Patient Assessment Chapter 10

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

A patients with a significant MOI and unresponsive medical patients.

Which of the following patient responses would establish the "E" in the SAMPLE history? A. "I was mowing the lawn when the pain began." B. "I am not having any difficulty breathing." C. "The chest pain started about 45 minutes ago." D. "I was in the hospital a week ago."

A. "I was mowing the lawn when the pain began."

You receive a call to a local 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: A. assess for a brachial pulse for 5 to 10 seconds. B. begin chest compressions and request backup. C. immediately transport the child to the hospital. D. open the airway and give two rescue breaths.

A. assess for a brachial pulse for 5 to 10 seconds.

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

A. avoid compressing both carotid arteries simultaneously.

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

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

Which of the following assessments would be the MOST useful determining the possible cause of a patient's altered mental status? A. blood glucose level. B. capillary refill time. C. blood pressure. D. reparatory rate.

A. blood glucose level.

A patient with profuse sweating is referred to as being: A. diaphoretic. B. plethoric. C. edematous. D. flushed.

A. diaphoretic.

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

A. ensure that you are safe.

Upon arriving as the scene of a patient with 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: A. introduce yourself to the patient. B. assess the patient's airway status. C. obtain a set of baseline vital signs. D. ask the patient what's wrong.

A. introduce yourself to the patient.

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

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

Findings such as inadequate breathing or an altered level of consciousness should be identified in the: A. primary assessment. B. focused assessment. C. secondary assessment. D. reassessment.

A. primary assessment.

Observations made when forming a general impression os a patient would include all of the following, EXCEPT: A. pulse strength. B. appearance. C. level of distress. D. race and gender.

A. pulse strength.

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

A. radiating.

A pulse with a consistent pattern is considered to be: A. regular. B. weak. C. irregular. D. strong.

A. regular.

What of the following signs of respiratory distress is usually observes only in pediatric patients? A. seesaw breathing. B. pursed-lip breathing. C. rapid respirations. D. accessory muscle use.

A. seesaw breathing.

Which of the following situations or conditions warrants immediate transport? A. severe chest pain and cool, pale skin. B. mild pain in the lower abdomen. C. decreased ability to move an extremity. D. ability to follow commands.

A. severe chest pain and cool, pale skin.

`Jugular venous distention suggests a problem with blood returning too the heart if the patient is: A. sitting up at a 45º angle. B. in a supine position. C. in a recumbent position. D. in a prone position.

A. sitting up at a 45º angle.

Which of the following statements regarding the mechanism if injury (MOI) is correct? A. the MOI may allow you to predict the severity of a patient's injuries. B. a significant MOI usually results in patient death or permanent disability. C. a nonsignificant MOI rules out the possibility of serious trauma. D. the exact location of a patient's injuries can be determines by the MOI.

A. the MOI may allow you to predict the severity of a patient's injuries.

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

A. the body's ability to compensate for shock decreases.

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

A. the patient receives definitive care.

Reassessment is performed to determine all of the following, EXCEPT: A. the reason why the patient called EMS. B. the nature of the newly identified problems. C. whether or not the patient is deteriorating. D. the patient's response to your treatment.

A. the reason why the patient called EMS.

Which of the following statements regarding the secondary assessment is correct? A. the secondary assessment should focus on a certain area or region of the body as determined by the chief complaint. B. during the secondary assessment, the EMT's primary focus should be in taking the patient's vital signs and obtaining a SAMPLE history. C. a secondary assessment should always be performed, even if you must continually manage life threats that were identified in the primary assessment. D. the secondary assessment should be performed en route to the hospital, regardless off the severity of the patient's condition.

A. the secondary assessment should focus on a certain area or region of the body as determined by the chief complaint.

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. note any changes in temperature. C. feel you touching the extremity. D. identify different types of stimuli.

A. wiggle his or her toes on command.

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

B. 2.

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

B. 60, 100.

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

B. 90 seconds.

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

B. 94% to 99%.

When using the pulse oximeter as part of your assessment of a patient, it is important to remember that: A. as long as the patient's oxygen saturation is greater than 95%, oxygen is usually not necessary, even if the patient is experiencing respiratory distress. B. any situation that causes vasoconstriction or loss of red blood cells, such as anemia or bleeding, may result in an inaccurate or misleading value. C. carbon monoxide has no effect on pulse oximetry readings because the pulse oximeter presumes that oxygen is saturating the hemoglobin. D. pulse oximetry is especially useful in patients who have cold extremities because vasoconstriction forces blood to the capillary beds.

B. any situation that causes vasoconstriction or loss of red blood cells, such as anemia or bleeding, may result in an inaccurate or misleading value.

CA 39-year-old male sustained a stab wound to the groin during an altercation at a bar. As you approach the patient, you note he is not conscious, is screaming gin pain, and is attempting to control the bleeding, which is bright red and spurting from his groin area. You should: A ensure his airway is patent. B. apply direct pressure to the wound. C. administer 100% supplemental oxygen. D. elevate his leg and keep him warm.

B. apply direct pressure to the wound.

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

B. cyanosis.

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

B. determine how much carbon dioxide is being exhaled.

A patient with high blood pressure would be expected to have skin that is: A. mottled and cool. B. flushed and red. C. cyanotic and dry. D. pale and moist.

B. flushed and red.

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

B. immediately begin CPR.

Which of the following statements regarding stridor is correct? A. it is a whistling sound heard in the lower airway. B. it is a high-pitched, crowding upper airway sound. C. it suggests the presence of fluid in the lungs. D. it is caused by incorrect airway positioning.

B. it is a high-pitched, crowding upper airway sound.

What maneuver should be used to open the airway of an unresponsive patient with suspected trauma? A. Tongue-jaw lift maneuver. B. jaw-thrust maneuver. C. head tilt-neck lift maneuver. D. head tilt-chin lift maneuver.

B. jaw-thrust maneuver.

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 the stabilization of the head. C. look in the ears for gross bleeding. D. prepare the immobilization equipment.

B. maintain the stabilization of the head.

Assessment of an unconscious patient's breathing begins by: A. inserting an oral airway. B. manually positioning the head. C. assessing respiratory rate and depth. D. clearing the mouth with suction as needed.

B. manually positioning the head.

Your primary assessment of an elderly woman who fell reveals an altered level of consciousness and a large hematoma to her forehead. After protecting her spine and administering oxygen, you should: A. reassess your interventions. B. perform a rapid exam. C. transport the patient immediately. D. perform a focused assessment of her head.

B. perform a rapid exam.

During your assessment of a 6-month-old male with vomiting and diarrhea, you note that his capillary refill time is approximately 4 seconds. From this information, you should conclude that the infant's: A. systolic blood pressure is normal. B. peripheral circulation is decreases. C. skin temperature is abnormally cold. D. respiratory status is adequate.

B. peripheral circulation is decreases.

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

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

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

B. radial.

During the scene size-up, you should routinely determine all of the following, EXCEPT: A. the mechanism of injury or nature of illness. B. the ratio of pediatric patients to adult patients. C. whether or not additional resources are needed. D. if there are any hazards that will jeopardize safety.

B. the ratio of pediatric patients to adult patients.

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

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

Your 12-year-old patient can speak only two or three words without pausing to take a breath. He has a serious breathing problem known as: A. nasal flaring. B. two- to three-word dyspnea. C. labored breathing. D. shallow respirations.

B. two- to three-word dyspnea.

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

C. "Does your mother have diabetes?"

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

C. "What seems to be the matter?"

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

C. 2 seconds.

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. applying direct pressure.

Poor peripheral circulation will cause the skin to appear: A. cyanotic. B. pink. C. ashen. D. flushed.

C. ashen.

While en route to the scene of a shooting, the dispatcher advises you that the perpetrator has fled the scene. You should: A. proceed to the scene as usual but exercise extreme caution upon arrival. B. ask the dispatcher if he or she knows the location of the perpetrator. C. confirm this information with law enforcement personnel at the scene. D request law enforcement personnel if the scene is unsafe upon arrival.

C. confirm this information with law enforcement personnel at the scene.

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

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

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? A. general impression. B. secondary assessment. C. history taking. D. primary assessment.

C. history taking.

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

C. is experiencing difficulty breathing.

In patients with deeply pigments skin, changes in color may be apparent only in certain areas, such as the: A. forehead and face. B. back of the neck. C. lips or oral mucosa. D. dorsal of the hand.

C. lips or oral mucosa.

For which of the following patients is spinal immobilization clearly indicated? A. man with an arrow impaled in his leg and no pulse distal to the injury. B. woman who fell from a standing position and has a deformed shoulder. C. man with altered mantle status after being exposed to blunt force trauma. D. woman in a minor motor-vehicle collision who complains of severe knees pain.

C. man with altered mantle status after being exposed to blunt force trauma.

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 tilt the patient's head back and lift his chin. B. apply a cervical collar and suction his airway. 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.

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

C. pink, warm, and dry.

Which of the following is the MOST accurate guise to palpating a pulse? A. use your thumb to increase the surface area that you are palpating. B. avoid compressing the artery against a bone or solid structure. C. place the tips of your index and long fingers over the pulse point. D. 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.

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

C. repeat the primary assessment.

A semiconscious patient pushes your hand away when you pinch his earlobe. You should describe his level of consciousness as: A. alert. B. unresponsive. C. responsive to painful stimuli. D. responsive to verbal stimuli.

C. responsive to painful stimuli.

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

C. shallow chest movement.

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

C. 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? A. assessment of oxygen saturation. B. focused secondary assessment. C. systematic head-to-toe examination. D. noninvasive blood pressure monitoring.

C. systematic head-to-toe examination.

Which of the following occurs when a patient's respirations are shallow? A. chest rise will be easily noticeable. B. oxygenation occurs more efficiently. C. tidal volume is markedly reduced. D. carbon dioxide elimination is increased.

C. tidal volume is markedly reduced.

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

C. without assistance.

Which of the following statements regarding the secondary assessment is correct? A. the purpose of the secondary assessment is to systematically examine every patient form head ro tow, regardless of the severity of his or her injury. B. if your general impression of a patient f=does not revel any obvious life threats, you should proceed directly to the secondary assessment. C. you may not have time to perform a secondary assessment if you must continually manage life threats that were identified during the primary assessment. D. a focused secondary assessment would be the most appropriate approach for a patient who experienced significant trauma to multiple body systems.

C. you may not have time to perform a secondary assessment if you must continually manage life threats that were identified during the primary assessment.

When assessing your patient's pain, he says it started in his chest but has spread to his legs. This is an example of what part of the OPQRST mnemonic? A.Onset. B.Quality. C.Region/radiation. D.Severity.

C.Region/radiation.

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

D. 60 and 100 beats/min.

How should you determine the pulse in an unresponsive 8-year-old patient? A. Palpate the radial pulse at the wrist. B. Palpate the brachial pulse inside the upper arm. C. Palpate the radial pulse with your thumb. D. Palpate the carotid pulse in the neck.

D. Palpate the carotid pulse in the neck.

Which of the following would you NOT detect while determining your initial general impression of a patient? A. Cyanosis. B. Gurgling respirations. C. Severe bleeding. D. Rapid heart rate.

D. Rapid heart rate.

In which of the following situations is a pertinent negative identified? A. a 50-year-old woman states that nothing makes her chest pain better or worse. B. a 56-year-old woman states that her chest hurts when she takes a deep breath. C. a 53-year-old man with dizziness also tells you that he has vomited three times. D. a 59-year-old man complains of crushing chest pain but denies shortness of breath.

D. a 59-year-old man complains of crushing chest pain but denies shortness of breath.

Which of the following findings indicates that your patient has a patent airway? A. inspiratory stridor. B. unresponsiveness. C. audible breathing. D. ability to speak.

D. ability to speak.

When performing the secondary assessment on a trauma patient, you note the presence of Battle sign. The is defined as: A. fluid drainage from the nose. B. unequal pupils. C. swelling to the orbital area. D. bruising behind the ear.

D. bruising behind the ear.

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

D. decreased blood oxygen.

Which of the following is an example of a symptom? A. hypertension. B. tachycardia. C. cyanosis. D. headache.

D. headache.

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

D. identify less-obvious injuries that require immediate treatment.

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

D. locate injuries not found in the primary assessment.

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

D. loss of vascular tone.

The chef 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. condition what exacerbates an underlying problem. D. most serious thing the patient is concerned about.

D. most serious thing the patient is concerned about.

When performing a rapid exam on a supine patient, what part of the body is typically assessed last? A. extremities. B. anterior chest. C. abdomen. D. posterior.

D. posterior.

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

D. rapid.

You arrive at the scene of an "injured person." As you exit the ambulance, you see a man lying on the front porch of his house. He appears to have been shot in the head and is lying in a pool of blood. You should: A. immediately assess the patient. B. proceed to the patient with caution. C. quickly assess the scene for a gun. D. retreat to a safe place and wait for law enforcement to arrive.

D. retreat to a safe place and wait for law enforcement to arrive.

The pulse oximeter is an assessment tool used to evaluate the: 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.

The pressure exerted against the walls of the artery when the left ventricle contracts is called the: A. diastolic pressure. B. apical pulse. C. pule pressure. D. systolic pressure.

D. systolic 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: A. atria relaxing. B. ventricles contracting. C. atria contracting. D. ventricles relaxing.

D. ventricles relaxing.