Chapter 10 - Patient Assessment
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: A. open his airway with the jaw-thrust maneuver. B. apply a pressure dressing to the patient's arm. C. apply a cervical collar and suction his airway. D. tilt the patient's head back and lift up on his chin.
A
A 50-year-old male is found unconscious in his car. There were no witnesses to the event. When gathering medical history information for this patient, the EMT should: A. determine if the patient has a medical alert bracelet or wallet card. B. ask law enforcement officials if they are familiar with the patient. C. wait for family members to arrive before asking any questions. D. defer SAMPLE history questions until you arrive at the hospital.
A
A blood pressure cuff that is too small for a patient's arm will give a: A. falsely high systolic and diastolic reading. B. falsely low systolic but high diastolic reading. C. falsely high systolic but low diastolic reading. D. falsely low systolic and diastolic reading.
A
A patient with spontaneous respirations is breathing: A. without assistance. B. without difficulty. C. with shallow depth. D. at a normal rate.
A
A patient's short-term memory is MOST likely intact if they correctly answer questions regarding: A. day and event. B. person and place. C. time and place. D. event and person.
A
Capnography is used to: A. determine how much carbon dioxide is being exhaled. B. trend a patient's blood pressure and assess for shock. C. assess how much oxygen is bound to the hemoglobin. D. assess how much oxygen is reaching the body's tissues.
A
When assessing motor function in a conscious patient's lower extremities, you should expect the patient to: A. wiggle his or her toes on command. B. identify different types of stimuli. C. feel you touching the extremity. D. note any changes in temperature.
A
When evaluating a patient with multiple complaints, the EMT's responsibility is to: A. determine which complaint poses the greatest threat to the patient's life. B. direct his or her attention to the most obvious signs and symptoms. C. assess each complaint based on the patient's perception of its seriousness. D. definitively rule out serious causes of each of the patient's complaints.
A
When interviewing a patient, you can show him or her that you understand the situation by: A. repeating statements back to him or her. B. interrupting him or her as needed for clarification. C. using medical terminology whenever possible. D. maintaining constant eye contact with him or her.
A
When performing a reassessment of your patient, you should first: A. repeat the primary assessment. B. obtain updated vital signs. C. reassess your interventions. D. confirm medical history findings.
A
When performing the secondary assessment on a trauma patient, you note the presence of Battle sign. This is defined as: A. bruising behind the ear. B. swelling to the orbital area. C. fluid drainage from the nose. D. unequal pupils.
A
When you use the palpation method to obtain a blood pressure, the measurement you obtain is the: A. systolic blood pressure. B. pulse pressure. C. cardiac output pressure. D. diastolic blood pressure.
A
Which of the following occurs when a patient's respirations are shallow? 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
Which of the following would the EMT likely NOT perform on a responsive patient with a headache and no apparent life-threatening conditions? A. Systematic head-to-toe examination B. Assessment of oxygen saturation C. Noninvasive blood pressure monitoring D. Focused secondary assessment
A
With regard to the assessment of a patient's cardiovascular status, capillary refill time is MOST reliable in: A. patients who are younger than 6 years of age. B. patients who are older than 70 years of age. C. patients who are significantly hypotensive. D. patients who were exposed to cold temperatures.
A
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: A. immediately suction her oropharynx. B. quickly insert an oropharyngeal airway. C. assess the rate and quality of her pulse. D. assist her breathing with a bag-valve mask.
A
A blood pressure cuff that is too small for a patient's arm will give a: A. falsely high systolic but low diastolic reading. B. falsely high systolic and diastolic reading. C. falsely low systolic but high diastolic reading. D. falsely low systolic and diastolic reading.
B
A patient in unstable condition should be reassessed at least every: A. 15 minutes. B. 5 minutes. C. 10 minutes. D. 20 minutes.
B
A patient who moves and cries out only when you pinch his or her trapezius muscle is said to be: A. conscious and alert. B. responsive to painful stimuli. C. responsive to verbal stimuli. D. completely unresponsive.
B
A patient with high blood pressure would be expected to have skin that is: A. pale and moist. B. flushed and red. C. mottled and cool. D. cyanotic and dry.
B
After performing a head tilt-chin lift maneuver to open the airway of an unresponsive patient who has a pulse, you should: A. place him or her in the recovery position. B. suction as needed and insert an airway adjunct. C. provide positive-pressure ventilatory assistance. D. assess respiratory rate, depth, and regularity.
B
As you assess the head of a patient with a suspected spinal injury, your partner should: A. assess the rest of the body for bleeding. B. maintain stabilization of the head. C. look in the ears for gross bleeding. D. prepare the immobilization equipment.
B
As you assess the head of a patient with a suspected spinal injury, your partner should: A. look in the ears for gross bleeding. B. maintain stabilization of the head. C. prepare the immobilization equipment. D. assess the rest of the body for bleeding.
B
If you cannot palpate a pulse in an unresponsive patient whose collapse was not witnessed, you should: A. apply an AED at once. B. immediately begin CPR. C. palpate at another pulse site. D. assess for adequate breathing.
B
If you cannot palpate a pulse in an unresponsive patient whose collapse was not witnessed, you should: A. palpate at another pulse site. B. immediately begin CPR. C. assess for adequate breathing. D. apply an AED at once.
B
In infants and small children, skin color should be assessed on the: A. forehead. B. palms and soles. C. chest and abdomen. D. underside of the arms.
B
Which of the following findings indicates that your patient has a patent airway? A. Inspiratory stridor B. Ability to speak C. Audible breathing D. Unresponsiveness
B
While en route to the scene of a shooting, the dispatcher advises you that the perpetrator has fled the scene. You should: A. ask the dispatcher if he or she knows the location of the perpetrator. B. confirm this information with law enforcement personnel at the scene. C. request law enforcement personnel if the scene is unsafe upon arrival. D. proceed to the scene as usual but exercise extreme caution upon arrival.
B
A pulse with a consistent pattern is considered to be: A. irregular. B. weak. C. regular. D. strong.
C
During the primary assessment, circulation is evaluated by assessing: A. blood pressure, pulse rate, and external bleeding. B. skin quality, blood pressure, and capillary refill. C. pulse quality, external bleeding, and skin condition. D. external bleeding, skin condition, and capillary refill.
C
External bleeding from an extremity can usually be controlled initially by: A. applying chemical ice packs. B. elevating the extremity. C. applying direct pressure. D. applying a tourniquet.
C
In patients with deeply pigmented skin, changes in color may be apparent only in certain areas, such as the: A. dorsum of the hand. B. back of the neck. C. lips or oral mucosa. D. forehead and face.
C
In responsive patients who are older than 1 year of age, you should palpate the pulse at the ________ artery. A. femoral B. carotid C. radial D. brachial
C
Observations made when forming a general impression of a patient would include all of the following, EXCEPT: A. appearance. B. race and gender. C. pulse strength. D. level of distress.
C
The "Golden Hour" begins when an injury occurs and ends when: A. the patient is admitted to the ICU. B. you arrive at the emergency department. C. the patient receives definitive care. D. you depart the scene for the hospital.
C
The chief complaint is MOST accurately defined as the: A. gross physical signs that you detect on assessment. B. most life-threatening condition that you discover. C. most serious thing the patient is concerned about. D. condition that exacerbates an underlying problem.
C
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: A. document your findings and perform a detailed assessment. B. apply the AED and analyze her cardiac rhythm. C. transport at once and consider requesting a paramedic unit. D. conclude that the irregular pulse is normal based on her age.
C
Which of the following is the MOST accurate guide to palpating a pulse? A. Avoid compressing the artery against a bone or solid structure. B. Apply firm pressure to the artery with your ring and little fingers. C. Place the tips of your index and long fingers over the pulse point. D. Use your thumb to increase the surface area that you are palpating.
C
Which of the following occurs when a patient's respirations are shallow? A. Oxygenation occurs more efficiently. B. Chest rise will be easily noticeable. C. Tidal volume is markedly reduced. D. Carbon dioxide elimination is increased.
C
Which of the following patients has signs of an altered mental status? A. A patient who overdosed and tells you he tried to kill himself B. A diabetic who has nausea and severe lightheadedness C. A patient with a head injury who is slow to answer questions D. A patient with an acute allergic reaction and dizziness
C
Which of the following pupillary changes would indicate depressed brain function? A. Both pupils constrict when a bright light is introduced. B. Both pupils dilate when a bright light is removed. C. Both pupils are sluggish with introduction of a bright light. D. Both pupils react briskly to light instead of sluggishly.
C
Which of the following questions would you ask a patient to ascertain the "M" in the SAMPLE history? A. "How long have you had your chest pain?" B. "Have you ever had any major surgeries?" C. "How much Tylenol do you take each day?" D. "When was the last time you ate a meal?"
C
A 71-year-old female slipped on a rug and fell. She is conscious but confused and complains of severe pelvic pain. Her respirations are 22 breaths/min and her heart rate is 120 beats/min. What should you do? A. Gently palpate her pelvis B. Transport her in a seated position C. Transport her on her left side D. Treat her for possible shock
D
Cyanosis of the skin is caused by: A. venous vasoconstriction. B. increased blood oxygen. C. peripheral vasodilation. D. decreased blood oxygen.
D
In infants and small children, skin color should be assessed on the: A. forehead. B. underside of the arms. C. chest and abdomen. D. palms and soles.
D
Pain that moves from its point of origin to another body location is said to be: A. provoking. B. referred. C. palliating. D. radiating.
D
Supplemental oxygen without assisted ventilation would MOST likely be administered to patients: A. with rapid respirations and a reduced tidal volume. B. who have accessory muscle use and slow breathing. C. who are semiconscious with shallow respirations. D. with difficulty breathing and adequate tidal volume.
D
The diastolic blood pressure represents the: A. difference in pressure between ventricular contraction and relaxation. B. average pressure against the arterial walls during a cardiac cycle. C. increased arterial pressure that occurs during ventricular contraction. D. minimum amount of pressure that is always present in the arteries.
D
The goal of the systematic head-to-toe exam that is performed during the secondary assessment is to A. definitively rule out significant internal injuries. B. assess only the parts of the body that are injured. C. detect and treat all non-life-threatening injuries. D. locate injuries not found in the primary assessment.
D
When auscultating the blood pressure in a patient's upper extremity, you should place the diaphragm (head) of the stethoscope over the _________ artery. A. femoral B. apical C. radial D. brachial
D
Which of the following factors would MOST likely cause a patient's pulse rate to be slower than normal? A. Anxiety or severe stress B. Lack of a regular exercise routine C. Internal bleeding from trauma D. Beta blocker medications
D
Which of the following medical history questions would be of LEAST pertinence in an acute situation? A. "Has this ever happened to you before?" B. "Are there medications that you cannot take?" C. "Does the pain stay in your chest?" D. "Does your mother have diabetes?"
D
Which of the following statements regarding the blood pressure is correct? A. Blood pressure is the most reliable indicator of perfusion. B. Blood pressure falls early in patients with hypoperfusion. C. The systolic pressure represents ventricular relaxation. D. Blood pressure is usually not measured in children younger than 3 years of age.
D
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: A. assess his blood pressure. B. apply a pulse oximeter. C. request a paramedic unit. D. assist his ventilations.
D
