Question 1

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?

Accepted Answer

Yellow-orange skin color is indicative of jaundice, which is commonly seen in liver disease due to the accumulation of bilirubin. None of the other listed diseases are known to cause yellow-orange skin.

Question 2

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

Accepted Answer

A warm, pink, and dry skin indicates normal circulation and perfusion. In shock, the skin would typically be cool and clammy. A fever could cause warm skin, but there would likely be other symptoms present such as sweating or a high temperature. Poor oxygenation would result in cyanosis or pallor, not a warm and pink appearance.

Question 3

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:

Accepted Answer

The answer of You must check the circulation of an...

Question 4

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?

Accepted Answer

After finding no life threats during the primary assessment, the first action in the secondary assessment should be to reevaluate the mechanism of injury to identify any hidden injuries or potential complications. This can help guide further assessment and treatment. Reassessing mental status, ensuring airway patency, and applying supplemental oxygen may be necessary interventions, but they are not the first step in the secondary assessment process.

Question 5

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?

Accepted Answer

In a trauma situation, especially with a mechanism of injury like a motor vehicle crash, spinal precautions are a priority. Taking manual in-line spinal stabilization is crucial to prevent further spinal injury.

Question 6

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

Accepted Answer

The patient complaining of leg pain for a week is considered the lowest priority as their symptoms have been present for a longer period of time and do not indicate an immediate life-threatening condition. The other patients all have symptoms that require more urgent attention.

Question 7

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

Accepted Answer

A capillary refill time of 2 seconds is considered normal for children of all ages, including 5-year-olds. A capillary refill time of 3 seconds may indicate poor peripheral perfusion, while a time of 4-6 seconds may indicate shock or dehydration.

Question 8

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:

Accepted Answer

The immediate priority in this situation is to control the bleeding, so applying direct pressure to the laceration is the best choice. Providing high-concentration oxygen and treating for shock should also be done as soon as possible, but controlling the bleeding takes priority. Determining the carotid pulse and assessing the airway and breathing should be done after the bleeding is under control.

Question 9

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

Accepted Answer

Cool and moist skin can be a sign of significant medical problems, such as shock or hypothermia. This finding should concern the EMT and prompt further assessment and interventions.

Question 10

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?

Accepted Answer

The purpose of the primary assessment is to identify and treat life-threatening conditions. This includes assessing the patient's airway, breathing, and circulation, as well as identifying any significant bleeding or injuries that require immediate intervention. While establishing a chief complaint and gathering past medical history may be part of the assessment, the primary goal is to address any life-threatening issues first. Determining if the patient's vital signs are stable and performing an exam focused on the chief complaint would typically come after the primary assessment has been completed.

Question 11

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

Accepted Answer

Capillary refill time can be unreliable in elderly and diabetic patients due to decreased capillary density and peripheral vascular disease. Skin color, temperature, and pulse strength may also be affected by circulatory status, but they are generally more reliable indicators.

Question 12

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

Accepted Answer

Examining the lining of the lips and mouth is the best way to determine if a patient is cyanotic, as this area is typically the first to show signs of oxygen deprivation. Pressing and releasing the skin on the palm, looking at and feeling the skin on the back of the hand, and inspecting the skin on the fingers and nail beds are all methods to check for dehydration and other conditions, but they are not specific to determining if a patient is cyanotic.

Question 13

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:

Accepted Answer

The patient's symptoms of difficulty breathing, intercostal retractions, and nasal flaring indicate dyspnea, which is a subjective experience of breathing discomfort. The breathing rate of 18 breaths per minute is within the normal range for an adult, so the terms apneic (no breathing), tachypneic (rapid breathing), and bradypneic (slow breathing) do not apply.

Question 14

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?

Accepted Answer

The EMT is performing a focused assessment, which involves a detailed examination of a specific area or injury of concern (in this case, the left hand).

Question 15

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

Accepted Answer

The correct understanding of capillary refill is demonstrated with choice D, which states that a capillary refill test for a child must be assessed at room temperature and be less than 2 seconds to be considered normal. Capillary refill is a measure of peripheral perfusion and indicates how well blood is flowing to the capillaries. A delay in capillary refill time may indicate inadequate perfusion, which can be a sign of shock or other serious medical conditions. Capillary refill time is typically assessed by applying pressure to a finger or toe until it blanches and then releasing the pressure, observing how long it takes for the color to return. A normal capillary refill time is usually less than 2 seconds in adults and less than 2-3 seconds in children.

Question 16

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

Accepted Answer

Vomitus in the airway can cause obstruction, which needs to be cleared before further assessment or intervention. Suctioning the airway is the appropriate next step to clear the vomitus and ensure the airway is patent. Only after clearing the airway can you proceed with assessing breathing, providing positive pressure ventilation, and administering supplemental oxygen if necessary.

Question 17

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:

Accepted Answer

The fast and weak radial pulse, cool skin, and prolonged capillary refill time are all indications of poor perfusion.

Question 18

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

Accepted Answer

Forming the general impression is a part of the primary assessment, which is the first phase of patient assessment. During this phase, the EMT will make quick observations to determine the overall condition of the patient, which includes forming a general impression based on their appearance, behavior, and level of distress.

Question 19

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

Accepted Answer

A capillary refill time of 3 seconds or less is considered normal for an adult female. Therefore, the correct answer is A.

Question 20

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:

Accepted Answer

Hot, dry skin is a common sign of heat exposure, which can be a serious medical emergency if not promptly treated. It is important to move the patient to a cool and shaded area, remove excess clothing if possible, and provide them with water to drink.

Quiz 13: Patient Assessment