IHSA Patient Assessment & Evaluation 3 — Questions and Answers
Question 1: Which vital sign provides the MOST reliable early indicator of internal hemorrhage in an otherwise healthy adult worker?
- Blood pressure
- Respiratory rate
- Pulse rate and quality (Correct answer)
- Skin temperature
Correct answer: Pulse rate and quality
Heart rate increases early as the body compensates for blood loss, often before blood pressure drops significantly.
Question 2: When performing a head-to-toe secondary assessment, which technique is used to check for internal abdominal injuries?
- Percussion and palpation (Correct answer)
- Auscultation only
- Visual inspection only
- Range of motion testing
Correct answer: Percussion and palpation
Palpation assesses rigidity or guarding and percussion can reveal free fluid, both indicating potential internal injury.
Question 3: A patient's pupils are unequal in size after a head trauma. This finding is called:
- Miosis
- Mydriasis
- Anisocoria (Correct answer)
- Nystagmus
Correct answer: Anisocoria
Anisocoria refers to unequal pupil sizes, which after head trauma can indicate increased intracranial pressure or brain herniation.
Question 4: What is the standard reassessment interval for an unstable patient in the field?
- Every 15 minutes
- Every 10 minutes
- Every 5 minutes (Correct answer)
- Every 2 minutes
Correct answer: Every 5 minutes
Unstable patients require reassessment every 5 minutes to detect rapid changes in condition.
Question 5: During a secondary assessment, crepitus felt over the chest wall most likely indicates:
- Pleural effusion
- Rib fracture or subcutaneous emphysema (Correct answer)
- Tension pneumothorax
- Diaphragmatic rupture
Correct answer: Rib fracture or subcutaneous emphysema
Crepitus—a crackling sensation under the skin—suggests fractured ribs or air trapped in subcutaneous tissue from a chest injury.
Question 6: Which method is used to quickly assess neurological status in the secondary survey beyond the AVPU scale?
- Glasgow Coma Scale (GCS) (Correct answer)
- FAST exam
- Cincinnati Stroke Scale
- SAMPLE mnemonic
Correct answer: Glasgow Coma Scale (GCS)
The Glasgow Coma Scale provides a more detailed neurological assessment by scoring eye, verbal, and motor responses.
Question 7: A patient has paradoxical chest wall movement after blunt trauma. This finding is MOST consistent with:
- Simple pneumothorax
- Cardiac tamponade
- Flail chest (Correct answer)
- Hemothorax
Correct answer: Flail chest
Flail chest occurs when multiple rib fractures cause a free-floating segment that moves opposite to the rest of the chest during breathing.
IHSA Patient Assessment & Evaluation 3
Which vital sign provides the MOST reliable early indicator of internal hemorrhage in an otherwise healthy adult worker?