West Coast EMT Chapter 9 -- Patient Assessment

A 39-year-old male sustained a stab wound to the groin during an altercation at a bar. As you approach the patient, you note that he is conscious. He is screaming in pain and is attempting to control the bleeding, which is bright red and spurting from his groin area. You should:

Select one:

A. elevate his legs and keep him warm.

B. apply direct pressure to the wound.

C. administer 100% supplemental oxygen.

D. ensure that his airway is patent.

B. apply direct pressure to the wound.

A palpable pulse is created by:

Select one:

A. electrical conduction in the heart producing ventricular contraction.

B. the pressure of circulating blood against the walls of the arteries.

C. pressure waves through the arteries caused by cardiac contraction.

D. the pressure that is caused when venous blood returns to the heart.

C. pressure waves through the arteries caused by cardiac contraction.

An elderly patient has fallen and hit her head. Your initial care should focus on:

Select one:

A. providing immediate transport.

B. obtaining baseline vital signs.

C. airway, breathing, and circulation.

D. gathering medical history data.

C. airway, breathing, and circulation

An injured patient is assigned a total score of 9 on the GCS. He is assigned a score of 2 for eye opening, a score of 3 for verbal response, and a score of 4 for motor response. Which of the following clinical findings is consistent with his GCS score?

Select one:

A. Opens eyes in response to voice, makes incomprehensible sounds, localizes pain

B. Opens eyes spontaneously, is confused when spoken to, exhibits abnormal flexion

C. Eyes remain closed, makes incomprehensible sounds, exhibits abnormal extension

D. Opens eyes in response to pain, uses inappropriate words, withdraws from pain

D. Opens eyes in response to pain, uses inappropriate words, withdraws from pain

During an EMS call, you should take standard precautions:

Select one:

A. before exiting the ambulance and before actual patient contact.

B. before you load the patient into the ambulance.

C. immediately after completion of your primary assessment.

D. after it has been determined that the patient is bleeding.

A. before exiting the ambulance and before actual patient contact.

In patients with deeply pigmented skin, changes in color may be apparent only in certain areas, such as the:

Select one:

A. back of the neck.

B. dorsum of the hand.

C. lips or oral mucosa.

D. forehead and face.

C. lips or oral mucosa.

Reassessment is performed to determine all of the following, EXCEPT:

Select one:

A. whether or not the patient is deteriorating.

B. the nature of any newly identified problems.

C. the reason why the patient called EMS.

D. the patient's response to your treatment.

C. the reason why the patient called EMS.

The chief complaint is MOST accurately defined as the:

Select one:

A. gross physical signs that you detect on assessment.

B. most serious thing the patient is concerned about.

C. condition that exacerbates an underlying problem.

D. most life-threatening condition that you discover.

B. most serious thing the patient is concerned about.

The rapid exam of a patient that occurs following the primary assessment should take no longer than:

Select one:

A. 60 to 90 seconds.

B. 90 to 120 seconds.

C. 120 to 180 seconds.

D. 30 seconds.

A. 60 to 90 seconds.

Treatment and transport priorities at the scene of a mass-casualty incident should be determined after:

Select one:

A. a physician arrives at the scene.

B. all the patients have been triaged.

C. area hospitals have been notified.

D. the number of patients is known.

B. all the patients have been triaged.

What maneuver should be used to open the airway of an unresponsive patient with suspected trauma?

Select one:

A. Head tilt-chin lift

B. Head tilt-neck lift

C. Jaw-thrust maneuver

D. Tongue-jaw lift

C. Jaw-thrust maneuver

When approaching a 32-year-old male who is complaining of traumatic neck pain, you should:

Select one:

A. approach him from behind and ask him not to move.

B. stand behind him and immediately stabilize his head.

C. ensure that the patient can see you approaching him.

D. assess his mental status by having him move his head.

C. ensure that the patient can see you approaching him.

When you shine a light into one pupil, the normal reaction of the other pupil should be to:

Select one:

A. dilate.

B. become larger.

C. not react.

D. become smaller.

D. become smaller.

Which of the following actions would NOT be performed during the scene size-up?

Select one:

A. Noting the position of a crashed motor vehicle

B. Asking a neighbor to secure the patient's dog

C. Notifying the dispatcher to send fire personnel

D. Rapidly assessing a patient's respiratory status

D. Rapidly assessing a patient's respiratory status

Which of the following conditions would be LEAST likely to cause an altered level of consciousness?

Select one:

A. Inadequate perfusion

B. Acute anxiety

C. Drug overdose

D. Poisoning

B. Acute anxiety

Which of the following scenarios does NOT involve the presence of any symptoms?

Select one:

A. A 44-year-old male with abdominal pain and severe dizziness

B. A 55-year-old male with a severe headache and 2 days of nausea

C. A 61-year-old female who is unconscious with facial cyanosis

D. A 49-year-old female with blurred vision and ringing in the ears

C. A 61-year-old female who is unconscious with facial cyanosis

Which of the following statements regarding the mechanism of injury (MOI) is correct?

Select one:

A. A nonsignificant MOI rules out the possibility of serious trauma.

B. A significant MOI always results in patient death or permanent disability.

C. The exact location of a patient's injuries can be determined by the MOI.

D. The MOI may allow you to predict the severity of a patient's injuries.

D. The MOI may allow you to predict the severity of a patient's injuries.

Which of the following statements regarding the secondary assessment is correct?

Select one:

A. The secondary assessment should be performed en route to the hospital, regardless of the severity of the patient's condition.

B. During the secondary assessment, the EMT's primary focus should be on taking the patient's vital signs and obtaining a SAMPLE history.

C. A secondary assessment should always be performed, even if you must continually manage life threats that were identified in the primary assessment.

D. The secondary assessment should focus on a certain area or region of the body as determined by the chief complaint.

D. The secondary assessment should focus on a certain area or region of the body as determined by the chief complaint.

You are assessing a 72-year-old man with abdominal pain. The patient is sitting in a chair; he is conscious, alert, and calm. As you are talking to the patient, your partner discreetly directs your attention to a handgun, which is located on a nearby table. You should:

Select one:

A. direct your partner to move the gun to a safe area and then advise the patient that his weapon has been secured.

B. document the presence of the weapon, including its specific location, and continue your assessment of the patient.

C. immediately cease all patient care, carefully back out of the residence, and request law enforcement assistance.

D. position yourself in between the patient and the gun and ask your partner to request law enforcement assistance.

D. position yourself in between the patient and the gun and ask your partner to request law enforcement assistance.

You should suspect that a patient is experiencing respiratory failure if he or she:

Select one:

A. is restless and is working hard to breathe.

B. has bradycardia and diminished muscle tone.

C. is anxious, tachycardic, and leaning forward.

D. has an increased heart rate and retractions.

B. has bradycardia and diminished muscle tone.