Prehospital Emergency Care Chapter 11 Vital Signs and History Taking

1) Which of these patient descriptions contains only vital signs?

A) Chief complaint of dizziness; skin, cool and clammy; respiratory rate, 16 breaths/min

B) Chief complaint of dizziness; BP, 110/76 mmHg; breath sounds, clear and equal

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

D) Heart rate, 88 beats/min; respiratory rate, 14 breaths/min; ECG is NSR

Answer: C

2) You are transporting a depressed female 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?

A) Once at the scene and once en route to the Emergency Department

B) Only baseline vital signs are required

C) Every 5 minutes

D) Every 15 minutes

Answer: D

3) The Emergency Medical Technician is correctly calculating a patient's respiratory rate when they:

A) Count the number of breaths in 1 minute and divide by 4.

B) Obtain a pulse oximetry reading and divide it by 3.

C) Assess the patient for any sign of respiratory difficulty.

D) Count the number of breaths for 30 seconds and multiply by 2

Answer: D

4) 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 Emergency Medical Technician should recognize the:

A) Respiratory rate as normal.

B) Heart as beating adequately.

C) Blood pressure as normal.

D) Heart rate as irregular.

Answer: D

5) Which of these findings related to breathing would be most concerning to the Emergency Medical Technician in an adult patient?

A) Respiratory rate of 18, complaint of weakness

B) Respiratory rate of 22, normal chest wall motion

C) Respiratory rate of 10, chest expansion of about 1 inch

D) Respiratory rate of 20, use of accessory muscles

Answer: D

6) Which of these statements made by your Emergency Medical Technician (EMT) partner indicates that they understand how to assess the patient's breathing?

A) "As long as the patient is breathing more than 20 times per minute, the patient is getting enough oxygen in their body."

B) "If the respiratory rate is normal, the patient is breathing adequately and getting enough oxygen."

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

D) "To determine if a patient is adequately breathing, the EMT must get a full set of vital signs."

Answer: C

7) 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 Emergency Medical Technician, you recognize that this condition is likely caused by:

A) The nasopharynx being blocked by mucus or heavy secretions.

B) The airway swelling shut.

C) The tongue partially blocking the airway.

D) The respiratory rate being less than 10 breaths/min.

Answer: C

8) 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 her 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?

A) Gurgling

B) Stridor

C) Snoring

D) Wheezing

Answer: B

9) An Emergency Medical Technician is correctly assessing a patient's radial pulse when he:

A) Uses the palm of his hand to feel the pulse on the upper arm.

B) Simultaneously checks for a heart rate on both sides of the neck.

C) Uses his thumb to feel for the pulse on the patient's lower arm, near the base of the thumb.

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

Answer: D

10) When assessing a patient's pulse, you note that it is irregular. To get an accurate heart rate, you would:

A) Listen to the pulse with a stethoscope.

B) Count the number of beats that occur in 1 minute.

C) Double the number of beats counted in 30 seconds.

D) Feel the carotid pulse for 30 seconds and multiply by 2.

Answer: B

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

A) Carotid

B) Inguinal

C) Pedal

D) Femoral

Answer: D

12) 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?

A) Brachial

B) Carotid

C) Pedal

D) Radial

Answer: D

13) 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:

A) Apply the AED.

B) Call for ALS assistance.

C) Check for a carotid pulse.

D) Start CPR.

Answer: C

14) 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?

A) Assess the patient's breathing

B) Obtain a blood pressure

C) Determine the rate and quality of the pulse

D) Establish the patient's level of consciousness

Answer: C

15) Which of these statements concerning assessment of the pulse is correct?

A) "The heart rate can be determined by doubling the number of beats counted in 30 seconds."

B) "To get the most accurate rate, the Emergency Medical Technician (EMT) should place a stethoscope over the pulse site and count the number of beats in 1 minute."

C) "A brachial pulse should be felt first in any patient younger than 6 years of age."

D) "After much experience, an EMT can calculate the pulse rate by just feeling it for a few seconds."

Answer: A

16) You determine an adult patient's heart rate to be 48 beats/min. That heart rate would be categorized as:

A) Tachypneic.

B) Normal.

C) Bradycardic.

D) Tachycardic.

Answer: C

18) 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?

A) The patient is in the early stage of cardiac arrest.

B) The left radial artery is extremely large.

C) There is a problem with the patient's veins.

D) The left radial artery may be occluded.

Answer: D

17) The Emergency Medical Technician recognizes which heart rate would most likely be considered normal for a 24-year-old male patient who is resting comfortably?

A) 54 beats/min

B) 62 beats/min

C) 110 beats/min

D) 124 beats/min

Answer: B

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

A) Strength

B) Rate

C) Regularity

D) Tone

Answer: A

20) 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:

A) Bounding and regular.

B) Prominent and bounding.

C) Strong and irregular.

D) Thready and regular.

Answer: C

21) When evaluating a patient's skin color, the Emergency Medical Technician should:

A) Observe the nail beds and/or mucous membranes inside the eyelids.

B) Examine the change in skin color when applying, then releasing pressure to the nail beds.

C) Look at the skin on the upper chest and feel it for warmth.

D) Examine the skin color of the face and compare it with the color of the arms.

Answer: A

22) You are assessing a confused dark-skinned patient who complains of a headache. When checking his skin color, you should:

A) Examine the skin around his ears and nose.

B) Evaluate the oral mucosa or conjunctiva.

C) Observe the skin on his forehead.

D) Look at and feel the skin on his neck and chest.

Answer: B

23) An Emergency Medical Technician has accurately checked the skin color of a dark-skinned patient who is in shock. How would this finding be best documented on a patient care report?

A) "Warm skin noted on the upper arm."

B) "Forehead and face show pink skin color."

C) "Pale color noted to the conjunctiva."

D) "Thoracic and abdominal skin normal in color.

Answer: C

24) Which of these methods most accurately assesses a patient's skin temperature?

A) Placing the tips of two fingers on the patient's wrist

B) Using the palm to feel the patient's forehead

C) Placing the back of the hand on the patient's abdomen

D) Placing the inside of the Emergency Medical Technician's arm against the patient's arm

Answer: C

25) Which of these statements made by an Emergency Medical Technician (EMT) indicates an accurate understanding of checking a patient's skin temperature?

A) "Checking the skin temperature is not precise, but provides a good estimate of abnormally high or low body temperatures."

B) "To properly evaluate a patient's skin temperature during the primary assessment, the EMT needs a thermometer."

C) "Flushed skin always indicates a high body temperature."

D) "With experience, the EMT can precisely determine a patient's body temperature by feeling the skin."

Answer: A

26) To test a pediatric patient's capillary refill, the Emergency Medical Technician will:

A) Apply gentle pressure to the radial pulse and watch color changes to the hand.

B) Firmly compress and then release pressure on the nail bed.

C) Examine the inside lining of one or both eyelids.

D) Apply pressure to an arm and then release that pressure.

Answer: B

27) The Emergency Medical Technician should recognize normal skin color in a healthy patient as:

A) White.

B) Warm.

C) Red.

D) Pink.

Answer: D

28) The assessment of a patient's skin color reveals a bluish discoloration. As a knowledgeable Emergency Medical Technician, you should identify:

A) Pallor caused by a decrease in blood flow to the tissues.

B) Cyanosis caused by inadequate oxygenation of the tissues.

C) Erythema caused by a decrease in body temperature.

D) Jaundice caused by an increase in blood flow to the extremities.

Answer: B

29) 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?

A) Persistent cough

B) Fever

C) Rectal bleeding

D) Headache

Answer: C

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

A) Bluish-gray

B) Pale and cyanotic

C) Pinkish and flushed

D) Yellowish

Answer: D

31) A patient with liver cancer exhibits a yellow discoloration to his entire body. The Emergency Medical Technician would correctly document this condition as:

A) Jaundice.

B) Cyanotic.

C) Pallor.

D) Flushed.

Answer: A

32) Which of these patients should the Emergency Medical Technician recognize as having a normal skin temperature?

A) A 25-year-old female who is dizzy with cool skin

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

C) A 47-year-old female with chest pain and warm-to-hot skin

D) An 88-year-old male who is weak with cool and dry skin

Answer: B

33) 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?

A) Cyanotic skin around the mouth

B) Decreased heart rate and flushed skin

C) Fingertips that are cool and blue

D) Skin on the abdomen that is hot and flushed

Answer: D

34) A patient presents with skin that is cool to the touch. The Emergency Medical Technician shows he understands this condition when he states:

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

B) "The patient must have an infection somewhere in his body."

C) "We should check his breath sounds; the patient probably has a lung infection, such as pneumonia."

D) "The patient most likely has a past medical history of hypertension."

Answer: A

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

A) Dry

B) Pink

C) Moist

D) Warm

Answer: C

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

A) A 4-year-old male

B) A 24-year-old female

C) A 67-year-old female

D) An 81-year-old male

Answer: A

37) 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?

A) Immediate return of color

B) 1-second capillary refill time

C) 2-second capillary refill time

D) 3-second capillary refill time

Answer: D

38) 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?

A) "That is a significant finding. We really need to get him on oxygen and get moving to the hospital."

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

C) "That finding likely indicates he has lost blood and the skin is not being adequately perfused."

D) "If his skin is also warm and moist, then the patient is most likely in shock."

Answer: B

39) Which of these statements made by an Emergency Medical Technician student indicates that he correctly understands the use of capillary refill when assessing a patient?

A) "Capillary refill is a very reliable sign of shock in any patient between the ages of 18 and 65 years."

B) "Capillary refill is a more reliable sign of perfusion quality in children younger than 6 years than in adolescents or adults."

C) "The possibility of chronic circulatory diseases makes the capillary refill test an excellent sign of circulation in the adult patient."

D) "If a delayed capillary refill is observed in a patient of any age, there is a high probability he or she is in shock."

Answer: B

40) When assessing a patient's pupils, the Emergency Medical Technician should:

A) Shine a light in one eye and watch for the pupil to dilate.

B) Cover one eye and shine a light in the other eye, watching for changes to the size of the pupil.

C) Determine the size of the pupil and then look for a change in pupillary size while shining a light in the eye.

D) Instruct the patient to blink several times and observe the size of the pupils.

Answer: C

41) 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:

A) Shading the patient's eyes.

B) Using a blue-tinged light.

C) Retracting the eyelid.

D) Hydrating the eyes with saline drops first.

Answer: A

42) Friends called 911 for a 22-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?

A) Pupils that constrict to light

B) Bloodshot eyes with large pupils

C) Nonreactive pupils that are unequal

D) Pupils that are constricted

Answer: D

43) 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 Emergency Medical Technician would best document this finding as:

A) Bilateral dilation of the pupils, unresponsive to light.

B) Constricted pupils bilaterally, nonreactive to light.

C) Bilateral midsize pupils that are reactive to light.

D) Nonreactive pupils of decreased size bilaterally

Answer: A

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

A) One pupil dilates and the other constricts in response to light.

B) Both pupils constrict when light is directed into one eye.

C) The patient reflexively closes the eyes to light.

D) The pupils are equal and do not change shape in response to light.

Answer: B

45) The Emergency Medical Technician is correct when he makes which of these statements about the assessment of the pupils?

A) "Dilated pupils are less of a concern than pupils that are constricted."

B) "If a patient's pupils are dilated but react to light, the pupillary exam is considered normal."

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

D) "Constricted pupils are less of a concern than are dilated pupils."

Answer: C

46) 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?

A) Dilation of the right pupil only

B) Constriction of both pupils

C) Dilation of the left pupil only

D) Constriction of the right pupil only

Answer: B

47) As you enter the scene of a medical emergency, the Emergency Medical Responder informs you that the patient is not breathing and has pupils that are fixed and dilated. Based on this description, what do you expect to see when you reach the patient's side?

A) Both pupils are large and change shape in response to light.

B) The patient must wear corrective lenses.

C) The patient has a past medical history of blindness.

D) Neither pupil will react when light is directed into the eyes.

Answer: D

48) To assess a patient's blood pressure, the Emergency Medical Technician will need a:

A) Pulse oximeter.

B) Sphygmomanometer.

C) Pulse oximeter and stethoscope.

D) Pair of gloves and stethoscope.

Answer: B

49) 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) "Since pediatric emergencies are less common than adult emergencies, it is best to call medical direction and ask what is normal."

B) "Any systolic blood pressure of less than 100 mmHg in a child is an emergency."

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

D) "It is helpful to ask the parent or caregiver what is normal for the child and compare your reading to that."

Answer: C

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

A) Inflate to a reading of 70 mmHg, check for a radial pulse, and continue inflation in 10 mmHg increments until the pulse is no longer felt

B) Inflate the cuff to 300 mmHg, and then leave the cuff inflated for 30 seconds prior to deflation

C) Inflate the cuff to a reading of 300 mmHg, and then deflate the cuff slowly until you hear a pulse

D) Inflate the cuff to three times the patient's age and listen for a heartbeat

Answer: A

51) You are observing a new Emergency Medical Technician just hired by your Emergency Medical Services agency. You know he has correctly positioned the blood pressure cuff on the patient's arm when:

A) The cuff is placed over the antecubital space and elbow.

B) The cuff is centered over the top of the radial artery.

C) The cuff is on the same level as the patient's heart.

D) The cuff covers one-third of the patient's upper arm.

Answer: C

52) When obtaining a blood pressure, the Emergency Medical Technician listens for a pulse over which blood vessel?

A) Radial artery

B) Antecubital vein

C) Carotid vessel

D) Brachial artery

Answer: D

53) An Emergency Medical Technician 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:

A) "As long as the reading is obtained, it should be accurate."

B) "Cuffs that are too small provide inaccurately high readings."

C) "Using a cuff that is too small can cause damage to the blood vessels."

D) "As long as the radial pulse remains intact, the cuff size is irrelevant."

Answer: B

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

A) Inflates the cuff maximally prior to slowly deflating and listening for a pulse.

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

C) Stops inflation and starts deflation as soon as the carotid pulse disappears.

D) Places the stethoscope under the cuff and deflates it.

Answer: B

55) A blood pressure is reported as 116/68 mmHg. Given this finding, which of these statements is true?

A) The systolic blood pressure is 116 mmHg.

B) The top number reflects the diastolic blood pressure.

C) The systolic pressure is determined by subtracting 68 from 116.

D) The diastolic blood pressure is 116 mmHg.

Answer: A

56) An Emergency Medical Technician has an accurate understanding of systolic blood pressure when he tells you that systolic blood pressure is:

A) Represented by the bottom number.

B) Produced when the heart contracts.

C) The pressure in the veins.

D) Caused by constriction of the arteries.

Answer: B

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

A) The systolic blood pressure is 118 mmHg.

B) The diastolic blood pressure is 130 mmHg.

C) The systolic blood pressure is 76 mmHg.

D) The diastolic blood pressure is 118 mmHg.

Answer: A

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

A) The pulse pressure is 224 mmHg.

B) The systolic blood pressure is 78 mmHg.

C) The constant pressure in the veins is 156 mmHg.

D) The diastolic blood pressure is 78 mmHg.

Answer: D

59) An Emergency Medical Technician has an accurate understanding of diastolic blood pressure when they tell you that diastolic pressure:

A) Is the pressure in the arteries when the heart is not contracting.

B) Can be estimated as one-third of the systolic blood pressure.

C) Can be easily obtained by palpating the blood pressure.

D) Should always be rounded to the nearest 10.

Answer: A

60) Which pulse site is commonly palpated during the process of obtaining a blood pressure by the palpation technique?

A) Brachial

B) Radial

C) Carotid

D) Pedal

Answer: B

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

A) Noisy environment

B) Normal pulse rate

C) Tachycardic pulse rate

D) Non-life-threatening condition

Answer: A

62) While reviewing a patient care report for a quality assurance process, the Emergency Medical Technician should recognize that a blood pressure has been palpated when they see:

A) Palp: 178/118 mmHg.

B) P / 118.

C) 118/178 (palpated).

D) 178 / P.

Answer: D

63) Which of these statements indicates an appropriate understanding of palpating a blood pressure?

A) "A palpated blood pressure is recorded when the brachial pulse fades out as the BP cuff is deflated."

B) "Palpated blood pressure is the technique of choice when the patient has a cardiac complaint."

C) "A palpated blood pressure is typically a little lower than a blood pressure obtained by auscultation."

D) "It is best to determine a palpated blood pressure using a stethoscope and pulse oximeter

Answer: C

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

A) Blood pressure cuff

B) Non-Invasive Blood Pressure (NIBP) machine

C) Blood pressure cuff and stethoscope

D) Stethoscope and pulse oximeter

Answer: A

65) 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?

A) "What were you doing when the dizziness started?"

B) "Who is your doctor and when was your last office visit?"

C) "Why exactly did you call the ambulance today?"

D) "You seem upset. Do you want to talk about it?

Answer: A

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

A) "The physician is Dr. Coleman."

B) "The pulse is 116 beats per minute."

C) "The pain is rated at 8/10."

D) "There is a history of pancreatitis."

Answer: D

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

A) Abdomen soft

B) History of asthma

C) Allergy to penicillin

D) Airway is open

Answer: C

68) A 69-year-old man has new 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?

A) The headache is a symptom related to the chief complaint.

B) The history of diabetes is a sign related to the chief complaint.

C) The dizziness is a sign indicating the severity of the chief complaint.

D) The history of diabetes is a contributing symptom of the chief complaint.

Answer: A

69) 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 Emergency Medical Technician best recognize as a sign related to the patient's chief complaint?

A) Chest pain that worsens with inspiration

B) Recent diagnosis of pneumonia

C) Complaint of light-headedness

D) Blood pressure of 116/84 mmHg

Answer: D

70) The Emergency Medical Technician is correct when he identifies baseline vital signs as:

A) A set of vital signs most close to normal.

B) The most important set of vital signs.

C) The first set of vital signs obtained.

D) Any change in two consecutive sets of vital signs.

Answer: C

71) After your first set of vitals were obtained, 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 Emergency Medical Technician should:

A) Take another blood pressure measurement in five minutes.

B) Compare this finding to the baseline blood pressure.

C) Ask the patient if he feels his blood pressure has changed.

D) Retake the blood pressure and compare it to a normal BP of 120/80 mmHg.

Answer: B

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

A) If the vital signs are within normal limits, it is safe to let the patient refuse transport.

B) The vital signs will help the Emergency Medical Technician (EMT) determine the relative stability or instability of the patient.

C) The patient's complaint is considered significant only if accompanied by abnormal vital signs.

D) The vital signs will allow the EMT to diagnose the cause of the nausea and vomiting.

Answer: B

73) 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:

A) "If you do not want me to take your blood pressure, I do not have to."

B) "I have seen plenty of big arms, and yours is nothing compared to some of them."

C) "I am getting your blood pressure, not measuring your arm, but you really need to lose some weight."

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

Answer: D

74) 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:

A) Change the subject.

B) Inform her of the vital signs.

C) Tell her they are normal.

D) Reassure her that she is fine.

Answer: B

75) You notice that your partner routinely takes only one set of vital signs when treating and transporting patients. When asked, he states that he gets just baseline vital signs because they are most important, as they provide information related to the patient's clinical status at the time of the EMS call. How would you respond?

A) "Examining several sets of vital signs can also indicate the effectiveness of your treatment."

B) "You must at least get a pulse rate every 15 minutes, since this is the most important vital sign."

C) "Documenting several sets of vital signs is the only way to get full reimbursement from insurance companies for the EMS call."

D) "You must get at least two sets of vital signs because that is what the national standard calls for."

Answer: A

76) 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 Emergency Medical Technician do in order to determine if this patient's condition is improving?

A) Ask the patient if she finds it easier to breathe

B) Inquire if the patient feels the need for another dose of albuterol

C) Obtain a pulse oximetry reading and breath sounds every 5 minutes

D) Re-obtain a SAMPLE history and look for new information

Answer: C

77) The Emergency Medical Technician (EMT) understands the primary reason to obtain a medical history using the SAMPLE mnemonic when he states:

A) "The SAMPLE mnemonic helps EMTs diagnose a patient's medical problem." B) "It is important to use the SAMPLE mnemonic because the emergency department will need the information."

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

D) "The SAMPLE mnemonic is important because it will give the EMT the patient's exact chief complaint."

Answer: C

78) You are assessing a 49-year-old male patient who complains of lower back pain. Which finding would be pertinent medical information related to the back pain that the Emergency Medical Technician will obtain using the SAMPLE mnemonic?

A) Heart rate of 48 and cool, clammy skin

B) Childhood case of measles

C) Last tetanus shot 5 years ago

D) Arthritis in the spine and pelvis

Answer: D

79) 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:

A) Provides the most accurate evaluation of the true heart rate.

B) Is a tool used to see if the airway needs to be opened.

C) Provides information about the amount of oxygen circulating in the blood.

D) Can tell how much carbon dioxide she is exhaling with each breath.

Answer: C

80) When using a pulse oximeter on an adult patient, the Emergency Medical Technician knows that the sensor is most often attached to the patient's:

A) Chest.

B) Forehead.

C) Ear.

D) Finger.

Answer: D

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

A) 100 percent.

B) Greater than 97 percent.

C) Greater than 90 percent.

D) Greater than 75 percent.

Answer: B

82) How should the Emergency Medical Technician document a pulse oximetry reading on the prehospital care report?

A) 97% SpO2

B) 97% O2

C) 97% PO

D) 97% PO2

Answer: A

83) 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 Emergency Medical Technician?

A) Prepare and apply the pulse oximeter before administering oxygen

B) Provide positive pressure ventilation with supplemental oxygen

C) Obtain a full set of vital signs, excluding the patient's temperature

D) Attempt to determine what happened to the patient or any existing medical problems

Answer: B

84) When should the Emergency Medical Technician use the pulse oximeter?

A) Only on patients who complain of shortness of breath

B) On any and all patients 1 year of age and older

C) Only if the patient has a history of lung disease

D) Routinely on all patients with a medical or trauma complaint

Answer: D

85) In patients with which of these conditions would the Emergency Medical Technician most likely get an inaccurate pulse oximeter reading despite proper application of the sensor?

A) Low blood pressure

B) Elevated body temperature

C) Unresponsiveness

D) Increased heart rate

Answer: A

86) 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?

A) Place the sensor on the child's toe

B) Restrain the child until a reading is obtained

C) Place the sensor on the other hand

D) Attach the sensor to his neck

Answer: A

87) 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?

A) Nasal congestion and runny nose

B) Skin retractions between the ribs during inhalation

C) Skin that is hot and dry

D) Systolic blood pressure of 92 mmHg

Answer: B

88) Where would the Emergency Medical Technician palpate for a popliteal pulse?

A) Posterior ankle

B) Upper arm

C) Behind the knee

D) Top of foot

Answer: C

89) Which of these patients should the Emergency Medical Technician recognize as tachycardic for their age bracket?

A) An 86-year-old male with chest pain and a heart rate of 96

B) A 2-year-old female with vomiting and a heart rate of 116

C) A 24-year-old female with diabetic complications and a heart rate of 54

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

Answer: D

90) When obtaining vital signs for a 67-year-old male patient with dizziness and nausea, your partner states that the pulse seems to disappear periodically when the patient takes a deep breath. As a knowledgeable Emergency Medical Technician, your best response would be:

A) "Given the patient's age, that is a typical finding and not an immediate concern."

B) "That is an important finding. We will have to let the doctor know about it."

C) "Let's move the patient to the stretcher for transport. That is an early sign of cardiac arrest."

D) "That finding is important because it suggests the radial artery is partially blocked."

Answer: B

91) Which of these blood pressure readings is normal for a 7-year-old male?

A) 114/62 mmHg

B) 120/80 mmHg

C) 76/50 mmHg

D) 94/30 mmHg

Answer: A

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

A) 240/88 mmHg

B) 158/44 mmHg

C) 136/92 mmHg

D) 246/Palpation

Answer: C

93) 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 Emergency Medical Technician should expect findings of:

A) A narrowed pulse pressure and possible shock.

B) Normal blood pressure since the patient is alert and oriented.

C) Diastolic hypertension and risk for stroke.

D) A normal heart rate given the patient's age

Answer: A

94) 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?

A) Heart rate

B) Skin color and temperature

C) Palpated blood pressure

D) Auscultation of breath sounds

Answer: B

95) 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:

A) Place the patient back into bed.

B) Determine the blood pressure by palpation.

C) Ask the patient if he is having chest pain.

D) Hold the patient upright until the blood pressure is obtained.

Answer: A

96) 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?

A) Move the blood pressure cuff down to the forearm

B) Palpate the blood pressure in the right arm

C) Use an automatic blood pressure monitor

D) Auscultate the blood pressure in the left arm

Answer: D

97) 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?

A) Supine blood pressure of 100/64 mmHg and respirations of 22 breaths/min

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

C) Standing pulse of 88 with the additional complaint of nausea

D) Standing SpO2 of 88% and heart rate of 96 beats/min

Answer: B

98) Correctly assessing orthostatic vital signs involves:

A) Taking the blood pressure and heart rate three times, 2 minutes apart.

B) Determining whether the patient's pulse disappears during deep inspiration.

C) Taking the blood pressure in the supine, seated, and standing positions.

D) Determining whether the patient's respirations and heart rate are within normal limits.

Answer: C

99) 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:

A) "It provides us with the most accurate measure of your heart rate."

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

C) "It tells us how well your heart is pumping blood."

D) "It allows us to monitor your blood pressure and respiratory status."

Answer: B

100) You have applied the pulse oximeter to a 73-year-old male patient who complains of weakness and abdominal pain. 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 patient's 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?

A) "Let's recheck the SpO2 in 2 minutes for any change."

B) "The reading must be wrong since he displays no cyanosis."

C) "The SpO2 is probably normal for him since he is very pale."

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

Answer: D