Chapter 10 Patient Assessment

Question 1

A rapid heart rate, more than 100 beats/min.

Answer 1

tachycardia

Question 2

Blood pressure that is higher than the normal range.

Answer 2

hypertension

Question 3

An upright position in which the patient leans forward onto two arms stretched forward and thrusts the head and chin forward.

Answer 3

tripod position

Question 4

A mnemonic used in evaluating a patient’s pain: Onset, Provocation/palliation, Quality, Region/radiation, Severity, and Timing.

Answer 4

OPQRST

Question 5

The time from injury to definitive care, during which treatment of shock and traumatic injuries should occur because survival potential is best; also called the Golden Period.

Answer 5

Golden Hour

Question 6

The increased pressure in an artery with each contraction of the ventricles (systole).

Answer 6

systolic pressure

Question 7

The forces, or energy transmission, applied to the body that cause injury.

Answer 7

mechanism of injury

Question 8

A step within the patient assessment process in which a systematic physical examination of the patient is performed. The examination may be a systematic exam or an assessment that focuses on a certain area or region of the body, often determined through the chief complaint.

Answer 8

secondary assessment

Question 9

A test that evaluates distal circulatory system function by squeezing (blanching) blood from an area such as a nail bed and watching the speed of its return after releasing the pressure.

Answer 9

capillary refill

Question 10

Movements in which the skin pulls in around the ribs during inspiration.

Answer 10

retractions

Question 11

The overall initial impression that determines the priority for patient care; based on the patient’s surroundings, the mechanism of injury, signs and symptoms, and the chief complaint.

Answer 11

general impression

Question 12

Objective finding that can be seen, heard, felt, smelled, or measured.

Answer 12

sign

Question 13

The motion of the portion of the chest wall that is detached in a flail chest; the motion—in during inhalation, out during exhalation—is exactly the opposite of normal chest wall motion during breathing.

Answer 13

paradoxical motion

Question 14

The secondary muscles of respiration. They include the neck muscles (sternocleidomastoids), the chest pectoralis major muscles, and the abdominal muscles.

Answer 14

accessory muscles

Question 15

A system implemented to manage disasters and mass-casualty incidents in which section chiefs, including finance/administration, logistics, operations, and planning, report to the incident commander.

Answer 15

incident command system

Question 16

A step within the patient assessment process performed at regular intervals during the assessment process to identify and treat changes in a patient’s condition. A patient in unstable condition should be reassessed every 5 minutes, whereas a patient in stable condition should be reassessed every 15 minutes.

Answer 16

reassessment

Question 17

The flow of blood through body tissues and vessels.

Answer 17

perfusion

Question 18

Damage to tissues as the result of exposure to cold; frozen or partially frozen body parts are frostbitten.

Answer 18

frostbite

Question 19

The average pressure in the circulatory system during one cardiac cycle.

Answer 19

mean arterial pressure

Question 20

A grating or grinding sensation or sound caused by fractured bone ends or joints rubbing together.

Answer 20

crepitus

Question 21

Any injury that prevents the patient from noticing other injuries he or she may have, even severe injuries; for example, a painful femur or tibia fracture that prevents the patient from noticing back pain associated with a spinal fracture.

Answer 21

distracting injury

Question 22

To listen to sounds within an organ with a stethoscope.

Answer 22

auscultate

Question 23

A step within the patient assessment process that identifies and initiates treatment of immediate and potential life threats.

Answer 23

primary assessment

Question 24

Breathing that occurs without assistance.

Answer 24

spontaneous respirations

Question 25

A mnemonic for assessment in which each area of the body is evaluated for Deformities, Contusions, Abrasions, Punctures/penetrations, Burns, Tenderness, Lacerations, and Swelling.

Answer 25

DCAP-BTLS

Question 26

Subjective findings that the patient feels but that can be identified only by the patient.

Answer 26

symptom

Question 27

The conclusion about the cause of the patient’s condition after considering the situation, history, and examination findings.

Answer 27

field impression

Question 28

Protective equipment that blocks exposure to a pathogen or a hazardous material.

Answer 28

personal protective equipment

Question 29

The general type of illness a patient is experiencing.

Answer 29

nature of illness

Question 30

A harsh, high-pitched respiratory sound, generally heard during inspiration, that is caused by partial blockage or narrowing of the upper airway; may be audible without a stethoscope.

Answer 30

stridor

Question 31

A slow heart rate, less than 60 beats/min.

Answer 31

bradycardia

Question 32

Respirations characterized by little movement of the chest wall (reduced tidal volume) or poor chest excursion.

Answer 32

shallow respirations

Question 33

Coarse, low-pitched breath sounds heard in patients with chronic mucus in the upper airways.

Answer 33

rhonchi

Question 34

The process of establishing treatment and transportation priorities according to severity of injury and medical need.

Answer 34

triage

Question 35

A type of physical assessment typically performed on patients who have sustained nonsignificant mechanisms of injury or on responsive medical patients. This type of examination is based on the chief complaint and focuses on one body system or part.

Answer 35

focused assessment

Question 36

A step within the patient assessment process that provides details about the patient’s chief complaint and an account of the patient’s signs and symptoms.

Answer 36

history taking

Question 37

A severe breathing problem in which a patient can speak only two to three words at a time without pausing to take a breath.

Answer 37

two-to three-word dyspnea

Question 38

An assessment tool that measures oxygen saturation of hemoglobin in the capillary beds.

Answer 38

pulse oximetry

Question 39

Narrowing of a blood vessel.

Answer 39

vasoconstriction

Question 40

Crackling, rattling breath sounds that signal fluid in the air spaces of the lungs.

Answer 40

crackles

Question 41

A component of air that typically makes up 0.03% of air at sea level; also a waste product exhaled during expiration by the respiratory system.

Answer 41

carbon dioxide

Question 42

The wave of pressure created as the heart contracts and forces blood out the left ventricle and into the major arteries.

Answer 42

pulse

Question 43

A noninvasive method to quickly and efficiently provide information on a patient’s ventilatory status, circulation, and metabolism; effectively measures the concentration of carbon dioxide in expired air over time.

Answer 43

capnography

Question 44

Yellow skin or sclera that is caused by liver disease or dysfunction.

Answer 44

jaundice

Question 45

Widening of the nostrils, indicating that there is an airway obstruction.

Answer 45

nasal flaring

Question 46

The way in which a patient responds to external stimuli, including verbal stimuli (sound), tactile stimuli (touch), and painful stimuli.

Answer 46

responsiveness

Question 47

An upright position in which the patient’s head and chin are thrust slightly forward to keep the airway open.

Answer 47

sniffing position

Question 48

The amount of air (in milliliters) that is moved into or out of the lungs during one breath.

Answer 48

tidal volume

Question 49

The biochemical processes that result in production of energy from nutrients within the cells; also called cellular respiration.

Answer 49

metabolism

Question 50

A blue skin discoloration that is caused by a reduced level of oxygen in the blood. Although paleness, or a decrease in blood flow, can be difficult to detect in dark-skinned people, it may be observed by examining mucous membranes inside the inner lower eyelid and capillary refill. On general observation, the patient may appear ashen or gray.

Answer 50

cyanosis

Question 51

Characterized by light or profuse sweating.

Answer 51

diaphoretic

Question 52

A brief history of a patient’s condition to determine signs and symptoms, allergies, medications, pertinent past history, last oral intake, and events leading to the injury or illness.

Answer 52

SAMPLE history

Question 53

The pressure that the blood exerts against the walls of the arteries as it passes through them.

Answer 53

blood pressure

Question 54

An indication of air movement in the lungs, usually assessed with a stethoscope.

Answer 54

breath sounds

Question 55

The pressure that remains in the arteries during the relaxing phase of the heart’s cycle (diastole) when the left ventricle is at rest.

Answer 55

diastolic pressure

Question 56

Involuntary muscle contractions (spasm) of the abdominal wall to minimize the pain of abdominal movement; a sign of peritonitis.

Answer 56

guarding

Question 57

Protective measures that have traditionally been developed by the Centers for Disease Control and Prevention (CDC) for use in dealing with objects, blood, body fluids, and other potential exposure risks of communicable disease.

Answer 57

standard precautions

Question 58

A characteristic crackling sensation felt on palpation of the skin, caused by the presence of air in soft tissues.

Answer 58

subcutaneous emphysema

Question 59

To examine by touch

Answer 59

palpate

Question 60

A high-pitched, whistling breath sound that is most prominent on expiration, and which suggests an obstruction or narrowing of the lower airways; occurs in asthma and bronchiolitis.

Answer 60

wheezing

Question 61

The mental status of a patient as measured by memory of person (name), place (current location), time (current year, month, and approximate date), and event (what happened).

Answer 61

orientation

Question 62

A condition in which the internal body temperature falls below 95 degrees F (35 degrees C).

Answer 62

hypothermia

Question 63

The reason a patient called for help; also, the patient’s response to questions such as “What’s wrong?” or “What happened?”

Answer 63

chief complaint

Question 64

A change in the way a person thinks and behaves that may signal disease in the central nervous system or elsewhere in the body.

Answer 64

altered mental status

Question 65

The delicate membrane that lines the eyelids and covers the exposed surface of the eye.

Answer 65

conjunctiva

Question 66

The key signs that are used to evaluate the patient’s overall condition, including respirations, pulse, blood pressure, level of consciousness, and skin characteristics.

Answer 66

vital signs

Question 67

A method of assessing the level of consciousness by determining whether the patient is awake and alert, responsive to verbal stimuli or pain, or unresponsive; used principally early in the assessment process.

Answer 67

AVPU scale Alert, Verbal, Pain, Unresponsiveness

Question 68

A step within the patient assessment process that involves a quick assessment of the scene and the surroundings to provide information about scene safety and the mechanism of injury or nature of illness before you enter and begin patient care.

Answer 68

scene size-up

Question 69

Blood pressure that is lower than the normal range.

Answer 69

hypotension

Question 70

Negative findings that warrant no care or intervention.

Answer 70

pertinent negatives

Question 71

Knowledge and understanding of one’s surroundings and the ability to recognize potential risks to the safety of the patient or EMS team.

Answer 71

situational awareness

Question 72

The use of muscles of the chest, back, and abdomen to assist in expanding the chest; occurs when air movement is impaired.

Answer 72

labored breathing

Question 73

The tough, fibrous, white portion of the eye that protects the more delicate inner structures.

Answer 73

sclera