EMT Chapter 8

Chapter 8 Multiple Choice 1. A. B. C. D. Which of the following is an example of a symptom? cyanosis headache tachycardia hypertension Answer: B Question Type: General Knowledge Page: 253 2. A. B. C. D. Which of the following scenarios does NOT involve the presence of any symptoms? a 44-year-old male with abdominal pain and severe dizziness a 49-year-old female with blurred vision and ringing in the ears a 55-year-old male with a severe headache and 2 days of nausea a 61-year-old female who is unconscious with facial cyanosis Answer: D Question Type: General Knowledge Page: 253 3. A. B. C. D. Which of the following actions would NOT be performed during the scene size-up? asking a neighbor to secure the patient’s dog rapidly assessing a patient’s respiratory status notifying the dispatcher to send fire personnel noting the position of a crashed motor vehicle Answer: B Question Type: General Knowledge Page: 255 4. While en route to the scene of a shooting, the dispatcher advises you that the caller states that the perpetrator has fled the scene. You should: 1 A. B. C. D. ask the dispatcher if he or she knows the location of the perpetrator. confirm this information with law enforcement personnel at the scene. request law enforcement personnel if the scene is unsafe upon arrival. proceed to the scene as usual but exercise extreme caution upon arrival. Answer: B Question Type: Critical Thinking Page: 255 5. A. B. C. D. Upon arriving at a potentially unsafe scene, you should: remove all bystanders. request another ambulance. move the patient to safety. ensure that you are safe. Answer: D Question Type: General Knowledge Page: 255 6. 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: A. immediately cease all patient care, carefully back out of the residence, and request law enforcement assistance. B. direct your partner to move the gun to a safe area and then advise the patient that his weapon has been secured. C. document the presence of the weapon, including its specific location, and continue your assessment of the patient. D. position yourself in between the patient and the gun and ask your partner to request law enforcement assistance. Answer: D Question Type: Critical Thinking Page: 256 7. Which of the following statements regarding the mechanism of injury (MOI) is correct? A. A nonsignificant MOI rules out the possibility of serious trauma. B. The MOI may allow you to predict the severity of a patient’s injuries. 2 C. The exact location of a patient’s injuries can be determined by the MOI. D. A significant MOI always results in patient death or permanent disability. Answer: B Question Type: General Knowledge Page: 257 8. The MOST effective way to determine whether your patient’s problem is medical or traumatic in origin is to: A. perform a careful and thorough assessment. B. establish the patient’s medical history early. C. take note of the patient’s general appearance. D. ask if bystanders are familiar with the patient. Answer: A Question Type: General Knowledge Page: 257 9. A. B. C. D. During an EMS call, you should take standard precautions: any time before you load the patient into the ambulance. after it has been determined that the patient is bleeding. immediately after completion of your primary assessment. upon exiting the ambulance, but before actual patient contact. Answer: D Question Type: General Knowledge Page: 258 10. Treatment and transport priorities at the scene of a mass-casualty incident should be determined after: A. a physician arrives at the scene. B. the number of patients is known. C. all the patients have been triaged. D. area hospitals have been notified. Answer: C Question Type: General Knowledge Page: 258 3 11. When is it MOST appropriate to consider requesting additional ambulances at an accident scene? A. after you have triaged all the critical patients B. when you determine there are multiple patients C. after noncritical patients have been identified D. when all the deceased patients are accounted for Answer: B Question Type: General Knowledge Page: 259 12. The goal of the primary assessment is to: A. determine if the patient’s problem is medical or trauma. B. identify patients that require transport to a trauma center. C. determine the need to perform a head-to-toe assessment. D. identify and rapidly treat all life-threatening conditions. Answer: D Question Type: General Knowledge Page: 261 13. Observations made when forming a general impression of a patient would include all of the following, EXCEPT: A. appearance. B. pulse strength. C. race and gender. D. level of distress. Answer: B Question Type: General Knowledge Page: 261 14. When approaching a 32-year-old male who is complaining of traumatic neck pain, you should: A. ensure that the patient can see you approaching him. B. approach him from behind and ask him not to move. C. stand behind him and immediately stabilize his head. D. assess his mental status by having him move his head. 4 Answer: A Question Type: General Knowledge Page: 261 15. Which of the following conditions would be LEAST likely to cause an altered level of consciousness? A. drug overdose B. inadequate perfusion C. acute anxiety D. poisoning Answer: C Question Type: General Knowledge Page: 262 16. Which of the following patients does NOT have an altered mental status? A. a patient with an acute allergic reaction and dizziness B. a diabetic who opens his eyes when you ask questions C. a patient with a head injury who is slow to answer questions D. a patient who overdosed and moans when he is touched Answer: A Question Type: General Knowledge Page: 262 17. A patient who does not respond to your questions but moves or cries out when his or her trapezius muscle is pinched, is said to be: A. conscious and alert. B. completely unresponsive. C. responsive to verbal stimuli. D. responsive to painful stimuli. Answer: D Question Type: General Knowledge Page: 262 18. An elderly patient has fallen and hit her head. You assess her level of consciousness as unresponsive using the AVPU scale. Your initial care should focus on: 5 A. B. C. D. obtaining baseline vital signs. gathering medical history data. providing immediate transport. airway, breathing, and circulation. Answer: D Question Type: Critical Thinking Page: 262 19. A patient’s short-term memory is MOST likely intact if he or she correctly answers questions regarding: A. time and place. B. date and event. C. event and person. D. person and place. Answer: B Question Type: General Knowledge Page: 263 20. A 29-year-old male with a head injury opens his eyes when you speak to him, is confused as to the time and date, and is able to move all of his extremities on command. His Glasgow Coma Scale (GCS) score is: A. 10. B. 12. C. 13. D. 14. Answer: C Question Type: General Knowledge Page: 263 21. 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? A. opens eyes in response to voice, makes incomprehensible sounds, localizes pain B. opens eyes in response to pain, uses inappropriate words, withdraws from pain C. opens eyes spontaneously, is confused when spoken to, exhibits abnormal flexion D. eyes remain closed, makes incomprehensible sounds, exhibits abnormal extension 6 Answer: B Question Type: General Knowledge Page: 263 22. When you inspect a patient’s pupils with a penlight, the pupils should normally react to the light by: A. constricting. B. enlarging. C. dilating. D. fluttering. Answer: A Question Type: General Knowledge Page: 264 23. When you shine a light into one pupil, the normal reaction of the other pupil should be to: A. dilate. B. not react. C. become larger. D. become smaller. Answer: D Question Type: General Knowledge Page: 264 24. Which of the following pupillary changes would indicate depressed brain function? A. Both pupils dilate when a bright light is removed. B. Both pupils constrict when a bright light is introduced. C. Both pupils react briskly to light instead of sluggishly. D. Both pupils dilate with introduction of a bright light. Answer: D Question Type: General Knowledge Page: 264 25. Which of the following conditions would MOST likely cause the pupils to remain significantly constricted? 7 A. B. C. D. severe cerebral hypoxia intracranial hemorrhaging overdose of an opiate drug oculomotor nerve pressure Answer: C Question Type: General Knowledge Page: 264 26. What maneuver should be used to open the airway of an unresponsive patient with suspected trauma? A. tongue-jaw lift B. jaw-thrust maneuver C. head tilt–chin lift D. head tilt–neck lift Answer: B Question Type: General Knowledge Page: 265 27. Which of the following statements regarding stridor is MOST correct? A. It is a whistling sound heard in the lower airway. B. It is caused by incorrect airway positioning. C. It is a high-pitched, crowing upper airway sound. D. It suggests the presence of fluid in the lungs. Answer: C Question Type: General Knowledge Page: 265, 268 28. Which of the following findings indicates that your patient has a patent airway? A. audible breathing B. forceful coughing C. inspiratory stridor D. unresponsiveness Answer: B Question Type: General Knowledge Page: 266 8 29. You respond to a call for a female pedestrian who has been struck by a car. As your partner maintains manual stabilization of her head, you perform a primary assessment. She is unconscious, has ineffective breathing, and has bloody secretions in her mouth. You should: A. assist her breathing with a bag-mask device. B. quickly insert an oropharyngeal airway. C. assess the rate and quality of her pulse. D. immediately suction her oropharynx. Answer: D Question Type: Critical Thinking Page: 266 30. A 40-year-old male crashed his motorcycle into a tree. He is semiconscious, has snoring respirations, and has a laceration to the forearm with minimal bleeding. You should: A. apply a cervical collar and suction his airway. B. open his airway with the jaw-thrust maneuver. C. apply a pressure dressing to the patient’s arm. D. tilt the patient’s head back and lift up on his chin. Answer: B Question Type: Critical Thinking Page: 266 31. After performing a head tilt–chin lift maneuver to open the airway of an unresponsive patient who has a pulse, you should: A. place him or her in the recovery position. B. provide positive-pressure ventilatory assistance. C. assess respiratory rate, depth, and regularity. D. suction as needed and insert an airway adjunct. Answer: D Question Type: Critical Thinking Page: 266 32. A patient with spontaneous respirations is breathing: A. at a normal rate. 9 B. with shallow depth. C. without difficulty. D. without assistance. Answer: D Question Type: General Knowledge Page: 266 33. Typical methods of assessing a patient’s breathing include all of the following, EXCEPT: A. listening to breath sounds with a stethoscope. B. observing for nasal flaring during inhalation. C. observing the chest for adequate rise and fall. D. quickly scanning the chest for obvious movement. Answer: B Question Type: General Knowledge Page: 266 34. Supplemental oxygen via nonrebreathing mask should be administered to patients: A. who are semiconscious with shallow respirations. B. with rapid respirations and a reduced tidal volume. C. who have accessory muscle use and slow breathing. D. with difficulty breathing and adequate tidal volume. Answer: D Question Type: General Knowledge Page: 266 35. You are dispatched to the county jail for an inmate who is sick.= When you arrive, you find the patient, a 33-year-old male, unresponsive. His airway is patent and his respirations are rapid and shallow. Your initial action should be to: A. apply a pulse oximeter. B. request a paramedic unit. C. provide assisted ventilation. D. assess his blood pressure. Answer: C Question Type: Critical Thinking Page: 266 10 36. If a patient develops difficulty breathing after your primary assessment, you should immediately: A. determine his or her respiratory rate. B. begin assisting his or her breathing. C. reevaluate his or her airway status. D. auscultate his or her breath sounds. Answer: C Question Type: General Knowledge Page: 266 37. The normal respiratory rate for an adult should range from: A. 10 to 15 breaths per minute. B. 12 to 20 breaths per minute. C. 18 to 24 breaths per minute. D. 24 to 28 breaths per minute. Answer: B Question Type: General Knowledge Page: 266 38. Normal respiratory rates should not exceed _______ breaths per minute in children and _______ breaths per minute in infants. A. 18, 28 B. 20, 30 C. 24, 45 D. 30, 50 Answer: D Question Type: General Knowledge Page: 267 39. Which of the following is the MOST effective method of assessing the quality of air movement in the lungs? A. evaluating the patient’s chest for cyanosis B. applying a pulse oximeter and monitoring the SpO2 C. auscultating breath sounds with a stethoscope 11 D. looking for the presence of accessory muscle use Answer: C Question Type: General Knowledge Page: 267 40. Which of the following abnormal breath sounds indicates obstruction of the upper airway? A. rales B. stridor C. crackles D. rhonchi Answer: B Question Type: General Knowledge Page: 268 41. Clinical signs of labored breathing include all of the following, EXCEPT: A. shallow chest movement. B. use of accessory muscles. C. supraclavicular retractions. D. gasping attempts to breathe. Answer: A Question Type: General Knowledge Page: 268 42. When a patient’s respirations are shallow: A. chest rise will be easily noticeable. B. tidal volume is markedly reduced. C. oxygenation occurs more efficiently. D. carbon dioxide elimination is increased. Answer: B Question Type: General Knowledge Page: 269 12 43. Which of the following signs of respiratory distress is seen MOST commonly in pediatric patients? A. seesaw breathing B. rapid respirations C. pursed-lip breathing D. accessory muscle use Answer: A Question Type: General Knowledge Page: 269 44. An adult patient who is NOT experiencing difficulty breathing will: A. be able to speak in complete sentences without unusual pauses. B. assume a position that will facilitate effective and easy breathing. C. exhibit an indentation above the clavicles and in between the ribs. D. have a respiratory rate that is between 20 and 24 breaths/min. Answer: A Question Type: General Knowledge Page: 269 45. You should suspect that a patient is experiencing respiratory failure if he or she: A. is restless and is working hard to breathe. B. has an increased heart rate and retractions. C. has bradycardia and diminished muscle tone. D. is anxious, tachycardic, and leaning forward. Answer: C Question Type: General Knowledge Page: 269 46. During the primary assessment, circulation is evaluated by assessing: A. skin quality, blood pressure, and capillary refill. B. pulse quality, external bleeding, and skin condition. C. blood pressure, pulse rate, and external bleeding. D. external bleeding, skin condition, and capillary refill. Answer: B Question Type: General Knowledge Page: 270 13 47. A palpable pulse is created by: A. the pressure of circulating blood against the walls of the arteries. B. the pressure that is caused when venous blood returns to the heart. C. pressure waves through the arteries caused by cardiac contraction. D. electrical conduction in the heart producing ventricular contraction. Answer: C Question Type: General Knowledge Page: 270 48. Which of the following is the MOST accurate guide to palpating a pulse? A. Avoid compressing the artery against a bone or solid structure. B. Place the tips of your index and long fingers over the pulse point. C. Use your thumb to increase the surface area that you are palpating. D. Apply firm pressure to the artery with your ring and little fingers. Answer: B Question Type: General Knowledge Page: 270 49. In responsive patients that are older than 1 year of age, you should palpate the pulse at the ________ artery. A. radial B. carotid C. brachial D. femoral Answer: A Question Type: General Knowledge Page: 270 50. Palpating the carotid pulse is not recommended in infants because: A. the pulse rate is usually too fast to count. B. a decrease in cerebral perfusion may occur. C. the carotid artery is more anterior in infants. D. you may inadvertently compress the trachea. 14 Answer: D Question Type: General Knowledge Page: 270 51. When palpating the carotid pulse of a responsive older patient, you should: A. avoid compressing both carotid arteries simultaneously. B. ensure that his or her head is in a hyperextended position. C. avoid gentle pressure so that weak pulses can be detected. D. firmly compress the artery because the pulse is often weak. Answer: A Question Type: General Knowledge Page: 270 52. You receive a call to a local daycare center for an unresponsive 8-month-old infant. Upon arrival, you perform an assessment and determine that the infant is not breathing. Your next action should be to: A. open the airway and give 2 rescue breaths. B. begin chest compressions and request backup. C. immediately transport the child to the hospital. D. assess for a brachial pulse for 5 to 10 seconds. Answer: D Question Type: Critical Thinking Page: 270 53. If you cannot palpate a pulse in an unresponsive patient, you should: A. attach an automated external defibrillator (AED) at once. B. immediately begin cardiopulmonary resuscitation (CPR). C. palpate at another pulse site. D. assess for adequate breathing. Answer: B Question Type: General Knowledge Page: 270 54. You respond to the residence of a 62-year-old male who is unresponsive. Your primary assessment reveals that he is apneic and pulseless. You should: 15 A. B. C. D. start CPR and attach the AED as soon as possible. ask the family if the patient has a terminal disease. perform CPR and transport the patient immediately. notify dispatch and request a paramedic ambulance. Answer: A Question Type: Critical Thinking Page: 270 55. Which of the following factors would MOST likely cause a patient’s pulse rate to be slower than normal? A. anxiety or severe stress B. beta-blocker medications C. internal bleeding from trauma D. lack of a regular exercise routine Answer: B Question Type: General Knowledge Page: 271 56. When palpating a patient’s pulse, you note that it is grossly irregular. You should: A. count the pulse rate for at least 30 seconds to ensure accuracy. B. count the number of pulsations in 15 seconds and multiply by four. C. count the number of pulsations in 30 seconds and multiply by two. D. count the pulse rate for a full minute to obtain an accurate reading. Answer: D Question Type: General Knowledge Page: 271 57. For an adult, the normal resting pulse should be between: A. 50 and 60 beats/min. B. 50 and 70 beats/min. C. 60 and 100 beats/min. D. 70 and 110 beats/min. Answer: C Question Type: General Knowledge Page: 271 16 58. In the adult, bradycardia is defined as a pulse rate less than _______ beats/min, and tachycardia is defined as a heart rate greater than _______ beats/min. A. 60, 100 B. 50, 110 C. 40, 120 D. 30, 130 Answer: A Question Type: General Knowledge Page: 272 59. A pulse with a consistent pattern is considered to be: A. weak. B. strong. C. regular. D. irregular. Answer: C Question Type: General Knowledge Page: 272 60. When palpating a patient’s pulse, you note that there is a short interval between pulsations. This indicates that the pulse is: A. slow. B. rapid. C. irregular. D. thready. Answer: B Question Type: General Knowledge Page: 272 61. When assessing a 62-year-old female with crushing chest pain, you note that her pulse is rapid and irregular. In addition to administering oxygen, you should: A. apply a cardiac monitor and observe her cardiac rhythm. B. transport at once and consider requesting a paramedic unit. C. document your findings and perform a detailed assessment. D. conclude that the irregular pulse is normal based on her age. 17 Answer: B Question Type: Critical Thinking Page: 272 62. In patients with deeply pigmented skin, changes in color may be apparent only in certain areas, such as the: A. back of the neck. B. forehead and face. C. dorsum of the hand. D. lips or oral mucosa. Answer: D Question Type: General Knowledge Page: 272 63. In infants and small children, skin color should be assessed on the: A. forehead. B. palms and soles. C. chest and abdomen. D. underside of the arms. Answer: B Question Type: General Knowledge Page: 272 64. Poor peripheral circulation will cause the skin to appear: A. pink. B. ashen. C. flushed. D. cyanotic. Answer: B Question Type: General Knowledge Page: 272 65. When assessing the skin of an unconscious patient, you note that it has a bluish tint to it. This finding is called: 18 A. B. C. D. pallor. flushing. cyanosis. mottling. Answer: C Question Type: General Knowledge Page: 272 66. Cyanosis of the skin is caused by: A. increased blood oxygen. B. peripheral vasodilation. C. venous vasoconstriction. D. decreased blood oxygen. Answer: D Question Type: General Knowledge Page: 272 67. Normal skin color, temperature, and condition should be: A. pink, warm, and dry. B. pale, cool, and moist. C. pink, warm, and moist. D. flushed, cool, and dry. Answer: A Question Type: General Knowledge Page: 272–273 68. A patient with high blood pressure would be expected to have skin that is: A. flushed and red. B. mottled and cool. C. pale and moist. D. cyanotic and dry. Answer: A Question Type: General Knowledge Page: 273 19 69. A 40-year-old male presents with pain to the right upper quadrant of his abdomen. He is conscious and alert with stable vital signs. During your assessment, you note that his skin and sclera are jaundiced. You should suspect: A. acute pancreatitis. B. liver dysfunction. C. gallbladder disease. D. renal insufficiency. Answer: B Question Type: Critical Thinking Page: 273 70. A patient with profuse sweating is referred to as being: A. flushed. B. plethoric. C. diaphoretic. D. edematous. Answer: C Question Type: General Knowledge Page: 273 71. When you assess capillary refill time (CRT) in an infant, normal color to the tested area should return within: A. 1 second. B. 2 seconds. C. 3 seconds. D. 4 seconds. Answer: B Question Type: General Knowledge Page: 274 72. During your assessment of a 6-month-old male with vomiting and diarrhea, you note that his capillary refill time is approximately 4 seconds. From this information, you should conclude that his: A. respiratory status is adequate. B. systolic blood pressure is normal. C. peripheral circulation is decreased. 20 D. skin temperature is abnormally cold. Answer: C Question Type: Critical Thinking Page: 274 73. With regard to the assessment of a patient’s cardiovascular status, capillary refill time is MOST reliable in: A. children who are younger than 6 years of age. B. patients who are significantly hypotensive. C. children who are older than 6 years of age. D. patients with decreased peripheral perfusion. Answer: A Question Type: General Knowledge Page: 274 74. External bleeding from an extremity can usually be controlled by a combination of: A. direct pressure and elevation. B. direct pressure and a tourniquet. C. elevation and chemical ice packs. D. elevation and pressure point control. Answer: A Question Type: General Knowledge Page: 274 75. 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, is screaming in pain, and is attempting to control the bleeding, which is bright red and spurting from his groin area. You should: A. ensure that his airway is patent. B. apply direct pressure to the wound. C. elevate his legs and keep him warm. D. administer 100% supplemental oxygen. Answer: B Question Type: Critical Thinking Page: 274 21 76. The full-body scan of a patient that occurs following the primary assessment should take no longer than: A. 30 seconds. B. 60 to 90 seconds. C. 90 to 120 seconds. D. 120 to 180 seconds. Answer: B Question Type: General Knowledge Page: 275 77. After performing a primary assessment, a rapid scan of the body should be performed in order to: A. determine the need for spinal motion restriction precautions. B. identify less obvious injuries that require immediate treatment. C. look specifically for signs and symptoms of inadequate perfusion. D. find and treat injuries or conditions that do not pose a threat to life. Answer: B Question Type: General Knowledge Page: 275 78. You should gently palpate a patient’s pelvis only if: A. you note gross deformity to the pelvic area. B. the patient does not complain of pelvic pain. C. the MOI suggests pelvic trauma. D. the possibility of a pelvic fracture has been ruled out. Answer: B Question Type: General Knowledge Page: 275 79. A 71-year-old female slipped on a rug and fell. She is conscious and alert and complains of severe pelvic pain. Her respirations are 22 breaths/min with adequate depth and her heart rate is 120 beats/min. Which of the following would NOT be appropriate for this patient? A. performing a full-body scan B. 100% supplemental oxygen 22 C. treating her for possible shock D. gentle palpation of the pelvis Answer: D Question Type: Critical Thinking Page: 275 80. When assessing a patient’s abdomen, you will typically evaluate for all of the following, EXCEPT: A. subcutaneous emphysema. B. open wounds or eviscerations. C. gross bleeding and tenderness. D. rigidity and obvious bleeding. Answer: A Question Type: General Knowledge Page: 275 81. Which of the following situations or conditions warrants immediate transport? A. mild pain in the lower abdomen B. severe chest pain and cool, pale skin C. decreased ability to move an extremity D. responsiveness and ability to follow commands Answer: B Question Type: General Knowledge Page: 275 82. When performing a full-body scan on a supine patient, what part of the body is typically assessed last? A. abdomen B. posterior C. extremities D. anterior chest Answer: B Question Type: General Knowledge Page: 275 23 83. As you assess the head of a patient with a suspected spinal injury, your partner should: A. maintain stabilization of the head. B. look in the ears for gross bleeding. C. prepare the immobilization equipment. D. assess the rest of the body for bleeding. Answer: A Question Type: General Knowledge Page: 276 84. A 50-year-old male presents with an altered mental status. His wife tells you that he had a small stroke= 3 years ago but has otherwise been in good health. The patient is responsive but unable to follow commands. After administering oxygen, you should: A. repeat the primary assessment. B. inquire about his family history. C. prepare for immediate transport. D. perform a head-to-toe assessment. Answer: C Question Type: Critical Thinking Page: 277 85. The Golden Period= begins when an injury occurs and ends when: A. the patient receives definitive care. B. the patient is admitted to the ICU. C. you depart the scene for the hospital. D. you arrive at the emergency department. Answer: A Question Type: General Knowledge Page: 277 86. After the first 60 minutes of experiencing a significant injury: A. the patient’s blood pressure elevates significantly. B. the patient’s injuries will most likely be irreparable. C. most patients will die secondary to internal bleeding. D. the body’s ability to compensate for shock decreases. 24 Answer: D Question Type: General Knowledge Page: 277 87. An unstable patient should be reassessed at least every: A. 5 minutes. B. 10 minutes. C. 15 minutes. D. 20 minutes. Answer: A Question Type: General Knowledge Page: 278 88. During a 30-minute transport of a stable patient, you should reassess him or her at least ________ times. A. 2 B. 3 C. 4 D. 6 Answer: A Question Type: General Knowledge Page: 278 89. What part of the patient assessment process focuses on obtaining additional information about the patient’s chief complaint and any medical problems he or she may have? A. history taking B. general impression C. primary assessment D. secondary assessment Answer: A Question Type: General Knowledge Page: 280 90. The chief complaint is MOST accurately defined as the: 25 A. B. C. D. most life-threatening condition that you discover. condition that exacerbates an underlying problem. most serious thing the patient is concerned about. gross physical signs that you detect on assessment. Answer: C Question Type: General Knowledge Page: 280 91. Upon arriving at the scene of a patient with difficulty breathing, you determine that the scene is safe. You enter the residence and find the patient sitting in a chair in obvious distress. Your first action should be to: A. ask the patient what’s wrong. B. obtain a set of baseline vital signs. C. assess the patient’s airway status. D. introduce yourself to the patient. Answer: D Question Type: Critical Thinking Page: 280 Answer: D Question Type: General Knowledge Page: 282 98. Palliating factors regarding a patient’s pain involve those that: A. worsen the pain. B. alleviate the pain. C. initiate the pain. D. change the pain. Answer: B Question Type: General Knowledge Page: 282 99. Pain that moves from its point of origin to another body location is said to be: A. radiating. B. referred. C. palliating. D. provoking. Answer: A Question Type: General Knowledge Page: 282 100. In which of the following situations is a pertinent negative identified? A. A 50-year-old woman states that nothing makes her chest pain better or worse. B. A 53-year-old man with dizziness also tells you that he has vomited three times. C. A 56-year-old woman states that her chest hurts every time she takes a deep breath. D. A 59-year-old man complains of crushing chest pain but denies shortness of breath. Answer: D Question Type: General Knowledge Page: 282 28 101. When evaluating a patient with multiple complaints, the EMT’s responsibility is to: A. direct his or her attention to the most obvious signs and symptoms. B. determine which complaint poses the greatest threat to the patient’s life. C. definitively rule out serious causes of each of the patient’s complaints. D. assess each complaint based on the patient’s perception of its seriousness. Answer: B Question Type: General Knowledge Page: 285 102. Which of the following statements regarding the secondary assessment is correct? A. The secondary assessment should focus on a certain area or region of the body as determined by the chief complaint. B. The secondary assessment should be performed en route to the hospital, regardless of the severity of the patient’s condition. C. A secondary assessment should be performed, even if you must continually manage life threats that were identified in the primary assessment. D. During the secondary assessment, the EMT’s primary focus should be on taking the patient’s vital signs and obtaining a SAMPLE history. Answer: A Question Type: General Knowledge Page: 289 103. Which of the following statements regarding the secondary assessment is correct? A. If your general impression of a patient does not reveal any obvious life threats, you should proceed directly to the secondary assessment. B. The purpose of the secondary assessment is to systematically examine every patient from head to toe, regardless of the severity of his or her injury. C. You may not have time to perform a secondary assessment if you must continually manage life threats that were identified during the primary assessment. D. A focused secondary assessment would be the most appropriate approach for a patient who experienced significant trauma to multiple body systems. Answer: C Question Type: General Knowledge Page: 289 104. The pulse oximeter is an assessment tool used to evaluate the: A. percentage of red blood cells. 29 B. effectiveness of oxygenation. C. saturation level of venous blood. D. amount of exhaled carbon dioxide. Answer: B Question Type: General Knowledge Page: 290 105. When using the pulse oximeter as part of your assessment of a patient, it is important to remember that: A. pulse oximetry is especially useful in patients who have cold extremities because vasoconstriction forces blood to the capillary beds. B. carbon monoxide has no effect on pulse oximetry readings because the pulse oximeter presumes that oxygen is saturating the hemoglobin. C. as long as the patient’s oxygen saturation is greater than 95%, oxygen is usually not necessary, even if the patient has respiratory distress. D. any situation that causes vasoconstriction or loss of red blood cells, such as anemia or bleeding, may result in an inaccurate or misleading value. Answer: D Question Type: General Knowledge Page: 290 106. End-tidal carbon dioxide (ETCO2) is defined as the: A. maximal concentration of CO2 at the end of an exhaled breath. B. maximum amount of CO2 that remains in the lungs at all times. C. total amount of CO2 that remains in the lungs between breaths. D. amount of CO2 that a person breathes in during a single inhalation. Answer: A Question Type: General Knowledge Page: 290 107. A low ETCO2 reading, as measured by capnography, would MOST likely be observed if: A. a patient in cardiac arrest is receiving high-quality CPR. B. an endotracheal (ET) tube is correctly placed in the trachea. C. there is an absence or decrease in the level of CO2 in the lungs. D. the cells produce large amounts of CO2 and return it to the lungs. 30 Answer: C Question Type: General Knowledge Page: 290 108. Which of the following would the EMT most likely NOT perform on a responsive patient with a headache and no apparent life-threatening conditions? A. focused secondary assessment B. assessment of oxygen saturation C. systemic head-to-toe examination D. noninvasive blood pressure monitoring Answer: C Question Type: General Knowledge Page: 291 109. The goal of the full-body scan that is performed during the secondary assessment is to: A. detect and treat all non–life-threatening injuries. B. assess only the parts of the body that are injured. C. definitively rule out significant internal injuries. D. locate injuries not found in the primary assessment. Answer: D Question Type: General Knowledge Page: 291 110. A full-body scan should be performed on: A. stable patients who are able to tell you exactly what happened. B. all patients with traumatic injuries who will require EMS transport. C. responsive medical patients and patients without a significant MOI. D. patients with a significant MOI and unresponsive medical patients. Answer: D Question Type: General Knowledge Page: 291 111. You respond to the scene of a motor vehicle collision. Upon arrival, you find the driver, a young female, sitting on the curb. She is confused, is in obvious respiratory 31 A. B. C. D. distress, and has pale, moist skin. As your partner manually stabilizes her head, you perform a primary assessment. After performing any immediate livesaving treatment, you should: perform a rapid scan of her entire body and prepare for immediate transport. assess her vital signs, secure her to a backboard, and transport her immediately. fully immobilize her spine, load her into the ambulance, and assess her vital signs. identify the specific areas of her injuries and focus your assessment on those areas. Answer: A Question Type: Critical Thinking Page: 291 112. When performing a full-body scan on a trauma patient, you note the presence of Battle’s sign. This is defined as: A. unequal pupils. B. bruising behind the ear. C. swelling to the orbital area. D. fluid drainage from the nose. Answer: B Question Type: General Knowledge Page: 291 113. A decrease in the blood pressure may indicate: A. a loss of vascular tone. B. arterial constriction. C. increased blood volume. D. forceful cardiac contraction. Answer: A Question Type: General Knowledge Page: 296 114. The pressure exerted against the walls of the artery when the left ventricle contracts is called the: A. blood pressure. B. systolic pressure. C. diastolic pressure. D. pulse pressure. 32 Answer: B Question Type: General Knowledge Page: 296 115. The diastolic pressure represents the: A. average pressure against the arterial walls during a cardiac cycle. B. minimum amount of pressure that is always present in the arteries. C. increased arterial pressure that occurs during ventricular contraction. D. difference in pressure between ventricular contraction and relaxation. Answer: B Question Type: General Knowledge Page: 296 116. While evaluating a patient with chest pain, your partner tells you that the patient’s blood pressure is 140/94 mm Hg. The lower number represents the pressure from the: A. atria relaxing. B. atria contracting. C. ventricles relaxing. D. ventricles contracting. Answer: C Question Type: General Knowledge Page: 296 117. A blood pressure cuff that is too small for a patient’s arm will give a: A. falsely low systolic and diastolic reading. B. falsely high systolic but low diastolic reading. C. falsely high systolic and diastolic reading. D. falsely low systolic but high diastolic reading. Answer: C Question Type: General Knowledge Page: 297 118. A properly sized blood pressure cuff should cover: A. two thirds the length from the armpit to the crease in the elbow. B. one half the length between the armpit to the crease in the elbow. 33 C. one third the length from the armpit to the crease at the elbow. D. the entire upper arm between the armpit and the crease at the elbow. Answer: A Question Type: General Knowledge Page: 297 119. Which of the following statements regarding the blood pressure is correct? A. The systolic pressure represents ventricular relaxation. B. Blood pressure falls early in patients with hypoperfusion. C. Blood pressure is the most reliable indicator of perfusion. D. Blood pressure is usually not measured in children younger than 3 years of age. Answer: D Question Type: General Knowledge Page: 298 120. When auscultating the blood pressure in a patient’s upper extremity, you should place the diaphragm (head) of the stethoscope over the _________ artery. A. radial B. apical C. femoral D. brachial Answer: D Question Type: General Knowledge Page: 298 121. When you use the palpation method to obtain a blood pressure, the measurement you obtain is the: A. pulse pressure. B. systolic blood pressure. C. diastolic blood pressure. D. cardiac output pressure. Answer: B Question Type: General Knowledge Page: 300 34 122. When assessing motor function in a conscious patient’s lower extremities, you should expect the patient to: A. wiggle his or her toes on command. B. feel you touching the extremity. C. note any changes in temperature. D. identify different types of stimuli. Answer: A Question Type: General Knowledge Page: 302 123. A crackling sound produced by air bubbles under the skin is called: A. crepitus B. rhonchi. C. Korotkoff sounds. D. subcutaneous emphysema. Answer: D Question Type: General Knowledge Page: 303 124. Jugular venous distention suggests a problem with blood returning to the heart if the patient is: A. in a supine position. B. in a prone position. C. in a recumbent position. D. sitting up at a 45° angle. Answer: D Question Type: General Knowledge Page: 303 125. Which of the following MOST accurately describes paradoxical movement of the chest wall? A. multiple rib fractures that cause a marked deformity of the chest wall B. a marked decrease in chest wall movement due to abdominal breathing C. only one section of the chest rises on inspiration while another area falls D. one side of the chest wall moves opposite the direction of the other 35 Answer: C Question Type: General Knowledge Page: 303 126. Reassessment is performed to determine all of the following, EXCEPT: A. the reason why the patient called EMS. B. the patient’s response to your treatment. C. whether or not the patient is deteriorating. D. the nature of any newly identified problems. Answer: A Question Type: General Knowledge Page: 306 127. When performing a reassessment of your patient, you should first: A. obtain updated vital signs. B. reassess your interventions. C. repeat the primary assessment. D. confirm medical history findings. Answer: C Question Type: General Knowledge Page: 306 36