118 Exam #1 Flashcards
Your febrile patient complains of body aches and vomiting, but denies diarrhea. In this case, diarrhea is a…
Pertinent Negative
(p. 537)
Your first priority on any incident is…
Responder Safety (p.505)
During your initial assessment, your unconscious medical patient has snoring respirations with a normal respiratory rate. You should…
Perform a head-tilt chin-lift maneuver (p. 512)
Your unconscious cyanotic patient has labored breathing at 46… times per minute. You should
insert a NPA and use a BVM to ventilate (p512-513)
Oxygen saturation should be maintained at a minimum of…
94% (p.547)
Your patient opens his eyes when you talk to him. He unintelligibly mumbles and he withdraws from painful stimuli. His GCS is…
9
(p. 516)
Your 28-year-old female patient describes the incident appropriately and accurately tells you the day of the week and their name. You are able to…
determine if the patient is oriented to person, place, time, event
(p.552)
Arterial pulses are a physical expression of…
Left ventricular contraction
A bruit indicates _______________ blood flow and is MOST clinically relevant in the _______________ arteries.
Turbulent; carotid
(p.569)
S1, the first heart sound, represents…
closure of the mitral and tricuspid valves
(p.568)
Distention of the jugular veins indicates…
increased venous pressure
A difference in pulse quality from one lower extremity to the other…
suggests a potentially serious vascular disruption
A patient is generally considered to have orthostatic vital signs (a positive tilt test) when…
the heart rate increases by 20 beats/min while the systolic BP decreases up to 20 and the diastolic BP increases > 10 from a supine to a standing position.
(p.571)
You are conducting a rapid exam and notice that your trauma patient is not breathing. You should…
begin BVM ventilations with supplemental oxygen
(p.512-513)
In the acronym SAMPLE, the ‘A’ stands for
allergies
In the acronym OPQRST, what does the ‘P’ stand for?
Provocation
During the secondary assessment, the correct examination order of the chest is…
Inspect, palpate, auscultate, then percuss
(p. 564)
A good question to ask during the history of present illness, for a patient who is experiencing difficulty breathing, is…
what makes your breathing better or worse?
Your 32-year-old patient is sitting on the couch leaning forward. She is struggling to catch her breath and is breathing rapidly. Your initial priority is to…
evaluate her airway
The grating sound, or the crunchy palpated sensation, caused by movement of broken bone ends against each other is called…
Crepitus
To evaluate the anterior chest for equal expansion during inspiration…
place your thumbs against the costal margin and the xiphoid process; with your thumbs touching the chest wall, watch the distance between your thumbs as the patient breathes.
Your 17-year-old male patient has a stab wound to the right upper quadrant of his abdomen. Evaluation of your patient shows a decreased level of consciousness with vital signs of BP 90/60, P 128, and R 22. Your best course of action would be to…
load the patient in the transport unit and continue treatment while transporting to the closest appropriate facility.
You are called to the scene of an office complex where a 36-year-old male window-washer has fallen approximately two stories, landing on a concrete walkway. He clearly has an angulated fracture of his femur. Cervical spine stabilization should be performed…
simultaneously with evaluation of the patient’s airway.
Your conscious 38-year-old patient is unable to speak or cough. Her coworker says, “We were eating lunch when she suddenly grasped her throat and could not speak.” You should…
perform the Heimlich maneuver, delivering up to five subdiaphragmatic abdominal thrusts.
The process of weighing the probability of one disease or condition versus another by comparing clinical findings that could account for the nature of a patient’s problem…
differential diagnosis
Examination of a patient reveals a palpable femoral pulse but no palpable radial pulse. You estimate the patient’s systolic blood pressure to be…
70mmHg
The soft and low-pitched sounds, normally heard over most of the lung surface, with a rustling quality during inspiration and softer sound during expiration are known as
vesicular
While evaluating a trauma patient, you note a weak, rapid carotid pulse and palpable radial pulse. You estimate this patient’s systolic blood pressure to be…
at least 80mmHg
Breath sounds that are not normal, such as crackles, rhonchi, and wheezes, are called…
adventitious
Structural integrity of the pelvis is assessed by…
gently pushing in and down on the iliac crests.
The general type of illness a patient is experiencing is called the…
nature of illness
Fine, popping sounds that indicate the presence of fluid in alveoli and small airways…
Crackles
Brassy, high-pitched crowing sound that indicates a narrow upper airway…
Stridor
Rattling sound produced by collections of mucous and other fluids in larger airways…
Rhonchi
High-pitched whistling sounds produced by air flowing through narrow lower airways…
Wheezes
The focused history and physical exam for all patients includes searching for medical ID devices that identify the patient’s medical history and allergies. These devices can be found…
on the patient’s wrist or ankle
Circulatory assessment consists of all of the following EXCEPT…
use of blood thinners (ie plavix, aspirin, coumadin)
Cognitive function can be MOST accurately defined as…
the ability to use reasoning
Rupture of which of the following abdominal structures would produce the fastest onset of hypoperfusion?
Aorta
The urinary bladder is located in the
pelvic cavity, posterior to the pubic bone.
A patient has been struck in the back with a baseball bat. On assessment, you note an obvious fracture to the 12th rib along the midscapular line on the left side. Which of the following organs would you suspect may possibly be injured?
Kidney
A 24-year-old male fell from a ladder and suffered an open fracture of the right radius. He is awake and alert. There is no radial pulse on the side of the fracture, and blood is spurting from the injury. The patient has multiple small lacerations and abrasions on the right palm and both arms with blood flowing steadily from these injuries. What problem should be treated first?
spurting hemorrhage
Cullen’s sign and Grey-Turner’s sign are classic findings in…
Intraabdominal hemorrhage
What abdominal quadrant is the spleen mostly located?
LUQ
Which abdominal quadrant should you palpate last?
The painful quadrant
Pick two of the following conditions that rhonchi are typically associated with.
Pneumonia
Bronchitis
The muscular and colored portion of the eye that constricts and dilates to regulate light falling on the retinal surface is called the
Iris
When assessing the eyes…
shining a penlight in one pupil should constrict the other pupil equally.
Approximately 19% of the population has a noticeable difference in the size of their pupils, a condition called…
Anisocoria
(P.558)
During the test of extra-occular eye movements, you should trace which figure in front of your patient’s eyes?
an “H”
1: Olfactory
Smell
II: Optic
Vision
III: Occulomotor
movement of the eye, pupil, eyelid
IV: Trochlear
Movement of the eye
V: Trigeminal
Chewing, touch of the mouth and face
VI: Abducens
movement of the eye
VII: Facial
Movement of the face: tears, salivation, taste
VIII: Auditory
Hearing and balance
IX: Glossopharyngeal
Swallowing; sensations in mouth and pharynx
X: Vagus
sensation and movement of pharynx, larynx, throat, and GI systems
XI: Accessory
movement of head and shoulders
XII: Hypoglossal
movement of the tongue
You are assessing a 24-year-old male trauma patient who is unconscious following an MVC. During the neurological exam, you test his Babinski reflex and the patient’s great toe flexes. You know that…
this is a normal finding in an infant, but not in an adult
Your unresponsive 28-year-old construction worker fell 30-feet from scaffolding onto hard ground. Your primary exam reveals no immediate life threats. You should perform a(n)
Detailed physical exam
You are treating an 70-year-old female who slipped and fell onto concrete, striking her head. During your primary assessment you perform a sternal rub which makes her open her eyes, moan, and flex both arms. Her Glasgow coma score is
7
The assessment of your 13-month-old patient reveals a bulging anterior fontanelle. This indicates
increased intracranial pressure (ICP)
You are treating a 45-year-old female complaining of a 2-day history of nausea and vomiting. While in the supine position, the patient’s vital signs are BP 96/50, P 104, and R 16. When in a high-Fowler’s position vital signs are BP 80/64, P 128, and R 20. You should suspect…
dehydration
Food is propelled along the course of the small and large intestines by the rhythmic contraction waves known as…
peristalsis
The role of the gallbladder is to
store bile until needed
Within the human body, the kidneys function to…
cleanse blood plasma of waste
An abnormal accumulation of fluid in the peritoneal cavity, which typically signals liver disease, is called…
ascites
The part of the assessment process that focuses on identifying and managing immediately or potentially life-threatening conditions is called the…
primary assessment
Which of the following is a subjective finding?
a complaint of chest pressure
A test of decreased breath sounds performed by placing the diaphragm of the stethoscope over the area in question while the patient says “ee”, and in which an “ay” sound indicates lung consolidation, is known as…
egophony
Lung fields with areas of consolidation indicate…
pneumonia or pulmonary contusion
A blotchy pattern on the skin, that may be a typical finding in states of severe protracted hypoperfusion and shock, is called…
mottling
Impairment of language that affects the production, or understanding, of speech is called…
aphasia
An acute change in mental status that is marked by the inability to focus, think logically, or maintain attention, is called…
delirium
Excessive sweating, often associated with shock, is known as…
diaphoresis
Assessing pediatric patients is different from assessing adults because children…
can make it difficult to obtain an accurate history of present illness (HPI).
Which of these statements about specific age groups of pediatric patients is correct?
6-12 year-olds are usually cooperative if you are honest with them and explain things.
When examining older infants and toddlers, you should…
leave the child on the parent’s lap while you assess.
For treatment purposes, infant age is defined as…
from 1 to 12 months of age
Which of the following sets of vital signs are age-appropriate for a 5-year-old?
BP 82/44, P 110, and R 24.
A combination of certification, licensure, and credentialing defines a paramedic’s…
Scope of practice
A list of active listening techniques includes…
reflection
Air bags have been proven to decrease injuries in motor vehicle collisions. Air bags are considered…
passive interventions
Heart disease and _______________ are the overall top leading causes of death in the United States (data from 2014).
cancer
Outcome objectives help to drive a community prevention program. Which is a good objective?
increase flu vaccines by 500 people
Which of the following caregiver stories is appropriate per typical growth and development norms?
“My 19-month old was running across the yard when he fell”
Likely complications of childhood and adolescent obesity include…
sleep apnea and hypertension
Concerns about body size, shape, or weight usually starts during…
early adolescence
A newborn or neonate age is from birth to…
one-month of age
Please select two characteristics that may cause small-for-gestational age (SGA) babies.
Maternal diabetes
Maternal drug use
Types of pain include…
somatic pain
Visceral pain originates…
from the body’s internal organs
Which of the following statements about pain is TRUE?
“As a side effect to the opiate-abuse epidemic, there is a national trend to under-treat and under-evaluate pain.”
While on-shift, you run a call for a patient that crashed is car into a tree. Your assessment reveals a strong odor of alcohol from him. The next morning, the on-coming paramedic tells you that your patient is a friend of his and asks you if he was really drunk? What should you do?
Politely refuse to talk about the patient, because that would be a violation of patient privacy.
The Health Information Technology for Economic and Clinical Health (HITECH) portion of the American Recovery and Reinvestment Act (ARRA) of 2009…
aims to develop a national healthcare infrastructure for electronic medical records.
Standing orders, training programs, and case reviews are examples of…
off-line medical control and direction
Please select the three patient assessment signs.
Jaundice
BP 84/40mmHg
Mottling
You are unable to defibrillate a patient because the defibrillator did not charge. The patient later dies, and the family learns you failed to change the battery the morning of the call, per your service’s standard operating procedures. The family would most probably sue you for…
Negligence
The conduct that would be expected of a reasonable, prudent individual with similar training and experience under similar circumstances is called…
standard of care
You are about to assess a patient who complains of fever, chills, and a 3-week history coughing up blood. The patient’s medications include isoniazid, rifampin, pyrazinamide, and ethambutol. In addition to donning gloves and eye protection, you should:
wear a properly fitted HEPA or N-95 mask
An unresponsive patient who has been breathing slowly and shallowly for an extended period of time would MOST likely have ________ skin.
Cyanotic
Your patient’s skin is flushed (reddened). Please select three possible causes.
fever
alcohol intake
superficial burns
The main disadvantage of patient care algorithms is they:
only address classic patient presentations
A component of the Pediatric Assessment Triangle (PAT) is…
appearance
