Emergency Care Chapter 12 Primary Assessment

Which term refers to the EMT's initial sense of the patient's condition, based on immediate

assessment of the patient's environment, appearance, and chief complaint?

A) General impression

B) Primary assessment

C) Scene size-up

D) Secondary assessment

A) General impression

Which of the following is not part of the general impression?

A) Patient's facial expression

B) Patient's age and sex

C) Position in which the patient is found

D) Patient's past medical history

D) Patient's past medical history

In EMS, what does mental status refer to?

A) The patient's level of awareness of his surroundings

B) Any history of mental illness that the patient may have

C) The patient's general level of intelligence

D) None of the above

A) The patient's level of awareness of his surroundings

In EMS, which of the following best describes the term intervention?

A) Determining if there is a problem

B) Taking steps to correct a problem

C) Creating a permanent record of patient care

D) Decreasing the EMT's liability for negligence

B) Taking steps to correct a problem

Which of the following describes the chief complaint?

A) Reason why the patient summoned EMS

B) Events immediately preceding the call for EMS

C) Overall impression of the patient's condition

D) All of the above

A) Reason why the patient summoned EMS

Which of the following represents the correct order of assessment for the EMT during the

primary assessment from start to end?

A) General impression, mental status, airway, breathing, circulation, patient priority

B) Mental status, general impression, airway, breathing, circulation, patient priority

C) Patient priority, general impression, mental status, airway, breathing, circulation

D) None of the above

A) General impression, mental status, airway, breathing, circulation, patient priority

What is the first thing the EMT does during the primary assessment?

A) Determines transport priority

B) Assesses mental status

C) Opens the airway

D) Forms a general impression

D) Forms a general impression

Which of the following best describes an EMS provider's "sixth sense"?

A) Diagnostic ability

B) General impression

C) Clinical judgment

D) Scene safety

C) Clinical judgment

Which of the following is the purpose of the primary assessment?

A) To detect and treat immediately life-threatening problems

B) To find all of the patient's signs and symptoms

C) To discover trends of improvement or deterioration in the patient's condition

D) To detect dangers to the patient and/or EMS crew

A) To detect and treat immediately life-threatening problems

Which of the following is true concerning the primary assessment?

A) Manual airway maneuvers must be performed on all patients.

B) The EMT should perform a sternal rub on all patients to test for response to painful stimuli.

C) External bleeding will be obvious as you enter the room and initially see the patient.

D) The primary assessment begins by just observing the patient as you enter the room.

D) The primary assessment begins by just observing the patient as you enter the room.

You are at the scene where a 19-year-old female college student has been drinking large

quantities of alcohol throughout the evening. On your arrival, the patient is lying on her back

with no signs of trauma; has vomited; and has slow, wet sounding respirations. Which of the

following should you do next?

A) Determine the respiratory rate.

B) Check for carotid and radial pulses.

C) Assist respirations with a bag-valve-mask device.

D) Open the patient's airway using a head-tilt, chin-lift maneuver.

D) Open the patient's airway using a head-tilt, chin-lift maneuver.

Your patient is a middle-aged man who appears to be in distress and is clutching his chest.

These observations lead you to suspect which type of problem?

A) Choking

B) Cardiac

C) Anaphylaxis

D) Digestive

B) Cardiac

Which of the following techniques is used when formulating the general impression?

A) Detecting odors

B) Listening for unusual sounds

C) Looking for visual clues

D) All of the above

D) All of the above

You find a middle-aged unresponsive man lying prone on the ground near a ladder. You

should:

A) move the ladder out of the way.

B) roll him over to a supine position.

C) pick him up with a scoop stretcher.

D) manually immobilize his head.

D) manually immobilize his head.

Your patient is a 72-year-old female who has "twisted her ankle" coming down some steps.

She is alert and complaining of pain in her right ankle, but she jokes about her "clumsiness."

Which of the following should you do next?

A) Take immediate manual control of the patient's cervical spine.

B) Administer high-concentration oxygen by nonrebreather mask.

C) Determine the presence of a carotid pulse.

D) Ask if the patient has pain anywhere beside her ankle.

D) Ask if the patient has pain anywhere beside her ankle.

Which of the following questions will most likely elicit your patient's chief complaint?

A) What made you call 911 this evening?

B) Do you have any medical problems?

C) How have you been feeling lately?

D) Have you been drinking today?

A) What made you call 911 this evening?

A patient whose mental status can be described as verbal is able to:

A) tell you his or her name, his or her location, and what day it is.

B) respond only to a stimulus such as the EMT rubbing his sternum with his knuckles.

C) talk spontaneously and respond to the EMT's questions.

D) respond to speaking or shouting by opening the eyes.

D) respond to speaking or shouting by opening the eyes.

Which of the following is not true regarding a patient who has a mental status of less than

alert?

A) His brain may not be getting enough oxygen.

B) He is in a state of rapid eye movement sleep.

C) He may not have adequate blood circulation.

D) He requires high-concentration oxygen.

B) He is in a state of rapid eye movement sleep.

The mnemonic AVPU is used to evaluate which of the following?

A) Patient's chief complaint

B) Patient's level of responsiveness

C) Patient's transport priority

D) EMT's general impression of the patient's condition

B) Patient's level of responsiveness

You are approaching a young adult male lying supine on the ground with his eyes closed.

You should:

A) open his airway.

B) ask him if he is okay.

C) expose his chest.

D) feel for a pulse.

B) ask him if he is okay.

Which of the following is not performed during the airway phase of the primary assessment?

A) Head-tilt, chin-lift maneuver

B) Obtaining the respiratory rate

C) Suctioning

D) Insertion of an oropharyngeal airway

B) Obtaining the respiratory rate

Which of the following is not assessed during the breathing phase of the primary

assessment?

A) The depth of respiration

B) The respiratory rate

C) The presence of respirations

D) The pulse oximetry reading

D) The pulse oximetry reading

You enter a room to find a 16-year-old female sitting upright in a chair with her back

straight, leaning forward, and her arms supporting her. She is having a hard time talking to you.

You should suspect:

A) abdominal pain.

B) chest discomfort.

C) allergic reaction.

D) respiratory distress.

D) respiratory distress.

Which of the following presentations would be considered normal during the breathing phase

of the primary assessment?

A) Respiratory rate of 6 with shallow depth

B) Respiratory rate of 28 with adequate depth

C) Respiratory rate of 12 with adequate depth

D) Respiratory rate of 16 with altered mental status

C) Respiratory rate of 12 with adequate depth

In the primary assessment, which of the following is not an acceptable method of assessing

the patient's circulatory status?

A) Assessing the patient's skin color

B) Taking a blood pressure reading

C) Checking a radial pulse

D) Looking for serious bleeding

B) Taking a blood pressure reading

For which of the following patients would capillary refill be a reliable sign of circulatory

status?

A) 24-year-old homeless man who has spent the night outside in the rain

B) 92-year-old man complaining of weakness on his right side

C) 50-year-old woman complaining of chest pain

D) 3-year-old child with a fever and cough

D) 3-year-old child with a fever and cough

During the primary assessment of a responsive adult patient, where should the pulse be

checked?

A) At the radial artery

B) At the femoral artery

C) At the brachial artery

D) At the carotid artery

A) At the radial artery

Your patient is a 42-year-old woman who fell two feet from a ladder and is complaining of

pain in her ankle. Which of the following are you unable to determine from the information

given?

A) Chief complaint

B) Airway status

C) General impression

D) Transport priority

D) Transport priority

Which of the following patients is a high priority for transport?

A) Adult male with dull abdominal pain

B) Adult male with sharp lower back pain

C) Adult male with a headache

D) Adult male with difficulty breathing

D) Adult male with difficulty breathing

You are approaching a 16-year-old male with bright red spurting blood coming from his leg.

He is screaming and he begs you to help him. You should:

A) control the bleeding.

B) ask him to calm down.

C) assess his airway.

D) apply oxygen.

A) control the bleeding.

You find a teenage male lying supine in his bedroom. You hear gurgling sounds from the

patient's mouth and see vomit with pill fragments on the floor. You should:

A) ventilate with oxygen.

B) suction the airway.

C) identify the pills.

D) perform chest thrusts.

B) suction the airway.

Which of the following is the most reliable means of determining whether a patient has any

immediately life-threatening conditions?

A) Systematic approach to assessment

B) Obtaining a detailed medical history

C) Thorough scene size-up

D) Use of intuition

A) Systematic approach to assessment

Which of the following is a good indication of a partially occluded airway?

A) The patient is crying loudly.

B) The patient is speaking clearly.

C) The patient is alert.

D) The patient has snoring respirations.

D) The patient has snoring respirations.

You have arrived on the scene at a high school football field where a 17-year-old male is

lying on the ground. He is unresponsive and cyanotic, and he is making obvious respiratory

effort without moving adequate amounts of air. Which of the following should be done first?

A) Assist ventilations with a bag-valve-mask device and supplemental oxygen.

B) Open the patient's airway using a manual maneuver.

C) Apply high-concentration oxygen by nonrebreather mask.

D) Insert a nasopharyngeal or oropharyngeal airway.

B) Open the patient's airway using a manual maneuver.

Your patient is a 33-year-old man who has been ejected from his vehicle during a high-speed

collision. During your primary assessment it is discovered that he is not moving, does not appear

to have adequate respirations, and has suffered moderate external bleeding. Which of the

following should be done first?

A) Control the bleeding with direct pressure.

B) Open the airway.

C) Begin bag-valve-mask ventilations.

D) Check the patient's carotid pulse.

B) Open the airway.

Which of the following indicates a possible circulatory problem?

A) Weak, thready pulse that is normal in rate

B) Slow pulse

C) Rapid pulse

D) All of the above

D) All of the above

Which of the following is the correct manner for checking for responsiveness in an

apparently unresponsive infant?

A) Pinching the earlobe

B) Rubbing the sternum with your knuckles

C) Flicking the soles of the feet

D) Shaking the child

C) Flicking the soles of the feet

What is a normal capillary refill time in a pediatric patient?

A) 3 seconds

B) 1 minute

C) 5 seconds

D) less than 2 seconds

D) less than 2 seconds

Which of the following is the proper position for maintaining the airway in a child with a

decreased level of consciousness?

A) Hyperextension of the neck; placing a pillow under the back if necessary

B) Placing the head and neck in a neutral position; using a folded towel under the shoulders if

necessary

C) Flexing the neck to place the chin on the chest; placing a folded towel under the back of the

head if necessary

D) Using a cervical collar to keep the chin elevated

B) Placing the head and neck in a neutral position; using a folded towel under the shoulders if

necessary

Which of the following differences should be expected when assessing a pediatric patient, as

compared to an adult patient?

A) The normal pulse rate is slower.

B) Capillary refill is not as reliable an indicator of circulatory status.

C) The normal respiratory rate is faster.

D) An adult's tongue is proportionally larger than that of a child and should always be considered

as a potential airway obstruction.

C) The normal respiratory rate is faster.

During the primary assessment of an unresponsive two-month-old infant, which pulse should

be palpated?

A) Brachial

B) Carotid

C) Umbilical

D) Radial

A) Brachial

Which of the following findings is generally not used to assess an adult's circulation?

A) Patient's skin color, temperature, and condition

B) Patient's distal pulse rate

C) Evaluation for bleeding

D) Patient's capillary refill time

D) Patient's capillary refill time

You are approaching an adult female lying supine on the ground with snoring respirations.

You should:

A) open her airway with a jaw-thrust maneuver.

B) insert an oropharyngeal airway.

C) insert a nasopharyngeal airway.

D) ventilate with a bag-valve mask.

A) open her airway with a jaw-thrust maneuver.