Question 1

Medical Patient

Accepted Answer

A patient with one or more medical diseases or conditions

Question 2

Trauma Patient

Accepted Answer

A patient suffering from one or more physical injuries

Question 3

History of Present Illness or Injury (HPI)

Accepted Answer

Information gathered regarding the symptoms and nature of patient's current concern

Question 4

Past Medical History

Accepted Answer

Information gathered regarding the patient's health problems in the past

Question 5

Symptom

Accepted Answer

Something regarding the patient's condition that the patient tells you

Question 6

Reassessment

Accepted Answer

A procedure for detecting changes in a patient's condition. It involves four steps; 1. Repeating the primary assessment 2. Repeating and recording VS 3. Repeating the physical exam 4. Checking interventions

Question 7

Rapid Trauma Assessment

Accepted Answer

A rapid assessment of the head, neck, chest, abdomen, pelvis, extremities, and posterior of the body to detect signs and symptoms of injury

Question 8

Stoma

Accepted Answer

A permanent surgical opening in the neck through which the patient breathes

Question 9

Tracheostomy

Accepted Answer

A surgical incision held open by a metal or plastic tube

Question 10

Paradoxical Motion

Accepted Answer

Movement of a part of the chest in the opposite direction to the rest of the chest during respiration

Question 11

Distention

Accepted Answer

A condition of being stretched, inflated, or larger than normal

Question 12

Priapism

Accepted Answer

Persistent erection of the penis that may result from spinal injury and some medical problems

Question 13

Detailed Physical Exam

Accepted Answer

An assessment of the head, neck, chest, abdomen, pelvis, extremities, and posterior of the body to detect signs and symptoms of injury. It differs from the Rapid Trauma Assessment only in that it also includes examination of the face, ears, eyes, nose, and mouth during the examination of the head

Question 14

The history will provide the most relevant information for: 1. a responsive medical patient 2. an unresponsive trauma patient 3. an unresponsive medical patient 4. a responsive trauma patient

Accepted Answer

1. a responsive medical patient The history requires a patient to be responsive with an unaltered mental status. If a patient is a trauma patient, while their medical history is important later on, right now, you have been called out there due to a traumatic condition, so medical hx generally does not have a bearing on it One medical hx that COULD affect the trauma patient, is a medical patient who is on blood thinners. Since this will create issues with controlling their external bleeding and can lead to internal hemorrhaging. So, it is important to get this information, however, the most RELEVANT information is gathered in the hx on a medical patient.

Question 15

For critical patients, the secondary assessment will often be conducted: 1. before transport 2. at the scene 3. in the ambulance 4. at the hospital

Accepted Answer

3. in the ambulance The reason that this is the case, is that you have labeled them as a priority transport, have initiated the transport and then you are actually enroute when you start the secondary assessment

Question 16

Your patient is unresponsive, has an unusual odor on his breath, and is incontinent of urine. You should suspect: 1. an endocrine emergency 2. a neurological emergency 3. a cardiac emergency 4. a respiratory emergency

Accepted Answer

1. an endocrine emergency Altered mental status, unusual breath odor, incontinence, excessive hunger, excessive thirst, urination indicate a diabetic emergency. Insulin is produce in the pancreas which is part of the Endocrine system. This COULD be a cardiac complaint This COULD be a neurologic complaint However, what pushes you more to the Diabetic/Endocrine emergency is the unusual order on breath. That is a tell-tale sx of a diabetic emergency None of the sx point to a respiratory emergency

Question 17

For a responsive medical patient, the hx indicates 1. whether to check VS 2. which medications to prescribe 3. which body systems to examine 4. whether to perform a reassessment

Accepted Answer

3. which body systems to examine For the responsive medical patient, the hx indicates which body systems are relevant to examine. An EMT does not prescribe medications Reassessing the patient at certain intervals as well as Taking VS are routine parts of assessing a patient

Question 18

What are the the categorization types based on the nature of the patients underlying complaint?

Accepted Answer

1. Medical patient - a patient with one or more medical diseases or conditions 2. Trauma patient - a patient suffering from one or more physical injuries 3. Unknown Patient - A patient with a problem of an undetermined nature

Question 19

FAST

Accepted Answer

Face Arm Speech Test

Question 20

For which type of of complaint should you conduct a FAST physical examination? 1. Mental status changes or neurologic complaints 2. Shortness of breath 3. Chest Pain or discomfort 4. Altered mental status with a diabetic hx

Accepted Answer

1. Mental status changes or neurologic complaints A Face-Arm-Speech Test (FAST) would be appropriate for patients with complaints of mental status changes or neurologic complaints

Question 21

Which of the following additional hx components would best assist you in the evaluation of a conscious medical patient with SOB from an allergic reaction? 1. Time of exposure to the allergen 2. Cough 3. Dyspnea on exertion 4. Excessive hunger or thirst

Accepted Answer

1. Time of exposure to the allergen For an allergic reaction, inquiring about exposure to an allergen would be most appropriate Dyspnea on exertion typically associated with cardiovascular complaints Cough typically associated with cardiovascular complaints Hunger and Thirst are generally associated with endocrine emergencies

Question 22

For an unresponsive medical patient 1. speak to family members of the patient or bystanders to gather the hx before conducting any physical examination 2. it is not necessary to attempt to gather the patients hx 3. you should gather as much of the patients hx as you can 4. ignore any information regarding the patient that does not come from a close family member

Accepted Answer

3. You should gather as much of the patients hx as you can For an unresponsive medical patient, you should gather as much of the patient's hx as you can by speaking to any family members or bystanders who may be able to provide pertinent information. Taking this hx should follow a rapid physical examination

Question 23

Which of the following should you do first when examining an unresponsive medical patient? 1. obtain a past medical hx 2. perform a rapid physical examination 3. assess baseline VS 4. transport

Accepted Answer

2. perform a rapid physical examination The rapid physical examination would be most important because with an unresponsive medical patient, communication will be impossible. VS will be important, but the physical examination will help you differentiate the patient into the proper category immediately. Transport will also be important, but not more important than a rapid physical examination. Past medical hx may be impossible to obtain.

Question 24

Which of the following questions might you ask a bystander when you are attempting to obtain the hx of an unresponsive patient? 1. What interventions have you performed if any? 2. How long have you been on scene? 3. What is the patients name? 4. What were you doing when the the incident occured?

Accepted Answer

3. What is the patients name? Bystanders may not know the patients name, but asking them is they know it, is pertinent to obtaining the hx of an unresponsive patient. The other questions are irrelevant to obtaining the patients HX

Question 25

Which of the following is a term that means rapid assessment of the head, neck, chest, abdomen, pelvis, extremities, and posterior of the body to detect sx of the injury? 1. HX of present illness 2. Pas medical HX 3. Rapid trauma assessment 4. SAMPLE

Accepted Answer

3. Rapid trauma assessment

Question 26

A 14 y/o F is complaining of knee pain after a fall on the playground. Witnesses state that she had no unconsciousness and stood immediately after falling. She is now alert and complaining of no other pain or injury. After completing a primary assessment, you should next: 1. assess the patients knee and leg 2. obtain a SAMPLE hx 3. apply a C-collar 4. complete a rapid trauma assessment

Accepted Answer

1. assess the patients knee and leg This patient likely has only an isolated traumatic injury. She does not have a significant MOI and has no sx of spinal involvement. Therefore, you should next assess her knee and leg, performing a physical exam based on the CC and MOI. Mobilization of the neck with a C-Collar would not be necessary based on the MOI. A rapid trauma assessment would be reserved for a severe trauma patient. The SAMPLE hx would be obtained after assessment of the likely injury

Question 27

Your patient fell from the roof of a house. What action would you take before assessing the ABCs? 1. take baseline VS 2. perform a rapid trauma assessment 3. obtain a past medical hx 4. manually stabilize the head and neck

Accepted Answer

4. manually stabilize the head and neck On the basis of the MOI, you should provide manual C-Spine stabilization before assessing the ABCs and -before taking baseline VS -before obtaining a past medical hx -before performing a rapid trauma assessment All of the above ARE parts of the secondary assessment you would perform after assessing the ABCs for this patient

Question 28

Which of the following statements is true of the rapid trauma assessment 1. the rapid trauma assessment should be performed at the scene 2. the rapid trauma assessment is for patients without a significant MOI 3. do not delay transport to conduct the rapid trauma assessment 4. limit the rapid trauma assessment to a visual inspection only

Accepted Answer

1. the rapid trauma assessment should be performed at the scene The rapid trauma assessment is for patients with a significant MOI. It only takes a few moments, includes inspection and palpation, and should be conducted before transport

Question 29

When assessing the head during a rapid trauma assessment, you would check for wounds, tenderness, deformities and what else? 1. Distention 2. Paradoxical motion 3. Crepitation 4. Tenderness

Accepted Answer

3. Crepitation When assessing the head during a rapid trauma assessment, you would check for wounds, tenderness, deformities, and crepitation, which is grating sound or a feeling of bones being rubbed together. Distention is assessed in the neck and abdomen Tenderness is assessed in the pelvis Paradoxical motion is assessed in the chest

Question 30

Which of the following patients has a significant MOI and would therefore be considered unstable? 1. Patient who fell from \<6 feet 2. Pedestrian hit by an automobile 3. Patient who fell from a bicycle 4. Patient with superficial burns over 2% of the body

Accepted Answer

2. Pedestrian hit by an automobile There is a significant MOI. The other MOI's would be minor MOI In the case of the falls, there may be no injury at all

Question 31

An assessment of the head, neck, chest, abdomen, pelvis, extremities, and posterior of the body to detect signs and symptoms of an injury is a: 1. detailed physical exam 2. past medical hx 3. differential diagnosis 4. reassessment

Accepted Answer

1. Detailed physical exam

Question 32

During which of the following would EMTs rely most on their own physical senses? 1. Past medical hx 2. Interviewing bystanders for additional information 3. Detailed physical examination 4. HX of the present illness

Accepted Answer

3. Detailed physical examination This is where you will use your senses to examine the patient. You may feel (palpate) for injuries, listen (auscultate) for abnormal breathing sounds, and look for swelling. It is important to use your senses to their fullest to get the most relevant information. When interviewing bystanders or conducting a hx of the present illness or a past medical hx, the physical senses would be involved but not as completely, and the EMT would be asking numerous questions and assessing the answers to them, which isn't primarily a physical exercise

Question 33

Secondary Assessment - RESPONSIVE PATIENT - MEDICAL - Step 1

Accepted Answer

1. Gather the chief complaint and the hx of the present illness using a body system approach. Use mnemonics such as OPQRST to help get detailed information from the patient

Question 34

Secondary Assessment - RESPONSIVE PATIENT - MEDICAL PATIENT - OPQRST - DEFINED

Accepted Answer

O - Onset - When did this start? P - Provocation - What makes it worse, what makes it better? Q - Quality - Can you DESCRIBE the pain for me? (do not give them suggestions, we tend to want to say, does it feel like an Elephant sitting on your chest? Because this is what we have heard for years and years when we have dealt with cardiac patients. We have then done a reverse Confirmation Bias, or we have convinced THEM to HELP OUR confirmation bias R - Radiation (Region) - Is the pain anywhere else? Does it stay where you are feeling it? Again, do not SUGGEST anything, we will tend to steer them to does it go down your arm, leg, into your back etc. Let THEM answer your question. S - Severity - 0-10 (O being NO pain, and 10 being the worst pain you have ever felt. Rate you pain for me) T - Time - When did this pain start?

Question 35

Secondary Assessment - RESPONSIVE PATIENT MEDICAL PATIENT - Step 2

Accepted Answer

Gather a past medical hx from the patient. Use SAMPLE to ensure a comprehensive hx

Question 36

Secondary Assessment - RESPONSIVE PATIENT MEDICAL PATIENT - Step 2 - SAMPLE Defined

Accepted Answer

S - Signs and Symptoms - What's wrong? This is something that you have most likely already have attained in the OPQRST or SHOULD HAVE. If not, this is your back-up A - Allergies - Are they allergic to any medications? They may tell you that they are allergic to shrimp and strawberries. OK, take it, do not tell them that you do not care about it. Just say, ok cool, what about medications? Give examples, Penicillin, that is the biggest usual one. M - Medications - What medications are they on? What medications are they SUPPOSED to be on and maybe have not taken? Are they supposed to be on Warfarin, are they supposed to be on Levetiracetam? Those two will tell you that they have some kind of cardiac issues (Warfarin - blood thinner) or they have a seizure disorder (Levetiracetam - anti-seizure medication). If they ARE on medications, you want to know the last time that they took them. P - Past medical hx - You want to know what medical hx that they have had. If they tell you about all kinds of hx that have NOTHING to do with current situation, then ask them if they have ever experienced the current situation before. Do NOT dismiss their PMH. L - Last Oral Intake - When was the last time that they had anything to eat or drink E - Events leading up to the injury or illness - What were they doing prior to the chest pains (CP)? Were they sleeping? Were they arguing with their significant other (maybe it is a stress related incident, maybe it is legitimate cardiac), Were they running 10 miles in 90 degree weather with 97% humidity?

Question 37

Secondary Assessment - RESPONSIVE PATIENT - MEDICAL PATIENT - Step 3

Accepted Answer

Conduct a physical exam (focusing on the area the patient is complaining about, and the related body systems)

Question 38

Secondary Assessment - RESPONSIVE PATIENT - MEDICAL PATIENT - Step 4

Accepted Answer

Obtain Baseline Vital Sx: Respirations Pulse Skin Temperature, Color, Dry/Moist Pupils Blood Pressure SpO2 (Blood Oxygen Saturation)

Question 39

Secondary Assessment - UNRESPONSIVE PATIENT - MEDICAL - Step 1

Accepted Answer

Conduct a rapid physical exam. Focus on body systems and areas related to the suspected condition (if known) Head Neck Chest Abdomen Pelvis Extremities Posterior

Question 40

Secondary Assessment - UNRESPONSIVE PATIENT - MEDICAL PATIENT - Step 2

Accepted Answer

Obtain baseline Vital Sx Respirations Pulse Skin Pupils Blood Pressure SpO2 (Blood O2 Saturation)

Question 41

Secondary Assessment - UNRESPONSIVE PATIENT - MEDICAL PATIENT - Step 3

Accepted Answer

Gather the hx of the present illness (OPQRST) from family or bystanders: O - Onset - Do they know when it started prior to when the patient went unresponsive? P - Provocation - Did they mention anything that made it worse or better? Q - Quality - Did they tell the family or bystanders what the pain felt like? R - Radiation - Did they mention if the pain stayed in one place or if it went anywhere else? S - Severity - Did they mention how bad the pain was? T - Time - When did the illness start?

Question 42

Secondary Assessment - UNRESPONSIVE PATIENT - MEDICAL PATIENT - Step 4

Accepted Answer

Gather a past medical hx (SAMPLE) from bystanders or family if possible: S - Signs and Symptoms - Again this is your fail safe to remember to get the "what's wrong" with the patient (besides them being unresponsive. What LEAD UP TO them being unresponsive? A - Allergies - Do they know if the patient is allergic to any medications? M - Medications - What medications is the patient on? P - Past Medical Hx - Is there any relevant past medical hx? Hs anything like this happened before? L - Last oral intake - Do they know when the patient ate or drank anything? E - Events leading to the illness - Do they know what the patient was doing PRIOR to the onset of the illness?

Question 43

Specific Medical Complaints: Shortness of Breath Additional Hx Physical Exam

Accepted Answer

Additional HX: - Cough - Fever or Chills - Dyspnea on exertion - Weight gain (indicates fluid) - Has prescribed bronchodilator? Physical Exam - Lung Sounds (presence and equality) - Wheezing - Work of breathing and positioning (Tripod example) - SpO2 (Oxygen Saturation) - Pedal or sacral edema

Question 44

Specific Medical Complaints Chest Pain or Discomfort Additional Hx Physical Exam

Accepted Answer

Additional Hx - Has prescribed nitroglycerin? - Taking aspirin Physical Exam - Skin color, temperature, and condition - Blood pressure - Pulse (including strength and regularity)

Question 45

Specific Medical Complaints: Mental Status Changes or Neurologic Complaints Additional Hx Physical Exam

Accepted Answer

Additional Hx - Headache - Seizure Physical Exam - FAST - (Face - Arm - Speech - Time) - Face - Does one side of the face droop? Ask patient to smile - Is the smile "normal" looking? Does one side of the smile look like a smile, and the other side stay straight (equates to a droop) Arms - Can Pt hold arms in front on them (does one arm droop?) If the patient has an unequal smile, and they have an arms that they cannot lift the Arms the same (it SHOULD be on the same side) S - Speech - Is their speech clear and understandable? T - Time - Time is critical, need to make sure that you get them to the hospital, get them packaged and to advanced care ASAP

Question 46

Specific Medical Complaints Allergic (involved components of the cardiovascular and respiratory systems) Additional Hx Physical Exam

Accepted Answer

Additional Hx - Time of Exposure - Time of symptoms onset Physical Exam - Stinger present? - Rash/hives (urticaria) - Lung Sounds (present and equal)? - Face and Neck Edema - SpO2 - Oxygen Saturation

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CH 15 Secondary Assessment Flashcards

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