Chapter 10 Workbook Flashcards by Tom Bowl

The process of sorting patients based on severity of condition

Triage

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A blue gray skin color associated with reduced oxygen levels

Cyanosis

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Air under the skin

Subcutaneous emphysema

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A heart rate greater than 100 beats/min

Tachycardia

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The delicate membrane lining of the eyelid

Conjunctiva

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A subjective finding that the patient tells you about

Symptom

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Neck, chest, and abdominal muscles used when difficulty breathing is present

Accessory muscles of respiration

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Sounds produced as air moves into and out of the lungs

Breath sounds

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The most serious thing the patient is concerned about

Chief complaint

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Profuse sweating

Diaphoretic

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A yellow skin color due to liver disease or dysfunction

Jaundice

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The mental status of a patient

Orientation

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Mnemonic for gathering information about a patient’s symptoms

OPQRST

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To examine by touch

Palpate

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The way in which a patient responds to external stimuli

Responsiveness

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The indentation above the clavicles and in the spaces between the ribs during breathing

Retractions

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The white of the eyes

Sclera

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Damage to tissues as the result of exposure to cold

Frostbite

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A crackling or grinding sound

Crepitus

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The motion of a segment of chest wall that is opposite the normal movement during breathing

Paradoxical motion

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OPQRST
What does the symptom feel like?

Quality

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OPQRST
How long have you had the symptom?

Timing

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SAMPLE
Are you taking any medications?

Medications

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SAMPLE
Did you eat this morning?

Last oral intake

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OPQRST Does anything make the symptoms better or worse?

Provocation/palliation

OPQRST On a scale of 1 to 10, how do you rate your symptom?

Severity

SAMPLE What were you doing before this happened?

Events leading up to illness

SAMPLE What type of reaction do you have when you take medication?

Allergies

OPQRST Does the pain move anywhere?

Region/radiation

OPQRST When did the problem begin?

Onset

SAMPLE Does your chest hurt?

Signs and symptoms

SAMPLE Have you been recently ill?

Past medical history

Which of the following is NOT considered part of the scene size-up? A. Determining the mechanism of injury B. Requesting additional assistance C. Determining the level of responsiveness D. Determining the need for personal protective equipment (PPE)/standard precautions

C. Determining the level of responsiveness

You should consider all women of childbearing years who are complaining of lower abdominal pain to be: A. Pregnant until proven otherwise B. Experiencing cramps associated with menstruation C. Victims of sexual assault D. Suffering from a urinary tract infection

A. Pregnant until proven otherwise

With ________, the force of the injury occurs over a broad area, and the skin is usually not broken. A. Motor vehicle collisions B. Blunt trauma C. Penetrating trauma D. Gunshot wounds

B. Blunt trauma

Which of the following conditions is NOT known to cause a slow capillary refill? A. Vasoconstriction B. Hypothermia C. Age D. Abdominal pain

D. Abdominal pain

________ is the measure of the amount of air that is moved into and out of the lungs in one breath. A. Residual volume B. Tidal volume C. Vital capacity D. Minute volume

B. Tidal volume

There are three elements to the physical exam. Which of the following is NOT one of those elements? A. Puncture B. Inspection C. Palpation D. Auscultation

A. Puncture

In a patient with deeply pigmented skin, where should you look for changes in color? A. Ear canals B. External eyelids C. Groin D. Mucous membranes of the mouth

D. Mucous membranes of the mouth

When the force of the injury occurs at a small point of contact between the skin and the object piercing the skin: A. motor vehicle collisions B. blunt trauma C. penetrating trauma D. falls

C. penetrating trauma

Which of the following is NOT considered a method for controlling external bleeding? A. Direct pressure B. Tourniquet C. Cold water D. Elevation

C. Cold water

The ________ is/are the most serious thing that the patient is concerned about, the reason why they called 9 1 1. A. chief complaint B. pertinent negatives C. severity D. past medical history

A. chief complaint

The four items used to assess the orientation of a patient’s mental status include all of the following EXCEPT: A. person B. place C. history D. events

C. history

An integral part of the rapid exam is evaluation using the mnemonic: A. AVPU B. DCAP BTLS C. OPQRST D. SAMPLE

B. DCAP BTLS

In the absence of light, the pupils will: A. constrict B. stay fixed C. dilate D. become unequal

C. dilate

When assessing the respiratory system, which of the following is NOT considered essential to the assessment? A. Respiratory rate B. Depth of breathing C. Quality/character of breathing D. Breath odor

D. Breath odor

Which of the following statements regarding assessment of the airway is TRUE? A. The body will not be supplied the necessary oxygen if the airway is not managed. B. You should use the head tilt–chin lift maneuver to open the airway in trauma patients. C. The tongue is generally not a cause of airway obstruction. D. A conscious patient who cannot speak or cry is most likely hyperventilating.

A. The body will not be supplied the necessary oxygen if the airway is not managed.

When determining the initial general impression, you should note all of the following EXCEPT: A. the patient's age B. the level of distress C. the events leading up to the incident D. the patient's sex

C. the events leading up to the incident

Which of the following is included in the primary assessment? A. Blood pressure B. Palpating a pulse C. Oxygen saturation D. Pupil size

B. Palpating a pulse

Which of the following conditions would be considered "high priority" when determining the priority of transport? A. Uncomplicated childbirth B. Mild abdominal pain C. Difficulty breathing D. Pink skin color

C. Difficulty breathing

What does the “P” on the AVPU scale represent? A. Responsive to palpation B. Responsive to pain C. Responsive to provocation D. Responsive to palliation

B. Responsive to pain

A normal respiratory rate for an adult is typically: A. 5 to 10 breaths per minute B. 12 to 20 breaths per minute C. 15 to 30 breaths per minute D. 20 to 30 breaths per minute

B. 12 to 20 breaths per minute

For children younger than 1 year, you should palpate the ______ artery when assessing the pulse. A. carotid B. radial C. femoral D. brachial

D. brachial

When there are low levels of oxygen in the blood, the lips and mucous membranes appear blue or gray. What is the name of this condition? A. Cyanosis B. Pallor C. Jaundice D. Ashen

A. Cyanosis

Your first consideration when assessing a pulse is to determine: A. how fast the rate is B. the quality C. if one is present D. if the rhythm is regular

C. if one is present

To obtain the pulse rate in most patients, you should count the number of pulses felt in a ______ period and then multiply by two. A. 15-second B. 20-second C. 25-second D. 30-second

D. 30-second

Which of the following is NOT considered a type of breath sound? A. Rhonchi B. Vibration C. Wheeze D. Stridor

B. Vibration

You are examining a 40-year-old female who you suspect might be a victim of abuse. Which of the following supports your suspicion? A. Mechanism of injury that matches the patient’s history B. Unremarkable medical history with no previous injuries C. Multiple injuries in various stages of healing D. Consistent history reporting by the patient

C. Multiple injuries in various stages of healing

When caring for a patient who is unable to speak or understand English, you should: A. raise the volume of your voice B. give the hospital advance notice in your radio report C. feel free to make derogatory remarks D. encourage the patient to learn English

B. give the hospital advance notice in your radio report

__________ is an assessment tool used to evaluate the effectiveness of oxygenation. A. Capnography B. Capnometry C. Pulse oximetry D. Blood glucose

C. Pulse oximetry

The pressure felt along the wall of the artery when the ventricles of the heart contract is referred to as the: A. asystolic pressure B. diastolic pressure C. idiopathic pressure D. systolic pressure

D. systolic pressure

A blood pressure cuff that’s too large for the patient: A. may result in a falsely low reading B. may result in a falsely high reading C. will not affect the reading D. should be used in patients with arm pain

A. may result in a falsely low reading

Which of the following is NOT typically found on an abdominal exam? A. Guarding B. Crepitation C. Tenderness D. Rigidity

B. Crepitation

Crackling sounds produced by air bubbles under the skin are known as: A. subcutaneous ecchymosis B. subcutaneous emphysema C. subcutaneous erythema D. subcutaneous emboli

B. subcutaneous emphysema

Unstable patients should be reassessed every _____ minutes. A. 5 B. 10 C. 15 D. 20

A. 5

In the _______ position, the patient sits leaning forward on outstretched arms with the head and chin thrust slightly forward. A. Fowler's B. tripod C. sniffing D. lithotomy

B. tripod

In an unresponsive adult patient, the primary location to assess the pulse is the _______ artery. A. carotid B. femoral C. radial D. brachial

A. carotid

Liver disease or dysfunction may cause ________, resulting in the patient's skin and sclera turning yellow. A. cyanosis B. jaundice C. diaphoresis D. lack of perfusion

B. jaundice

When obtaining a blood pressure by palpation in the arm, you should place your fingertips on the _______ artery. A. carotid B. brachial C. radial D. posterior tibial

C. radial

_______ is performed at regular intervals during the assessment process, and its purpose is to identify and treat changes in a patient's condition. A. primary assessment B. reassessment C. secondary assessment D. scene size-up

B. reassessment

Which of the following is NOT considered a sign? A. Dizziness B. Marked deformities C. External bleeding D. Wounds

A. Dizziness

When blood pressure drops, the body compensates to maintain perfusion to the vital organs by: A. decreasing the pulse rate B. dilating the arteries C. decreasing the respiratory rate D. decreasing the blood flow to the skin and extremities

D. decreasing the blood flow to the skin and extremities

When assessing and treating a patient who is visually impaired, it is important that you do all of the following EXCEPT: A. speak loudly into the patient's ear because he or she can't see you B. announce yourself when entering the residence C. put items that were moved back into their previous position D. explain to the patient what is happening

A. speak loudly into the patient's ear because he or she can't see you

Which of the following statements is false regarding the assessment of patients with a language barrier? A. You should find an interpreter. B. You should determine whether the patient understands you. C. Your questioning should be lengthy and complex. D. You should be aware of the language diversity in your community.

C. Your questioning should be lengthy and complex.

True/False Responsiveness is evaluated with the mnemonic DCAP-BTLS.

False

True/False Reassessment is not necessary for stable patients.

False

True/False An assessment of the patient’s musculoskeletal system typically is done because of a chief complaint associated with some type of trauma.

True

True/False The apparent absence of a palpable pulse in an unresponsive patient is not a cause for concern.

False

True/False A patient with a poor general impression is considered a priority patient.

True

True/False When assessing the head, you should assess the patient’s ears and nose for fluid.

True

True/False Paradoxical motion of the chest wall is commonly associated with upper respiratory infections.

False

True/False The abdomen is broken into six areas for assessment at the EMT level.

False

True/False In the reassessment process, you should reevaluate everything that has been done to this point in the patient assessment process.

True

True/False Law enforcement personnel may be needed at scenes to control traffic or intervene in domestic violence situations.

True

True/False Determining the mental status and the level of consciousness of a patient take a great deal of time while on scene.

False

True/False Depressed brain function can result from trauma or stroke.

True

True/False PEARL is used to describe skin color.

False

True/False You should consider providing positive pressure ventilation in a conscious patient who has a respiratory rate of 14 breaths/min.

False

True/False When documenting vital signs, you should note whether the patient’s respirations are regular or irregular.

True

True/False Patients with difficulty breathing, severe chest pain, and signs of poor perfusion should be transported immediately.

True

True/False Correct identification of high-priority patients is an essential aspect of the primary assessment and helps to improve patient outcome.

True

True/False You should not interrupt patients when speaking, and you should be empathetic to their situations.

True

True/False Being openly judgmental of patients who may have a chemical dependency is acceptable as long as you remain professional.

False

True/False Scenes involving domestic violence can be extremely dangerous for EMS personnel.

True

True/False You should consider all females of childbearing age who are reporting lower abdominal pain to be pregnant unless ruled out by history or other information.

True

True/False Once you have allowed a talkative patient a chance to express himself or herself, you should allow the patient to continue talking about whatever he or she wants.

False

True/False EMTs can expect anxious patients to exhibit signs of psychological shock.

True

True/False It is unusual for a patient, family member, or friend to vent hostility toward EMS.

False

True/False Information gathered from an intoxicated patient may be unreliable.

True

True/False Your presence may make a crying patient feel more secure.

True

True/False Depression is not a common reason for patients to call for EMS.

False

True/False When assessing a patient, you should inspect the pelvis for symmetry and any obvious signs of injury, bleeding, and deformity.

True

True/False Pulse and motor and sensory functions are typically assessed when examining a patient's extremities.

True

A(n) ________ is an objective condition that you can observe about the patient.

sign

________ ________ are protective measures for dealing with blood and bodily fluids.

Standard precautions

When there are multiple patients, you should use the ________ ________ ________ to help organize the triage, logistics, and treatment of patients.

incident command system

________ ________ ________ should be requested for patients with severe injuries or complex medical problems.

Advanced life support

Identifying and initiating treatment of immediate, potentially life threatening conditions is the goal of the ________ ________.

primary assessment

You should think of the ________ ________ as a visual assessment, gathering information as you approach the patient.

general impression

________ is the flow of blood through body tissues and vessels.

Perfusion

________ tests the mental status of the patient by checking memory and thinking ability.

Orientation

When light is shined into the eyes, the pupils should ________.

constrict

A brassy, crowing sound that is prominent on inspiration, suggesting a mildly occluded airway, is referred to as ________.

stridor

If there is a potential for trauma, use the _______-_______ ________ to open the airway.

jaw-thrust maneuver

During ________, the chest muscles relax, and air is released out of the lungs.

exhalation

If a patient seems to develop difficulty breathing after your primary assessment, you should immediately reevaluate the ________.

airway

If you hear fluid in the airway during your assessment, you should immediately ________ the airway to prevent aspiration.

suction

A patient who coughs up thick yellow or green sputum most likely has a(n) ________ ________.

respiratory infection

________ ________ and seesaw breathing in a pediatric patient indicate inadequate breathing.

Nasal Flaring

If you cannot palpate a pulse in an unresponsive patient, you should begin ________.

CPR

________ is a heart rate greater than 100 beats/min.

Tachycardia

The ________ is the delicate membrane lining the eyelids, and it covers the exposed surface of the eye.

conjunctiva

Skin that is cool, clammy, and pale in your primary assessment typically indicates ________.

hypoperfusion

When the skin is bathed in sweat, it is described as ________.

diaphoretic

A capillary refill time should be less than ________ second(s).

Direct pressure stops bleeding and helps the blood to ________, or clot, naturally.

coagulate

A rapid scan to identify immediate threats should take no more than ________ second(s).

The ________ ________ refers to the time from injury to definitive care.

Golden Hour

The goal of the primary assessment is to identify and treat ________ ________.

life threats

________ ________ provides details about the patient's chief complaint and an account of the patient's signs and symptoms.

History taking

You should use ________ ________ questions when taking a history of a patient.

open ended

________ is a mnemonic used to gather past medical or trauma history.

SAMPLE

________ ________ are negative findings used to help identify a patient's problem.

patient negatives

________ ________ should be assessed in all known diabetic patients and all patients who are unresponsive for an unknown reason.

Blood glucose

________ describes the process of touching or feeling the patient for abnormalities.

Palpations

________ is a noninvasive method that can quickly and efficiently provide information on a patient's ventilatory status, circulation, and metabolism.

Capnography

________ ________ is the residual pressure that remains in the arteries during the relaxation phase of the heart.

Diastolic pressure

A(n) ________ assessment should be performed anytime you are confronted with a patient who has a change in mental status, a possible head injury, or syncope.

neurological

Short Answers What is the single goal of primary assessment?

To identify and initiate treatment of immediate or potential life threats

Short Answers What is the general impression based on?

Age, sex, race, level of distress, and overall appearance

Short Answers What do the letters ABC stand for in the assessment process?

Airway, Breathing, Circulation

Short Answers What four kinds of questions are asked when assessing orientation, and what purpose do these questions serve?

Orientation to person, place, time, and event; evaluates long term, intermediate, and short term memory

Short Answers What three questions should you ask yourself when assessing a patient's breathing?

1. Is the patient breathing? 2. Is the patient breathing adequately? 3. Is the patient hypoxic?

Short Answers List the elements of DCAP BTLS.

D: Deformities C: Contusions A: Abrasions P: Punctures/Penetrations B: Burns T: Tenderness L: Lacerations S: Swelling

Short Answers What three questions should you ask yourself to determine if additional resources are needed at a scene?

1. Does the scene pose a threat to you, your patient, or others? 2. How many patients are there? 3. Do we have the resources to respond to their conditions?

Short Answers Define the acronym PEARL.

Pupils equal and round, regular in size, react to light

Short Answers Explain the difference between a sign and a symptom.

A sign is a condition that can be seen, heard, felt, smelled, or measured (objective). A symptom is something that the patient reports to you as a problem or feeling (subjective).

Short Answers You are caring for a 24-year-old male with a pertinent sexual history. What questions should he be asked as part of your history taking?

1. Is there pain associated with urination? 2. Do you have any discharge, sores, or an increase in urination? 3. Do you have burning or difficulty voiding? 4. Has there been any trauma? 5. Have you had recent sexual encounters?

Ambulance Calls You are dispatched to a motor vehicle collision where you find a 32-year-old man with extensive trauma to the face and gurgling in his airway. He is responsive only to pain. You also note that the windshield is spider-webbed and that there is deformity to the steering wheel. He is not wearing a seat belt. How would you best manage this patient? What clues tell you the transport status?

Maintain c-spine control and manage the airway with suction and oxygen. Conduct a rapid survey and transport to the nearest appropriate facility. This patient is a priority transport due to the mechanism of injury, level of consciousness, and airway compromise. The vehicle damage suggests possible occult injuries.

Ambulance Calls You are dispatched to a local residence for “difficulty breathing.” You find a man standing in his kitchen, leaning against a counter in a tripod position, and holding a metered-dose inhaler. As you question him, you see that he is working very hard to breathe, hear wheezing, and note that he can answer you with only one- or two-word responses. What is the transport status of this patient?

This patient is experiencing a serious asthma attack. The use of accessory muscles (nasal flaring, tracheal tugging, suprasternal and intercostal muscle retractions), work of breathing, wheezing, and limited verbal responses indicate the severity of the attack, necessitating immediate transport.

Ambulance Calls You are dispatched to “man fallen” at a private home. You arrive to find an older man who appears to have fallen down a flight of wooden stairs onto a cement basement floor. He is responsive to painful stimuli, has bruising, and has a small laceration above his left eye. How would you best manage this patient?

The head injury is likely more severe than the visible bruising and laceration. Potential skull fractures, contusions, or intracranial bleeding may be present. Significant head trauma raises the likelihood of cervical spine fractures. The mechanism of the fall should be questioned, as underlying medical conditions may have contributed. Full cervical spine precautions and high flow oxygen application are recommended, along with prompt transport.

Chapter 10 Workbook Flashcards

(151 cards)