Chapter 11 - Patient Assessment

In general, +3 pitting edema is characterized by indentation of the skin to a depth of:

1/2 inch to 1 inch.

Gathering a patient's medical history and performing a secondary assessment should occur:

After life threats have been identified and corrected in the primary assessment.

A patient with a blood pressure of 210/100 mm Hg would be expected to have a pulse that is:

Bounding.

The paramedic should address a patient:

As the patient wishes to be addressed.

An opaque black area against the red reflex of the eye is indicative of:

Cataracts.

Clinical signs of an inflamed joint include all of the following, EXCEPT:

Deformity

Poor skin turgor in an infant or child is MOST indicative of:

Dehydration.

If a patient does not respond to a question within a couple of seconds, he or she:

May be deciding if he or she can trust you enough to answer the question.

_______ entails gently striking the surface of the body, typically where it overlies various body cavities.

Percussion.

A patient who is absolutely still and resists any movement should be suspected of having:

Peritonitis.

The focused assessment of a responsive medical patient is guided by:

The chief complaint.

Sonorous respirations are MOST likely caused by:

An anatomic airway obstruction.

Changes in hair growth or loss of hair are LEAST suggestive of:

An infection.

Swollen lymph nodes in the anterior neck usually indicate:

An infection.

Which of the following reassessment findings is MOST significant in a patient with penetrating chest trauma?

Blood pressure of 90/76 mm Hg.

If a patient's trigeminal nerve is intact, he or she should be able to:

Clench his or her jaw.

S1, the first heart sound, represents:

Closure of the mitral and tricuspid.

A multisystems trauma patient opens his eyes in response to pain, moans when you ask him his name, and withdraws from painful stimuli. From this information, you should:

Conclude that he has severe neurologic dysfunction.

Making your patient aware that you perceive something inconsistent with his or her behavior is called:

Confrontation.

Using casual nicknames can be especially problematic when:

Cultural differences exist between the patient and the paramedic.

An unresponsive patient who has been breathing slowly and shallowly for an extended period of time would MOST likely have ___________ skin.

Cyanotic.

Stimulation of the sympathetic nervous system causes:

Diaphoresis.

A working hypothesis of the nature of a patient's problem is called the:

Differential diagnosis.

A deformed steering wheel in conjunction with a deployed airbag indicates that the:

Driver was not wearing a seat belt.

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:

Ensure that a witness is present at all times.

Asymmetry of the face could indicate:

Facial nerve palsy.

Paying attention, making eye contact, and repeating key information from the patient's answers are examples of:

Facilitation.

Documentation of your physical examination should be:

Factual and nonjudgmental.

During a 20-minute transport of a critical patient, you should make a concerted effort to reassess the patient _____ times.

Four.

You arrive at the scene of a motor vehicle crash in which a small passenger car struck a bridge pillar. The patient, a conscious young woman, is still seated in her car. The scene is safe and law enforcement is directing traffic. Upon initial contact with the patient, you should:

Have your partner manually stabilize her head as you assess her mental status.

It would MOST likely be necessary to ask a patient a direct question if:

He or she is not giving you usable facts about himself or herself.

You would MOST likely encounter bilateral dependent edema in a patient with:

Heart failure.

If a mechanical means is required to keep a patient's airway open, you should initially:

Insert an airway adjunct.

After determining that the scene is safe, the FIRST step in approaching a patient is to:

Introduce yourself to the patient.

Objective patient information:

Is based on fact or observation.

Upon arriving at the scene of a patient with difficulty breathing, you find the patient, a 300-pound man, sitting on the couch in his living room. The patient is conscious and alert and tells you that he is chronically short of breath but feels worse today and wishes to be transported to the hospital. As you begin your assessment, your partner should:

Request lifting assistance.

When examining the anterior abdomen of a patient who complains of abdominal pain:

Routinely palpate the least painful area(s) first.

Assessment of the female genitalia:

Should be limited to inspection only.

A patient with dysarthria has:

Slurred speech.

When assessing any patient, the paramedic should remember that:

Some patients with a traumatic injury could also have an underlying medical component.

If a patient is able to shrug his or her shoulder and turn his or her head from left to right, the ___________ nerve is likely intact.

Spinal accessory.

EMS providers who read off a list of questions to the patient to fill in all the blanks on the run report:

Tend to make little or no eye contact with the patient.

A patient is generally considered to have orthostatic vital signs when:

The heart rate increases by 20 beats/min or more when going from a supine to a standing position.

More often than not, the paramedic will form his or her general impression of a patient based on:

The initial presentation and chief complaint.

A bruit indicates ____________ blood flow and is MOST significant in the ____________ arteries.

Turbulent, carotid.

A patient who does not respond to verbal or tactile stimuli is:

Unresponsive.

Which of the following hazards would you LEAST likely encounter at the scene of a motor vehicle crash?

Unruly patient.

Flushed skin is commonly seen as a result of all the following EXCEPT:

Vasoconstriction.

All of the following are adventitious breath sounds, EXCEPT:

Vesicular sounds.

Diffuse pain caused by hollow organ obstruction and stretching of the smooth muscle wall is called ______ pain.

Visceral.

Other than overall patient appearance, the patient's __________ is/are the MOST objective data for determining his or her status.

Vital signs.

When a patient presents with two seemingly unrelated complaints, it is MOST important for the paramedic to determine:

Which complaint has a higher priority.

Which of the following statements regarding an intoxicated patient is correct?

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.

When scoring a patient's deep tendon reflexes, normally active reflexes would be assigned a score of:

2+

The history of present illness is defined as:

A chronologic account of the patient's signs and symptoms.

The MOST reliable means of attempting to determine an unresponsive medical patient's problem is:

A thorough head-to-toe physical examination.

Your entire assessment of a patient should:

Appear to be a seamless process.

Before asking a patient about any mental health issues, the paramedic should:

Ask questions relating to his or her physical health.

At 3:00 a.m. you receive a call for a "man down." While en route to the scene, you ask the dispatcher to provide additional information, but the dispatcher advises you the caller was abrupt on the phone and then hung up. You should:

Ask the dispatcher if law enforcement is en route to the scene.

To appreciate the S2 sound:

Ask the patient to breathe normally and hold his or her breath on inhalation.

When assessing the head and face during the full-body exam, you should:

Avoid palpating any cranial depressions.

Frank blood or clear, watery fluid draining from the ear canal following head trauma is MOST suggestive of a(an):

Basilar skull fracture.

The general type of illness a patient is experiencing is called the:

Nature of illness.

A pathologic fracture occurs when:

Normal forces are applied to abnormal bone structures.

The diagnosis of a problem involving the shoulder can often be made by simply:

Noting the patient's posture.

The mnemonic "OPQRST" is a tool that:

Offers an easy-to-remember approach to analyzing a patient's chief complaint.

The skin becomes ___ when red blood cell perfusion to the capillary beds of the skin is poor.

Pale.

Which assessment technique usually yields the MOST significant diagnostic information during the abdominal exam?

Palpation.

On most runs, the two MOST important pieces of patient history information that you need to obtain initially are the:

Patient's name and chief complaint.

The MOST effective way to obtain a medical history from a patient who is crying is to:

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.

The presence of rhonchi during auscultation of the lungs is MOST suggestive of:

Pneumonia.

Serial vital signs:

Provide comparative data regarding the patient's condition.

The brachioradialis tendon is located:

Proximal to the wrist.

An empathetic attitude:

Puts you in your patient's shoes.

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:

Reflection.