EMS Chapter 9
A normal respiratory rate for an adult is typically:
12-20 breaths per minute
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 Comas Scale (GCS) score is:
13
During a 30 minute transport of a stable patient, you should reassess him or her at least ____________ times.
2
When you access 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
For an adult the normal resting pulse should be between:
60 and 100 beats/min
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
The rapid exam of a patient that occurs following the primary assessment should take no longer than:
60-90 seconds
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
Which of the following scenarios does NOT involve the presence of any symptoms?
A 61-year-old female who is unconscious with facial cyanosis
Which of the following factors would MOST likely cause a patients pulse rate to be slower than normal?
Beta-blocker medications
Which of the assessments would be the MOST useful in determining the possible cause of a patients altered mental status?
Blood glucose level
For children younger than 1 year old, you should palpate the ______ artery when assessing the pulse.
Brachial
When assessing the skin of an unresponsive patient, you note that it has a bluish tint to it. This finding is called:
Cyanosis
An integral part of the rapid scan is evaluation using the mnemonic:
DCAP-BTLS
A patient's short term memory is MOST likely intact if he or she correctly answers questions regarding:
Date and Event
Which of the following medical history questions would be of least pertinence in an acute situation?
Does your mother have diabetes
A 71 year old female slipped on a rug and fell. She is conscious and alert and complains of severe 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 patient?
Gentle palpation of the pelvis
You should suspect that a patient is experiencing respiratory failure if he or she:
Has bradycardia and diminished muscle tone
Which of the following statements regarding stridor is correct?
High pitched crowing upper airway sound.
What part of the patient assessment process focuses on obtaining additional information about the patients chief complaint and any medical problems he or she may have?
History taking
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
Which of the following patients response would establish the "E" in the SAMPLE history?
I was mowing the lawn when the pain began
What maneuver should be used to open the airway of an unresponsive patient with suspected trauma?
Jaw thrust maneuver
The diastolic blood pressure represents the:
Minimum amount of the pressure that is always present in the arteries
Which of the following MOST accurately describes paradoxical movement of the chest wall?
Only one section of the chest rises on inspiration, while another area falls
An injured patient is assigned a total score of 9 on GCS. He is assigned a score of 2 for eye opening, a score of 3 for verbal response, and a score of 4 for motor response. Which of the following clinical findings is consistent with his GCS score?
Opens eyes in response to pain, uses inappropriate words, withdraws from pain
With regard to the assessment of a patient's cardiovascular status, capillary refill time is MOST reliable in:
Patients who are younger that 6 years of age
The systematic head to toe assessment should be performed on:
Patients with a significant MOI and unresponsive medical patients
________ is the circulation of blood within an organ or tissue.
Perfusion
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
When performing a rapid exam on a supine patient, what part of the body is typically assessed last?
Posterior
A palpable pulse is created by:
Pressure waves through the arteries caused by cardiac contraction
Which of the following situations or conditions warrants immediate transport?
Severe chest pain and cool, pale skin
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:
Start cpr and attach the AED as soon as possible
A brassy, crowing sound that is prominent on inspiration and suggests a mildly occluded airway is referred to as _________.
Stridor
Which of the following abnormal breath sounds indicates obstruction of the upper airway?
Stridor
When assessing patients abdomen, you will evaluate for all of the following, Except:
Subcutaneous emphysema
Which of the following would the EMT likely NOT perform on a responsive patient with a headache and no apparent life-threatening conditions?
Systematic head to toe examination
Which of the following statements regarding the mechanism of injury (MOI) is correct?
The MOI may allow you to predict the severity of a patients injuries
Which of the following statements regarding the blood pressure is correct?
The blood pressure is usually not measured in children younger than 3 years of age
Which of the following statements regarding the secondary assessment is correct?
The secondary assessment 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 tells you that the patient's blood pressure is 140/94 mm Hg. The lower number represents the pressure from the:
Ventricles relaxing
Which of the following questions is used to determine a patient's chief complaint?
What seems to be the matter?
Which of the following conditions would be LEAST likely to cause an altered level of consciousness?
acute anxiety
If a patient seems to develop difficulty breathing after your primary assessment, you should immediately reevaluate the _________.
airway
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 patients 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 vasoconstriction 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 spurting 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 unresponsive 8 month old infant. Upon arrival, you perform an assessment and determine that the infant is not breathing. Your next action should be to:
assess for a brachial pulse for 5 to 10 seconds
Which of the following is the MOST effective method of assessing the quality of air movement in the 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
With _______, the force of the injury over a broad area, and the skin is usually not broken.
blunt trauma
When auscultating the blood pressure in a patient's upper extremity, you should place the diaphragm (head) of the stethoscope over the _________ artery.
brachial
When performing the secondary assessment on a trauma patient, you note the presence of Battle sign. This is defined as:
bruising behind the ear
The reason a patient called for help
chief complaint
When you inspect a patients pupils with a penlight, the pupils should normally react to the light by:
constricting
When palpating a patients pulse, you note that it is grossly irregular. You should:
count the pulse rate for a full minute to obtain an accurate reading
When there are low levels of oxygen in the blood, the lips and mucous membranes appear blue or gray. This condition is called:
cyanosis
Cyanosis of the skin is caused by:
decreased blood oxygen
Capnography is used to:
determine how much carbon dioxide is being exhaled
The scene size-up consists of all of the following, EXCEPT:
determining level of responsiveness
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 a potentially unsafe scene, you should:
ensure that you are safe
A blood pressure cuff that is too small for a patients 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 findings indicates that your patient has a patent airway?
forceful coughing
Skin that is cool clammy and pale in your primary assessment typically indicates_________.
hypoperfusion
After performing a primary assessment, a rapid exam of the body should be performed to:
identify less-obvious injuries that require immediate treatment
If you cannot palpate a pulse in an unresponsive patient whose collapse was not witnessed, you should:
immediately begin CPR
When there are multiple patients, you should use the_________ to help organize the triage, logistics, and treatment of patients.
incident command system
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
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:
is experiencing difficulty breathing
In patients with deeply pigmented skin, changes in color may be apparent only in certain areas, such as the:
lips or oral mucosa
A 40-year old male presents with pain to the right upper quadrant of his abdomen. He is conscious and alert with stable vital signs. During your assessment, you note that his skin and sclera are jaundiced. You should suspect:
liver dysfunction
The goal of the systematic head to toe exam that is performed during the secondary assessment is to:
locate injuries not found in the primary assessment
A decrease in blood pressure may indicate:
loss of vascular tone
As you assess the head of a patient with a suspected spinal injury, your partner should:
maintain stabilization of the head
The best indicator of brain function is the patient's:
mental status
The chief complaint is MOST accurately defined as the:
most serious thing the patient is concerned about
A 40 year old male crashed his motorcycle into a tree. He is semiconscious, has snoring respirations and has a laceration to forearm with minimal bleeding. You should:
open his airway with the jaw thrust maneuver
The mental status of a patient
orientation
Normal skin color, temperature, and condition should be:
pink, warm, and dry.
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 yourself in between the patient and the gun and ask your partner to request law enforcement assistance
A 50 year old male presents with altered mental status. His wife tells you that he had a small stroke 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
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:
provide assisted ventilation
In responsive patients who are older than 1 year of age, you should palpate the pulse at the ______ artery.
radial
Pain that moves from its point of origin to another body location is said to be:
radiating
When palpating a patients 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
If a patient develops difficulty breathing after your primary assessment, you should immediately:
reevaluate his or her airway status
A pulse with a consistent pattern is considered to be:
regular
When interviewing a patient, you can show him or her that 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 signs of respiratory distress is seen MOST commonly in pediatric patients?
seesaw breathing
Clinical signs of labored breathing include all of the following, EXCEPT:
shallow chest movement
Jugular venous distention suggests a problem with blood returning to the heart if the patient is:
sitting up at a 45 degree angle
A crackling sound produced by air bubbles under the skin is called:
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 adjunct
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 patients pelvis only if:
the patient does not complain of pelvic pain
The gold hour begins when an injury occurs and ends when:
the patient receives definitive care
Reassessment is performed to determine all of the following EXCEPT:
the reason why the patient called EMS
When a patients respiration are shallow
tidal volume is markedly reduced
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:
transport at once and consider requesting a paramedic unit
The process of establishing treatment and transport priorities
triage
A properly sized blood pressure cuff should cover:
two thirds the length from the armpit to the crease in the elbow.
When assessing motor function in a conscious patients 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 respiration is breathing:
without assistance
