Patient assessment

You respond to the residence of a 62-year-old male who is unresponsive. Your primary assessment reveals that he is apneic and pulseless. You should: Select one: • A. perform CPR and transport the patient immediately. - B. start CPR and attach the AED as soon as possible. - C. ask the family if the patient has a terminal disease. - D. notify dispatch and request a paramedic ambulance.

- B. start CPR and attach the AED as soon as possible.

Which of the following scenarios does NOT involve the presence of any symptoms? Select one: A. A 44-year-old male with abdominal pain and severe dizziness B. A 49-year-old female with blurred vision and ringing in the ears • C A 61-year-old female who is unconscious with facial cyanosis D A 55-year-old male with a severe headache and 2 days of nausea

A 61-year-old female who is unconscious with facial cyanosis

Which of the following pupillary changes would indicate depressed brain function? Select one: A. Both pupils are sluggish with introduction of a bright light. B. Both pupils react briskly to light instead of sluggishly. C. Both pupils dilate when a bright light is removed. D. Both pupils constrict when a bright light is introduced.

A. Both pupils are sluggish with introduction of a bright light.

When approaching a 32-year-old male who is complaining of traumatic neck pain, you should: Select one: A. ensure that the patient can see you approaching him. B. assess his mental status by having him move his head. C. stand behind him and immediately stabilize his head. D. approach him from behind and ask him not to move.

A. ensure that the patient can see you approaching him.

The goal of the systematic head-to-toe exam that is performed during the secondary assessment is to: Select one: A. locate injuries not found in the primary assessment. B. assess only the parts of the body that are injured. • C. detect and treat all non-life-threatening injuries. D. definitively rule out significant internal injuries.

A. locate injuries not found in the primary assessment.

After performing a head tilt-chin lift maneuver to open the airway of an unresponsive patient who has a pulse, you should: Select one: A. suction as needed and insert an airway adjunct. B. provide positive-pressure ventilatory assistance. C. assess respiratory rate, depth, and regularity. D. place him or her in the recovery position.

A. suction as needed and insert an airway adjunct.

Which of the following questions is used to determine a patient's chief complaint? Select one: A. "What seems to be the matter?" B. "When did the chest pain begin?" C. "Do you have a history of diabetes?" D. "Are you having trouble breathing?"

A. "What seems to be the matter?"

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. Select one: A. 60, 100 B. 50, 110 C. 30, 130 D. 40, 120

A. 60, 100

Which of the following conditions would be LEAST likely to cause an altered level of consciousness? Select one: A. Acute anxiety B. Inadequate perfusion • C. Drug overdose D. Poisoning

A. Acute anxiety

When you use the palpation method to obtain a blood pressure, the measurement you obtain is the: Select one: A. systolic blood pressure. • B. cardiac output pressure. C. pulse pressure. D. diastolic blood pressure.

A. systolic blood pressure.

When evaluating a patient with multiple complaints, the EMT's responsibility is to: Select one: A.determine which complaint poses the greatest threat to the patient's life. B.definitively rule out serious causes of each of the patient's complaints. C.direct his or her attention to the most obvious signs and symptoms. D.assess each complaint based on the patient's perception of its seriousness.

A.determine which complaint poses the greatest threat to the patient's life.

A palpable pulse is created by: Select one: A.pressure waves through the arteries caused by cardiac contraction. B.the pressure that is caused when venous blood returns to the heart. C. the pressure of circulating blood against the walls of the veins. D. electrical conduction in the heart producing contraction of the atria.

A.pressure waves through the arteries caused by cardiac contraction.

Which of the following is the MOST effective method of assessing the quality of air movement in the lungs? Select one: A. Auscultating breath sounds with a stethoscope B. Looking for the presence of accessory muscle use C. Evaluating the patient's chest for cyanosis D Applying a pulse oximeter and monitoring the SpO2

Auscultating breath sounds with a stethoscope

When assessing a 62-year-old female with crushing chest pain, you note that her pulse is rapid and irregular. You should administer supplemental oxygen if needed and then: Select one: A. document your findings and perform a detailed assessment. B. transport at once and consider requesting a paramedic unit. C conclude that the irregular pulse is normal based on her age. D. apply the AED and analyze her cardiac rhythm.

B. transport at once and consider requesting a paramedic unit.

The rapid exam of a patient that occurs following the primary assessment should take no longer than: Select one: A. 120 seconds. B. 90 seconds. C. 60 seconds. D. 30 seconds.

B. 90 seconds.

When should you take standard precautions during an EMS call? Select one: A. Before you load the patient into the ambulance. B. Before exiting the ambulance and before actual patient contact. C. Immediately after completion of your primary assessment. D After it has been determined that the patient is bleeding.

B. Before exiting the ambulance and before actual patient contact.

You are dispatched to the county jail for an inmate who is "sick." When you arrive, you find the patient, a 33-year-old male, unresponsive. His airway is patent, and his respirations are rapid and shallow. Your initial action should be to: Select one: A. apply a pulse oximeter. B. assist his ventilations. C. assess his blood pressure. D. request a paramedic unit.

B. assist his ventilations.

When you inspect a patient's pupils with a penlight, the pupils should normally react to the light by: Select one: A. dilating. B. constricting. C. fluttering. D. enlarging.

B. constricting.

You respond to a call for a female pedestrian who has been struck by a car. As your partner maintains manual stabilization of her head, you perform a primary assessment. She is unconscious, has ineffective breathing, and has bloody secretions in her mouth. You should: Select one: A. assess the rate and quality of her pulse. B. immediately suction her oropharynx. C.assist her breathing with a bag-valve mask. D. quickly insert an oropharyngeal airway.

B. immediately suction her oropharynx.

A decrease in blood pressure may indicate: Select one: A. increased blood volume. B. loss of vascular tone. C. arterial constriction. D. forceful cardiac contraction.

B. loss of vascular tone.

A 50-year-old male presents with altered mental status. His wife tells you that he had a "small stroke" 3 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: Select one: A. perform a head-to-toe assessment. B. prepare for immediate transport. C. inquire about his family history. D. repeat the primary assessment.

B. prepare for immediate transport.

A properly sized blood pressure cuff should cover: Select one: A.the entire upper arm between the armpit and the crease at the elbow. B.two thirds the length from the armpit to the crease at the elbow. C.one half the length between the armpit and the crease at the elbow. D.one third the length from the armpit to the crease at the elbow.

B.two thirds the length from the armpit to the crease at the elbow.

Which of the following patients has signs of an altered mental status? Select one: A. A diabetic who has nausea and severe lightheadedness B. A patient who overdosed and tells you he tried to kill himself C. A patient with a head injury who is slow to answer questions D. A patient with an acute allergic reaction and dizziness

C. A patient with a head injury who is slow to answer questions

The goal of the primary assessment is to: Select one: A. determine the need to perform a head-to- toe assessment. • B. identify and rapidly treat all life- threatening conditions. C. identify patients that require transport to a trauma center. D. determine if the patient's problem is medical or traumatic.

C. identify patients that require transport to a trauma center.

A 40-year-old male crashed his motorcycle into a tree. He is semiconscious, has snoring respirations, and has a laceration to the forearm with minimal bleeding. You should: Select one: A. apply a cervical collar and suction his airway. B. tilt the patient's head back and lift up on his chin. C. open his airway with the jaw-thrust maneuver. D. apply a pressure dressing to the patient's arm.

C. open his airway with the jaw-thrust maneuver.

During the primary assessment, circulation is evaluated by assessing: Select one: A. blood pressure, pulse rate, and external bleeding. B external bleeding, skin condition, and capillary refill. C. pulse quality, external bleeding, and skin condition. D. skin quality, blood pressure, and capillary refill.

C. pulse quality, external bleeding, and skin condition.

What part of the patient assessment process focuses on obtaining additional information about the patient's chief complaint and any medical problems he or she may have? Select one: A. Primary assessment B. Secondary assessment C. History taking D. General impression

C. History taking

Capnography is used to: Select one: A. trend a patient's blood pressure and assess for shock. B. assess how much oxygen is reaching the body's tissues. • C. determine how much carbon dioxide is being exhaled. D. assess how much oxygen is bound to the hemoglobin.

C. determine how much carbon dioxide is being exhaled.

The systematic head-to-toe assessment should be performed on: Select one: - A responsive medical patients and patients without a significant MOI. B. stable patients who are able to tell you exactly what happened. • C. patients with a significant MOl and unresponsive medical patients. D. all patients with traumatic injuries who will require EMS transport.

C. patients with a significant MOl and unresponsive medical patients.

If a patient develops difficulty breathing after your primary assessment, you should immediately: Select one: A. auscultate his or her breath sounds. B. determine his or her respiratory rate. C. reevaluate his or her airway status. D. begin assisting his or her breathing.

C. reevaluate his or her airway status.

A patient who moves and cries out only when you pinch his or her trapezius muscle is said to be: Select one: A. conscious and alert. B. completely unresponsive. C. responsive to painful stimuli. D. responsive to verbal stimuli.

C. responsive to painful stimuli.

When you use the palpation method to obtain a blood pressure, the measurement you obtain is the: Select one: A. cardiac output pressure. B. pulse pressure. C. systolic blood pressure. D. diastolic blood pressure.

C. systolic blood pressure.

While evaluating a patient with chest pain, your partner tells you that the patient's blood pressure is 140/94 mm Hg. The lower number represents the pressure from the: Select one: A. atria relaxing. B. atria contracting. C. ventricles relaxing. D. ventricles contracting.

C. ventricles relaxing.

A patient with spontaneous respirations is breathing: Select one: • A. without difficulty. B. at a normal rate. C. without assistance. D. with shallow depth.

C. without assistance.

When palpating the carotid pulse of a responsive patient, you should: Select one: A. firmly compress the artery because the pulse is often weak. B avoid gentle pressure so that weak pulses can be detected. C. avoid compressing both carotid arteries simultaneously. D. ensure that his or her head is in a hyperextended position.

C.avoid compressing both carotid arteries simultaneously.

An adult patient who is NOT experiencing difficulty breathing will: Select one: A.assume a position that will facilitate effective and easy breathing. B.exhibit an indentation above the clavicles and in between the ribs. C.be able to speak in complete sentences without unusual pauses. D.have a respiratory rate that is between 20 and 24 breaths/min.

C.be able to speak in complete sentences without unusual pauses.

The diastolic blood pressure represents the: Select one: A.increased arterial pressure that occurs during ventricular contraction. B.average pressure against the arterial walls during a cardiac cycle. C.minimum amount of pressure that is always present in the arteries. D.difference in pressure between ventricular contraction and relaxation.

C.minimum amount of pressure that is always present in the arteries.

When interviewing a patient, you can show him or her that you understand the situation by: Select one: A. interrupting him or her as needed for clarification. B. using medical terminology whenever possible. C. repeating statements back to him or her. D. maintaining constant eye contact with him or her.

C.repeating statements back to him or her.

Which of the following scenarios does NOT involve the presence of any symptoms? Select one: A. A 44-year-old male with abdominal pain and severe dizziness B. A 55-year-old male with a severe headache and 2 days of nausea C. A 49-year-old female with blurred vision and ringing in the ears D. A 61-year-old female who is unconscious with facial cyanosis

D. A 61-year-old female who is unconscious with facial cyanosis

An adult patient who is NOT experiencing difficulty breathing will: Select one: A. have a respiratory rate that is between 20 and 24 breaths/min. B. assume a position that will facilitate effective and easy breathing. C. exhibit an indentation above the clavicles and in between the ribs. D. be able to speak in complete sentences without unusual pauses.

D. be able to speak in complete sentences without unusual pauses.

When palpating a patient's pulse, you note that it is grossly irregular. You should: Select one: A. count the number of pulsations in 30 seconds and multiply by two. B. count the pulse rate for a full minute to obtain an accurate reading. C. count the number of pulsations in 15 seconds and multiply by four. D. count the pulse rate for at least 30 seconds to ensure accuracy.

D. count the pulse rate for at least 30 seconds to ensure accuracy.

The MOST effective way to determine whether your patient's problem is medical or traumatic in origin is to: Select one: A. take note of the patient's general appearance. B. ask if bystanders are familiar with the patient. C establish the patient's medical history early. D. perform a careful and thorough assessment.

D. perform a careful and thorough assessment.

You respond to the scene of a motor vehicle collision. Upon arrival, you find the driver, a young female, sitting on the curb. She is confused; is in obvious respiratory distress; and has pale, moist skin. As your partner manually stabilizes her head, you perform a primary assessment. After performing any immediate life-saving treatment, you should: Select one: A identify the specific areas of her injuries and focus your assessment on those areas. B. fully immobilize her spine, load her into the ambulance, and assess her vital signs. C. assess her vital signs, secure her to a backboard, and transport her immediately. D. perform a detailed head-to-toe exam and prepare for immediate transport.

D. perform a detailed head-to-toe exam and prepare for immediate transport.

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: Select one: A. direct your partner to move the gun to a safe area and then advise the patient that his weapon has been secured. B immediately cease all patient care, carefully back out of the residence, and request law enforcement assistance. C. document the presence of the weapon, including its specific location, and continue your assessment of the patient. D. position yourself in between the patient and the gun and ask your partner to request law enforcement assistance.

D. position yourself in between the patient and the gun and ask your partner to request law enforcement assistance.

When you assess capillary refill time in an infant, normal color to the tested area should return within: Select one: • A. 3 seconds. B. 4 seconds. C. 1 second. D. 2 seconds.

D. 2 seconds.

Which of the following would the EMT likely NOT perform on a responsive patient with a headache and no apparent life-threatening conditions? Select one: A. Assessment of oxygen saturation B. Focused secondary assessment C.Noninvasive blood pressure monitoring D. Systematic head-to-toe examination

D. Systematic head-to-toe examination

An elderly patient has fallen and hit her head. You assess her level of consciousness as unresponsive using the AVPU scale. Your initial care should focus on: Select one: A. gathering medical history data. B. obtaining baseline vital signs. C. providing immediate transport. D. airway, breathing, and circulation.

D. airway, breathing, and circulation.

When assessing the skin of an unresponsive patient, you note that it has a bluish tint to it. This finding is called: Select one: A. pallor. B. mottling. C. flushing. D. cyanosis.

D. cyanosis.

If you cannot palpate a pulse in an unresponsive patient whose collapse was not witnessed, you should: Select one: A. apply an AED at once. B. assess for adequate breathing. C. palpate at another pulse site. D. immediately begin CPR.

D. immediately begin CPR.

In responsive patients who are older than 1 year of age, you should palpate the pulse at the artery. Select one: A. carotid B. femoral • C. brachial D. radial

D. radial

The "Golden Hour" begins when an injury occurs and ends when: Select one: A. you arrive at the emergency department. B. the patient is admitted to the ICU. C. you depart the scene for the hospital. D. the patient receives definitive care.

D. the patient receives definitive care.

When assessing motor function in a conscious patient's lower extremities, you should expect the patient to: Select one: A. feel you touching the extremity. B. note any changes in temperature. C. identify different types of stimuli. D. wiggle his or her toes on command.

D. wiggle his or her toes on command.

Which of the following abnormal breath sounds indicates obstruction of the upper airway? Select one: • A. Rhonchi B. Crackles C. Rales • D. Stridor

D.Stridor

Which of the following MOST accurately describes paradoxical movement of the chest wall? Select one: • A. Only one section of the chest rises on inspiration, while another area falls B. Multiple rib fractures that cause a marked deformity of the chest wall C A marked decrease in chest wall movement due to abdominal breathing D. One side of the chest wall moves opposite the direction of the other

Only one section of the chest rises on inspiration, while another area falls

When palpating the carotid pulse of a responsive patient, you should: Select one: A. avoid compressing both carotid arteries simultaneously. B. ensure that his or her head is in a hyperextended position. C. firmly compress the artery because the pulse is often weak. D. avoid gentle pressure so that weak pulses can be detected.

avoid compressing both carotid arteries simultaneously.

After performing a primary assessment, a rapid exam of the body should be performed to: Select one: A. look specifically for signs and symptoms of inadequate perfusion. B. determine the need for spinal motion restriction precautions. C. identity less-obvious injuries that require immediate treatment. D. find and treat injuries or conditions that do not pose a threat to life.

c. Identity less-obvious injuries that require immediate treatment.

A blood pressure cuff that is too small for a patient's arm will give a: Select one: A. falsely low systolic and diastolic reading. B. falsely high systolic but low diastolic reading. C. falsely low systolic but high diastolic reading. D. falsely high systolic and diastolic reading.

falsely high systolic and diastolic reading.

You should suspect that a patient is experiencing respiratory failure if he or she: Select one: A. is restless and is working hard to breathe. B. is anxious, tachycardic, and leaning forward. C. has an increased heart rate and retractions. D. has bradycardia and diminished muscle tone.

has bradycardia and diminished muscle tone.

As time progresses following a significant injury: Select one: A. the patient's injuries will most likely be irreparable. B. the body's ability to compensate for shock decreases. C. the patient's blood pressure elevates significantly. D most patients will die secondary to internal bleeding.

the body's ability to compensate for shock decreases.

Supplemental oxygen without assisted ventilation would MOST likely be administered to patients: Select one: A. with difficulty breathing and adequate tidal volume. B. with rapid respirations and a reduced tidal volume. C. who have accessory muscle use and slow breathing. - D. who are semiconscious with shallow respirations.

with difficulty breathing and adequate tidal volume.

A 29-year-old male with a 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 his extremities on command. His Glasgow Coma Scale (GCS) score is: Select one: • A. 13. B. 10. C. 14. D. 12.

• A. 13.

During a 30-minute transport of a stable patient, you should reassess him or her at least times. Select one: • A. 2 B. 6 C. 4 D. 3

• A. 2

A patient in unstable condition should be reassessed at least every: Select one: • A. 5 minutes. B. 10 minutes. • C. 20 minutes. • D. 15 minutes.

• A. 5 minutes.

For an adult, the normal resting pulse should be between: Select one: • A. 60 and 100 beats/min. B. 50 and 60 beats/min. C. 100 and 110 beats/min. • D. 40 and 50 beats/min.

• A. 60 and 100 beats/min.

Which of the following findings indicates that your patient has a patent airway? Select one: • A. Ability to speak B. Unresponsiveness C. Audible breathing • D. Inspiratory stridor

• A. Ability to speak

Which of the following assessments would be the MOST useful in determining the possible cause of a patient's altered mental status? Select one: • A. Blood glucose level B. Capillary refill time C. Blood pressure D. Respiratory rate

• A. Blood glucose level

Which of the following occurs when a patient's respirations are shallow? Select one: • A. Tidal volume is markedly reduced. B. Oxygenation occurs more efficiently. C. Carbon dioxide elimination is increased. • D. Chest rise will be easily noticeable.

• A. Tidal volume is markedly reduced.

A patient's short-term memory is MOST likely intact if they correctly answer questions regarding: Select one: • A. day and event. B. time and place. C. event and person. D. person and place.

• A. day and event.

Cyanosis of the skin is caused by: Select one: • A. decreased blood oxygen. B. increased blood oxygen. C. peripheral vasodilation. D. venous vasoconstriction.

• A. decreased blood oxygen.

As you assess the head of a patient with a suspected spinal injury, your partner should: Select one: • A. maintain stabilization of the head. B. prepare the immobilization equipment. C. look in the ears for gross bleeding. D. assess the rest of the body for bleeding.

• A. maintain stabilization of the head.

Normal skin color, temperature, and condition should be: Select one: • A. pink, warm, and dry. B. flushed, cool, and dry. C. pale, cool, and moist. D. pink, warm, and moist.

• A. pink, warm, and dry.

Which of the following medical history questions would be of LEAST pertinence in an acute situation? Select one: A. "Does the pain stay in your chest?" • B. "Does your mother have diabetes? C. "Has this ever happened to you before?" D."Are there medications that you cannot take?"

• B. "Does your mother have diabetes?

Which of the following is an example of a symptom? Select one: • A. Tachycardia • B. Headache C. Hypertension D. Cyanosis

• B. Headache

Treatment and transport priorities at the scene of a mass-casualty incident should be determined after: Select one: A. area hospitals have been notified. • B. all the patients have been triaged. C. a physician arrives at the scene. D. medical control has been contacted.

• B. all the patients have been triaged.

When you shine a light into one pupil, the normal reaction of the other pupil should be to: Select one: A. become larger. • B. become smaller. C. dilate. • D. not react.

• B. become smaller.

Upon arriving at a potentially unsafe scene, you should first: Select one: A. move the patient to safety. • B. ensure that you are safe. C. remove all bystanders. • D. request another ambulance

• B. ensure that you are safe.

A patient is sitting in a chair, leaning forward on his outstretched arms. His head and chin are thrust forward. This position indicates that he: Select one: A. has a decreased level of consciousness. • B. is experiencing difficulty breathing. C. has abdominal muscle spasms. D. is experiencing severe back pain.

• B. is experiencing difficulty breathing.

Clinical signs of labored breathing include all of the following, EXCEPT: Select one: • A. use of accessory muscles. • B. shallow chest movement. C. gasping attempts to breathe. D. supraclavicular retractions.

• B. shallow chest movement.

When assessing a patient's abdomen, you will evaluate for all of the following, EXCEPT: Select one: A. gross bleeding and tenderness. • B. subcutaneous emphysema. • C. open wounds or eviscerations. D. rigidity and obvious bleeding.

• B. subcutaneous emphysema.

The goal of the systematic head-to-toe exam that is performed during the secondary assessment is to: Select one: A detect and treat all non-life-threatening injuries. B. assess only the parts of the body that are injured. • C. locate injuries not found in the primary assessment. D. definitively rule out significant internal injuries.

• C. locate injuries not found in the primary assessment.

Which of the following factors would MOST likely cause a patient's pulse rate to be slower than normal? Select one: A. Anxiety or severe stress B. Internal bleeding from trauma • C. Beta blocker medications D. Lack of a regular exercise routine

• C. Beta blocker medications

Which of the following signs of respiratory distress is usually observed only in pediatric patients? Select one: A. Pursed-lip breathing B. Rapid respirations • C. Seesaw breathing D. Accessory muscle use

• C. Seesaw breathing

Which of the following abnormal breath sounds indicates obstruction of the upper airway? Select one: • A. Rhonchi B. Rales • C. Stridor • D. Crackles

• C. Stridor

Pain that moves from its point of origin to another body location is said to be: Select one: • A. palliating. B. provoking. • C. radiating. • D. referred.

• C. radiating.

When palpating a patient's pulse, you note that there is a short interval between pulsations. This indicates that the pulse is: Select one: A. irregular. B. slow. • C. rapid. D. thready.

• C. rapid.

When performing a reassessment of your patient, you should first: Select one: • A. obtain updated vital signs. B. confirm medical history findings. • C. repeat the primary assessment. D. reassess your interventions

• C. repeat the primary assessment.

The goal of oxygenation for most patients is an oxygen saturation of: Select one: A. 100% B. 88% to 90% C. 90% to 94% • D. 94% to 99%

• D. 94% to 99%

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, is screaming in pain, and is attempting to control the bleeding, which is bright red and spurting from his groin area. You should: Select one: A. elevate his legs and keep him warm. B. administer 100% supplemental oxygen. C. ensure that his airway is patent. • D. apply direct pressure to the wound.

• D. apply direct pressure to the wound.

In infants and small children, skin color should be assessed on the: Select one: • A. forehead. B. underside of the arms. C. chest and abdomen. • D. palms and soles

• D. palms and soles

The pulse oximeter is an assessment tool used to evaluate the: Select one: • A. amount of exhaled carbon dioxide. • B. level of carbon dioxide. C. quantity of red blood cells. • D. saturation level of arterial blood.

• D. saturation level of arterial blood.

You should avoid palpating a patient's pelvis if: Select one: A. the MOI suggests trauma to the pelvis. B. the patient is older than 50 years of age. C. the pelvis does not appear deformed. • D. the patient complains of pelvic pain.

• D. the patient complains of pelvic pain.