EMR Patient Assessment Test

Which of the following statements is considered a chief complaint?

"I'm having trouble breathing."

Which of the following describes adequate adult breathing?

12 to 20 breaths per minute

Utility Company

A vehicle collision has caused damage to an electrical pole.

What does the A in ABC represent?

Airway

You arrive on the scene of a bar fight where you find a 22-year-old male who has been struck several times with a broken bottle. What should be your first action on the scene?

Ask the police to remove all bystanders from the area.

Which of these situations requires ALS support?

Cardiac arrest Head trauma and altered mental status Uncontrolled external bleeding

Which of the following situations describes a medical problem?

Caused by illness, environment, or substances

You respond to a collision involving a motorcycle. Upon your arrival you see a a small pickup truck and motorcycle lying on its side. The scene is safe, and you don protective gloves and approach the truck. The truck has a one-foot intrusion into the passenger door. The driver of the truck reports no injury, but states that the motorcyclist was ejected and landed on the sidewalk about 75 feet from the vehicle. What injuries can you expect from this mechanism of injury?

Chest trauma Head trauma Multiple fractures and abrasions Pelvis trauma

What does the C in the primary assessment ABCs refer to?

Circulation

What possible hazards might you suspect at the scene of a high-speed collision involving several vehicles and a vehicle fire?

Explosion danger Fire danger Unstable vehicles Leaking fuel

You respond to a patient who is unconscious. As an EMS provider, you have the authority to treat this patient based on which of the following?

Implied consent

If someone responds to Painful Stimuli they would

Move away from an ear pinch and grimace with a trapezius squeeze

You are called to a house for a man who "won't wake up." A family member leads you to the bedroom where the unresponsive patient is lying supine on the bed. What should you do next?

Open the patient airway using the head-lift, chin-lift maneuver

You and your partner respond to a call involving an unknown injury. When you arrive at the home, everything is dark and quiet. What should you do?

Quietly approach the house in a single-file line, being careful not to block the front doorway

You pinch a patient's armpit in order to determine the patient's level of consciousness. The patient responds by moving away from the stimulus. How do you describe this patient's level of consciousness?

Responsive to painful stimuli

You approach a patient who appears unconscious and does not respond to your questions. But, when you ask him to squeeze your fingers, he is able to do so. How would you describe this patient?

Responsive to verbal stimuli

Which of the following is a responsibility of the EMS professional on the scene of a call?

Scene leadership Scene safety Personal safety in the form of BSI Maintaining awareness of the scene

Which of these items are identified during scene size-up?

Scene safety Nature of the call Number of patients requiring care Need for additional support

Law Enforcement

Shots are fired on the emergency scene.

Which of the following factors should be considered when evaluating a fall?

Surface the patient landed on Area of the body impacted first Interruptions to the fall Distance of the fall

Why is it important to determine the total number of ill or injured patients at a scene?

The number of patients will determine how to proceed with the assessment and whether or not additional support is needed.

Which of the following are basic life support (BLS) unit skills?

Transport patients Provide basic first aid Administer medications based on local protocols Provide manual c-spine precautions

A patient who does not respond to any kind of stimulus is extremely ill and requires immediate transport.

True

What does the U in AVPU stand for?

Unresponsive

Which of the following is an example of a mechanism of injury? (MOI)

A fall from a ladder

Which of the following statements about a general impression is correct?

A general impression is formed within a few seconds.

Extrication unit

A patient is trapped in a car after a collision. The car doors will not open due to the damage.

Advanced Life Support Team

A patient with a heart-related medical history has substantial chest pain and shortness of breath.

What is a nature of illness?

A patient's medical problem

Why must EMS professionals look for placards on a commercial vehicle involved in a collision?

A placard will indicate the presence of hazardous materials onboard.

Why is the assessment of airway, breathing, and circulation (ABCs) an important part of the primary assessment?

A problem in any of these areas could be life-threatening.

Hazardous Materials Team

A tanker with several visible placards has been T-boned by a car and is leaking an unknown liquid.

What does the A in AVPU stand for?

Alert

You respond to an elderly woman who slipped and fell on her icy driveway. She is able to identify herself, her location, the time of day, and what happened. How would you classify her based on her level of consciousness?

Alert

You are called to a person down. Upon arrival, you see a male lying on the ground. You identify yourself and ask the patient what happened. He responds by opening his eyes and mumbling something you do not understand. How would you classify his level of consciousness?

Altered mental status

Your patient is a 70-year-old male. You ask him, "Mr. Jansen, are you okay?" He does not respond. You raise your voice and say, "Mr. Jansen, can you squeeze my hand?" He still does not respond. What should you do next?

Apply a painful stimulus, such as the trapezius squeeze

During the primary assessment, you quickly expose a patient to check for major bleeding. You observe a significant puncture wound on the patient's abdomen. What should you do?

Apply direct pressure to the wound with gloved fingers

Step 3 in a primary assessment

Assess airway and breathing

Step 4 in a primary assessment

Assess circulation

Step 2 in a primary assessment

Assess level of consciousness

You and your partner respond to a call involving a stabbing. After taking proper safety and BSI precautions, you approach the patient. You manually open the patient's airway by performing a head-tilt, chin-lift maneuver while your partner determines that the patient is responsive to painful stimuli. What should be your partner's next move?

Assess the patient's breathing

How should an EMS professional respond to a life-threat discovered during the primary assessment?

Begin immediate treatment

Which of the following situations should increase the index of suspicion?

Blast injuries Falls Penetrating trauma

You are dispatched to a trauma at a baseball practice. A patient has been struck on the lower left abdominal quadrant by a fast-pitch ball. What type of trauma is this?

Blunt trauma

Where should the pulse of a 9-month-old child be assessed?

Brachial artery

What does the B in ABC represent?

Breathing

Recall the scenario where you and your partner respond to an automobile collision involving a car and an electrical pole. Power lines are down, smoke is streaming from the car, and two people appear unconscious inside the vehicle. What are some signs of danger on this scene?

Downed power lines

Why are EMS professionals required to take body substance isolation (BSI) precautions?

Emergency scenes involve unexpected contact with body fluids that could infect emergency workers with illness.

Step 5 in a primary assessment

Evaluate patient priorities

What is an index of suspicion?

Expectations about a patient's injury based on the mechanism of injury

You are dispatched to an apartment building for a woman in labor. You are told to expect a delivery on-scene. What personal protective equipment might be needed for this call?

Eye protection Surgical mask or face shield Examination gloves Gown

EMS professionals must tend to both large and small wounds during the primary assessment.

False

EMS professionals use only their sense of sight when evaluating a scene for signs of danger.

False

If police have determined a scene is safe, there is no need for the EMS professional to do his own scene size-up.

False

It is always easy to locate patients and determine the total number of patients involved in an incident.

False

Only patients with significant injuries receive a primary assessment.

False

The head-tilt, chin-lift maneuver should be used on patients with suspected spinal injuries.

False

The need for additional support at an emergency scene is based solely on the number of injured or ill patients.

False

Which agency often handles rescue situations?

Fire department

Step 1 in a primary assessment

Form a general impression

If someone has an unresponsive level of consciousness they would

Have no response to stimuli and have a priority for transport

You respond to a call involving an overturned tractor trailer with a placard indicating the presence of radioactive materials. Which agency should be summoned to help handle this scene?

Hazardous materials team

You respond to a patient trapped by falling equipment at a construction site. The patient has multiple lacerations and fractures. What PPE should be worn in this situation?

Helmet with face guard and puncture-proof gloves

You are called to the scene of a 42-year-old male with respiratory distress. Upon arrival at the patient's home, you don gloves, make sure the scene is safe, and then approach the patient. The patient is sitting on the edge of a chair leaning forward. You note that his effort of breathing is severely increased. He tries to talk to you but can only get out three words per breath. What is your general impression of this patient?

His posture and breathing indicate that he needs emergency care.

What is the main goal of the primary assessment?

Identify potential life threats

You and your partner are the single responding unit to a scene involving multiple casualties. You immediately recognize that the situation is more than you and your partner can handle. What should you do?

Immediately request additional support

Your patient is a middle-aged man who is breathing six times per minute. You note a shallow rise and fall of his chest during respirations. How would you describe this patient's breathing?

Inadequate and too slow

What makes this MOI more suspect for serious trauma?

It involves several significant impacts to the body.

As you approach your patient, she quickly and easily begins explaining how she injured herself. What can you assume about her airway?

It is patent.

You approach the scene of an unknown call, which police have determined is safe to enter. However, as you get on-scene you see a commotion next door to the residence you are responding to. Police have taken cover behind their cars and have their weapons drawn. What is your evaluation of this scene?

It is unsafe due to the possibility of violence in the area.

Which of the following statements about personal protective equipment is correct?

It must be easily available.

Toxic substances should be suspected in which of the following situations?

Leaks and spills Fires Confined spaces Patients with similar symptoms

You respond to the scene of a low-speed vehicle collision. One car was struck on the driver's side door. What injuries would you expect the driver to have?

Left leg fracture and chest wall injury

What does an AVPU check assess?

Level of consciousness

On an adult patient, where should you look for signs of cyanosis, or blue skin color?

Lips and nail beds

You arrive on the scene of a young patient who has been propelled off a trampoline and is now lying supine in the grass. You determine that the scene is safe and approach the patient. Based on the mechanism of injury, you suspect the patient may have a spinal injury. What should you do next?

Manually stabilize the cervical spine

You are called to a multiple vehicle accident. When you arrive, you discover six vehicles have been involved in the collision. There appear to be many injured people. What type of situation is this?

Multiple-casualty incident

You respond to a 61-year-old female with a history of asthma. You find the patient seated on a sofa with oxygen from a home supply on her nose. She is breathing 28 times a minute and her breath is shallow. You also note nasal flaring. Is this patient's breathing adequate?

No

Which of the following would be part of a general impression?

Patient's position

You are called to a house for "shots fired" and find police already on the scene. What should you do next?

Quickly conduct your own scene size up before entering the scene

You respond to a call involving a patient trapped in a vehicle. Which agency should be summoned for additional support?

Rescue and extrication unit

If someone responds to Verbal Stimuli they would

Respond to a loud voice and Wiggle their toes when instructed

What does the P in AVPU stand for?

Responds to painful stimuli

What does the V in AVPU stand for?

Responds to verbal stimuli

You and your partner respond to a call. As you pull up to the scene, you hear loud arguing. Then you hear the sound of gunfire. How should you respond?

Retreat and call for police backup

You arrive at the scene of a vehicle collision. What should be your first course of action?

Scan and evaluate the entire area

You and your partner are dispatched to the scene of a fall. On-scene, you discover that the patient has fallen 20 feet from scaffolding. How would you characterize the patient's fall?

Significant MOI

Which of the following is an example of a life-threatening condition?

Significant chest wounds Severe bleeding Blocked airway No pulse

Fire Department

Smoke is visible from a car that has been involved in a collision.

Why are incidents involving multiple types of collisions particularly serious?

The potential for injury is multiplied because of the different types of collisions.

Additional Ambulances

Three patients require immediate care and transport

Air medical transport should be used only in cases of life- or limb-threatening situations.

True

As an EMS professional, protecting yourself from violence is just as important as protecting yourself from any other on-scene hazard.

True

How are penetrating wounds categorized?

Velocity

What steps should you take to protect yourself from secondary crashes at a collision site?

Wear bright safety clothing

When does scene size-up begin?

When you are dispatched to the call

When sizing up a scene that involves leaking fluids, what should an EMS provider consider?

Whether or not there is a source for ignition close

What kind of information does an EMS provider obtain about a patient's pulse during the primary assessment?

Whether pulse is slow, normal, fast, or irregular

You respond to a patient complaining of abdominal pain. You find the patient in a bedroom with an empty bottle of pills on the floor. Could the empty bottle of pills be an important clue?

Yes. The empty bottle could indicate that the patient has taken too many pills. It could indicate the patient's nature of illness.

If someone has an alert level of consciousness they would

speak clearly and have an A&O x 4