Patient Assessment Chapter 13 & 14 StudyBlue

Which of the following questions would be of LEAST pertinence when trying to determine a patient's current health status?

"Are your mother and father still living?"

Which of the following is an example of a leading question?

"Do you think that you are experiencing a cardiac emergency?"

Which of the following questions will yield the LEAST reliable information when assessing a patient with abdominal pain?

"Does the pain radiate to your chest or back?"

When assessing a hemodynamically stable child, the toe-to-head approach is generally indicated for children who are:

1 to 3 years of age.

Which of the following clinical presentations warrants immediate transport?

Chest discomfort; heart rate of 110 beats/min; systolic BP of 90 mm Hg

When scoring a patient's deep tendon reflexes, normally active reflexes would be assigned a score of:

2+.

At 3:00 a.m. you receive a call for a "man down." While en route to the scene, you ask the dispatcher to provide additional information, but the dispatcher advises you the caller was abrupt on the phone and then hung up. You should:

ask the dispatcher if law enforcement is en route to the scene

To appreciate the S1 sound: .

ask the patient to breathe normally and hold his or her breath on expiration

You are caring for an unresponsive 54-year-old man with an apparent isolated head injury after he fell from a standing position. Your partner is maintaining manual stabilization of the patient's head while assisting his breathing. Your rapid head-to-toe exam reveals only a large hematoma to the patient's forehead. Further assessment reveals that the patient is wearing a medical alert bracelet that reads "allergic to codeine." You should:

assess his blood glucose reading and give dextrose if necessary.

When assessing the head and face during the full-body exam, you should:

avoid palpating any cranial depressions.

When using a tympanic device to obtain a patient's body temperature, you should:

be aware of extrinsic factors that can skew the reading.

An appropriately sized blood pressure cuff should:

be one half to two thirds the size of the upper arm

A patient with a blood pressure of 210/100 mm Hg would be expected to have a pulse that is:

bounding

Blood pressure is the product of:

cardiac output and peripheral vascular resistance.

You would NOT expect to encounter decreased breath sounds in a patient with:

cardiac tamponade.

You will MOST likely develop your field impression of a patient based on the:

chief complaint and patient history.

When your patient is a non-English-speaking person, his or her child is often able to function as an interpreter because:

children quickly absorb a new language in school.

A multi-systems trauma patient opens his eyes in response to pain, moans when you ask him his name, and withdraws from painful stimuli. From this information, you should:

conclude that he has severe neurologic dysfunction

Making your patient aware that you perceive something inconsistent with his or her behavior is called:

confrontation

Intermittent claudication is defined as:

cramplike pain in the lower extremities due to poor circulation.

Using casual nicknames can be especially problematic when:

cultural differences exist between the patient and the paramedic.

After performing your primary assessment of a patient, your next action should be to:

decide what care is needed at the scene versus en route to the hospital

Clinical signs of an inflamed joint include all of the following, EXCEPT:

deformity

Asking the patient about the date, time, location, and events surrounding the current situation will enable you to:

determine if the patient is alert to person, place, time, and event.

A key part of making your practice of prehospital care successful is for you to:

develop and cultivate your own style of assessment and an overall strategy for evaluating and providing care

A working hypothesis of the nature of a patient's problem is called the:

differential diagnosis

A deformed steering wheel in conjunction with a deployed air bag indicates that the:

driver was not wearing a seat belt

If your patient becomes seductive or makes sexual advances toward you, you should advise the patient that your relationship with him or her is strictly professional and then:

ensure that a witness is present at all times.

Proper documentation of your physical examination of a patient is MOST important because it:

ensures an accurate historical accounting of the patient's problems prior to entering the hospital.

Working to ensure a patient's privacy, confidentiality, and comfort level will:

establish positive patient rapport and encourage honest, open communication.

The Babinski sign, grasping, and sucking are:

examples of primitive reflexes

Paying attention, making eye contact, and repeating key information from the patient's answers are examples of:

facilitation

When auscultating heart sounds, you should place your stethoscope at the:

fifth intercostal space, over the apex of the heart.

A conscious patient's respiratory rate should be measured:

for a minimum of 30 seconds

A responsive patient who is talking or crying:

has a patent airway

Tidal volume is MOST effectively assessed by:

observing for rise and fall of the chest.

When asking questions pertaining to a patient's sexual history, it is important to remember that:

obtaining the history in a private setting is essential.

The mnemonic "OPQRST" is a tool that:

offers an easy-to-remember approach to analyzing a patient's chief complaint.

To obtain a heart rate in infants younger than 1 year of age, you should:

palpate the brachial artery.

When assessing a trauma patient's chest, you should remember that:

paradoxical movement may not be grossly apparent due to the splinting effect of chest muscle spasms.

Abdominal guarding is MOST commonly encountered in patients with:

peritoneal irritation

The MOST effective way to obtain a medical history from a patient who is crying is to:

place your hand on his or her shoulder (if appropriate for the patient) and reassure him or her that you are in control of the situation.

When asking a patient if he or she uses illegal drugs, you will MOST likely get accurate information if you:

remain professional and nonjudgmental.

When transferring a geriatric patient from a hospital to an extended care facility, it is MOST important to:

review the patient's transfer paperwork.

The optic nerve is a _______ nerve, and controls _______.

sensory, light perception and vision

When assessing any patient, the paramedic should remember that:

some patients with a traumatic injury could also have an underlying medical component.

The diameter of a patient's pupils and their reactivity to light provide information about the:

status of cerebral perfusion.

If a patient's family member is hostile and begins shouting at you, you should:

tell the person that if he or she continues to shout, you will not feel safe and will need to call law enforcement.

EMS providers who read off a list of questions to the patient to fill in all the blanks on the run report:

tend to make little or no eye contact with the patient

Cognitive function can be MOST accurately defined as:

the ability to use reasoning.

A patient is generally considered to have orthostatic vital signs when:

the heart rate increases by 20 beats/min or more when going from a supine to a standing position

When caring for an unresponsive trauma patient, a complete secondary assessment:

will probably not be performed in its entirety.

In general, +3 pitting edema is characterized by indentation of the skin to a depth of:

½ in to 1 in.

Which of the following factors would likely NOT skew a pulse oximetry reading?

Hypertension

Which of the following actions would you likely NOT perform at the scene of a fall before engaging in the care of a conscious patient?

Speaking with immediate family

Which of the following statements regarding the patient assessment process is correct?

The assessment process must be organized and systematic, yet flexible enough to allow you to maximize the amount of information you can gather.

Which of the following statements regarding the rapid exam of a trauma patient is correct?

The rapid exam is used to identify injuries that must be managed before and during packaging and loading the patient for transport.

Which of the following hazards would you LEAST likely encounter at the scene of a motor vehicle crash?

Unruly patient

Which of the following statements regarding an intoxicated patient is correct?

While the patient is trying to explain things to you, his or her anger can escalate faster than if he or she were not intoxicated.

Situational depression is:

a reaction to a stressful event in a patient's life

The MOST reliable means of attempting to determine an unresponsive medical patient's problem is:

a thorough head-to-toe physical examination

The rapid exam of a patient is usually performed:

after all life-threatening conditions have been identified and addressed in the primary assessment.

Gathering a patient's medical history and performing a secondary assessment should occur:

after life threats have been identified and corrected in the primary assessment

Which of the following is an example of a pertinent negative?

A patient with chest discomfort denies shortness of breath.

Which of the following statements regarding ascites is correct?

Ascites is a collection of fluid within the peritoneal cavity.

Which of the following is the MOST practical method of assessing for gross neurologic deficits during your assessment of a patient?

Ask the patient if he or she can feel and move his or her fingers and toes.

Which of the following actions will provide the BEST personal protection when caring for a patient on uneven terrain?

Making lifts and moves as controlled as possible

__________ entails gently striking the surface of the body, typically where it overlies various body cavities.

Percussion

Sonorous respirations are MOST likely caused by:

an anatomic airway obstruction

The history of present illness is MOST accurately described as:

an elaboration of the chief complaint

Swollen lymph nodes in the anterior neck usually indicate:

an infection.

You are in the BEST position to decide what, if any, care needs to be provided at the scene versus en route to the hospital once you:

are able to quantify how sick a patient is.

The paramedic should address a patient:

as the patient wishes to be addressed.

You arrive at the scene of a motor vehicle crash in which a small passenger car struck a bridge pillar. The patient, a conscious young woman, is still seated in her car. The scene is safe and law enforcement is directing traffic. Upon initial contact with the patient, you should:

have your partner manually stabilize her head as you assess her mental status.

You would MOST likely encounter bilateral dependent edema in a patient with:

heart failure.

The body's reaction to increased internal or external temperature would MOST likely cause the skin to become:

hot and moist

You are transporting a conscious middle-aged woman who fell from a second-story balcony while watering her plants. Full spinal motion restriction precautions have been implemented, supplemental oxygen is being administered, and an IV line of normal saline is in place. With a 15-minute estimated time of arrival at the hospital, the patient's mental status markedly decreases and her respirations become shallow and are making a gurgling sound. Your FIRST action should be to:

immediately suction her oropharynx.

Distention of the jugular veins indicates:

increased venous capacitance

The fourth heart sound (S4):

indicates increased pressure in the atria

If manual positioning of a patient's head is required to keep his or her airway open, you should:

insert an airway adjunct

A neighbor finds her elderly female friend unresponsive on her kitchen floor. As you are performing your primary assessment, the neighbor tells you that she does not know what happened to her friend. The patient moans when you speak to her and is breathing at a normal rate with adequate depth. You should:

insert an airway adjunct, apply supplemental oxygen, and implement spinal motion restriction precautions

After determining that the scene is safe, the FIRST step in approaching a patient is to:

introduce yourself to the patient

Your patient will MOST likely develop a good first impression of you if you:

look and act professional and confident.

An inward curve of the lumbar spine just above the buttocks is called:

lordosis

A patient who gives the emergency department physician completely different information than he or she gave to you in the field:

may have an organic condition, such as a brain tumor

The presence of rhonchi during auscultation of the lungs is MOST suggestive of:

pneumonia

A 29-year-old woman is in active labor. During your visual exam, you see a limb protruding from her vagina. Upon noting this, it is MOST important to:

prepare for immediate transport

When dealing with a patient who has multiple symptoms, the MOST effective way to develop an appropriate care plan is to:

prioritize the patient's complaints.

Serial vital signs:

provide comparative data regarding the patient's condition.

Lower extremity shortening and/or internal or external rotation are findings often associated with:

proximal lower extremity injury

The MOST clinically significant indicator(s) of ischemia in a limb is/are:

pulselessness

An empathetic attitude:

puts you in your patient's shoes

Vascular compromise in a lower extremity is characterized by:

unilateral pulse deficit and pallor.

A patient who does not respond to verbal or tactile stimuli is:

unresponsive

Flushed skin is commonly seen as a result of all the following, EXCEPT:

vasoconstriction

All of the following are adventitious breath sounds, EXCEPT:

vesicular sounds

Diffuse pain caused by hollow organ obstruction and stretching of the smooth muscle wall is called __________ pain.

visceral

When the blood vessels supplying the skin are fully dilated, the skin becomes:

warm and pink.

Any time you encounter jugular venous distention in a patient, you should determine:

where the venous obstruction is that is impeding blood return to the heart

When a patient presents with two seemingly unrelated complaints, it is MOST important for the paramedic to determine:

which complaint has a higher priority.