Ch. 9 Patient Assessment Quiz
Which of the following questions is used to determine a patient's chief complaint? A) "What seems to be the matter?" B) "When did the chest pain begin?" C) "Are you having trouble breathing?" D) "Do you have a history of diabetes?"
Correct Answer A) "What seems to be the matter?"
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) using medical terminology whenever possible. C) maintaining constant eye contact with him or her. D) interrupting him or her as needed for clarification.
Correct Answer A) repeating statements back to him or her.
The rapid exam of a patient that occurs following the primary assessment should take no longer than: A) 30 seconds. B) 60 to 90 seconds. C) 90 to 120 seconds. D) 120 to 180 seconds.
Correct Answer B) 60 to 90 seconds.
When performing a rapid exam on a supine patient, what part of the body is typically assessed last? A) Abdomen B) Posterior C) Extremities D) Anterior chest
Correct Answer B) Posterior
After performing a primary assessment, a rapid exam of the body should be performed to: A) determine the need for spinal motion restriction precautions. B) identify less-obvious injuries that require immediate treatment. C) look specifically for signs and symptoms of inadequate perfusion. D) find and treat injuries or conditions that do not pose a threat to life.
Correct Answer B) identify less-obvious injuries that require immediate treatment.
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) apply the AED and analyze her cardiac rhythm. B) transport at once and consider requesting a paramedic unit. C) document your findings and perform a detailed assessment. D) conclude that the irregular pulse is normal based on her age.
Correct Answer B) transport at once and consider requesting a paramedic unit.
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 53-year-old man with dizziness also tells you that he has vomited three times. C) A 56-year-old woman states that her chest hurts when she takes a deep breath. D) A 59-year-old man complains of crushing chest pain but denies shortness of breath.
Correct Answer D) A 59-year-old man complains of crushing chest pain but denies shortness of breath.
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 respiratory distress. Your first action should be to: A) ask the patient what's wrong. B) obtain a set of baseline vital signs. C) assess the patient's airway status. D) introduce yourself to the patient.
Correct Answer D) introduce yourself to the patient.
A crackling sound produced by air bubbles under the skin is called: A) crepitus B) rhonchi. C) Korotkoff sounds. D) subcutaneous emphysema.
Correct Answer D) subcutaneous emphysema.
When there are low levels of oxygen in the blood, the lips and mucous membranes appear blue or gray. This condition is called: A) Cyanosis B) Pallor C) Jaundice D) Ashen
Correct Response A) Cyanosis
During a 30-minute transport of a stable patient, you should reassess him or her at least ________ times. A) 2 B) 3 C) 4 D) 6
Correct Response A) 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) 60, 100 B) 50, 110 C) 40, 120 D) 30, 130
Correct Response A) 60, 100
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) History taking B) General impression C) Primary assessment D) Secondary assessment
Correct Response A) History taking
Which of the following signs of respiratory distress is seen MOST commonly in pediatric patients? A) Seesaw breathing B) Rapid respirations C) Pursed-lip breathing D) Accessory muscle use
Correct Response A) Seesaw breathing
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) The secondary assessment should be performed en route to the hospital, regardless of the severity of the patient's condition. C) A secondary assessment should always be performed, even if you must continually manage life threats that were identified in the primary assessment. D) During the secondary assessment, the EMT's primary focus should be on taking the patient's vital signs and obtaining a SAMPLE history.
Correct Response A) The secondary assessment should focus on a certain area or region of the body as determined by the chief complaint.
When palpating the carotid pulse of a responsive patient, you should: A) avoid compressing both carotid arteries simultaneously. B) ensure that his or her head is in a hyperextended position. C) avoid gentle pressure so that weak pulses can be detected. D) firmly compress the artery because the pulse is often weak.
Correct Response 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) assume a position that will facilitate effective and easy breathing. C) exhibit an indentation above the clavicles and in between the ribs. D) have a respiratory rate that is between 20 and 24 breaths/min.
Correct Response A) be able to speak in complete sentenc
When you inspect a patient's pupils with a penlight, the pupils should normally react to the light by: A) constricting. B) enlarging. C) dilating. D) fluttering.
Correct Response A) constricting.
Capnography is used to: A) determine how much carbon dioxide is being exhaled. B) assess how much oxygen is bound to the hemoglobin. C) trend a patient's blood pressure and assess for shock. D) assess how much oxygen is reaching the body's tissues.
Correct Response A) determine how much carbon dioxide is being exhaled.
A patient with high blood pressure would be expected to have skin that is: A) flushed and red. B) mottled and cool. C) pale and moist. D) cyanotic and dry.
Correct Response A) flushed and red
A decrease in blood pressure may indicate: A) loss of vascular tone. B) arterial constriction. C) increased blood volume. D) forceful cardiac contraction.
Correct Response A) loss of vascular tone
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 significantly hypotensive. C) patients who were exposed to cold temperatures. D) patients who are older than 70 years of age.
Correct Response A) patients who are younger than 6 years of age.
Normal skin color, temperature, and condition should be: A) pink, warm, and dry. B) pale, cool, and moist. C) pink, warm, and moist. D) flushed, cool, and dry.
Correct Response A) pink, warm, and dry.
In responsive patients who are older than 1 year of age, you should palpate the pulse at the ________ artery. A) radial B) carotid C) brachial D) femoral
Correct Response A) radial
Pain that moves from its point of origin to another body location is said to be: A) radiating. B) referred. C) palliating. D) provoking.
Correct Response A) radiating.
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: A) start CPR and attach the AED as soon as possible. B) ask the family if the patient has a terminal disease. C) perform CPR and transport the patient immediately. D) notify dispatch and request a paramedic ambulance.
Correct Response A) start CPR and attach the AED as soon as possible.
When assessing a patient's abdomen, you will evaluate for all of the following, EXCEPT: A) subcutaneous emphysema. B) open wounds or eviscerations. C) gross bleeding and tenderness. D) rigidity and obvious bleeding.
Correct Response A) subcutaneous emphysema.
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.
Correct Response A) the patient receives definitive care.
A properly sized blood pressure cuff should cover: A) two thirds the length from the armpit to the crease at the elbow. B) one half the length between the armpit and the crease at the elbow. C) one third the length from the armpit to the crease at the elbow. D) the entire upper arm between the armpit and the crease at the elbow.
Correct Response A) two thirds the length from the armpit to the crease at the elbow.
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) feel you touching the extremity. C) note any changes in temperature. D) identify different types of stimuli.
Correct Response A) wiggle his or her toes on command.
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) "Does your mother have diabetes?" C) "Has this ever happened to you before?" D) "Are there medications that you cannot take?"
Correct Response B) "Does your mother have diabetes?"
When you assess capillary refill time in an infant, normal color to the tested area should return within: A) 1 second. B) 2 seconds. C) 3 seconds. D) 4 seconds.
Correct Response B) 2 seconds.
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) Beta-blocker medications C) Internal bleeding from trauma D) Lack of a regular exercise routine
Correct Response B) Beta-blocker medications
What maneuver should be used to open the airway of an unresponsive patient with suspected trauma? A) Tongue-jaw lift B) Jaw-thrust maneuver C) Head tilt-chin lift D) Head tilt-neck lift
Correct Response B) 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? A) Opens eyes in response to voice, makes incomprehensible sounds, localizes pain B) Opens eyes in response to pain, uses inappropriate words, withdraws from pain C) Opens eyes spontaneously, is confused when spoken to, exhibits abnormal flexion D) Eyes remain closed, makes incomprehensible sounds, exhibits abnormal extension
Correct Response B) Opens eyes in response to pain, uses inappropriate words, withdraws from pain
Which of the following situations or conditions warrants immediate transport? A) Mild pain in the lower abdomen B) Severe chest pain and cool, pale skin C) Decreased ability to move an extremity D) Responsiveness and ability to follow commands
Correct Response B) Severe chest pain and cool, pale skin
Which of the following abnormal breath sounds indicates obstruction of the upper airway? A) Rales B) Stridor C) Crackles D) Rhonchi
Correct Response B) Stridor
Palliating factors regarding a patient's pain involve those that: A) worsen the pain. B) alleviate the pain. C) initiate the pain. D) change the pain.
Correct Response B) alleviate the pain.
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. He is screaming in pain and is attempting to control the bleeding, which is bright red and spurting from his groin area. You should: A) ensure that his airway is patent. B) apply direct pressure to the wound. C) elevate his legs and keep him warm. D) administer 100% supplemental oxygen.
Correct Response B) apply direct pressure to the wound
Poor peripheral circulation will cause the skin to appear: A) pink. B) ashen. C) flushed. D) cyanotic.
Correct Response B) ashen.
With _____, the force of the injury occurs over a broad area, and the skin is usually not broken. A) motor vehicle collisions B) blunt trauma C) penetrating trauma D) gunshot wounds
Correct Response B) blunt trauma
When performing the secondary assessment on a trauma patient, you note the presence of Battle sign. This is defined as: A) unequal pupils. B) bruising behind the ear. C) swelling to the orbital area. D) fluid drainage from the nose.
Correct Response B) bruising behind the ear.
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: A) acute pancreatitis. B) liver dysfunction. C) gallbladder disease. D) renal insufficiency.
Correct Response B) liver dysfunction.
The diastolic blood pressure represents the: A) average pressure against the arterial walls during a cardiac cycle. B) minimum amount of pressure that is always present in the arteries. C) increased arterial pressure that occurs during ventricular contraction. D) difference in pressure between ventricular contraction and relaxation.
Correct Response B) minimum amount of pressure that is always present in the arteries.
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) apply a cervical collar and suction his airway. B) open his airway with the jaw-thrust maneuver. C) apply a pressure dressing to the patient's arm. D) tilt the patient's head back and lift up on his chin.
Correct Response B) open his airway with the jaw-thrust maneuver.
When palpating a patient's pulse, you note that there is a short interval between pulsations. This indicates that the pulse is: A) slow. B) rapid. C) irregular. D) thready.
Correct Response B) rapid.
When you use the palpation method to obtain a blood pressure, the measurement you obtain is the: A) pulse pressure. B) systolic blood pressure. C) diastolic blood pressure. D) cardiac output pressure.
Correct Response B) systolic blood pressure.
You should gently palpate a patient's pelvis only if: A) you note gross deformity to the pelvic area. B) the patient does not complain of pelvic pain. C) the MOI suggests significant trauma to the pelvis. D) the possibility of a pelvic fracture has been ruled out.
Correct Response B) the patient does not complain of pelvic pain.
When a patient's respirations are shallow: A) chest rise will be easily noticeable. B) tidal volume is markedly reduced. C) oxygenation occurs more efficiently. D) carbon dioxide elimination is increased.
Correct Response B) tidal volume is markedly reduced.
Which of the following questions would you ask a patient to ascertain the "M" in the SAMPLE history? A) "Have you ever had any major surgeries?" B) "How long have you had your chest pain?" C) "How much Tylenol do you take each day?" D) "When was the last time you ate a meal?"
Correct Response C) "How much Tylenol do you take each day?"
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: A) 10. B) 12. C) 13. D) 14.
Correct Response C) 13.
Which of the following conditions would be LEAST likely to cause an altered level of consciousness? A) Drug overdose B) Inadequate perfusion C) Acute anxiety D) Poisoning
Correct Response C) Acute anxiety
Which of the following is the MOST effective method of assessing the quality of air movement in the lungs? A) Evaluating the patient's chest for cyanosis B) Applying a pulse oximeter and monitoring the SpO2 C) Auscultating breath sounds with a stethoscope D) Looking for the presence of accessory muscle use
Correct Response C) Auscultating breath sounds with a stethoscope
Which of the following assessments would be the MOST useful in determining the possible cause of a patient's altered mental status? A) Respiratory rate B) Blood pressure C) Blood glucose level D) Capillary refill time
Correct Response C) Blood glucose level
Which of the following statements regarding stridor is correct? A) It is a whistling sound heard in the lower airway. B) It is caused by incorrect airway positioning. C) It is a high-pitched, crowing upper airway sound. D) It suggests the presence of fluid in the lungs.
Correct Response C) It is a high-pitched, crowing upper airway sound.
Which of the following MOST accurately describes paradoxical movement of the chest wall? A) Multiple rib fractures that cause a marked deformity of the chest wall B) A marked decrease in chest wall movement due to abdominal breathing C) Only one section of the chest rises on inspiration, while another area falls D) One side of the chest wall moves opposite the direction of the other
Correct Response C) Only one section of the chest rises on inspiration, while another area falls
Which of the following would the EMT likely NOT perform on a responsive patient with a headache and no apparent life-threatening conditions? A) Focused secondary assessment B) Assessment of oxygen saturation C) Systematic head-to-toe examination D) Noninvasive blood pressure monitoring
Correct Response C) Systematic head-to-toe examination
Treatment and transport priorities at the scene of a mass-casualty incident should be determined after: A) a physician arrives at the scene. B) the number of patients is known. C) all the patients have been triaged. D) area hospitals have been notified.
Correct Response C) all the patients have been triaged.
When assessing the skin of an unresponsive patient, you note that it has a bluish tint to it. This finding is called: A) pallor. B) flushing. C) cyanosis. D) mottling.
Correct Response C) cyanosis.
The scene size-up consists of all of the following, EXCEPT: A) determining the mechanism of injury. B) requesting additional assistance. C) determining level of responsiveness. D) using personal protective equipment (PPE) and standard precautions.
Correct Response C) determining level of responsiveness.
A patient with profuse sweating is referred to as being: A) flushed. B) plethoric. C) diaphoretic. D) edematous.
Correct Response C) diaphoretic.
A blood pressure cuff that is too small for a patient's arm will give a: A) falsely low systolic and diastolic reading. B) falsely high systolic but low diastolic reading. C) falsely high systolic and diastolic reading. D) falsely low systolic but high diastolic reading.
Correct Response C) falsely high systolic and diastolic reading.
The best indicator of brain function is the patient's: A) pulse rate. B) papillary response. C) mental status. D) respiratory rate and depth.
Correct Response C) mental status.
A 50-year-old male presents with altered mental status. His wife tells you that he had a "small stroke" three years ago but has otherwise been in good health. The patient is responsive but unable to follow commands. After administering oxygen if needed, you should: A) repeat the primary assessment. B) inquire about his family history. C) prepare for immediate transport. D) perform a head-to-toe assessment.
Correct Response C) prepare for immediate transport.
A palpable pulse is created by: A) the pressure of circulating blood against the walls of the arteries. B) the pressure that is caused when venous blood returns to the heart. C) pressure waves through the arteries caused by cardiac contraction. D) electrical conduction in the heart producing ventricular contraction.
Correct Response C) 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: A) apply a pulse oximeter. B) request a paramedic unit. C) provide assisted ventilation. D) assess his blood pressure
Correct Response C) provide assisted ventilation.
If a patient develops difficulty breathing after your primary assessment, you should immediately: A) determine his or her respiratory rate. B) begin assisting his or her breathing. C) reevaluate his or her airway status. D) auscultate his or her breath sounds.
Correct Response C) reevaluate his or her airway status
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) atria contracting. C) ventricles relaxing. D) ventricles contracting.
Correct Response C) ventricles relaxing.
Normal respiratory rates should not exceed _______ breaths per minute in toddlers and _______ breaths per minute in infants. A) 18, 28 B) 20, 30 C) 30, 40 D) 40, 60
Correct Response D) 40, 60
Which of the following scenarios does NOT involve the presence of any symptoms? A) A 44-year-old male with abdominal pain and severe dizziness B) A 49-year-old female with blurred vision and ringing in the ears C) A 55-year-old male with a severe headache and 2 days of nausea D) A 61-year-old female who is unconscious with facial cyanosis
Correct Response D) A 61-year-old female who is unconscious with facial cyanosis
Which of the following statements regarding the blood pressure is correct? A) The systolic pressure represents ventricular relaxation. B) Blood pressure falls early in patients with hypoperfusion. C) Blood pressure is the most reliable indicator of perfusion. D) Blood pressure is usually not measured in children younger than 3 years of age.
Correct Response D) Blood pressure is usually not measured in children younger than 3 years of age.
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 is NOT indicated for this patient? A) Rapid head-to-toe exam B) Application of a cervical collar C) Treating her for possible shock D) Gentle palpation of the pelvis
Correct Response D) Gentle palpation of the pelvis
An elderly patient has fallen and hit her head. Your initial care should focus on: A) obtaining baseline vital signs. B) gathering medical history data. C) providing immediate transport. D) airway, breathing, and circulation.
Correct Response D) airway, breathing, and circulation.
When using the pulse oximeter as part of your assessment of a patient, it is important to remember that: A) pulse oximetry is especially useful in patients who have cold extremities because vasoconstriction forces blood to the capillary beds. B) carbon monoxide has no effect on pulse oximetry readings because the pulse oximeter presumes that oxygen is saturating the hemoglobin. C) 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. D) any situation that causes vasoconstriction or loss of red blood cells, such as anemia or bleeding, may result in an inaccurate or misleading value.
Correct Response D) any situation that causes vasoconstriction or loss of red blood cells, such as anemia or bleeding, may result in an inaccurate or misleading value.
You receive a call to a 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) open the airway and give two rescue breaths. B) begin chest compressions and request backup. C) immediately transport the child to the hospital. D) assess for a brachial pulse for 5 to 10 seconds.
Correct Response D) assess for a brachial pulse for 5 to 10 seconds.
When you shine a light into one pupil, the normal reaction of the other pupil should be to: A) dilate. B) not react. C) become larger. D) become smaller.
Correct Response D) become smaller.
During an EMS call, you should take standard precautions: A) before you load the patient into the ambulance. B) after it has been determined that the patient is bleeding. C) immediately after completion of your primary assessment. D) before exiting the ambulance and before actual patient contact.
Correct Response D) before exiting the ambulance and before actual patient contact
For children younger than 1 year old, you should palpate the _____ artery when assessing the pulse. A) carotid B) radial C) femoral D) brachial
Correct Response D) brachial
When auscultating the blood pressure in a patient's upper extremity, you should place the head of the stethoscope over the _________ artery. A) radial B) apical C) femoral D) brachial
Correct Response D) brachial
When palpating a patient's pulse, you note that it is grossly irregular. You should: A) count the pulse rate for at least 30 seconds to ensure accuracy. B) count the number of pulsations in 15 seconds and multiply by four. C) count the number of pulsations in 30 seconds and multiply by two. D) count the pulse rate for a full minute to obtain an accurate reading.
Correct Response D) count the pulse rate for a full minute to obtain an accurate reading.
Upon arriving at a potentially unsafe scene, you should: A) remove all bystanders. B) request another ambulance. C) move the patient to safety. D) ensure that you are safe.
Correct Response D) ensure that you are safe.
A patient is sitting in a chair, leaning forward on his outstretched arms. His head and chin are thrust forward. This position indicates that he: A) has abdominal muscle spasms. B) is experiencing severe back pain. C) has a decreased level of consciousness. D) is experiencing difficulty breathing.
Correct Response D) is experiencing difficulty breathing.
In patients with deeply pigmented skin, changes in color may be apparent only in certain areas, such as the: A) back of the neck. B) forehead and face. C) dorsum of the hand. D) lips or oral mucosa.
Correct Response D) lips or oral mucosa.
The systematic head-to-toe assessment should be performed on: A) stable patients who are able to tell you exactly what happened. B) all patients with traumatic injuries who will require EMS transport. C) responsive medical patients and patients without a significant MOI. D) patients with a significant MOI and unresponsive medical patients.
Correct Response D) patients with a significant MOI and unresponsive medical patients.
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: A) immediately cease all patient care, carefully back out of the residence, and request law enforcement assistance. B) direct your partner to move the gun to a safe area and then advise the patient that his weapon has been secured. C) document the presence of the weapon, including its specific location, and continue your assessment of the patient. D) position yourself in between the patient and the gun and ask your partner to request law enforcement assistance.
Correct Response D) position yourself in between the patient and the gun and ask your partner to request law enforcement assistance.
A patient who does not respond to your questions, but moves or cries out when his or her trapezius muscle is pinched, is said to be: A) conscious and alert. B) completely unresponsive. C) responsive to verbal stimuli. D) responsive to painful stimuli.
Correct Response D) responsive to painful stimuli.
Jugular venous distention suggests a problem with blood returning to the heart if the patient is: A) in a supine position. B) in a prone position. C) in a recumbent position. D) sitting up at a 45° angle.
Correct Response D) sitting up at a 45° angle.
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) provide positive-pressure ventilatory assistance. C) assess respiratory rate, depth, and regularity. D) suction as needed and insert an airway adjunct.
Correct Response D) suction as needed and insert an airway adjunct.
Supplemental oxygen without assisted ventilation would MOST likely be administered to patients: A) who are semiconscious with shallow respirations. B) with rapid respirations and a reduced tidal volume. C) who have accessory muscle use and slow breathing. D) with difficulty breathing and adequate tidal volume.
Correct Response D) with difficulty breathing and adequate tidal volume.