Ch 9 Patient Assessment
Which of the following medical history questions would be of LEAST pertinence in an acute situation?
"Does your mother have diabetes?"
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 patient responses would establish the "E" in the SAMPLE history?
"I was mowing the lawn when the pain began."
Which of the following questions is used to determine a patient's chief complaint?
"What seems to be the matter?"
The normal respiratory rate for an adult should range from:
12 to 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 Coma 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 assess capillary refill time (CRT) in an infant, normal color to the tested area should return within:
2 seconds
Normal respiratory rates should not exceed _______ breaths per minute in children and _______ breaths per minute in infants.
30, 50
An unstable patient should be reassessed at least every:
5 minutes
For an adult, the normal resting pulse should be between:
60 and 100 beats/min.
The full-body scan of a patient that occurs following the primary assessment should take no longer than:
60 to 90 seconds.
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
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 statements regarding the blood pressure is correct?
Blood pressure is usually not measured in children younger than 3 years of age.
Which of the following pupillary changes would indicate depressed brain function?
Both pupils dilate with introduction of a bright light.
Which of the following statements regarding stridor is MOST correct?
It is a high-pitched, crowing upper airway sound.
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.
Which of the following statements regarding the mechanism of injury (MOI) is correct?
The MOI may allow you to predict the severity of a patient's injuries.
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.
Which of the following statements regarding the secondary assessment is correct?
You may not have time to perform a secondary assessment if you must continually manage life threats that were identified during the primary assessment.
Which of the following scenarios does NOT involve the presence of any symptoms?
a 61-year-old female who is unconscious with facial cyanosis
A decrease in the blood pressure may indicate:
a loss of vascular tone.
Which of the following patients does NOT have an altered mental status?
a patient with an acute allergic reaction and dizziness
Which of the following conditions would be LEAST likely to cause an altered level of consciousness?
acute anxiety
An elderly patient has fallen and hit her head. You assess her level of consciousness as unresponsive using the AVPU scale. 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 patient's 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, 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 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:
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 older 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.
Which of the following factors would MOST likely cause a patient's pulse rate to be slower than normal?
beta-blocker medications
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 a full-body scan on a trauma patient, you note the presence of Battle's sign. This is defined as:
bruising behind the ear.
With regard to the assessment of a patient's cardiovascular status, capillary refill time is MOST reliable in:
children who are younger than 6 years of age.
While en route to the scene of a shooting, the dispatcher advises you that the caller states that the perpetrator has fled the scene. You should:
confirm this information with law enforcement personnel at the scene.
When you inspect a patient's pupils with a penlight, the pupils should normally react to the light by:
constricting.
When palpating a patient's pulse, you note that it is grossly irregular. You should:
count the pulse rate for a full minute to obtain an accurate reading.
When assessing the skin of an unconscious patient, you note that it has a bluish tint to it. This finding is called:
cyanosis
A patient's short-term memory is MOST likely intact if he or she correctly answers questions regarding:
date and event
Cyanosis of the skin is caused by:
decreased blood oxygen.
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:
determine if the patient has a medical alert bracelet or wallet card.
When evaluating a patient with multiple complaints, the EMT's responsibility is to:
determine which complaint poses the greatest threat to the patient's life.
A patient with profuse sweating is referred to as being:
diaphoretic.
External bleeding from an extremity can usually be controlled by a combination of:
direct pressure and elevation.
The pulse oximeter is an assessment tool used to evaluate the:
effectiveness of oxygenation.
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 patient's 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
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 would NOT be appropriate 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 is an example of a symptom?
headache
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?
history taking
The goal of the primary assessment is to:
identify and rapidly treat all life-threatening conditions.
After performing a primary assessment, a rapid scan of the body should be performed in order to:
identify less obvious injuries that require immediate treatment.
If you cannot palpate a pulse in an unresponsive patient, you should:
immediately begin cardiopulmonary resuscitation (CPR).
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:
immediately suction her oropharynx.
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 obvious distress. Your first action should be to:
introduce yourself to the patient.
What maneuver should be used to open the airway of an unresponsive patient with suspected trauma?
jaw-thrust maneuver
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 full-body scan that is performed during the secondary assessment is to:
locate injuries not found in the primary assessment.
As you assess the head of a patient with a suspected spinal injury, your partner should:
maintain stabilization of the head.
End-tidal carbon dioxide (ETCO2) is defined as the:
maximal concentration of CO2 at the end of an exhaled breath.
The diastolic pressure represents the:
minimum amount of pressure that is always present in the arteries.
The chief complaint is MOST accurately defined as the:
most serious thing the patient is concerned about.
Typical methods of assessing a patient's breathing include all of the following, EXCEPT:
observing for nasal flaring during inhalation.
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
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:
open his airway with the jaw-thrust maneuver.
An injured patient is assigned a total score of 9 on the 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
Which of the following conditions would MOST likely cause the pupils to remain significantly constricted?
overdose of an opiate drug
In infants and small children, skin color should be assessed on the:
palms and soles.
A full-body scan should be performed on:
patients with a significant MOI and unresponsive medical patients.
The MOST effective way to determine whether your patient's problem is medical or traumatic in origin is to:
perform a careful and thorough assessment.
You respond to the scene of a motor vehicle collision. Upon arrival, you find the driver, a young female, sitting on the curb. She is confused, is in obvious respiratory distress, and has pale, moist skin. As your partner manually stabilizes her head, you perform a primary assessment. After performing any immediate livesaving treatment, you should:
perform a rapid scan of her entire body and prepare for immediate transport.
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 his:
peripheral circulation is decreased.
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.
When performing a full-body scan on a supine patient, what part of the body is typically assessed last?
posterior
A 50-year-old male presents with an altered mental status. His wife tells you that he had a "small stroke" 3 years ago but has otherwise been in good health. The patient is responsive but unable to follow commands. After administering oxygen, you should:
prepare for immediate transport.
A palpable pulse is created by:
pressure waves through the arteries caused by cardiac contraction.
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.
During the primary assessment, circulation is evaluated by assessing:
pulse quality, external bleeding, and skin condition.
Observations made when forming a general impression of a patient would include all of the following, EXCEPT:
pulse strength.
In responsive patients that 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 patient's 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 patient's 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 performing a reassessment of your patient, you should first:
repeat the primary assessment.
When interviewing a patient, you can show him or her that you understand the situation by:
repeating statements back to him or her.
Which of the following signs of respiratory distress is seen MOST commonly in pediatric patients?
seesaw breathing
Which of the following situations or conditions warrants immediate transport?
severe chest pain and cool, pale skin
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° angle.
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.
Which of the following abnormal breath sounds indicates obstruction of the upper airway?
stridor
A crackling sound produced by air bubbles under the skin is called:
subcutaneous emphysema.
When assessing a patient's abdomen, you will typically evaluate for all of the following, EXCEPT:
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.
Which of the following would the EMT most likely NOT perform on a responsive patient with a headache and no apparent life-threatening conditions?
systemic head-to-toe examination
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.
After the first 60 minutes of experiencing a significant injury:
the body's ability to compensate for shock decreases.
You should gently palpate a patient's pelvis only if:
the patient does not complain of pelvic pain.
The "Golden Period" 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.
A low ETCO2 reading, as measured by capnography, would MOST likely be observed if:
there is an absence or decrease in the level of CO2 in the lungs.
When a patient's respirations 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. In addition to administering oxygen, you should:
transport at once and consider requesting a paramedic unit.
A properly sized blood pressure cuff should cover:
two thirds the length from the armpit to the crease in the elbow.
During an EMS call, you should take standard precautions:
upon exiting the ambulance, but before actual patient contact.
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
When is it MOST appropriate to consider requesting additional ambulances at an accident scene?
when you determine there are multiple patients
When assessing motor function in a conscious patient's lower extremities, you should expect the patient to:
wiggle his or her toes on command.
Supplemental oxygen via nonrebreathing mask should be administered to patients:
with difficulty breathing and adequate tidal volume.
A patient with spontaneous respirations is breathing:
without assistance
Palpating the carotid pulse is not recommended in infants because:
you may inadvertently compress the trachea.
