Question 1

Signs of inadequate breathing include all of the following EXCEPT:

Accepted Answer

Presence of bronchovesicular breath sounds is not a sign of inadequate breathing, as these sounds are considered normal lung sounds heard during auscultation. Retractions of intercostal and supraclavicular tissues, nasal flaring, and accessory muscle use are all signs of inadequate breathing that indicate the body is working harder to obtain oxygen.

Question 2

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.

Accepted Answer

When a pulse cannot be palpated in the wrist, the next step is to palpate for a pulse in the neck (carotid pulse). The carotid pulse is located on either side of the trachea and is easily palpable in most adults. It is important to use gentle pressure when palpating for a pulse to avoid compressing the artery too much.

Question 3

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

Accepted Answer

While blood pressure is an important measure of circulation, it is not typically assessed during the primary assessment in the pre-hospital setting. The steps in assessing circulation during a primary assessment include controlling major bleeding, checking for skin signs (such as color, temperature, and moisture), and checking for a radial pulse.

Question 4

Which of the following statements regarding stridor is TRUE?

Accepted Answer

The correct treatment of stridor depends on the underlying problem. Stridor can be caused by various conditions, including upper respiratory infections, choking or foreign body obstruction, allergic reactions, and tumors. Therefore, the treatment approach will depend on the specific cause of the stridor. Immediate intubation is not always required and may only be necessary in severe cases where the airway is compromised. Stridor can also originate in the upper airways, making statement A false. Statement B is also false because stridor can indicate a potentially serious condition and requires medical attention.

Question 5

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?

Accepted Answer

The patient appears to be in respiratory distress and is not maintaining adequate oxygen saturation, as seen by the cyanosis. The most appropriate adjunct in this scenario would be a bag-valve mask, which can provide positive pressure ventilation and help improve oxygenation. The other options may not provide enough oxygen or support for the patient's current condition. It may also be necessary to consider advanced airway management if the patient's condition continues to deteriorate.

Question 6

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

Accepted Answer

Counting the number of breaths over a minute is not a part of assessing the airway, but rather an assessment of breathing. The focus of airway assessment should be on evaluating the patency and adequacy of air movement through the upper airway. Looking for chest rise and fall, feeling for air movement, and listening for airflow are all appropriate actions when assessing the airway.

Question 7

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

Accepted Answer

Forming a general impression allows you to quickly determine the patient's overall clinical status and prioritize their care. It includes assessing for any immediate threats to life, such as lack of breathing, severe bleeding, or altered mental status. This information helps guide your initial interventions and treatment plan.

Question 8

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?

Accepted Answer

Absent lung sounds on one side of the chest can be a sign of a tension pneumothorax, which is a life-threatening condition that requires immediate intervention. The provider should assess for signs of a tension pneumothorax, such as tracheal deviation or jugular vein distension. If these signs are present, the patient should receive immediate needle decompression of the affected side of the chest. If tension pneumothorax is not present, the provider can continue the rapid trauma assessment to identify other injuries.

Question 9

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

Accepted Answer

The purpose of manual stabilization of the cervical spine during the primary assessment of a trauma patient is to prevent the patient from moving his neck. This is important because movement of the neck can worsen any spinal cord injury that may be present. Controlling the patient, airway manipulation, and avoiding litigation are not the primary reasons for manual stabilization of the cervical spine.

Question 10

To assess an infant's airway, you should:

Accepted Answer

The answer of To assess an infant's airway, you should:
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Question 11

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:

Accepted Answer

Given the patient's condition of being responsive only to painful stimuli and having a low respiratory rate (eight times per minute), the most appropriate oxygen delivery method is a bag-valve-mask (BVM) device. This is because the patient's breathing is inadequate, and the BVM can provide both the necessary oxygen and assist in ventilation.

Question 12

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

Accepted Answer

Clammy skin refers to skin that is cool and moist, which can be a sign of various medical conditions such as shock or low blood sugar levels.

Question 13

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

Accepted Answer

The level of consciousness increasing is not a pattern of deterioration, but rather a sign of improvement. Option A, B, and C are all patterns of deterioration.

Question 14

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

Accepted Answer

Flicking the soles of an infant's feet is a common method of assessing their responsiveness to painful stimuli. This is known as the Babinski reflex and is a normal reflex in infants, but it should disappear by the age of 2. Pinching the cheeks or fingernails or rubbing the sternum are not standardized methods for assessing responsiveness to painful stimuli in infants.

Question 15

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

Accepted Answer

Multiple gunshot wounds can cause significant blood loss and shock, leading to decreased perfusion to the skin and ultimately cool and moist skin. This is a sign of a medical emergency and requires immediate attention.

Question 16

To determine whether a patient is breathing, you should:

Accepted Answer

Listening and feeling for breathing at the mouth and nose is the most reliable way to determine if a patient is breathing. Observing movement of the abdomen or using a pulse oximeter may not accurately indicate if the patient is actually breathing. Auscultating the chest is primarily done to assess lung sounds and may not be necessary to determine if the patient is breathing or not.

Question 17

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

Accepted Answer

Pinching one of the fingernails is a method to apply a painful stimulus to check the patient's response to pain after they do not respond to verbal stimuli. This is a part of the primary assessment to determine the level of consciousness and responsiveness, following the AVPU scale (Alert, responds to Verbal stimuli, responds to Pain, Unresponsive).

Question 18

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

Accepted Answer

Mottled, cyanotic, pale, or ashen skin color may indicate impaired blood flow, significant blood loss, or loss of spinal cord function, but is not typically associated with hypertensive crisis.

Question 19

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:

Accepted Answer

The patient is showing a response to a painful stimulus, which indicates a level of mental status between being fully responsive and unresponsive. Therefore, the best choice is B) responds to painful stimulus.

Question 20

The sound of gurgling associated with breathing usually indicates:

Accepted Answer

The sound of gurgling associated with breathing typically indicates the presence of fluid in the upper airway, such as in cases of pulmonary edema or aspiration.

Quiz 2: Primary Assessment