Question 1

You are evaluating a patient who was a restrained driver of a motor vehicle that crashed into the median barrier at 40 mph. He is awake, alert, and oriented, complaining of neck and back pain. There is a bruise across his upper abdomen in the shape of the seat belt. Based on this information, you should assume he is a ________ trauma patient, and transport him to ________.
A) major; the closest hospital
B) minor; the closest hospital
C) minor; the patient's hospital of choice
D) major; a trauma center

Accepted Answer

The patient's mechanism of injury (MOI) suggests that he is a major trauma patient. He was a restrained driver involved in a high-speed motor vehicle collision, which puts him at significant risk for internal injuries. Additionally, he has bruising across his upper abdomen from the seat belt, which indicates that he sustained a hard impact. Therefore, it is best to transport him to a trauma center, which has the necessary resources and specialists to provide him with appropriate care.

Question 2

Which of the following may indicate either cardiac tamponade or tension pneumothorax?
A) Cushing's reflex
B) Hypertension
C) Subcutaneous emphysema
D) Distended neck veins

Accepted Answer

Both cardiac tamponade and tension pneumothorax can cause compression on the heart, which can lead to distended neck veins. However, none of the other options are specific to these conditions. Cushing's reflex may indicate increased intracranial pressure, hypertension is a common finding in many conditions, and subcutaneous emphysema may indicate a pneumothorax but is not specific to tension pneumothorax.

Question 3

A patient is complaining of abdominal pain, nausea, and vomiting. Which of the following will provide you with the most immediately useful information?
A) Checking for discoloration of the tongue
B) Asking about any unusual taste in the mouth
C) Asking about the presence of coffee-grounds emesis
D) Finding out about any unusual stress in the patient's life

Accepted Answer

Coffee-grounds emesis is a symptom of gastrointestinal bleeding, which could be a potential cause of the patient's abdominal pain, nausea, and vomiting. Checking for discoloration of the tongue or asking about an unusual taste in the mouth are not likely to provide information about the underlying cause of the patient's symptoms. Asking about unusual stress may provide important information about the patient's overall health, but it is not a specific symptom associated with abdominal pain, nausea, and vomiting.

Question 4

A fast, systematic assessment designed to identify other life-threatening injuries after the primary assessment is the:
A) 1-minute exam.
B) rapid secondary assessment.
C) focused physical exam.
D) detailed physical exam.

Accepted Answer

The rapid secondary assessment is specifically designed to identify any other life-threatening injuries or conditions that may have been missed during the primary assessment. The 1-minute exam is not a commonly used assessment, and both the focused and detailed physical exams are more focused on assessing specific areas of injury or concern.

Question 5

Which of the following best describes why a focused history is important in responsive medical patients?
A) It supports diagnostic impression.
B) It allows treatments to be initiated immediately.
C) It helps to formulate a field diagnosis.
D) It identifies signs of medical complications.

Accepted Answer

The answer of Which of the following best describes why...

Question 6

The careful, thorough process of eliciting a patient's history and conducting a physical exam is known as the:
A) primary survey.
B) rapid medical assessment.
C) secondary assessment.
D) ongoing assessment.

Accepted Answer

The term "secondary assessment" refers to the detailed evaluation of a patient's history and physical exam. The primary survey focuses on quickly identifying any immediate life-threatening conditions, while the rapid medical assessment is a brief evaluation used to determine whether additional resources (such as advanced life support) are needed. Ongoing assessment refers to the continuous monitoring of a patient's vital signs and clinical status.

Question 7

Why is a detailed physical exam rarely performed on critical trauma patients in the prehospital setting?
A) It produces too much patient anxiety.
B) It is used only on medical patients.
C) The rapid trauma assessment performs the same function.
D) It usually yields little immediately useful information.

Accepted Answer

In critical trauma situations, time is of the essence, and a detailed physical exam may not provide information that can be immediately acted upon. The focus is on rapid assessment and stabilization.

Question 8

Reassessment should include which of the following?
1) Assess effects of interventions.
2) Check vital signs.
3) Assess skin condition.
4) Do detailed physical exam.
5) Check airway patency.
A) 1, 2, 3, and 5
B) 2, 4, and 5
C) 1, 2, 4, and 5
D) 1, 3, and 4

Accepted Answer

Reassessment should include assessing the effects of interventions, checking vital signs, assessing skin condition, and checking airway patency. While a detailed physical exam may be necessary in certain situations, it is not always required during reassessment.

Question 9

A 60-year-old man presents with altered mental status. There is no evidence of trauma. Which of the following is most likely to give you specific information about the underlying cause of the patient's condition?
A) Pulse oximetry
B) A Babinski reflex
C) End-tidal carbon dioxide monitoring
D) Blood glucose determination

Accepted Answer

Blood glucose determination can give specific information about the underlying cause of altered mental status by identifying hypoglycemia or hyperglycemia as a possible cause. The other options listed can provide important information about respiratory status and neurologic function, but may not necessarily pinpoint the exact cause of altered mental status.

Question 10

Evaluation of the pelvis in the rapid trauma assessment includes pressing on the symphysis pubis in which direction?
A) Inferiorly
B) Posteriorly
C) Laterally
D) Medially

Accepted Answer

Pressing on the symphysis pubis posteriorly is part of the rapid trauma assessment to evaluate the stability of the pelvis and detect potential pelvic fractures.

Question 11

Special emphasis should be placed on which of the following during your rapid secondary assessment?
A) Mental status
B) Cranial nerve function
C) Cardiovascular and respiratory systems
D) Areas suggested by the chief complaint

Accepted Answer

During a rapid secondary assessment, special emphasis should be placed on areas suggested by the chief complaint to identify any immediate threats to life or function related to the patient's primary concern.

Question 12

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.

Accepted Answer

Forming a general impression is an important part of the primary assessment as it allows you to quickly determine the general clinical status and priority of the patient, which then helps guide your further assessment and treatment. It includes observing the patient's level of consciousness, general appearance, and obvious life threats such as severe bleeding or difficulty breathing. While it may provide some clues about vital signs, it is not the primary means of estimating them. Determination of baseline mental status and stabilization of the cervical spine are also important components of the primary assessment but are not directly related to forming a general impression.

Question 13

Which of the following is NOT part of the medical history?
A) Past injuries
B) Type of health care insurance
C) Current medications
D) Current symptoms

Accepted Answer

The type of health care insurance is not part of the medical history, as it is not directly related to a patient's health status or medical conditions. The medical history includes past injuries, current medications, and current symptoms, among other relevant information about a patient's health.

Question 14

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.

Accepted Answer

The level of consciousness increasing would not be a pattern of deterioration, as it would indicate an improvement in the patient's condition. The other options (A, B, and C) all describe potential signs of deterioration.

Question 15

Which of the following patient conditions requires immediate transport?
A) Neck pain following a motor vehicle collision
B) Unresponsiveness to painful stimuli after ALS interventions
C) Narcotic overdose
D) Wrist fracture with diminished distal sensation

Accepted Answer

Unresponsiveness to painful stimuli after ALS interventions indicates a life-threatening condition requiring immediate transport to a hospital with higher level of care.

Question 16

You are en route to a hospital with a patient who appears stable following a motor vehicle collision. To detect changes in the patient's condition, you should do which of the following during transport?
A) Detailed physical examination
B) Neurological assessment
C) Repeat the primary assessment
D) Rapid trauma assessment

Accepted Answer

During transport, it is important to repeat the primary assessment to detect any changes in the patient's condition. This allows the EMS provider to catch any deterioration in the patient's status and take appropriate action. While a detailed physical examination or a rapid trauma assessment may be necessary in certain situations, repeating the primary assessment is the best choice for detecting changes in a stable patient during transport. A neurological assessment may also be necessary if there is concern for head or spinal cord injury.

Question 17

Which of the following will provide the LEAST information about a patient complaining of abdominal pain?
A) Checking for unusual breath odors
B) Looking for Cullen's sign
C) Assessing reaction of the pupils to light
D) Performing a tilt test

Accepted Answer

Assessing the reaction of the pupils to light is not related to abdominal pain and would provide no relevant information. Checking for unusual breath odors and looking for Cullen's sign are specific physical exams that can help identify potential causes of abdominal pain. Performing a tilt test may also provide relevant information about potential causes of abdominal pain such as dehydration or blood pressure issues.

Question 18

Which of the following is NOT a reason that a reassessment is important?
A) It allows you to detect trends in the patient's status.
B) It determines changes in the patient's conditions.
C) It reassures the patient you are taking good care of him.
D) It allows you to assess the effects of interventions.

Accepted Answer

Reassessments are important for clinical reasons, such as detecting changes in the patient's condition and assessing the effects of interventions. While reassurance is important for patient satisfaction and building a therapeutic relationship, it is not a primary reason for conducting a reassessment.

Question 19

Which of the following is the sequence of steps when assessing a major trauma patient?
1) Secondary assessment
2) Primary assessment
3) Reconsider mechanism of injury
4) History
5) Vital signs
6) Detailed physical exam
A) 2, 5, 3, 1, 4
B) 2, 3, 1, 5, 4
C) 2, 6, 5, 3, 4
D) 2, 1, 3, 4, 5

Accepted Answer

The sequence for assessing a major trauma patient follows the acronym ABCDE, which stands for Airway, Breathing, Circulation, Disability, and Exposure. This is the primary assessment, and it is the first step in evaluating a patient's condition following a major trauma. The steps in this process are: 1) evaluate airway 2) assess breathing 3) evaluate circulation 4) assess disability 5) expose the patient to perform a head-to-toe physical exam. Once the ABCDE primary assessment is completed, a secondary assessment may be performed, which includes obtaining vital signs, taking the patient's history, performing a detailed physical examination, and re-evaluating the mechanism of injury. The sequence for the secondary assessment is 3, 1, 4, 5, and 6, which corresponds to reconsidering the mechanism of injury, performing a detailed physical exam, obtaining vital signs, taking the patient's history, and performing a head-to-toe physical examination. Therefore, the correct answer is B, as it correctly follows the ABCDE primary assessment and the subsequent steps of the secondary assessment.

Question 20

Which of the following statements best describes proper history-taking technique in the assessment of a major trauma patient?
A) Perform the history before assessing the patient.
B) Complete a rapid history by using the SAMPLE acronym.
C) Collect a comprehensive health history.
D) Medical history is not a significant issue in the trauma patient and can be skipped.

Accepted Answer

In the assessment of a major trauma patient, time is of the essence. Therefore, a rapid assessment is necessary, and the SAMPLE acronym can be used as a guide for taking a quick history. S = Signs and symptoms, A = Allergies, M = Medications, P = Pertinent past medical history, L = Last meal or when was the last time the patient ate, and E = Events leading to the injury or illness. A comprehensive health history may not be possible given the circumstances, and medical history can be significant in the management of the trauma patient.

Quiz 7: Patient Assessment in the Field

Which of the following may indicate either cardiac tamponade or tension pneumothorax?

A patient is complaining of abdominal pain, nausea, and vomiting. Which of the following will provide you with the most immediately useful information?

A fast, systematic assessment designed to identify other life-threatening injuries after the primary assessment is the:

Which of the following best describes why a focused history is important in responsive medical patients?

The careful, thorough process of eliciting a patient's history and conducting a physical exam is known as the:

Why is a detailed physical exam rarely performed on critical trauma patients in the prehospital setting?

Reassessment should include which of the following? 1) Assess effects of interventions. 2) Check vital signs. 3) Assess skin condition. 4) Do detailed physical exam. 5) Check airway patency.

A 60-year-old man presents with altered mental status. There is no evidence of trauma. Which of the following is most likely to give you specific information about the underlying cause of the patient's condition?

Evaluation of the pelvis in the rapid trauma assessment includes pressing on the symphysis pubis in which direction?

Special emphasis should be placed on which of the following during your rapid secondary assessment?

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

Which of the following is NOT part of the medical history?

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

Which of the following patient conditions requires immediate transport?

You are en route to a hospital with a patient who appears stable following a motor vehicle collision. To detect changes in the patient's condition, you should do which of the following during transport?

Which of the following will provide the LEAST information about a patient complaining of abdominal pain?

Which of the following is NOT a reason that a reassessment is important?

Which of the following is the sequence of steps when assessing a major trauma patient? 1) Secondary assessment 2) Primary assessment 3) Reconsider mechanism of injury 4) History 5) Vital signs 6) Detailed physical exam

Which of the following statements best describes proper history-taking technique in the assessment of a major trauma patient?