Chapter 12- Primary Assessment
During the primary assessment of an unresponsive two-month old infant, which pulse should be palpated?
Brachial
You assess a patient's breathing rate and see signs of hypoxia and respiratory distress, so you provide the patient with oxygen. You do this during which phase of the primary assessment?
Breathing
Which of the following statements is TRUE about the primary assessment?
Critical conditions that are identified during the primary assessment must be treated immediately as found.
Which of the following is completed first during the primary assessment?
Forming a general impression
What BEST defines the immediate sense of the patient's degree of distress, formulated from the patient's immediate environment, appearance, and chief complaint?
General impression
You are caring for a patient that looks at you as you approach. Which of the following represents the typical order of assessment for the EMT during the primary assessment from start to end?
General impression, mental status, airway, breathing, circulation, patient priority
Which of the following is TRUE regarding a patient who has a mental status of less than "alert"?
His brain may not be getting enough oxygen.
In which of the following patients would you check a brachial pulse initially?
Infant
What is a normal capillary refill time in a pediatric patient?
Less than 2 seconds
Which condition would be a critical concern during primary assessment?
Major arterial bleeding
You determine that a patient's airway is endangered and initiate the airway phase of the primary assessment. Which of the following would you NOT do during this phase?
Obtain the respiratory rate
Your patient is a 33-year-old man who has been ejected from his vehicle during a high-speed collision. During your primary assessment, you discover that he is not moving, does not appear to have adequate respirations, and has suffered moderate external bleeding. Which of the following should be done first?
Open the airway.
You have arrived on the scene at a high school football field where a 17-year-old male is lying on the ground. He is unresponsive and cyanotic, and he is making obvious respiratory effort without moving adequate amounts of air. Which of the following should be done first?
Open the patient's airway using a manual maneuver.
You are at the scene where a 19-year-old female college student has been drinking large quantities of alcohol throughout the evening. On your arrival, the patient is lying on her back with no signs of trauma, has vomited, and has slow, wet-sounding respirations. Which of the following should you do next?
Open the patient's airway using a head-tilt, chin-lift maneuver.
For which would you suspect an airway intervention is MOST likely to be necessary?
Patient with obvious head trauma
Which of the following is the proper position for maintaining the airway in a child with a decreased level of consciousness?
Placing the head and neck in a neutral position
If a patient is alert and breathing adequately but exhibits cyanotic skin, then which intervention is MOST appropriate?
Provide oxygen based on the patient's need as determined by your examination, the patient's complaint and level of distress, and the pulse oximetry readings.
Which of the following presentations would be considered normal during the breathing phase of the primary assessment?
Respiratory rate of 12 with adequate depth
How would you assess the mental status of an infant who appears unresponsive?
Speak as a verbal stimulus and flick the feet as a painful stimulus.
Which of the following is the most reliable means of determining whether a patient has any immediately life-threatening conditions?
Systematic approach to assessment
In the primary assessment, which of the following is NOT an acceptable method of assessing the patient's circulatory status?
Taking a blood pressure reading
In EMS, which of the following BEST describes the term intervention?
Taking steps to correct a problem
Which of the following situations shows the mnemonic AVPU in action?
The EMT determines that the patient is awake and can answer questions correctly.
Which of the following differences should be expected when assessing a pediatric patient, as compared to the adult patient?
The normal respiratory rate is faster.
Which of the following is a good indication of an occluded airway?
The patient has snoring respirations.
A 13-year-old male has crashed an ATV. He was not wearing a helmet and was found unconscious. His airway is patent and is breathing adequately, but you hear rales in his chest and diminished lung sounds in his right chest. You assess this patient's priority for transport as high. What is one reason?
The patient is unconscious.
During your assessment of a patient who is suspected of having had a stroke, you have to pinch his nail beds for him to respond. Which of the following would best categorize this patient's mental status?
The patient responds to painful stimuli.
Which of the following is true concerning the primary assessment?
The primary assessment begins as soon as the EMT can observe the patient.
Which of the following is the purpose of the primary assessment?
To detect and treat immediately life-threatening problems
Your patient is a 42-year-old woman who fell two feet from a ladder and is complaining of pain in her ankle. Which of the following are you unable to determine from the information given?
Transport priority
Which of the following questions will MOST likely elicit your patient's chief complaint?
What made you call 911 this evening?
A patient whose mental status can be described as verbal is:
a patient that responds to speaking or shouting by opening the eyes.
A sign of lifelessness that would indicate going directly to a pulse check and the C-A-B approach is:
agonal breathing
The "A" in ABCs is:
airway.
At a glance when developing your general impression of a patient, you can see that a patient is:
apparently lifeless.
A 40-year-old male has crashed his motorcycle. Your general impression identifies that he is unconscious and that he has spurting blood pouring out of the junction between his leg and his groin. You also hear gurgling respirations. You should FIRST:
apply direct pressure to the bleeding wound.
You are approaching a young adult male lying supine on the ground with his eyes closed. You should FIRST:
ask him if he is okay.
A 66-year-old female has been found apneic and pulseless. You should immediately:
begin chest compressions.
As you interview a patient with a medical complaint, the reason why the ambulance was called is often referred to as the:
chief complaint.
You are approaching a 16-year-old male with bright red spurting blood coming from his leg. He is screaming, and he begs you to help him. You should FIRST:
control the bleeding.
The expected response of an infant to a verbal stimulus involving a shout or the painful stimulus of flicking the infant's feet is:
crying.
You are called to a scene of a fall and find the patient unconscious with a twisted leg. A general impression of this patient would be:
deciding that the patient's fall was severe and injured the patient's leg.
During the primary assessment, an example of a life threat to circulation that must be managed right away would be:
external arterial bleeding.
A 45-year-old female is found unconscious. She is not breathing but has a pulse. You should NEXT:
initiate positive pressure ventilations.
The primary assessment:
is the first step in the total assessment of a patient.
During the primary assessment, you would focus exclusively on:
life threats.
You find a middle-aged unresponsive man lying prone on the ground near a ladder. You should FIRST:
manually immobilize his head and neck.
Your partner is assessing a 55-year-old man who was found sitting on the tailgate of his truck after being involved in a motor vehicle collision. You should FIRST:
manually immobilize the cervical spine.
You are approaching an adult female lying supine on the ground with snoring respirations. You should FIRST:
open her airway with a jaw-thrust maneuver.
Which of the following phases of patient interaction is MOST likely the phase in which the EMT will discover and deal with life-threatening problems?
primary assessment
You enter a room to find a 16-year-old female sitting upright in a chair with her back straight, leaning forward, and her arms supporting her. She is having a hard time talking to you. You should suspect:
respiratory distress.
A patient's level of responsiveness is that patient's mental:
status.
During your primary assessment, you note blood in the patient's mouth and hear gurgling. You should NEXT:
suction the airway and clear any secretions.
You find a teenage male lying supine in his bedroom. You hear gurgling sounds from the patient's mouth and see vomit with pill fragments on the floor. You should FIRST:
suction the airway.
A 56-year-old male has fallen off a 12-foot ladder. After ensuring scene safety and completing the scene size-up, you should NEXT:
take manual cervical spine precautions.
A patient's chief complaint is:
the reason EMS was summoned.
A 25-year-old male was shot in the leg. He has visibly lost a lot of blood, and when assessing this patient's circulation, you determine that this patient has life-threatening bleeding. You should control the bleeding and:
treat for shock.
A 58-year-old male crashed his vehicle at high speed. He was not wearing his seatbelt and has a deep laceration on his forehead and neck pain. It is not clear whether there was a period of unconsciousness before your arrival on the scene. You decide that because of the potential for loss of consciousness from a head injury and the significant MOI, this patient is a high priority and should go to the trauma center. This decision reflects your clinical judgment, which is based on:
your experience in observing and treating patients.
Which of the following would be the BEST method to open the airway on an unresponsive trauma patient?
Jaw-thrust maneuver
Which of the following findings is generally NOT used to assess an adult's circulation?
Patient's capillary refill time
For which of the following patients would capillary refill be a reliable sign of circulatory status?
3-year-old child with a fever and cough
Which of the following acronyms may be used in assessing the patient's level of consciousness?
AVPU
Which of the following patients is a high priority for transport?
Adult male with difficulty breathing
An EMT develops a suspicion that a patient is in shock while developing a general impression of the patient. What signs has the EMT likely seen?
Anxiety, pallor, sweatiness
Your patient is a 72-year-old female who has "twisted her ankle" coming down some steps. She is alert and complaining of pain in her right ankle, but she jokes about her "clumsiness." Which of the following should you do next?
Ask if the patient has pain anywhere besides her ankle.
During the primary assessment of a responsive adult patient, where should the pulse be checked?
At the radial artery