriate treatment for this patient is​ to: A. apply a nasal cannula at 8 lpm. B. deliver oxygen via​ blow-by with a mask. C. begin​ bag-valve mask ventilations. D. initiate a nebulizer mask with albuterol.

deliver oxygen via​ blow-by with a mask.

The amount of pressure on the arterial walls when the left ventricle is at rest is called​ the: A. pulse pressure. B. systolic blood pressure. C. diastolic blood pressure. D. mean arterial pressure.

diastolic blood pressure.

As you evaluate your​ patient's skin​ color, you find it is pale and moist. Pallor and moist skin may​ indicate: A. heat exposure. B. ​hypoperfusion, or shock. C. late carbon monoxide poisoning. D. liver disease.

hypoperfusion, or shock

Asking a bystander who witnessed the patient fall to the ground is a method​ of: A. determining the​ patient's mental status. B. investigating the chief complaint. C. determining the mechanism of injury. D. acquiring a SAMPLE history.

investigating the chief complaint

The patient is presenting with mouth​ breathing, flaring​ nostrils, and sitting in the tripod position. The EMT knows that this​ patient: A. is attempting to compensate. B. is probably having a heart attack. C. is having an asthma attack. D. needs an inhaler.

is attempting to compensate

The frequency of respiration is usually calculated as the number of ventilations​ in: A. 15 seconds. B. one minute. C. two minutes. D. 30 seconds.

one minute.

In infants and​ children, retraction of the​ skin, muscles, and other tissues around the clavicle and between the ribs​ indicates: A. shallow breathing. B. labored breathing. C. ​see-saw breathing. D. normal breathing.

labored breathing.

The use of accessory muscles in the​ neck, chest, or abdomen to breathe and nasal flaring is indicative​ of: A. tripod positioning. B. labored respirations. C. trouble exhaling. D. irregular respiratory rhythm.

labored respirations.

Before relying on a noninvasive blood pressure​ monitor, the EMT​ should: A. manually auscultate a blood pressure. B. program the machine to operate every 15 minutes. C. ensure that the cuff is tight. D. program the machine to operate every 5 minutes.

manually auscultate a blood pressure.

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: A. allergic reaction. B. traumatic brain injury. C. subdural hematoma. D. narcotic use.

narcotic use.

If you are in an excessively noisy​ environment, you may wish to check your​ patient's blood pressure​ by: A. dispensation. B. escalation. C. palpation. D. intervention.

palpation.

The​ "P" in the acronym SAMPLE stands​ for: A. palpation. B. pertinent past history. C. pain. D. provocation.

pertinent past history.

When your patient tells you he had a heart valve replaced two years​ ago, this is​ considered: A. a chief complaint. B. irrelevant to​ today's problems. C. pertinent past medical history. D. an event leading up to.

pertinent past medical history.

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: A. pulsus paradoxus. B. an irregular pulse. C. pulsus interruptus. D. cardiopulmonary interruption.

pulsus paradoxus.