Deck 11: Baseline Vital Signs, Monitoring Devices, and History Taking

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Question
Which one of the pulses listed below is palpated in the groin area?

A) Carotid
B) Inguinal
C) Pedal
D) Femoral
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Question
You determine a radial pulse is readily palpable, but has uneven intervals between beats. This would best be documented on the prehospital care report as:

A) bounding and regular.
B) prominent and bounding.
C) strong and irregular.
D) thready and regular.
Question
Which of the following signs related to breathing would be most concerning to the EMT?

A) Respiratory rate of 18, complaint of weakness
B) Respiratory rate of 22, chest expansion of 1 inch
C) Respiratory rate of 10, speaking without difficulty
D) Respiratory rate of 20, use of accessory muscles
Question
Which patient description contains only vital signs?

A) Chief complaint of dizziness, skin cool and clammy, respiratory rate 16
B) Chief complaint of dizziness, BP 110/76 mmHg, breath sounds clear and equal
C) Skin warm and dry, heart rate 74, pupils equal and reactive
D) Heart rate 88, respiratory rate 14, blood glucose level 98 mg/dL
Question
Emergency Medical Responders inform you that a 27-year-old male with altered mental status has an open airway and is breathing 9 times every 30 seconds. His pulse rate is 40 beats per minute, and he has bruises to his chest. Based on this information, the EMT should recognize the:

A) respiratory rate as normal.
B) heart as beating adequately.
C) blood pressure as normal.
D) heart rate as irregular.
Question
You determine a patient's heart rate to be 48 beats per minute. That heart rate would be categorized as:

A) tachypneic.
B) normal.
C) bradycardic.
D) tachycardic.
Question
Which piece of equipment would the EMT need to obtain a patient's vital signs?

A) Glucometer
B) Stethoscope
C) Oxygen
D) Automated defibrillator
Question
Which statement made by your partner indicates that he understands assessment of a patient's breathing?

A) "As long as the patient is breathing over 20 times a minute, he is getting enough oxygen in his body."
B) "If the respiratory rate is normal, the patient is breathing adequately and getting enough oxygen."
C) "A rate less than 8 may allow adequate breathing, but requires further evaluation and assessment."
D) "To determine if a patient is adequately breathing, the EMT must get a full set of vital signs."
Question
Which one of the following characteristics is a quality of a patient's pulse?

A) Strength
B) Rate
C) Regularity
D) Tone
Question
A young female patient has been stung by a bee and states that her "throat is closing up." She states that she is allergic to bee stings and the last time this happened, she had to have a "tube put into my windpipe." She is struggling to breathe and can only speak a few words at a time. Knowing that allergic reactions can cause swelling in the pharynx and at the level of the larynx, which one of the following respiratory sounds would indicate that the patient indeed has swelling in this area?

A) Gurgling
B) Stridor
C) Snoring
D) Wheezing
Question
You are assessing a 61-year-old male who is confused. During the primary assessment, you cannot locate a radial pulse. Your immediate action should be to:

A) apply the AED.
B) call for ALS assistance.
C) check for a carotid pulse.
D) start CPR.
Question
When assessing a patient's pulse, you note that it is irregular. To get an accurate heart rate, you would:

A) listen to the pulse with a stethoscope.
B) count the number of beats that occur in 1 minute.
C) double the number of beats obtained in 30 seconds.
D) feel the carotid pulse for 30 seconds and multiply by 2.
Question
When assessing a patient's pulse, you can locate the right radial pulse, but not the left. Which one of the following is the most likely explanation for this finding?

A) The patient is in the early stage of cardiac arrest.
B) The left radial artery is extremely large.
C) There is a problem with the patient's veins.
D) The left radial artery may be occluded.
Question
A family has called you for a 41-year-old male they cannot wake up. They state he has been threatening to kill himself and believe that he may have intentionally overdosed on his pain medications. As you enter the patient's bedroom, you observe him supine on the floor with his eyes closed. As he breathes, you hear snoring respirations. As a knowledgeable EMT, you recognize which one of the following?

A) He will require immediate suctioning.
B) He is sleeping and has not overdosed.
C) His tongue is partially blocking the airway.
D) His respiratory rate must be less than 10 per minute.
Question
The EMT recognizes which one of the following heart rates (beats per minute) as normal for a 24-year-old male?

A) 54
B) 62
C) 110
D) 124
Question
The EMT is correctly calculating a patient's respiratory rate when he or she:

A) asks the patient to describe how he feels when he breathes.
B) obtains a pulse oximetry reading and divides it by 3.
C) assesses the patient for any sign of respiratory difficulty.
D) counts the number of breaths for 30 seconds and multiplies by 2.
Question
You have been called to assess a conscious and alert 5-year-old whose chief complaint is nausea and vomiting over the last 2 hours. When assessing his pulse, you should first check which pulse?

A) Brachial
B) Carotid
C) Pedal
D) Radial
Question
During the primary assessment of a geriatric patient complaining of shortness of breath and fever, you quickly locate the radial pulse. What should you do next?

A) Assess the patient's breathing.
B) Obtain a blood pressure.
C) Determine the rate and quality of the pulse.
D) Establish the patient's level of consciousness.
Question
An EMT is correctly assessing a patient's radial pulse when he:

A) uses the palm of his hand to feel the pulse on the upper arm.
B) simultaneously checks for a heart rate on both sides of the neck.
C) uses his thumb to feel for the pulse on the patient's lower arm.
D) uses his fingertips to feel for a pulse at the patient's wrist.
Question
Which one of the following statements concerning assessment of the pulse is correct?

A) "The heart rate can be determined by doubling the number of beats counted in 30 seconds."
B) "To get the most accurate rate, the EMT should place a stethoscope over the pulse site and count the number of beats in 1 minute."
C) "A brachial pulse should be felt first in any patient under 6 years of age."
D) "After much experience, an EMT can estimate the pulse rate by just feeling it for a few seconds."
Question
You are assessing a confused dark-skinned patient complaining of a headache. When checking his skin color, you should:

A) examine the skin around his ears and nose.
B) evaluate the palms of his hands or soles of his feet.
C) observe the skin on his forehead.
D) look and feel the skin on his neck and chest.
Question
A patient with pancreatic cancer exhibits a yellow discoloration to his entire body. The EMT would correctly document this condition as:

A) jaundice.
B) cyanotic.
C) pallor.
D) flushed.
Question
You are called to a long-term care facility to assess and transport a patient with a high fever. You do not have a thermometer on your unit. Which one of the following signs should you use to confirm the patient's increased body temperature?

A) Cyanotic skin around the mouth
B) Decreased heart rate and flushed skin
C) Fingertips that are cool and blue
D) Skin on the abdomen that is hot and flushed
Question
You are called for a 2-year-old child who is sick. When testing her capillary refill, which one of the following would be the most cause for concern?

A) Immediate return of color
B) 1-second capillary refill time
C) 2-second capillary refill time
D) 3-second capillary refill time
Question
Assessment of a patient's skin color reveals a bluish discoloration. As a knowledgeable EMT, you should identify:

A) pallor caused by a decrease in blood flow to the tissues.
B) cyanosis caused by inadequate oxygenation of the tissues.
C) pallor caused by a decrease in body temperature.
D) jaundice caused by an increase in blood flow to the extremities.
Question
Which one of the following statements made by an EMT indicates an accurate understanding of checking a patient's skin temperature?

A) "Checking the skin temperature is not precise, but a good estimate of abnormally high or low body temperatures."
B) "To properly evaluate a patient's skin temperature during the primary assessment, the EMT needs a thermometer."
C) "It is important to remember that flushed skin always indicates a high body temperature."
D) "With experience, the EMT can precisely determine a patient's body temperature by feeling the skin."
Question
A patient has advanced liver disease from years of exposure to toxic chemicals in his place of employment. Which one of the following skin colors would the EMT expect?

A) Bluish-gray
B) Pale and cyanotic
C) Pinkish and flushed
D) Yellow-orange
Question
For which patient would a capillary refill time of 3 seconds be most indicative of poor perfusion?

A) 4-year-old male
B) 24-year-old female
C) 67-year-old female
D) 81-year-old male
Question
An EMT has accurately checked the skin color of a patient. Which one of the following indicates correct documentation?

A) "Warm skin noted on the upper arm."
B) "Forehead and face show pink skin color."
C) "Pale color noted to the conjunctiva."
D) "Thoracic and abdominal skin normal in color."
Question
When evaluating a patient's skin color, the EMT should:

A) observe the nail beds and/or mucous membranes inside the eyelids.
B) examine the change in skin color when applying then releasing pressure to the nail beds.
C) look at the skin on the upper chest and feel it for warmth.
D) examine the skin color of the face and compare it with the color of the arms.
Question
Which one of the following statements made by an EMT student indicates that he correctly understands the use of capillary refill when assessing a patient?

A) "Capillary refill is a very reliable sign of shock in any patient between the ages of 18 and 65 years."
B) "Capillary refill is a more reliable sign of blood circulation in children under 6 years of age than in adolescents or adults."
C) "The possibility of chronic circulatory diseases makes the capillary refill test an excellent sign of circulation in the adult patient."
D) "If a delayed capillary refill is observed in any aged patient, there is a high probability he or she is in shock."
Question
A patient presents with skin that is cool to the touch. The EMT shows he understands this condition when he states:

A) "This would appear to indicate a problem with the circulation of blood."
B) "The patient must have an infection somewhere in his body."
C) "We should check his breath sounds; he probably has a lung infection."
D) "The patient most likely has a past medical history of hypertension."
Question
When assessing a patient's pupils, the EMT should:

A) shine a light in one eye and watch for the pupil to dilate.
B) cover one eye and shine a light in the other, watching for changes to the size of the pupil.
C) determine the size of the pupil and then look for a change in pupillary size as you shine a light in the eye.
D) instruct the patient to blink several times and observe the size of the pupils.
Question
To test a patient's capillary refill, the EMT will:

A) apply gentle pressure to the radial pulse and watch color changes to the hand.
B) firmly compress and then release pressure on the nail bed.
C) examine the inside lining of one or both eyelids.
D) apply pressure and then release that pressure from the arm.
Question
You are assessing a female patient with a complaint of shortness of breath. When assessing her skin, which one of the following should be recognized as abnormal?

A) Dry
B) Pink
C) Moist
D) Warm
Question
Which one of the following is an accurate method of assessing a patient's skin temperature?

A) Placing the tips of two fingers on the patient's wrist
B) Using the palm to feel the patient's forehead
C) Placing the back of the hand on the patient's abdomen
D) Placing the inside of the arm against the patient's arm
Question
The EMT should recognize normal skin color in a healthy patient as:

A) white.
B) warm.
C) red.
D) pink.
Question
A patient presents with extremely pale skin. His family states that this is not his normal skin color. His vital signs are pulse 108, respirations 18, blood pressure 102/86, and SpO₂ 96% Which one of the following complaints would make the most sense given this clinical presentation?

A) Persistent cough
B) Fever
C) Rectal bleeding
D) Headache
Question
A patient who was shoveling snow developed chest pain, immediately sat down in a nearby bus shelter, and called 911. Prior to moving him into the ambulance, your partner performs a primary assessment and reports that the patient's capillary refill is 5 seconds. Which one of the following statements would be most appropriate for you to make?

A) "That is a significant finding. We really need to get him on oxygen and moving to the hospital."
B) "The cold temperature may cause the capillary refill to be 5 seconds; we should assess further."
C) "That seemingly indicates he has lost blood and it is not perfusing the skin adequately."
D) "If his skin is also warm and moist, then he is most likely in shock."
Question
Which one of the following patients should the EMT recognize as having a normal skin temperature?

A) 25-year-old female who is dizzy with cool skin
B) 36-year-old male complaining of nausea with warm skin
C) 47-year-old female with chest pain and warm-to-hot skin
D) 88-year-old male who is weak with skin that is cool and dry
Question
As you enter the scene of a medical emergency, the Emergency Medical Responder informs you that the patient is not breathing and has pupils that are fixed and dilated. Based on this description, which one of the following are you expecting to see when you reach the patient's side?

A) Both pupils are large and change shape to light.
B) The patient must wear corrective lenses.
C) The patient has a past medical history of blindness.
D) Neither pupil will react when light is directed into the eyes.
Question
Your partner is having a difficult time determining what a normal and abnormal blood pressure is for a child. Which one of the following statements will help him most?

A) "Since pediatric emergencies are less common than adult emergencies. It is best to call medical direction and ask what is normal."
B) "Any systolic blood pressure of less than 100 mmHg in a child is an emergency."
C) "A normal systolic pressure can be estimated by doubling the child's age and adding it to 80."
D) "It is helpful to ask the parent or caregiver what is normal for the child and compare your reading to that."
Question
You have placed the blood pressure cuff on the arm of a patient who is short of breath. What is your next step?

A) Inflate to a reading of 70 mmHg, check for a radial pulse, and continue inflation until the pulse is no longer felt.
B) Inflate the cuff to 300 mmHg, and then have the cuff inflated for 30 seconds prior to deflation.
C) Inflate the cuff to a reading of 300 mmHg, and then deflate the cuff slowly until you hear a pulse.
D) Inflate the cuff to three times the patient's age and listen for a heartbeat.
Question
What pulse site is commonly used when the EMT elects to palpate a blood pressure?

A) Brachial
B) Radial
C) Carotid
D) Pedal
Question
When obtaining a blood pressure, the EMT listens for a pulse over what blood vessel?

A) Radial artery
B) Antecubital vein
C) Carotid vessels
D) Brachial artery
Question
You observe your partner correctly obtaining a patient's blood pressure when he:

A) inflates the cuff maximally prior to slowly deflating and listening for a pulse.
B) deflates the cuff 2 mmHg per second while listening with a stethoscope.
C) stops inflation and starts deflation as soon as the radial pulse disappears.
D) places the stethoscope under the cuff and deflates it.
Question
The EMT is correct when he makes which one of the following statements about assessment of the pupils?

A) "Dilated pupils are less of a concern than pupils that are constricted."
B) "If a patient's pupils are dilated but react to light, the pupillary exam is considered normal."
C) "Some people naturally have unequal pupils, but both should react to light."
D) "Constricted pupils are less of a concern than are dilated pupils."
Question
An EMT student asks you if it matters if the blood pressure cuff seems too small for a patient, even though a reading can still be obtained. You should respond:

A) "As long as the reading is obtained, it should be accurate."
B) "Cuffs that are too small provide inaccurately high readings."
C) "Using a cuff that is too small can cause damage to the blood vessels."
D) "As long as the radial pulse remains intact, the cuff size is irrelevant."
Question
A blood pressure is reported as 116/68 mmHg. Which one of the following is true?

A) The systolic blood pressure is 116 mmHg.
B) The top number reflects the diastolic blood pressure.
C) The systolic pressure is determined by subtracting 68 from 116.
D) The diastolic blood pressure is 116 mmHg.
Question
A 41-year-old male patient reacts to painful stimuli by moaning. You shine a light at his right pupil. Which one of the following reactions would be normal?

A) Dilation of the right pupil
B) Constriction of the left pupil
C) Dilation of the left pupil
D) Closure of both eyelids
Question
An EMT has an accurate understanding of the systolic blood pressure when he tells you that the systolic blood pressure is:

A) represented by the bottom number.
B) produced when the heart contracts.
C) the pressure in the veins.
D) caused by constriction of the arteries.
Question
Friends called 911 for a 37-year-old female who intentionally overdosed on a narcotic drug. Which one of the following eye findings would reinforce that the patient did indeed take a narcotic?

A) Pupils that constrict to light
B) Bloodshot eyes with large pupils
C) Nonreactive pupils that are unequal
D) Pupils that are constricted
Question
An EMT has an accurate understanding of the diastolic blood pressure when she tells you that the diastolic pressure:

A) is the pressure in the arteries when the heart is not contracting.
B) can be estimated as one-third of the systolic blood pressure.
C) can be easily obtained by palpating the blood pressure.
D) should always be rounded to the nearest 10.
Question
To assess a patient's blood pressure, the EMT will need a:

A) pulse oximeter.
B) sphygmomanometer.
C) pulse oximeter and stethoscope.
D) pair of gloves and stethoscope.
Question
Which one of the following indicates a normal pupillary exam?

A) One pupil dilates and the other constricts to light.
B) Both pupils constrict when light is directed into the eye.
C) The patient reflexively closes his eyes to light.
D) The pupils are equal and do not change shape to light.
Question
Which one of the following indicates that the EMT has correctly positioned the blood pressure cuff on the patient's arm?

A) The cuff is placed over the antecubital space and elbow.
B) The cuff is centered over the top of the radial artery.
C) The cuff is on the same level as the patient's heart.
D) The cuff covers one-third of the patient's upper arm.
Question
You are assessing a patient who is in bright sunlight after collapsing in the hot sun at a picnic. If you cannot immediately move the patient out of the sun, assessment of the pupils will be made more accurate by:

A) shading the patient's eyes.
B) using a blue-tinged light.
C) retracting the eyelid.
D) hydrating the eyes with saline drops.
Question
Assessment of a patient who is unresponsive reveals pupils that are both large at 8 millimeters and do not change size in response to light. The EMT would best document this finding as:

A) bilateral dilation of the pupils.
B) constricted pupils nonreactive to light.
C) midsize pupils that are reactive to light.
D) nonreactive pupils of decreased size.
Question
When getting a blood pressure on a patient, the radial pulse disappears when the gauge reads 130 mmHg. When deflating the cuff, the EMT hears a pulse at 118 mmHg. The pulse disappears at 76 mmHg. Which one of the following is true?

A) The systolic blood pressure is 118 mmHg.
B) The diastolic blood pressure is 130 mmHg.
C) The systolic blood pressure is 76 mmHg.
D) The diastolic blood pressure is 118 mmHg.
Question
Your partner reports that a patient's blood pressure is 156/78 mmHg. From this reading, you realize:

A) The pulse pressure is 224 mmHg.
B) The systolic blood pressure is 78 mmHg.
C) The constant pressure in the veins is 156 mmHg.
D) The diastolic blood pressure is 78 mmHg.
Question
A 69-year-old man is complaining of weakness to the left arm and leg. He also states that he is nauseated and has a headache. The patient's past medical history includes stroke and diabetes. In relation to this information, which one of the following is true?

A) The headache is a symptom related to the chief complaint.
B) The history of diabetes is a sign related to the chief complaint.
C) The dizziness is a sign indicating the severity of the chief complaint.
D) The history of diabetes is a contributing symptom of the chief complaint.
Question
In the prehospital care report, the EMT should recognize that a blood pressure has been palpated when she sees:

A) Palp: 178/118 mmHg.
B) P / 118.
C) 118/178 (palpated).
D) 178 / P.
Question
Which one of the following descriptions would be obtained when asking about the "A" component of the SAMPLE history?

A) Abdomen soft
B) History of asthma
C) Allergy to penicillin
D) Airway open
Question
The EMT understands the primary reason to obtain a medical history using the SAMPLE mnemonic when he states:

A) "The SAMPLE mnemonic helps EMTs to diagnose a patient's medical problem."
B) "It is important to use the SAMPLE mnemonic because the emergency department will need the information."
C) "After performing the primary assessment, the SAMPLE mnemonic helps guide the EMT in further assessment and care."
D) "The SAMPLE mnemonic is important because it will give the EMT the patient's exact chief complaint."
Question
When using a pulse oximeter on an adult patient, the EMT knows that the sensor is most often attached to the patient's:

A) chest.
B) forehead.
C) ear.
D) finger.
Question
Which one of the statements listed below indicates an appropriate understanding of palpating a blood pressure?

A) "A palpated blood pressure is recorded when the brachial pulse returns as the BP cuff is deflated."
B) "Palpated blood pressures are the technique of choice when the patient has a cardiac complaint."
C) "A palpated blood pressure is typically falsely lower than a blood pressure obtained by auscultation."
D) "It is best to determine a palpated blood pressure using a stethoscope and pulse oximeter."
Question
Which one of the following is an indication to palpate the blood pressure?

A) Noisy environment
B) Normal pulse rate
C) Tachycardic pulse rate
D) Non-life-threatening condition
Question
When obtaining a medical history using the SAMPLE mnemonic, which one of the following statements relates to the "P" component?

A) "The physician is Dr. Coleman."
B) "The pulse is 116 beats per minute."
C) "The pain is rated at 8/10."
D) "There is a history of pancreatitis."
Question
After you apply the pulse oximeter to a patient complaining of chest discomfort, she asks you what you are assessing. You would respond by telling her that the pulse oximeter:

A) provides the most accurate evaluation of the heart rate.
B) is a tool used to see if the airway needs to be opened.
C) measures the amount of oxygen circulating in the blood.
D) can tell how much carbon dioxide she is exhaling.
Question
The EMT is correct when he identifies baseline vital signs as:

A) a set of vital signs most close to normal.
B) the most important set of vital signs.
C) the first set of vital signs obtained.
D) any change in two consecutive sets of vital signs.
Question
You notice that your partner routinely only takes one set of vitals when treating and transporting patients. When asked, he states that he only gets baseline vitals since they are most important as they provide information related to the patient's clinical status at the time of the EMS call. How would you respond?

A) "Examining several sets of vital signs can indicate the effectiveness of your treatment."
B) "You must at least get a pulse rate every 15 minutes since this is the most important vital sign."
C) "Comparing several sets of vital signs is the only way you will know if the patient is improving or deteriorating."
D) "You must get at least two sets of vital signs because that is what the national standard calls for."
Question
A female patient who called 911 when she noticed blood in her stool is scared and anxious. Her pulse rate is 124 and her blood pressure is 88/60 mmHg. After you get her vital signs, she nervously asks you if they are normal. Given her anxiety, you should:

A) change the subject.
B) inform her of the vital signs.
C) tell her they are normal.
D) reassure her that she is fine.
Question
Which statement is true regarding vital signs obtained from a patient with nausea and vomiting?

A) If the vital signs are within normal limits, it is safe to let the patient refuse transport.
B) The vital signs will help to determine the relative stability or instability of the patient.
C) The patient's complaint will be significant only if accompanied by abnormal vital signs.
D) The vital signs will allow the EMT to diagnose the cause of the nausea and vomiting.
Question
Which one of the following illustrates a question that would be asked when obtaining a medical history, using the SAMPLE mnemonic, for a female patient who is crying and complaining of dizziness?

A) "What were you doing when the dizziness started?"
B) "Who is your doctor and when was your last office visit?"
C) "Why exactly did you call the ambulance today?"
D) "You seem upset. Do you want to talk about it?"
Question
Your partner states that he wants to palpate the blood pressure. What equipment would you hand him?

A) Blood pressure cuff
B) Stethoscope
C) Blood pressure cuff and stethoscope
D) Stethoscope and pulse oximeter
Question
An obese female has called you with the complaint of abdominal pain. The regular adult cuff will not fit around her arm, so you retrieve the large adult cuff from your supplies. Embarrassed, the woman says, "My arm is so fat. Do you really need to roll up my sleeve to get my blood pressure?" Your best response would be:

A) "If you do not want me to take your blood pressure, I do not have to."
B) "I have seen plenty of big arms, and yours is nothing compared to some of them."
C) "I am getting your blood pressure, not measuring your arm, but you really need to lose some weight."
D) "I am not concerned with the size of your arm. I am interested in your blood pressure."
Question
A patient states that he is short of breath, light-headed, and has chest pain that worsens when he takes a deep breath. Assessment reveals an open airway, adequate breathing, and a rapid pulse of 120 beats per minute. His skin is hot to the touch, and he has a blood pressure of 116/84 mmHg. The patient informs you that he was diagnosed with pneumonia three days ago and has not been taking the prescribed antibiotics. Which one of these assessment findings would the EMT best recognize as a sign related to the patient's chief complaint?

A) Chest pain that worsens with inspiration
B) Recent diagnosis of pneumonia
C) Complaint of light-headedness
D) Blood pressure of 116/84 mmHg
Question
You are assessing a 49-year-old male complaining of lower back pain. Which one of the following would be pertinent medical information related to the back pain that the EMT will obtain using the SAMPLE mnemonic?

A) Heart rate of 48 and cool clammy skin
B) Childhood case of measles
C) Last tetanus shot five years ago
D) Arthritis in the spine and pelvis
Question
You have assisted the patient in taking one of his nitroglycerin tablets. Five minutes later, you note the blood pressure is 108/74 mmHg. To determine if the nitroglycerin has affected the blood pressure, the EMT should:

A) take another blood pressure in five minutes.
B) compare to the baseline blood pressure.
C) ask the patient if he feels his blood pressure has changed.
D) retake the blood pressure and compare it to a normal BP of 120/80 mmHg.
Question
A female patient with a history of asthma called 911 with a complaint of shortness of breath. On scene, you assisted her with the administration of her metered dose inhaler containing albuterol. Which one of the following interventions will you use to best determine if the patient is improving or not?

A) Ask the patient if she finds it easier to breathe.
B) Inquire if she feels the need for another dose of albuterol.
C) Obtain pulse oximetry readings every 3 minutes.
D) Re-obtain a SAMPLE history and look for new information.
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Deck 11: Baseline Vital Signs, Monitoring Devices, and History Taking
1
Which one of the pulses listed below is palpated in the groin area?

A) Carotid
B) Inguinal
C) Pedal
D) Femoral
D
2
You determine a radial pulse is readily palpable, but has uneven intervals between beats. This would best be documented on the prehospital care report as:

A) bounding and regular.
B) prominent and bounding.
C) strong and irregular.
D) thready and regular.
C
3
Which of the following signs related to breathing would be most concerning to the EMT?

A) Respiratory rate of 18, complaint of weakness
B) Respiratory rate of 22, chest expansion of 1 inch
C) Respiratory rate of 10, speaking without difficulty
D) Respiratory rate of 20, use of accessory muscles
D
4
Which patient description contains only vital signs?

A) Chief complaint of dizziness, skin cool and clammy, respiratory rate 16
B) Chief complaint of dizziness, BP 110/76 mmHg, breath sounds clear and equal
C) Skin warm and dry, heart rate 74, pupils equal and reactive
D) Heart rate 88, respiratory rate 14, blood glucose level 98 mg/dL
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5
Emergency Medical Responders inform you that a 27-year-old male with altered mental status has an open airway and is breathing 9 times every 30 seconds. His pulse rate is 40 beats per minute, and he has bruises to his chest. Based on this information, the EMT should recognize the:

A) respiratory rate as normal.
B) heart as beating adequately.
C) blood pressure as normal.
D) heart rate as irregular.
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6
You determine a patient's heart rate to be 48 beats per minute. That heart rate would be categorized as:

A) tachypneic.
B) normal.
C) bradycardic.
D) tachycardic.
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7
Which piece of equipment would the EMT need to obtain a patient's vital signs?

A) Glucometer
B) Stethoscope
C) Oxygen
D) Automated defibrillator
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8
Which statement made by your partner indicates that he understands assessment of a patient's breathing?

A) "As long as the patient is breathing over 20 times a minute, he is getting enough oxygen in his body."
B) "If the respiratory rate is normal, the patient is breathing adequately and getting enough oxygen."
C) "A rate less than 8 may allow adequate breathing, but requires further evaluation and assessment."
D) "To determine if a patient is adequately breathing, the EMT must get a full set of vital signs."
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9
Which one of the following characteristics is a quality of a patient's pulse?

A) Strength
B) Rate
C) Regularity
D) Tone
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10
A young female patient has been stung by a bee and states that her "throat is closing up." She states that she is allergic to bee stings and the last time this happened, she had to have a "tube put into my windpipe." She is struggling to breathe and can only speak a few words at a time. Knowing that allergic reactions can cause swelling in the pharynx and at the level of the larynx, which one of the following respiratory sounds would indicate that the patient indeed has swelling in this area?

A) Gurgling
B) Stridor
C) Snoring
D) Wheezing
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11
You are assessing a 61-year-old male who is confused. During the primary assessment, you cannot locate a radial pulse. Your immediate action should be to:

A) apply the AED.
B) call for ALS assistance.
C) check for a carotid pulse.
D) start CPR.
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12
When assessing a patient's pulse, you note that it is irregular. To get an accurate heart rate, you would:

A) listen to the pulse with a stethoscope.
B) count the number of beats that occur in 1 minute.
C) double the number of beats obtained in 30 seconds.
D) feel the carotid pulse for 30 seconds and multiply by 2.
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13
When assessing a patient's pulse, you can locate the right radial pulse, but not the left. Which one of the following is the most likely explanation for this finding?

A) The patient is in the early stage of cardiac arrest.
B) The left radial artery is extremely large.
C) There is a problem with the patient's veins.
D) The left radial artery may be occluded.
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14
A family has called you for a 41-year-old male they cannot wake up. They state he has been threatening to kill himself and believe that he may have intentionally overdosed on his pain medications. As you enter the patient's bedroom, you observe him supine on the floor with his eyes closed. As he breathes, you hear snoring respirations. As a knowledgeable EMT, you recognize which one of the following?

A) He will require immediate suctioning.
B) He is sleeping and has not overdosed.
C) His tongue is partially blocking the airway.
D) His respiratory rate must be less than 10 per minute.
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15
The EMT recognizes which one of the following heart rates (beats per minute) as normal for a 24-year-old male?

A) 54
B) 62
C) 110
D) 124
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16
The EMT is correctly calculating a patient's respiratory rate when he or she:

A) asks the patient to describe how he feels when he breathes.
B) obtains a pulse oximetry reading and divides it by 3.
C) assesses the patient for any sign of respiratory difficulty.
D) counts the number of breaths for 30 seconds and multiplies by 2.
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17
You have been called to assess a conscious and alert 5-year-old whose chief complaint is nausea and vomiting over the last 2 hours. When assessing his pulse, you should first check which pulse?

A) Brachial
B) Carotid
C) Pedal
D) Radial
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18
During the primary assessment of a geriatric patient complaining of shortness of breath and fever, you quickly locate the radial pulse. What should you do next?

A) Assess the patient's breathing.
B) Obtain a blood pressure.
C) Determine the rate and quality of the pulse.
D) Establish the patient's level of consciousness.
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19
An EMT is correctly assessing a patient's radial pulse when he:

A) uses the palm of his hand to feel the pulse on the upper arm.
B) simultaneously checks for a heart rate on both sides of the neck.
C) uses his thumb to feel for the pulse on the patient's lower arm.
D) uses his fingertips to feel for a pulse at the patient's wrist.
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20
Which one of the following statements concerning assessment of the pulse is correct?

A) "The heart rate can be determined by doubling the number of beats counted in 30 seconds."
B) "To get the most accurate rate, the EMT should place a stethoscope over the pulse site and count the number of beats in 1 minute."
C) "A brachial pulse should be felt first in any patient under 6 years of age."
D) "After much experience, an EMT can estimate the pulse rate by just feeling it for a few seconds."
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21
You are assessing a confused dark-skinned patient complaining of a headache. When checking his skin color, you should:

A) examine the skin around his ears and nose.
B) evaluate the palms of his hands or soles of his feet.
C) observe the skin on his forehead.
D) look and feel the skin on his neck and chest.
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22
A patient with pancreatic cancer exhibits a yellow discoloration to his entire body. The EMT would correctly document this condition as:

A) jaundice.
B) cyanotic.
C) pallor.
D) flushed.
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23
You are called to a long-term care facility to assess and transport a patient with a high fever. You do not have a thermometer on your unit. Which one of the following signs should you use to confirm the patient's increased body temperature?

A) Cyanotic skin around the mouth
B) Decreased heart rate and flushed skin
C) Fingertips that are cool and blue
D) Skin on the abdomen that is hot and flushed
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24
You are called for a 2-year-old child who is sick. When testing her capillary refill, which one of the following would be the most cause for concern?

A) Immediate return of color
B) 1-second capillary refill time
C) 2-second capillary refill time
D) 3-second capillary refill time
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25
Assessment of a patient's skin color reveals a bluish discoloration. As a knowledgeable EMT, you should identify:

A) pallor caused by a decrease in blood flow to the tissues.
B) cyanosis caused by inadequate oxygenation of the tissues.
C) pallor caused by a decrease in body temperature.
D) jaundice caused by an increase in blood flow to the extremities.
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26
Which one of the following statements made by an EMT indicates an accurate understanding of checking a patient's skin temperature?

A) "Checking the skin temperature is not precise, but a good estimate of abnormally high or low body temperatures."
B) "To properly evaluate a patient's skin temperature during the primary assessment, the EMT needs a thermometer."
C) "It is important to remember that flushed skin always indicates a high body temperature."
D) "With experience, the EMT can precisely determine a patient's body temperature by feeling the skin."
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27
A patient has advanced liver disease from years of exposure to toxic chemicals in his place of employment. Which one of the following skin colors would the EMT expect?

A) Bluish-gray
B) Pale and cyanotic
C) Pinkish and flushed
D) Yellow-orange
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28
For which patient would a capillary refill time of 3 seconds be most indicative of poor perfusion?

A) 4-year-old male
B) 24-year-old female
C) 67-year-old female
D) 81-year-old male
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29
An EMT has accurately checked the skin color of a patient. Which one of the following indicates correct documentation?

A) "Warm skin noted on the upper arm."
B) "Forehead and face show pink skin color."
C) "Pale color noted to the conjunctiva."
D) "Thoracic and abdominal skin normal in color."
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30
When evaluating a patient's skin color, the EMT should:

A) observe the nail beds and/or mucous membranes inside the eyelids.
B) examine the change in skin color when applying then releasing pressure to the nail beds.
C) look at the skin on the upper chest and feel it for warmth.
D) examine the skin color of the face and compare it with the color of the arms.
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31
Which one of the following statements made by an EMT student indicates that he correctly understands the use of capillary refill when assessing a patient?

A) "Capillary refill is a very reliable sign of shock in any patient between the ages of 18 and 65 years."
B) "Capillary refill is a more reliable sign of blood circulation in children under 6 years of age than in adolescents or adults."
C) "The possibility of chronic circulatory diseases makes the capillary refill test an excellent sign of circulation in the adult patient."
D) "If a delayed capillary refill is observed in any aged patient, there is a high probability he or she is in shock."
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32
A patient presents with skin that is cool to the touch. The EMT shows he understands this condition when he states:

A) "This would appear to indicate a problem with the circulation of blood."
B) "The patient must have an infection somewhere in his body."
C) "We should check his breath sounds; he probably has a lung infection."
D) "The patient most likely has a past medical history of hypertension."
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33
When assessing a patient's pupils, the EMT should:

A) shine a light in one eye and watch for the pupil to dilate.
B) cover one eye and shine a light in the other, watching for changes to the size of the pupil.
C) determine the size of the pupil and then look for a change in pupillary size as you shine a light in the eye.
D) instruct the patient to blink several times and observe the size of the pupils.
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34
To test a patient's capillary refill, the EMT will:

A) apply gentle pressure to the radial pulse and watch color changes to the hand.
B) firmly compress and then release pressure on the nail bed.
C) examine the inside lining of one or both eyelids.
D) apply pressure and then release that pressure from the arm.
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35
You are assessing a female patient with a complaint of shortness of breath. When assessing her skin, which one of the following should be recognized as abnormal?

A) Dry
B) Pink
C) Moist
D) Warm
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36
Which one of the following is an accurate method of assessing a patient's skin temperature?

A) Placing the tips of two fingers on the patient's wrist
B) Using the palm to feel the patient's forehead
C) Placing the back of the hand on the patient's abdomen
D) Placing the inside of the arm against the patient's arm
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37
The EMT should recognize normal skin color in a healthy patient as:

A) white.
B) warm.
C) red.
D) pink.
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38
A patient presents with extremely pale skin. His family states that this is not his normal skin color. His vital signs are pulse 108, respirations 18, blood pressure 102/86, and SpO₂ 96% Which one of the following complaints would make the most sense given this clinical presentation?

A) Persistent cough
B) Fever
C) Rectal bleeding
D) Headache
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39
A patient who was shoveling snow developed chest pain, immediately sat down in a nearby bus shelter, and called 911. Prior to moving him into the ambulance, your partner performs a primary assessment and reports that the patient's capillary refill is 5 seconds. Which one of the following statements would be most appropriate for you to make?

A) "That is a significant finding. We really need to get him on oxygen and moving to the hospital."
B) "The cold temperature may cause the capillary refill to be 5 seconds; we should assess further."
C) "That seemingly indicates he has lost blood and it is not perfusing the skin adequately."
D) "If his skin is also warm and moist, then he is most likely in shock."
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40
Which one of the following patients should the EMT recognize as having a normal skin temperature?

A) 25-year-old female who is dizzy with cool skin
B) 36-year-old male complaining of nausea with warm skin
C) 47-year-old female with chest pain and warm-to-hot skin
D) 88-year-old male who is weak with skin that is cool and dry
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41
As you enter the scene of a medical emergency, the Emergency Medical Responder informs you that the patient is not breathing and has pupils that are fixed and dilated. Based on this description, which one of the following are you expecting to see when you reach the patient's side?

A) Both pupils are large and change shape to light.
B) The patient must wear corrective lenses.
C) The patient has a past medical history of blindness.
D) Neither pupil will react when light is directed into the eyes.
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42
Your partner is having a difficult time determining what a normal and abnormal blood pressure is for a child. Which one of the following statements will help him most?

A) "Since pediatric emergencies are less common than adult emergencies. It is best to call medical direction and ask what is normal."
B) "Any systolic blood pressure of less than 100 mmHg in a child is an emergency."
C) "A normal systolic pressure can be estimated by doubling the child's age and adding it to 80."
D) "It is helpful to ask the parent or caregiver what is normal for the child and compare your reading to that."
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43
You have placed the blood pressure cuff on the arm of a patient who is short of breath. What is your next step?

A) Inflate to a reading of 70 mmHg, check for a radial pulse, and continue inflation until the pulse is no longer felt.
B) Inflate the cuff to 300 mmHg, and then have the cuff inflated for 30 seconds prior to deflation.
C) Inflate the cuff to a reading of 300 mmHg, and then deflate the cuff slowly until you hear a pulse.
D) Inflate the cuff to three times the patient's age and listen for a heartbeat.
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44
What pulse site is commonly used when the EMT elects to palpate a blood pressure?

A) Brachial
B) Radial
C) Carotid
D) Pedal
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45
When obtaining a blood pressure, the EMT listens for a pulse over what blood vessel?

A) Radial artery
B) Antecubital vein
C) Carotid vessels
D) Brachial artery
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46
You observe your partner correctly obtaining a patient's blood pressure when he:

A) inflates the cuff maximally prior to slowly deflating and listening for a pulse.
B) deflates the cuff 2 mmHg per second while listening with a stethoscope.
C) stops inflation and starts deflation as soon as the radial pulse disappears.
D) places the stethoscope under the cuff and deflates it.
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47
The EMT is correct when he makes which one of the following statements about assessment of the pupils?

A) "Dilated pupils are less of a concern than pupils that are constricted."
B) "If a patient's pupils are dilated but react to light, the pupillary exam is considered normal."
C) "Some people naturally have unequal pupils, but both should react to light."
D) "Constricted pupils are less of a concern than are dilated pupils."
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48
An EMT student asks you if it matters if the blood pressure cuff seems too small for a patient, even though a reading can still be obtained. You should respond:

A) "As long as the reading is obtained, it should be accurate."
B) "Cuffs that are too small provide inaccurately high readings."
C) "Using a cuff that is too small can cause damage to the blood vessels."
D) "As long as the radial pulse remains intact, the cuff size is irrelevant."
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49
A blood pressure is reported as 116/68 mmHg. Which one of the following is true?

A) The systolic blood pressure is 116 mmHg.
B) The top number reflects the diastolic blood pressure.
C) The systolic pressure is determined by subtracting 68 from 116.
D) The diastolic blood pressure is 116 mmHg.
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50
A 41-year-old male patient reacts to painful stimuli by moaning. You shine a light at his right pupil. Which one of the following reactions would be normal?

A) Dilation of the right pupil
B) Constriction of the left pupil
C) Dilation of the left pupil
D) Closure of both eyelids
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51
An EMT has an accurate understanding of the systolic blood pressure when he tells you that the systolic blood pressure is:

A) represented by the bottom number.
B) produced when the heart contracts.
C) the pressure in the veins.
D) caused by constriction of the arteries.
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52
Friends called 911 for a 37-year-old female who intentionally overdosed on a narcotic drug. Which one of the following eye findings would reinforce that the patient did indeed take a narcotic?

A) Pupils that constrict to light
B) Bloodshot eyes with large pupils
C) Nonreactive pupils that are unequal
D) Pupils that are constricted
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53
An EMT has an accurate understanding of the diastolic blood pressure when she tells you that the diastolic pressure:

A) is the pressure in the arteries when the heart is not contracting.
B) can be estimated as one-third of the systolic blood pressure.
C) can be easily obtained by palpating the blood pressure.
D) should always be rounded to the nearest 10.
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54
To assess a patient's blood pressure, the EMT will need a:

A) pulse oximeter.
B) sphygmomanometer.
C) pulse oximeter and stethoscope.
D) pair of gloves and stethoscope.
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55
Which one of the following indicates a normal pupillary exam?

A) One pupil dilates and the other constricts to light.
B) Both pupils constrict when light is directed into the eye.
C) The patient reflexively closes his eyes to light.
D) The pupils are equal and do not change shape to light.
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56
Which one of the following indicates that the EMT has correctly positioned the blood pressure cuff on the patient's arm?

A) The cuff is placed over the antecubital space and elbow.
B) The cuff is centered over the top of the radial artery.
C) The cuff is on the same level as the patient's heart.
D) The cuff covers one-third of the patient's upper arm.
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57
You are assessing a patient who is in bright sunlight after collapsing in the hot sun at a picnic. If you cannot immediately move the patient out of the sun, assessment of the pupils will be made more accurate by:

A) shading the patient's eyes.
B) using a blue-tinged light.
C) retracting the eyelid.
D) hydrating the eyes with saline drops.
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58
Assessment of a patient who is unresponsive reveals pupils that are both large at 8 millimeters and do not change size in response to light. The EMT would best document this finding as:

A) bilateral dilation of the pupils.
B) constricted pupils nonreactive to light.
C) midsize pupils that are reactive to light.
D) nonreactive pupils of decreased size.
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59
When getting a blood pressure on a patient, the radial pulse disappears when the gauge reads 130 mmHg. When deflating the cuff, the EMT hears a pulse at 118 mmHg. The pulse disappears at 76 mmHg. Which one of the following is true?

A) The systolic blood pressure is 118 mmHg.
B) The diastolic blood pressure is 130 mmHg.
C) The systolic blood pressure is 76 mmHg.
D) The diastolic blood pressure is 118 mmHg.
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60
Your partner reports that a patient's blood pressure is 156/78 mmHg. From this reading, you realize:

A) The pulse pressure is 224 mmHg.
B) The systolic blood pressure is 78 mmHg.
C) The constant pressure in the veins is 156 mmHg.
D) The diastolic blood pressure is 78 mmHg.
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61
A 69-year-old man is complaining of weakness to the left arm and leg. He also states that he is nauseated and has a headache. The patient's past medical history includes stroke and diabetes. In relation to this information, which one of the following is true?

A) The headache is a symptom related to the chief complaint.
B) The history of diabetes is a sign related to the chief complaint.
C) The dizziness is a sign indicating the severity of the chief complaint.
D) The history of diabetes is a contributing symptom of the chief complaint.
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62
In the prehospital care report, the EMT should recognize that a blood pressure has been palpated when she sees:

A) Palp: 178/118 mmHg.
B) P / 118.
C) 118/178 (palpated).
D) 178 / P.
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63
Which one of the following descriptions would be obtained when asking about the "A" component of the SAMPLE history?

A) Abdomen soft
B) History of asthma
C) Allergy to penicillin
D) Airway open
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64
The EMT understands the primary reason to obtain a medical history using the SAMPLE mnemonic when he states:

A) "The SAMPLE mnemonic helps EMTs to diagnose a patient's medical problem."
B) "It is important to use the SAMPLE mnemonic because the emergency department will need the information."
C) "After performing the primary assessment, the SAMPLE mnemonic helps guide the EMT in further assessment and care."
D) "The SAMPLE mnemonic is important because it will give the EMT the patient's exact chief complaint."
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65
When using a pulse oximeter on an adult patient, the EMT knows that the sensor is most often attached to the patient's:

A) chest.
B) forehead.
C) ear.
D) finger.
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66
Which one of the statements listed below indicates an appropriate understanding of palpating a blood pressure?

A) "A palpated blood pressure is recorded when the brachial pulse returns as the BP cuff is deflated."
B) "Palpated blood pressures are the technique of choice when the patient has a cardiac complaint."
C) "A palpated blood pressure is typically falsely lower than a blood pressure obtained by auscultation."
D) "It is best to determine a palpated blood pressure using a stethoscope and pulse oximeter."
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67
Which one of the following is an indication to palpate the blood pressure?

A) Noisy environment
B) Normal pulse rate
C) Tachycardic pulse rate
D) Non-life-threatening condition
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68
When obtaining a medical history using the SAMPLE mnemonic, which one of the following statements relates to the "P" component?

A) "The physician is Dr. Coleman."
B) "The pulse is 116 beats per minute."
C) "The pain is rated at 8/10."
D) "There is a history of pancreatitis."
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69
After you apply the pulse oximeter to a patient complaining of chest discomfort, she asks you what you are assessing. You would respond by telling her that the pulse oximeter:

A) provides the most accurate evaluation of the heart rate.
B) is a tool used to see if the airway needs to be opened.
C) measures the amount of oxygen circulating in the blood.
D) can tell how much carbon dioxide she is exhaling.
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70
The EMT is correct when he identifies baseline vital signs as:

A) a set of vital signs most close to normal.
B) the most important set of vital signs.
C) the first set of vital signs obtained.
D) any change in two consecutive sets of vital signs.
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71
You notice that your partner routinely only takes one set of vitals when treating and transporting patients. When asked, he states that he only gets baseline vitals since they are most important as they provide information related to the patient's clinical status at the time of the EMS call. How would you respond?

A) "Examining several sets of vital signs can indicate the effectiveness of your treatment."
B) "You must at least get a pulse rate every 15 minutes since this is the most important vital sign."
C) "Comparing several sets of vital signs is the only way you will know if the patient is improving or deteriorating."
D) "You must get at least two sets of vital signs because that is what the national standard calls for."
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72
A female patient who called 911 when she noticed blood in her stool is scared and anxious. Her pulse rate is 124 and her blood pressure is 88/60 mmHg. After you get her vital signs, she nervously asks you if they are normal. Given her anxiety, you should:

A) change the subject.
B) inform her of the vital signs.
C) tell her they are normal.
D) reassure her that she is fine.
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73
Which statement is true regarding vital signs obtained from a patient with nausea and vomiting?

A) If the vital signs are within normal limits, it is safe to let the patient refuse transport.
B) The vital signs will help to determine the relative stability or instability of the patient.
C) The patient's complaint will be significant only if accompanied by abnormal vital signs.
D) The vital signs will allow the EMT to diagnose the cause of the nausea and vomiting.
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74
Which one of the following illustrates a question that would be asked when obtaining a medical history, using the SAMPLE mnemonic, for a female patient who is crying and complaining of dizziness?

A) "What were you doing when the dizziness started?"
B) "Who is your doctor and when was your last office visit?"
C) "Why exactly did you call the ambulance today?"
D) "You seem upset. Do you want to talk about it?"
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75
Your partner states that he wants to palpate the blood pressure. What equipment would you hand him?

A) Blood pressure cuff
B) Stethoscope
C) Blood pressure cuff and stethoscope
D) Stethoscope and pulse oximeter
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76
An obese female has called you with the complaint of abdominal pain. The regular adult cuff will not fit around her arm, so you retrieve the large adult cuff from your supplies. Embarrassed, the woman says, "My arm is so fat. Do you really need to roll up my sleeve to get my blood pressure?" Your best response would be:

A) "If you do not want me to take your blood pressure, I do not have to."
B) "I have seen plenty of big arms, and yours is nothing compared to some of them."
C) "I am getting your blood pressure, not measuring your arm, but you really need to lose some weight."
D) "I am not concerned with the size of your arm. I am interested in your blood pressure."
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77
A patient states that he is short of breath, light-headed, and has chest pain that worsens when he takes a deep breath. Assessment reveals an open airway, adequate breathing, and a rapid pulse of 120 beats per minute. His skin is hot to the touch, and he has a blood pressure of 116/84 mmHg. The patient informs you that he was diagnosed with pneumonia three days ago and has not been taking the prescribed antibiotics. Which one of these assessment findings would the EMT best recognize as a sign related to the patient's chief complaint?

A) Chest pain that worsens with inspiration
B) Recent diagnosis of pneumonia
C) Complaint of light-headedness
D) Blood pressure of 116/84 mmHg
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78
You are assessing a 49-year-old male complaining of lower back pain. Which one of the following would be pertinent medical information related to the back pain that the EMT will obtain using the SAMPLE mnemonic?

A) Heart rate of 48 and cool clammy skin
B) Childhood case of measles
C) Last tetanus shot five years ago
D) Arthritis in the spine and pelvis
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79
You have assisted the patient in taking one of his nitroglycerin tablets. Five minutes later, you note the blood pressure is 108/74 mmHg. To determine if the nitroglycerin has affected the blood pressure, the EMT should:

A) take another blood pressure in five minutes.
B) compare to the baseline blood pressure.
C) ask the patient if he feels his blood pressure has changed.
D) retake the blood pressure and compare it to a normal BP of 120/80 mmHg.
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80
A female patient with a history of asthma called 911 with a complaint of shortness of breath. On scene, you assisted her with the administration of her metered dose inhaler containing albuterol. Which one of the following interventions will you use to best determine if the patient is improving or not?

A) Ask the patient if she finds it easier to breathe.
B) Inquire if she feels the need for another dose of albuterol.
C) Obtain pulse oximetry readings every 3 minutes.
D) Re-obtain a SAMPLE history and look for new information.
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