Chapter 10: Patient Assessment Flashcards
Select one
A pulse with a consistent pattern is considered to be:
1. Strong
2. Irregular
3. Regular
4. Weak
Rugular
Select one
A 40-year-old male presents with pain to th eright upper quadrant of his abdomen. He is conscious and alert with stable vital signs. During your assessment, you note that his skin and sclera are jaundiced. You should suspect:
1. Acute pancreatitis
2. Renal insufficiency
3. Liver dysfunction
4. Gallbladder disease
Liver dysfunction
Define
Symptom
A subjective finding that the patient tells you about.
OPQRST
What does the “T” stand for?
Timing: How long have you had the symptom?
Select one
Which of the following statements regarding the secondary assessment is correct?
1. During the secondary assessment, the EMT’s primary focus should be on taking the patient’s vital signs and obtaining a SAMPLE history.
2. The secondary assessment should be performed en route to the hospital, regardless of the severity of the patient’s condition.
3. The secondary assessment should focus on a certain area or region of the body as determined by the chief complaint.
4. 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 focus on a certain area or region of the body as determined by the chief complaint.
True or False
EMT’s can expect anxious patients to exhibit signs of psychological shock.
True
Describe
What is a symptom
A subjective condition the patient feels and tells you about.
Patient assessment steps
What does the fourth step secondary assessment (medical or trauma) entail?
- Systematically assess the patient
- Secondary assessment and/or focused assessment
- Assess vital signs using the appropriate monitoring device
Define
Palpate
To examine by touch
True or False
Correct identificaiton of high-priority patients is an essencial aspect of the primary assessment and helps to improve patient outcome.
True
SAMPLE
What does the “E” stand for?
Events: Events leading up to injury or illness? What occured between onset and EMS arrival?
OPQRST
What does the “P” stand for?
Provication/palliation: Does anything make the symptoms better or worse?
Select one
In the absence of light, the pupils will:
1. Constrict
2. Stay fixed
3. Dilate
4. Become unequal
Dilate
OPQRST
What does the “O” stand for?
Onset: What were you doing when symptoms began?
Define
Tachycardia
Heart rate greater than 100 beats/min.
Select one
In infants and small children, skin color should be assessed on the:
1. Palms and soles.
2. Chest and abdomen.
3. Underside of the arms.
4. Forehead.
Palms and soles.
Define
Orientation
Primary assessment (LOC)
The mental status of the patient as measured by memory of person, place, time, and event.
Select one
Which of the following is NOT typically found on an abdominal scan?
1. Guarding
2. Crepitation
3. Tenderness
4. Rigidity
Crepitation
Describe
What is a sign?
Objective condition you can observe about the patient.
SAMPLE
What does the “S” stand for?
Signs and symptoms: What signs and symptoms occured at onset?
Select one
A patients short-term memory is MOST likely intact if they correctly answer questions regarding:
1. Person and place.
2. Event and person.
3. Day and event.
4. Time and place.
Day and event
What are the steps to patient assessment?
- Scene size-up
- Primary assessment
- History taking
- Secondary assessment: medical or trauma
- Reassessment
Select one
Which of the following patients has signs of an altered mental status?
1. A patient who overdosed and tells you he tried to kill himself.
2. A patient with an acute allergic reaction and dizziness.
3. A patient with a head injury who is slow to answer questions.
4. A diabetic who has nausea and severe lightheadedness
A patient with a head injury who is slow to answer questions.
Select one
When you assess capillary refill time in an infant, normal color to the tested area should return within:
1. 2 seconds
2. 3 seconds
3. 4 seconds
4. 1 second
2 seconds
Define
Crepitus
A crackling or grinding sound, caused by fractured bone ends or joints rubbing together.
Select one
When ausculating the blood pressure in a patients upper extremity, you should place the diaphragm (head) of the stethescope over the ____ artery.
1. Femoral
2. Brachial
3. Radial
4. Apical
Brachial
Select one
Which of the following statements regarding the secondary assessment is correct?
- During the secondary assessment, the EMT’s primary focus should be on taking the patients vital signs and obtaining a SAMPLE history.
- The secondary assessment should be performed en route to the hospital, regardless of teh severity of the patients condition.
- The secondary assessment should focus on a certain are or region of the body determined by the chief complaint.
- The 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 focus on a certain are or region of the body as determined by the chief complaint.
Define
Frostbite
Damage to tissue as a result of exposure to cold
Define
Paradoxical motion
The motion of a segment of the chest wall that is opposite the normal movement during breathing.
Define
Sclera
The white portion of the eyes.
Select one
When assessing motor function in a conscious patients lower extremities, you should expect the patient to:
1. Identify different types of stimuli.
2. Wiglge his or her toes on command.
3. Feel you touching the extremity.
4. Note any changes in temperature.
Wiggle his or her toes on command.
Select one
A palpable pulse is created by:
1.1 Pressure waves through the arteries caused by cardiac contraction.
2.Electrical conduction in the heart producing contractino of the atria.
3.The pressude of circulating blood against the walls of teh veins.
4.The pressure that is caused when venous blood returns to the heart.
Pressure waves through the arteries casued by cardiac contraction
SAMPLE
What does the “M” stand for?
Medications: What medications were the patient prescribed?
Define
Diaphoretic
Profuse sweating
Slect one
Which of the following questions is used to determine a patients chief complaint?
1. “Are you having trouble breathing?”
2. “When did the chest pain begin?”
3. “What seems to be the matter?”
4. “Do you have a history of diabetes?”
“What seems to be the matter?”
OPQRST
What does the “R” stand for?
Region/radiation: Where do you feel the symptom?
Define
Conjunctiva
The delicate membrane lining of the eyelids
Select one
A palpable pulse is created by:
1. Pressure waves through the arteries caused by cardiac contraction.
2. Electrical conduction in the heart producing contraction of the atria.
3. The pressure of circulatinf blood against the walls of the veins.
4. The pressure that is caused when venous blood returns to the heart
Pressure waves through the arteries caused by cardiac contraction
Select one
An elderly patient has fallen and hit her head. You assess her LOC as unresponsive using the AVPU scale. Your initial care should focus on:
1. Obtaining baseline vital signs.
2. Airway, breathing, and circulation.
3. Gatheriong medical history data.
4. Providing immediate transport.
Airway, breathing, and circulation
Select one
Which of the following assessments would be the MOST useful in determining the possible cause of a patients altered mental status?
1. Respritory rate.
2. Capillary refil time.
3. Blood pressure.
4. Blood glucose level.
Blood glucose level
Select one
Normal respritory rates should not exceed ____ breaths per minute in toddlers and ____ breaths per minute in infants.
1. 30, 40
2. 20, 30
3. 40, 60
4. 18, 28
Should not exceed 40 for toddlers and 60 for infants.
Select one
Your first consideration when assessing a pulse is to determine:
1. How fast the rate is
2. The quality
3. If one is present
4. If the rhythym is regular
If one is present
Select one
Which of the following statements regarding stridor is correct?
1. It is a whistling sound heard in the lower airway.
2. It suggests the presence of fluid in the lungs.
3. It is a high-pitched, crowing upper airway sound.
4. It is caused by incorrct airway positioning.
It is a high-pitched crowing, upper airway sound.
Select one
When assessing the respritory system, which of the following is NOT considered essencial to the assessment?
1. Respritory rate
2. Depth of breathing
3. Quality/character of breathing
4. Breath odor
Breath odor
Select one
The ____ is performed at regular intervals during the assessment process, and its purpose is to identify and treat changes in a patients condition.
1. Primary assessment
2. Reassessment
3. Secondary assessment
4. Scene size-up
Reassessment
Retractions
Indentation above the clavicles and in the spaces between the ribs during breathing.
Select one
When ausculating the blood pressure in a patients upper extremity, you should place the diaphragm (heaf) of the stethoscope over the ____ artery.
- Femoral
- Brachial
- Radial
- Apical
Brachial
Define
Triage
The process of sorting patients based on severity of condition.
Select one
A patient in an unstable condition should be reassessed at least every:
1. 10 minutes
2. 15 minutes
3. 20 minutes
4. 5 minutes
5 minutes
Select one
Which of the following conditions would be LEAST likely to cuase an altered level of consciousness?
- Acute anxiety
- Inadequate perfusion
- Drug overdose
- Poisoning
Acute anxiety
True or False
Determining the mental status and the LOC of a patient take a great deal of time while on scene.
False
Select one
Which of the following signs of respritory distress is usually observed only in pediatric patients?
1. Seesaw breathing.
2. Accessory muscle use.
3. Pursed-lip breathing.
4. Rapid respirations.
Seesaw breathing
Select one
The “Golden Hour” begins when an injury occurs and ends when:
1. You arrive at the emergency.
2. The patient is admitted to the ICU.
3. You depart the scene for the hospital.
4. The patient recieves definitive care.
The patient recieves definitive care
Select one
Jugular veneous distention (JVD) suggests a problem with blood returning to the heart if the patinet is:
1. In a recumbent position
2. In a supine position
3. Sitting up at a 45 degree angle
4. In a prone postion
Sitting up at a 45 degree angle
Select one
Which of the following is the MOST effective method of assessing the air quality of air movement in the lungs?
1. Ausculating breath sounds with a stethoscope.
2. Looking for the presence of accessory muscle use.
3. Applying a pulse oximeter and monitoring the SpO2%.
4. Evaluating the patients chest for cyanosis.
Ausculating breath sounds with a stethoscope.
True or False
It is unusual for a patient, family member, or friend to vent hostility toward EMS.
False
Define
Breath sounds
Sounds produced as air moves into and out of the lungs.
OPQRST
What does the “Q” stand for?
Quality: What does the symptom feel like?
Define
Subcutaneous Emphysema
A characteristic crackling sensation felt on palpation of the skin caused by the presence of air in soft tissues.
Define
OPQRST
Mneumonic for gathering information about a patients symptoms.
Onset, provocation/palliation, quality, region/radiation, severity, and timing.
Define
Responsiveness
The way a patient responds to external stimuli, including verbal stimuli, tactile stimuli, and painful stimuli.
Select one
The goal of the primary assessment is to:
1. Determine the need to perform a head-to-toe assessment.
2. Identify and rapidly treat all life-threatening conditions.
3. Determine if the patients problem is medical or traumatic
4. Identify patients that require transport to a trauma center.
Identify and treat all life-threatening conditions.
Define
Chief complaint
The most serious thing the patient is worried about; also the patients answer to questions like “whats wrong?” or “what happened?”.
Patient assessment steps
What does the fifth step reassessment entail?
- Repeate the primary assessment
- Reassess vitals
- Reassess chief complaint
- Recheck interventions
- Identify and treat changes in patients condition
- Reassess the patient every five minutes for unstable patients and every 15 minutes for a stable patient.
What are the 5 sections of patient assessment?
- Scene size up
- Primary assessment
- History taking
- Secondary assessment
- Reassessment
Define
Accessory muscles of respiration
Neck, chest, and abdominal muscles used when difficulty breathing is present.
Select one
Which of the following is included in the primary assessment?
1. Blood pressure.
2. Palpating a pulse
3. Ocygen saturation
4. Pupil size
Palpating a pulse
select one
Which of the following statements regarding the blood pressure is correct?
1. Blood pressure is not usually measured in children under 3 years of age.
2. Blood pressure falls early in patients with hypoperfusion.
3. Blood pressure is the most reliable indicator of perfusion.
4. The systolic pressure represents centricular relaxation.
Blood pressure is not usually measured in children younger than 3 years of age.
Patietn assessment steps
What does the second step primary assessment entail?
- Form a general impression
- Assess LOC
- Assess ABC’s: Identify and treat life threats
- Perform primary assessment
- Determine priority of patient care and transport
OPQRST
What does the “S” stand for?
Severity: On a scale of 1-10 how bad does it hurt?
Select one
A pulse with a consistent pattern is considered to be:
1. Strong
2. Irregular
3. Regular
4. Weak
Regular
Select one
When should you take standard precautions during an EMS call?
1. After it has been determined that the patient is bleeding.
2. Before you load the patient into the ambulance.
3. Before exiting the ambulance and before actual patient contact.
4. Immediately after completion of your primary assessment.
Before exititing the ambulance and before actual patient contact
Select one
Which of the following factors would MOST likely cause a patients pulse rate to be slower than normal?
1. Internal bleeding from trauma.
2. Anxiety or severe stress.
3. Beta blocker medications.
4. Lack of regular excersize routine.
Beta blocker medications
Select one
Which of the following statements regarding assessment of the airway is true?
1. The body will not be supplied the neccessary oxygen if the airway is not managed.
2. You should use the headtilt chin-lift maneuver to open the airway in trauma patients.
3. The tongue is generally not a cuase of airway obstruction.
4. A conscious patient who cannot speak or cry is most likely hyperventilating.
The body will not be supplied the neccessary oxygen if the airway is not managed.
Define
Cyanosis
Blueish-gray skin color associated with reduced oxygen levels.
Select one
What part of the patient assessment process focuses on obtaining additional information about the patients chief complaint and any medical problems he or she may have?
1. General impression
2. Primary assessment
3. History taking
4. Secondary assessment
History taking
Define
Jaundice
A yellow skin color due to liver disease or dysfunction.
Select one
When performing a rapid exam on a supine patient, what part of the body is typically assessed last?
1. Posterior
2. Anterior chest
3. Abdomen
4. Extremities
Posterior
Patient assessment steps
What does the third step History taking entail?
Investigate the chief complaint (history of present illness) obtain SAMPLE history.
Select one
A patient with high blood pressure would be expected to have skin that is:
1. Pale and moist
2. Flushed and red
3. Mottled and cool
4. Cyanotic and dry
Flushed and red
Select one
When you inspect a patients pupils with a pen light, the pupuls should normally react to the light by:
1. Fluttering.
2. Dilating.
3. Constricting.
4. Enlarging
Constricting
Select one
As time progresses following a significant injury:
1. Most patients will die secondary to internal bleading.
2. The patients injuries will most likely be irreparable.
3. The bodys ability to compensate for shock decreases.
4. the patients blood pressure elevates significantly.
The bodys ability to compensate for shock decreases.
True or False
You should consider providing positive pressure ventilation in a conscious patient who has a respritory rate of 14 breaths/min.
False
SAMPLE
What does the “L” stand for?
Last oral intake: when or what did the patient last eat or drink?
SAMPLE
What does the “P” stand for?
Pertinent/Past medical history: Any history of medical, surgical, or trauma?
Select one
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:
- Apply the AED and analyze her cardiac rhythm.
- Transport at once and consider requesting a paramaedic unit.
- Conclude that the irregular pulse is normal based on her age.
- Document your findings and perform a detailed assessment.
Transport at once and consider requesting a paramedic unit
Patient assessment steps
What does the first step scene size-up entail?
- Ensure scene safety
- Determine NOI or MOI
- Take standard precautions
- Determine number of patients
- Consider additional/specialized resources
Select one
Which of the following statements regarding the secondary assessment is correct?
1. 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.
2. If your general impression of a patient does not reveal any obvious life threats, you should proceed directly to the secondary assessment.
3. A focused secondary assessment would be the most appropriate approach for a patient who experianced significant trauma to multiple body systems.
4. You may not have the time to perform a secondary assessment if you must continually manage life threats that were identified during the primary assessment.
You may not have time to perform a secondary assessment if you must continually manage life threats that were identified during the primary assessment.
SAMPLE
What does the “A” stand for?
Allergies: Is the patient allergic to any medications, food, or other substance?
Select one
Reassessment is performed to determine all of the following, except:
1. Whether or not the patient is deteriorating.
2. The nature of any newly identified problems.
3. The patient response to your treatment.
4. The reason why the patient called EMS.
The reason why the patient called EMS.
