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patient assessment Flashcards

1
Q

Acites

A

Abdominal swelling

Consider liver disease, CHF, renal failure

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2
Q

Cullen’s sign

A

Bruising around umbilicus

Consider intra-abdominal bleeding

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3
Q

Grey Turner’s sign

A

Bruising over flanks

Consider intra-abdominal bleeding

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4
Q

Pitting edema

A

Depression left by pressure of finger

Consider CHF, renal failure

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5
Q

5 major components of patient assessment

A
  1. Scene size-up
  2. Primary assessment
  3. Patient history
  4. Secondary assessment
  5. Reassessment
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6
Q

Islets of langerhans cells:

A

Alpha
Beta
Delta

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7
Q

Alpha cells (islets of langerhans)

A

Produce: glucagon

Effect: increase blood glucose

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8
Q

Beta cells (islets of langerhans)

A

Produce: insulin

Effect: decrease blood glucose

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9
Q

Delta cells (islets of langerhans)

A

Produce: somatostatin

Effect: inhibits production of glucagon and insulin

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10
Q

Scene size-up

A
  • scene safety
  • BSI
  • MOI/NOI
  • # patients
  • Additional resources
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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)
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12
Q

The four assessment techniques

A
  1. Inspection: observation
  2. Palpation: touch
  3. Auscultation: listen
  4. Percussion: not frequently used
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13
Q

ASPN

A

Associated Symptoms- additional symptoms associated with chief complaint

Pertinent Negatives- symptoms that are not present

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14
Q

Body systems assessment

A
  1. HEENT: head, eyes, ears, nose, throat
  2. Chest and lungs
  3. Abdomen (GI/GU)
  4. Musculoskeletal
  5. Neurological
  6. Hematologic
  7. Endocrine
  8. Psychiatric
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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

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16
Q

The purpose of the initial assessment is to identify and correct:

A

Immediately life threatening conditions

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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
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18
Q

Standard precautions is a component of:

A

Scene size-up

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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

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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

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21
Q

Which of the following is true regarding scene safety?

A

Personal safety is top priority

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22
Q

Which of the following is true regarding scene safety?

A

May be evident from clues around the scene

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23
Q

Determining the patient’s priority for transport is a component of the:

A

Initial assessment

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24
Q

Components of the initial assessment include:

A

Airway, breathing and circulation

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25
Q

While performing the initial assessment of a patient, you note an open wound to the chest. This injury should be treated:

A

During the initial assessment

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26
Q

If the mechanism of injury is significant or if your patient is unresponsive:

A

Have your partner hold the head and neck

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27
Q

Serious external hemorrhage should be controlled

A

During the initial assessment

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28
Q

If you suspect a possible cervical spine injury, you should open the patient’s airway with:

A

Jaw thrust

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29
Q

To record your patient’s mental status, use the acronym AVPU. Which of the following is true?

A

Painful stimuli

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30
Q

Signs of inadequate breathing in the adult patient include:

A

A respiratory rate of 24

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31
Q

Performing a primary assessment should take ____________ unless you must intervene with lifesaving measures.

A

Less than 1 minute

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32
Q

Cyanotic, pale, or ashen skin may indicate:

A

Vascular compromise

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33
Q

Which of the following statements regarding assessment of an infant’s or a small child’s respiration is true?

A

Infants and children grunt to maintain back pressure

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34
Q

A female patient with abdominal pain is always considered:

A

Pregnant until otherwise proven

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35
Q

How the focused history and physical exam are performed is based on the initial assessment and:

A

Patient’s chief complaint

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36
Q

One subclassification of trauma patients includes those:

A

With an isolated injury

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37
Q

Predictors of serious internal injury of a patient include:

A

Motorcycle crash

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38
Q

The predictors of serious internal injury for infants and children that differ from those for adults include:

A

A fall from higher than 10ft

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39
Q

The mnemonic SAMPLE is helpful in evaluating a major trauma patient. The letters represent:

A

An abbreviated patient history format

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40
Q

The M in the mnemonic SAMPLE stands for:

A

Medication

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41
Q

The P in the mnemonic SAMPLE stands for:

A

Pertinent medical history

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42
Q

Subcutaneous emphysema is:

A

Air under the skin causing crackling

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43
Q

Treatment for a tension pneumothorax includes:

A

Needle decompression

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44
Q

A patient with a ________ fracture or dislocation risks lacerating the iliac arteries and veins, through which he can lose a significant amout of blood.

A

Pelvic

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45
Q

When assessing the trauma patient with an isolated injury, you most likely will not need to perform a(n):

A

Detailed physical exam

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46
Q

The history for a responsive medical patient should include the:

A

Chief complaint, history of present illness, past medical history, family history, and review of the systems

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47
Q

Once you have obtained a chief complaint from a responsive medical patient, you should next:

A

Obtain history of present illness

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48
Q

In the acronym OPQRST-ASPN, ASPN stands for:

A

Associated symptoms and pertinent negatives

49
Q

To quickly test the seventh cranial nerve (CN-VII), you should have your patient:

A

Show his teeth

50
Q

After completing the initial assessment of an unresponsive medical patient, you should next:

A

Perform a rapid secondary assessment

51
Q

After conducting the focussed physical exam for a responsive medical patient, you should next:

A

Provide necessary emergency medical care authorized by standing orders

52
Q

The detailed physical exam is designed for use:

A

Patients in route to the hospital

53
Q

The ongoing assessment:

A

Detects trends, determines changes, assesses intervention effects

54
Q

The ongoing assessment should be conducted every ___________ minutes for stable patients and every __________ minutes for unstable patients.

A

15, 5

55
Q

The process of informed observation is:

A

Inspection

56
Q

Which of the following is not a type of percussion?

A

Pointed

57
Q

It is best to examine which of the following patients using the toe-to-head method?

A

9 month old with a fever

58
Q

Voice changes that are caused by vocal cord problems are known as:

A

Dysphonia

59
Q

The first physical exam finding you will often observe with an emergency condition is a change in:

A

Mental status

60
Q

_________________ usually indicates an increase in sympathetic nervous system stimulation as the body compensates for another problem.

A

Tachycardia

61
Q

The difference between the systolic and diastolic pressures is known as:

A

Pulse pressure

62
Q

A positive orthostaticvitalsign change means that upon standing the patient’s pulse rate:

A

Increased by 15 bpm

63
Q

A blood pressure cuff fits the patient correctly if it covers:

A

2/3 the upper arm

64
Q

Skin color should be assessed where the ___________is the thinnest.

A

Epidermis

65
Q

An elevated,palpable area containing liquid or viscous matter is called a:

A

Cyst

66
Q

Clubbing of the fingernails occurs because of:

A

Chronic hypoxia

67
Q

Which of the following cranial nerves does NOT control eye movement?

A

Trigeminal nerve

68
Q

The ___________is a coiled structure that transmits sound to the acoustic nerve.

A

Cochlea

69
Q

Battle’s sign is a common but late sign of:

A

Basilar skull fracture

70
Q

An adult normally has ____________permanent teeth

A

32

71
Q

To examine the postauricularlymph node, you palpate:

A

On or under the mastoid process

72
Q

Popping,nonmusicalsounds heard during inspiration are called:

A

Stridor

73
Q

The resistance in the vessels that the heart must overcome to eject blood is called:

A

Afterload

74
Q

Tennis elbow is found by palpating the:

A

Medial epicondyle

75
Q

A condition that makes posterior chest and lung examination difficult is thoracic:

A

Kophoscoliosis

76
Q

A light, popping, nonmusical sound heard upon auscultation of the lungs is best described as:

A

Crackles

77
Q

A loud, harsh sound over the trachea on auscultation with a stethoscope suggests:

A

Normal air movement

78
Q

A tear in the tracheobronchial tree or a pneumothorax can be characterized by ________ in the neck.

A

Subcutaneous emphysema

79
Q

All of the following characteristics indicate a normal appearance to oral mucosa EXCEPT:

A

Patches of white

80
Q

Areas of a neurologic exam include all of the following EXCEPT:

A

Cranium

81
Q

Discoloration over the umbilicus, known as ________ sign, is a(n) ________ indicator of intraabdominal bleeding.

A

Cullen’s, late

82
Q

During the abdominal exam, areas that are known to be painful or tender should be examined:

A

Last

83
Q

During ventricular systole, the ventricles contract while the:

A

Tricuspid and mitral valve a close

84
Q

For you to assess for jugular venous distention, your patient should be ________ at a ________-degree angle.

A

Sitting, 45

85
Q

Increased fremitus over part of the patient’s chest wall may indicate:

A

Pneumonia

86
Q

Nasal flaring is an indication of:

A

Respiratory distress

87
Q

Normal pediatric respiratory and heart rates ________ as children grow older.

A

Decreases

88
Q

Petechiae are skin lesions characterized by:

A

Reddish purple spots less than 0.5 cm in diameter

89
Q

Pleural effusion is characterized by the presence of:

A

Fluid in the pleural space

90
Q

Rales, or crackles, would be most typically auscultated in patients with which of the following conditions?

A

CHF

91
Q

Skin color is best evaluated by observing the:

A

Nail beds and conjunctiva

92
Q

The condition of the nail bed caused by chronic hypoxia associated with cardiopulmonary diseases is called:

A

Clubbing

93
Q

The crunching sound that is made when unlubricated skeletal parts rub against each other is called:

A

Crepitus

94
Q

Which of the following best describes the pulse pressure?

A

The difference between systolic and diastolic blood pressures

95
Q

The patient’s age,sex,race,birthplace, and occupation are included in which element of the comprehensive patient history?

A

Preliminary data

96
Q

The mnemonic OPQRST-ASPN is a toolused during which element of the comprehensive patient history?

A

Present illness/injury

97
Q

Which of the following is true regarding the patient’s chief complaint?

A

Chief complaint is why EMS was called

98
Q

In the OPQRST mnemonic,the “P”stands for:

A

Provocative/palliative factors

99
Q

The termreferred painmeans pain that:

A

Is felt at a location away from the source

100
Q

Which of the following statements about obtaining a patient’s past medical history is true?

A

Asking about surgeries may help you correctly assess your patients current problem

101
Q

The patient’s family/social history should include questions regarding:

A

Tobacco, alcohol and drugs

102
Q

The CAGE questionnaire should be employed when investigating:

A

Alcohol use

103
Q

The patient’s home situation,daily life,and religious beliefs are among the elements that may be determined when investigating the patient’s:

A

Current health status

104
Q

Which of the following statements is true regarding the review of systems?

A

Questions you ask will be determined by the patient’s chief complaint, condition, and clinical status

105
Q

A sudden onset of shortness of breathat night is called:

A

Paroxysmal nocturnal dyspnea

106
Q

The termgravidarefers to the number of:

A

Number of times a woman has been pregnant

107
Q

A preliminary list of possible causes for your patient’s problem is called a:

A

Differential diagnosis

108
Q

Having the ability to view the world through another’s eyes while remaining true to yourself is called:

A

Empathy

109
Q

The term “encode”means to:

A

Create a message

110
Q

Reasons for failingto communicate include:

A

Lack of privacy

111
Q

Ways to build trust and rapport with a patient,a family,and bystanders include:

A

Modulation your voice appropriately

112
Q

Elements of nonverbal communication include all of the following,EXCEPT:

A

Written questions

113
Q

In the United States personal distance,or ‘personal space,’ is considered to extend _______________from an individual.

A

1.5 - 4ft

114
Q

Standing below the patient’s eye level indicates:

A

A willingness to let the patient have some control in the situation

115
Q

An open stance means that you are:

A

Confident

116
Q

Which of the following statements about social distance is TRUE?

A

It is used for interpersonal business transactions

117
Q

Questions framed to guide the direction of a patient’s answer are called:

A

Leading questions

118
Q

Appropriate questioning techniques include all of the following, EXCEPT:

A

Using medical terminology

119
Q

One the speaker has stopped talking,provide feedback to confirm that your understand the message. Feedback techniques include all of the following,EXCEPT:

A

Distancing

patient assessment (1 decks)

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