Chapter 10: Patient Assessment

Question 1

Knowledge and understanding of one’s surroundings and the ability to recognize potential risks to the safety of the patient or EMS team.

Answer 1

situational awareness

Question 2

The tough, fibrous, white portion of the eye that protects the more delicate inner structures.

Answer 2

sclera

Question 3

An upright position in which the patient’s head and chin are thrust slightly forward to keep the airway open.

Answer 3

sniffing position

Question 4

The delicate membrane that lines the eyelids and covers the exposed surface of the eye.

Answer 4

conjunctiva

Question 5

A harsh, high-pitched respiratory sound, generally heard during inspiration, that is caused by partial blockage or narrowing of the upper airway; may be audible without a stethoscope.

Answer 5

stridor

Question 6

Subjective findings that the patient feels but that can be identified only by the patient.

Answer 6

symptom

Question 7

Blood pressure that is higher than the normal range.

Answer 7

hypertension

Question 8

A noninvasive method to quickly and efficient provide information on a patient’s ventilatory status, circulation, and metabolism; effectively measures the concentration of carbon dioxide in expired air over time.

Answer 8

capnography

Question 9

A mnemonic for assessment in which each area of the body is evaluated for Deformities, Contusions, Abrasions, Puntures/penetrations, Burns, Tenderness, Lacerations, and Swelling.

Answer 9

DCAP-BTLS

Question 10

A component of air that typically makes up 0.03% of air at sea level; also a waste product exhaled during expiration by the respiratory system.

Answer 10

carbon dioxide

Question 11

Protective measures that have traditionally been developed by the Centers for Disease Control and Prevention (CDC) for use in dealing with objects, blood, body fluids, and other potential exposure risks of communicable disease.

Answer 11

standard precautions

Question 12

The increased pressure in an artery with each contraction of the ventricles (systole).

Answer 12

systolic pressure

Question 13

Movements in which the skin pulls in around the ring during inspiration.

Answer 13

retractions

Question 14

A step within the patient assessment process performed at regular intervals during the assessment process to identify and treat changes in a patient’s condition. A patient in unstable condition should be reassessed every 5 minutes, whereas a patient in stable condition should be reassessed every 15 minutes.

Answer 14

reassessment

Question 15

The biochemical processes that result in production of energy from nutrients within the cells; also called cellular respiration.

Answer 15

metabolism

Question 16

Respirations characterized by little movement of the chest wall (reduced tidal volume) or poor chest excursion.

Answer 16

shallow respirations

Question 17

A mnemonic used in evaluating a patient’s pain: Onset, Provocation/palliation, Quality, Region/radiation, Severity, and Timing.

Answer 17

OPQRST

Question 18

A step within the patient assessment process in which a systemic physical examination of the patient is performed. The examination may be a systemic exam or an assessment that focuses on a certain area or region of the body, often determined through the chief complaint.

Answer 18

secondary assessment

Question 19

To examine by touch

Answer 19

palpate

Question 20

A type of physical assessment typically performed on patients who have sustained no significant mechanisms of injury or on responsive medical patients. This type of examination is based on the chief complaint and focuses on one body system or part.

Answer 20

focused assessment

Question 21

The mental status of a patient as measured by memory of person (name), place (current location), time (current year, month, and approximate date), and event (what happened).

Answer 21

orientation

Question 22

Negative findings that warrant no care or intervention.

Answer 22

pertinent negatives

Question 23

A slow heart rate, less than 60 beats/min.

Answer 23

bradycardia

Question 24

The amount of air (in milliliters) that is moved into or out of the lungs during one breath.

Answer 24

tidal volume

Question 25

Breathing that occurs without assistance.

Answer 25

spontaneous respirations

Question 26

A step within the patient assessment process that involves a quick assessment of the scene and the surroundings to provide information about scene safety and the mechanism of injury or nature of illness before you enter and begin patient care.

Answer 26

scene size-up

Question 27

Objective finding that can be seen, heard, felt, smelled, or measured.

Answer 27

sign

Question 28

An upright position in which the patient leans forward onto two arms stretched forward and thrusts the head and chin forward.

Answer 28

tripod position

Question 29

A brief history of a patient’s condition to determine signs and symptoms, allergies, medications, pertinent past history, last oral intake, and events leading to the injury or illness.

Answer 29

SAMPLE history

Question 30

Yellow skin or sclera that is caused by liver disease or dysfunction.

Answer 30

jaundice

Question 31

A step within the patient assessment process that identifies and initiates treatment of immediate and potential life threats.

Answer 31

primary assessment

Question 32

Involuntary muscle contractions (spasm) of the abdominal wall to minimize the pain of abdominal movement, a sign of peritonitis.

Answer 32

guarding

Question 33

The flow of blood through body tissues and vessels.

Answer 33

perfusion

Question 34

The process of establishing treatment and transportation priorities according to severity of injury and medical need.

Answer 34

triage

Question 35

crackling, rattling breath sounds that signal fluid in the air spaces of the lungs.

Answer 35

crackles

Question 36

A change in the way a person thinks and behaves that may signal disease in the central nervous system or elsewhere in the body.

Answer 36

altered mental status

Question 37

A heating or grinding sensation or sound caused by fractured bone ends or joints rubbing together.

Answer 37

crepitus

Question 38

The time from injury to definitive care, during which treatment of shock and traumatic injuries should occur because survival potential is best, also called the Golden Period.

Answer 38

Golden Hour

Question 39

Narrowing of a blood vessel

Answer 39

vasoconstriction

Question 40

A method of assessing the level of consciousness by determining whether the patient is awake and alert, responsive to verbal stimuli or pain, or unresponsive; used principally early in the assessment process.

Answer 40

AVPU scale

Question 41

An assessment tool that measures oxygen saturation of hemoglobin in the capillary beds.

Answer 41

pulse oximetry

Question 42

A blue skin discoloration that caused by a reduced level of oxygen in the blood. Although paleness, or a decrease in blood flow, can be difficult to detect in dark-skinned people, it may be observed by examining mucous membranes inside the inner lower eyelid and capillary refill. On general observation, the patient may appear ashen or gray.

Answer 42

cyanosis

Question 43

The wave of pressure created as the heart contracts and forced blood out the left ventricle and into the major arteries.

Answer 43

pulse

Question 44

The conclusion about the cause of the patient’s condition after considering the situation, history, and examination findings.

Answer 44

field impression

Question 45

Coarse, low pitched breath sounds heard in patients with chronic mucus in the upper airways.

Answer 45

rhonchi

Question 46

The key signs that are used to evaluate the patients overall condition, including respirations, pulse, blood pressure, level of consciousness, and skin characteristics.

Answer 46

vital signs

Question 47

A condition in which the internal body temperature falls below 95 degrees F (35 degrees C)

Answer 47

hypothermia

Question 48

The overall initial impression that determines the priority for patient care; based on the patient’s surroundings, the mechanism of injury, signs and symptoms, and the chief complaint.

Answer 48

general impression

Question 49

Characterized by light or profuse sweating.

Answer 49

diaphoretic

Question 50

A characteristic cracking sensation felt on palpation of the skin, caused by the presence of air in soft tissues.

Answer 50

subcutaneous emphysema

Question 51

A severe breathing problem in which a patient can speak only two to three words at a time without pausing to take a breath.

Answer 51

two-to three-word dyspnea

Question 52

Protective equipment that blocks exposure to a pathogen or a hazardous material

Answer 52

personal protective equipment

Question 53

The reason a patient called for help; also, the patient’s response to questions such as “What’s wrong?” or “What happened?”

Answer 53

chief complaint

Question 54

The pressure that remains in the arteries during the relaxing phase of the heart’s cycle (diastole) when the left ventricle is at rest.

Answer 54

diastolic pressure

Question 55

The way which a patient responds to external stimuli, including verbal stimuli (sound), tactile stimuli (touch), and painful stimuli.

Answer 55

responsiveness

Question 56

Any injury that prevents the patient from noticing other injuries her or she may have, even severe injuries; for example, a painful femur or tibia fracture that prevents the patient from noticing back pain associated with a spinal fracture.$

Answer 56

distracting injury

Question 57

A test that evaluates distal circulatory system function by squeezing (blanching) blood from an area such as a nail bed and watching the speed of its return after releasing the pressure

Answer 57

capillary refill

Question 58

The general type of illness a patient is experiencing.

Answer 58

nature of illness

Question 59

An indication of air movement in the lungs, usually assessed with a stethoscope.

Answer 59

breath sounds

Question 60

Blood pressure that is lower than the normal range.

Answer 60

hypotension

Question 61

Damage to tissues as the result of exposure to cold; frozen or partially frozen body parts are frostbitten.

Answer 61

frostbite

Question 62

To listen to sounds within an organ with a stethoscope.

Answer 62

auscultate

Question 63

The pressure that the blood experts against the walls of the arteries as it passes through them.

Answer 63

blood pressure

Question 64

A grating or grinding sensation or sound caused by fractured bone ends or joints rubbing together.

Answer 64

crepitus

Question 65

The average pressure in the circulatory system during one cardiac cycle.

Answer 65

mean arterial pressure

Question 66

The use of muscles of the chest, back, and abdomen to assist in expanding the chest; occurs when air movement is impaired.

Answer 66

labored breathing

Question 67

A step within the patient assessment process that provides details about the patient’s chief complaint and an account of the patient’s signs and symptoms.

Answer 67

history taking

Question 68

Widening of the nostrils, indicating that there is an airway obstruction

Answer 68

nasal flaring

Question 69

A high-pitched, whistling breath sound that is most prominent on expiration, and which suggests an obstruction or narrowing of the lower airways; occurs is asthma and bronchiolitis

Answer 69

wheezing

Question 70

The secondary muscles of respiration. They include the neck muscles (sternocleidomastoids), the chest pectoralis major muscles, and the abdominal muscles.

Answer 70

accessory muscles

Question 71

A rapid heart rate, more than 100 beats/min.

Answer 71

tachycardia

Question 72

The forces, or energy transmission, applied to the body that cause injury.

Answer 72

mechanism of injury

Question 73

A system implemented to manage disasters and mass casualty incidents in which section chiefs, including finance/administration, logistics, operations, and planning, report to the incident commander.

Answer 73

incident command system

Question 74

The motion of the portion the chest wall that is detached in a flail chest; the motion—in during inhalation, out during exhalation—is exactly the opposite of normal chest wall motion during breathing.

Answer 74

paradoxical motion