Deck 13: Patient Assessment

Question 1

You are instructing an Emergency Medical Responder course. One of the students asks you how the head-tilt, chin-lift airway maneuver works to open the airway. Your response is:

A) "It opens the airway by lifting the tongue from the back of the throat."
B) "It creates an open airway by separating the lips, thus allowing air to enter."
C) "It stimulates the patient to begin taking deeper breaths, thus moving air into the lungs."
D) "It opens the airway by relaxing and expanding the size of the throat."

Answer 1

A

Question 2

You arrive at the scene of a fall, where a 42-year-old woman fell backward off a step ladder while cleaning her kitchen windows. She is seated on the floor complaining of pain to her ankle. She tells you, "If I had just gone to work today instead of using vacation time, this would have never happened!" Based on information thus far, which of the following can you conclude?

A) She is alert with an open airway.
B) Her pulse rate is within normal limits.
C) She does not require rapid transport.
D) She does not have any other injuries.

Answer 2

A

Question 3

You have been dispatched to a residence for an 89-year-old female with a nonspecific complaint. When assessing this patient, which of the following will you do first to develop a better understanding of the emergency?

A) Obtain the patient's vital signs and current medications.
B) Gather a medical history including allergy information.
C) Contact medical direction for advisement.
D) Determine if the complaint is medical or trauma related.

Answer 3

D

Question 4

A 36-year-old patient who has overdosed on an unknown drug presents with his eyes closed, even when his name is loudly called. Which one of the following should the EMT do first?

A) Check the patient's vital signs.
B) Check the mental status.
C) Assess for a radial pulse.
D) Determine what drug was taken.

Question 5

You have been dispatched to an apartment for an elderly male complaining of shortness of breath. When do you start the process of forming a general impression about this patient?

A) As you and your partner approach him
B) After completing the primary assessment
C) As soon as you obtain his chief complaint
D) Following the completion of vital signs

Question 6

During the primary assessment, how should you best determine the adequacy of a patient's breathing?

A) Determine the patient's mental status.
B) Compare the respirations and pulse rate.
C) Calculate the number of breaths per minute.
D) Examine the rise and fall of the chest.

Question 7

As you arrive by the side of a 64-year-old unresponsive female, you hear snoring respirations. Your immediate action would be to:

A) suction the mouth and airway.
B) determine the chief complaint.
C) administer supplemental oxygen.
D) perform a manual jaw-thrust maneuver.

Question 8

You are by the side of a patient complaining of shortness of breath with a history of heart problems, including congestive heart failure (CHF). When assessing the airway, which one of the following observations best indicates that it is patent?

A) She easily tells you that she is having chest pain.
B) She is sitting in an upright position because she cannot lie flat.
C) She can only speak in extremely short sentences.
D) She is lethargic and confused to person, place, and time.

Question 9

You have been called for an adult patient who suffered a seizure. He is sitting on the floor, and looks at you as you enter the room. When questioned, he cannot remember the date or where he is. The patient's mental status can best be described as:

A) alert but confused.
B) lethargic and agitated.
C) altered.
D) verbally disoriented.

Question 10

The EMT shows she understands the importance and reason for forming a general impression when she states:

A) "The general impression permits a rapid diagnosis of the patient's problem."
B) "Forming a general impression allows me to fully assess the emergency situation."
C) "The general impression enables me to rule out any life-threatening conditions."
D) "Forming a general impression provides me with a rough idea of the patient's overall status."

Question 11

When assessing a sick or injured patient, which of the following indicates the appropriate order?

A) Primary assessment; reassessment, secondary assessment
B) Scene size-up, secondary assessment, primary assessment
C) Scene size-up, primary assessment, secondary assessment
D) Scene size-up, history, secondary assessment, primary assessment

Question 12

An EMT is assessing a 9-month-old infant who is "not acting right" per his mother. Assessment reveals him to be extremely irritable, crying weakly, and shows he does not want to be touched by the EMT. Which one of the following best describes this infant's mental status?

A) Alert
B) Lethargic
C) Verbal
D) Crying

Question 13

A 26-year-old male has been ejected from a car after it rolled several times in the median of the interstate. As you perform the primary assessment, you find him prone and unresponsive. Your immediate action is to:

A) assess his breathing.
B) apply a cervical collar.
C) log-roll him supine.
D) place an oral airway.

Question 14

A conscious and alert 44-year-old female complains of chest pain and mild shortness of breath. She appears to have no difficulty speaking and states that the pain suddenly started about 2 hours ago. There is a history of blood clots in the lungs in her family, and she is scared and would like to be evaluated. Which of the following should you do first?

A) Consider administering oxygen.
B) Determine the adequacy of her breathing.
C) Place her on the stretcher for transport.
D) Perform a secondary assessment.

Question 15

Which patient would be classified as unresponsive?

A) 39-year-old-female who is confused
B) 52-year-old who cannot answer your questions
C) 70-year-old female who has suffered a stroke
D) 46-year-old-male who does not respond when his fingers are pinched

Question 16

Which of the following statements made by the EMT indicates that he has appropriately initiated the first phase of the patient assessment?

A) "I have placed an oral airway in the patient."
B) "The scene appears to be free of hazards."
C) "Blood pressure is 124/80 mmHg."
D) "Can you tell me why you called the ambulance?"

Question 17

On scene you find a 91-year-old female who fell down two steps after suddenly complaining of a severe headache. She is unresponsive with gurgling respirations. What instruction should you immediately give your partner?

A) "Please perform the head-tilt, chin-lift to open the airway."
B) "Check her breathing and let me know the rate."
C) "Let's move her to the stretcher and get moving to the hospital."
D) "Get the suction out and clear out her airway."

Question 18

To stabilize the cervical spine of a trauma patient while simultaneously opening the airway, how should you position her head?

A) Tilted slightly forward
B) Tilted slightly back
C) Neutral and in-line
D) In the position found

Question 19

You are assessing a 4-year-old patient whose panicked mother states that she cannot wake him. The child is breathing but his eyes are closed. To best determine the child's mental status, you should first:

A) apply pressure to the child's nail beds.
B) say loudly, "Open your eyes!"
C) ask the mother how long the child has been asleep.
D) determine the child to be unresponsive.

Question 20

An Emergency Medical Responder informs you that a 59-year-old female is responsive to verbal stimuli. Which one of the following presentations should you expect?

A) She is able to answer all questions appropriately when asked.
B) She cannot be awakened when her name is called.
C) Her eyes are closed, but she will wiggle her fingers if told.
D) She is awake, but having difficulty telling you her name and where she is.

Question 21

The patient's family states that their 16-year-old daughter has a history of asthma and has been complaining of shortness of breath for the past two days. She has been taking her metered-dose inhaler with some relief, but this morning, they found her lethargic and struggling to breathe. Your assessment reveals her to be responsive to verbal stimuli with an open airway and shallow respirations of 44 per minute. You hear minimal wheezing to both lungs. Your immediate action in caring for this patient is to:

A) insert an oral airway.
B) apply a nonrebreather mask.
C) position her on her side.
D) start positive pressure ventilation.

Question 22

A responsive but confused construction worker has fallen 10 feet from scaffolding, landing on his head and left shoulder. His airway is open and his breathing is adequate. Coworkers state that he was unresponsive for a period of 2 minutes following the fall and is on medications for depression and heart problems. Based on this information, the EMT should classify him as what kind of patient?

A) Trauma
B) Trauma and behavioral
C) Medical and trauma
D) Medical, trauma, and behavioral

Question 23

When performing the primary assessment of a conscious adult, you typically palpate which pulse first?

A) Carotid
B) Femoral
C) Radial
D) Brachial

Question 24

You cannot locate a radial pulse on a 54-year-old male who is alert, confused, and breathing adequately. Which of the following should you do immediately?

A) Start cardiopulmonary resuscitation.
B) Attach the automated external defibrillator (AED).
C) Start positive pressure ventilation.
D) Check for the carotid pulse.

Question 25

What is the purpose of assessing the pulse on an unresponsive patient during the primary assessment?

A) Calculate the precise heart rate.
B) Decide if the breathing is adequate.
C) Determine the presence of a heartbeat.
D) Establish if the patient requires oxygen.

Question 26

You arrive on the scene of a motor vehicle collision and are presented with a patient complaining of chest pain after striking his chest on the steering wheel. On scene Emergency Medical Responders (EMRs) are maintaining cervical immobilization manually. He is alert and oriented and has a patent airway. His respirations are 24 with good chest rise and fall, and his skin is warm and dry. His heart rate is 96 and SpO₂ 92% on room air. At this time you should:

A) apply a cervical spine immobilization collar.
B) provide supplemental oxygen.
C) obtain a blood pressure and medical history.
D) start positive pressure ventilation.

Question 27

The EMT would recognize which one of the following patients as breathing at a normal rate?

A) 8-year-old male breathing 26 times per minute
B) 44-year-old male breathing 6 times per minute
C) 6-month-old infant breathing 52 times per minute
D) 22-year-old female breathing 26 times per minute

Question 28

You are by the side of a 64-year-old male patient who collapsed at home. After assessing his level of consciousness, airway, and breathing, you determine that he is unresponsive with an open airway, but not breathing. What instruction should you immediately give your partner?

A) "Let's place an oral airway and start ventilations."
B) "Please check his blood pressure and skin temperature."
C) "Go ahead and apply the automated external defibrillator."
D) "We will need to start cardiopulmonary resuscitation."

Question 29

You have just determined that a 92-year-old female is unresponsive. Your next action would be to:

A) open the airway.
B) check for a pulse.
C) determine the past medical history.
D) immediate transport.

Question 30

Forming a general impression is essential in the assessment of any patient because it:

A) indicates whether or not a primary assessment is required.
B) helps to determine the clinical status of a patient.
C) determines the stability or instability of a patient.
D) reveals the injuries the patient has suffered.

Question 31

What item regarding breathing rates must the EMT remember when assessing the respirations of a pediatric patient?

A) It is similar to that of an adult.
B) It is typically slower than that of an adult.
C) It is not significant in the assessment.
D) It is usually faster than that of an adult.

Question 32

A 28-year-old female has fallen 20 feet from the roof a house. She is lying supine and does not appear to be conscious or breathing. On arrival at her side, what should the EMT do first?

A) Open her airway using a head-tilt, chin-lift maneuver.
B) Apply manual in-line spinal stabilization.
C) Start positive pressure ventilation.
D) Open her airway and assess her circulation.

Question 33

You have been called for a 6-month-old male with a high fever who has seized. Currently, he is not seizing and appears to be sleeping. When performing the primary assessment on this patient, which of the following is appropriate?

A) Evaluate the pulse before examining the breathing.
B) Check for the presence of a pulse in the brachial artery.
C) Move the baby to the ambulance before performing the primary assessment.
D) Obtain a blood pressure when checking the patient's circulation status.

Question 34

Which of the following patients should the EMT identify as having the most adequate breathing?

A) 61-year-old confused female breathing at a rate of 8 breaths per minute
B) 34-year-old male with abdominal pain who is alert and oriented with good chest rise and fall
C) 19-year-old male breathing 16 times per minute with slight wheezing in the lungs
D) 67-year-old female breathing 26 times per minute with good chest rise and fall

Question 35

A 31-year-old male breathing at a rate of 6 times per minute can best be described as:

A) bradypneic.
B) hyperventilating.
C) tachypneic.
D) bradycardic.

Question 36

You have been called to the side of a 37-year-old female whose chief complaint is confusion, anxiety, and chest tightness. Assessment shows her airway to be patent, respirations 46 per minute, heart rate 134, blood pressure 128/54 mmHg, and SpO₂ at 93%. In regards to the respiratory rate, you would recognize:

A) it will result in too much air being placed in the lungs.
B) it is not a concern because the patient is still getting oxygen.
C) it does not allow the lungs enough time to adequately fill.
D) it will cause damage to the lungs if not corrected.

Question 37

To best evaluate the adequacy of breathing in an unresponsive adult, the EMT should:

A) assess the skin color.
B) check the pupils.
C) observe the chest rise.
D) look for cyanosis.

Question 38

You are assessing an 8-month-old whose mother states has been vomiting for two days and not eating or drinking. When assessing the pulse, you should check which site?

A) Temporal
B) Radial
C) Femoral
D) Brachial

Question 39

Which one of the following patients should receive supplemental oxygen with a nonrebreather mask or nasal cannula?

A) 39-year-old male with a sprained ankle and breathing 16 times per minute
B) 18-year-old who overdosed on a drug and is unresponsive and breathing 6 times a minute
C) 42-year-old female who is confused, weak, and dizzy, and adequately breathing 14 times per minute
D) 61-year-old male who is unresponsive with a foreign body airway obstruction that cannot be removed with abdominal thrusts

Question 40

When assessing an adult trauma patient's circulation status during the primary assessment, the EMT's assessment should include:

A) carotid pulse, capillary refill, blood pressure, and skin color.
B) radial pulse, skin temperature, and presence of external bleeding.
C) skin color, pulse rate, blood pressure, and skin temperature.
D) pulse rate, blood pressure, capillary refill, and skin condition.

Question 41

A patient has called 911 for abdominal pain and generalized weakness. On arrival you note that the patient's skin is a yellow-orange color. Which one of the following diseases revealed to you during the history would best correlate to this patient's skin?

A) Lung cancer
B) Stroke
C) Liver disease
D) Diabetes

Question 42

During your primary assessment, you note the patient's skin to be warm, pink, and dry. This should seemingly indicate:

A) possible shock.
B) possible fever.
C) poor oxygenation.
D) normal circulation.

Question 43

You must check the circulation of an 8-year-old child with a high fever who has been vomiting for the past 2 hours. The child is very frightened and crying. Given the situation, you should:

A) palpate the radial artery.
B) obtain a carotid pulse.
C) feel for a brachial pulse.
D) listen to the heart with a stethoscope.

Question 44

You have completed the primary assessment on a patient who was thrown from a motorcycle, impacting his head and back on the nearby sidewalk. After finding no life threats during the primary assessment, what action should you take first when starting a secondary assessment?

A) Reassess the patient's mental status.
B) Ensure that the airway is patent.
C) Reevaluate the mechanism of injury.
D) Apply supplemental oxygen.

Question 45

As you approach a patient who was involved in a motor vehicle crash, you note that he has dark, oozing blood coming from an open fracture to his lower left tibia. The patient was removed from the car by bystanders and is being held by a family member. Which of the following should you do immediately?

A) Assess and open the airway.
B) Take manual in-line spinal stabilization.
C) Apply direct pressure to the bleeding.
D) Provide supplemental oxygen.

Question 46

Which one of the following patients is considered the lowest priority for a rapid secondary exam and immediate transport?

A) 32-year-old woman who is unresponsive
B) 72-year-old man complaining of leg pain for a week
C) 7-year-old boy who has had abdominal pain for 2 hours
D) 55-year-old woman with difficulty breathing

Question 47

Which one of the following capillary refill times is considered normal for a 5-year-old child?

A) 3 seconds
B) 2 seconds
C) 6 seconds
D) 4 seconds

Question 48

An intoxicated 19-year-old female has fallen through a large plate glass window. As you approach, you note her to be sitting up and holding her hand over a large laceration that is spurting bright red blood. In this situation, you would immediately:

A) provide high-concentration oxygen and treat for shock.
B) determine the presence and rate of the carotid pulse.
C) apply direct pressure to the laceration.
D) assess the airway for patency and breathing for adequacy.

Question 49

When performing the primary assessment of a 45-year-old patient, which one of the following skin findings should concern the EMT?

A) Cool and moist skin
B) 1-second capillary refill
C) Pink color to the nail beds
D) Skin that is warm to the touch

Question 50

You are interviewing a prospective candidate for the position of EMT with your service. During the interview, you ask the applicant to describe the purpose of the primary assessment. Which statement best describes that purpose?

A) "To establish a chief complaint and gather the past medical history."
B) "To determine if the patient's vital signs are stable."
C) "Identify and treat life-threatening conditions."
D) "Perform an exam focused on the patient's chief complaint."

Question 51

Your patient is an 82-year-old and diabetic. Which one of the following assessment parameters is the least reliable sign indicating circulatory status?

A) Capillary refill
B) Skin color
C) Skin temperature
D) Pulse strength

Question 52

At a nursing home, you find an elderly patient extremely short of breath. To best determine if the patient is cyanotic, you should:

A) press and release the skin on the palm.
B) examine the lining of the lips and mouth.
C) look at and feel the skin on the back of the hand.
D) inspect the skin on the fingers and nail beds.

Question 53

A 43-year-old male has called 911 with the complaint of difficulty breathing. On scene you note he is breathing at a rate of 18 breaths per minute. He also exhibits intercostal retractions and nasal flaring. The EMT should document this patient's breathing as:

A) dyspneic.
B) apneic.
C) tachypneic.
D) bradypneic.

Question 54

A patient has been shot once in the left hand. After performing the primary assessment, the EMT quickly focuses his attention on the left hand and begins a specific assessment of the injury. What type of exam is the EMT performing?

A) Extremity
B) Focused
C) Specific
D) Rapid

Question 55

Which of the following statements made by an EMT shows he correctly understands capillary refill?

A) "Capillary refill is a reliable sign of perfusion in adults, but not as reliable in infants and children."
B) "Red flushed skin in the adult is a normal finding when assessing capillary refill."
C) "A capillary refill of 4 or more seconds in any age patient indicates that he or she is well oxygenated."
D) "For a capillary refill test to be normal for a child, it must be assessed at room temperature and be less than 2 seconds."

Question 56

As you perform the primary assessment on an unresponsive patient, you discover vomitus in her airway. Which of the following should you do next?

A) Check the breathing.
B) Start positive pressure ventilation.
C) Apply supplemental oxygen.
D) Suction the airway.

Question 57

A 5-year-old boy has been vomiting profusely for two days. Your assessment indicates that his airway is open, respirations adequate, and radial pulse fast and weak. His skin is cool and capillary refill time is 5 seconds. The EMT should understand that the patient is:

A) hypoxic.
B) malnourished.
C) poorly perfused.
D) feverous.

Question 58

Forming the general impression is started during which phase of patient assessment?

A) Reassessment
B) Secondary assessment
C) Primary assessment
D) Care transfer in the emergency department

Question 59

Which one of the following capillary refill times is considered the upper limit of normal for an adult female?

A) 3 seconds
B) 2 seconds
C) 6 seconds
D) 4 seconds

Question 60

A 62-year-old female patient who has been working in her garden has hot, dry skin. You should recognize this as a possible sign of:

A) heart problems.
B) heat exposure.
C) hypoperfusion.
D) stroke.

Question 61

When assessing a critically injured patient, the EMT should detect which one of the following injuries or conditions when performing the secondary assessment?

A) Decreased level of consciousness
B) Weak carotid pulse and clammy skin
C) Inadequate respiratory effort
D) Bruising and tenderness to the abdomen

Question 62

A 66-year-old female patient was involved in a vehicle rollover. While evaluating her abdomen, which one of the following abdominal assessment parameters should you be least concerned about?

A) Rigidity
B) Distention
C) Guarding
D) Bowel sounds

Question 63

When performing the secondary assessment, the EMT would find which one of the following injuries first?

A) Deformity to the left thigh
B) Bruising to the abdomen
C) Unstable pelvis
D) Decreased pulse in the left foot

Question 64

Assessment of a patient's neck reveals that the trachea is deviated to the left. Based on this assessment finding, the EMT should suspect an injury located to the patient's:

A) chest.
B) abdomen.
C) cervical spine.
D) head.

Question 65

You are performing a secondary assessment and are assessing your patient's chest. Which one of the following findings do you associate most with fracture of the ribs?

A) Ecchymosis to the chest wall
B) Decreased breath sounds
C) Paradoxical chest wall motion
D) Jugular venous distention

Question 66

The "S" in SAMPLE stands for:

A) Significance
B) Severity
C) Sign
D) Seriousness

Question 67

A 62-year-old female was struck by a car traveling approximately 45 miles per hour. After being struck, she was thrown 15 feet onto the sidewalk, impacting the pavement with her head and chest. The primary assessment has been completed and life threats addressed. The patient's husband is by her side. When performing the secondary exam on this patient, which of the following should the EMT perform first?

A) Examine the head and chest for other life-threatening injuries.
B) Obtain a full set of vital signs including a pulse oximeter reading.
C) Inquire from family if the patient has any past medical history.
D) Assess the patient from head to toe for additional injuries.

Question 68

Which of the following physical findings is least consistent with an injured extremity?

A) Deformities
B) Vomiting
C) Contusions
D) Burns

Question 69

While treating a patient who was assaulted by a mob of angry people in a bar, the EMT finds the patient to be confused, tachycardic, with cool skin and a poor capillary refill. Based on this information, how would you categorize this patient?

A) Stable
B) Potentially unstable
C) Unstable
D) Potential high priority

Question 70

When teaching a group of Emergency Medical Responders (EMRs) about the mechanism of injury, which one of the following points should you stress?

A) The more significant the mechanism of injury, the greater the chance the patient has been injured.
B) The mechanism of injury should not be overly considered since this causes many patients to be over-treated.
C) The mechanism of injury is the sole criteria by which an EMT decides whether or not immediate transport is required.
D) The mechanism of injury can be used to dictate the order in which the primary assessment is conducted.

Question 71

When you assess the lower back of an elderly patient who fell, he grimaces and tells you that it hurts when you palpate the injury site. You should recognize which one of the following conditions?

A) Pain
B) Tenderness
C) Crepitus
D) Ecchymosis

Question 72

When assessing the breath sounds (during a rapid secondary exam) of a critical trauma patient, it is best to auscultate each lung in at least how many places?

A) 2
B) 8
C) 4
D) 6

Question 73

On what patient should the EMT perform a rapid head-to-toe secondary assessment, as opposed to a focused secondary assessment?

A) 22-year-old male who is alert and oriented with a deformed ankle that occurred when he tripped playing basketball and landed hard
B) 36-year-old construction worker who was shot in the hand with a nail gun; the nail remains impaled in his hand and bleeding is minor
C) 24-year-old male with stable vitals who is alert and oriented and is complaining of chest pain secondary to a motor vehicle collision in which the passenger was killed
D) 46-year-old roofer with a history of coronary heart disease, complaining of a burn to his left lower leg after being splashed with hot tar

Question 74

A 44-year-old male was cutting limbs from high in a tree when he fell. He is found to be unresponsive with snoring respirations. His breathing is inadequate at a rate of 8 per minute and his carotid pulse is weak and difficult to locate. Following the primary assessment and initial management of life threats, which of the following actions will the EMT complete while performing the secondary assessment?

A) Obtain vital signs and get a past medical history from the family.
B) Start positive pressure ventilation with a bag-valve mask.
C) Place an oral airway and cervical collar on the patient.
D) Perform a trauma jaw-thrust to open the airway.

Question 75

A 40-year-old male patient has crashed his motorcycle. He complains of pain to his right leg. When palpating his leg, you are assessing for:

A) sensation.
B) crepitation.
C) bruising.
D) rigidity.

Question 76

When assessing breath sounds during the secondary assessment, the EMT shows he is employing a correct technique when he listens:

A) at the left second intercostal space followed by the right second intercostal space.
B) first to the apex and base of the right lung and then to the apex and base of the left lung.
C) to the base of the lung by placing the stethoscope at the third intercostal space laterally.
D) over the left and right lateral wall while instructing the patient to breathe shallowly and fast.

Question 77

Which one of the following assessment findings indicates that the patient has intact motor function in his lower extremities?

A) The skin of his toes is pink and warm.
B) He does not complain of pain to his lower extremities.
C) He can wiggle his toes when instructed.
D) He states that he can feel you touching his toe.

Question 78

When assessing the chest of a patient who was shot multiple times, you find a gunshot wound to the third intercostal space on the left lateral chest. Which one of the following should you do immediately?

A) Check for equality of breath sounds.
B) Initiate positive pressure ventilation with oxygen.
C) Roll the patient and look for an exit wound.
D) Cover the opening with a gloved hand.

Question 79

You are performing a secondary assessment on the unrestrained adult passenger involved in a motor vehicle collision, in which the car rolled end over end several times at a high rate of speed. The patient is responsive to painful stimuli and in a state of shock. When assessing the head, which one of the following is appropriate?

A) Cleaning a laceration to the scalp
B) Checking the pupils with a penlight
C) Performing a blind finger sweep to check the airway
D) Applying pressure to a depressed area of the skull

Question 80

A 41-year-old male patient has fallen from a second-story roof. He is complaining of right leg pain and pain to his pelvic region. When performing the secondary assessment on this patient, which one of the following should the EMT intentionally not perform?

A) Palpation of the patient's abdomen
B) Immobilization to a long spine board
C) Palpation of the pelvic region
D) Transporting the patient supine