Guide to Patient Assessment and Module Test

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hiker0001
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263210
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Guide to Patient Assessment and Module Test
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2014-02-22 15:14:46
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Guide Patient Assessment
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Guide to Patient Assessment and Module Test
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  1. Three main components of patient assessment:
    • scene size up
    • primary assessment
    • secondary assessment
  2. Important thing prior to scene size up:
    BSI - body substance isolation
  3. Six components of the scene size up:
    • Personal, partner, and patient safety; reconsider BSI
    • Environmental hazards
    • Number of patients
    • MOI/NOI
    • Additional resources
    • Need for spinal immobilization
  4. When does spinal immobilization start?
    initial assessment
  5. Nine components of the primary assessment:
    • General impression; life threatening conditions
    • Patient rapport
    • Determine responsiveness
    • Airway
    • Breathing
    • Circulation
    • Disabilities/deformities
    • Chief complaint
    • Transport decision
  6. When is LOC determined?
    During the primary assessment as appropriate
  7. Four components of determining LOC:
    • person
    • place
    • time
    • event
  8. What is the mnemonic for determining responsiveness during the primary assessment?
    • Alert
    • Verbal
    • Painful
    • Unresponsive
  9. What is the next step if a patient is unresponsive or if breathing is absent or agonal during the primary assessment?
    check for a pulse
  10. Two aspects of airway assessment during the primary assessment:
    • Patent/obstructed
    • Consider mechanism
  11. Two aspects of breathing assessment during the primary assessment:
    • Fast/slow
    • Shallow/deep
  12. Four aspects of circulation assessment during the primary assessment:
    • Pulse - fast/slow, reg/irreg, strong/weak
    • Skin signs
    • Life threatening bleeding
    • Capillary refill
  13. Something to consider when assessing airway during the primary assessment:
    suction
  14. Two things to consider when assessing breathing during the primary assessment:
    • oxygenation/ventilation
    • lung sounds
  15. What should you consider when assessing circulation during the primary assessment?
    resuscitation and/or shock management
  16. Two aspects of the transport decision:
    • Prioritize patients
    • Distance from ALS/hospital
  17. Patients are divided into one of two categories during the secondary assessment:
    • Responsive medical/minor trauma
    • Major Trauma/unresponsive medical
  18. The primary assessment is also known as the ____ assessment.
    initial
  19. Two components of the secondary assessment:
    • focused history
    • physical
  20. Five components of the secondary assessment of a responsive medical/minor trauma patient:
    • OPQRST
    • SAMPLE
    • Vitals
    • Pertinent body check
  21. OPQRST:
    • Onset - Sudden/Gradual
    • Provoke/Palliation
    • Quality
    • Region/Radiation/Reoccurrence
    • Severity
    • Time
  22. SAMPLE:
    • Signs/Symptoms
    • Allergies/Age/Weight
    • Medications
    • Pertinent Medical History
    • Last oral intake/Last exit
    • Events Surrounding Incident
  23. Five components of a vitals check during secondary assessment:
    • Blood pressure
    • Eyes
    • Lung sounds
    • Respirations
    • Pulse
    • Pulse oximetry
  24. Three things to assess when examining eyes:
    • size
    • equality
    • reactivity
  25. Three things to assess when checking respirations:
    • rate
    • effort
    • tidal volume
  26. Three things to assess when checking pulse:
    • rate
    • rhythm
    • quality
  27. At what oxygen percentage is oxygenation necessary?
    below 95%
  28. Five components of the secondary assessment of a major trauma/unresponsive medical patient:
    • 60 second rapid trauma assessment
    • vitals
    • OPQRST
    • SAMPLE
    • Detailed physical exam
  29. While eating dinner, your partner suddenly grabs his throat and has a panicked look on his face. He has a weak cough, faint inspiratory stridor, and cyanosis around the lips. You should:
    A. deliver up to five back blows and reassess him.
    B. place him in a supine position and open his airway.
    C. stand behind him and administer abdominal thrusts.
    D. encourage him to cough as forcefully as he can.
    C. stand behind him and administer abdominal thrusts.
    (this multiple choice question has been scrambled)
  30. Which of the following is the LEAST reliable assessment parameter to evaluate when determining the presence of shock in infants and children?
    A. skin condition
    B. capillary refill
    C. blood pressure
    D. heart rate
    C. blood pressure
    (this multiple choice question has been scrambled)
  31. Which of the following organs or tissues can survive the longest without oxygen?
    A. kidneys
    B. muscle
    C. heart
    D. liver
    B. muscle
    (this multiple choice question has been scrambled)
  32. Which of the following structures is contained within the mediastinum?
    A. bronchioles
    B. larynx
    C. lungs
    D. esophagus
    D. esophagus
    (this multiple choice question has been scrambled)
  33. Irregular respirations characterized by an increasing rate and depth of breathing followed by periods of apnea are called:
    A. eupneic respirations.
    B. Cheyne-Stokes respirations.
    C. agonal respirations.
    D. ataxic respirations.
    B. Cheyne-Stokes respirations.
    (this multiple choice question has been scrambled)
  34. You are performing mouth-to-mask ventilations with oxygen connected and set at a flow rate of 15 L/min. What percentage of oxygen is your patient receiving?
    A. 45%
    B. 55%
    C. 75%
    D. 65%
    B. 55%
    (this multiple choice question has been scrambled)
  35. You are ventilating a 40-year-old uninjured man who is apneic but has a pulse. When your partner reassesses his blood pressure, he notes that it has decreased significantly from previous readings. You elevate
    the patient's legs, but this action has no effect. You should:
    A. ensure that you are delivering one breath every 3 to 5 seconds.
    B. increase the volume of your ventilations and reassess his blood pressure.
    C. perform a head-to-toe assessment to look for bleeding.
    D. reevaluate the rate and volume of your ventilations.
    D. reevaluate the rate and volume of your ventilations.
    (this multiple choice question has been scrambled)
  36. The actual exchange of oxygen and carbon dioxide occurs in the:
    A. pulmonary capillaries.
    B. bronchioles.
    C. alveolar sacs.
    D. apex of the lung.
    C. alveolar sacs.
    (this multiple choice question has been scrambled)
  37. Which of the following oxygen flowmeters is NOT affected by gravity and can be used in any position when attached to an oxygen
    cylinder?
    A. pressure-compensated flowmeter
    B. ball-and-float flowmeter
    C. vertical-position flowmeter
    D. Bourdon-gauge flowmeter
    D. Bourdon-gauge flowmeter
    (this multiple choice question has been scrambled)
  38. The MOST common cause of dehydration in pediatric patients is:
    A. refusal to drink fluids.
    B. internal blood loss.
    C. vomiting and diarrhea.
    D. high fever.
    C. vomiting and diarrhea.
    (this multiple choice question has been scrambled)
  39. Which of the following patients would MOST likely have a delayed onset of an allergic reaction?
    A. a 30-year-old male who was stung by a bee
    B. a 21-year-old female who inhaled pollen
    C. a 50-year-old male who was exposed to latex
    D. a 45-year-old male who ingested penicillin
    D. a 45-year-old male who ingested penicillin
    (this multiple choice question has been scrambled)
  40. A subluxation occurs when:
    A. a fracture and a dislocation exist.
    B. a bone develops a hairline fracture.
    C. a joint is incompletely dislocated.
    D. ligaments are partially severed.
    C. a joint is incompletely dislocated.
    (this multiple choice question has been scrambled)
  41. The pressure of gas in a full cylinder of oxygen is approximately _______ pounds per square inch (psi).
    A. 1,000
    B. 500
    C. 2,000
    D. 1,500
    C. 2,000
    (this multiple choice question has been scrambled)
  42. In contrast to younger patients, older patients are more prone to a decrease in blood pressure upon standing because:
    A. the baroreceptors have become less sensitive to blood pressure.
    B. their red blood cells are destroyed at a faster than normal rate.
    C. any change in position causes blood to be shunted to the brain.
    D. the aging process results in an overall increase in blood volume.
    A. the baroreceptors have become less sensitive to blood pressure.
    (this multiple choice question has been scrambled)
  43. When performing your secondary assessment on an older patient who has been injured, it is important to:
    A. recall that it will take a less severe mechanism of injury to cause significant injuries.
    B. routinely perform a focused exam to minimize time at the scene.
    C. focus your assessment just on the area(s) of pain or obvious injury.
    D. perform an in-depth physical exam prior to initiating any treatment.
    A. recall that it will take a less severe mechanism of injury to cause significant injuries.
    (this multiple choice question has been scrambled)
  44. Signs and symptoms of preeclampsia include:
    A. marked hypoglycemia.
    B. dyspnea and bradycardia.
    C. dysuria and constipation.
    D. headache and edema.
    D. headache and edema.
    (this multiple choice question has been scrambled)
  45. Which of the following skull fractures would be the LEAST likely to present with palpable deformity or other outward signs?
    A. basilar
    B. open
    C. linear
    D. compressed
    C. linear
    (this multiple choice question has been scrambled)
  46. Cardiogenic shock following AMI is caused by:
    A. a profound increase in the patient's heart rate.
    B. widespread dilation of the systemic vasculature.
    C. hypovolemia secondary to severe vomiting.
    D. decreased pumping force of the heart muscle.
    D. decreased pumping force of the heart muscle.
    (this multiple choice question has been scrambled)
  47. When ventilating an adult with a BVM device without oxygen, the volume delivered with each breath should be approximately:
    A. 10 ml/kg.
    B. 18 ml/kg.
    C. 7 ml/kg.
    D. 15 ml/kg.
    A. 10 ml/kg.
    (this multiple choice question has been scrambled)
  48. The LEAST practical place to store a portable oxygen cylinder is:
    A. near the side or rear door.
    B. in the driver's compartment.
    C. on the ambulance stretcher.
    D. inside the jump kit.
    B. in the driver's compartment.
    (this multiple choice question has been scrambled)
  49. You and your partner are treating a 66-year-old man who experienced a sudden onset of respiratory distress. He is conscious but is unable to follow simple verbal commands. Further assessment reveals
    that his breathing is severely labored and his oxygen saturation is 80%.
    A. apply high-flow oxygen via nonrebreathing mask.
    B. assist his ventilations with a bag-mask device.
    C. attempt to insert an oropharyngeal airway.
    D. apply a continuous positive airway pressure (CPAP) device and monitor his breathing.
    B. assist his ventilations with a bag-mask device.
    (this multiple choice question has been scrambled)
  50. Typical components of an oral patient report include all of the following, EXCEPT:
    A. the set of baseline vital signs taken at the scene.
    B. the patient's response to treatment you provided.
    C. important medical history not previously given.
    D. the chief complaint or mechanism of injury.
    A. the set of baseline vital signs taken at the scene.
    (this multiple choice question has been scrambled)
  51. A 66-year-old female with a history of hypertension and diabetes  presents with substernal chest pressure of 2 hours' duration.  Her blood pressure is 140/90 mm Hg, her pulse is 100 beats/min and irregular, and her respirations are 22 breaths/min with adequate depth. The patient does not have prescribed nitroglycerin, but her husband does. You should:
    A. administer oxygen, give her 324 mg aspirin, and assess her further.
    B. give her 100% oxygen, attach the AED, and transport immediately.
    C. give her one nitroglycerin and reassess her systolic blood pressure.
    D. obtain a SAMPLE history and contact medical control for advice.
    A. administer oxygen, give her 324 mg aspirin, and assess her further.
    (this multiple choice question has been scrambled)
  52. Signs and symptoms of exposure to a nerve agent include:
    A. tachycardia, flushed skin, and unequal pupils.
    B. hypertension and severe pulmonary edema.
    C. salivation, pinpoint pupils, and diarrhea.
    D. dry mouth, dilated pupils, and headache.
    C. salivation, pinpoint pupils, and diarrhea.
    (this multiple choice question has been scrambled)
  53. You are performing mouth-to-mask ventilations with high-flow oxygen connected.  What should be the oxygen inlet flow-rate standard?
    A. 6-8 liters / minute
    B. 20 liters / minute
    C. 1-2 liters / minute
    D. 15 liters / minute
    D. 15 liters / minute
    (this multiple choice question has been scrambled)
  54. Which of the following signs is commonly observed in patients with right-sided heart failure?
    A. labored breathing
    B. dependent edema
    C. flat jugular veins
    D. pulmonary edema
    B. dependent edema
    (this multiple choice question has been scrambled)

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