Chapter 9 Patient assessment
Which of the following patient responses would establish the "E" in the SAMPLE History?
"I was mowing the lawn when the pain began"
A 29 year old male with head injury opens his eyes when you speak to him, is confused as to the time and date and is able to move all of the extremities on command. His Glasgow Coma Scale score is
13
During a 30-minute transport of a stable patient, you should reassess him or her at least ________ times.
2
When you assess capillary refill time in an infant, normal color to the tested area should return within
2 seconds
Normal respiratory rates should not exceed ______ breaths per minute in toddlers and ______ breaths per minute in infants
40,60
The rapid exam of a patient that occurs following the primary assessment should take no longer than
60 to 90 seconds
In the adult, bradycardia is defined as a pulse rate less than _____ beats/min and tachycardia is defined as a heart rate greater than ______ beats/min
60, 100
Which of the following does NOT involve the presence of any symptoms?
A 61 year old female who is unconscious with facial cyanosis
which of the following conditions would be LEAST likely to cause an altered level of consciousness
Acute anxiety
Which of the following assessments would be the most useful in determining the possible cause of patient's altered mental status.
Blood glucose level
Which of the following statements regarding the blood pressure is correct?
Blood pressure is usually not measured in children younger than 3 years of age
A 71 year old female slipped on a rug and fell. She is conscious and alert and complains of sever pelvic pain. Her respirations are 22 breaths/min with adequate depth and her heart rate is 120 beats/min. Which of the following is NOT indicated for this patent.
Gentle Palpation of the pelvis
Which of the following questions would you ask a patient to ascertain the "M" in the SAMPLE history?
How much tylenol do you take each day?
Upon arriving at the scene of a patient with difficulty breathing, you determine that the scene is safe. You enter the residence and find the patient sitting in a chair in respiratory distress. Your first action should be to
Introduce yourself to the patient
Which of the following statements regarding stridor is correct
It is a high pitched, crowing airway sound
Which of the following statements regarding stridor is correct?
It is a high pitched, crowing upper airway sound
What maneuver should be used to open the airway of an unresponsive patient with suspected trauma?
Jaw thrust maneuver
A decrease in blood pressure may indicate
Loss of vascular tone
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 verbal response, and a score of 4 for motor response. which of the following clinical findings is consistent with his GCS score
Opens eyes inresponse to pain, uses inappropriate words, withdraws from pain
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?
Position your in between the patient and the gun and ask your partner to request law enforcement assistance.
When performing a rapid exam on a supine patient, what part of the body is typically assessed last
Posterior
When palpating a patient's pulse, you note that there is a short interval between pulsations. This indicates that the pulse is:
Rapid
Which of the following actions would NOT be performed during the scene size up
Rapidly assessing a patients respiratory status
Which of the following signs of respiratory distress is seen MOST commonly in pediatricg patients
Seesaw breathing
Which of the following statements regarding the mechanism of injury is correct
The MOI may allow you to predict the severity of a patients injuries
The "Golden Hour" begins when an injury occurs and ends when:
The patient receives definitive care
Which of the following statements regarding the secondary assessment is correct?
The secondary assesment should focus on a certain area or region of the body as determined by the chief complaint
while evaluating a patient with chest pain, your partner tel you that the patient's blood pressure is 140/94 mm hg. The lower number represents the pressure from the:
Ventricles relaxing
In which of the following situations is a pertinent negative identified?
a 59 year old man complains of crushing chest pain but denies shortness of breath
An elderly patient has fallen and hit her head, Your initial care should focus on
airway, breathing and circulation
Treatment and transport priorities at the scene of a mass casualty incident should be determined after
all the patients have been triaged
Palliating factors regarding a patient's pain involve those that
alleviate the pain
When using the pulse oximeter as part of your assessment of a patient, it is important to remember that
any situation that causes vasocontriction or loss of red blood cells, such as anemia or bleeding, may result in an inaccurate or misleading value
A 39 year old male sustained a stab wound to the groin during an altercation at a bar. As you approach the patient, you note that he is conscious. He is screaming in pain and is attempting to control the bleeding, which is bright red and squirting from his groin area. You should:
apply direct pressure to the wound
Poor peripheral circulation will cause the skin to appear
ashen
You receive a call to a daycare center for an unresponsice 8 month old infant. Upon arrival, you preform an assment and determine that the infant is not breathing Your next action should be
assess for bronchial pulse for 5 to 10 seconds
Which of the following is the most effective method of assessing the quality of air movement in lungs?
auscultating breath sounds with a stethoscope
When palpating the carotid pulse of a responsive patient, you should
avoid compressing both carotid arteries simultaneously
An adult patient who is NOT experiencing difficulty breathing will
be able to speak in complete sentences without unusual pauses
when you shine a light into one pupil, the normal reaction of the other pupil should be to
become smaller
During an EMS call, you should take standard precautions
before exiting the ambulance and before actual patient contact
Which of the following factors would most likely cause a patent's pulse rate to be slower than normal
beta blocker medication
When performing the secondary assessment on a trauma patient, you note the presence of battle sign. This is defined as:
bruising behind the ear
When you inspect a patient's pupils with a penlight, the pupils should normally react to the light by:
constricting
When palpating a patient's pulse, you note that it is grossly irregular. You should
count the pulse rate for a full minute to obtain an accurate reading
When assessing the skin of an unresponsive patient, you note that it has bluish tint to it the findings is called:
cyanosis
A patient's short term memory is MOST likely intact if her or she correctly answers questions regarding
date and event
Capnography is used to
determine how much carbon dioxide is being exhaled.
A patient with profuse sweating is referred to as being
diaphoretic
A patient with profuse sweating is referred to as being:
diaphoretic
When approaching a 32 year old male who is complaining of traumatic neck pain, you should
ensure that the patient can see you approaching him
Upon arriving at potentially unsafe scene, you should
ensure that you are safe
A blood pressure cluff that is too small for patient's arm will give a
falsely high systolic and diastolic reading
A patient with high blood pressure would be expected to have skin that is
flushed and red
Which of the following indicates that your patient has a patent airway
forceful coughing
You should suspect that a patient is experiencing respiratory failure if he or she
has bradycardia and diminished muscle tone
You should suspect that a patient is experiencing respiratory failure if her or she
has bradycardia and disminished muscle tone
After performing a primary assessment, a rapid exam of the body should be performed to
identify less obvious injuries that require immediate treatment
In patients with deeply pigmented skin, changed in color may be apparent only in certain areas, such as the
lips or oral mucosa
a 40 year old male present with pain to the right upper abdomen. He is conscious and alert with stable vital signs During the assessment, you note that his skin and sclera are jaundiced You should suspect
liver dysfunction
The goal of systematic head to toe exam that is performed during the secondary assesment is to
locate injuries not found in the primary assesment
A decrease in blood pressure may indicate
loss of vascular tone
a decrease in blood pressure may indicate
loss of vascular tone
As you assess the head of a patient with a suspect spinal injury, your partner should
maintain stabilization of the head
The diastolic blood pressure represents the
minimum amount of pressure that is always present in the arteries
The chief complaint is MOST accurately defined as the
most serious thing the patient is concerned about
The chief complaint is most accurately defined as the
most serious thing the patient is concerned about
Which of the following MOST accurately describes paradoxical movement of the chest wall
only one section the chest rises on inspiration while another area falls
With regard to the assessment of patient's cardiovascular status, capillary refill time is most reliable in
patients who are younger than 6 years of age
Normal skin color, temperature and condition should be
pink, warm and dry
Which of the following is the most accurate guide to palpating a pulse
place the tips of your index and long fingers over the pulse point
a 50 year old male presents with altered mental status. His wife tells you that he had a "small stoke" three years ago but has otherwise been in good health. The patient is responsive but unable to follow commands. After administering oxygen if needed, you should
prepare for immediate transport
The palpable pulse is created by
pressure waves through the arteries caused by cardiac contraction
You are dispatched to the county jail for an inmate who is "sick" when you arrive, you find the patient, a 33 year old, unresponsive, HIs airway is patent and his respirations are rapid and shallow, Your initial action should be to
provide assisted ventilation
If a patient develops difficulty breathing after your primary assessment, you should immediately
reevaulate his or her airway status
When interviewing a patient, you can show him or her you understand the situation by
repeating statements back to him or her
A patient who does not respond to your questions, but moves or cries out when his or her trapezius muscle is pinched, is said to be
responsive to painful stimuli
Which of the following situations or conditions warrants immediate transport
severe chest pain and cool, pale skin
which of the following situations or conditions warrants immediate transport
severe chest pain and cool, pale skin
Clinical signs of labored breathing include all the following, EXCEPT
shallow chest movements
Jugular venous distention suggests a problem with blood returning to the heart if the patient
sitting up at a 45 degree angle
You respond to the residence of a 62 year old man who is unresponsive. Your primary assessment reveals that he is apneic and pulseless You should
start CPR and attach the AED as soon as possible
When assessing a patient's abdomen, you will evaulate for all of the following EXCEPT
subcutaneous emphysema
After performing a head tilt chin lift maneuver to open the airway of an unresponsive patient who has a pulse you should
suction as needed and insert an airway adjuct
Which of the following would the EMT likely NOT perform on a responsive patient with a headache and no apparent life threatening conditions
systemic head to toe examination
When you use the palpation method to obtain a blood pressure, the measurement you obtain is the:
systolic blood pressure
The pressure exerted against the walls of the artery when the left ventricle contracts is called the
systolic pressure
As time progresses following a significant injury
the body's ability to compensate for shock decreases
You should gently palpate a patient's pelvis only if
the patient does not complain of pelvic pain
Reassessment is performed to determine all of the following, EXCEPT
the reason why the patient called EMS
When assessing a 62 year old female with crushing chest pain, you not that her pulse is rapid and irregular. You should administer supplemental oxygen if needed and then
transport at once and consider requesting a paramedic unit
a properly sized blood pressure cuff should cover
two length from the armpit to the crease at the elbow
When assessing motor funtion in a conscious patient's lower extremities, you should expect the patient to
wiggle his or her toes on command
Supplemental oxygen without assisted ventilation would MOST likely be administered to patients
with difficulty breathing and adequate tidal volume
A patient with spontaneous respirations is beathing
without assistance
