Quiz 6 - Patient Assessment

Question 1

The presence of rhonchi during auscultation of the lungs is MOST suggestive of

A. pneumonia.

B. asthma.

C. toxic inhalation.

D. pneumothorax.

Answer 1

A. pneumonia.

Question 2

The presence of rales during auscultation of the chest indicates all of the following conditions, EXCEPT:

A. bronchospasm.

B. pulmonary edema.

C. toxic inhalation.

D. heart failure.

Answer 2

A. bronchospasm.

Question 3

Which of the following statements regarding ascites is correct?

A. Ascites is a collection of fluid within the peritoneal cavity.

B. The abdomen of a patient with ascites has a sunken appearance.

C. The most common cause of ascites is an acute splenic injury.

D. Percussion of the abdomen will often yield hyperresonance.

Answer 3

A. Ascites is a collection of fluid within the peritoneal cavity.

Question 4

An opaque black area against the red reflex of the eye is indicative of:

A. conjunctivitis.

B. cataracts.

C. retinitis.

D. macular degeneration.

Answer 4

B. cataracts.

Question 5

Other than overall patient appearance, the patient’s __________ is/are the MOST objective data for determining his or her status

A. medications

B. chief complaint

C. medical history

D. vital signs

Answer 5

D. vital signs

Question 6

You would NOT expect to encounter decreased breath sounds in a patient with:

A. opiate intoxication.

B. pulmonary edema.

C. status asthmaticus.

D. cardiac tamponade

Answer 6

D. cardiac tamponade

Question 7

At its worst, kyphosis can become a source of:

A. restrictive lung disease.

B. complete immobility.

C. pathologic fractures.

D. extremity paralysis.

Answer 7

A. restrictive lung disease.

Question 8

The mnemonic “OPQRST” is a tool that:

A. allows the paramedic to reach a field diagnosis quickly and initiate treatment.

B. offers an easy-to-remember approach to analyzing a patient’s chief complaint.

C. is used commonly to rule out conditions that are immediately life threatening.

D. is only effective when assessing a patient who is experiencing severe pain.

Answer 8

B. offers an easy-to-remember approach to analyzing a patient’s chief complaint.

Question 9

In general, +3 pitting edema is characterized by indentation of the skin to a depth of:

A. ¼ in to ½ in.

B. 0 in to ¼ in.

C. ½ in to 1 in.

D. greater than 1 in.

Answer 9

C. ½ in to 1 in.

Question 10

If a patient does not respond to a question within a couple of seconds, he or she:

A. may be deciding if he or she can trust you enough to answer the question.

B. should have the question repeated back to him or her using different terms.

C. must be assumed to have an altered mental status until proven otherwise.

D. should immediately be asked another question to facilitate gathering data.

Answer 10

A. may be deciding if he or she can trust you enough to answer the question.

Question 11

Which of the following significant mechanisms of injury is unique to the infant and child?

A. Fall from greater than 10 ft

B. Ejection from a car’s back seat

C. Penetrating injury to the head

D. Vehicle-pedestrian collision

Answer 11

A. Fall from greater than 10 ft

Question 12

A pathologic fracture occurs when:

A. normal forces are applied to normal bone structures.

B. abnormal forces are applied to abnormal bone structures.

C. normal forces are applied to abnormal bone structures.

D. abnormal forces are applied to normal bone structures.

Answer 12

C. normal forces are applied to abnormal bone structures.

Question 13

Blood pressure is the product of:

A. stroke volume and heart rate.

B. right atrial preload and ventricular stroke volume.

C. left ventricular ejection fraction and afterload.

D. cardiac output and peripheral vascular resistance.

Answer 13

D. cardiac output and peripheral vascular resistance.

Question 14

When dealing with a patient who has multiple symptoms, the MOST effective way to develop an appropriate care plan is to:

A. prioritize the patient’s complaints.

B. perform a complete head-to-toe exam.

C. assume that all complaints are linked.

D. address all complaints simultaneously.

Answer 14

A. prioritize the patient’s complaints.

Question 15

Situational depression is:

A. a condition that usually requires inpatient care.

B. often characterized by violent bouts of rage.

C. a reaction to a stressful event in a patient’s life.

D. ongoing and does not appear to have a cause.

Answer 15

C. a reaction to a stressful event in a patient’s life.

Question 16

Abdominal guarding is MOST commonly encountered in patients with:

A. intra-abdominal bleeding.

B. chronic liver inflammation.

C. peritoneal irritation.

D. acute renal failure.

Answer 16

C. peritoneal irritation.

Question 17

Serial vital signs:

A. provide comparative data regarding the patient’s condition.

B. are of no value unless they are repeated every 5 minutes.

C. establish a baseline to which further vital signs are compared.

D. provide definitive information about the patient’s problem.

Answer 17

A. provide comparative data regarding the patient’s condition.

Question 18

Which of the following reassessment findings is MOST significant in a patient with penetrating chest trauma?

A. Loud heart tones to auscultation

B. Blood pressure of 90/76 mm Hg

C. Symmetrical chest rise and fall

D. Heart rate of 78 beats per minute

Answer 18

B. Blood pressure of 90/76 mm Hg

Question 19

Which of the following is the MOST practical method of assessing for gross neurologic deficits during your assessment of a patient?

A. Ask the patient to lift both legs and hold them up for 20 to 30 seconds.

B. Assess capillary refill time at the forehead and the fingernails and toenails.

C. Check deep tendon reflexes with a reflex hammer or similar object.

D. Ask the patient if he or she can feel and move his or her fingers and toes

Answer 19

D. Ask the patient if he or she can feel and move his or her fingers and toes

Question 20

Which of the following clinical presentations warrants immediate transport?

A. Two days of vomiting; heart rate of 110 beats/min; warm, dry skin

B. 38 weeks gestation; crowning; history of hypertension; tachycardia

C. 250 mL external blood loss; systolic BP of 130 mm Hg; moderate pain

D. Chest discomfort; heart rate of 110 beats/min; systolic BP of 90 mm Hg

Answer 20

D. Chest discomfort; heart rate of 110 beats/min; systolic BP of 90 mm Hg

Question 21

The fourth heart sound (S4):

A. is normal in 25% of the population.

B. indicates increased pressure in the atria.

C. represents increased left ventricular stretching.

D. occurs immediately before the S2 sound.

Answer 21

B. indicates increased pressure in the atria.

Question 22

If a patient’s trigeminal nerve is intact, he or she should be able to:

A. clench his or her jaw.

B. swallow without difficulty.

C. frown.

D. maintain balance.

Answer 22

A. clench his or her jaw.

Question 23

The Babinski sign, grasping, and sucking are:

A. abnormal findings in infants.

B. voluntary motor responses.

C. examples of primitive reflexes.

D. signs of nervous system dysfunction.

Answer 23

C. examples of primitive reflexes.

Question 24

A patient who complains of double vision has:

A. diplopia.

B. anisocoria.

C. hyperopia.

D. ptosis.

Answer 24

A. diplopia.

Question 25

An appropriately sized blood pressure cuff should: A. cover at least two thirds of the patient's upper arm. B. be one half to two thirds the size of the upper arm. C. cover at least one third of the patient's upper arm. D. completely encompass the entire upper arm.

Answer 25

B. be one half to two thirds the size of the upper arm.

Question 26

When assessing a hemodynamically stable child, the toe-to-head approach is generally indicated for children who are: A. younger than 2 years of age. B. 1 to 3 years of age. C. 4 to 5 years of age. D. younger than 12 months of age.

Answer 26

B. 1 to 3 years of age.

Question 27

A patient is generally considered to have orthostatic vital signs when: A. the heart rate increases by 20 beats/min or more when going from a supine to a standing position. B. the respiratory rate becomes fast and the depth becomes shallow when he or she suddenly stands up. C. he or she experiences chest pain and a rapid, irregular heart rate when going from a seated to a standing position. D. the systolic BP increases and the diastolic BP decreases when going from a lying to a sitting position.

Answer 27

A. the heart rate increases by 20 beats/min or more when going from a supine to a standing position.

Question 28

When assessing a patient who is under the influence of alcohol, it is MOST important to remember that: A. the amount of alcohol consumed is often overstated. B. alcohol can mask any number of signs and symptoms. C. suspicions of alcohol intoxication must be documented. D. the patient often gives a reliable and accurate history.

Answer 28

B. alcohol can mask any number of signs and symptoms.

Question 29

Flushed skin is commonly seen as a result of all the following, EXCEPT: A. superficial burns. B. heat exposure. C. fever. D. vasoconstriction.

Answer 29

D. vasoconstriction.

Question 30

A patient who is absolutely still and resists any movement should be suspected of having: A. intra-abdominal bleeding. B. a bowel obstruction. C. peritonitis. D. kidney stones

Answer 30

C. peritonitis.

Question 31

Bruising in the periumbilical area is indicative of: A. a leaking aortic aneurysm. B. a ruptured urinary bladder. C. intraperitoneal hemorrhage. D. ruptured ectopic pregnancy.

Answer 31

C. intraperitoneal hemorrhage.

Question 32

Tidal volume is MOST effectively assessed by: A. auscultating breath sounds. B. noting the patient's respiratory rate. C. looking for accessory muscle use. D. observing for rise and fall of the chest.

Answer 32

D. observing for rise and fall of the chest.

Question 33

Bulging of a child's anterior fontanelle is: A. suggestive of significant dehydration. B. pathologic when observed in a quiet child. C. benign if the child is not flailing around. D. suggestive of an intracerebral hemorrhage.

Answer 33

B. pathologic when observed in a quiet child.

Question 34

The diameter of a patient's pupils and their reactivity to light provide information about the: A. amount of vitreous humor. B. intactness of the first cranial nerve. C. status of cerebral perfusion. D. level of carbon dioxide in the brain.

Answer 34

C. status of cerebral perfusion.

Question 35

You would MOST likely encounter bilateral dependent edema in a patient with: A. heart failure. B. diabetes mellitus. C. arterial occlusion. D. deep vein occlusion.

Answer 35

A. heart failure.

Question 36

Distention of the jugular veins indicates: A. a state of hypovolemia. B. increased venous capacitance. C. left-sided heart failure. D. decreased venous pressure.

Answer 36

B. increased venous capacitance.

Question 37

When auscultating heart sounds, you should place your stethoscope at the: A. fifth intercostal space, over the apex of the heart. B. second intercostal space, over the base of the heart. C. sternal border at the second or third intercostal space. D. third or fourth intercostal space, in the midaxillary line.

Answer 37

A. fifth intercostal space, over the apex of the heart.

Question 38

During a 20-minute transport of a critical patient, you should make a concerted effort to reassess the patient ___ times. A. three B. four C. two D. one

Answer 38

B. four

Question 39

When your patient is a non-English-speaking person, his or her child is often able to function as an interpreter because: A. most children of non-English-speaking parents speak English. B. the child is usually not as scared as his or her parent is. C. children quickly absorb a new language in school. D. you can usually teach a child English quickly

Answer 39

C. children quickly absorb a new language in school.

Question 40

Stimulation of the sympathetic nervous system causes: A. sweating. B. bradycardia. C. vasodilation. D. warm, moist skin.

Answer 40

D. warm, moist skin.