Deck 2: Primary Assessment

Question 1

Signs of inadequate breathing include all of the following EXCEPT:

A) presence of bronchovesicular breath sounds.
B) retractions of intercostal and supraclavicular tissues.
C) nasal flaring.
D) accessory muscle use.

Answer 1

presence of bronchovesicular breath sounds.

Question 2

You are assessing an adult patient. When you palpate her wrist to locate a pulse, you do not feel one. You should immediately palpate for a ________ pulse.

A) brachial
B) femoral
C) apical
D) carotid

Answer 2

carotid

Question 3

Steps in assessing circulation during a primary assessment include all of the following EXCEPT:

A) controlling major bleeding.
B) determining the blood pressure.
C) checking for skin signs.
D) checking for a radial pulse.

Answer 3

determining the blood pressure.

Question 4

Which of the following statements regarding stridor is TRUE?

A) Stridor originates in the lower airways.
B) Stridor is seldom of clinical significance.
C) The correct treatment of stridor depends on the underlying problem.
D) The presence of stridor requires immediate intubation.

Question 5

Your patient appears awake, but barely looks at you when you call his name. His airway is open, and he is breathing at 34 times per minute. He appears cyanotic. Which of the following adjuncts is most appropriate at this point?

A) Nonrebreather mask
B) Bag-valve mask
C) Nasopharyngeal airway
D) Nasal cannula

Question 6

When assessing the airway, which of the following actions is NOT appropriate?

A) Look for chest rise and fall.
B) Feel for air movement.
C) Listen for airflow.
D) Count the number of breaths over a minute.

Question 7

Forming a general impression as part of your primary assessment helps you to:

A) determine baseline mental status.
B) determine general clinical status and priority.
C) make a determination about stabilization of the cervical spine.
D) estimate vital signs.

Question 8

While performing a primary assessment on a trauma patient who has fallen from a roof, you discover absent lung sounds on the right side. Which of the following actions should you take next?

A) Assess for signs of a tension pneumothorax.
B) Intubate the patient.
C) Continue the rapid trauma assessment.
D) Decompress the patient's chest.

Question 9

The purpose of manual stabilization of the cervical spine during the primary assessment of a trauma patient is to:

A) allow you to control the patient.
B) allow for easier airway manipulation.
C) prevent the patient from moving his neck.
D) help you avoid litigation.

Question 10

To assess an infant's airway, you should:

A) perform a tongue-jaw lift.
B) hyperextend the head and lift the chin.
C) perform a jaw-thrust maneuver.
D) carefully extend the head and neck.

Question 11

Your patient is not alert but is responsive to painful stimulus. His airway is patent. He is breathing at eight times per minute. Your next action should be to administer oxygen via a:

A) nasal cannula.
B) simple face mask.
C) nonrebreather mask.
D) bag-valve-mask device.

Question 12

A patient with skin described as "clammy" has ________ skin.

A) cool and dry
B) warm and dry
C) warm and moist
D) cool and moist

Question 13

Patterns of deterioration in patient condition may include all of the following EXCEPT:

A) skin becomes cool, pale, and moist.
B) the heart rate significantly increases or decreases.
C) the respiratory rate significantly increases or decreases.
D) the level of consciousness increases.

Question 14

The best method for determining responsiveness to painful stimuli in an infant is to:

A) pinch his cheeks.
B) pinch his fingernails.
C) rub his sternum.
D) flick the soles of his feet.

Question 15

You are assessing a 28-year-old man with multiple gunshots to his abdomen. You should expect his skin to be:

A) cool and moist.
B) hot and moist.
C) warm and dry.
D) cold and dry.

Question 16

To determine whether a patient is breathing, you should:

A) listen and feel for breathing at the mouth and nose.
B) observe for movement of the abdomen.
C) apply a pulse oximeter.
D) auscultate the chest.

Question 17

After determining that a patient does not respond to verbal stimuli, your next action would be to:

A) place him in the recovery position.
B) pinch one of his fingernails.
C) insert an oropharyngeal airway.
D) apply manual cervical spine stabilization.

Question 18

Mottled, cyanotic, pale, or ashen skin color may indicate any of the following EXCEPT:

A) hypertensive crisis.
B) impaired blood flow to an extremity.
C) significant blood loss.
D) loss of spinal cord function.

Question 19

During the primary assessment, your patient groans and tries to turn away when you apply a sternal rub. Otherwise, there is no other response. The patient's mental status can best be described as:

A) alert.
B) responds to painful stimulus.
C) responds to verbal stimulus.
D) unresponsive.

Question 20

The sound of gurgling associated with breathing usually indicates:

A) foreign body obstruction of the upper airway.
B) fluid in the upper airway.
C) thick mucus in the lower airways.
D) constriction of the bronchioles.

Question 21

Pulse quality refers to:

A) rhythm.
B) strength.
C) location.
D) rate.

Question 22

Which of the following sounds can typically be heard without the use of a stethoscope?

A) Rhonchi
B) Bowel sounds
C) Stridor
D) Crackles

Question 23

What does the "U" in A-V-P-U stand for?

A) Unresponsive
B) Unconscious
C) Uncooperative
D) Undetermined

Question 24

You locate a 55-year-old woman lying supine on the side of a road. There are no bystanders. You determine that the patient is unresponsive. Which of the following should be your next action?

A) Apply a cervical collar.
B) Provide high-flow oxygen.
C) Open the airway with a jaw-thrust maneuver.
D) Intubate the trachea.

Question 25

Which of the following conditions is NOT typically associated with wheezing?

A) Foreign bodies in the small airways
B) Asthma
C) Bronchospasm
D) Upper airway swelling

Question 26

Your patient is awake and complaining of chest pain. His airway is patent, and he is breathing at 18 times per minute with adequate tidal volume. What is your next action?

A) Administer oxygen at 15 lpm via nonrebreather mask.
B) Begin positive pressure ventilations via bag-valve-mask device.
C) Insert a nasopharyngeal airway.
D) Administer oxygen at 2 lpm via nasal cannula.

Question 27

Your patient is unresponsive to painful stimulus and has snoring respirations. What is your next action?

A) Check for a pulse.
B) Perform a head-tilt, chin-lift maneuver.
C) Administer oxygen at 15 lpm.
D) Suction.

Question 28

All of the following are signs of inadequate breathing in an infant EXCEPT:

A) cyanosis.
B) use of accessory muscles.
C) altered mental status.
D) a respiratory rate of 32 breaths per minute.

Question 29

Medical patients with altered mental status are stabilized in a manner similar to that that is appropriate for:

A) critical trauma patients.
B) any other medical patient.
C) a patient complaining of chest pain.
D) a patient with isolated extremity trauma.

Question 30

Devices for maintaining airway patency in a five-year-old patient include all of the following EXCEPT a(n):

A) endotracheal tube.
B) oropharyngeal airway.
C) suction unit.
D) pharyngotracheal lumen airway.

Question 31

Which of the following problems is it NOT critical to find during the primary assessment?

A) Scalp hematoma
B) Bright red blood spurting from a thigh wound
C) Respiratory distress
D) Foreign body airway obstruction

Question 32

Your three-year-old patient opens her eyes and responds when you speak to her. Her mental status is best described as:

A) alert.
B) responsive to tactile stimuli.
C) responsive to verbal stimuli.
D) lethargic.

Question 33

Which of the following best describes why patients with serious illnesses or injuries should be transported without delay?

A) Definitive care cannot be provided in the prehospital setting.
B) Most patients are uncomfortable with the level of care provided by paramedics.
C) Paramedics must become available for additional calls as soon as possible.
D) The shorter the contact time with the patient, the less the potential for liability.

Question 34

Which of the following statements about airway management is TRUE?

A) Immediate intubation is required for all unresponsive patients.
B) Dual lumen airways are acceptable for use in children over the age of four years.
C) If a patient cannot be intubated because of an intact gag reflex, a dual lumen airway can be used.
D) Nasopharyngeal airways are contraindicated in patients with possible basilar skull fracture.

Question 35

In an infant, the heart rate is best detected by either palpating the brachial artery or:

A) auscultating the carotid pulse.
B) palpating the femoral pulse.
C) palpating the carotid pulse.
D) auscultating the apical pulse.

Question 36

If an abnormal finding is noted in the patient's respiratory rate or pattern during the chest examination, you should:

A) immediately ensure adequate ventilation.
B) intervene only if pulse oximetry is less than 85 percent.
C) immediately determine the exact cause.
D) continue the examination before finding and treating the cause.

Question 37

Your patient is a three-year-old who presents with a fever. His parents state that he has had diarrhea and vomiting for two days. The patient has not eaten in 24 hours. To best evaluate the patient's peripheral perfusion status, you should evaluate his:

A) respiratory rate.
B) fingertip sensation.
C) capillary refill.
D) blood pressure.

Question 38

When assessing the chest, you should cover any open wounds you locate with a(n) ________ dressing.

A) wet
B) occlusive
C) antibacterial
D) dry gauze

Question 39

In infants, capillary refill is a good incicatior of adequate circulation and can be checked in the:

A) limbs.
B) dorsum of the hand.
C) torso.
D) face.

Question 40

Your patient does not respond to you when you call his name. What should you do next?

A) Apply a painful stimulus.
B) Continue shouting.
C) Assume he is unresponsive.
D) Insert an oral airway.

Question 41

According to the 2015 AHA guidelines/recommendations, a patient who appears to be unresponsive and not breathing or breathing ineffectively should be assessed using which mnemonic memory aid?

A) ABC
B) BAC
C) CBA
D) CAB

Question 42

You are examining a patient's peripheral vasculature when you note that he has no radial pulse. Your next step would be to:

A) prepare for immediate transport.
B) defibrillate with 200 joules.
C) start CPR.
D) palpate a carotid pulse.