patient assessment Flashcards
1
Q
Acites
A
Abdominal swelling
Consider liver disease, CHF, renal failure
2
Q
Cullen’s sign
A
Bruising around umbilicus
Consider intra-abdominal bleeding
3
Q
Grey Turner’s sign
A
Bruising over flanks
Consider intra-abdominal bleeding
4
Q
Pitting edema
A
Depression left by pressure of finger
Consider CHF, renal failure
5
Q
5 major components of patient assessment
A
- Scene size-up
- Primary assessment
- Patient history
- Secondary assessment
- Reassessment
6
Q
Islets of langerhans cells:
A
Alpha
Beta
Delta
7
Q
Alpha cells (islets of langerhans)
A
Produce: glucagon
Effect: increase blood glucose
8
Q
Beta cells (islets of langerhans)
A
Produce: insulin
Effect: decrease blood glucose
9
Q
Delta cells (islets of langerhans)
A
Produce: somatostatin
Effect: inhibits production of glucagon and insulin
10
Q
Scene size-up
A
- scene safety
- BSI
- MOI/NOI
- # patients
- Additional resources
11
Q
Primary assessment
A
- general impression
- Spinal precautions
- LOC
- Airway -(manual, suction, mechanical)
- Breathing -(ventilation and supplemental O2; manage flail chest and sucking chest wounds)
- Circulation -(assess pulse, CPR if needed; manage life-threatening bleeding; skin color temp condition)
12
Q
The four assessment techniques
A
- Inspection: observation
- Palpation: touch
- Auscultation: listen
- Percussion: not frequently used
13
Q
ASPN
A
Associated Symptoms- additional symptoms associated with chief complaint
Pertinent Negatives- symptoms that are not present
14
Q
Body systems assessment
A
- HEENT: head, eyes, ears, nose, throat
- Chest and lungs
- Abdomen (GI/GU)
- Musculoskeletal
- Neurological
- Hematologic
- Endocrine
- Psychiatric
15
Q
The problem-oriented evaluation of a patient with establishment of priorities based on existing and potential threats to human life is called:
A
Patient assessment
16
Q
The purpose of the initial assessment is to identify and correct:
A
Immediately life threatening conditions
17
Q
Which of the following problems would you be likely to note during your scene size-up of a situation?
A
BSI Scene safety #pts Moi/noi Additional resources
18
Q
Standard precautions is a component of:
A
Scene size-up
19
Q
In a medical emergency you can sometimes determine the nature of your patient’s illness from clues at the scene. These would include:
A
Smells, sounds and things you see
20
Q
The most effective method of preventing disease transmission between you and your patients is:
A
Washing your hands before and after patient contact
21
Q
Which of the following is true regarding scene safety?
A
Personal safety is top priority
22
Q
Which of the following is true regarding scene safety?
A
May be evident from clues around the scene
23
Q
Determining the patient’s priority for transport is a component of the:
A
Initial assessment
24
Q
Components of the initial assessment include:
A
Airway, breathing and circulation
25
While performing the initial assessment of a patient, you note an open wound to the chest. This injury should be treated:
During the initial assessment
26
If the mechanism of injury is significant or if your patient is unresponsive:
Have your partner hold the head and neck
27
Serious external hemorrhage should be controlled
During the initial assessment
28
If you suspect a possible cervical spine injury, you should open the patient's airway with:
Jaw thrust
29
To record your patient's mental status, use the acronym AVPU. Which of the following is true?
Painful stimuli
30
Signs of inadequate breathing in the adult patient include:
A respiratory rate of 24
31
Performing a primary assessment should take ____________ unless you must intervene with lifesaving measures.
Less than 1 minute
32
Cyanotic, pale, or ashen skin may indicate:
Vascular compromise
33
Which of the following statements regarding assessment of an infant's or a small child's respiration is true?
Infants and children grunt to maintain back pressure
34
A female patient with abdominal pain is always considered:
Pregnant until otherwise proven
35
How the focused history and physical exam are performed is based on the initial assessment and:
Patient's chief complaint
36
One subclassification of trauma patients includes those:
With an isolated injury
37
Predictors of serious internal injury of a patient include:
Motorcycle crash
38
The predictors of serious internal injury for infants and children that differ from those for adults include:
A fall from higher than 10ft
39
The mnemonic SAMPLE is helpful in evaluating a major trauma patient. The letters represent:
An abbreviated patient history format
40
The M in the mnemonic SAMPLE stands for:
Medication
41
The P in the mnemonic SAMPLE stands for:
Pertinent medical history
42
Subcutaneous emphysema is:
Air under the skin causing crackling
43
Treatment for a tension pneumothorax includes:
Needle decompression
44
A patient with a ________ fracture or dislocation risks lacerating the iliac arteries and veins, through which he can lose a significant amout of blood.
Pelvic
45
When assessing the trauma patient with an isolated injury, you most likely will not need to perform a(n):
Detailed physical exam
46
The history for a responsive medical patient should include the:
Chief complaint, history of present illness, past medical history, family history, and review of the systems
47
Once you have obtained a chief complaint from a responsive medical patient, you should next:
Obtain history of present illness
48
In the acronym OPQRST-ASPN, ASPN stands for:
Associated symptoms and pertinent negatives
49
To quickly test the seventh cranial nerve (CN-VII), you should have your patient:
Show his teeth
50
After completing the initial assessment of an unresponsive medical patient, you should next:
Perform a rapid secondary assessment
51
After conducting the focussed physical exam for a responsive medical patient, you should next:
Provide necessary emergency medical care authorized by standing orders
52
The detailed physical exam is designed for use:
Patients in route to the hospital
53
The ongoing assessment:
Detects trends, determines changes, assesses intervention effects
54
The ongoing assessment should be conducted every ___________ minutes for stable patients and every __________ minutes for unstable patients.
15, 5
55
The process of informed observation is:
Inspection
56
Which of the following is not a type of percussion?
Pointed
57
It is best to examine which of the following patients using the toe-to-head method?
9 month old with a fever
58
Voice changes that are caused by vocal cord problems are known as:
Dysphonia
59
The first physical exam finding you will often observe with an emergency condition is a change in:
Mental status
60
_________________ usually indicates an increase in sympathetic nervous system stimulation as the body compensates for another problem.
Tachycardia
61
The difference between the systolic and diastolic pressures is known as:
Pulse pressure
62
A positive orthostatic vital sign change means that upon standing the patient's pulse rate:
Increased by 15 bpm
63
A blood pressure cuff fits the patient correctly if it covers:
2/3 the upper arm
64
Skin color should be assessed where the ___________ is the thinnest.
Epidermis
65
An elevated, palpable area containing liquid or viscous matter is called a:
Cyst
66
Clubbing of the fingernails occurs because of:
Chronic hypoxia
67
Which of the following cranial nerves does NOT control eye movement?
Trigeminal nerve
68
The ___________ is a coiled structure that transmits sound to the acoustic nerve.
Cochlea
69
Battle's sign is a common but late sign of:
Basilar skull fracture
70
An adult normally has ____________ permanent teeth
32
71
To examine the postauricular lymph node, you palpate:
On or under the mastoid process
72
Popping, nonmusical sounds heard during inspiration are called:
Stridor
73
The resistance in the vessels that the heart must overcome to eject blood is called:
Afterload
74
Tennis elbow is found by palpating the:
Medial epicondyle
75
A condition that makes posterior chest and lung examination difficult is thoracic:
Kophoscoliosis
76
A light, popping, nonmusical sound heard upon auscultation of the lungs is best described as:
Crackles
77
A loud, harsh sound over the trachea on auscultation with a stethoscope suggests:
Normal air movement
78
A tear in the tracheobronchial tree or a pneumothorax can be characterized by ________ in the neck.
Subcutaneous emphysema
79
All of the following characteristics indicate a normal appearance to oral mucosa EXCEPT:
Patches of white
80
Areas of a neurologic exam include all of the following EXCEPT:
Cranium
81
Discoloration over the umbilicus, known as ________ sign, is a(n) ________ indicator of intraabdominal bleeding.
Cullen's, late
82
During the abdominal exam, areas that are known to be painful or tender should be examined:
Last
83
During ventricular systole, the ventricles contract while the:
Tricuspid and mitral valve a close
84
For you to assess for jugular venous distention, your patient should be ________ at a ________-degree angle.
Sitting, 45
85
Increased fremitus over part of the patient's chest wall may indicate:
Pneumonia
86
Nasal flaring is an indication of:
Respiratory distress
87
Normal pediatric respiratory and heart rates ________ as children grow older.
Decreases
88
Petechiae are skin lesions characterized by:
Reddish purple spots less than 0.5 cm in diameter
89
Pleural effusion is characterized by the presence of:
Fluid in the pleural space
90
Rales, or crackles, would be most typically auscultated in patients with which of the following conditions?
CHF
91
Skin color is best evaluated by observing the:
Nail beds and conjunctiva
92
The condition of the nail bed caused by chronic hypoxia associated with cardiopulmonary diseases is called:
Clubbing
93
The crunching sound that is made when unlubricated skeletal parts rub against each other is called:
Crepitus
94
Which of the following best describes the pulse pressure?
The difference between systolic and diastolic blood pressures
95
The patient's age, sex, race, birthplace, and occupation are included in which element of the comprehensive patient history?
Preliminary data
96
The mnemonic OPQRST-ASPN is a tool used during which element of the comprehensive patient history?
Present illness/injury
97
Which of the following is true regarding the patient's chief complaint?
Chief complaint is why EMS was called
98
In the OPQRST mnemonic, the "P" stands for:
Provocative/palliative factors
99
The term referred pain means pain that:
Is felt at a location away from the source
100
Which of the following statements about obtaining a patient's past medical history is true?
Asking about surgeries may help you correctly assess your patients current problem
101
The patient's family/social history should include questions regarding:
Tobacco, alcohol and drugs
102
The CAGE questionnaire should be employed when investigating:
Alcohol use
103
The patient's home situation, daily life, and religious beliefs are among the elements that may be determined when investigating the patient's:
Current health status
104
Which of the following statements is true regarding the review of systems?
Questions you ask will be determined by the patient's chief complaint, condition, and clinical status
105
A sudden onset of shortness of breath at night is called:
Paroxysmal nocturnal dyspnea
106
The term gravida refers to the number of:
Number of times a woman has been pregnant
107
A preliminary list of possible causes for your patient's problem is called a:
Differential diagnosis
108
Having the ability to view the world through another's eyes while remaining true to yourself is called:
Empathy
109
The term "encode" means to:
Create a message
110
Reasons for failing to communicate include:
Lack of privacy
111
Ways to build trust and rapport with a patient, a family, and bystanders include:
Modulation your voice appropriately
112
Elements of nonverbal communication include all of the following, EXCEPT:
Written questions
113
In the United States personal distance, or 'personal space,' is considered to extend _______________ from an individual.
1.5 - 4ft
114
Standing below the patient's eye level indicates:
A willingness to let the patient have some control in the situation
115
An open stance means that you are:
Confident
116
Which of the following statements about social distance is TRUE?
It is used for interpersonal business transactions
117
Questions framed to guide the direction of a patient's answer are called:
Leading questions
118
Appropriate questioning techniques include all of the following, EXCEPT:
Using medical terminology
119
One the speaker has stopped talking, provide feedback to confirm that your understand the message. Feedback techniques include all of the following, EXCEPT:
Distancing
