Question 1

You have been called for an 83-year-old female 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 one of the following signs related to heart failure would you specifically look for when examining the patient's neck?

Accepted Answer

When examining a patient with congestive heart failure, jugular vein distention is a sign that indicates increased pressure in the heart and is specifically related to heart failure. This can help guide treatment decisions and further assessment. Bruising to the neck, deviated trachea, and posterior tenderness on palpation are not commonly associated with heart failure and would not be as relevant in this scenario.

Question 2

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

Accepted Answer

Asking if a patient is currently taking any medications will give you information related to the "M" in SAMPLE, which stands for medications.

Question 3

You are transporting an 18-year-old male who has been injured in a motor-vehicle collision. He has a decreased level of consciousness and has suffered injuries to his head, chest, and lower right leg. When you are conducting the reassessment of the patient's head and neck, which one of the following is appropriate?

Accepted Answer

In this scenario, the patient has suffered injuries to the head and neck, making it important to conduct a thorough reassessment of these areas. However, option A is not appropriate as the head-tilt, chin-lift maneuver is not recommended for patients with suspected head or neck injuries. Option B is also not recommended as inserting any object into the ear can cause further damage or worsen bleeding. Option D is also not recommended as removing the cervical collar can potentially cause further injury to the neck if not done carefully and by trained personnel. Therefore, option C is the best choice as re-palpating the face and scalp can help identify any new areas of tenderness or deformities that may have developed during transport.

Question 4

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

Accepted Answer

The history phase of the patient assessment is where the EMT determines the patient's medical history, which includes any medications they are taking. The primary assessment focuses on identifying and treating immediate life threats, while the OPQRST exam and chief complaint are used to gather information about the patient's current symptoms and pain.

Question 5

The EMT recognizes that for a trauma patient who is alert and oriented, he should obtain the history during what component of patient assessment?

Accepted Answer

During the secondary assessment, the EMT should obtain a detailed history from the patient. However, the EMT should also gather information during the primary assessment and scene size-up to aid in patient care. Reassessment is important for monitoring the patient's response to treatment and adjusting care as necessary, but it is not the appropriate time to obtain a history from an alert and oriented trauma patient.

Question 6

You are transporting a 31-year-old male 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?

Accepted Answer

A rapid secondary assessment on an unresponsive trauma patient involves performing a head-to-toe exam to identify any injuries that may not have been apparent during the primary assessment. This comprehensive approach ensures that no injuries are missed.

Question 7

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?

Accepted Answer

Crackles are a sign of fluid in the lungs, which can be caused by a number of conditions, including pneumonia, heart failure, and pulmonary edema. Assessing the abdomen can help to rule out other causes of the crackles, such as ascites or a distended bladder.

Question 8

An 18-year-old female 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. Which of the following would you do next?

Accepted Answer

As the patient specifically mentioned the pain in her right ankle, the next step would be to assess the right ankle and foot. This will help to determine the extent of the injury and guide further treatment. Blood sugar can be checked later, and a head-to-toe exam is not necessary in this situation. Ice can be applied after the ankle is assessed.

Question 9

A 69-year-old male called 911 because of the sudden onset of pain and numbness to 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 him to be alert and oriented with no life-threatening conditions to the airway, breathing, or circulation. When performing the secondary assessment on this patient, which one of the following is most appropriate?

Accepted Answer

Since the patient has a history of blood clots in the leg and is experiencing pain and numbness in the leg, a physical exam of the leg is most appropriate during the secondary assessment. This can help identify any signs of an active blood clot that may require emergency intervention. A rapid head-to-toe exam may still be performed, but assessing the leg would be a priority. Immediate transport may not be necessary if the patient is stable and there are other assessments that need to be performed. Placement of a nasal airway would not be indicated unless there were signs of airway obstruction.

Question 10

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

Accepted Answer

Reassessment is typically performed while transporting the patient to the hospital to monitor changes in the patient's condition and ensure ongoing care.

Question 11

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 obtained from the:

Accepted Answer

The patient is the best source of information regarding their chief complaint and medical history. They can provide a detailed account of their symptoms and any relevant medical history that can guide the EMT's assessment and treatment. While vital signs are important to gather as part of the assessment, they do not provide information about the patient's medical history or chief complaint. Medical direction can provide guidance on treatment options, but does not provide information specific to the patient. Family members may be able to provide some insight into the patient's medical history, but may not be reliable or knowledgeable enough to provide accurate information.

Question 12

When assessing a stable patient with a medical complaint, which piece of information will be obtained first and will help to guide the type of exam after the primary assessment has been completed?

Accepted Answer

The answer of When assessing a stable patient with a...

Question 13

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

Accepted Answer

The sudden complaint of difficulty breathing is a serious issue and can indicate a life-threatening condition. It is necessary to stop the exam and address the patient's new complaint immediately. Failure to do so can lead to a deterioration in the patient's condition.

Question 14

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

Accepted Answer

The secondary assessment is beneficial because it allows the EMT to systematically assess the patient for any missed or additional injuries beyond what was identified in the primary assessment. It can also help guide additional care and treatment. Option B is incorrect because determining the need for positive pressure ventilation or CPR would be identified in the primary assessment, and not the secondary assessment. Option C is incorrect because the secondary assessment is not used to determine the exact mechanism of injury, but rather to assess for additional injuries. Option D is incorrect because while the secondary assessment does evaluate airway, breathing, and circulation, it is not the best assessment for detecting problems with these areas, as that would be addressed in the primary assessment.

Question 15

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:

Accepted Answer

Obtaining a medical history from the patient is the next appropriate step in this scenario as it can provide information about the onset and nature of the pain, which can help in identifying the possible cause and guide further evaluation and treatment. The other options, such as gathering medical information from the family or performing a rapid head-to-toe exam, may not be directly related to addressing the patient's pain complaint. Repeating the primary assessment may not yield significant new information if there are no significant changes in the patient's condition.

Question 16

An unresponsive 54-year-old male 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 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:

Accepted Answer

The answer of An unresponsive 54-year-old male was found by...

Question 17

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

Accepted Answer

It is important to explain to the patient what you are doing and why during assessment to maintain patient rapport and trust, and to ensure informed consent before any treatment or transport decisions are made.

Question 18

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

Accepted Answer

Conducting a rapid medical assessment is the best choice in this scenario as the patient is unresponsive, and the primary assessment has already been completed to address any immediate life-threatening issues. The secondary assessment involves a more detailed evaluation of the patient's condition and gathering additional information to aid in treatment, but this cannot be done until the patient's current state is assessed. Obtaining vital signs, gathering a SAMPLE history, and contacting medical direction can all be part of the secondary assessment, but they should be done after the initial evaluation of the patient.

Question 19

The EMT is using the OPQRST mnemonic to gather information from a patient with abdominal pain. Which one of the following patient statements is a response to the letter "P" in this memory aid?

Accepted Answer

"P" in the OPQRST mnemonic stands for Provocation/Palliation, which refers to what makes the patient's symptoms better or worse. The statement "It hurts worse when I take a deep breath." directly addresses this by indicating an action that provokes or exacerbates the pain.

Question 20

An alert and oriented 69-year-old female is complaining 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 the following assessment findings shows that the EMT is appropriately assessing this patient?

Accepted Answer

The fact that there is no abdominal guarding noted is important since guarding is a sign of potential intra-abdominal pathology. The other assessment findings mentioned are not related to the patient's chief complaint of right-sided abdominal pain.

Quiz 13: Patient Assessment