Quiz 9 (Chapters Flashcards
An 81-year-old female is complaining of chest pain. After asking her to describe the current problem and history of the present illness, you should next:
ask the patient about her past medical history.
Your elderly patient reports having stomach cramps for several hours. He denies any trauma and he hasn’t eaten for several hours. Which of the following is most important to your assessment of this patient?
Asking if he has been having regular bowel movements
Part of forming a strong foundation of knowledge is:
becoming extremely familiar with signs and symptoms of commonly encountered conditions.
Which of the following terms describes a condition of being stretched, inflated, or larger than normal?
Distention
When using the memory aid OPQRST, which of the following questions would help you find out about P?
Does anything make the pain better or worse?
Mr. Green is complaining of severe difficulty breathing after being stung by a bee. His wife states he has had reactions to bee stings before, but not quite this severe. Which medications should you specifically ask him about?
Epinephrine
Which of the following should you consider when deciding whether ALS personnel should be requested?
Would ALS-level care benefit the patient?
Under what circumstance should a reassessment not be performed?
Ongoing lifesaving interventions are required.
You are called for a patient who is complaining of being weak and dizzy. He reports that he does not have enough money to pay for his medications so he has not gotten them refilled. Your service has an automatic blood pressure machine and you use it to measure the patient’s blood pressure while you count his respirations. The blood pressure machine reports a blood pressure of 280/140. What should you do next?
Take a manual blood pressure.
An unconscious trauma patient should always be assumed to have which of the following types of injury?
Spine
You have performed a rapid trauma assessment on a patient with multiple long-bone injuries. Your next assessment step should be which of the following?
Obtain baseline vital signs and past medical history.
On which of the following patients should a reassessment be performed?
All patients should be reassessed
You are alone in the back of the ambulance where you are ventilating an apneic patient. Which of the following is the best way to manage the reassessment?
Continue ventilating the patient during transport and skip the reassessment.
Your patient called 911 because he was having chest pain. He states that his pain is a 7 on a 10-point scale. As part of your care, you assist him with taking his nitroglycerin per medical direction. After waiting a few minutes for the medication to take effect, you should:
ask him what his pain is like now.
While assessing the past medical history of a 68-year-old male patient involved in a fall from a 4-foot stepladder, you use the acronym SAMPLE. What does the A refer to?
Allergies
You are caring for a teenager who is having a severe allergic reaction. He has hives all over his stomach, is having respiratory distress, and is wheezing. After you administer oxygen, you get a set of vital signs. Medical direction has ordered you to assist with administration of his EpiPen. You will monitor the success of your interventions during the:
reassessment.
For which of the following patients is a focused physical examination appropriate?
A 25-year-old female with a history of asthma and who is complaining of difficulty breathing
Mrs. Butler is a 66-year-old woman who is complaining of chest pain. Which of the following questions would be best in helping you determine if the pain is radiating?
Are you having pain anywhere beside your chest?
Which of the following is not a purpose of a rapid trauma assessment?
To focus care on specific injuries
You are transporting a 30-year-old male who has been shot in the chest. He is suffering from a sucking chest wound and has a decreased level of consciousness. How often should you perform a reassessment?
Every 5 minutes
What is the first step in the reassessment process?
Primary assessment
Your answer is correct.
When assessing a 14-year-old male patient that has been involved in a bicycle accident, you notice that he has a small amount of blood coming from his left forearm. This observation is known as which of the following?
Sign
The process by which an EMT forms a field diagnosis is known as:
critical thinking.
Which of the following is represented by the “P” in OPQRST?
Provocation
Which of the following terms best describes a grating sound or feeling of bones rubbing together?
Crepitation
A 32-year-old male was rescued from a burning building by firemen. He was unconscious when he was rescued, and the firemen informed you that there was evidence of illegal drugs in the room with the patient. When assessing this patient, you would assume that the patient may have:
both medical and trauma issues.
Immediately following a rapid physical exam on an unresponsive medical patient, which of the following should you do next?
Obtain baseline vital signs.
Determining a patient’s stability:
helps indicate the frequency with which the patient must be reassessed.
Which of the following is done immediately after scene size-up, regardless of whether a trauma patient has a significant mechanism of injury?
Primary assessment
Mr. Hughes is a 49-year-old man complaining of chest pain. To find out about the quality of his chest pain, which of the following questions is most appropriate?
Can you describe how the pain in your chest feels?
Once you have reached a possible diagnosis for a patient, you should:
continue to look for data that will help rule in or rule out other conditions.
When you are looking for a sign, you would:
examine the patient.
You are called for an alert patient with respiratory distress. As part of your primary assessment, you place the patient on oxygen via nasal cannula at 2 liters per minute. You continue with the rest of your assessment including taking a set of vital signs. During your reassessment, you notice that the patient’s respiratory rate has increased to 24 times per minute and he is having increasing trouble breathing. You should:
switch your patient to a nonrebreather mask at 15 liters per minute.
You are caring for a patient who was in a motor vehicle accident and who has significant injuries to the chest, abdomen, head, and lower extremities. She is unstable and requires artificial ventilation. Her vital signs have not yet stabilized, but you feel her best chance of survival is rapid transport to the nearest trauma facility. While in the ambulance, you should:
continue interventions to maintain airway, breathing, and circulation.
In the assessment of a responsive medical patient, which of the following will provide you with the most important information?
Patient’s medical history
You are called for a patient who was discovered unconscious in his bed this morning. You immediately complete a primary assessment and determine that he is breathing and has a good pulse. What should you do next?
Complete a rapid physical exam
Expert clinicians may use different approaches of thinking through problems, but which of the following will they have in common?
Strong foundation of knowledge
Which of the following is the technique of physical examination that requires the use of a stethoscope?
Auscultation
If no one strategy works for everything, that means:
you need to be able to use more than a single tactic.
Your 76-year-old female patient is having trouble breathing. When you auscultate her lungs, you hear crackles (rales), and you are concerned that she may have pulmonary edema. Her oxygen saturation is 92%, so you place her on 100% oxygen via a nonrebreather mask. Her breathing gets a little easier with the oxygen. You decide to expedite transport since she is anxious about her condition. Later, as you are completing your reassessment, you see that her respirations have slowed to 8 times per minute and she is barely staying awake. What should you do next?
Begin ventilating her with a bag-valve mask.
This is the correct answer.D.
If a patient complains of abdominal pain localized to a specific area of the abdomen, which of the following techniques should be used to assess the abdomen?
Palpate the painful area last.
During reassessment, you notice that your patient is making gurgling sounds. Which of the following should you do immediately?
Suction the airway.
As you arrive at the emergency department with an unresponsive trauma patient, the nurse asks for your trending assessment. Why is this information important to the nurse?
She can evaluate whether or not the patient is improving.
Your patient is a 16-year-old female who is reporting abdominal pain and nausea. She says it came on when she woke up this morning. Her mother says that her daughter has been tired and cranky lately and has not been eating well for a couple of weeks. In fact, every time you ask a question, the patient’s mother answers. What should you do next?
Have your partner interview the mother in the next room
In medical terms, bruises are known as which of the following?
Contusion
Which of the following methods should be used to have a patient rate the amount of pain he is having?
Have the patient rate the pain on a scale of 0 (no pain) to 10 (worst pain).
Where might you find a patient’s medical alert identification jewelry?
Necklace
B.
Bracelet
Your answer is not correct.C.
Ankle bracelet
D.
All of the above
Which of the following questions is appropriate to ask in obtaining pertinent past history in a SAMPLE history?
”Do you have any other medical problems?”
Your patient is a 14-year-old male who was run over by a tractor and is now unresponsive. During the rapid assessment, you should look for clear drainage coming from the patient’s ________ indicating a serious injury.
ears
For the physical examination of a responsive medical patient, you would focus on:
examining body systems related to the chief complaint.
When questioning bystanders about an unresponsive patient’s medications, what is a permissible word to use?
Medicines
While performing a detailed physical exam on a patient involved in a fall from 30 feet, the patient (who had previously been responding to your questions) stops responding. What should you do next?
Repeat the primary assessment.
Your patient is a 24-year-old female who swallowed a handful of pills of unknown type. Although she was initially alert and oriented with no complaints, you note that she is now beginning to slur her words and is becoming progressively lethargic. What is the highest priority in dealing with this patient?
Maintaining an open airway
What does distention refer to when describing your patient’s abdomen?
Larger than normal
You are assessing a 76-year-old male patient who has been involved in a fall from a standing position. You have completed the scene size-up and primary assessment. What should you do next?
Secondary assessment
When should you obtain a set of baseline vital signs on an unresponsive pediatric medical patient?
After the rapid physical examination
When a patient describes how he feels, he is telling you which of the following?
His symptoms
When checking breath sounds in a trauma patient, what should the EMT assess for first?
Presence and equality
You have a patient who is unresponsive on the floor. What is the best way to rule in or rule out trauma as a cause of the patient’s unresponsiveness?
Look for bystanders and ask them if they witnessed the incident
________ is reassessing and recording findings of the reassessment so they can be compared to earlier findings.
Trending
Your patient has been hit in the arm with a baseball during practice. He is alert and oriented, complaining of pain to his left arm with obvious black discoloration of the skin. What type of assessment is called for in this situation?
Focused exam
Why should you check baseline vital signs in the unresponsive medical patient?
To provide a place from which to compare later vital signs
You are transporting a 20-year-old soccer player who injured his ankle during a match. His injury appears to be isolated and he has no significant past medical history. How frequently should you perform a reassessment on this patient?
15 minutes
When using the memory aid SAMPLE, which of the following would you do to determine L?
Ask, “When was the last time you had anything to eat or drink?”
You are called for a 58-year-old male who is concerned that his blood pressure is too high. He tells you that he has had a headache and is feeling a little dizzy. You notice that his skin is flushed and feels warm to the touch. As you finish taking his vital signs, you should:
write down the patient’s vital signs.
While performing the secondary assessment, you are focusing on such things as obtaining a pulse and blood pressure, jugular vein distention, and palpating the chest. Your patient most likely has:
a cardiovascular complaint.
While an EMT forms a field diagnosis on the scene of an emergency, how do the steps differ from the traditional approach to diagnosis?
The EMT must rule in or out the most serious conditions associated with the patient’s presentation.
An EMT’s assessment differs from an assessment made in the emergency department in which way?
The EMT is working with limited resources.
Your patient is the 18-year-old male driver of a vehicle that struck a tree. He is conscious and complaining of neck pain. The passenger is obviously dead. You have performed your primary assessment. Which of the following is the next step?
Perform a rapid trauma assessment.
A 19-year-old male is found seated, grasping his left humerus, after colliding with another player during a rugby match. Which of the following techniques of assessment would be used to identify his body position and general condition as you approach?
Observation
While en route to the hospital, your 67-year-old male patient with chest pain breaks out in a sweat and becomes very pale. He clutches his chest. You should next:
reassess.
You have responded for a patient with shortness of breath. He reports that his breathing problems began this morning and have gotten worse over the last few hours. You ask if he has taken anything to help his symptoms and he tells you that he has used his inhaler several times in the last hour. The information you have just gathered can be classified as:
the history of present illness.
You are on the scene of a 16-year-old patient in respiratory distress. The patient has a history of asthma. After placing the patient on oxygen and performing the primary and secondary assessments, you are confident that the patient is indeed having an asthma attack. How can you be sure your field diagnosis is accurate?
Think of all possible causes of respiratory distress and rule them in or out as potential diagnoses based on your clinical findings.
The basic components of a secondary assessment are:
physical examination, patient history, and vital signs.
You are treating a 57-year-old male for chest pain. You have gathered all pertinent history of the present illness, completed two sets of vital signs, talked with medical direction, and assisted the patient with two doses of his nitroglycerin. Determination of whether or not the nitroglycerin was effective is assessed during the:
reassessment.
Your patient is a 45-year-old female who complains of “twisting her ankle” when she slipped on a patch of ice. Which of the following is not appropriate?
Detailed physical exam
In which of the following patients should you check for the possibility of spinal injury?
An unresponsive diabetic who appears to have fallen down
Which of the following techniques of physical examination must an EMT master?
Observation, palpation, and auscultation
Your answer is correct.
While transporting a patient to the hospital, the EMT repeats his reassessment including vital signs every 15 minutes until he arrives at the emergency department. According to this information, which of the following best describes your patient’s current status?
Stable
