EMT-B Chapter 9 – Patient Assessment – Flashcards
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When performing a rapid exam on a supine patient, what part of the body is typically assessed last?
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Extremities
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In responsive patients that are older than 1 year of age, you should palpate the pulse at the ________ artery.
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radial
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Which of the following MOST accurately describes paradoxical movement of the chest wall? a) A marked decrease in chest wall movement due to abdominal breathing b) One side of the chest wall moves opposite the direction of the other c) Only one section of the chest rises on inspiration, while another area falls d) Multiple rib fractures that cause a marked deformity of the chest wall
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c) Only one section of the chest rises on inspiration, while another area falls
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Supplemental oxygen via nonrebreathing mask should be administered to patients:
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with difficulty breathing and adequate tidal volume
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When palpating a patient's pulse, you note that it is grossly irregular. You should:
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count the pulse rate for a full minute to obtain an accurate reading
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When assessing a patient's abdomen, you will evaluate for all of the following, EXCEPT: A. open wounds or eviscerations. B. gross bleeding and tenderness. C. rigidity and obvious bleeding. D. subcutaneous emphysema.
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D. subcutaneous emphysema.
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ou 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:
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position yourself in between the patient and the gun and ask your partner to request law enforcement assistance.
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A patient with profuse sweating is referred to as being
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Diaphoretic
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When approaching a 32-year-old male who is complaining of traumatic neck pain, you should:
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ensure that the patient can see you approaching him
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Which of the following questions would you ask a patient to ascertain the "M" in the SAMPLE history?
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"How much Tylenol do you take each day?"
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Which of the following patient responses would establish the "E" in the SAMPLE history?
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"I was mowing the lawn when the pain began."
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A patient's short-term memory is MOST likely intact if he or she correctly answers questions regarding:
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date and event
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A patient with high blood pressure would be expected to have skin that is:
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flushed and red
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You should gently palpate a patient's pelvis only if:
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the patient does not complain of pelvic pain.
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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? a) Rapid head-to-toe exam b) Gentle palpation of the pelvis c) Application of a cervical collar d) Treating her for possible shock
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b) Gentle palpation of the pelvis
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Which of the following is the MOST accurate guide to palpating a pulse?
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place the tips of your index and long fingers over the pulse point
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You should suspect that a patient is experiencing respiratory failure if he or she: a) is anxious, tachycardic, and leaning forward. b) has bradycardia and diminished muscle tone. c) has an increased heart rate and retractions. d) is restless and is working hard to breathe.
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b) has bradycardia and diminished muscle tone.
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When palpating the carotid pulse of a responsive patient, you should:
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avoid compressing both carotid arteries simultaneously
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When palpating a patient's pulse, you note that there is a short interval between pulsations. This indicates that the pulse is:
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Rapid
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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:
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13
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When you shine a light into one pupil, the normal reaction of the other pupil should be to:
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become smaller.
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The MOST effective way to determine whether your patient's problem is medical or traumatic in origin is to:
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perform a careful and thorough assessment.
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Which of the following actions would NOT be performed during the scene size-up?
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rapidly assessing a patient's respiratory status
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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.
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60, 100
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In patients with deeply pigmented skin, changes in color may be apparent only in certain areas, such as the
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lips or oral mucosa.
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Which of the following signs of respiratory distress is seen MOST commonly in pediatric patients?
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seesaw breathing
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When using the pulse oximeter as part of your assessment of a patient, it is important to remember that
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any situation that causes vasoconstriction or loss of red blood cells, such as anemia or bleeding, may result in an inaccurate or misleading value.
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Which of the following findings indicates that your patient has a patent airway?
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forceful coughing
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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:
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open his airway with the jaw-thrust maneuver.
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A crackling sound produced by air bubbles under the skin is called:
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subcutaneous emphysema
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When you inspect a patient's pupils with a penlight, the pupils should normally react to the light by:
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constricting.
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A pulse with a consistent pattern is considered to be:
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Regular
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Which of the following is an example of a symptom?
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headache
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Which of the following would the EMT likely NOT perform on a responsive patient with a headache and no apparent life-threatening conditions? a) Systematic head-to-toe examination b) Noninvasive blood pressure monitoring c) Assessment of oxygen saturation d) Focused secondary assessment
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a) Systematic head-to-toe examination
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After performing a head tilt-chin lift maneuver to open the airway of an unresponsive patient who has a pulse, you should:
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suction as needed and insert an airway adjunct.
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An elderly patient has fallen and hit her head. You assess her level of consciousness as unresponsive using the AVPU scale. Your initial care should focus on:
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airway, breathing, and circulation.
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Which of the following statements regarding the mechanism of injury (MOI) is correct?
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The MOI may allow you to predict the severity of a patient's injuries.
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The normal respiratory rate for an adult should range from:
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12 to 20 breaths per minute.
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Normal respiratory rates should not exceed _______ breaths per minute in toddlers and _______ breaths per minute in infants.
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40, 60
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You receive a call to a daycare center for an unresponsive 8-month-old infant. Upon arrival, you perform an assessment and determine that the infant is not breathing. Your next action should be to:
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assess for a brachial pulse for 5 to 10 seconds
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Which of the following statements regarding the secondary assessment is correct?
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You may not have time to perform a secondary assessment if you must continually manage life threats that were identified during the primary assessment.
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The goal of the systematic head-to-toe exam that is performed during the secondary assessment is to:
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locate injuries not found in the primary assessment
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When a patient's respirations are shallow:
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tidal volume is markedly reduced.
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Reassessment is performed to determine all of the following, EXCEPT:
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the reason why the patient called EMS.
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Jugular venous distention suggests a problem with blood returning to the heart if the patient is:
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sitting up at a 45° angle.
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The diastolic pressure represents the:
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minimum amount of pressure that is always present in the arteries.
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The pressure exerted against the walls of the artery when the left ventricle contracts is called the:
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Systolic pressure
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When auscultating the blood pressure in a patient's upper extremity, you should place the diaphragm (head) of the stethoscope over the _________ artery.
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brachial
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Which of the following situations or conditions warrants immediate transport?
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severe chest pain and cool, pale skin
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While en route to the scene of a shooting, the dispatcher advises you that the caller states that the perpetrator has fled the scene. You should:
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confirm this information with law enforcement personnel at the scene.
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Family histroy
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"Does your mother have diabetes?"
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Which of the following factors would MOST likely cause a patient's pulse rate to be slower than normal?
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beta-blocker medications
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What maneuver should be used to open the airway of an unresponsive patient with trauma
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jaw-thrust maneuver
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Which of the following statements regarding the blood pressure is correct?
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Blood pressure is usually not measured in children younger than 3 years of age.
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For an adult, the normal resting pulse should be between:
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60 and 100 beats/min.
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When you shine a light into one pupil, the normal reaction of the other pupil should be
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become smaller.
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You respond to the residence of a 62-year-old male who is unresponsive. Your primary assessment reveals that he is apneic and pulseless. You should:
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start CPR and attach the AED as soon as possible.
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The full-body scan of a patient that occurs following the primary assessment should take no longer than:
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60 to 90 seconds.
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Which of the following questions is used to determine a patient's chief complaint?
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"What seems to be the matter?"
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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?
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History taking
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End-tidal carbon dioxide (ETCO2) is defined as the
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maximal concentration of CO2 at the end of an exhaled breath.
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A properly sized blood pressure cuff should cover
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two thirds the length from the armpit to the crease in the elbow.
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A blood pressure cuff that is too small for a patient's arm will give a:
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falsely high systolic and diastolic reading
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You are dispatched to the county jail for an inmate who is "sick." When you arrive, you find the patient, a 33-year-old male, unresponsive. His airway is patent and his respirations are rapid and shallow. Your initial action should be to:
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provide assisted ventilation.
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The rapid exam of a patient that occurs following the primary assessment should take no longer than:
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90 to 120 seconds
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Which of the following is the most effective method of assessing the quality of air movement in the lungs? a) Auscultating breath sounds with a stethoscope b) Evaluating the patient's chest for cyanosis c) Applying a pulse oximeter and monitoring the SpO2 d) Looking for the presence of accessory muscle use
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a) Auscultating breath sounds with a stethoscope
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For children younger than 1 year old, you should palpate the _____ artery when assessing the pulse.
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brachial
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Cyanosis of the skin is caused by:
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decreased blood oxygen
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Which of the following scenarios does NOT involve the presence of any symptoms? a) A 55-year-old male with a severe headache and 2 days of nausea b) A 44-year-old male with abdominal pain and severe dizziness c) A 49-year-old female with blurred vision and ringing in the ears d) A 61-year-old female who is unconscious with facial cyanosis
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d) A 61-year-old female who is unconscious with facial cyanosis
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Which of the following conditions would be least likely to cause an altered level of consciousness? a) Acute anxiety b) Drug overdose c) Poisoning d) Inadequate perfusion
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a) Acute anxiety
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The systematic head-to-toe assessment should be performed on: a) responsive medical patients and patients without a significant MOI. b) stable patients who are able to tell you exactly what happened. c) all patients with traumatic injuries who will require EMS transport. d) patients with a significant MOI and unresponsive medical patients.
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a) responsive medical patients and patients without a significant MOI.
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Which of the following medical history questions would be of LEAST pertinence in an acute situation? a) "Has this ever happened to you before?" b) "Are there medications that you cannot take?" c) "Does your mother have diabetes?" d) "Does the pain stay in your chest?"
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c) "Does your mother have diabetes?"
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Which of the following assessments would be the MOST useful in determining the possible cause of a patient's altered mental status? a) Blood pressure b) Capillary refill time c) Blood glucose level d) Respiratory rate
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c) Blood glucose level
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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:
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prepare for immediate transport
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During the primary assessment, circulation is evaluated by assessing:
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pulse quality, external bleeding, and skin condition.
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Treatment and transport priorities at the scene of a mass-casualty incident should be determined after:
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all the patients have been triaged.
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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:
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responsive to painful stimuli.
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Capnography is used to:
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determine how much carbon dioxide is being exhaled
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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. What clinical finding is consistent with his GCS score?
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opens eyes in response to pain, uses inappropriate words, withdraws from pain
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When performing the secondary assessment on a trauma patient, you note the presence of Battle sign. This is defined as:
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bruising behind the ear
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