EMT Chapter 9- Patient Assessment Part 1

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A 39-year-old male sustained a stab wound to the groin during an altercation at a bar. As you approach the patient, you note that he is conscious. He is screaming in pain and is attempting to control the bleeding, which is bright red and spurting from his groin area. You should:

apply direct pressure to the wound.

A palpable pulse is created by:

pressure waves through the arteries caused by cardiac contraction.

An elderly patient has fallen and hit her head. Your initial care should focus on:

airway, breathing, and circulation.

An injured patient is assigned a total score of 9 on the GCS. He is assigned a score of 2 for eye opening, a score of 3 for verbal response, and a score of 4 for motor response. Which of the following clinical findings is consistent with his GCS score?

Opens eyes in response to pain, uses inappropriate words, withdraws from pain

In patients with deeply pigmented skin, changes in color may be apparent only in certain areas, such as the:

lips or oral mucosa

Reassessment is performed to determine all of the following, EXCEPT:

the reason why the patient called EMS.

The chief complaint is MOST accurately defined as the:

most serious thing the patient is concerned about.

The rapid exam of a patient that occurs following the primary assessment should take no longer than:

60 to 90 seconds

Treatment and transport priorities at the scene of a mass-casualty incident should be determined after:

all the patients have been triaged.

What maneuver should be used to open the airway of an unresponsive patient with suspected trauma?

jaw thrust maneuver

When approaching a 32-year-old male who is complaining of traumatic neck pain, you should:

ensure that the patient can see you approaching him.

When you shine a light into one pupil, the normal reaction of the other pupil should be to:

become smaller

Which of the following actions would NOT be performed during the scene size-up?

Rapidly assessing a patient’s respiratory status

Which of the following conditions would be LEAST likely to cause an altered level of consciousness?

Acute anxiety

Which of the following scenarios does NOT involve the presence of any symptoms?

A 61-year-old female who is unconscious with facial cyanosis

Which of the following statements regarding the mechanism of injury (MOI) is correct?

The MOI may allow you to predict the severity of a patient’s injuries.

Which of the following statements regarding the secondary assessment is correct?

The secondary assessment should focus on a certain area or region of the body as determined by the chief complaint.

You are assessing a 72-year-old man with abdominal pain. The patient is sitting in a chair; he is conscious, alert, and calm. As you are talking to the patient, your partner discreetly directs your attention to a handgun, which is located on a nearby table. You should:

position yourself in between the patient and the gun and ask your partner to request law enforcement assistance.

You should suspect that a patient is experiencing respiratory failure if he or she:

has bradycardia and diminished muscle tone.

A normal respiratory rate for an adult is typically:

12 to 20 breaths per minute

An integral part of the rapid scan is evaluation using the mnemonic:

DCAP-BTLS.

For children younger than 1 year old, you should palpate the _____ artery when assessing the pulse.

brachial

The best indicator of brain function is the patient’s:

mental status

The scene size-up consists of all of the following, EXCEPT:

determining level of responsiveness.

When there are low levels of oxygen in the blood, the lips and mucous membranes appear blue or gray. This condition is called:

cyanosis

With _____, the force of the injury occurs over a broad area, and the skin is usually not broken.

blunt trauma

_______ is the circulation of blood within an organ or tissue.

perfusion

A brassy, crowing sound that is prominent on inspiration and suggests a mildly occluded airway is referred to as

stridor

If a patient seems to develop difficulty breathing after your primary assessment, you should immediately reevaluate the _________.

airway

Skin that is cool, clammy, and pale in your primary assessment typically indicates _______

hypoperfusion

When there are multiple patients, you should use the ______ to help organize the triage, logistics, and treatment of patients.

Incident Command System

A 29-year-old male with a head injury opens his eyes when you speak to him, is confused as to the time and date, and is able to move all of his extremities on command. His Glasgow Coma Scale (GCS) score is:

13.

A 40-year-old male crashed his motorcycle into a tree. He is semiconscious, has snoring respirations, and has a laceration to the forearm with minimal bleeding. You should:

open his airway with the jaw-thrust maneuver.

A 40-year-old male presents with pain to the right 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:

liver dysfunction

A 50-year-old male presents with altered mental status. His wife tells you that he had a "small stroke" three years ago but has otherwise been in good health. The patient is responsive but unable to follow commands. After administering oxygen if needed, you should:

prepare for immediate transport

A 71-year-old female slipped on a rug and fell. She is conscious and alert and complains of severe pelvic pain. Her respirations are 22 breaths/min with adequate depth and her heart rate is 120 beats/min. Which of the following is NOT indicated for this patient?

Gentle palpation of the pelvis

A blood pressure cuff that is too small for a patient’s arm will give a:

falsely high systolic and diastolic reading.

A crackling sound produced by air bubbles under the skin is called:

subcutaneous emphysema.

A decrease in blood pressure may indicate

loss of vascular tone

A patient is sitting in a chair, leaning forward on his outstretched arms. His head and chin are thrust forward. This position indicates that he:

is experiencing difficulty breathing

A patient who does not respond to your questions, but moves or cries out when his or her trapezius muscle is pinched, is said to be:

responsive to painful stimuli

A patient with high blood pressure would be expected to have skin that is:

flushed and red.

A patient with profuse sweating is referred to as being:

diaphoretic.

A patient with spontaneous respirations is breathing:

without assistance

A patient’s short-term memory is MOST likely intact if he or she correctly answers questions regarding:

date and event

A properly sized blood pressure cuff should cover:

two thirds the length from the armpit to the crease at the elbow.

A pulse with a consistent pattern is considered to be:

regular

After performing a head tilt-chin lift maneuver to open the airway of an unresponsive patient who has a pulse, you should:

suction as needed and insert an airway adjunct.

After performing a primary assessment, a rapid exam of the body should be performed to:

identify less-obvious injuries that require immediate treatment.

An adult patient who is NOT experiencing difficulty breathing will:

be able to speak in complete sentences without unusual pauses.

As time progresses following a significant injury:

the body’s ability to compensate for shock decreases.

As you assess the head of a patient with a suspected spinal injury, your partner should:

maintain stabilization of the head.

Capnography is used to:

determine how much carbon dioxide is being exhaled.

Clinical signs of labored breathing include all of the following, EXCEPT:

shallow chest movement

Cyanosis of the skin is caused by:

decreased blood oxygen

During a 30-minute transport of a stable patient, you should reassess him or her at least ________ times.

2

For an adult, the normal resting pulse should be between:

60 and 100 beats/min.

If a patient develops difficulty breathing after your primary assessment, you should immediately:

reevaluate his or her airway status.

If you cannot palpate a pulse in an unresponsive patient whose collapse was not witnessed, you should:

immediately begin CPR

In responsive patients who are older than 1 year of age, you should palpate the pulse at the ________ artery.

radial

In the adult, bradycardia is defined as a pulse rate less than _______ beats/min, and tachycardia is defined as a heart rate greater than _______ beats/min.

60, 100

In which of the following situations is a pertinent negative identified?

A 59-year-old man complains of crushing chest pain but denies shortness of breath.

Jugular venous distention suggests a problem with blood returning to the heart if the patient is:

sitting up at a 45° angle.

Normal respiratory rates should not exceed _______ breaths per minute in toddlers and _______ breaths per minute in infants.

40, 60

Normal skin color, temperature, and condition should be:

pink, warm, and dry.

Pain that moves from its point of origin to another body location is said to be:

radiating

Palliating factors regarding a patient’s pain involve those that:

alleviate the pain.

Poor peripheral circulation will cause the skin to appear:

ashen

Supplemental oxygen without assisted ventilation would MOST likely be administered to patients:

with difficulty breathing and adequate tidal volume.

The "Golden Hour" begins when an injury occurs and ends when:

the patient receives definitive care.

The diastolic blood pressure represents the:

minimum amount of pressure that is always present in the arteries.

The goal of the systematic head-to-toe exam that is performed during the secondary assessment is to:

locate injuries not found in the primary assessment.

The pressure exerted against the walls of the artery when the left ventricle contracts is called the:

systolic pressure

The systematic head-to-toe assessment should be performed on:

patients with a significant MOI and unresponsive medical patients.

Upon arriving at a potentially unsafe scene, you should:

ensure that you are safe.

Upon arriving at the scene of a patient with difficulty breathing, you determine that the scene is safe. You enter the residence and find the patient sitting in a chair in respiratory distress. Your first action should be to:

introduce yourself to the patient

What part of the patient assessment process focuses on obtaining additional information about the patient’s chief complaint and any medical problems he or she may have?

history taking

When a patient’s respirations are shallow:

tidal volume is markedly reduced

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:

transport at once and consider requesting a paramedic unit.

When assessing a patient’s abdomen, you will evaluate for all of the following, EXCEPT:

subcutaneous emphysema.

When assessing motor function in a conscious patient’s lower extremities, you should expect the patient to:

wiggle his or her toes on command.

When assessing the skin of an unresponsive patient, you note that it has a bluish tint to it. This finding is called:

cyanosis

When auscultating the blood pressure in a patient’s upper extremity, you should place the head of the stethoscope over the _________ artery.

brachial

When interviewing a patient, you can show him or her that you understand the situation by:

repeating statements back to him or her.

When palpating a patient’s pulse, you note that it is grossly irregular. You should:

count the pulse rate for a full minute to obtain an accurate reading.

When palpating a patient’s pulse, you note that there is a short interval between pulsations. This indicates that the pulse is:

rapid.

When palpating the carotid pulse of a responsive patient, you should:

avoid compressing both carotid arteries simultaneously.

When performing a rapid exam on a supine patient, what part of the body is typically assessed last?

Posterior

When performing the secondary assessment on a trauma patient, you note the presence of Battle sign. This is defined as:

bruising behind the ear

When using the pulse oximeter as part of your assessment of a patient, it is important to remember that:

any situation that causes vasoconstriction or loss of red blood cells, such as anemia or bleeding, may result in an inaccurate or misleading value.

When you assess capillary refill time in an infant, normal color to the tested area should return within:

2 seconds

When you inspect a patient’s pupils with a penlight, the pupils should normally react to the light by:

constricting

When you use the palpation method to obtain a blood pressure, the measurement you obtain is the:

systolic blood pressure

Which of the following abnormal breath sounds indicates obstruction of the upper airway?

stridor

Which of the following assessments would be the MOST useful in determining the possible cause of a patient’s altered mental status?

blood glucose level

Which of the following factors would MOST likely cause a patient’s pulse rate to be slower than normal?

Beta-blocker medications

Which of the following findings indicates that your patient has a patent airway?

Forceful coughing

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