FISDAP Patient Assessment 2 — Questions and Answers
Question 1: During a focused physical exam of a trauma patient with a mechanism of injury suggesting spinal involvement, which area should be assessed first?
- Lower extremities
- Cervical spine (Correct answer)
- Abdomen
- Chest
Correct answer: Cervical spine
The cervical spine is assessed first in trauma patients with a suspicious mechanism to detect tenderness, deformity, or instability before moving the patient.
Question 2: A patient presents with altered mental status and a blood glucose reading of 38 mg/dL. After administering oral glucose, reassessment reveals no improvement. What is the NEXT appropriate intervention?
- Administer a second dose of oral glucose
- Establish IV access and administer dextrose 50% (Correct answer)
- Recheck blood glucose in 15 minutes
- Perform a 12-lead ECG
Correct answer: Establish IV access and administer dextrose 50%
When oral glucose fails in a hypoglycemic patient, IV dextrose (D50) is the next step to rapidly correct glucose levels.
Question 3: Which component of the SAMPLE history is being collected when the EMT asks, 'Have you had this type of chest pain before?'
- Signs and Symptoms
- Allergies
- Pertinent past history (Correct answer)
- Last oral intake
Correct answer: Pertinent past history
Asking about prior episodes of the same complaint gathers pertinent past medical history, the 'P' in SAMPLE.
Question 4: When assessing a patient's pupils with a penlight, you note one pupil is fixed and dilated while the other is reactive. This finding is MOST consistent with:
- Bilateral optic nerve damage
- Uncal herniation compressing cranial nerve III (Correct answer)
- Hypoglycemia
- Hypovolemic shock
Correct answer: Uncal herniation compressing cranial nerve III
Unilateral fixed and dilated pupil indicates compression of cranial nerve III, often from uncal herniation due to elevated intracranial pressure.
Question 5: A conscious adult patient refuses treatment after a thorough assessment. Which action is MOST appropriate?
- Restrain the patient and transport
- Document the refusal and have the patient sign an AMA form (Correct answer)
- Call medical direction and then leave without documentation
- Administer treatment without consent
Correct answer: Document the refusal and have the patient sign an AMA form
A competent adult has the right to refuse care; EMTs must document the refusal thoroughly and obtain a signed against medical advice (AMA) form.
Question 6: During the secondary assessment of a patient complaining of abdominal pain, you note rigidity on palpation of all four quadrants. This finding MOST likely suggests:
- Constipation
- Peritonitis (Correct answer)
- Kidney stone
- Muscle strain
Correct answer: Peritonitis
Diffuse abdominal rigidity is a classic sign of peritonitis, indicating irritation of the peritoneal lining.
Question 7: A 45-year-old male presents with sudden onset of tearing chest pain radiating to his back. Blood pressure is 190/110 in the right arm and 150/90 in the left arm. You MOST suspect:
- Myocardial infarction
- Aortic dissection (Correct answer)
- Pulmonary embolism
- Pneumothorax
Correct answer: Aortic dissection
Tearing chest pain radiating to the back with unequal bilateral blood pressures is the hallmark presentation of aortic dissection.
FISDAP Patient Assessment 2
During a focused physical exam of a trauma patient with a mechanism of injury suggesting spinal involvement, which area should be assessed first?