Prehospital Emergency Care Chapter 13 Patient Assessment

65) For which of these patients should the EMT perform a rapid head-to-toe secondary assessment, as opposed to a focused secondary assessment?

A) 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) A 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) A 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) A 46-year-old roofer with a history of coronary heart disease, who complains of a burn to his left lower leg after being splashed with hot tar

Answer: C

1) When assessing a sick or injured patient, which of these indicates the appropriate order in which this assessment should occur?

A) Primary assessment; reassessment, and secondary assessment

B) Scene size-up, secondary assessment, and primary assessment

C) Scene size-up, primary assessment, and secondary assessment

D) Scene size-up, history, secondary assessment, and primary assessment

Answer: C

2) You have been dispatched to a residence for an 89-year-old female patient with a nonspecific complaint. When assessing this patient, what should you do first to develop an initial impression regarding emergency?

A) Obtain the patient's vital signs and current medications

B) Gather a medical history including allergy information

C) Contact medical direction for advice

D) Determine whether the complaint is medical or trauma related

Answer: D

3) Which of these statements made by the EMT indicates that he has appropriately initiated the first phase of 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?"

Answer: B

4) You arrive at the scene of a fall, where a 42-year-old woman fell backward off a stepladder while cleaning her kitchen windows. She is seated on the floor and complains 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, what can you conclude?

A) The patient 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: A

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

Answer: A

6) 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."

Answer: D

7) 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 knows his name but cannot remember the date, what happened, or where he is. This patient's mental status can best be described as:

A) Alert but confused.

B) Lethargic and agitated.

C) Obtunded and altered.

D) Agitated and verbally disoriented.

Answer: A

8) An Emergency Medical Responder informs you that a 59-year-old female patient is responsive to verbal stimuli. What would be the most accurate representation of this status?

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 open them if you call her name.

D) She is awake, but having difficulty telling you her name and where she is.

Answer: C

9) A 36-year-old patient who has overdosed on an unknown drug presents in a seemingly unresponsive state as you walk into the room. Given this, what should you do next given the options listed?

A) Check the patient's vital signs

B) Assess the patient's mental status

C) Determine whether a radial pulse is present

D) Ask bystanders which drug was taken

Answer: B

10) Which of these patients would be classified as unresponsive?

A) A 39-year-old-female who is confused

B) A 52-year-old male who cannot answer your questions

C) A 70-year-old female who has experienced a stroke

D) A 46-year-old-male who does not respond when his fingers are pinched

Answer: D

11) 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) Identify the child as unresponsive.

Answer: B

12) An EMT is assessing a 9-month-old infant who is "not acting right" per his mother. Assessment reveals the child to be extremely irritable, crying weakly, and resistant to being touched by the EMT. Which description best describes this infant's mental status?

A) Alert

B) Lethargic

C) Verbal

D) Obtunded

Answer: A

13) You are by the side of a patient who complains of shortness of breath and has a history of heart problems, including congestive heart failure (CHF). When assessing the airway, which of these observations best indicates that it is still patent?

A) The patient easily tells you that she is having chest pain.

B) The patient is sitting in an upright position because she cannot lie flat.

C) The patient can speak only in extremely short sentences.

D) The patient is lethargic and confused to person, place, and time.

Answer: A

14) As you arrive by the side of an 84-year-old unresponsive female patient, 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.

Answer: D

15) On scene, you find a 91-year-old female patient who fell down two steps after suddenly complaining of a severe headache. She is unresponsive with gurgling respirations and bradypnea. Which instruction should you immediately give your partner after manual spinal motion restriction is applied?

A) "Please perform the head-tilt, chin-lift maneuver to open the airway."

B) "Initiate positive pressure ventilation with supplemental oxygen at a rate of 10 ventilations per minute."

C) "Let's move her to the stretcher and get moving to the hospital."

D) "Get the suction out and clear out her airway."

Answer: D

16) A 26-year-old male patient 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) Logroll him into supine position.

D) Place an oral airway

Answer: C

17) A conscious and alert 64-year-old female patient 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. Her daughter on scene advises you there is a history of blood clots in the lungs of her family, and she is scared and would like her mother to be evaluated. Which of these steps should you take first?

A) Consider administering oxygen to the patient

B) Determine the adequacy of the patient's breathing

C) Place the patient on the stretcher for transport

D) Perform a secondary assessment on the patient

Answer: B

18) You are an assistant instructor for 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, allowing air to enter."

C) "It stimulates the patient to begin taking deeper breaths, thereby moving air into the lungs."

D) "It opens the airway by relaxing and expanding the size of the throat."

Answer: A

19) To manually provide spine motion restriction of 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

Answer: C

20) 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

Answer: D

21) Which of these patients would the EMT identify as having the most adequate breathing, free from any respiratory distress?

A) A 61-year-old confused female breathing at a rate of 8 breaths/min

B) A 34-year-old male with abdominal pain who is alert and oriented with good chest rise and fall

C) A 19-year-old male breathing 16 times per minute with slight wheezing in the lungs

D) A 67-year-old female breathing 26 times per minute with good chest rise and fall

Answer: B

22) The EMT would recognize which of these patients as having a normal breathing rate?

A) An 8-year-old male breathing 24 times per minute

B) A 44-year-old male breathing 6 times per minute

C) A 6-month-old infant breathing 58 times per minute

D) A 22-year-old female breathing 26 times per minute

Answer: A

23) Which finding individually would most likely indicate that a patient is breathing inadequately?

A) An SpO2 of less than 94%

B) A respiratory rate of 20 breaths/min in an adult

C) Numbness and tingling of the fingers and toes

D) Shortness of breath during exercise

Answer: A

24) You have been called to the side of a 37-year-old female patient whose chief complaint is confusion, anxiety, and chest tightness. Assessment shows her airway to be patent, respirations are 46 breaths/min, heart rate is 134 beat/min, blood pressure is 128/54 mmHg, and SpO2 is 93%. In regard 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.

Answer: C

25) 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.

Answer: C

26) The patient's family states that their 11-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 metereddose inhaler with some relief, but this morning, they found her lethargic and struggling to breathe. Your assessment reveals the patient to be responsive to verbal stimuli with an open airway and shallow respirations of 46 breaths/min. You hear minimal wheezing in both lungs. What is your immediate action in caring for this patient?

A) Insert an oral airway

B) Apply a nonrebreather mask

C) Position her on her side

D) Start positive pressure ventilation

Answer: D

27) 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. The patient still has a weak carotid pulse. Which instruction should you immediately give to your partner?

A) "Let's attempt placement of an OPA or NPA and start ventilations."

B) "Please check the patient's blood pressure and apply the pulse oximeter."

C) "Go ahead and apply the automated external defibrillator."

D) "We will need to start cardiopulmonary resuscitation."

Answer: D

28) You arrive on the scene of a motor vehicle collision and are presented with a patient who complains of chest pain after striking his chest on the steering wheel. On-scene Emergency Medical Responders are maintaining cervical spine motion restriction manually. The patient is alert and oriented and has a patent airway. His respirations are 24 breaths/min with good chest rise and fall, and his skin is warm and dry. He describes some shortness of breath, his heart rate is 96 beats/min, and his SpO2 is 92% on room air. At this time, you should:

A) Apply a cervical collar.

B) Provide oxygen via nasal cannula at 2−4 liters per minute.

C) Obtain a blood pressure and medical history.

D) Start positive pressure ventilation.

Answer: B

29) Which characteristic regarding breathing rates must the EMT remember when assessing the respirations of a pediatric patient?

A) Respirations in a pediatric patient are similar to those of an adult.

B) Respirations in a pediatric patient are typically slower than those of an adult.

C) Respirations in a pediatric patient are not significant in the assessment of breathing adequacy.

D) Respirations in a pediatric patient are usually faster than those of an adult.

Answer: D

30) A 28-year-old female patient has fallen 20 feet from the roof a house where she was standing to watch fireworks from a nearby park. 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 motion restriction

C) Start positive pressure ventilation after placing an OPA or NPA

D) Open her airway and assess her circulation

Answer: B

31) You have just determined that a 92-year-old female patient found in bed is unresponsive, but still has a carotid pulse. Your next action would be to:

A) Open the airway manually.

B) Check for a radial pulse.

C) Determine the past medical history.

D) Immediate transport.

Answer: A

32) Near the end of a workday, a construction worker fell 10 feet from scaffolding, landing on his head and left shoulder. He is found to be spontaneously alert, but confused. 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 initially classify him as which kind of patient?

A) Trauma

B) Trauma and behavioral

C) Medical and trauma

D) Medical, trauma, and behavioral

Answer: A

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

A) Indicates whether 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.

Answer: B

34) Which of these patients should receive oxygen via an oxygenation adjunct such as an NRB or nasal cannula?

A) A 39-year-old male with a sprained ankle who is breathing 16 times per minute

B) An 18-year-old female who overdosed on a drug and is unresponsive and breathing 4 times per minute

C) A 42-year-old female who is confused, weak, and dizzy, and adequately breathing 14 times per minute

D) A 61-year-old male who is unresponsive, with a foreign body airway obstruction that cannot be removed with abdominal thrusts

Answer: C

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

A) Carotid pulse, capillary refill, blood pressure, and skin color.

B) Radial and/or carotid pulse, skin characteristics, 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.

Answer: B

36) You cannot locate a radial pulse on a 54-year-old male patient who is alert, confused, and breathing adequately. What 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

Answer: D

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

A) To calculate the precise heart rate

B) To decide whether the breathing is adequate

C) To determine the presence of a heartbeat

D) To establish whether the patient requires oxygen

Answer: C

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

A) Carotid

B) Femoral

C) Radial

D) Brachial

Answer: C

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

A) Temporal

B) Radial

C) Femoral

D) Brachial

Answer: D

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

A) Evaluate the pulse before examining the breathing

B) Check for the presence of a pulse in the brachial artery

C) Move the patient to the ambulance before performing the primary assessment

D) Obtain a blood pressure when checking the patient's circulation status

Answer: B

41) 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.

Answer: A

42) 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 and a large hematoma on his head. The patient was removed from the car by bystanders and appears confused. What should you do immediately?

A) Assess and open the airway

B) Take manual in-line spine motion restriction

C) Apply direct pressure to the bleeding

D) Provide supplemental oxygen

Answer: B

43) An intoxicated 19-year-old female patient 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 on her opposite arm that is still 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.

Answer: C

44) 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 disease revealed to you during the history would best correlate to this patient's skin, and would this likely infer the patient has a medical problem or a traumatic injury?

A) Lung cancer-medical problem

B) Brain injury-traumatic injury

C) Liver disease-medical problem

D) Internal bleeding-traumatic injury

Answer: C

45) At a nursing home, you find an elderly patient extremely short of breath. To best determine whether this 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.

Answer: B

46) During your primary assessment, you note the patient's skin to be warm, pink, and dry. This finding would seem to indicate:

A) Possible shock.

B) Possible fever.

C) Poor oxygenation.

D) Normal circulation

Answer: D

47) When performing the primary assessment of a 45-year-old patient, which of these 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

Answer: A

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

A) Heart problems.

B) Heat exposure.

C) Hypoperfusion.

D) Stroke.

Answer: B

49) Which of these statements made by an EMT student 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 a patient of any age 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."

Answer: D

50) 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 moist, and the capillary refill time is 5 seconds. This patient is most likely:

A) Hypoxic.

B) Malnourished.

C) Poorly perfused.

D) Feverous.

Answer: C

51) Which capillary refill time is considered the upper limit of normal for an adult female?

A) 3 seconds

B) 2 seconds

C) 6 seconds

D) 4 seconds

Answer: A

52) Which capillary refill time is considered normal for a 5-year-old child?

A) 3 seconds

B) 2 seconds

C) 5 seconds

D) 4 seconds

Answer: B

53) Your patient is 82 years old and has diabetes. Which assessment parameter is the least reliable sign indicating this patient's peripheral circulatory status?

A) Capillary refill

B) Skin color

C) Skin temperature

D) Pulse strength

Answer: A

54) Which of these patients is considered the lowest priority for a rapid secondary exam and immediate transport?

A) A 32-year-old woman who is unresponsive

B) A 72-year-old man complaining of leg pain for a week

C) A 7-year-old boy who has had severe abdominal pain for 4 hours

D) A 55-year-old woman with difficulty breathing

Answer: B

55) As you perform the primary assessment on an unresponsive patient, you discover vomitus in her airway. What should you do next?

A) Check the breathing

B) Start positive pressure ventilation

C) Apply supplemental oxygen

D) Suction the airway

Answer: D

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

A) "Establish a chief complaint and gather the past medical history."

B) "Determine whether 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."

Answer: C

57) A 43-year-old male patient has called 911 with the complaint of difficulty breathing. Once on scene, you note he is breathing at a rate of 18 breaths/min. He also exhibits intercostal retractions and nasal flaring. The pulse oximeter reads 93% on room air. The EMT should document this patient's breathing as:

A) Dyspneic.

B) Apneic.

C) Tachypneic.

D) Bradypneic.

Answer: A

58) Forming the general impression starts during which phase of patient assessment?

A) Reassessment

B) Secondary assessment

C) Primary assessment

D) Care transfer in the emergency department

Answer: C

59) You have completed the primary assessment on a patient who was thrown from a motorcycle and landed on his head and back on the nearby sidewalk. After initiating spine motion restriction and finding no life threats during the primary assessment, which action should you take first when starting a secondary assessment?

A) Determine the patient's SAMPLE history

B) Obtain baseline vital signs

C) Conduct a physical exam

D) Load the patient into the ambulance

Answer: C

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

A) Extremity

B) Focused

C) Specific

D) Rapid

Answer: B

61) A 44-year-old male patient 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 breaths/min and his carotid pulse is weak and difficult to locate. Following the primary assessment and initial management of life threats, which of these 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 maneuver to open the airway

Answer: A

62) A 62-year-old female patient 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, spine motion restriction precautions have been provided, and life threats addressed. The patient's husband is by her side. When performing the secondary exam on this patient, what should the EMT do 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) Ask the family member if the patient has any past medical history

D) Perform a rapid head-to-toe physical assessment

Answer: D

63) When teaching a group of Emergency Medical Responders about the mechanism of injury, which point 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 is no longer considered in the assessment because research has shown this information causes many patients to be over-treated.

C) The mechanism of injury is the sole criterion on which an EMT decides whether immediate transport is required.

D) The mechanism of injury can be used to dictate the order in which the primary assessment is conducted.

Answer: A

64) 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

Answer: C

66) When assessing a critically injured patient, the EMT should detect which of these 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

Answer: D

67) When performing the secondary assessment, the EMT would likely find which of these injuries first?

A) Deformity to the left thigh

B) Bruising to the abdomen

C) Unstable pelvis

D) Decreased pulse in the left foot

Answer: B

68) When you assess the abdomen of an elderly patient who fell down a flight of stairs, he grimaces and tells you that it hurts when you palpate there. The perception by the patient of increased pain upon palpation of an injured site is known as:

A) Pain.

B) Tenderness.

C) Instability or crepitation.

D) Ecchymosis.

Answer: B

69) You are performing a secondary assessment on an unrestrained adult passenger who was 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 with purposeful motion and in a state of shock. When assessing the patient's head, which of these would be appropriate for you to do?

A) Clean a laceration of the scalp

B) Check the pupils with a penlight

C) Perform a blind finger sweep to check the airway

D) Apply pressure to a depressed area of the skull

Answer: B

70) 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. What 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

Answer: D

71) You are performing a secondary assessment and are assessing the patient's chest. Which of these findings would 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

Answer: C

72) 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 take fast and shallow breaths.

Answer: A

73) 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.

Answer: A

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

A) Palpation of the patient's abdomen

B) Securing the patient to a long spine board

C) Palpation of the pelvic region

D) Transporting the patient supine

Answer: C

75) Which of these 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.

Answer: C

76) 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) 1

C) 4

D) 3

Answer: A

77) Which of these physical findings is least consistent with an injured extremity?

A) Deformities

B) Vomiting

C) Contusions

D) Crepitation

Answer: B

78) What does the "S" in SAMPLE stand for?

A) Significance

B) Severity

C) Sign

D) Seriousness

Answer: C

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

A) Rigidity

B) Distention

C) Guarding

D) Bowel sounds

Answer: D

80) 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.

Answer: B

81) While you are performing a secondary assessment on a male patient who was ejected from his motorcycle, the patient suddenly states that it has become very hard to breathe. You would:

A) Make a mental note and continue with your exam.

B) Stop your exam and evaluate the patient's new complaint.

C) Reassess the patient, beginning with the head.

D) Reconsider the mechanism of injury and look for a chest injury.

Answer: B

82) An 18-year-old female patient with a history of diabetes twisted her right ankle while playing volleyball. She is alert and oriented and states that the pain is excruciating. The primary assessment is complete and yields no life-threatening conditions. What should you do next?

A) Perform a head-to-toe exam

B) Apply ice to the ankle

C) Check her blood sugar

D) Assess the right ankle and foot

Answer: D

83) The EMT recognizes that for a trauma patient who is alert and oriented, he should obtain the patient's medical history during which component of patient assessment?

A) Primary assessment

B) Scene size-up

C) Secondary assessment

D) Reassessment

Answer: C

84) At a continuing education seminar being taught by your medical director, the instructor asks the group for one reason why the secondary assessment is beneficial to perform on the trauma patient. Which of these responses is most appropriate?

A) "It is useful in finding additional injuries and guiding additional care."

B) "It is a good tool that allows the EMT to determine whether critical interventions such as positive pressure ventilation or CPR are needed."

C) "It is an effective means to determine the exact mechanism of injury."

D) "It is the best assessment for detecting problems with the airway, breathing, or circulation."

Answer: A

85) When performing a secondary assessment on an alert and oriented female patient with a deformed left leg, the EMT should:

A) Describe to the patient your findings and the injuries as you encounter them.

B) Reassure the patient that she will be okay and the injury is nothing to worry about.

C) Inform the patient that if you assess her, she must submit to all treatment by EMS providers.

D) Explain to the patient what you are doing before and during the assessment.

Answer: D

86) When assessing a stable patient with a medical complaint, which piece of information will typically be obtained first?

A) Vital signs

B) Chief complaint

C) Level of consciousness

D) Past medical history

Answer: D

87) A 31-year-old male is complaining of left-side flank pain that radiates into his groin. He is alert and oriented, and the primary assessment reveals no life-threatening conditions. Given the patient's status, your next step should be to:

A) Gather medical information from the family.

B) Perform a rapid head-to-toe exam.

C) Obtain a medical history from the patient.

D) Repeat the primary assessment.

Answer: C

88) A 69-year-old male patient called 911 because of a sudden onset of pain and then numbness in his left leg. He states that he has a history of blood clots that form in the leg and the pain feels exactly as it did the last time that this occurred. He denies any trauma to the extremity. You perform the primary assessment and find the patient to be alert and oriented with no lifethreatening deficits to the airway, breathing, or circulation. When initiating the secondary assessment on this patient, what would be appropriate to do?

A) Perform a rapid head-to-toe exam

B) Initiate immediate transport

C) Place a nasal airway as a precautionary measure

D) Perform a physical exam of the leg

Answer: D

89) An unresponsive 54-year-old male patient was found by family in his bed. They state that he has not been feeling well and complained of chest pain before going to bed approximately 1 hour ago. According to the family, he has no prior medical history and does not take any medications. The primary assessment reveals no life-threatening conditions. When performing the secondary assessment on this patient, the EMT should:

A) Start by examining the patient's head.

B) Contact the patient's family doctor.

C) Determine whether the chest pain still exists.

D) Focus the examination on the chest.

Answer: A

90) The EMT recognizes that the best source of information for a responsive medical patient with a specific chief complaint and no known medical history is:

A) The patient's vital signs.

B) The patient.

C) Medical direction.

D) The family.

Answer: B

91) The EMT is using the OPQRST mnemonic to gather information from a patient with abdominal pain. Which of these patient statements is a response to the "P" component of this memory aid?

A) "It hurts worse when I take a deep breath."

B) "My pulse feels as though it is racing."

C) "I have a past history of asthma."

D) "The pain started about 2 hours ago."

Answer: A

92) During assessment of a responsive medical patient, you gather a medical history using the memory aid SAMPLE. To obtain information related to the "M" component, which question should you ask?

A) "Do you have any past medical problems?"

B) "Are you allergic to any medications?"

C) "Are you currently taking any medications?"

D) "Can you point to where it hurts the most?"

Answer: C

93) The EMT determines the medications a patient takes during which phase of the patient assessment?

A) Primary assessment

B) OPQRST exam

C) Chief complaint

D) SAMPLE history

Answer: D

94) An alert and oriented 69-year-old female patient complains of low, right-sided abdominal pain. She describes the pain as "knife-like" and states that it started suddenly 1 hour ago. Her only medical history is hypertension, for which she takes the medication Lisinopril. Which of these assessment findings shows that the EMT is appropriately assessing this patient given the chief complaint?

A) No trauma noted to the head

B) No pain on palpation to the chest

C) No deformity to the upper extremities

D) No abdominal guarding noted

Answer: D

95) A 20-year-old female patient is found unresponsive. The first step of the secondary assessment for this patient is to:

A) Obtain vital signs.

B) Conduct a rapid medical assessment.

C) Gather a SAMPLE history from the family.

D) Contact medical direction for advisement

Answer: B

96) You have been called for an 83-year-old female patient who is having difficulty breathing. She informs you that she has congestive heart failure and feels as though she is "filling up" with fluid. The primary assessment shows her to be alert and oriented with inadequate breathing. Her pulse is rapid and weak, and her skin is cool and dry. When performing a secondary assessment, which sign related to heart failure would you specifically look for when examining this patient's neck?

A) Bruising to the neck

B) Deviated trachea

C) Jugular vein distention

D) Posterior tenderness on palpation

Answer: C

97) You have been summoned to a retail store, where you are directed to a middle-aged woman who was found in the bathroom on the toilet. Your assessment shows her to be responsive to painful stimuli with an open airway and labored breathing. Her pulse is fast and regular, and her skin is warm to the touch. The primary assessment has been completed and the appropriate care given. As the stretcher is prepared, you perform the secondary assessment. When assessing her chest, you note the presence of crackles to both lungs. What should you do next?

A) Place the patient on the stretcher

B) Assess the abdomen

C) Obtain vital signs

D) Evaluate the head and neck

Answer: B

98) When you are caring for a patient with either a medical complaint or a traumatic injury, you should typically perform the reassessment:

A) Before the secondary assessment.

B) When a life-threatening condition is found.

C) Immediately following the primary assessment.

D) While transporting the patient to the hospital.

Answer: D

99) You are transporting a 31-year-old male patient who was severely injured in a motor vehicle collision. He is unresponsive and being ventilated by your partner with a bag-valve mask. How will you conduct the rapid secondary assessment on this patient?

A) Perform a head-to-toe exam

B) Focus on the chest and abdomen

C) Palpate the body parts but do not auscultate them

D) Focus on the head and torso

Answer: A

100) You are transporting an 18-year-old male patient who was injured in a motor vehicle collision. He has a decreased level of consciousness and has injuries to his head, chest, and lower right leg. While you are conducting the reassessment of the patient's head and neck, which of these actions is most appropriate?

A) Maintaining the patient's airway with the head-tilt, chin-lift maneuver

B) Placing a sterile dressing in the patient's right ear canal, which is oozing blood

C) Taking time to carefully re-palpate the patient's face and scalp

D) Carefully removing the cervical collar to reassess the back of the patient's neck

Answer: C