Deck 12: The Primary Assessment

Question 1

You are at the scene where a 19-year-old female college student has been drinking large quantities of alcohol throughout the evening.On your arrival,the patient is lying on her back with no signs of trauma,has vomited,and has slow,wet sounding respirations.Which of the following should you do next?

A) Determine the respiratory rate.
B) Check for carotid and radial pulses.
C) Assist respirations with a bag-valve-mask device.
D) Open the patient's airway using a head-tilt, chin-lift maneuver.

Answer 1

Open the patient's airway using a head-tilt, chin-lift maneuver.

Question 2

Which of the following is completed first during the primary assessment?

A) Determining transport priority
B) Assessing mental status
C) Opening the airway
D) Forming a general impression

Answer 2

Forming a general impression

Question 3

Which of the following describes the chief complaint?

A) Reason why the patient summoned EMS
B) Events immediately preceding the call for EMS
C) Overall impression of the patient's condition
D) All of the above

Answer 3

Reason why the patient summoned EMS

Question 4

Which of the following represents the correct order of assessment for the EMT during the primary assessment from start to end?

A) General impression, mental status, airway, breathing, circulation, patient priority
B) Mental status, general impression, airway, breathing, circulation, patient priority
C) Patient priority, general impression, mental status, airway, breathing, circulation
D) None of the above

Question 5

Which of the following BEST describes an EMS provider's "sixth sense"?

A) Diagnostic ability
B) General impression
C) Clinical judgment
D) Scene safety

Question 6

Which of the following is NOT part of the general impression?

A) Patient's facial expression
B) Patient's age and race
C) Position in which the patient is found
D) Patient's past medical history

Question 7

The mnemonic AVPU is used to evaluate which of the following?

A) Patient's chief complaint
B) Patient's level of responsiveness
C) Patient's transport priority
D) EMT's general impression of the patient's condition

Question 8

In EMS,what does mental status refer to?

A) Patient's level of awareness of his surroundings
B) Any history of mental illness that the patient may have
C) Patient's general level of intelligence
D) None of the above

Question 9

In EMS,which of the following BEST describes the term intervention?

A) Determining if there is a problem
B) Taking steps to correct a problem
C) Creating a permanent record of patient care
D) Decreasing the EMT's liability for negligence

Question 10

Which of the following is the purpose of the primary assessment?

A) To detect and treat immediately life-threatening problems
B) To find all of the patient's signs and symptoms
C) To discover trends of improvement or deterioration in the patient's condition
D) To detect dangers to the patient and/or EMS crew

Question 11

A patient whose mental status can be described as "verbal" is able to:

A) tell you his or her name, his or her location, and what day it is.
B) respond only to a stimulus such as the EMT rubbing his sternum with his knuckles.
C) talk spontaneously and respond to the EMT's questions.
D) respond to speaking or shouting by opening the eyes.

Question 12

You are approaching a young adult male lying supine on the ground with his eyes closed.You should:

A) open his airway.
B) ask him if he is okay.
C) expose his chest.
D) feel for a pulse.

Question 13

Which of the following questions will most likely elicit your patient's chief complaint?

A) What made you call 911 this evening?
B) Do you have any medical problems?
C) How have you been feeling lately?
D) Have you been drinking today?

Question 14

Your patient is a 72-year-old female who has "twisted her ankle" coming down some steps.She is alert and complaining of pain in her right ankle,but she jokes about her "clumsiness." Which of the following should you do next?

A) Take immediate manual control of the patient's cervical spine.
B) Administer high-concentration oxygen by nonrebreather mask.
C) Determine the presence of a carotid pulse.
D) Ask if the patient has pain anywhere besides her ankle.

Question 15

What BEST defines the immediate sense of the patient's degree of distress,formulated from the patient's immediate environment,appearance,and chief complaint?

A) General impression
B) Primary assessment
C) Scene size-up
D) Secondary assessment

Question 16

Which of the following is true concerning the primary assessment?

A) Manual airway maneuvers must be performed on all patients.
B) The EMT should perform a sternal rub on all patients to test for response to painful stimuli.
C) External bleeding will be obvious as you enter the room and initially see the patient.
D) The primary assessment begins by just observing the patient as you enter the room.

Question 17

Which of the following techniques is used when formulating the general impression?

A) Detecting odors
B) Listening for unusual sounds
C) Looking for visual clues
D) All of the above

Question 18

Which of the following is NOT true regarding a patient who has a mental status of less than "alert"?

A) His brain may not be getting enough oxygen.
B) He is in a state of rapid eye movement sleep.
C) He may not have adequate blood circulation.
D) He requires high-concentration oxygen.

Question 19

Your patient is a middle-aged man who appears to be in distress and is clutching his chest.These observations lead you to suspect which type of problem?

A) Choking
B) Cardiac
C) Anaphylaxis
D) Digestive

Question 20

You find a middle-aged unresponsive man lying prone on the ground near a ladder.You should:

A) move the ladder out of the way.
B) roll him over to a supine position.
C) pick him up with a scoop stretcher.
D) manually immobilize his head.

Question 21

Which of the following is the correct manner for checking for responsiveness in an apparently unresponsive infant?

A) Pinching the earlobe
B) Rubbing the sternum with your knuckles
C) Flicking the soles of the feet
D) Shaking the child

Question 22

Your patient is a 33-year-old man who has been ejected from his vehicle during a high-speed collision.During your primary assessment it is discovered that he is not moving,does not appear to have adequate respirations,and has suffered moderate external bleeding.Which of the following should be done first?

A) Control the bleeding with direct pressure.
B) Open the airway.
C) Begin bag-valve-mask ventilations.
D) Check the patient's carotid pulse.

Question 23

You are approaching a 16-year-old male with bright red spurting blood coming from his leg.He is screaming,and he begs you to help him.You should:

A) control the bleeding.
B) ask him to calm down.
C) assess his airway.
D) apply oxygen.

Question 24

You enter a room to find a 16-year-old female sitting upright in a chair with her back straight,leaning forward,and her arms supporting her.She is having a hard time talking to you.You should suspect:

A) abdominal pain.
B) chest discomfort.
C) allergic reaction.
D) respiratory distress.

Question 25

Which of the following is the proper position for maintaining the airway in a child with a decreased level of consciousness?

A) Hyperextension of the neck; placing a pillow under the back if necessary
B) Placing the head and neck in a neutral position; using a folded towel under the shoulders if necessary
C) Flexing the neck to place the chin on the chest; placing a folded towel under the back of the head if necessary
D) Using a cervical collar to keep the chin elevated

Question 26

Which of the following is NOT performed during the "Airway" phase of the primary assessment?

A) Head-tilt, chin-lift maneuver
B) Obtaining the respiratory rate
C) Suctioning
D) Insertion of an oropharyngeal airway

Question 27

In the primary assessment,which of the following is NOT an acceptable method of assessing the patient's circulatory status?

A) Assessing the patient's skin color
B) Taking a blood pressure reading
C) Checking a radial pulse
D) Looking for serious bleeding

Question 28

What is a normal capillary refill time in a pediatric patient?

A) 3 seconds
B) 1 minute
C) 5 seconds
D) less than 2 seconds

Question 29

During the primary assessment of a responsive adult patient,where should the pulse be checked?

A) At the radial artery
B) At the femoral artery
C) At the brachial artery
D) At the carotid artery

Question 30

For which of the following patients would capillary refill be a reliable sign of circulatory status?

A) 24-year-old homeless man who has spent the night outside in the rain
B) 92-year-old man complaining of weakness on his right side
C) 50-year-old woman complaining of chest pain
D) 3-year-old child with a fever and cough

Question 31

You have arrived on the scene at a high school football field where a 17-year-old male is lying on the ground.He is unresponsive and cyanotic,and he is making obvious respiratory effort without moving adequate amounts of air.Which of the following should be done first?

A) Assist ventilations with a bag-valve-mask device and supplemental oxygen.
B) Open the patient's airway using a manual maneuver.
C) Apply high-concentration oxygen by nonrebreather mask.
D) Insert a nasopharyngeal or oropharyngeal airway.

Question 32

Which of the following is NOT assessed during the "Breathing" phase of the primary assessment?

A) Determining the depth of respiration
B) Counting the respiratory rate
C) Determining the presence of respirations
D) Obtaining a pulse oximetry reading

Question 33

Which of the following presentations would be considered normal during the "Breathing" phase of the primary assessment?

A) Respiratory rate of 6 with shallow depth
B) Respiratory rate of 28 with adequate depth
C) Respiratory rate of 12 with adequate depth
D) Respiratory rate of 16 with altered mental status

Question 34

Which of the following is the most reliable means of determining whether a patient has any immediately life-threatening conditions?

A) Systematic approach to assessment
B) Obtaining a detailed medical history
C) Thorough scene size-up
D) Use of intuition

Question 35

Which of the following indicates a possible circulatory problem?

A) Weak, thready pulse that is normal in rate
B) Slow pulse
C) Rapid pulse
D) All of the above

Question 36

Which of the following patients is a high priority for transport?

A) Adult male with dull abdominal pain
B) Adult male with sharp lower back pain
C) Adult male with a headache
D) Adult male with difficulty breathing

Question 37

Your patient is a 42-year-old woman who fell two feet from a ladder and is complaining of pain in her ankle.Which of the following are you unable to determine from the information given?

A) Chief complaint
B) Airway status
C) General impression
D) Transport priority

Question 38

Which of the following differences should be expected when assessing a pediatric patient,as compared to the adult patient?

A) The normal pulse rate is slower.
B) Capillary refill is not as reliable an indicator of circulatory status.
C) The normal respiratory rate is faster.
D) An adult's tongue is proportionally larger than that of a child and should always be considered as a potential airway obstruction.

Question 39

You find a teenage male lying supine in his bedroom.You hear gurgling sounds from the patient's mouth and see vomit with pill fragments on the floor.You should:

A) ventilate with oxygen.
B) suction the airway.
C) identify the pills.
D) perform chest thrusts.

Question 40

Which of the following is a good indication of an occluded airway?

A) The patient is crying loudly.
B) The patient is speaking clearly.
C) The patient is alert.
D) The patient has snoring respirations.

Question 41

Your partner is assessing a 55-year-old man who was found sitting on the tailgate of his truck after being involved in a motor vehicle collision.In order to provide for stabilization of the patient's cervical spine,you should:

A) lay the patient down in the truck bed.
B) instruct the patient to stand up.
C) stand behind the patient in the truck bed.
D) assist the patient to the stretcher.

Question 42

Which of the following findings is generally NOT used to assess an adult's circulation?

A) Patient's skin color, temperature, and condition
B) Patient's distal pulse rate
C) Evaluation for bleeding
D) Patient's capillary refill time

Question 43

During the primary assessment of an unresponsive two-month old infant,which pulse should be palpated?

A) Brachial
B) Carotid
C) Umbilical
D) Radial

Question 44

You are approaching an adult female lying supine on the ground with snoring respirations.You should:

A) open her airway with a jaw-thrust maneuver.
B) insert an oropharyngeal airway.
C) insert a nasopharyngeal airway.
D) ventilate with a bag-valve mask.