JIBC Paramedic Patient Assessment 4 — Questions and Answers
Question 1: Which reassessment interval is recommended for an unstable critical patient during transport?
- 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 deterioration and evaluate treatment effectiveness during transport.
Question 2: A trauma patient presents with Beck's triad (hypotension, muffled heart sounds, JVD). Which condition does this MOST suggest?
- Tension pneumothorax
- Cardiac tamponade (Correct answer)
- Massive hemothorax
- Aortic dissection
Correct answer: Cardiac tamponade
Beck's triad of hypotension, muffled heart sounds, and jugular venous distension is the classic presentation of pericardial tamponade.
Question 3: When documenting patient assessment findings, what does 'pertinent negatives' refer to?
- Findings that worsen the patient's prognosis
- Symptoms that are absent but relevant to the suspected diagnosis (Correct answer)
- Negative results from diagnostic tests
- Environmental factors that contributed to the call
Correct answer: Symptoms that are absent but relevant to the suspected diagnosis
Pertinent negatives are symptoms or signs that would be expected given the suspected condition but are absent, which aids in narrowing the differential diagnosis.
Question 4: During the environmental assessment of a suicide attempt, which action is MOST important before entering the scene?
- Determining the patient's mental health history
- Ensuring law enforcement has cleared the scene for safety (Correct answer)
- Obtaining consent from family members present
- Identifying the method used for the attempt
Correct answer: Ensuring law enforcement has cleared the scene for safety
Law enforcement must clear potential threat scenes before EMS personnel enter to ensure responder safety.
Question 5: A patient involved in a high-speed MVA is ambulatory at the scene. Which finding should MOST increase the paramedic's index of suspicion for significant internal injury?
- Mild abrasions to the forearms
- Complaint of minor shoulder pain
- Seatbelt sign (bruising across the abdomen/chest) (Correct answer)
- Intact air bags deployed
Correct answer: Seatbelt sign (bruising across the abdomen/chest)
A seatbelt sign indicates significant deceleration force was transmitted to the torso, raising concern for solid organ, hollow organ, or vascular injuries.
Question 6: Which statement about capillary refill time (CRT) is MOST accurate for adult assessment?
- CRT greater than 2 seconds in adults always indicates shock
- CRT is an unreliable perfusion indicator in adults and should not be used
- CRT greater than 2 seconds in adults suggests impaired peripheral perfusion but must be interpreted in clinical context (Correct answer)
- CRT is most accurate when assessed on the lower extremities
Correct answer: CRT greater than 2 seconds in adults suggests impaired peripheral perfusion but must be interpreted in clinical context
While CRT >2 seconds suggests poor perfusion, it can be affected by age, temperature, and medications, so it must be interpreted alongside other clinical findings.
Question 7: The Cincinnati Prehospital Stroke Scale assesses three findings. Which set is correct?
- Facial droop, arm drift, speech abnormality (Correct answer)
- Headache, vision changes, confusion
- Pupil changes, arm weakness, blood pressure elevation
- Dizziness, ataxia, slurred speech
Correct answer: Facial droop, arm drift, speech abnormality
The Cincinnati Stroke Scale uses facial droop, arm drift, and abnormal speech — any single positive finding has 72% sensitivity for stroke.
JIBC Paramedic Patient Assessment 4
Which reassessment interval is recommended for an unstable critical patient during transport?