Module 3 Exam Study Guide (248 terms - in depth)

You determine a​ patient's radial pulse is readily​ palpable, but has uneven intervals between beats. This finding would best be documented on the prehospital care report​ as:

Strong and irregular

Which of these would be an indication to palpate the blood​ pressure?

Noisy environment

Which of these patients should the EMT recognize as having a normal skin​ temperature?

A​ 36-year-old male complaining of nausea with warm skin

A​ 43-year-old female has accidentally taken too much of her antidepressant medication and is now confused. Emergency Medical Responders are on scene and providing the patient with​ high-concentration oxygen. As you arrive at the​ patient's side, your first action should be​ to:

Perform a primary assessment

You are observing a new EMT just hired by your EMS agency. You know he has correctly positioned the blood pressure cuff on the​ patient's arm​ when:

The cuff is on the same level as the​ patient's heart

The EMT is correct when he makes which of these statements about assessment of the​ pupils?

​"Some people naturally have unequal​ pupils, but both should react to​ light."

For which of these patients would a capillary refill time of 3 seconds be most indicative of poor​ perfusion?

A​ 4-year-old male

Which of these statements is true regarding vital signs obtained from a patient with nausea and​ vomiting?

The vital signs will help the EMT determine the relative stability or instability of the patient

A mother has called 911 because her​ 2-year-old daughter is fussy and not eating. When assessing the​ toddler, what would be the best indication of her perfusion​ status?

Skin color and temperature

An EMT has an accurate understanding of systolic blood pressure when he tells you that systolic blood pressure​ is:

Produced when the heart contracts

Your partner is having a difficult time determining normal and abnormal blood pressures for a child. Which of these statements will help him​ most?

​"A minimally acceptable systolic pressure can be estimated by doubling the​ child's age and adding it to​ 70."

After you apply the pulse oximeter to a patient who complains of chest​ discomfort, she asks you what you are assessing. You would respond by telling her that the pulse​ oximeter:

Provides information about the amount of oxygen circulating in the blood

A family has called 911 for a​ 41-year-old male family member whom they cannot wake up. They state he has been threatening to kill himself and believe that he may have intentionally overdosed on his pain medications. As you enter the​ patient's bedroom, you observe him supine on the floor with his eyes closed. As he​ breathes, you hear snoring respirations. As a knowledgeable​ EMT, you recognize that this condition is likely caused​ by:

The tongue partially blocking the airway

An alert and oriented​ 87-year-old female patient has fallen and suffered a​ 3-cm laceration to the back of her head. According to the​ patient, her walker became caught in the​ carpet, causing her to trip. When obtaining a medical​ history, who should the EMT address​ first?

The patient

A​ 41-year-old male patient reacts to painful stimuli by moaning. You shine a light at his right pupil​ only, while looking at both pupils. What would be a normal​ finding?

Constriction of the right and left pupils

You are attempting to get a history from a​ 56-year-old female patient who is short of breath. When you ask​ questions, the daughter continually answers for the patient. To best handle this​ situation, you​ should:

Explain to the daughter it is important for the patient to answer whenever possible

Assessment of a patient who is unresponsive reveals pupils that are both large at 6 millimeters and do not change size in response to light. The EMT would best document this finding​ as:

Bilateral dilation of the​ pupils, unresponsive to light

You are called to a​ long-term care facility to assess and transport a patient with a high fever. You do not have a thermometer on your unit. Which alternative sign should you use to confirm the​ patient's increased body​ temperature?

Skin on the abdomen that is hot and flushed

An EMT student asks you if it matters whether the blood pressure cuff seems too small for a​ patient, if a reading can still be obtained. You should​ respond:

​"Cuffs that are too small provide inaccurately high​ readings."

Which of these is an example of an​ open-ended question?

​"Why did you call​ 911?"

A patient presents with extremely pale skin. His family states that this is not his normal skin color. His vital signs are​ pulse, 118;​ respirations, 18​ breaths/min; blood​ pressure, 102/86​ mmHg; and​ SpO2, 96%. Which complaint would make the most sense given this clinical​ presentation?

Rectal bleeding

You cannot obtain a reading on the pulse oximeter after applying the sensor to the​ patient's finger. What would be the most common reason for this​ difficulty?

The​ patient's hands are cold

A pulse oximetry reading obtained on room air is considered normal when it​ is:

Greater than 97 percent

You have arrived by the side of a cyanotic patient who is responsive only to painful stimuli and exhibiting stridorous respirations. What is the most appropriate action by the​ EMT?

Provide positive pressure ventilation with supplemental oxygen

When assessing a​ patient's pulse, you can locate the right radial​ pulse, but not the left. What is the most likely explanation for this​ finding?

The left radial artery may be occluded

A patient states that he is short of​ breath, is​ light-headed, and has chest pain that worsens when he takes a deep breath. Assessment reveals an open​ airway, adequate​ breathing, and a rapid pulse of 120​ beats/min. The​ patient's skin is hot to the​ touch, and he has a blood pressure of​ 116/84 mmHg. The patient informs you that he was diagnosed with pneumonia 3 days ago and has not been taking the prescribed antibiotics. Which of these assessment findings would the EMT best recognize as a sign related to the​ patient's chief​ complaint?

Blood pressure of​ 116/84 mmHg

A young female patient has been stung by a bee and complains that her​ "throat is closing​ up." She states that she is allergic to bee​ stings; the last time this​ happened, she had to have a​ "tube put into my​ windpipe." She is struggling to breathe and can speak only a few words at a time. Knowing that allergic reactions can cause swelling in the pharynx and the​ larynx, what airway sound would indicate that the patient indeed has swelling in this​ area?

Stridor

You have assisted the patient in taking one of his nitroglycerin tablets due to​ cardiac-type chest pain. Five minutes​ later, you note the​ patient's blood pressure is​ 108/74 mmHg. To determine if the nitroglycerin has affected the blood​ pressure, the EMT​ should:

Compare this finding to the baseline blood pressure

Which of these pieces of information would be obtained by the EMT when getting a history using the SAMPLE​ mnemonic?

Sensation of dizziness prior to falling

The EMT understands the primary reason to obtain a medical history using the SAMPLE mnemonic when he​ states:

​"After performing the primary​ assessment, the SAMPLE mnemonic helps guide the EMT in further assessment and​ care."

Friends called 911 for a​ 37-year-old female who intentionally overdosed on a narcotic drug at a college party. Which​ eye-related findings would reinforce that the patient did indeed take a​ narcotic?

Pupils that are constricted

Which of these questions would be asked when obtaining a medical​ history, using the SAMPLE​ mnemonic, for a female patient who is crying and complaining of​ dizziness?

​"What were you doing when the dizziness​ started?"

Which of these statements made by a patient would the EMT regard as a​ symptom?

​"My pain is​ sharp, the worst​ I've ever​ felt."

The purpose of the OPQRST mnemonic is to guide the EMT​ in:

Exploring the​ patient's chief complaint

When you are applying the pulse oximeter sensor to a​ patient's finger, he asks you what this device is for. Your response would​ be:

​"It measures the amount of oxygen being carried by your blood​ cells."

Which of these statements made by your EMT partner indicates that he understands assessment of a​ patient's breathing?

​"A rate less than 8 times per minute may allow adequate​ breathing, but requires further evaluation and​ assessment."

To assess a​ patient's blood​ pressure, the EMT will need​ a:

Sphygmomanometer

The EMT is correctly calculating a​ patient's respiratory rate when he or​ she:

Counts the number of breaths for 30 seconds and multiplies by 2

When obtaining a blood pressure for a​ patient, the radial pulse disappears when the gauge reads 130 mmHg. When deflating the​ cuff, the EMT hears a pulse at 118 mmHg. The pulse disappears at 76 mmHg. Given​ this, which of these statements is​ true?

The systolic blood pressure is 118 mmHg

The EMT is correctly palpating a central pulse when he palpates​ the:

Femoral pulse

Your EMT student has a good understanding of​ end-tidal carbon dioxide monitoring when she​ states:

​"Any disturbance to the​ breathing, circulation, or metabolic state of the patient can alter the​ reading."

To test a pediatric​ patient's capillary​ refill, the EMT​ will:

Firmly compress and then release pressure on the nail bed

When obtaining a medical history using the SAMPLE​ mnemonic, which of these statements relates to the​ "P" component?

​"There is a history of​ pancreatitis."

An EMT has accurately checked the skin color of a​ dark-skinned patient. How would this finding be best documented on a patient care​ report?

​"Pale color noted to the​ conjunctiva."

You are assessing a​ 61-year-old male patient who is confused. During the primary​ assessment, you cannot locate a radial pulse. Your immediate action should be​ to:

Check for a carotid pulse

Which of these blood pressures represents diastolic hypertension in an adult​ patient?

​136/92 mmHg

A patient has advanced liver disease from years of exposure to toxic chemicals in his place of employment. Which skin color would the EMT expect given this​ status?

​Yellow-orange

A patient who appears to be intoxicated has fallen and is complaining of pain to his right arm. He is loud and using profane language. What should be your initial approach to the​ patient?

​"Let me put an ice pack on your wrist. It will help it feel​ better."

A​ 69-year-old man complains of weakness to the left arm and leg. He also states that he is nauseated and has a headache. The​ patient's past medical history includes stroke and diabetes. In relation to this​ information, which of these statements is​ true?

The headache is a symptom related to the chief complaint

You and a paramedic partner are caring for a patient who overdosed on a drug that has caused her to become apneic. Your EMT student is providing BVM ventilations with supplemental oxygen via an endotracheal tube placed by the paramedic. The patient still has a good pulse and acceptable blood pressure. The pulse oximeter reads​ 95% and the ETCO2 monitor reads 28 mmHg. Given these​ findings, the EMT​ should:

Ask the EMT student ventilating the patient to slow the ventilatory rate

You are caring for a​ 5-year-old male patient with a complaint of difficulty breathing. Your assessment indicates that the patient is tachypneic with labored breathing. While gaining more information about the​ patient's respiratory​ function, which finding would you recognize as most​ important?

Skin retractions between the ribs during inhalation

A patient with liver cancer exhibits a yellow discoloration to his entire body. The EMT would correctly document this condition​ as:

Jaundice

An obese female patient has called you with a complaint of abdominal pain. The regular adult cuff will not fit around her​ arm, so you retrieve the large adult cuff from your supplies.​ Embarrassed, the woman​ says, "My arm is so fat. Do you really need to roll up my sleeve to get my blood​ pressure?" Your best response would​ be:

​"I am not concerned with the size of your arm. I am interested in your blood​ pressure."

During the primary assessment of a geriatric patient complaining of shortness of breath and​ fever, you quickly locate the radial pulse. What should you do​ next?

Determine the rate and quality of the pulse

A patient who was shoveling snow developed chest​ pain, immediately sat down in a nearby bus​ shelter, and called 911. Prior to moving him into the​ ambulance, your partner performs a primary assessment and reports that the​ patient's capillary refill is 5 seconds. Which of these would be an appropriate statement for you to​ make?

​"The cold temperature may cause the capillary refill to be 5​ seconds; we should assess​ further."

You observe your partner correctly obtaining a​ patient's blood pressure when​ he:

Deflates the cuff 2 mmHg per second while listening with a stethoscope

Which of these descriptions would be obtained when asking about the​ "A" component of the SAMPLE​ history?

Allergy to penicillin

A female patient with a history of asthma called 911 with a complaint of shortness of breath. On​ scene, you assisted her with the administration of her​ metered-dose inhaler containing albuterol. What can the EMT do to best determine if this​ patient's condition is​ improving?

Obtain a pulse oximetry reading and breath sounds every 5 minutes

You have applied the pulse oximeter to a​ 73-year-old male patient who complains of weakness and heart palpitations. Your partner reports that the​ patient's breath sounds are clear and​ equal, with a respiratory rate of 16​ breaths/min and skin that is warm but pale in color. He then states the following vital​ signs: pulse,​ 92; blood​ pressure, 168/70​ mmHg; and​ SpO2, 92% on room air. Given this​ information, which of these instructions would be most​ appropriate?

​"Let's initiate oxygen at 2 liters per minute via a nasal​ cannula."

A patient with chest pain informs you that the pain is greater when he takes a deep breath. The EMT is using the active listening technique of​ "facilitation" and​ "clarification" when he responds by​ saying:

​"I see. Can you describe what the pain feels​ like?"

You are assessing a patient who is in bright sunlight after collapsing in the hot sun at a picnic. If you cannot immediately move the patient out of the​ sun, assessment of the pupils will be made more accurate​ by:

Shading the​ patient's eyes

You have placed the blood pressure cuff on the arm of a patient who is short of breath. What is your next​ step?

Inflate to a reading of 70​ mmHg, check for a radial​ pulse, and continue inflation until the pulse is no longer felt

An​ 86-year-old female patient has called 911 for rectal bleeding. There is a large amount of dark red blood and clots in the toilet and on the​ patient's clothing. The Emergency Medical Responder reports a blood pressure of​ 84/68 mmHg with a heart rate of 124​ beats/min. Given this​ information, the EMT should expect findings​ of:

A narrowed pulse pressure and possible shock

You have been called to assess a conscious and alert​ 5-year-old child whose chief complaint is nausea and vomiting over the last 2 hours. When assessing his​ pulse, you should first check which​ pulse?

Radial

Which of these questions would the EMT ask when using the OPQRST​ mnemonic?

​"Does the pain feel dull or​ sharp?"

A patient presents with skin that is cool to the touch. The EMT shows he understands this condition when he​ states:

​"This may indicate a problem with the​ patient's blood​ circulation."

The EMT is correctly using a noninvasive blood pressure monitor when​ she:

Auscultates a blood pressure before applying and activating the device

When obtaining a blood​ pressure, the EMT listens for a pulse over which blood​ vessel?

Brachial artery

Which of these characteristics would be considered a pulse​ "quality" factor?

Strength

You are called for a​ 2-year-old female child who is sick. When testing her capillary​ refill, what would be the greatest cause for​ concern?

​3-second capillary refill time

You have been dispatched to a residence for a female patient with unknown injuries. At the​ patient's side, you quickly become aware that the​ 43-year-old female was assaulted by her husband. The husband comes into the room and​ states, "Don't you touch​ her, or I will take care of​ you, too!" What should be the​ EMT's immediate​ action?

Leave the house​ immediately, taking the patient with​ you, if possible

A female patient called 911 when she noticed blood in her​ stool, and became scared and anxious. Her pulse rate is 124 and her blood pressure is​ 88/60 mmHg. After you get her vital​ signs, she nervously asks you how they are. Given her​ anxiety, you​ should:

Inform her of the vital signs

What is the name of the pulse that is palpated in the groin​ area?

Femoral

You and a paramedic partner are caring for a patient who overdosed on a drug that has caused her to become apneic. Your EMT student is providing BVM ventilations with supplemental oxygen via an endotracheal tube placed by the paramedic. How often should vital signs be reassessed on this​ patient?

Every 5 minutes

When should the EMT use the pulse​ oximeter?

Routinely on all patients with a medical or trauma complaint

Which of these would indicate a normal pupillary exam has​ occurred?

Both pupils constrict when light is directed into one eye

When using the OPQRST​ mnemonic, the EMT is getting information as it applies to the​ "P" category when she​ asks:

​"Do you feel more short of breath when you are lying​ down?"

When you are obtaining the blood pressure of a patient in a standing​ position, the patient states that he suddenly feels weak and is going to pass out. Your immediate action should be​ to:

Place the patient back into bed

You determine a​ patient's heart rate to be 48​ beats/min. That heart rate would be categorized​ as:

Bradycardic

You are transporting a depressed patient who states that she is thinking of killing herself by taking a​ "whole bunch of​ pills." After providing this​ information, the patient has refused to speak and has remained silent. Your physical assessment of the patient reveals she is stable. How often should vital signs be​ reassessed?

Every 15 minutes

You are transporting a depressed patient who states that she is thinking of killing herself by taking a​ "whole bunch of​ pills." After providing you this​ information, the patient has refused to speak and has remained silent. Your physical assessment of the patient reveals she is stable. Which of these statements would be most appropriate for you to make at this​ time?

​"I understand if you do not want to talk. I will be sitting here if you need​ anything."

In patients with which of these conditions would the EMT most likely get an inaccurate pulse oximeter reading despite proper application of the​ sensor?

Low blood pressure

When using the SAMPLE​ mnemonic, which of these statements made by the patient would be categorized under the letter​ "M"?

​"I take​ Zocor, but I am not sure​ why."

When using a pulse oximeter on an adult​ patient, the EMT knows that the sensor is most often attached to the​ patient's:

Finger

You have been dispatched to a residence for a​ 14-year-old female patient complaining of abdominal pain. As you enter the living​ room, you see the conscious patient lying on a couch with her father and an Emergency Medical Responder at her side. Which action should the EMT perform​ first?

Introduce yourself and your partner

Which of these patient descriptions contains only vital​ signs?

​Skin, warm and​ dry; heart​ rate, 74​ beats/min; pupils equal and reactive

Assessment of a​ patient's skin color reveals a bluish discoloration. As a knowledgeable​ EMT, you should​ identify:

Cyanosis caused by inadequate oxygenation of the tissues

You believe a patient for whom you are caring is starting to experience respiratory failure. Which of these findings is supportive of this​ suspicion?

ETCO2 of 56 mmHg

Your partner reports that a​ patient's blood pressure is​ 156/78 mmHg. From this​ reading, you​ realize:

The diastolic blood pressure is 78 mmHg

An EMT is correctly assessing a​ patient's radial pulse when​ he:

Uses his fingertips to feel for a pulse on the anterior and lateral aspects of the​ patient's wrist

Emergency Medical Responders inform you that a​ 27-year-old male patient with altered mental status has an open airway and is breathing 9 times every 30 seconds. His pulse rate is 40​ beats/min, and he has bruises to his chest. Based on this vital sign and presentation​ information, the EMT should recognize​ the:

Respiratory rate as normal

While reviewing a patient care report for a quality assurance​ process, the EMT should recognize that a blood pressure has been palpated when she​ sees:

178​ / P

Your partner states that he wants to palpate the blood pressure. Which equipment would you hand​ him?

Blood pressure cuff

You are trying to get a pulse oximeter reading on an​ 18-month-old child with difficulty breathing. Every time you place the sensor on the​ child's finger, he becomes upset and removes it. What is your best course of​ action?

Place the sensor on the​ child's toe

Which of these patients should the EMT recognize as tachycardic for his or her age​ bracket?

A​ 37-year-old male with a complaint of fatigue and a heart rate of 104

When assessing a patient who does not speak the same language as you or your​ partner, the best approach in the immediate care of the patient is​ to:

Request that a family member act as an interpreter

Medical direction has asked that you obtain orthostatic vital signs for a​ 54-year-old female patient who complains of dizziness and weakness. Her baseline vital signs obtained while she was sitting in a chair were​ pulse, 84;​ respirations, 26​ breaths/min; blood​ pressure, 118/62​ mmHg; and​ SpO2, 95%. Which one set of vital signs upon reassessment would indicate that this patient has a positive orthostatic​ test?

Standing blood pressure of​ 92/54 mmHg and heart rate of 106​ beats/min

You are assessing a female patient with a complaint of shortness of breath. When assessing her​ skin, which finding should be recognized as​ abnormal?

Moist

You are unable to auscultate a blood pressure in a​ patient's right arm. What should you do next to obtain the most accurate baseline assessment of this​ patient's vital​ signs?

Auscultate the blood pressure in the left arm

How should the EMT document a pulse oximetry reading on the prehospital care​ report?

​97% SpO2