Chapter 10

Question 1

1. 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:

notify dispatch and request a paramedic ambulance.

perform CPR and transport the patient immediately.

ask the family if the patient has a terminal disease.

start CPR and attach the AED as soon as possible.

Answer 1

start CPR and attach the AED as soon as possible.

Question 2

2. In which of the following situations is a pertinent negative identified?

A 50-year-old woman states that nothing makes her chest pain better or worse.

A 53-year-old man with dizziness also tells you that he has vomited three times.

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

A 56-year-old woman states that her chest hurts when she takes a deep breath.

Answer 2

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

Question 3

3. Which of the following factors would MOST likely cause a patient’s pulse rate to be slower than normal?

Lack of a regular exercise routine

Beta blocker medications

Anxiety or severe stress

Internal bleeding from trauma

Answer 3

Beta blocker medications

Question 4

4. After performing a head tilt-chin lift maneuver to open the airway of an unresponsive patient who has a pulse, you should:

place him or her in the recovery position..

provide positive-pressure ventilatory assistance.

assess respiratory rate, depth, and regularity.

suction as needed and insert an airway adjunct.

Answer 4

suction as needed and insert an airway adjunct.

Question 5

5. An adult patient who is NOT experiencing difficulty breathing will:

have a respiratory rate that is between 20 and 24 breaths/min.

be able to speak in complete sentences without unusual pauses.

assume a position that will facilitate effective and easy breathing.

exhibit an indentation above the clavicles and in between the ribs.

Answer 5

be able to speak in complete sentences without unusual pauses.

Question 6

6. Which of the following pupillary changes would indicate depressed brain function?

Both pupils are sluggish with introduction of a bright light.

Both pupils-react briskly to light instead of sluggishty.

Both pupils dilate when a bright light is removed.

Both pupils constrict when a bright light is introduced.

Answer 6

Both pupils are sluggish with introduction of a bright light.

Question 7

7. Pamating factors regarding a patient’s pain involve those that:

alleviate the pain.

initiate the pain.

change the pain.

worsen the pain.

Answer 7

alleviate the pain.

Question 8

8. You are assessing a 72-year-old man with abdominal pain. The patient is sitting in a chair; he is conscious, ale and calm. As you are talking to the patient, your partner discreetly directs your attention to a handgun, which located on a nearby table. You should:

position yourself in between the patient and the gun and ask your partner to request law enforcement assistance.

document the presence of the weapon, including its specific location, and continue your assessment of the patient.

direct your partner to move the gun to a safe area and then advise the patient that his weapon has been secured.

immediately cease all patient care, carefully back out of the residence, and request law enforcement assistance.

Answer 8

position yourself in between the patient and the gun and ask your partner to request law enforcement assistance.

Question 9

9. For which of the following patients is spinal immobilization clearly indicated?

Woman in a minor motor-vehicle collision who complains of severe knee pain

Man with an arrow impaled in his leg and no pulse distal to the injury

Man with altered mental status after being exposed to blunt force trauma

Woman who fell from a standing position and has a deformed shoulder

Answer 9

Man with altered mental status after being exposed to blunt force trauma

Question 10

10. Which of the following findings indicates that your patient has a patent airway?

Inspiratory stridor

Audible breathing

Ability to speak

Unresponsiveness.

Answer 10

Ability to speak

Question 11

11. Which of the following MOST accurately describes paradoxical movement of the chest wall?

Only one section of the chest rises on inspiration, while another area falls ?

One side of the chest wall moves opposite the direction of the other

A marked decrease in chest wall movement due to abdominal breathing

Multiple rib fractures that cause a marked deformity of the chest wall

Answer 11

Only one section of the chest rises on inspiration, while another area falls ?

Question 12

12. Poor peripheral circulation will cause the skin to appear:

pink

ashen.

flushed.

cyanotic

Answer 12

ashen.

Question 13

13. You should avoid palpating a patient’s pelvis if:

the MOI suggests trauma to the pelvis.

the patient complains of pelvic pain.

the patient is older than 50 years of age.

the pelvis does not appear deformed.

Answer 13

the patient complains of pelvic pain.

Question 14

14. When evaluating a patient with multiple complaints, the EMT’s responsibility is to:

definitively rule out serious causes of each of the patient’s complaints.

assess each complaint based on the patient’s perception of its seriousness.

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

direct his or her attention to the most obvious signs and symptoms.

Answer 14

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

Question 15

15. 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/min and her heart rate is 120 beats/min. What should you do?

Transport her on her left side

Treat her for possible shock

Transport her in a seated position

Gently palpate her pelvis

Answer 15

Treat her for possible shock

Question 16

16. When assessing motor function in a conscious patient’s lower extremities, you should expect the patient to:

wiggle his or her toes on command.

feel you touching the extremity.

identify different types of stimuli.

note any changes in temperature.

Answer 16

wiggle his or her toes on command.

Question 17

17. Which of the following statements regarding the blood pressure is correct?

The systolic pressure represents ventricular relaxation.

Blood pressure is the most reliable indicator of perfusion.

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

Blood pressure falls early in patients with hypoperfusion.

Answer 17

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

Question 18

18. Reassessment is performed to determine all of the following, EXCEPT:

the reason why the patient called EMS.

whether or not the patient is deteriorating.

the patient’s response to your treatment.

the nature of any newly identified problems.

Answer 18

the reason why the patient called EMS.

Question 19

19. When should you take standard precautions during an EMS call?

Before exiting the ambulance and before actual patient contact.

Before you load the patient into the ambulance.

After it has been determined that the patient is bleeding.

Immediately after completion of your primary assessment.

Answer 19

Before exiting the ambulance and before actual patient contact.

Question 20

20. Which of the following signs of respiratory distress is usually observed only in pediatric patients?

Pursed-lip breathing

Seesaw breathing

Rapid respirations

Accessory muscle use

Answer 20

Seesaw breathing

Question 21

21. Which of the following patients has signs of an altered mental status?

A diabetic who has nausea and severe lightheadedness

A patient with an acute allergic reaction and dizziness

A patient with a head injury who is slow to answer questions

A patient who overdosed and tells you he tried to kill himself

Answer 21

A patient with a head injury who is slow to answer questions

Question 22

22. After performing a primary assessment, a rapid exam of the body should be performed to:

find and treat injuries or conditions that do not pose a threat to life.

identify less-obvious injuries that require immediate treatment

look specifically for signs and symptoms of inadequate perfusion.

determine the need for spinal motion restriction precautions.

Answer 22

identify less-obvious injuries that require immediate treatment

Question 23

23. Normal skin color, temperature, and condition should be:

pink, warm, and moist.

flushed, cool, and dry.

pale, cool, and moist.

pink, warm, and dry

Answer 23

pink, warm, and dry

Question 24

24. A crackling sound produced by air bubbles under the skin is called:

crepitus.

subcutaneous emphysema.

rhonchi.

Korotkoff sounds.

Answer 24

subcutaneous emphysema.

Question 25

25. Which of the following actions would NOT be performed during the scene Size-up?

Asking a neighbor to secure the patient’s dog

Rapidly assessing a patient’s respiratory status

Notifying the dispatcher to send fire personnel

Noting the position of a crashed motor vehicle

Answer 25

Rapidly assessing a patient’s respiratory status

Question 26

26. When performing the secondary assessment on a trauma patient, you note the presence of Battle sign. This is defined as:

unequal pupils.

bruising behind the ear.

fluid drainage from the nose.

swelling to the orbital area.

Answer 26

bruising behind the ear.

Question 27

27. A patient’s short-term memory is MOST likely intact if they correctly answer questions regarding:

day and event.

event and person.

time and place.

person and place

Answer 27

day and event.

Question 28

28. Which of the following statements regarding the secondary assessment is correct?

A secondary assessment should always be performed, even if you must continually manage life threats that were identified in the primary assessment.

The secondary assessment should be performed en route to the hospital, regardless of the severity of the patient’s condition.

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

During the secondary assessment, the EMT’s primary focus should be on taking the patient’s vital signs and obtaining a SAMPLE history.

Answer 28

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

Question 29

29. During a 30-minute transport of a stable patient, you should reassess him or her at least ________ times.

6

4

3

2

Answer 29

2

Question 30

30. The MOST effective way to determine whether your patient’s problem is medical or traumatic in origin is to

establish the patient’s medical history early.

ask if bystanders are familiar with the patient.

perform a careful and thorough assessment.

take note of the patient’s general appearance.

Answer 30

perform a careful and thorough assessment.

Question 31

31. 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:

apply a pressure dressing to the patient’s arm

open his airway with the jaw-thrust maneuver.

tilt the patient’s head back and lift up on his chin.

apply a cervical collar and suction his airway.

Answer 31

open his airway with the jaw-thrust maneuver.

Question 32

32. Observations made when forming a general impression of a patient would include all of the following, EXCEPT:

pulse strength.

level of distress

appearance.

race and gender.

Answer 32

pulse strength.

Question 33

33. 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:

13.

14.

Answer 33

13.

Question 34

34. Capnography is used to:

assess how much oxygen is reaching the body’s tissues.

determine how much carbon dioxide is being exhaled.

trend a patient’s blood pressure and assess for shock.

assess how much oxygen is bound to the hemoglobin.

Answer 34

determine how much carbon dioxide is being exhaled.

Question 35

35. The goal of oxygenation for most patients is an oxygen saturation of:

88% to 90%

100%

90% to 94%

94% to 99%

Answer 35

94% to 99%

Question 36

36. Which of the following medical history questions would be of LEAST pertinence in an acute situation?

“Are there medications that you cannot take?”

“Does your mother have diabetes?”

“has this ever happened to you before?”

“Does the pain stay in your chest?”

Answer 36

“Does your mother have diabetes?”

Question 37

37. Which of the following is the MOST effective method of assessing the quality of air movement in the lungs?

Applying a pulse oximeter and monitoring the SpO2

Looking for the presence of accessory muscle use

Evaluating the patient’s chest for cyanosis

Auscultating breath sounds with a stethoscope

Answer 37

Auscultating breath sounds with a stethoscope

Question 38

38. 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:

introduce yourself to the patient.

obtain a set of baseline vital signs.

ask the patient what’s wrong.

assess the patient’s airway status.

Answer 38

introduce yourself to the patient.

Question 39

39. Jugular venous distention suggests a problem with blood returning to the heart if the patient is:

in a prone position.

in a recumbent position.

sitting up at a 45° angle.

in a supine position.

Answer 39

sitting up at a 45° angle.

Question 40

40. If a patient develops difficulty breathing after your primary assessment, you should immediately:

reevaluate his or her airway status.

auscultate his or her breath sounds.

determine his or her respiratory rate.

begin assisting his or her breathing.

Answer 40

reevaluate his or her airway status.

Question 41

41. The diastolic blood pressure represents the:

difference in pressure between ventricular contraction and relaxation.

minimum amount of pressure that is always present in the arteries.

average pressure against the arterial walls during a cardiac cycle.

increased arterial pressure that occurs during ventricular contraction.

Answer 41

minimum amount of pressure that is always present in the arteries.

Question 42

42. Pain that moves from its point of origin to another body location is said to be:

provoking.

referred.

palliating.

radiating.

Answer 42

radiating.

Question 43

43. Which of the following statements regarding the secondary assessment is correct?

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.

You may not have time to perform a secondary assessment if you must continually manage life threats that were identified during the primary assessment.

A focused secondary assessment would be the most appropriate approach for a patient who experienced significant trauma to multiple body systems. d.

If your general impression of a patient does not reveal any obvious life threats, you should proceed directly to the secondary assessment.

Answer 43

You may not have time to perform a secondary assessment if you must continually manage life threats that were identified during the primary assessment.

Question 44

44. When approaching a 32-year-old male who is complaining of traumatic neck pain, you should:

ensure that the patient can see you approaching him.

stand behind him and immediately stabilize his head.

approach him from behind and ask him not to move.

assess his mental status by having him move his head.

Answer 44

ensure that the patient can see you approaching him.

Question 45

45. The rapid exam of a patient that occurs following the primary assessment should take no longer than:

120 seconds.

90 seconds.

30 seconds.

60 seconds.

Answer 45

90 seconds.

Question 46

46. In responsive patients who are older than 1 year of age, you should palpate the pulse at the ________ artery

Brachial

Radial

Carotid

Femoral

Answer 46

Radial

Question 47

47. An injured patient is assigned a total score of 9 on the GCS. He is assigned a score of 2 for eye opening, a scc 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?

Eyes remain closed, makes incomprehensible sounds, exhibits abnormal extension

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

Opens eyes spontaneously, is confused when spoken to, exhibits abnormal flexion

Opens eyes in response to voice, makes incomprehensible sounds, localizes pain

Answer 47

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

Question 48

48. A patient with spontaneous respirations is breathing:

without difficulty.

without assistance.

with shallow depth.

at a normal rate.

Answer 48

without assistance.

Question 49

49. When performing a reassessment of your patient, you should first:

obtain updated vital signs.

confirm medical history findings.

repeat the primary assessment.

reassess your interventions.

Answer 49

repeat the primary assessment.

Question 50

50. The pressure exerted against the walls of the artery when the left ventricle contracts is called the:

pulse pressure.

diastolic pressure.

systolic pressure.

apical pulse.

Answer 50

systolic pressure.

Question 51

51. 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.

60, 100

40, 120

30, 130

50, 110

Answer 51

60, 100

Question 52

52. 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:

identify the specific areas of her injuries and focus your assessment on those areas.

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

assess her vital signs, secure her to a backboard, and transport her immediately.

fully immobilize her spine, load her into the ambulance, and assess her vital signs.

Answer 52

fully immobilize her spine, load her into the ambulance, and assess her vital signs.

Question 53

53. 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:

atria contracting.

atria relaxing.

ventricles relaxing.

ventricles contracting

Answer 53

ventricles relaxing.

Question 54

54. When you inspect a patient’s pupils with a penlight, the pupils should normally react to the light by:

dilating

constricting

fluttering.

enlarging

Answer 54

constricting

Question 55

55. When you use the palpation method to obtain a blood pressure, the measurement you obtain is the:

pulse pressure.

cardiac output pressure.

diastolic blood pressure.

systolic blood pressure.

Answer 55

systolic blood pressure.

Question 56

56. When you assess capillary refill time in an infant, normal color to the tested area should return within:

4 seconds.

3 seconds.

1 second.

2 seconds

Answer 56

2 seconds

Question 57

57. When palpating a patient’s pulse, you note that it is grossly irregular. You should:

count the pulse rate for a full minute to obtain an accurate reading.

count the number of pulsations in 30 seconds and multiply by two.

count the pulse rate for at least 30 seconds to ensure accuracy.

count the number of pulsations in 15 seconds and multiply by four.

Answer 57

count the pulse rate for a full minute to obtain an accurate reading.

Question 58

58. During the primary assessment, circulation is evaluated by assessing:

blood pressure, pulse rate, and external bleeding.

external bleeding, skin condition, and capillary refill.

skin quality, blood pressure, and capillary refill.

pulse quality, external bleeding, and skin condition.

Answer 58

pulse quality, external bleeding, and skin condition.

Question 59

59. When palpating a patient’s pulse, you note that there is a short interval between pulsations. This indicates that the pulse is:

rapid.

thready.

slow.

irregular.

Answer 59

rapid.