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Emergency Care, 13e (Limmer et al.)
Chapter 14 The Secondary Assessment
1) The patient was a driver in a lateral impact motor vehicle collision. During the assessment of
his chest, the EMT notes a segment of the chest wall moving in the opposite direction from the
rest of the chest. Which of the following BEST describes this finding?
A) Flutter segment
B) Tension pneumothorax
C) Paradoxical movement
D) Intercostal retractions
Objective: 14.1
2) When assessing a 14-year-old male patient that has been involved in a bicycle accident, you
notice that he has a small amount of blood coming from his left forearm. This observation is
known as which of the following?
A) Sign
B) Symptom
C) Clue
D) Indication
Objective: 14.1
1
3) What is the sound or feel of broken bones rubbing against each other called?
A) Emesis
B) Decapitation
C) Osteomyelitis
D) Crepitation
Objective: 14.1
4) What term describes a permanent surgical opening in the neck through which a patient
breathes?
A) Cricothyrotomy
B) Tracheostomy
C) Laryngectomy
D) Stoma
Objective: 14.1
5) What term describes a surgical incision in the neck that is held open by a metal or plastic tube
through which a patient can breathe or be placed on a ventilator?
A) Cricothyrotomy
B) Stoma
C) Tracheostomy
D) Tracheopharyngeal fistula
Objective: 14.1
2
6) When a patient describes how he feels, he is telling you which of the following?
A) His syndrome
B) His diagnosis
C) His signs
D) His symptoms
Objective: 14.1
7) You are assessing a 76-year-old male patient that has been involved in a fall from a standing
position. You have completed the scene size-up and primary assessment. What should you do
next?
A) Focused history assessment
B) Ongoing assessment
C) Secondary assessment
D) Reassessment
Objective: 14.2
3
8) You have a patient who is unresponsive on the floor. What is the best way to rule in or rule out
trauma as a cause of the patient's unresponsiveness?
A) Examine the patient for signs of trauma.
B) Look for a Glasgow Coma Scale score that is less than 8.
C) Check the patient's blood sugar to rule out hypoglycemia.
D) Look for bystanders and ask them if they witnessed the incident.
Objective: 14.2
9) Which of the following techniques of physical examination must an EMT master?
A) Percussion, inspection, and palpation
B) Auscultation, observation, and percussion
C) Visualization, percussion, and auscultation
D) Observation, palpation, and auscultation
Objective: 14.3
4
10) Which of the following methods should be used to have a patient rate the amount of pain he
is having?
A) Have the patient rate the pain on a scale of 1 (least) to 10 (worst).
B) Ask the patient to state whether the pain is mild, moderate, severe, or unbearable.
C) Use the memory aid AVPU.
D) Use the memory aid DCAP.
Objective: 14.3
11) You are caring for a teenager who is having a severe allergic reaction. He has hives all over
his stomach, is having respiratory distress, and is wheezing. After you administer oxygen, you
get a set of vital signs. Medical direction has ordered you to assist with administration of his Epi-
Pen®. You will monitor the success of your interventions during the:
A) primary assessment.
B) secondary assessment.
C) reassessment.
D) focused exam.
Objective: 14.3
5
12) While performing a detailed physical exam on a patient involved in a fall from 30 feet, the
patient (who had previously been responding to your questions) stops responding. What should
you do next?
A) Start CPR.
B) Continue the detailed physical assessment.
C) Call medical control for orders.
D) Repeat the primary assessment.
Objective: 14.4
13) You are assessing a patient that has been involved in a motor vehicle crash. Which of the
following questions would be the most important to ask him?
A) Why were you in such a hurry?
B) How much fuel is in your car?
C) Have you been in a crash before?
D) How fast was the vehicle going?
Objective: 14.4
6
14) You are responding to an unresponsive 65-year-old male patient. The patient has snoring
respirations, a scalp laceration, and an obvious fracture of the left ankle. What is the best initial
course of action?
A) Bandage the scalp wound.
B) Perform a complete primary and secondary assessment to make sure you know exactly what
is wrong before treating the patient.
C) Place an oral airway in the patient.
D) Splint the ankle to avoid lacerating any nerves or arteries.
Objective: 14.4
15) Your patient has been hit in the arm with a baseball during practice. He is alert and oriented,
complaining of pain to his left arm with obvious black discoloration of the skin. What type of
assessment is called for in this situation?
A) Rapid trauma exam
B) Detailed physical exam
C) Area exam
D) Focused exam
Objective: 14.4
7
16) Which of the following is false regarding the purpose of immediately documenting vital
signs once they are obtained?
A) It may be difficult to recall the vital signs accurately later on.
B) You will be able to compare each set of vital signs with the previous ones to detect trends in
the patient's condition.
C) Failure to record the vital signs immediately is considered falsifying the medical record.
D) You will be able to report the vital signs accurately when contacting the receiving facility.
Objective: 14.4
17) Your patient is a 16-year-old female who is reporting abdominal pain and nausea. She says it
came on when she woke up this morning. Her mother says that her daughter has been tired and
cranky lately and has not been eating well for a couple of weeks. In fact, every time you ask a
question, the patient's mother answers. What should you do next?
A) Ask the mother to please be quiet.
B) Have your partner interview the mother in the next room.
C) Tell the mother to leave the room.
D) Ignore the mother and continue to try to talk to the patient.
Objective: 14.4
8
18) You are called for a patient who is complaining of being weak and dizzy. He reports that he
does not have enough money to pay for his medications so he has not gotten them refilled. Your
service has an automatic blood pressure machine and you use it to measure the patient's blood
pressure while you count his respirations. The blood pressure machine reports a blood pressure
of 280/140. What should you do next?
A) Call immediately for ALS response.
B) Begin transport immediately.
C) Continue with vital sign assessment.
D) Take a manual blood pressure.
Objective: 14.4
19) When assessing a patient who has been stabbed. Which of the following information should
the EMT gain first?
A) Angle at which the knife entered the patient
B) Size and type of the knife
C) Owner of the knife
D) Make and model of the knife
Objective: 14.4
9
20) In which of the following circumstances is manual stabilization of the cervical spine
ALWAYS necessary?
A) Trauma above the level of the clavicles
B) Blunt trauma
C) Trauma to the lower extremities
D) Penetrating trauma
Objective: 14.4
21) In which of the following patients should you check for the possibility of spinal injury?
A) A responsive patient with no history of injury who is complaining of a headache and neck
pain
B) An unresponsive patient found in her bed with no obvious injury
C) An unresponsive diabetic who appears to have fallen down
D) All of the above
Objective: 14.4
10
