AMLS Ch. 1 - Medical Pt Assessment Exam Questions with correct Answers

As you obtain historical information regarding your patient, you note that the patient's presentation and responses are very similar to several patient complaints you have treated in the past. Integrating this information from past experiences to this current experience is known as: a. Pattern recognition b. Active listening c. Clinical decision making d. Clinical reasoning - Answer- a. Pattern recognition along with the cardinal presentation, history, and physical exam, evaluation of diagnostic findings, and good critical thinking skills all contribute to effective, efficient diagnosis and management of medical patients. In which situation has the threat to your personal safety been reduced most significantly? a. An angry schizophrenic patient has been calmed using verbal diffusing techniques. b. A barking dog has been secured in a kennel in the yard. c. The perpetrator of a shooting has fled, and police are on the scene with you. d. Your partner has taken an angry family member into another room. - Answer- b. Healthcare providers in all environments and situations must remain vigilant in identifying potential safety issues for both the patient and provider. Securing the dog in a kennel away from the patient and providers eliminates that threat. The schizophrenic patient may be temporarily calmed but remains at high risk of outbursts. An armed fugitive is a danger, even though they have left the scene. Prehospital providers should never separate themselves or be placed in a situation where communication, patient care, or escape is difficult. Assistance should be obtained to deal with the angry family member. You evaluate the patient's environment to assess for: a. Safety concerns b. Room temperature c. Assistive devices d. All of the above - Answer- d. Prehospital and in-hospital areas that involve patients and their families should be continually assessed for environmental concerns such as comfort and temperature, assistive equipment, and lifting and moving issues. Assistive devices like walkers, oxygen concentrators, and dentures indicate perfusion and nutrition/ dehydration issues. All providers should use their sense of smell, vision, hearing, and touch when assessing the environment and patient. An unresponsive patient has a needle in his arm when you arrive. His pupils are pinpoint, and he is breathing four times per minute. You are preparing to administer naloxone. At this point, opioid overdose is your initial: a. Differential diagnosis b. Primary diagnosis c. Terminal diagnosis d. Working diagnosis - Answer- a. This initial diagnosis is based on your global patient assessment and general impression. As additional historical, physical exam, and diagnostic findings are obtained, you'll rule out and rule in various possible differential diagnoses until a working diagnosis is determined. An 18-year-old male had a tonic-clinic seizure. Coworkers report no known seizure history. You can arouse him to voice. P 118, R 20, BP 102/ 68. The diagnostic test most likely to narrow your differential diagnosis would be: a. 12-Lead ECG b. Blood glucose analysis c. End-tidal CO2 measurement d. Pulse oximetry - Answer- b. While pulse oximetry may be useful, obtaining end-tidal CO2 measurement and a 12-lead ECG are not essential treatment interventions with this critical patient. Seizure activity utilizes significant adenosine triphosphate (ATP) energy and glucose, so obtaining a baseline blood glucose level is essential. A 23-year-old female has an acute onset of left flank pain. You should investigate which of the following regarding her pain? a. Dysuria b. Fever with productive cough c. Increase in appetite d. Syncopal episodes - Answer- a. Dysuria is the most significant associated complaint relative to the left flank pain complaint. Fever, changes in appetite, and syncope would be key symptoms in complaints of dyspnea, abdominal pain, or alterations in mentation. When you use an interpreter to question a 42-year-old female about her abdominal pain, what is the best way to ensure information has been conveyed accurately and completely? a. Ask the interpreter to have the patient repeat back key information about your treatment plan to ensure understanding. b. Have her husband interpret because it will save time, as he will know a significant amount of her history. c. Let the patient write her answers, and have the interpreter restate them so you will have a record of her statements for your report. d. Wait until you arrive at the hospital to find an interpreter to ensure an accurate interpretation of key findings. - Answer- c. Restating and summarizing the discussion is essential to clarity and decreases the likelihood of misinterpreting information during verbal communication, especially when a shared language is not spoken. Written documentation should include statements made by the patient, noting they were interpreted by a third party. (Objective 8) After you ensure scene safety, your highest priority is to: a. Form a working diagnosis b. Form a differential diagnosis c. Determine the root cause of the patient's problem d. Rule out immediate life threats - Answer- d. Once you're safe to evaluate the patient, you must next form a general impression and take a primary survey to determine whether the patient's presentation identifies a life threat, potential life threat, or non- life threat. If a life threat is identified, immediate interventions would be initiated. Which of the following physical findings points most specifically to increased intracranial pressure? a. BP 200/ 60 mm Hg b. Both pupils are 5 mm and react sluggishly to light. c. Glasgow Coma Scale score is 7. d. Respiratory rate is 8 and irregular. - Answer- d. In the secondary survey, obtaining historical, physical exam, and diagnostic information and initiating treatment interventions are based on the emergent or nonemergent status of the patient. These assessment components are dynamic and don't necessarily follow a rigid format. You are transferring a 65-year-old female with renal failure from the nursing home. She has a history of "abnormal lab values" and is drowsy and weak. You note the following lab values: serum calcium 10.0 mg/ dL (0.55 mmol/ L), pH 7.28, potassium 6.1 mEq/ L. The patient goes into cardiac arrest after you load her into the ambulance. After epinephrine, you should first consider giving her: a. Calcium chloride b. Lactated Ringer's bolus