EMT Chapter 10
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 admnistering oxygen if needed, you should: A. prepare for immediate transport B. repeat the primary assessment C. perform a head-to-toe assessment D. inquire about his family history
A
A decrease in blood pressure may indicate: A. loss of vascular tone B. arterial constriction C. forceful cardiac contraction D. increased blood volume
A
A pulse with a consistent pattern is considered to be: A. regular B. strong C. irregular D. weak
A
As time progresses following a significant injury: A. the body's ability to compensate for shock decreases B. the patient's blood pressure elevates significantly C. most patients will die secondary to internal bleeding D. the patient's injuries will most likely be irreparable
A
Clinical signs of labored breathing include all of the following, EXCEPT: A. shallow chest movement B. supraclavicular retractions C. gasping attempts to breathe D. use of accessory muscles
A
Cyanosis of the skin is caused by: A. decreased blood oxygen B. venous vasoconstriction C. peripheral vasodilation D. increased blood oxygen
A
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
Poor peripheral circulation will cause the skin to appear: A. ashen B. pink C. flushed D. cyanotic
A
When you assess capillary refill time in an infant, normal color to the tested area should return within: A. 2 seconds B. 4 seconds C. 3 seconds D. 1 second
A
When you inspect a patient's pupils with a penlight, the pupils should normally react to the light by: A. constricting B. enlarging C. fluttering D. dilating
A
Which of the following findings indicates that your patient has a patent airway? A. Ability to speak B. Audible breathing C. Unresponsiveness D. Inspiratory stridor
A
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
A
When assessing a patient's abdomen, you will evaluate for all of the following, EXCEPT: A. gross bleeding and tenderness B. subcutaneous emphysema C. rigidity and obvious bleeding D. open wounds or eviscerations
B
The goal of oxygenation for most patients is an oxygen saturation of: A. 88% to 90% B. 100% C. 94% to 99% D. 90% to 94%
C
Which of the following abnormal breath sounds indicates obstruction of the upper airway? A. Rhonchi B. Rales C. Stridor D. Crackles
C
Supplemental oxygen without assisted ventilation would MOST likely be administered to patients: A. who have accessory muscle use and slow breathing B. who are semiconscious with shallow respirations C. with rapid respirations and a reduced tidal volume D. with difficulty breathing and adequate tidal volume
D
The pressure exerted against the walls of the artery when the left ventricle contracts is called the: A. diastolic pressure B. pulse pressure C. apical pulse D. systolic pressure
D
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. immediately transport the child to the hospital C. begin chest compressions and request backup D. assess for a brachial pulse for 5 to 10 seconds
D
The rapid exam of a patient that occurs following the primary assessment should take no longer than: A. 90 seconds B. 120 seconds C. 60 seconds D. 30 seconds
A
A patient in unstable condition should be reassessed at least every: A. 15 minutes B. 5 minutes C. 20 minutes D. 10 minutes
B
Which of the following questions is used to determine a patient's chief complaint? A. "Do you have a history of diabetes?" B. "What seems to be the matter?" C. "Are you having trouble breathing?" D. "When did the chest pain begin?"
B
With regard to the assessment of a patient's cardiovascular status, capillary refill time is MOST reliable in: A. patients who are older than 70 years of age B. patients who are younger than 6 years of age C. patients who are significantly hypotensive D. patients who were exposed to cold temepratures
B
Capnography is used to: A. assess how much oxygen is bound to the hemoglobin B. trend a patient's blood pressure and assess for shock C. determine how much carbon dioxide is being exhaled D. assess how much oxygen is reaching the body's tissues
C
A patient with high blood pressure would be expected to have skin that is: A. mottled and cool B. pale and moist C. cyanotic and dry D. flushed and red
D
Which of the following signs of respiratory distress is usually observed only in pediatric patients? A. Rapid respirations B. Pursed-lip breathing C. Accessory muscle use D. Seesaw breathing
D
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: A. apply direct pressure to the wound B. administer 100% supplemental oxygen C. ensure that his airway is patent D. elevate his legs and keep him warm
A
When auscultating the blood pressure in a patient's upper extremity, you should place the diaphragm (head) of the stethoscope over the _____ artery. A. brachial B. femoral C. apical D. radial
A
While en route to the scene of a shooting, the dispatcher advises you that the perpetrator has fled the scene. You should: A. confirm this information with law enforcement personnel at the scene B. ask the dispatcher if he or she knows the location of the perpetrator C. request law enforcement personnel if the scene is unsafe upon arrival D. proceed to the scene as usual but exercise extreme caution upon arrival
A
Observations made when forming a general impression of a patient would include all of the following, EXCEPT: A. race and gender B. pulse strength C. level of distress D. appearance
B
When palpating the carotid pulse of a responsive patient, you should: A. firmly compress the artery because the pulse is often weak B. avoid compressing both carotid arteries simultaneously C. ensure that his or her head is in a hyperextended position D. avoid gentle pressure so that weak pulses can be detected
B
When performing a rapid exam on a supine patient, what part of the body is typically assessed last? A. Abdomen B. Posterior C. Anterior chest D. Extremities
B
Which of the following statements regarding the secondary assessment is correct? A. If your general impression of a patient does not reveal any obvious life threats, you should proceed directly to the secondary assessment B. You may not have time to perform a secondary assessment if you must continually manage life threats that were identified during the primary assessment C. The purpose of the secondary assessment is to systematically examine every patient from head to toe, regardless of the severity of his or her injury D. A focused secondary assessment would be the most appropriate approach for a patient who experienced significant trauma to multiple body systems
B
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. direct your partner to move the gun to a safe area and then advise the patient that his weapon has been secured B. position yourself in between the patient and the gun and ask your partner to request law enforcement assistance C. document the presence of the weapon, including its specific location, and continue your assessment of the patient D. immediately cease all patient care, carefully back out of the residence, and request law enforcement assistance
B
For which of the following patients is spinal immobilization clearly indicated? A. Woman who fell from a standing position and has a deformed shoulder B. Woman in a minor motor-vehicle collision who complains of severe knee pain C. Man with altered mental status after being exposed to blunt force trauma D. Man with an arrow impaled in his leg and no pulse distal to the injury
C
Reassessment is performed to determine all of the following, EXCEPT: A. whether or not the patient is deteriorating B. the nature of any newly identified problems C. the reason why the patient called EMS D. the patient's response to your treatment
C
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. Secondary assessment B. Primary assessment C. History taking D. General impression
C
When assessing motor function in a conscious patient's lower extremities, you should expect the patient to: A. note any changes in temperature B. identify different types of stimuli C. wiggle his or her toes on command D. feel you touching the extremity
C
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. definitive 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
When is it MOST appropriate to consider requesting additional ambulances at an accident scene? A. After you have triaged all the critical patients B. When all the deceased patients are accounted for C. When you determine there are multiple patients D. After noncritical patients have been identified
C
Which of the following assessments would be the MOST useful in determining the possible cause of a patient's altered mental status? A. Blood pressure B. Capillary refill time C. Blood glucose level D. Respiratory rate
C
Which of the following occurs when a patient's respirations are shallow? A. Carbon dioxide elimination is increased B. Oxygenation occurs more efficiently C. Tidal volume is markedly reduced D. Chest rise will be easily noticeable
C
Which of the following pupillary changes would indicate depressed brain function? A. Both pupils react briskly to light instead of sluggishly B. Both pupils constrict when a bright light is introduced C. Both pupils are sluggish with introduction of a bright light D. Both pupils dilate when a bright light is removed
C
Which of the following situations or conditions warrants immediate transport? A. Decreased ability to move an extremity B. Ability to follow commands C. Severe chest pain and cool, pale skin D. Mild pain in the lower abdomen
C
Which of the following statements regarding stridor is correct? A. It is caused by incorrect airway positioning B. It suggest the presence of fluid in the lungs C. It is high-pitched,, crowing upper airway sound D. It is a whistling sound heard in the lower airway
C
An adult patient who is NOT experiencing difficulty breathing will: A. assume a position that will facilitate effective and easy breathing B. have respiratory rate that is between 20 and 24 breaths/min C. exhibit an indentation above the clavicles and in between the ribs D. be able to speak in complete sentences without unusual pauses
D
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. liver dysfunction B. acute pancreatitis C. renal insufficiency D. gallbladder disease
A
Jugular venous distention suggest a problem with blood returning to the heart if the patient is: A. sitting up at a 45° angle B. in a recumbent position C. in a prone position D. in a supine position
A
Normal respiratory rates should not exceed _____ breaths per minute in toddlers and _____ breaths per minute in infants A. 40, 60 B. 20, 30 C. 30, 40 D. 18, 28
A
Normal skin color, temperature, and condition should be: A. pink, warm, and dry B. pink, warm, and moist C. pale, cool, and moist D. flushed, cool, and dry
A
The "Golden Hour" begins when an injury occurs and ends when: A. the patient receives definitive care B. you depart the scene for the hospital C. you arrive at the emergency department D. the patient is admitted to the ICU
A
The goal of the primary assessment is to: A. identify and rapidly treat all life-threatening conditions B. identify patients that require transport to a trauma center C. determine if the patient's problem is medical or traumatic D. determine the need to perform a head-to-toe assessment
A
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. assess only the parts of the body that are injured D. definitively rule out significant internal injuries
A
The systematic head-to-toe assessment should be performed on: A. patients with a significant MOI and unresponsive medical patients B. responsive medical patients and patients without a significant MOI C. stable patients who are able to tell you exactly what happened D. all patients with traumatic injuries who will require EMS transport
A
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 maneuver C. Head tilt-neck maneuver D. Tongue-jaw lift maneuver
A
Which of the following is the MOST effective method of assessing the quality of air movement in the lungs? A. Auscultating breath sounds with a stethoscope B. Applying a pulse oximeter and monitoring the SpO2 C. Looking for the presence of accessory muscle use D. Evaluating the patient's chest for cyanosis
A
Which of the following would the EMT likely NOT perform on a responsive patient with a headache and no apparent life-threatening conditions? A. Systematic head-to-toe examination B. Noninvasive blood pressure monitoring C. Focused secondary assessment D. Assessment of oxygen saturation
A
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 up on his chin B. open his airway with the jaw-thrust maneuver C. apply a cervical collar and suction his airway D. apply a pressure dressing to the patient's arm
B
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: A. ask law enforcement officials if they are familiar with the patient B. determine if the patient has a medical alert bracelet or wallet card C. wait for family members to arrive before asking any questions D. defer SAMPLE history questions until you arrive at the hospital
B
A 71-year-old female slipped on a rug and fell. She is conscious but confused and complains of severe pelvic pain. Her respirations are 22 breaths per minute, and her heart rate is 120 beats per minute. What should you do? A. Transport her in a seated position B. Treat her for possible shock C. Transport her on her left side D. Gently palpate her pelvis
B
A blood pressure cuff that is too small for a patient's arm will give a: A. falsely low systolic but high diastolic reading B. falsely high systolic and diastolic reading C. falsely high systolic but low diastolic reading D. falsely low systolic and diastolic reading
B
A palpable pulse is created by: A. the pressure that is caused when venous blood returns to the heart B. pressure waves through the arteries caused by cardiac contraction C. the pressure of circulating blood against the walls of the veins D. electrical conduction in the heart producing contraction of the atria
B
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 a decreased level of consciousness B. is experiencing difficulty breathing C. has abdominal muscle spasms D. is experiencing severe back pain
B
After performing a head tilt-chin lift maneuver to open the airway of an unresponsive patient, you should: A. provide positive-pressure ventilatory assistance B. suction as needed and insert an airway adjunct C. place him or her in the recovery position D. assess respiratory rate, depth, and regularity
B
For an adult, the normal resting pulse should be between: A. 40 and 50 beats per minute B. 60 and 100 beats per minute C. 100 and 110 beats per minute D. 50 and 60 beats per minute
B
In infants and small children, skin color should be assessed on the: A. chest and abdomen B. palms and soles C. forehead D. underside of the arms
B
In which of the following situations is a pertinent negative identified? A. A 53-year-old man with dizziness also tells you that he has vomited three times B. A 59-year-old man complains of crushing chest pain but denies shortness of breath C. A 50-year-old woman states that nothing makes her chest pain better or worse D. A 56-year-old woman states that her chest hurts when she takes a deep breath
B
The diastolic blood pressure represents the: A. difference in pressure between ventricular contraction and relaxation B. minimum amount of pressure that is always present in the arteries C. increased arterial pressure that occurs during ventricular contraction D. average pressure against the arterial walls during a cardiac cycle
B
The normal respiratory rate for an adult should range from: A. 10 to 12 breaths per minute B. 12 to 20 breaths per minute C. 24 to 28 breaths per minute D.. 18 to 24 breaths per minute
B
The pulse oximeter is an assessment tool used to evaluate the: A. amount of exhaled carbon dioxide B. saturation level of arterial blood C. level of carbon dioxide D. quantity of red blood cells
B
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. immediately suction her oropharynx C. quickly insert an oropharyngeal airway D. assess the rate and quality of her pulse
B
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: A. assess her vital signs, secure her to a backboard, and transport her immediately B. perform a detailed head-to-toe exam and prepare for immediate transport C. identify the specific areas of her injuries and focus your assessment on those areas D. fully immobilize her spine, load her into the ambulance, and assess her vital signs
B
If you cannot palpate a pulse in an unresponsive patient, you should: A. assess for adequate breathing B. palpate at another pulse site C. immediately begin CPR D. apply an AED at once
C
In responsive patients who are older than 1 year of age, you should palpate the pulse at the ________ artery. A. femoral B. carotid C. radial D. brachial
C
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. 50, 100 B. 30, 130 C. 60, 100 D. 40, 120
C
The MOST effective way to determine whether your patient's problem is medical or traumatic in origin is to: A. take note of the patient's general appearance B. ask if bystanders are familiar with the patient C. perform a careful and thorough assessment D. establish the patient's medical history early
C
Treatment and transport priorities at the scene of a mass-casualty incident should be determined after: A. medical control has been contacted B. area hospitals have been notified C. all the patients have been triaged D. a physician arrives at the scene
C
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. mottling C. cyanosis D. flushing
C
When interviewing a patient, you can show him or her that you understand the situation by: A. interrupting him or her as needed for clarification B. maintaining constant eye contact with him or her C. repeating statements back to him or her D. using medical terminology whenever possible
C
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. 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 C. any situation that causes vasoconstriction or loss of red blood cells, such as anemia or bleeding, may result in an inaccurate or misleading value D. carbon monoxide has no effect on pulse oximetry readings because the pulse oximeter presumes presumes that oxygen is saturating the hemoglobin
C
Which of the following statements regarding the blood pressure is correct? A. Blood pressure is the most reliable indicator of perfusion B. The systolic pressure represents ventricular relaxation C. Blood pressure is usually not measured in children younger than 3 years of age D. Blood pressure falls early in patients with hypoperfusion
C
Which of the following statements regarding the mechanism of injury (MOI) is correct? A. A nonsignificant MOI rules out the possibility of serious treatment B. The exact location of a patient's injuries can be determined by the MOI C. The MOI may allow you to predict the severity of a patient's injuries D. A significant MOI usually results in patient death or permanent disability
C
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 contracting B. ventricles contracting C. ventricles relaxing D. atria relaxing
C
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. request a paramedic unit B. apply a pulse oximeter C. assist his ventilations D. assess his blood pressure
C
You respond to the residence of a 62-year-old male who is unresponsive. Your patient assessment reveals that he is apneic and pulseless. You should: A. notify dispatch and request a paramedic ambulance B. ask the family if the patient has a terminal disease C. start CPR and attach the AED as soon as possible D. perform CPR and transport the patient immediately
C
As you assess the head of a patient with a suspected spinal injury, your partner should: A. look in the ears for gross bleeding B. assess the rest of the body for bleeding C. prepare the immobilization equipment D. maintain stabilization of the head
D
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. respiratory status is adequate C. skin temperature is abnormally cold D. peripheral circulation is decreased
D
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. auscultate his or her breath sounds D. reevaluate his or her airway status
D
Pain that moves from its point of origin to another body location is said to be: A. provoking B. palliating C. referred D. radiating
D
Palliating factors regarding a patient's pain involve those that: A. change the pain B. worsen the pain C. initiate the pain D. alleviate the pain
D
Upon arriving at a potentially unsafe scene, you should first: A. remove all bystanders B. request another ambulance C. move the patient to safety D. ensure that you are safe
D
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. assess the patient's airway status B. ask the patient what's wrong C. obtain a set of baseline vital signs D. introduce yourself to the patient
D
When approaching a 32-year-old male who is complaining of traumatic neck pain, you should: A. stand behind him and immediately stabilize his head B. approach him from behind and ask him not to move C. assess his mental status by having him move his head D. ensure that the patient can see you approaching him
D
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. document your findings and perform a detailed assessment B. apply the AED and analyze her cardiac rhythm C. conclude that the irregular pulse is normal based on her age D. transport at once and consider requesting a paramedic unit
D
When should you take standard precautions during an EMS call? A. Before you load the patient into the ambulance B. Immediately after completion of your primary assessment C. After it has been determined that the patient is bleeding D. Before exiting the ambulance and before actual patient contact
D
When you shine a light into one pupil, the normal reaction of the other pupil should be to: A. not react B. dilate C. become larger D. become smaller
D
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
Which of the following factors would MOST likely cause a patient's pulse rate to be slower than normal? A. Lack of a regular exercise routine B. Internal bleeding from trauma C. Anxiety or severe stress D. Beta blocker medications
D
Which of the following patient responses would establish the "E" in the SAMPLE history? A. "I am not having any difficulty breathing." B. "The chest pain started about 45 minutes ago." C. "I was in the hospital a week ago" D. "I was mowing the lawn when the pain began."
D
Which of the following questions is used to determine a patient's chief complaint? A. "Are you having trouble breathing?" B. "When did the chest pain begin?" C. "Do you have a history of diabetes?" D. "What seems to be the matter?"
D
Which of the following scenarios does NOT invoke the presence of any symptoms? A. A 49-year-old female with blurred vision and ringing in the ears B. A 44-year-old male with abdominal pain and severe dizziness 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
D
