Patient Assessment Basics [ 1 ] Quiz / Test | Sci / Tech

Quiz Answer Key and Fun Facts

1. One of the key assessments in evaluating a patient is the Glasgow Coma Score (or Scale), which evaluates the patient's neurological status. What three things are assessed in the Glasgow Coma Score?

Answer: Eye Opening, Verbal Response, Motor Response

The highest possible Glasgow Coma Score is 15, and the lowest possible score is 3. A score of 13, 14 or 15 can indicate a mild head injury, scores of 8 - 12 can indicate a moderate head injury, and a score of less than 8 is generally associated with a severe head injury.

2. An important part of emergency medicine is having a thorough knowledge of anatomy. In which quadrant of the abdomen is the liver located?

Answer: Right Upper Quadrant (RUQ)

Abdominal pain is a common call for a paramedic, and it's important that you know what goes where inside the abdomen so that you can make an accurate diagnosis.

If the patient is complaining of abdominal pain, you will need to assess the abdomen. The abdomen should be examined systematically, and ensure that you examine the painful part last, so that you can compare it to the non-painful parts. Look for swelling, discolouration, skin temperature and rigidity.

3. Early in their careers, paramedics learn the medical use of the term "shock", as well as learning about this can best be treated. In 2008, at a basic level, how many different stages (not types) of shock were recognized and taught?

Answer: 3

When I was a young paramedic, we were taught that there are three stages to shock, and these were defined as compensated shock, decompensated (or uncompensated) shock, and irreversible shock. In compensated shock, the patient may be lethargic or confused, and their pulse rate will be slightly elevated.

In decompensated shock the patient may be confused or even unconscious, and their pulse rate will be markedly elevated. In irreversible shock, the patient will have a slow pulse rate and be in a coma. Now that I'm an old paramedic, these divisions have recently been further broken down, and you may see four or five different stages of shock listed in some texts.

4. There are numerous causes of shock, and the paramedic needs to be aware of the causes in order to help the patient most effectively. Which of the following options can cause hypovolaemic shock?

Answer: External bleeding / Vomiting and Diarrhoea

Hypovolaemic shock is frequently caused by bleeding, or through severe vomiting and diarrhoea. Each scenario leaves the patient with a decrease in their circulating blood volume.
Myocardial infarction, which is the technical term for a heart attack, causes cardiogenic shock, so named because it is caused by the heart itself.
Cardio = Heart.

5. Another assessment tool used by paramedics is the "Rule of Nines". For what types of injuries do paramedics apply the "Rule of Nines"?

Answer: Burns

The Rule of Nines is used to calculate the Total Body Surface Area (TBSA) involved in burns injuries. Another way to do this is to imagine the burnt areas in comparison to the size of the patient's own palm. Each area the same size as their palm is roughly equivalent to 1% of their TBSA.

6. Spinal cord injuries are, unfortunately, common calls for a paramedic. When questioning a conscious patient that you suspect of having a spinal cord injury, I always try to ask the patient questions that don't have a 'yes' or 'no' answer, as people often nod or shake their heads subconsciously when giving these answers. True or False - This is the preferred method of questioning a conscious patient suspected of having a spinal injury?

Answer: True

It is important that you ask the patient open questions as people have a very bad habit of nodding their heads when saying yes, and shaking their heads when saying no. Since we want the patient to have the best possible chance of recovery from this injury, it is essential to immobilise the head and discourage the patient from moving it themselves.

7. Taking a patient's blood pressure is something that happens for almost every patient a paramedic sees, and the same thing happens when you visit your doctor for a check up. One number is the systolic blood pressure, and one number is the diastolic blood pressure. What does the diastolic blood pressure represent?

Answer: The pressure of blood in the vessels when the heart is at rest.

The diastolic blood pressure represents the pressure of blood in the vessels between each heart beat. This is usually the second number that the paramedic or the doctor says if they say (for example) that your blood pressure is 125 on 65. This blood pressure reading may be written up as 125/65. Sometimes, the paramedic may only take your systolic blood pressure. To do this, they will put the cuff on your arm, inflate it, and let it down while they feel your pulse.

This method is unable to determine your diastolic blood pressure - they need to get their stethoscope out to listen if they want to take your diastolic blood pressure.

8. Feeling for a pulse on any patient is something that I do almost without thinking about it these days. When I am feeling a pulse in the crook of the person's elbow, which pulse am I taking?

Answer: Brachial

The crook of the elbow is known as the antecubital fossa, which some paramedics refer to as "the cube". The Brachial artery is located in the elbow, and therefore the brachial pulse is felt in the crook of the elbow. The Carotid artery is in your neck, and the Popliteal artery runs behind your knee.

The Cephalic is a vein that runs along your forearm, and you may see a paramedic place a cannula in this vein.

9. Look into my eyes is not something that is reserved for magicians and hypnotists, as paramedics look into the eyes of almost every patient (if not every patient). Pupils that are larger than normal may sometimes be referred to as 'blown'. Which of the following causes 'blown' pupils?

Answer: Snorting Cocaine

The eyes may be the windows to the soul, but for paramedics they can also be clues as to what might be wrong with a person who has called the ambulance.

Using cocaine, hallucinogenic mushrooms, mescaline, LSD and MDMA (which is Ecstasy) all cause the pupils to become abnormally large. Heroin use, Funnel Web spider bites and brightly lit environments all cause unusually small (or pinpoint) pupils.

10. Wheezes, rales, crackles and creps (oh my!) are noises that paramedics are trained to recognise and treat during the course of their learning. In which organ do we usually refer to hearing wheezes, rales, crackles or creps?

Answer: The Lungs

Wheezes, rales, crackles and creps and different sounds that may be heard when assessing the breathing of a patient. If a patient seems to be having difficulty in breathing, then the paramedic will have a listen to the chest of the patient with their stethoscope in an effort to identify what the problem may be, and decide on a course of action or treatment from there.

Source: Author ecnalubma

This quiz was reviewed by FunTrivia editor crisw before going online.
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Patient Assessment Basics [ 1 ] Quiz

Whenever I get a call to go and see someone, my first task is to assess the patient. Effective and efficient patient assessment is key to my job. Welcome to the world of the paramedic.

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