Chapter 10 - Patient Assessment

Question 1

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. He is screaming in pain and is attempting to control the bleeding, which is bright red and spurting from his groin area. You should:

Select one:

A. elevate his legs and keep him warm.
B. apply direct pressure to the wound.
C. administer 100% supplemental oxygen.
D. ensure that his airway is patent.

Answer 1

B. apply direct pressure to the wound.

Question 2

A palpable pulse is created by:

Select one:

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.

Answer 2

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

Question 3

An elderly patient has fallen and hit her head. Your initial care should focus on:

Select one:

A. obtaining baseline vital signs.
B. providing immediate transport.
C. gathering medical history data.
D. airway, breathing, and circulation.

Answer 3

D. airway, breathing, and circulation.

Question 4

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?

Select one:

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

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

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

D. Eyes remain closed, makes incomprehensible sounds, exhibits abnormal extension

Answer 4

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

Question 5

During an EMS call, you should take standard precautions:

Select one:

A. before exiting the ambulance and before actual patient contact.

B. before you load the patient into the ambulance.

C. after it has been determined that the patient is bleeding.

D. immediately after completion of your primary assessment.

Answer 5

A. before exiting the ambulance and before actual patient contact.

Question 6

In patients with deeply pigmented skin, changes in color may be apparent only in certain areas, such as the:

Select one:

A. lips or oral mucosa.
B. forehead and face.
C. back of the neck.
D. dorsum of the hand.

Answer 6

A. lips or oral mucosa.

Question 7

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

Select one:

A. whether or not the patient is deteriorating.
B. the patient’s response to your treatment.
C. the reason why the patient called EMS.
D. the nature of any newly identified problems.

Answer 7

C. the reason why the patient called EMS.

Question 8

The chief complaint is MOST accurately defined as the:

Select one:

A. most serious thing the patient is concerned about.
B. most life-threatening condition that you discover.
C. gross physical signs that you detect on assessment.
D. condition that exacerbates an underlying problem.

Answer 8

A. most serious thing the patient is concerned about.

Question 9

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

Select one:

A. 120 to 180 seconds.
B. 90 to 120 seconds.
C. 60 to 90 seconds.
D. 30 seconds.

Answer 9

C. 60 to 90 seconds.

Question 10

Treatment and transport priorities at the scene of a mass-casualty incident should be determined after:

Select one:

A. all the patients have been triaged.
B. a physician arrives at the scene.
C. area hospitals have been notified.
D. the number of patients is known.

Answer 10

A. all the patients have been triaged.

Question 11

What maneuver should be used to open the airway of an unresponsive patient with suspected trauma?

Select one:

A. Tongue-jaw lift
B. Head tilt–neck lift
C. Head tilt–chin lift
D. Jaw-thrust maneuver

Answer 11

D. Jaw-thrust maneuver

Question 12

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

Select one:

A. ensure that the patient can see you approaching him.
B. stand behind him and immediately stabilize his head.
C. assess his mental status by having him move his head.
D. approach him from behind and ask him not to move.

Answer 12

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

Question 13

When you shine a light into one pupil, the normal reaction of the other pupil should be to:

Select one:

A. become larger.
B. dilate.
C. not react.
D. become smaller.

Answer 13

D. become smaller.

Question 14

Which of the following actions would NOT be performed during the scene size-up?

Select one:

A. Asking a neighbor to secure the patient’s dog
B. Notifying the dispatcher to send fire personnel
C. Rapidly assessing a patient’s respiratory status
D. Noting the position of a crashed motor vehicle

Answer 14

C. Rapidly assessing a patient’s respiratory status

Question 15

Which of the following conditions would be LEAST likely to cause an altered level of consciousness?

Select one:

A. Inadequate perfusion
B. Acute anxiety
C. Drug overdose
D. Poisoning

Answer 15

B. Acute anxiety

Question 16

Which of the following scenarios does NOT involve the presence of any symptoms?

Select one:

A. A 44-year-old male with abdominal pain and severe dizziness

B. A 61-year-old female who is unconscious with facial cyanosis

C. A 55-year-old male with a severe headache and 2 days of nausea

D. A 49-year-old female with blurred vision and ringing in the ears

Answer 16

B. A 61-year-old female who is unconscious with facial cyanosis

Explanantion:

Signs - What the EMT can see

Symptoms - Something only the patient experiences

Question 17

Which of the following statements regarding the mechanism of injury (MOI) is correct?

Select one:

A. A significant MOI always results in patient death or permanent disability.

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 nonsignificant MOI rules out the possibility of serious trauma.

Answer 17

C. The MOI may allow you to predict the severity of a patient’s injuries.

Question 18

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

Select one:

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

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

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

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

Answer 18

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

Question 19

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:

Select one:

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

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

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.

Answer 19

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

Question 20

You should suspect that a patient is experiencing respiratory failure if he or she:

Select one:

A. has an increased heart rate and retractions.
B. is anxious, tachycardic, and leaning forward.
C. is restless and is working hard to breathe.
D. has bradycardia and diminished muscle tone.

Answer 20

D. has bradycardia and diminished muscle tone.

Question 21

During the scene size-up, you should routinely determine all of the following, EXCEPT:
A. the mechanism of injury or nature of illness.
B. the ratio of pediatric patients to adult patients.
C. whether or not additional resources are needed.
D. if there are any hazards that will jeopardize safety.

Answer 21

B. the ratio of pediatric patients to adult patients.

Question 22

You arrive at the scene of an “injured person.” As you exit the ambulance, you see a man lying on the front porch of his house. He appears to have been shot in the head and is lying in a pool of blood. You should:

A. immediately assess the patient.
B. proceed to the patient with caution.
C. quickly assess the scene for a gun.
D. retreat to a safe place and wait for law enforcement to arrive.

Answer 22

D. retreat to a safe place and wait for law enforcement to arrive.

Question 23

Findings such as inadequate breathing or an altered level of consciousness should be identified in the:
A. primary assessment.
B. focused assessment.
C. secondary assessment.
D. reassessment.

Answer 23

A. primary assessment.

Question 24

Which of the following would you NOT detect while determining your initial general impression of a patient?
A. Cyanosis
B. Gurgling respirations
C. Severe bleeding
D. Rapid heart rate

Answer 24

D. Rapid heart rate

Question 25

Your primary assessment of an elderly woman who fell reveals an altered level of consciousness and a large hematoma to her forehead. After protecting her spine and administering oxygen, you should:
A. reassess your interventions.
B. perform a rapid exam.
C. transport the patient immediately.
D. perform a focused assessment of her head.

Answer 25

B. perform a rapid exam.

If any life-threatening problems are discovered in the primary assessment, they should be addressed immediately. The EMT should then perform a rapid exam to look for other potentially life-threatening injuries or conditions.

Question 26

A semiconscious patient pushes your hand away when you pinch his earlobe. You should describe his level of consciousness as:
A. alert.
B. unresponsive.
C. responsive to painful stimuli.
D. responsive to verbal stimuli.

Answer 26

C. responsive to painful stimuli.

Question 27

Assessment of an unconscious patient’s breathing begins by:
A. inserting an oral airway.
B. manually positioning the head.
C. assessing respiratory rate and depth.
D. clearing the mouth with suction as needed.

Answer 27

B. manually positioning the head.

Question 28

Your 12-year-old patient can speak only two or three words without pausing to take a breath. He has a serious breathing problem known as:
A. nasal flaring.
B. two- to three-word dyspnea.
C. labored breathing.
D. shallow respirations.

Answer 28

B. two- to three-word dyspnea.

Question 29

How should you determine the pulse in an unresponsive 8-year-old patient?
A. Palpate the radial pulse at the wrist.
B. Palpate the brachial pulse inside the upper arm.
C. Palpate the radial pulse with your thumb.
D. Palpate the carotid pulse in the neck

Answer 29

D. Palpate the carotid pulse in the neck

Question 30

When assessing your patient’s pain, he says it started in his chest but has spread to his legs. This is an example of what part of the OPQRST mnemonic?
A. Onset
B. Quality
C. Region/radiation
D. Severity

Answer 30

C. Region/radiation

The region/radiation section of the OPQRST mnemonic assesses a patient’s pain—where it hurts and where the pain has spread. Because the patient informed you that his pain spread from his chest to his legs, this would be an example of radiation.

Question 31

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:
Select one:
A. transport at once and consider requesting a paramedic unit.
B. conclude that the irregular pulse is normal based on her age.

C. document your findings and perform a detailed assessment.
D. apply the AED and analyze her cardiac rhythm.

Answer 31

A. transport at once and consider requesting a paramedic unit.

Question 32

Which of the following abnormal breath sounds indicates obstruction of the upper airway?
Select one:
A. Rhonchi
B. Crackles
C. Rales
D. Stridor

Answer 32

D. Stridor

Question 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:
Select one:
A. 13.
B. 10.
C. 14.
D. 12

Answer 33

A. 13.

Question 34

After performing a primary assessment, a rapid exam of the body should be performed to:
Select one:
A. determine the need for spinal motion restriction precautions.

B. look specifically for signs and symptoms of inadequate perfusion.

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

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

Answer 34

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

Question 35

The systematic head-to-toe assessment should be performed on:
Select one:
A. responsive medical patients and patients without a significant MOI.

B. stable patients who are able to tell you exactly what happened.

C. all patients with traumatic injuries who will require EMS transport.

D. patients with a significant MOI and unresponsive medical patients.

Answer 35

D. patients with a significant MOI and unresponsive medical patients.

Question 36

Palliating factors regarding a patient’s pain involve those that:
Select one:
A. alleviate the pain.
B. worsen the pain.
C. change the pain.
D. initiate the pain.

Answer 36

A. alleviate the pain.