Ch. 9 Patient Assessment

In general, you should assess the blood pressure in all patients who are at least ____ years of age.

3

Based solely on the mechanism of injury, which of the following adult patients is at greatest risk for serious injuries?

4' 5" patient who fell 14'

During your assessment of a patient with closed head trauma, you note that he opens his eyes in response to pain, groans when you speak to him, and withdraws his shoulder when you pinch his earlobe. You should assign him a Glasgow Coma Scale score of:

8

In adult females and adolescents, systolic blood pressure is considered critically low when it is less _____ mm Hg or less.

80

A 40-year-old female complains of a sudden onset of chest pressure. When assessing the history of her present illness, which of the following patient responses would identify a palliating factor?

A. "The pressure seems to subside when I sit down."

In a responsive patient, capnography is used to:

A. determine the amount of carbon dioxide produced by aerobic metabolism

During your reassessment of a patient with an illness or injury, it is important to:

A. document any changes in his or her condition

Clues about the potential seriousness of your patient's injury or injuries are MOST reliably obtained by:

A. evaluating the mechanism of injury

All of the following conditions would require immediate transport after the primary assessment and treatment phase, EXCEPT:

A. headache without mental status change

A 70-year-old male tells you that he took three of his wife's nitroglycerin tablets for chest pain prior to calling EMS. This information is clinically important to you because it:

A. may have an effect on the treatment you provide

Determining the mechanism of injury will contribute to your decision of whether you should:

A. perform a rapid assessment or focused exam

Loud, high-pitched and hollow sounds auscultated over the manubrium are called:

Bronchial sounds

During your rapid trauma assessment (rapid body scan) of a man who sustained a gunshot wound to the chest, you note the presence of air under the skin. This clinical finding is referred to as subcutaneous:

Emphysema

A small truck slid off the road and struck a utility pole. The driver, a 40-year-old male, has only minor abrasions from the airbag. His 38-year-old wife was killed in the crash. After performing a primary assessment of the driver, you should:

Perform a rapid trauma assessment

A patient with congenital anisocoria would be expected to have pupils that:

Unequal in size

A 56-year-old female called EMS because of shortness of breath. During your assessment, she tells you that this began four days ago. Which of the following questions would be MOST appropriate to ask her regarding the duration of her chief complaint?

What prompted you to call EMS today?

Compared to the patient's chief complaint, the primary problem is:

What's actually wrong with the patient

A 39-year-old male complains of severe lower abdominal pain. His airway is patent and his respirations are eupneic. Assessment of his skin reveals that it is cool and clammy. You should:

administer supplemental oxygen.

A 30-year-old male was ejected from his car after hitting a tree at a high rate of speed. Your assessment reveals that he is pulseless, apneic, and has multiple systems trauma. Treatment for this patient includes all of the following, EXCEPT:

applying an AED and defibrillating if indicated.

A 63-year-old male is being transported to the hospital for an acute exacerbation of his emphysema. He is on oxygen via nasal cannula at 4 L/min. During your reassessment, you note that his mental status has deteriorated and his respirations have become markedly slow and shallow. You should:

assist his ventilations with a bag-mask device.

A 49-year-old male collapsed and is now unresponsive. There is no evidence of trauma. Your primary assessment reveals that he is pulseless and apneic. You should:

begin CPR and apply the AED as soon as it is available.

Law enforcement requests your assistance at a local nightclub for a patient who was assaulted. Upon arrival, an officer escorts you to the patient, a 21-year-old male, who is bleeding severely from a lacerated brachial artery. The patient is conscious and is screaming in pain. You should immediately:

control the bleeding with direct pressure.

A 30-year-old male presents with signs of shock. He is conscious but anxious, and is in no obvious respiratory distress. After applying oxygen, you attach a pulse oximeter, which reads 78%. This low oxygen saturation reading is MOST likely the result of:

decreased perfusion

A young male is found to be unconscious. When assessing his pupils, you note that they dilate when exposed to bright light. This clinical finding is MOST suggestive of:

depressed brain function

A 40-year-old female is unconscious following blunt trauma to the chest. During the rapid trauma assessment (rapid body scan), you auscultate the chest and hear rhonchi. This indicates:

fluid in the larger airways in the lungs.

Assessment of a patient's pelvis is appropriately performed by:

gently compressing it inward.

Following the primary assessment, the MOST appropriate order to proceed when treating a responsive medical patient is:

history of present illness, SAMPLE history, focused physical exam, baseline vital signs.

A 50-year-old male has fallen from a significant height. He is conscious and alert, but is unable to feel or move both of his lower extremities. This is MOST likely the result of:

injury to spinal cord

A 55-year-old male complains of severe pain to the right lower quadrant of his abdomen. During your assessment, you should first palpate the:

left upper quadrant

An electronic blood pressure cuff that measures readings using stepped deflation:

may be more accurate in patients who are moving because the pressure in the cuff is released in intervals at variable lengths, allowing the system to better detect oscillations.

A patient who coughs up thick yellow or green sputum:

most likely has an advanced respiratory infection.

During your assessment of a 33-year-old female with an altered mental status, you note a fruity odor on her breath. You should:

obtain a blood glucose reading.

Following the primary assessment, your actions prior to transport of a critically-injured patient should include:

rapid trauma assessment, spinal immobilization, vital signs.

A 60-year-old male complains of right upper quadrant abdominal pain and pain to his right shoulder. He denies pain in between his abdomen and shoulder. The patient's description of his pain describes:

referred pain.

During transport of a 34-year-old male with a possible femur fracture, you perform a reassessment. This process begins with:

repeating the primary assessment.

A patient who is in a tripod position is:

sitting and leaning forward on outstretched arms with the head and chin thrust slightly forward.

A restrained 19-year-old male was involved in a rollover motor-vehicle crash. With the exception of a small laceration to his forehead, he appears stable. When reconsidering the mechanism of injury, you should:

treat him for potentially life-threatening injuries.

All of the following elements are essential to the AEMT's critical-thinking ability, EXCEPT:

using extraneous data to formulate an appropriate patient care plan

During your secondary assessment of a 70-year-old male with congestive heart failure, you note the presence of 4+ pitting edema to his lower extremities. This means that:

you are able to make an indentation in the skin of greater than 1".