JIBC - Justice Institute of British Columbia Paramedic Patient Assessment Questions and Answers — Questions and Answers
Question 1: You arrive on scene to a multi-vehicle collision. Your initial scene survey reveals three patients. Which of the following actions is your immediate priority according to the Paramedic Patient Assessment Model?
- Perform a rapid trauma survey on the patient who is screaming the loudest.
- Immediately begin treating the visible bleeding on a patient who is ambulatory.
- Assess the level of consciousness and airway of the patient who appears unresponsive. (Correct answer)
- Gather SAMPLE histories from all conscious patients to determine underlying conditions.
Correct answer: Assess the level of consciousness and airway of the patient who appears unresponsive.
The Paramedic Patient Assessment Model, like all triage and primary survey models, prioritizes identifying and managing the most immediate life threats first. An unresponsive patient is at the highest risk for airway compromise, which is the most critical life threat. While bleeding and other injuries are important, they are secondary to ensuring a patent airway and adequate breathing in an unresponsive patient.
Question 2: When assessing a patient with an altered level of consciousness, the mnemonic AEIOU-TIPS is used to consider potential causes. Which of the following correctly represents the 'I' in this mnemonic?
- Infection, Insulin, Intoxication
- Ischemia, Imbalance, Injury
- Infection, Insulin, Ingestion
- Insulin, Infection (Correct answer)
Correct answer: Insulin, Infection
The AEIOU-TIPS mnemonic is a tool to remember the common causes of altered mental status. The 'I' specifically stands for Insulin (representing hypoglycemia or hyperglycemia) and Infection (such as sepsis or meningitis). While intoxication and ingestion are causes, they are typically covered by 'A' (Alcohol) and 'O' (Overdose/Oxygen) or 'P' (Poisoning/Psychiatric).
Question 3: A 58-year-old male complains of central chest pain that started 30 minutes ago while resting. After completing your primary survey and obtaining vital signs, what is the most appropriate next step in your focused assessment?
- Perform a detailed head-to-toe secondary survey.
- Administer oxygen via nasal cannula regardless of SpO2 reading.
- Use the OPQRST mnemonic to further characterize the pain. (Correct answer)
- Immediately apply a 12-lead ECG before asking further questions.
Correct answer: Use the OPQRST mnemonic to further characterize the pain.
For a patient with a chief complaint of pain, especially suspected cardiac pain, using the OPQRST mnemonic (Onset, Provocation/Palliation, Quality, Radiation, Severity, Time) is the standard method to gather a detailed history of the presenting illness. This information is critical for forming a differential diagnosis and guiding treatment. A full head-to-toe is not immediately indicated, oxygen is guided by SpO2, and while a 12-lead is crucial, it should be done concurrently with or immediately after the history taking, not before.
Question 4: During the rapid trauma survey of an unresponsive motor vehicle collision patient, you assess the chest. Which finding would be the highest priority to manage immediately?
- A large area of bruising over the sternum.
- Palpable crepitus over the left lateral ribs.
- Asymmetrical chest rise with absent breath sounds on one side. (Correct answer)
- A simple, non-displaced fracture of the clavicle.
Correct answer: Asymmetrical chest rise with absent breath sounds on one side.
Asymmetrical chest rise with absent breath sounds is a hallmark sign of a life-threatening tension pneumothorax or a massive hemothorax. This represents a critical breathing and circulation problem that must be addressed immediately during the primary survey. Bruising, crepitus, and a clavicle fracture are significant findings but do not pose the same immediate threat to life.
Question 5: You are forming a general impression of a 2-year-old child from across the room using the Pediatric Assessment Triangle (PAT). Which of the following components is part of this initial assessment tool?
- Blood pressure.
- Work of Breathing. (Correct answer)
- Capillary refill time.
- Lung sounds.
Correct answer: Work of Breathing.
The Pediatric Assessment Triangle (PAT) is a rapid, hands-off visual and auditory assessment tool. Its three components are Appearance, Work of Breathing, and Circulation to the Skin. Work of Breathing is assessed by looking for signs like nasal flaring, retractions, and abnormal positioning. Blood pressure, capillary refill, and lung sounds are all part of the subsequent hands-on primary and secondary surveys, not the initial PAT.
Question 6: When assessing a patient's neurological status using the Glasgow Coma Scale (GCS), which response corresponds to a motor score of 5?
- Withdrawal from pain.
- Abnormal flexion (decorticate).
- Obeys commands.
- Localizes to pain. (Correct answer)
Correct answer: Localizes to pain.
The GCS motor response is scored on a 6-point scale. A score of 6 is 'Obeys commands.' A score of 5 is 'Localizes to pain,' where the patient purposefully moves to remove a painful stimulus. 'Withdrawal from pain' is a score of 4, and 'Abnormal flexion' is a score of 3.
JIBC - Justice Institute of British Columbia Paramedic Patient Assessment Questions and Answers
You arrive on scene to a multi-vehicle collision.
Your initial scene survey reveals three patients.
Which of the following actions is your immediate priority according to the Paramedic Patient Assessment Model?