Deck 2: Scene Size-Up

Question 1

A scene size-up is performed for all of the following reasons EXCEPT:

A) to assess the mechanism of injury.
B) to assess a baseline mental status.
C) to provide information that will guide your medical care.
D) to assess the need for additional resources.

Answer 1

to assess a baseline mental status.

Question 2

A paramedic should wear a properly fitted HEPA mask when evaluating a patient exhibiting signs and symptoms of:

A) influenza.
B) asthma.
C) COPD.
D) tuberculosis.

Answer 2

tuberculosis.

Question 3

Which of the following is a potentially life-threatening patient complaint?

A) Fractures of the tibia and radius
B) Asthma
C) Headache
D) Chest pain

Answer 3

Chest pain

Question 4

You find an adult patient lying supine on the sidewalk after being struck by a vehicle traveling at 10 mph. The patient is alert with stable vital signs. The mechanism of injury and initial patient presentation are most consistent with suspected:

A) pneumothorax.
B) closed-head injury.
C) abdominal trauma.
D) lower extremity trauma.

Question 5

Which of the following is NOT a consideration when evaluating the mechanism of injury?

A) Mass and velocity of objects involved
B) Whether the mechanism was blunt or penetrating
C) Direction of impact
D) Whether it is a rural or an urban setting

Question 6

When responding to calls involving two-vehicle collisions, you must always suspect:

A) multiple patients.
B) patients with altered mental status.
C) flail chest.
D) severe lower extremity injuries.

Question 7

All of the following mechanisms of injury yield a high level of suspicion for life-threatening injury EXCEPT:

A) a stab wound distal to the knee.
B) a collision between a motorcycle and a pedestrian.
C) falling off the top of a 30-foot extension ladder.
D) a patient ejection from a motor vehicle after a collision.

Question 8

Which of the following provides a clue to the nature of an illness?

A) Medication bottles on the nightstand
B) Length of a knife
C) Caliber of ammunition
D) Surface on which a patient fell

Question 9

Which of the following is most likely to result in life-threatening hemorrhage?

A) Epistaxis
B) Lacerated femoral artery
C) Fractured radius and ulna
D) Bleeding hemorrhoids

Question 10

A paramedic should wear protective eyewear when caring for a patient who is:

A) coughing up blood-tinged sputum.
B) complaining of dizziness.
C) unresponsive.
D) all of the above.

Question 11

You arrive at a location and begin to read the scene by:

A) approaching the patient.
B) observing the immediate surroundings.
C) conducting a focused exam.
D) addressing life threats.

Question 12

A car has struck a pedestrian at about 45 mph. While assessing the patient, you note bilateral tibia and fibula fractures. Which of the following best describes why the patient should be transported to a trauma center?

A) Pain from the fractures cannot be treated in the prehospital setting.
B) Other serious injuries are likely.
C) These fractures cannot be treated in a community hospital.
D) Fractures always require immediate surgery.

Question 13

Which of the following is NOT an example of a mechanism of injury?

A) An episode of chest pressure
B) A fall from a ladder
C) A low-speed motor vehicle collision
D) A high-velocity gunshot wound

Question 14

Which of the following best describes when you should perform a scene size-up?

A) Once you arrive at the patient's side
B) Throughout your time on the scene
C) When you initially arrive at the scene
D) As you are leaving the scene

Question 15

At the scene of a multiple-vehicle collision, which of the following actions should you take first?

A) Wait for additional resources to arrive.
B) Treat the most seriously injured patient.
C) Quickly scan the scene to count patients.
D) Go directly to the first patient you see.

Question 16

When approaching a potential crime scene, you should:

A) enter the scene if no signs of danger are noted.
B) quickly enter the scene, retrieve the victim, and withdraw to the vehicle.
C) park away from the scene until the police arrive and secure the scene.
D) park and wait in front of the scene so the victim knows you are there.

Question 17

Components of a scene size-up include all of the following EXCEPT:

A) patient's chief complaint.
B) number of patients.
C) mechanism of injury.
D) dangers to bystanders.

Question 18

Your patient is a 75-year-old man who is alert and responds to your questions. Which of the following is the best source of information about this patient?

A) Family or friends
B) The medical record
C) The patient
D) The physician

Question 19

Which of the following factors may influence your index of suspicion of a patient's condition? Select the letter choice with the best combination of the following factors: 1. Age
2) Gender
3) Race
4) Forces involved with the mechanism of injury

A) 1, 2, and 4
B) 1, 3, and 4
C) 1, 2, 3, and 4
D) 4 only

Question 20

Which of the following is usually the best source of information about an alert and oriented patient?

A) The patient
B) Visual cues
C) Diagnostic tests
D) Family members

Question 21

The purpose of manual stabilization of the cervical spine during the primary assessment of a trauma patient is to:

A) allow you to control the patient.
B) allow for easier airway manipulation.
C) prevent the patient from moving his neck.
D) help you avoid litigation.

Question 22

When responding to a domestic dispute, you should:

A) have your dispatcher tell the patient to come outside.
B) wait for law enforcement to arrive.
C) refuse the call unless law enforcement is on the scene.
D) determine whether or not the assailant is still on the scene.

Question 23

After determining that a patient does not respond to verbal stimuli, your next action would be to:

A) place him in the recovery position.
B) pinch one of his fingernails.
C) insert an oropharyngeal airway.
D) apply manual cervical spine stabilization.

Question 24

To assess an infant's airway, you should:

A) perform a tongue-jaw lift.
B) hyperextend the head and lift the chin.
C) perform a jaw-thrust maneuver.
D) carefully extend the head and neck.

Question 25

Which of the following best describes why you should call for additional assistance when dealing with multiple patients?

A) Risks to each provider decrease as more responders arrive on the scene.
B) You are responsible only for command and triage.
C) You cannot safely and effectively treat all the patients.
D) Fair distribution of workload is required by most unions.

Question 26

You respond to a scene where gunshots have been heard, and there is a report of a "man down." You should enter the scene when:

A) you arrive on the scene.
B) dispatch informs you the scene is safe.
C) you observe the gunman fleeing the scene.
D) police officers arrive and secure the scene.

Question 27

You are treating a 27-year-old asthmatic patient outside a bar when a growing crowd becomes hostile and unruly. To protect yourself, your crew, and your patient, you should:

A) move the patient into the bar.
B) use your vehicle to disperse the crowd.
C) exit the scene, leaving the patient behind.
D) remove yourselves and the patient from the scene.

Question 28

To determine whether a patient is breathing, you should:

A) listen and feel for breathing at the mouth and nose.
B) observe for movement of the abdomen.
C) apply a pulse oximeter.
D) auscultate the chest.

Question 29

A patient with skin described as "clammy" has ________ skin.

A) cool and dry
B) warm and dry
C) warm and moist
D) cool and moist

Question 30

Which of the following statements regarding stridor is TRUE?

A) Stridor originates in the lower airways.
B) Stridor is seldom of clinical significance.
C) The correct treatment of stridor depends on the underlying problem.
D) The presence of stridor requires immediate intubation.

Question 31

You are assessing an adult patient. When you palpate her wrist to locate a pulse, you do not feel one. You should immediately palpate for a ________ pulse.

A) brachial
B) femoral
C) apical
D) carotid

Question 32

Which of the following senses should a paramedic use to recognize hazards at the scene of an emergency?

A) Smell
B) Hearing
C) Sight
D) All of the above

Question 33

The sound of gurgling associated with breathing usually indicates:

A) foreign body obstruction of the upper airway.
B) fluid in the upper airway.
C) thick mucus in the lower airways.
D) constriction of the bronchioles.

Question 34

When assessing the airway, which of the following actions is NOT appropriate?

A) Look for chest rise and fall.
B) Feel for air movement.
C) Listen for airflow.
D) Count the number of breaths over a minute.

Question 35

Steps in assessing circulation during a primary assessment include all of the following EXCEPT:

A) controlling major bleeding.
B) determining the blood pressure.
C) checking for skin signs.
D) checking for a radial pulse.

Question 36

You are assessing a 28-year-old man with multiple gunshots to his abdomen. You should expect his skin to be:

A) cool and moist.
B) hot and moist.
C) warm and dry.
D) cold and dry.

Question 37

Forming a general impression as part of your primary assessment helps you to:

A) determine baseline mental status.
B) determine general clinical status and priority.
C) make a determination about stabilization of the cervical spine.
D) estimate vital signs.

Question 38

Your patient appears awake, but barely looks at you when you call his name. His airway is open, and he is breathing at 34 times per minute. He appears cyanotic. Which of the following adjuncts is most appropriate at this point?

A) Nonrebreather mask
B) Bag-valve mask
C) Nasopharyngeal airway
D) Nasal cannula

Question 39

Mottled, cyanotic, pale, or ashen skin color may indicate any of the following EXCEPT:

A) hypertensive crisis.
B) impaired blood flow to an extremity.
C) significant blood loss.
D) loss of spinal cord function.

Question 40

As the first unit on the scene of a mass-casualty incident, you and your partner should:

A) stay together, assuming a joint command role.
B) split up, with one assuming a command role, the other a triage role.
C) stay together, both locating and triaging patients.
D) split up, with both initiating patient triage.

Question 41

In an infant, the heart rate is best detected by either palpating the brachial artery or:

A) auscultating the carotid pulse.
B) palpating the femoral pulse.
C) palpating the carotid pulse.
D) auscultating the apical pulse.

Question 42

Medical patients with altered mental status are stabilized in a manner similar to that that is appropriate for:

A) critical trauma patients.
B) any other medical patient.
C) a patient complaining of chest pain.
D) a patient with isolated extremity trauma.

Question 43

You locate a 55-year-old woman lying supine on the side of a road. There are no bystanders. You determine that the patient is unresponsive. Which of the following should be your next action?

A) Apply a cervical collar.
B) Provide high-flow oxygen.
C) Open the airway with a jaw-thrust maneuver.
D) Intubate the trachea.

Question 44

Your patient is awake and complaining of chest pain. His airway is patent, and he is breathing at 18 times per minute with adequate tidal volume. What is your next action?

A) Administer oxygen at 15 lpm via nonrebreather mask.
B) Begin positive pressure ventilations via bag-valve-mask device.
C) Insert a nasopharyngeal airway.
D) Administer oxygen at 2 lpm via nasal cannula.

Question 45

All of the following are signs of inadequate breathing in an infant EXCEPT:

A) cyanosis.
B) use of accessory muscles.
C) altered mental status.
D) a respiratory rate of 32 breaths per minute.

Question 46

While performing a primary assessment on a trauma patient who has fallen from a roof, you discover absent lung sounds on the right side. Which of the following actions should you take next?

A) Assess for signs of a tension pneumothorax.
B) Intubate the patient.
C) Continue the rapid trauma assessment.
D) Decompress the patient's chest.

Question 47

Your patient is unresponsive to painful stimulus and has snoring respirations. What is your next action?

A) Check for a pulse.
B) Perform a head-tilt, chin-lift maneuver.
C) Administer oxygen at 15 lpm.
D) Suction.

Question 48

Patterns of deterioration in patient condition may include all of the following EXCEPT:

A) skin becomes cool, pale, and moist.
B) the heart rate significantly increases or decreases.
C) the respiratory rate significantly increases or decreases.
D) the level of consciousness increases.

Question 49

During the primary assessment, your patient groans and tries to turn away when you apply a sternal rub. Otherwise, there is no other response. The patient's mental status can best be described as:

A) alert.
B) responds to painful stimulus.
C) responds to verbal stimulus.
D) unresponsive.

Question 50

Which of the following best describes why patients with serious illnesses or injuries should be transported without delay?

A) Definitive care cannot be provided in the prehospital setting.
B) Most patients are uncomfortable with the level of care provided by paramedics.
C) Paramedics must become available for additional calls as soon as possible.
D) The shorter the contact time with the patient, the less the potential for liability.

Question 51

Your three-year-old patient opens her eyes and responds when you speak to her. Her mental status is best described as:

A) alert.
B) responsive to tactile stimuli.
C) responsive to verbal stimuli.
D) lethargic.

Question 52

Devices for maintaining airway patency in a five-year-old patient include all of the following EXCEPT a(n):

A) endotracheal tube.
B) oropharyngeal airway.
C) suction unit.
D) pharyngotracheal lumen airway.

Question 53

The best method for determining responsiveness to painful stimuli in an infant is to:

A) pinch his cheeks.
B) pinch his fingernails.
C) rub his sternum.
D) flick the soles of his feet.

Question 54

Which of the following problems is it NOT critical to find during the primary assessment?

A) Scalp hematoma
B) Bright red blood spurting from a thigh wound
C) Respiratory distress
D) Foreign body airway obstruction

Question 55

Your patient does not respond to you when you call his name. What should you do next?

A) Apply a painful stimulus.
B) Continue shouting.
C) Assume he is unresponsive.
D) Insert an oral airway.

Question 56

When assessing the chest, you should cover any open wounds you locate with a(n) ________ dressing.

A) wet
B) occlusive
C) antibacterial
D) dry gauze

Question 57

What does the "U" in A-V-P-U stand for?

A) Unresponsive
B) Unconscious
C) Uncooperative
D) Undetermined

Question 58

Signs of inadequate breathing include all of the following EXCEPT:

A) presence of bronchovesicular breath sounds.
B) retractions of intercostal and supraclavicular tissues.
C) nasal flaring.
D) accessory muscle use.

Question 59

Your patient is not alert but is responsive to painful stimulus. His airway is patent. He is breathing at eight times per minute. Your next action should be to administer oxygen via a:

A) nasal cannula.
B) simple face mask.
C) nonrebreather mask.
D) bag-valve-mask device.

Question 60

Which of the following statements about airway management is TRUE?

A) Immediate intubation is required for all unresponsive patients.
B) Dual lumen airways are acceptable for use in children over the age of four years.
C) If a patient cannot be intubated because of an intact gag reflex, a dual lumen airway can be used.
D) Nasopharyngeal airways are contraindicated in patients with possible basilar skull fracture.

Question 61

The active listening technique of reflection involves:

A) repeating the patient's words back to him to check for understanding.
B) confronting the patient if you feel he is hiding something relevant.
C) not allowing the patient to stray from the current problem.
D) asking closed-ended questions to keep the patient on track.

Question 62

In infants, capillary refill is a good incicatior of adequate circulation and can be checked in the:

A) limbs.
B) dorsum of the hand.
C) torso.
D) face.

Question 63

When you ask your patient questions to eliminated confusion, you are using the technique called:

A) reflection.
B) interpretation.
C) facilitation.
D) clarification.

Question 64

Your patient is a three-year-old who presents with a fever. His parents state that he has had diarrhea and vomiting for two days. The patient has not eaten in 24 hours. To best evaluate the patient's peripheral perfusion status, you should evaluate his:

A) respiratory rate.
B) fingertip sensation.
C) capillary refill.
D) blood pressure.

Question 65

Which of the following establishes the foundation for gathering good information?

A) Using active listening
B) Providing appropriate reassurance
C) Asking only open-ended questions
D) Using common sense

Question 66

Without proper terminology and verbal communications skills, the receiver will be unable to ________ the message.

A) decode
B) resend
C) encode
D) receive

Question 67

Which of the following statements regarding patient communication is TRUE?

A) Avoid using interpreters.
B) Use language appropriate to the patient's level of understanding.
C) Cultural differences make no difference in professional communication.
D) Use medical terminology to keep things on a professional level.

Question 68

Pulse quality refers to:

A) rhythm.
B) strength.
C) location.
D) rate.

Question 69

Which of the following actions can you take to establish rapport with a patient early in the interview?

A) Ask as many questions as possible.
B) Maintain control of the interview at all times.
C) Respond to her condition with empathy.
D) Do not show emotion.

Question 70

Which of the following statements regarding effective history taking is TRUE?

A) Use a combination of open- and closed-ended questions.
B) Never ask potentially embarrassing questions.
C) Always use open-ended questions.
D) Always use closed questions.

Question 71

If an abnormal finding is noted in the patient's respiratory rate or pattern during the chest examination, you should:

A) immediately ensure adequate ventilation.
B) intervene only if pulse oximetry is less than 85 percent.
C) immediately determine the exact cause.
D) continue the examination before finding and treating the cause.

Question 72

Which of the following conditions is NOT typically associated with wheezing?

A) Foreign bodies in the small airways
B) Asthma
C) Bronchospasm
D) Upper airway swelling

Question 73

You are examining a patient's peripheral vasculature when you note that he has no radial pulse. Your next step would be to:

A) prepare for immediate transport.
B) defibrillate with 200 joules.
C) start CPR.
D) palpate a carotid pulse.

Question 74

Which of the following nonverbal cues demonstrates your sincerity to the patient?

A) Offering a comforting touch or shaking the patient's hand
B) Averting your gaze to avoid making the patient uncomfortable
C) Touching a patient, even though he may appear uncomfortable being touched
D) Maintaining a distance of 4 to 6 feet from the patient

Question 75

When you detect an inconsistency in a patient's story, which of the following techniques should you use?

A) Clarification
B) Interpretation
C) Confrontation
D) Facilitation

Question 76

According to the 2015 AHA guidelines/recommendations, a patient who appears to be unresponsive and not breathing or breathing ineffectively should be assessed using which mnemonic memory aid?

A) ABC
B) BAC
C) CBA
D) CAB

Question 77

Which of the following sounds can typically be heard without the use of a stethoscope?

A) Rhonchi
B) Bowel sounds
C) Stridor
D) Crackles

Question 78

Encouraging your patient with your body language to provide more information is called:

A) interpretation.
B) clarification.
C) reflection.
D) facilitation.

Question 79

Which of the following statements can show your empathy toward the patient?

A) "What is your name?"
B) "You say that your chest doesn't hurt, but you keep rubbing it."
C) "Are you sure that you take a diuretic?"
D) "That must have been very difficult."

Question 80

The history begins with an open-ended question about your patient's:

A) general health.
B) chief complaint.
C) severity of symptoms.
D) past medical history.