Patient Assessment and Diagnosis Flashcards

A 28-year-old female of childbearing age presents to the ED with lower abdominal pain and vaginal spotting. Which assessment is MOST critical before further workup?

Answer: Urine pregnancy test

A urine pregnancy test must be performed first to rule out ectopic pregnancy before other diagnostics, as this is a life-threatening condition.

Which capnography waveform finding indicates esophageal intubation?

Answer: Absence of waveform with ETCO2 near zero

Absence of a capnography waveform and ETCO2 near zero confirms esophageal intubation, as the stomach does not produce sustained CO2.

A patient presents with a sudden onset of the 'worst headache of my life.' Which condition must be ruled out FIRST?

Answer: Subarachnoid hemorrhage (SAH)

A thunderclap headache described as the worst ever is the classic presentation of subarachnoid hemorrhage until proven otherwise.

Which finding is MOST consistent with cardiac tamponade on physical examination?

Answer: Hypotension, JVD, and muffled heart sounds (Beck's triad)

Beck's triad — hypotension, JVD, and muffled heart sounds — is the classic presentation of cardiac tamponade.

A patient presents with sudden onset dyspnea, pleuritic chest pain, and unilateral leg swelling after a long flight. SpO2 is 88%. Which condition is MOST likely?

Answer: Pulmonary embolism

Dyspnea, pleuritic chest pain, hypoxia, and unilateral leg swelling following prolonged immobility are classic features of pulmonary embolism.

Which finding on abdominal assessment is MOST associated with peritonitis?

Answer: Rebound tenderness and involuntary guarding

Rebound tenderness (pain worsened by rapid release of pressure) and involuntary guarding indicate peritoneal irritation consistent with peritonitis.

A patient with chronic renal failure presents with confusion, peaked T waves, prolonged PR interval, and wide QRS on ECG. The most urgent intervention is:

Answer: Administer calcium gluconate IV

Calcium gluconate is given first to stabilize the myocardial membrane and prevent fatal arrhythmia in severe hyperkalemia with ECG changes.