BCEN Emergency Assessment 2 — Questions and Answers
Question 1: When performing a secondary assessment on a trauma patient, which mnemonic guides a head-to-toe evaluation?
- OPQRST
- DCAP-BTLS (Correct answer)
- SAMPLE
- AVPU
Correct answer: DCAP-BTLS
DCAP-BTLS (Deformities, Contusions, Abrasions, Punctures/Penetrations, Burns, Tenderness, Lacerations, Swelling) guides systematic head-to-toe trauma assessment.
Question 2: A patient presents with unequal pupils after head trauma. The left pupil is 6mm and non-reactive; the right is 3mm and reactive. What does this finding suggest?
- Bilateral brainstem herniation
- Ipsilateral uncal herniation on the left side (Correct answer)
- Pontine hemorrhage
- Opioid toxicity
Correct answer: Ipsilateral uncal herniation on the left side
A unilaterally dilated, non-reactive pupil after head trauma indicates uncal herniation with compression of cranial nerve III on the same side.
Question 3: During triage of a mass casualty incident, a patient is breathing only after repositioning the airway and has a respiratory rate of 28. Under START triage, this patient is categorized as:
- Black (deceased/expectant)
- Green (minor)
- Yellow (delayed)
- Red (immediate) (Correct answer)
Correct answer: Red (immediate)
Under START triage, a patient who breathes only after airway repositioning is categorized red (immediate) regardless of respiratory rate.
Question 4: When assessing capillary refill time in an adult, which finding is considered abnormal?
- Less than 1 second
- 1 to 2 seconds
- Greater than 2 seconds (Correct answer)
- Exactly 2 seconds
Correct answer: Greater than 2 seconds
Capillary refill time greater than 2 seconds in adults indicates impaired peripheral perfusion and may suggest shock or vascular compromise.
Question 5: A patient with chest pain rates their pain 8/10 and describes it as crushing, radiating to the left arm, with diaphoresis. Which initial assessment action is highest priority?
- Obtain a 12-lead ECG (Correct answer)
- Draw cardiac biomarkers
- Administer aspirin
- Place on continuous pulse oximetry
Correct answer: Obtain a 12-lead ECG
A 12-lead ECG should be obtained within 10 minutes of arrival for suspected ACS to identify ST-elevation and guide reperfusion therapy.
Question 6: Which finding on respiratory assessment indicates the need for immediate airway intervention?
- Respiratory rate of 18 breaths/min
- SpO2 of 96% on room air
- Accessory muscle use with nasal flaring (Correct answer)
- Mild bilateral wheezing
Correct answer: Accessory muscle use with nasal flaring
Accessory muscle use with nasal flaring are signs of severe respiratory distress indicating impending airway failure requiring immediate intervention.
Question 7: The Glasgow Coma Scale (GCS) assesses which three components?
- Pupils, motor, verbal
- Eye opening, verbal response, motor response (Correct answer)
- Orientation, memory, comprehension
- Alertness, voice, pain, unresponsive
Correct answer: Eye opening, verbal response, motor response
The GCS evaluates eye opening (1-4), verbal response (1-5), and motor response (1-6) for a total score ranging from 3 to 15.
BCEN Emergency Assessment 2
When performing a secondary assessment on a trauma patient, which mnemonic guides a head-to-toe evaluation?