Chapter 9: PATIENT ASSESSMENT

When you assess capillary refill time in an infant, normal color to the tested area should return within: a. 2 seconds. b. 1 second. c. 3 seconds. d. 4 seconds.

a. 2 seconds.

Which of the following statements regarding the blood pressure is correct? a. Blood pressure is usually not measured in children younger than 3 years of age. b. Blood pressure falls early in patients with hypoperfusion. c. The systolic pressure represents ventricular relaxation. d. Blood pressure is the most reliable indicator of perfusion.

a. Blood pressure is usually not measured in children younger than 3 years of age.

What maneuver should be used to open the airway of an unresponsive patient with suspected trauma? a. Jaw-thrust maneuver b. Head tilt-chin lift c. Head tilt-neck lift d. Tongue-jaw lift

a. Jaw-thrust maneuver

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. A secondary assessment should always be performed, even if you must continually manage life threats that were identified in the primary assessment. c. The secondary assessment should be performed en route to the hospital, regardless of the severity of the patient's condition. d. During the secondary assessment, the EMT's primary focus should be on taking the patient's vital signs and obtaining a SAMPLE history.

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

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: a. airway, breathing, and circulation. b. gathering medical history data. c. obtaining baseline vital signs. d. providing immediate transport.

a. airway, breathing, and circulation.

The pulse oximeter is an assessment tool used to evaluate the: a. effectiveness of oxygenation. b. saturation level of venous blood. c. amount of exhaled carbon dioxide. d. percentage of red blood cells

a. effectiveness of oxygenation.

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

a. locate injuries not found in the primary assessment.

The chief complaint is MOST accurately defined as the: a. most serious thing the patient is concerned about. b. most life-threatening condition that you discover. c. condition that exacerbates an underlying problem. d. gross physical signs that you detect on assessment.

a. most serious thing the patient is concerned about.

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 life-saving treatment, you should: a. perform a detailed head-to-toe exam and prepare for immediate transport. b. fully immobilize her spine, load her into the ambulance, and assess her vital signs. c. identify the specific areas of her injuries and focus your assessment on those areas. d. assess her vital signs, secure her to a backboard, and transport her immediately.

a. perform a detailed head-to-toe exam and prepare for immediate transport.

A palpable pulse is created by: a. pressure waves through the arteries caused by cardiac contraction. b. the pressure that is caused when venous blood returns to the heart. c. the pressure of circulating blood against the walls of the arteries. d. electrical conduction in the heart producing ventricular contraction.

a. pressure waves through the arteries caused by cardiac contraction.

During the primary assessment, circulation is evaluated by assessing: a. pulse quality, external bleeding, and skin condition. b. skin quality, blood pressure, and capillary refill. c. blood pressure, pulse rate, and external bleeding. d. external bleeding, skin condition, and capillary refill.

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

The pressure exerted against the walls of the artery when the left ventricle contracts is called the: a. systolic pressure. b. pulse pressure. c. diastolic pressure. d. blood pressure.

a. systolic pressure.

When a patient's respirations are shallow: a. tidal volume is markedly reduced. b. chest rise will be easily noticeable. c. carbon dioxide elimination is increased. d. oxygenation occurs more efficiently.

a. tidal volume is markedly reduced.

Which of the following questions would you ask a patient to ascertain the "M" in the SAMPLE history? a. "When was the last time you ate a meal?" b. "How much Tylenol do you take each day?" c. "Have you ever had any major surgeries?" d. "How long have you had your chest pain?"

b. "How much Tylenol do you take each day?"

During a 30-minute transport of a stable patient, you should reassess him or her at least ________ times. Select one: a. 4 b. 2 c. 6 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

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

b. A 59-year-old man complains of crushing chest pain but denies shortness of breath.

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. History taking c. Secondary assessment d. Primary assessment

b. History taking

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.

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

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

A crackling sound produced by air bubbles under the skin is called: a. Korotkoff sounds. b. subcutaneous emphysema. c. crepitus d. rhonchi.

b. subcutaneous emphysema.

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

c. Auscultating breath sounds with a stethoscope

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 spontaneously, is confused when spoken to, exhibits abnormal flexion b. Opens eyes in response to voice, makes incomprehensible sounds, localizes pain c. Opens eyes in response to pain, uses inappropriate words, withdraws from pain d. Eyes remain closed, makes incomprehensible sounds, exhibits abnormal extension

c. Opens eyes in response to pain, uses inappropriate words, withdraws from pain

Which of the following would the EMT likely NOT perform on a responsive patient with a headache and no apparent life-threatening conditions? a. Noninvasive blood pressure monitoring b. Assessment of oxygen saturation c. Systematic head-to-toe examination d. Focused secondary assessment

c. Systematic head-to-toe examination

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.

c. falsely high systolic and diastolic reading.

A patient with high blood pressure would be expected to have skin that is: a. cyanotic and dry. b. mottled and cool. c. flushed and red. d. pale and moist.

c. flushed and red.

The goal of the primary assessment is to: a. identify patients that require transport to a trauma center. b. determine if the patient's problem is medical or traumatic. c. identify and rapidly treat all life-threatening conditions. d. determine the need to perform a head-to-toe assessment.

c. identify and rapidly treat all life-threatening conditions.

When assessing a patient's abdomen, you will evaluate for all of the following, EXCEPT: a. gross bleeding and tenderness. b. rigidity and obvious bleeding. c. subcutaneous emphysema. d. open wounds or eviscerations.

c. subcutaneous emphysema.

A properly sized blood pressure cuff should cover: a. one half the length between the armpit and the crease at the elbow. b. one third the length from the armpit to the crease at the elbow. c. two thirds 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.

c. two thirds the length from the armpit to the crease at the elbow.

Which of the following conditions would be LEAST likely to cause an altered level of consciousness? a. Drug overdose b. Inadequate perfusion c. Poisoning d. Acute anxiety

d. Acute anxiety

For which of the following patients is spinal immobilization clearly indicated? a. Woman in a minor motor-vehicle collision who complains of severe knee pain b. Man with an arrow impaled in his leg and no pulse distal to the injury c. Woman who fell from a standing position and has a deformed shoulder d. Man who was struck in the head and is now confused and has slurred speech

d. Man who was struck in the head and is now confused and has slurred speech

Which of the following signs of respiratory distress is seen MOST commonly in pediatric patients? a. Accessory muscle use b. Pursed-lip breathing c. Rapid respirations d. Seesaw breathing

d. Seesaw breathing

Treatment and transport priorities at the scene of a mass-casualty incident should be determined after: a. the number of patients is known. b. a physician arrives at the scene. c. area hospitals have been notified. d. all the patients have been triaged.

d. all the patients have been triaged.

A patient's short-term memory is MOST likely intact if he or she correctly answers questions regarding: a. time and place. b. person and place. c. event and person. d. date and event.

d. date and event.

When approaching a 32-year-old male who is complaining of traumatic neck pain, you should: a. assess his mental status by having him move his head. b. approach him from behind and ask him not to move. c. stand behind him and immediately stabilize his head. d. ensure that the patient can see you approaching him.

d. ensure that the patient can see you approaching him.

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

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

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. assist her breathing with a bag-valve mask. b. quickly insert an oropharyngeal airway. c. assess the rate and quality of her pulse. d. immediately suction her oropharynx.

d. immediately suction her oropharynx.

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. gallbladder disease. c. renal insufficiency. d. liver dysfunction.

d. liver dysfunction.

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 pressure dressing to the patient's arm. b. tilt the patient's head back and lift up on his chin. c. apply a cervical collar and suction his airway. d. open his airway with the jaw-thrust maneuver.

d. open his airway with the jaw-thrust maneuver.

When assessing motor function in a conscious patient's lower extremities, you should expect the patient to: a. identify different types of stimuli. b. note any changes in temperature. c. feel you touching the extremity. d. wiggle his or her toes on command.

d. wiggle his or her toes on command.