Emergency Care 13th Edition Limmer Test Bank

Emergency Care 13th Edition Limmer
Test Bank
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Emergency Care, 13e (Limmer et al.)
Chapter 13 Vital Signs and Monitoring Devices
1) When the heart contracts and forces blood into the arteries, the pressure created is known as
the:
A) pulse pressure.
B) systolic blood pressure.
C) diastolic blood pressure.
D) central venous pressure.
Answer: B
Explanation: A) INCORRECT. Although when the heart contracts it does generate a pulse, the
arterial pressure is not called pulse pressure.
B) CORRECT. The pressure in the arteries when the heart contracts is called systolic blood
pressure.
C) INCORRECT. Diastolic blood pressure is the pressure remaining in the arteries when the
heart relaxes.
D) INCORRECT. Arterial pressure would not be referred to as venous.
Page Ref: 316
Objective: 13.1
2) What is the pressure remaining in the arteries after the pulse wave has passed through?
A) Venous pressure
B) Systolic blood pressure
C) Diastolic blood pressure
D) Resting blood pressure
Answer: C
Explanation: A) INCORRECT. The term venous would not be used in reference to arterial
pressure.
B) INCORRECT. The pressure in the arteries when the heart contracts is called systolic blood
pressure.
C) CORRECT. Diastolic blood pressure is the pressure remaining in the arteries when the heart
relaxes.
D) INCORRECT. A resting blood pressure refers to the condition of the patient, not a particular
pressure during the circulatory cycle.
Page Ref: 316
Objective: 13.1
1
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3) A patient with a pulse rate of 120 beats per minute is considered which of the following?
A) Dyscardic
B) Normocardic
C) Tachycardic
D) Bradycardic
Answer: C
Explanation: A) INCORRECT. Dyscardic is not a commonly used medical term and it does not
apply to a pulse rate of 120.
B) INCORRECT. The term normocardic is sometimes used in reference to a normal heart
rhythm or pulse rate; it does not apply in this scenario.
C) CORRECT. A pulse rate above 100 beats per minute is considered rapid, or tachycardic.
D) INCORRECT. The term bradycardia generally refers to a heart rate below 60 beats per
minute.
Page Ref: 309
Objective: 13.1
4) The method of taking blood pressure by using a stethoscope to listen to the characteristic
sounds produced is called:
A) auscultation.
B) articulation.
C) palpation.
D) pulsation.
Answer: A
Explanation: A) CORRECT. The term auscultation means listening.
B) INCORRECT. Articulation does not refer to blood pressure or listening.
C) INCORRECT. The term palpation refers to feeling or touching.
D) INCORRECT. Pulsation is a rhythmic throbbing, unrelated to listening for sounds.
Page Ref: 318
Objective: 13.1
5) Upon assessment of your patient, you notice that he has cool, sweaty skin. This finding is best
described as which of the following?
A) Diagnosis
B) Sign
C) Complaint
D) Symptom
Answer: B
Explanation: A) INCORRECT. A diagnosis is a determination of a specific medical condition.
A patient's appearance is not a diagnosis.
B) CORRECT. A sign is something that can be observed, palpated, or measured.
C) INCORRECT. A complaint is generally a reason that the patient has sought care, not an
observation during the assessment.
D) INCORRECT. A symptom is how the patient feels, not generally something that is
observable by the EMT.
Page Ref: 309
Objective: 13.2
2
6) The abbreviation mmHg indicates that the blood pressure is measured by which of the
following comparisons?
A) Minimum heart rate
B) Millimeters of mercury
C) Millimeters of water
D) Atmospheric pressure
Answer: B
Explanation: A) INCORRECT. Minimum heart rate is not abbreviated as mmHg.
B) CORRECT. Millimeters of mercury, or mmHg, refers to the units on the blood pressure
gauge.
C) INCORRECT. The abbreviation mmHg does not indicate a water measurement.
D) INCORRECT. Atmospheric pressure is not referred to by the abbreviation mmHg.
Page Ref: 318
Objective: 13.2
7) The first set of vital sign measurements obtained are often referred to as which of the
following?
A) Baseline vital signs
B) Normal vital signs
C) Standard vital signs
D) None of the above
Answer: A
Explanation: A) CORRECT. The first measurements you obtain are called the baseline vital
signs. You can gain even more valuable information when you repeat the vital signs and compare
them to the baseline measurements.
B) INCORRECT. The first set of vital signs obtained is not generally called normal.
C) INCORRECT. The term standard vital signs is not commonly used to describe the first set of
vital signs obtained by an EMT.
D) INCORRECT. One of the options provided is correct.
Page Ref: 309
Objective: 13.2
8) An oxygen saturation of 97% is considered which of the following?

A) Severe hypoxia
B) Normal
C) Hypoxia
D) Significant hypoxia
Answer: B
Explanation: A) INCORRECT. An SpO2 of 85% or less indicates severe hypoxia.
B) CORRECT. The oxygen saturation, or SpO2, is typically 96 to 100% in a normal healthy
person.
C) INCORRECT. Hypoxia is generally considered any oxygen saturation reading 95% or less.
D) INCORRECT. 86 to 90% indicates significant or moderate hypoxia.
Page Ref: 324
Objective: 13.2
3
9) In a blood pressure reading of 120/80, the 120 is measuring what body process?
A) Diastolic blood pressure; when the left ventricles contract and the blood is forced into the
arteries
B) Systolic blood pressure; when the right ventricles contract and the blood is forced into the
veins
C) Systolic blood pressure; when the left ventricles contract and the blood is forced into the
arteries
D) Systolic blood pressure; when the left ventricles contract and the blood is forced into the
veins
Answer: C
Explanation: A) INCORRECT. Diastolic pressure is not created when the heart contracts.
B) INCORRECT. The right ventricle does not force blood into the veins.
C) CORRECT. The first number in a blood pressure reading is the systolic pressure, which is
created when the left ventricle contracts and forces blood into the arteries.
D) INCORRECT. The left ventricle contracting should not force blood into the veins.
Page Ref: 316
Objective: 13.2
10) Which of the following are the vital signs that need to be recorded?
A) Pulse, respiration, skin color, skin temperature and condition
B) Pulse, respiration, skin color, skin temperature and condition, pupils, blood pressure, and
bowel sounds
C) Pulse, respiration, skin color, skin temperature and condition, pupils, and blood pressure
D) Pulse, respiration, skin color, skin temperature, pupils, and blood pressure
Answer: C
Explanation: A) INCORRECT. There a several other vital signs obtained during a standard set.
B) INCORRECT. Bowel sounds are not part of a standard set of prehospital vital signs.
C) CORRECT. The standard vital signs obtained by an EMT are; pulse and respiratory rates,
skin color, temperature and condition, pupil size, equality and reaction, and blood pressure.
D) INCORRECT. This list is missing one standard vital sign that must be assessed by the EMT.
Page Ref: 309
Objective: 13.2
4
11) Breathing sounds that should concern the EMT are:
A) snoring, gurgling, wheezing, crowing, and crowning.
B) retractions, and diaphragmatic breathing.
C) tachycardia, retractions, and diaphragmatic breathing.
D) snoring, gurgling, wheezing, and crowing.
Answer: D
Explanation: A) INCORRECT. Crowning is a term that refers to a stage of childbirth; it is
unrelated to breathing sounds.
B) INCORRECT. Retractions and diaphragmatic breathing are visual respiratory assessments,
not audible.
C) INCORRECT. Tachycardia refers to the patient's heart rate, and retractions and diaphragmatic
breathing are not breathing sounds.
D) CORRECT. Patients who have snoring, gurgling, wheezing, or crowing breath sounds should
concern the EMT as they indicate respiratory challenges.
Page Ref: 313
Objective: 13.3
12) A(n) ________ set of vital signs is important for critical decision making for the EMT.
A) unbiased
B) accurate
C) complete
D) repeated
Answer: B
Explanation: A) INCORRECT. Vital signs are measured against standards; they are not
subjective or open to bias.
B) CORRECT. An accurate set of vital signs is an important foundation for critical decision
making.
C) INCORRECT. A set of vital signs that are complete but wrong will not benefit the patient or
the EMT.
D) INCORRECT. Although repeated vital signs can be important when making ongoing patient
care decisions, it is not simply repetition that makes them valuable.
Page Ref: 310
Objective: 13.3
5
13) You are assessing a 48-year-old male who is unconscious. The scene is safe and you hear the
patient gurgling. What is your next action?
A) Suction the airway.
B) Insert an airway adjunct.
C) Open the airway with a head tilt.
D) Quickly check the pulse.
Answer: A
Explanation: A) CORRECT. Gurgling sounds usually mean that you need to suction the
patient's airway.
B) INCORRECT. An unresponsive adult patient with gurgling respirations should not receive an
airway adjunct as the first step.
C) INCORRECT. Opening this patient's airway with a head-tilt, chin-lift maneuver as the first
step would not be appropriate.
D) INCORRECT. There would be no benefit in checking this patient's pulse as the next action.
Page Ref: 312
Objective: 13.4
14) You are unable to find a radial pulse on a patient from a motor vehicle crash. You should:
A) listen for heart sounds
B) begin chest compressions.
C) attempt to find the carotid pulse.
D) apply the pulse oximeter.
Answer: C
Explanation: A) INCORRECT. Listening for heart sounds would not be the next step if the
patient's radial pulse cannot be located.
B) INCORRECT. There are many reasons why it might be difficult to feel a radial pulse.
However, that does not mean the patient is pulseless.
C) CORRECT. The carotid pulse would be the next option for measuring the patient's pulse.
D) INCORRECT. There would be no benefit in using a pulse oximeter on this patient after not
being able to locate a radial pulse.
Page Ref: 311
Objective: 13.4
6
15) A patient being transported by ambulance to the hospital can have his blood pressure
measured by which of the following methods?
A) Blood pressure monitor
B) Palpation
C) Auscultation
D) Any of the above
Answer: D
Explanation: A) INCORRECT. There are several acceptable ways to obtain a blood pressure
during transport; one of them is by using a blood pressure monitor.
B) INCORRECT. Of the ways to obtain a blood pressure while transporting a patient; palpation
is one of them.
C) INCORRECT. Blood pressure can be auscultated during transport, but there are other ways to
obtain blood pressure also.
D) CORRECT. During transport, a patient's blood pressure can be obtained through auscultation,
palpation, or with a monitor.
Page Ref: 318
Objective: 13.4
16) You respond to a cafeteria to find an unconscious person with gurgling sounds upon
exhalation and inhalation. What is the probable cause of the respiratory sounds?
A) Cardiac arrest
B) Complete airway obstruction
C) Fluids in the airway
D) Tongue blocking the airway
Answer: C
Explanation: A) INCORRECT. There is nothing to indicate cardiac arrest as the cause for these
respiratory sounds.
B) INCORRECT. If the patient had a complete airway obstruction, there would be no exhalation
or inhalation.
C) CORRECT. Gurgling breath sounds normally indicate fluids in the patient's airway.
D) INCORRECT. A tongue occlusion of the airway will often cause snoring respirations.
Page Ref: 313
Objective: 13.4
7
17) How often should a patient's vital signs be reassessed during transport to the hospital after he
has had his pulse restored with CPR and the use of an AED?
A) Every 10 minutes
B) Every 15 minutes
C) Every 2 minutes
D) Every 5 minutes
Answer: D
Explanation: A) INCORRECT. Reassessing vitals every 10 minutes on a post-cardiac arrest
patient would not be proper care.
B) INCORRECT. Only stable patients should have vitals reassessed every 15 minutes; this
patient is not stable.
C) INCORRECT. Taking this patient's vital signs every 2 minutes is not practical.
D) CORRECT. A resuscitated patient is considered unstable; vital signs should be reassessed
every 5 minutes.
Page Ref: 322
Objective: 13.4
18) Where do baseline vital signs fit into the sequence of patient assessment?
A) Ongoing assessment
B) At primary assessment
C) At secondary assessment
D) At the patient's side
Answer: C
Explanation: A) INCORRECT. The term ongoing assessment is generally no longer used in
prehospital care.
B) INCORRECT. The primary assessment is where immediate life threats are found and treated;
baseline vitals are not gathered at this point.
C) CORRECT. During the secondary assessment, the EMT will obtain the first (or baseline) set
of vital signs.
D) INCORRECT. Although the EMT must obviously be near the patient to obtain vitals, the
physical location in relation to the patient is usually defined by the situation.
Page Ref: 307
Objective: 13.4
19) Vital signs should be reassessed every ________ minutes for a stable patient.
A) 15
B) 10
C) 5
D) 20
Answer: A
Explanation: A) CORRECT. Stable patients need repeat vital signs at least every 15 minutes.
B) INCORRECT. Repeating vitals every 10 minutes would be unnecessary for a stable patient.
C) INCORRECT. Critical patients should have vital signs reassessed every 5 minutes.
D) INCORRECT. Waiting 20 minutes between vital sign reassessments would not be proper
care, even when caring for a stable patient.
Page Ref: 322
Objective: 13.4
8
20) Recording and documenting your patient's first set of vital signs is very important because,
when combined with reassessments, it allows you to do which of the following?
A) Make an accurate diagnosis of the patient's illness.
B) Compare your patient's condition with other patients' conditions.
C) Discover trends and changes in the patient's condition.
D) Fill in all of the blanks on the patient care report form.
Answer: C
Explanation: A) INCORRECT. Emergency responders do not diagnose patients.
B) INCORRECT. There is generally no benefit in comparing one patient to another.
C) CORRECT. Determining a baseline set of vital signs and repeating them over time shows any
changes in the patient's condition.
D) INCORRECT. Taking and trending vital signs are much more important than just completing
a PCR.
Page Ref: 309
Objective: 13.5
21) In a conscious adult patient, which of the following pulses should be assessed initially?
A) Brachial
B) Radial
C) Carotid
D) Pedal
Answer: B
Explanation: A) INCORRECT. In an infant who is 1 year old or less, you should find the
brachial pulse in the upper arm first.
B) CORRECT. During the determination of vital signs, you should initially find a radial pulse in
patients 1 year of age and older.
C) INCORRECT. Only when you cannot palpate the preferred initial pulse location should the
carotid be used.
D) INCORRECT. A pedal pulse would not be assessed first in any patient.
Page Ref: 311
Objective: 13.6
9
22) You are assessing a 55-year-old male complaining of chest pain and have determined that his
radial pulse is barely palpable. You also determine that there were 20 pulsations over a span of
30 seconds. Based on this, how would you report this patient's pulse?
A) Pulse 20, weak, and regular
B) Pulse 20 and weak
C) Pulse 40 and weak
D) Pulse 40, weak, and irregular
Answer: C
Explanation: A) INCORRECT. The pulse rate should be reported based on the number of heart
beats in one minute; as for regularity, there is not enough information provided.
B) INCORRECT. Although the pulse would be reported as weak in this situation, the patient's
pulse rate is not 20.
C) CORRECT. The 20 pulsations counted in 30 seconds would be doubled to obtain a per
minute pulse rate.
D) INCORRECT. There is no indication that the patient's rhythm is irregular.
Page Ref: 311
Objective: 13.6
23) The increase in the work of breathing is reported as:

A) labored breathing.
B) troubled breathing.
C) noisy breathing.
D) obstructed breathing.
Answer: A
Explanation: A) CORRECT. When a patient is struggling to breathe, usually accompanied by
accessory muscle use and retractions, it is called labored.
B) INCORRECT. Troubled breathing is not a commonly used medical term.
C) INCORRECT. A patient can struggle to breathe without it being noisy.
D) INCORRECT. The term obstructed indicates a blockage, which may or not be present in a
patient who is working hard to breathe.
Page Ref: 313
Objective: 13.6
10
24) You are called to care for a child who has fallen out of a third-story window. You arrive to
find the child in his mother's arms. As you approach, you notice the child's skin is pale with dark
spots of cyanosis. You would report this uncommon condition of blotchy skin as:
A) mottling.
B) flushed.
C) jaundiced.
D) cyanotic.
Answer: A
Explanation: A) CORRECT. An uncommon skin coloration is mottling, a blotchy appearance
that sometimes occurs in patients, especially children and the elderly, who are in shock.
B) INCORRECT. Skin described as flushed is uniformly red in appearance and generally occurs
due to heat.
C) INCORRECT. Jaundice gives skin and eyes a yellow appearance and is caused by liver
abnormalities.
D) INCORRECT. Hypoxia causes skin to appear bluish or sometimes gray, which is called
cyanosis.
Page Ref: 314
Objective: 13.6
25) The term cyanosis is used when the patient's skin color is noted to be which of the following
characteristics?
A) Yellow
B) Blue-gray
C) Very pale
D) Flushed
Answer: B
Explanation: A) INCORRECT. Jaundice gives skin and eyes a yellow appearance and is caused
by liver abnormalities.
B) CORRECT. Cyanotic skin will have a blue-gray appearance.
C) INCORRECT. Skin that is pale is not described as cyanotic.
D) INCORRECT. The term flushed in reference to skin appearance means that it is red, which is
not cyanotic.
Page Ref: 314
Objective: 13.6
11
26) Which of the following is the BEST way to assess a patient's skin temperature?
A) Place your cheek against the patient's forehead.
B) Place the back of your hand against the patient's forehead.
C) Place your cheek against the patient's abdomen.
D) Place the back of your hand against the patient's abdomen.
Answer: B
Explanation: A) INCORRECT. It would not be following proper body substance protection
guidelines to place your cheek on the patient's forehead.
B) CORRECT. To determine skin temperature, feel the patient's forehead with the back of your
hand.
C) INCORRECT. Placing your cheek against a patient's abdomen would be inappropriate.
D) INCORRECT. The patient's abdomen is not the best place to determine skin temperature.
Page Ref: 314
Objective: 13.6
27) Your patient is in late stages of liver failure and has requested to be transported to the
emergency department. You take your body substance isolation and move him to your cot and
notice his skin is warm and dry with a yellow color. Your radio report to the hospital should state
your patient is:
A) flushed.
B) mottled.
C) jaundiced.
D) cyanotic.
Answer: C
Explanation: A) INCORRECT. When skin appears red it is called flushed.
B) INCORRECT. Mottling, a blotchy appearance that sometimes occurs in patients, especially
children and the elderly, who are in shock.
C) CORRECT. Some liver abnormalities can cause patients to have a yellow skin coloration,
which is called jaundice.
D) INCORRECT. Cyanosis is a blue-gray skin color caused by hypoxia.
Page Ref: 314
Objective: 13.6
12
28) When the EMT checks the pupils he or she is checking for what three things?
A) Movement, gaze, and equality
B) Color, equality, and reactivity
C) Reactivity, gaze, and equality
D) Size, equality, and reactivity
Answer: D
Explanation: A) INCORRECT. Movement and gaze are not assessed by an EMT when checking
pupils.
B) INCORRECT. The color of a patient's eyes is not commonly checked when assessing the
pupils.
C) INCORRECT. An EMT is not assessing for gaze when checking pupils.
D) CORRECT. When you check pupils, you should look for three things: size, equality, and
reactivity (reacting to light by changing size).
Page Ref: 316
Objective: 13.6
29) What is the normal response of the pupils when exposed to bright light?
A) Fluttering
B) Dilation
C) Constriction
D) No effect
Answer: C
Explanation: A) INCORRECT. Pupils should not flutter when exposed to light.
B) INCORRECT. Growing larger when exposed to bright light is not a normal pupillary
response.
C) CORRECT. Normally, pupils will constrict when exposed to light.
D) INCORRECT. Pupils that do not react to bright light are commonly referred to as fixed; it is
not a normal finding.
Page Ref: 315
Objective: 13.6
30) Which of the following is NOT a cause of unequal pupils?

A) Fright
B) Artificial eye
C) Stroke
D) Eye injury
Answer: A
Explanation: A) CORRECT. Fear will not cause a person's pupils to be unequal.
B) INCORRECT. Since artificial eyes do not react to light, it is not uncommon to find unequal
pupils in patients who have them.
C) INCORRECT. A stroke of brain injury can cause pupils to become unequal.
D) INCORRECT. Certain eye injuries can cause the pupil to react differently than the uninjured
eye.
Page Ref: 315-316
Objective: 13.6
13
31) Which of the following BEST describes the proper placement of the blood pressure cuff?
A) Covering two-thirds of the upper arm
B) Midway between the elbow and shoulder
C) One inch below the armpit
D) Covering the patient's elbow
Answer: A
Explanation: A) CORRECT. The cuff should cover two-thirds of the upper arm, elbow to
shoulder.
B) INCORRECT. A cuff placed midway between the elbow and shoulder would not be correct.
C) INCORRECT. Using a measurement of one inch below the armpit would cause the cuff to be
placed incorrectly on some patients.
D) INCORRECT. Placing the cuff over the patient's elbow would not give a proper blood
pressure reading.
Page Ref: 318
Objective: 13.6
32) You are called to a 72-year-old patient with weakness and headache with an initial blood
pressure of 140/92. Her repeat blood pressure at 5 minutes is unchanged. Her condition is called:
A) stroke.
B) prehypertension.
C) hypertension.
D) hypotension.
Answer: C
Explanation: A) INCORRECT. There is no specific indication that this patient has suffered a
stroke.
B) INCORRECT. Readings between the limits of 121 to 139 mmHg systolic and 81 to 89 mmHg
diastolic indicate a condition sometimes called prehypertension.
C) CORRECT. If an adult has a systolic pressure of 140 mmHg or greater or a diastolic pressure
of 90 mmHg or greater, the person has hypertension.
D) INCORRECT. Hypotension is the condition when a patient's systolic pressure falls below 90
mmHg.
Page Ref: 318
Objective: 13.6
14
33) What are the three ways to take blood pressure?
A) Sphygmomanometer, blood pressure monitor, and heart monitor
B) Palpation, auscultation, and blood pressure monitor
C) Sphygmomanometer, auscultation, and blood pressure monitor
D) Auscultation, palpation, and osculation
Answer: B
Explanation: A) INCORRECT. A heart monitor would not be used to obtain a blood pressure.
B) CORRECT. Three common techniques are used to measure blood pressure with a
sphygmomanometer: auscultation, palpation, and blood pressure monitor.
C) INCORRECT. A sphygmomanometer is the device used when taking a blood pressure,
regardless of the method used with it.
D) INCORRECT. Osculation is not a term associated with taking blood pressure.
Page Ref: 318
Objective: 13.6
34) All of the following are common techniques for measuring blood pressure, except:
A) Palpation
B) Rhythm method
C) Blood pressure monitor
D) Auscultation
Answer: B
Explanation: A) INCORRECT. Determining blood pressure by palpation is an effective method
when it is too loud to auscultate the pressure.
B) CORRECT. There is no commonly accepted blood pressure technique called the rhythm
method.
C) INCORRECT. Blood pressure monitors are used in many EMS systems to obtain patient
blood pressures.
D) INCORRECT. Auscultation is the most common method for measuring blood pressure.
Page Ref: 318
Objective: 13.6
15
35) To determine blood pressure, the EMT should position the cuff over the upper arm and place
the stethoscope over the brachial artery. Next, she should inflate the cuff, then slowly deflate the
cuff, listening for clicks or tapping sounds while remembering the number at the first sound.
What is the next step in taking a blood pressure?
A) Dump all the pressure and record the number as the diastolic pressure.
B) Re-inflate the cuff on the patient's arm and repeat the process to verify the reading.
C) Continue releasing pressure until the clicks or tapping stop, and record both numbers. These
are the blood pressure.
D) Remove the cuff from the patient's arm, place it on the opposite arm, and repeat the process to
verify the reading.
Answer: C
Explanation: A) INCORRECT. Dumping the pressure at that point would not give you an
accurate diastolic.
B) INCORRECT. Re-inflating the cuff after obtaining the systolic reading would serve no
purpose.
C) CORRECT. The systolic number is the gauge reading when the sounds start, and the diastolic
number is the reading when the sounds stop; both are needed.
D) INCORRECT. There is generally no reason to repeat a blood pressure on the patient's other
arm, and it would not be the next step in this situation.
Page Ref: 321
Objective: 13.6
36) You are attempting to assess the blood pressure of a 35-year-old male at the scene of a
multiple vehicle collision. The scene is very noisy and you are unable to clearly hear the patient's
heartbeat. You should:
A) use an automatic blood pressure machine.
B) obtain the blood pressure by palpation.
C) try using the patient's other arm.
D) have your partner try auscultating the blood pressure.
Answer: B
Explanation: A) INCORRECT. An automatic blood pressure machine would not be the next
best option in this situation.
B) CORRECT. EMTs often work in environments that make auscultation difficult. Measuring
blood pressure by palpation would be the most appropriate alternative in this situation.
C) INCORRECT. Switching arms will not make the environment less noisy.
D) INCORRECT. If the environment is too loud to auscultate a heartbeat, it would potentially
waste time to have others try hearing it.
Page Ref: 318
Objective: 13.6
16
37) You are transporting a patient down a bumpy road. Your patient's blood pressure has just
been measured by the monitor to be 190/110. The patient's blood pressure on scene was 130/80.
You should:
A) ignore the blood pressure reading.
B) have the driver increase truck speed.
C) apply the automatic cuff to the other arm.
D) re-measure the blood pressure manually.
Answer: D
Explanation: A) INCORRECT. The reading should not be ignored because it may indicate a
change in the patient's condition.
B) INCORRECT. Increasing the speed on a bumpy road will not make the monitor more
accurate.
C) INCORRECT. If the bumpy road is causing the monitor to misread the blood pressure,
changing arms will not make a difference.
D) CORRECT. Automatic blood pressure machines can be unreliable on bumpy roads. Before
making any decisions based on the patient's blood pressure, it is important to verify such a
drastic change using a more accurate method.
Page Ref: 321-322
Objective: 13.6
38) When taking blood pressure, the cuff should be inflated to what point?
A) 30 mmHg beyond the point where the pulse disappears
B) Until the patient says it hurts
C) Until the Velcro starts to crackle
D) Until the gauge reads 200 mmHg
Answer: A
Explanation: A) CORRECT. The blood pressure cuff should be inflated 30 mmHg past the point
where the radial pulse disappears.
B) INCORRECT. The patient complaining of pain from the cuff is not the gauge for knowing
when to stop inflating it.
C) INCORRECT. The Velcro can crackle randomly during use of the cuff. It is not a good
indicator for when to stop inflating it.
D) INCORRECT. Inflation of the cuff may or may not need to be stopped when the gauge reads
200 mmHg, it depends on the patient.
Page Ref: 321
Objective: 13.6
17
39) You are transporting a patient to the hospital from a motor vehicle crash. Your patient's
initial blood pressure was 88/52. You should reassess blood pressure:
A) at least every 5 minutes.
B) at least every 15 minutes.
C) only if the pulse rate changes.
D) only if the patient gets worse.
Answer: A
Explanation: A) CORRECT. Patients with vital signs that suggest instability should have their
vital signs reassessed at least every 5 minutes.
B) INCORRECT. Only stable patients should have vitals reassessed every 15 minutes; this
patient is not stable.
C) INCORRECT. Reassessment standards for vitals are not based on pulse changes.
D) INCORRECT. It may be hard to determine if the patient is getting better or worse without
reassessing vital signs.
Page Ref: 322
Objective: 13.6
40) The device that some EMS services use as a light wave device to measure oxygen saturation
(SpO2) is called a(n):
A) capnography.
B) sphygmomanometer.
C) end tidal CO2 meter.
D) pulse oximeter.
Answer: D
Explanation: A) INCORRECT. Capnography measures carbon dioxide, not oxygen.
B) INCORRECT. A sphygmomanometer is used to measure blood pressure.
C) INCORRECT. Carbon dioxide is measured by an end tidal CO2 meter.
D) CORRECT. A pulse oximeter is commonly used to measure oxygen saturation.
Page Ref: 324
Objective: 13.6
18
41) You are assessing an 82-year-old female that has been lost in the woods behind her nursing
home for several hours on a crisp fall evening. Your pulse oximeter shows her oxygen saturation
to be 82% even though she appears to be breathing adequately. In order to ensure an accurate
reading you should:
A) try a different pulse oximeter.
B) place the probe on the patient's toe.
C) place the probe on the patient's earlobe.
D) warm the patient's hands and try again.
Answer: D
Explanation: A) INCORRECT. Based on the patient's presentation and immediate history, it is
probable that the pulse oximeter being used is not the problem.
B) INCORRECT. A standard pulse oximeter used in EMS is not designed for use on toes and
even if it were, based on the patient's presentation, the reading probably would be similar.
C) INCORRECT. Placing the probe on the patient's earlobe would most likely not be any more
effective.
D) CORRECT. The pulse oximeter may not be accurate if the extremity being used is cold.
Warming the extremity should produce a better reading.
Page Ref: 325
Objective: 13.6
42) Your patient is warm, dry, pink, and denies shortness of breath. Which of the following
should the EMT expect to find when evaluating the patient's oxygen saturation?
A) 91%
B) 98%
C) 102%
D) 95%
Answer: B
Explanation: A) INCORRECT. A patient with 91% oxygen saturation would be suffering from
mild hypoxia and would not present as this patient does.
B) CORRECT. The patient is obviously not hypoxic, so the oxygen saturation should be in the
normal range.
C) INCORRECT. A patient cannot have an oxygen saturation higher than 100%.
D) INCORRECT. Oxygen saturation of 95% is mild hypoxia; a hypoxic patient would not
present with warm, dry and pink skin, and most likely would have shortness of breath.
Page Ref: 324
Objective: 13.6
19
43) The range of normal blood glucose level is from a low of 60 to 80 mg/dL to a high of:
A) 110 to 130.
B) 100 to 120.
C) 90 to 100.
D) 120 to 140.
Answer: D
Explanation: A) INCORRECT. A normal glucose reading can be higher than 110 to 130.
B) INCORRECT. It is not uncommon for a normal glucose reading to be higher than 100 to 120.
C) INCORRECT. A normal blood glucose level can be higher than 100.
D) CORRECT. A normal blood glucose level is usually at least 60 to 80 mg/dL and no more
than 120 or 140.
Page Ref: 327
Objective: 13.6
44) You are about to apply a blood pressure cuff to an unconscious patient when you notice that
she appears to have a tube underneath the skin of her arm. The tube feels like it has fluid going
through it. You should:
A) move the cuff down to the forearm and inflate.
B) continue to take her blood pressure in the arm.
C) find another site to measure her blood pressure.
D) use an automatic blood pressure cuff instead.
Answer: C
Explanation: A) INCORRECT. It would not be appropriate to use that arm for a blood pressure;
it is possible that the patient has a dialysis shunt or other device implanted.
B) INCORRECT. This patient has a dialysis shunt or some other artificial device in her arm.
Inflating a blood pressure cuff in that arm could damage the device and perhaps cause internal
bleeding.
C) CORRECT. Switching to the other arm or a thigh would be much safer than attempting to use
the original arm.
D) INCORRECT. Regardless of the type of cuff used, an arm that appears to have a shunt or
other implanted device should not be used to obtain a blood pressure.
Page Ref: 318; 321
Objective: 13.7
20
45) Your patient has a heart rate of 82, a respiratory rate of 16, and a blood pressure of 120/80
and does not appear to be in any distress. You should repeat vital sign measurements at least
every:
A) 5 minutes.
B) 10 minutes.
C) 15 minutes.
D) 20 minutes.
Answer: C
Explanation: A) INCORRECT. This patient is stable; there is no reason to reassess vitals every
5 minutes with stable patients.
B) INCORRECT. Vital sign reassessments every 10 minutes are not standard for stable or
unstable patients.
C) CORRECT. Vital signs should be reassessed at least every 15 minutes in stable patients.
D) INCORRECT. It would be inappropriate to wait 20 minutes before reassessing vital signs
with any patient.
Page Ref: 322
Objective: 13.8
46) Which of the following is a normal respiratory rate for an adult at rest?
A) 12 breaths per minute
B) 10 breaths per minute
C) 24 breaths per minute
D) 22 breaths per minute
Answer: A
Explanation: A) CORRECT. An adult at rest should have a respiratory rate of 12 breaths per
minute.
B) INCORRECT. 10 breaths per minute would be too slow to be considered normal.
C) INCORRECT. An adult patient with 24 breaths per minute while at rest is in respiratory
distress.
D) INCORRECT. 22 breaths per minute is considered too rapid for a healthy adult at rest.
Page Ref: 312
Objective: 13.8
21
47) You have a 38-year-old patient who has fainted. Following your local protocol you use a
light wave device to determine the SpO2. As the EMT, you attach the device on the patient's
finger, which gives you a reading of 91. What does that reading indicate?
A) Significant hypoxia
B) Severe hypoxia
C) Normal results
D) Mild hypoxia
Answer: D
Explanation: A) INCORRECT. A reading of 86 to 90% indicates significant or moderate
hypoxia.
B) INCORRECT. A SpO2 of 85% or less indicates severe hypoxia.
C) INCORRECT. A normal SpO2 is between 96 and 100%.
D) CORRECT. An oxygen saturation reading between 91 and 95% is considered to be mild
hypoxia.
Page Ref: 324
Objective: 13.8
48) When pupils are dilated they are:

A) elliptical or elongated in shape.
B) smaller than normal.
C) larger than normal.
D) irregularly shaped.
Answer: C
Explanation: A) INCORRECT. Pupils are generally round, no matter what size they are.
B) INCORRECT. Smaller than normal pupils are called constricted.
C) CORRECT. When a pupil dilates it gets larger than normal.
D) INCORRECT. An irregularly-shaped pupil would not necessarily be referred to as dilated.
Page Ref: 315
Objective: 13.8
49) Slight movement of the chest during respiration is usually indicative of which of the
following?
A) Labored breathing
B) Normal breathing
C) Noisy breathing
D) Shallow breathing
Answer: D
Explanation: A) INCORRECT. Labored breathing will present with excessive chest movement,
including accessory muscle use and retractions.
B) INCORRECT. A patient whose chest expands an average distance during inhalation is
considered to be breathing normally.
C) INCORRECT. The sounds associated with breathing can be unrelated to chest movement.
D) CORRECT. Shallow breathing occurs when there is only slight movement of the chest or
abdomen.
Page Ref: 313
Objective: 13.8
22
50) An inaccurate oxygen saturation reading can result in all of the following except:
A) carbon monoxide inhalation.
B) a patient that smokes cigarettes.
C) a patient wearing fingernail polish.
D) Any of the above
Answer: D
Explanation: A) INCORRECT. There are several things that can make an oxygen saturation
reading inaccurate; carbon monoxide exposure is one of them.
B) INCORRECT. Smoking cigarettes can sometimes cause false oxygen saturation readings, but
there are several other things that can also cause them.
C) INCORRECT. It may occasionally be difficult to get an accurate oxygen saturation reading if
the patient is wearing fingernail polish, but there are several other factors that can also cause
inaccuracies.
D) CORRECT. Cigarette smoking, carbon monoxide poisoning, and fingernail polish can also
result in inaccurate oxygen saturation readings.
Page Ref: 325-326
Objective: 13.8
51) You respond to a 30-month-old patient who has passed out. Is the patient's blood pressure
important to your treatment and why?
A) Yes, blood pressure must be taken on everyone because without it we cannot impact the
patient's field management.
B) No, blood pressure taken on children younger than age 3 can cause damage to the tender
tissues of the arm that could lead to hypertension in later life.
C) Yes, blood pressure can be taken on children because it is the only way we can understand the
patient's condition.
D) No, blood pressure taken on children younger than age 3 is difficult and has little impact on
the patient's field management.
Answer: D
Explanation: A) INCORRECT. Blood pressures are not relevant on a patient this young.
B) INCORRECT. Obtaining a blood pressure on a young child has not been shown to affect
hypertension later in life.
C) INCORRECT. Assessing a child's condition is not commonly dependent on blood pressure.
D) CORRECT. Blood pressures are difficult to obtain with any accuracy on infants and children
younger than 3 and have little bearing on the patient's field management.
Page Ref: 322
Objective: 13.9
23
52) An approximate normal systolic blood pressure can be calculated for infants and children by
using which of the following formulas?
A) 80 plus 2 times the age in years
B) 120 plus 2 times the age in years
C) 120 minus 2 times the age in years
D) 80 times 2 plus the age in years
Answer: A
Explanation: A) CORRECT. The approximate normal systolic pressure for an infant or child is
calculated by multiplying the patient's age by 2 and adding 80.
B) INCORRECT. The systolic pressure of a child or infant is not estimated by adding 120 to the
age times 2.
C) INCORRECT. Multiplying a child's age times 2 and subtracting 120 would not give an
approximate systolic pressure.
D) INCORRECT. Multiplying 80 times 2 and adding the patient's age does not give an
approximate systolic pressure for pediatric patients.
Page Ref: 317
Objective: 13.9
53) If capillary refill is assessed in a child patient, how long should it take the normal pink color
to return to the nail bed?
A) 2 seconds
B) 4 seconds
C) 3 seconds
D) 5 seconds
Answer: A
Explanation: A) CORRECT. If it takes longer than 2 seconds for the color to return to a
pediatric patient's nail beds the blood is probably not circulating well.
B) INCORRECT. It should not take as long as 4 seconds for the color to return to the child's nail
beds.
C) INCORRECT. If it takes 3 seconds for the color to return, the patient's blood may not be
circulating properly.
D) INCORRECT. Five seconds is far too long for the nail bed color to return in a normal
pediatric patient.
Page Ref: 314
Objective: 13.9
24
54) What category would include a patient with a blood pressure of 134/84 mmHg?
A) Hypotension
B) Normotension
C) Hypertension
D) Prehypertension
Answer: D
Explanation: A) INCORRECT. Hypotension is generally considered to exist when the systolic
pressure falls below 90 mmHg.
B) INCORRECT. A normal blood pressure is a systolic pressure of no greater than 120 mmHg
and a diastolic pressure of no greater than 80 mmHg.
C) INCORRECT. If an adult has a systolic pressure of 140 mmHg or greater or a diastolic
pressure of 90 mmHg or greater, the person has hypertension.
D) CORRECT. Readings between the limits of 121 to 139 mmHg systolic and 81 to 89 mmHg
diastolic indicate a condition sometimes called prehypertension.
Page Ref: 318
Objective: 13.9
55) You respond to a childcare center for a report of an injured 4-year-old. Her pulse is 130 beats
per minute. Which of the following BEST describes this finding?
A) Bradycardic
B) Normal for the child's age
C) Tachycardic
D) Unable to determine without knowing the family history
Answer: C
Explanation: A) INCORRECT. A 4-year-old with a pulse of 130 would not be considered
bradycardic.
B) INCORRECT. 130 beats per minute is not normal for a 4-year-old child.
C) CORRECT. A heart rate above 120 in a 4-year-old patient would be considered tachycardic.
D) INCORRECT. The patient's family history has nothing to do with describing a pulse rate
finding.
Page Ref: 310
Objective: 13.9
25

Emergency Care 13th Edition Limmer Test Bank

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Emergency Care 13th Edition Limmer

8) An oxygen saturation of 97% is considered which of the following?

23) The increase in the work of breathing is reported as:

30) Which of the following is NOT a cause of unequal pupils?

48) When pupils are dilated they are:

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