History Taking Practice Questions

67 multiple-choice questions on History taking for paramedic and EMT students, from Chapter 11 (Patient Assessment). Read each question, pick your answer, then tap Show answer to check it and read the explanation.

67 practice questions

1. The chief complaint is best recorded:

   1. A. As your field impression
   2. B. As the most severe finding
   3. C. In the patient's own words
   4. D. As the dispatch reason
   Show answer

   Answer: C. In the patient's own words

   Quote it directly when you can.

2. OPQRST is used primarily to:

   1. A. Document current medications
   2. B. Explore the present complaint
   3. C. Assess orientation and mental status
   4. D. Record allergies and reactions
   Show answer

   Answer: B. Explore the present complaint

   It is especially useful for pain. Onset, provocation, quality, radiation, severity, time.

3. The P in OPQRST refers to:

   1. A. What provokes or palliates it
   2. B. Pulse quality and regularity
   3. C. The position the patient is found in
   4. D. The pain score from 0 to 10
   Show answer

   Answer: A. What provokes or palliates it

   Ask what makes it better and what makes it worse.

4. The Q in OPQRST asks about:

   1. A. Quick versus gradual onset
   2. B. Quantity of medication taken
   3. C. Questions the family has raised
   4. D. The character of the symptom
   Show answer

   Answer: D. The character of the symptom

   Ask for it in the patient's own words. Crushing, sharp, burning, and tearing all suggest different problems.

5. The S in SAMPLE stands for:

   1. A. Scene safety
   2. B. Severity of illness
   3. C. Skin condition
   4. D. Signs and symptoms
   Show answer

   Answer: D. Signs and symptoms

   Signs are what you observe; symptoms are what the patient reports.

6. The E in SAMPLE refers to:

   1. A. Emergency contacts for the patient
   2. B. Equipment and interventions used
   3. C. Examination findings on arrival
   4. D. Events leading up to the illness
   Show answer

   Answer: D. Events leading up to the illness

   What the patient was doing when it started often points to the cause.

7. The L in SAMPLE refers to:

   1. A. Last medication
   2. B. Level of consciousness
   3. C. Last oral intake
   4. D. Location of pain
   Show answer

   Answer: C. Last oral intake

   It matters for surgery, diabetes, and aspiration risk.

8. Pertinent negatives are important because they:

   1. A. Shorten the patient interview
   2. B. Are required for insurance billing
   3. C. Help rule conditions in or out
   4. D. Fill gaps in the narrative report
   Show answer

   Answer: C. Help rule conditions in or out

   They also show the thoroughness of your assessment. "Denies shortness of breath" is clinically meaningful.

9. When a patient's history seems inconsistent, the paramedic should:

   1. A. Seek more sources and document objectively
   2. B. Confront the patient about discrepancies
   3. C. Disregard the history and rely on vitals
   4. D. Label the patient an unreliable historian
   Show answer

   Answer: A. Seek more sources and document objectively

   Use family, medications, and the scene as sources. Hypoxia, hypoglycemia, and fear all cause inconsistent histories.

10. The most valuable history source for an unresponsive patient is often:

    1. A. Prior hospital records at the facility
    2. B. The dispatch report and CAD notes
    3. C. The patient's initial vital signs
    4. D. Family, bystanders, and pill bottles
    Show answer

    Answer: D. Family, bystanders, and pill bottles

    Medical alert devices help too. Take the medications with you when possible.

11. Asking about medication adherence is useful because:

    1. A. It replaces the need for a medication list
    2. B. Protocols require it before any treatment
    3. C. Missed or doubled doses cause emergencies
    4. D. Patients rarely deviate from prescriptions
    Show answer

    Answer: C. Missed or doubled doses cause emergencies

    Ask in a nonjudgmental way. Missed or doubled doses commonly cause emergencies such as seizures, hypoglycemia, and heart failure. Adherence questions add to the medication list rather than replacing it, and patients often deviate from prescriptions.

12. A medical alert bracelet or wallet card should be:

    1. A. Removed and secured with valuables
    2. B. Read and reported to receiving staff
    3. C. Given to police for identification
    4. D. Left alone to protect patient privacy
    Show answer

    Answer: B. Read and reported to receiving staff

    It may reveal diabetes, anticoagulant use, or allergies. Also check phones for medical identification screens.

13. The history provides what proportion of diagnostic information?

    1. A. Very little once vitals are obtained
    2. B. A small fraction compared with the exam
    3. C. The majority only in trauma patients
    4. D. The majority in most medical patients
    Show answer

    Answer: D. The majority in most medical patients

    Listen.

14. Two patients have headaches. One says hers was 'the worst ever, like a thunderclap' while lifting weights; the other's came on gradually over a day. Which OPQRST element best separates them?

    1. A. Quality
    2. B. Region
    3. C. Onset
    4. D. Time
    Show answer

    Answer: C. Onset

    Sudden thunderclap onset, especially with exertion, is a red flag for subarachnoid hemorrhage, while gradual onset suggests tension, migraine, or sinus causes. Quality can be similar in both, location does not reliably separate them, and time refers to how long the headache has lasted. (Replaces an item repeating s04-q001.)

15. A patient may have more than one complaint, so the paramedic should:

    1. A. Identify the primary one and note others
    2. B. Address only the first one mentioned
    3. C. Ignore complaints unrelated to dispatch
    4. D. Treat every complaint with equal priority
    Show answer

    Answer: A. Identify the primary one and note others

    What worries you most?

16. The history of present illness explores:

    1. A. Current medications and doses
    2. B. Past illnesses and surgeries
    3. C. The chief complaint in detail
    4. D. Allergies and prior reactions
    Show answer

    Answer: C. The chief complaint in detail

    OPQRST.

17. Onset asks:

    1. A. How severe it is on a scale
    2. B. Where the symptom is located
    3. C. When and how it started
    4. D. What makes it feel better
    Show answer

    Answer: C. When and how it started

    Note whether onset was sudden or gradual. Sudden onset is often serious.

18. Asking "What were you doing when it started?" is useful because it:

    1. A. Screens mainly for illegal drug use
    2. B. Replaces the need for a full OPQRST history
    3. C. Reveals exertional symptoms and triggers
    4. D. Applies mainly to trauma mechanisms
    Show answer

    Answer: C. Reveals exertional symptoms and triggers

    Activity at onset reveals triggers and links symptoms to exertion, such as chest pain that starts while climbing stairs. It is part of the onset question in OPQRST rather than a replacement for it, it applies to medical complaints as well as trauma, and it is not a drug screen.

19. A patient's chest pain is relieved by sitting up and leaning forward and gets worse when she lies flat. Which condition does this suggest?

    1. A. Pneumothorax
    2. B. Pericarditis
    3. C. Aortic dissection
    4. D. Appendicitis
    Show answer

    Answer: B. Pericarditis

    The P in OPQRST (provocation and palliation) can be very specific. Pericarditis pain is classically sharp, worse lying supine and with inspiration, and eased by sitting up and leaning forward. Pneumothorax causes sudden pleuritic pain and dyspnea, dissection causes tearing pain that position does not relieve, and appendicitis causes abdominal pain.

20. Asked what his pain feels like, a patient says it is 'tearing, like something ripping through to my back.' Which condition must you consider?

    1. A. Stable exertional angina
    2. B. Aortic dissection
    3. C. Costochondritis
    4. D. Biliary colic
    Show answer

    Answer: B. Aortic dissection

    Quality is best recorded in the patient's words. A tearing or ripping pain that radiates to the back is classic for aortic dissection, so check pulses and BP in both arms and watch for neurologic deficits. Angina is usually pressure, costochondritis is reproducible chest wall pain, and biliary colic is right upper quadrant pain after meals.

21. Crushing or pressure-like chest pain suggests:

    1. A. Cardiac ischemia
    2. B. Musculoskeletal strain
    3. C. Anxiety or panic attack
    4. D. Pleural irritation
    Show answer

    Answer: A. Cardiac ischemia

    Classic description.

22. Sharp, pleuritic chest pain suggests:

    1. A. Anxiety or a panic attack
    2. B. Pleurisy, pericarditis, or PE
    3. C. Classic myocardial ischemia
    4. D. Gastric reflux or peptic ulcer
    Show answer

    Answer: B. Pleurisy, pericarditis, or PE

    Worse with breathing.

23. Tearing chest pain radiating to the back suggests:

    1. A. Pleural irritation
    2. B. Aortic dissection
    3. C. Myocardial infarction
    4. D. Esophageal reflux
    Show answer

    Answer: B. Aortic dissection

    Emergency.

24. Region and radiation ask:

    1. A. What makes it better or worse
    2. B. Where it is and where it spreads
    3. C. When it started and how fast
    4. D. How severe it is from 0 to 10
    Show answer

    Answer: B. Where it is and where it spreads

    Point to it.

25. Severity asks:

    1. A. When it started and how fast
    2. B. Where it is and where it spreads
    3. C. What makes it better or worse
    4. D. How bad it is on a 0 to 10 scale
    Show answer

    Answer: D. How bad it is on a 0 to 10 scale

    Reassess.

26. Time asks:

    1. A. How bad it is on a 0 to 10 scale
    2. B. How long it has lasted
    3. C. What makes it better or worse
    4. D. Where it is and where it spreads
    Show answer

    Answer: B. How long it has lasted

    Also ask whether it is constant or intermittent. Duration.

27. Signs are:

    1. A. Symptoms described by family or bystanders
    2. B. The provider's working diagnostic opinion
    3. C. What the patient reports feeling or sensing
    4. D. What the provider observes or measures
    Show answer

    Answer: D. What the provider observes or measures

    Objective.

28. Symptoms are:

    1. A. Signs observed by bystanders on scene
    2. B. What the patient reports experiencing
    3. C. What the provider observes or measures
    4. D. Findings measured on the monitor
    Show answer

    Answer: B. What the patient reports experiencing

    Subjective.

29. Allergy history should include:

    1. A. Food allergies and intolerances only
    2. B. Medication allergies, not foods
    3. C. All agents and the type of reaction
    4. D. Environmental agents such as latex only
    Show answer

    Answer: C. All agents and the type of reaction

    Include medications, foods, and environmental agents. What happened?

30. Medication history should include:

    1. A. Only medications taken in the last week
    2. B. Current prescriptions without dosages
    3. C. Prescriptions only, not OTC products
    4. D. Prescriptions, OTC drugs, and supplements
    Show answer

    Answer: D. Prescriptions, OTC drugs, and supplements

    Include recreational substances as well. Everything.

31. A patient with known epilepsy has had a seizure. Which question about his medication is most useful?

    1. A. 'Have you missed any doses lately?'
    2. B. 'Who prescribed your seizure medicine?'
    3. C. 'How long have you been taking them?'
    4. D. 'Do your pills make you feel drowsy?'
    Show answer

    Answer: A. 'Have you missed any doses lately?'

    Missed antiseizure doses are a common cause of breakthrough seizures, so ask about adherence, recent dose changes, and new interacting drugs. Who prescribed the drug, how long he has taken it, and whether it causes drowsiness are reasonable background questions but rarely explain why a seizure happened today.

32. Recent medication changes matter because:

    1. A. Older medications are more dangerous
    2. B. They matter only in pediatric patients
    3. C. They matter only in elderly patients
    4. D. New drugs or doses may cause the problem
    Show answer

    Answer: D. New drugs or doses may cause the problem

    Ask what changed.

33. Pertinent past medical history includes:

    1. A. Every diagnosis since childhood, equally
    2. B. Only conditions currently treated
    3. C. Prior surgeries only, not illnesses
    4. D. Conditions relevant to the complaint
    Show answer

    Answer: D. Conditions relevant to the complaint

    Include relevant surgeries and hospitalizations. Focus.

34. Last oral intake matters for:

    1. A. Aspiration risk and hypoglycemia
    2. B. Determining dietary allergies
    3. C. Patients with known diabetes only
    4. D. Predicting length of hospital stay
    Show answer

    Answer: A. Aspiration risk and hypoglycemia

    Aspiration risk matters with sedation or surgery. Time and what.

35. A patient collapsed after standing up quickly from the toilet and woke within seconds. Which part of SAMPLE best explains the likely cause?

    1. A. Events leading up to the collapse
    2. B. Allergies to any of his medications
    3. C. Last oral intake of food
    4. D. Past history of surgeries
    Show answer

    Answer: A. Events leading up to the collapse

    The E in SAMPLE, the events before the episode, often gives the diagnosis. Collapse right after standing quickly or straining at the toilet points to orthostatic or vasovagal syncope. Allergies, last meal, and past surgeries rarely explain the event, although syncope red flags still need evaluation.

36. The SAMPLE history can be obtained from:

    1. A. The patient only, for confidentiality
    2. B. Patient, family, bystanders, and records
    3. C. Family members only when present
    4. D. Medical records only, for accuracy
    Show answer

    Answer: B. Patient, family, bystanders, and records

    Multiple sources.

37. You find a man unresponsive in his apartment, alone, with no medical alert jewelry. Which is the best history source?

    1. A. His neighbor's best guess about his age, job, and habits
    2. B. The 911 caller's report to dispatch
    3. C. Pill bottles, a medication list, or a phone health app
    4. D. The temperature inside the apartment
    Show answer

    Answer: C. Pill bottles, a medication list, or a phone health app

    When a patient cannot talk, the scene supplies history: pill bottles, medication lists, home equipment, and phone emergency or health apps that often hold conditions, medications, and contacts. A neighbor's guess and a 911 caller's report add little specific medical detail, and room temperature is an environmental clue rather than a history source.

38. An unresponsive patient wears a medical alert bracelet that reads 'Adrenal insufficiency - steroid dependent.' Why does this matter?

    1. A. It means he is allergic to all corticosteroid drugs
    2. B. It means his condition cannot cause hypotension
    3. C. It means steroids should be held until the ED
    4. D. He may need stress-dose hydrocortisone for shock
    Show answer

    Answer: D. He may need stress-dose hydrocortisone for shock

    A medical alert device is history the patient cannot give. A steroid-dependent patient may be in adrenal crisis and need stress-dose hydrocortisone (often 100 mg IV/IM in adults, per protocol) for hypotension. The bracelet does not indicate a steroid allergy, adrenal crisis classically causes refractory hypotension, and holding steroids until the ED lets the crisis progress.

39. A patient's own description of a prior event:

    1. A. Is unreliable and should be disregarded
    2. B. Is less accurate than family accounts
    3. C. Matters only if records confirm it
    4. D. Is valuable; patients recognize recurrence
    Show answer

    Answer: D. Is valuable; patients recognize recurrence

    This feels like my last heart attack.

40. Family history is relevant when:

    1. A. The complaint is a simple laceration
    2. B. The patient was injured in a fall
    3. C. Inherited disease could explain it
    4. D. The patient is under 18 years old
    Show answer

    Answer: C. Inherited disease could explain it

    Family history matters when an inherited condition could explain the complaint, such as early cardiac death in relatives of a young patient with syncope. Age under 18 does not make it relevant by itself, and it adds little to a fall injury or a simple laceration.

41. Social history includes:

    1. A. Home life, support, substances, and work
    2. B. Travel history and hobbies only
    3. C. Substance use only, for toxicology
    4. D. Employment status and income only
    Show answer

    Answer: A. Home life, support, substances, and work

    Disposition planning.

42. Asking about alcohol use should be:

    1. A. Delegated to hospital staff
    2. B. Direct and nonjudgmental
    3. C. Avoided to protect rapport
    4. D. Framed as a warning of consequences
    Show answer

    Answer: B. Direct and nonjudgmental

    How much do you drink?

43. Asking about drug use should be:

    1. A. Avoided unless police are present
    2. B. Followed by a report to law enforcement
    3. C. Direct, nonjudgmental, and explained
    4. D. Delegated to the receiving hospital
    Show answer

    Answer: C. Direct, nonjudgmental, and explained

    Explain that it is relevant to care. Honesty improves care.

44. Asking about pregnancy should be:

    1. A. Asked only if pregnancy looks obvious
    2. B. Asked of women of childbearing age
    3. C. Asked only of married patients
    4. D. Avoided unless the patient raises it
    Show answer

    Answer: B. Asked of women of childbearing age

    Ask whenever the complaint is relevant. Ectopic pregnancy.

45. Asking about sexual history is appropriate when:

    1. A. It is relevant to the complaint
    2. B. The patient is a teenager
    3. C. The patient has a minor ankle injury
    4. D. A family member asks about it
    Show answer

    Answer: A. It is relevant to the complaint

    Ask about sexual history when it is relevant to the complaint, such as pelvic pain, urinary symptoms, or possible pregnancy, and ask in private. Being a teenager does not by itself make it relevant, an ankle injury gives no reason to ask, and a family member's request does not justify seeking private information.

46. Asking about safety at home screens for:

    1. A. Fall hazards and home clutter only
    2. B. Firearm ownership for scene safety
    3. C. Fire and smoke detector safety
    4. D. Domestic violence and elder abuse
    Show answer

    Answer: D. Domestic violence and elder abuse

    Ask when alone.

47. Asking about mental health history is appropriate when:

    1. A. Police are present on scene
    2. B. The presentation suggests it
    3. C. The patient is over age 65
    4. D. Transfer of care is complete
    Show answer

    Answer: B. The presentation suggests it

    Ask about mental health history, with sensitivity, when the presentation suggests it, such as behavioral change, overdose, or unexplained symptoms; depression affects many conditions. Police presence and age over 65 are not indications, and after transfer of care you no longer collect the history.

48. Asking about advance directives is appropriate when:

    1. A. The patient has a minor sprain
    2. B. Transport is already complete
    3. C. The patient is younger than 30 years old
    4. D. The situation or illness warrants it
    Show answer

    Answer: D. The situation or illness warrants it

    Ask about advance directives, calmly and early, when the situation or illness warrants it, such as a terminal illness or a patient at risk of arrest. A minor sprain or young age gives no reason to raise it, and waiting until transport is complete is too late to guide care.

49. A review of systems in the field is:

    1. A. Complete, covering every body system
    2. B. Omitted entirely in the field
    3. C. Identical to the hospital review
    4. D. Abbreviated to relevant systems
    Show answer

    Answer: D. Abbreviated to relevant systems

    Time-limited.

50. Which question is open-ended?

    1. A. What does the pain feel like?
    2. B. Is the pain sharp or is it dull?
    3. C. Does it hurt when I press here?
    4. D. Did the pain start earlier today?
    Show answer

    Answer: A. What does the pain feel like?

    Invites description.

51. Which question is leading?

    1. A. It's a crushing pain, right?
    2. B. When did the pain first start?
    3. C. What does the pain feel like?
    4. D. Where exactly is the pain located?
    Show answer

    Answer: A. It's a crushing pain, right?

    Suggests the answer.

52. Interrupting a patient within the first 20 seconds:

    1. A. Is necessary to keep the interview focused
    2. B. Improves the accuracy of the history
    3. C. Is common and cuts off key information
    4. D. Saves time without losing information
    Show answer

    Answer: C. Is common and cuts off key information

    Let them finish.

53. A patient who is a poor historian may be:

    1. A. Unmotivated to answer questions
    2. B. Seeking drugs or secondary gain
    3. C. Hypoxic, in pain, or frightened
    4. D. Deliberately dishonest with providers
    Show answer

    Answer: C. Hypoxic, in pain, or frightened

    Confusion and communication barriers are also common causes. Find the cause.

54. When history conflicts with findings:

    1. A. Trust the findings over the history
    2. B. Document only the more reliable one
    3. C. Document both and investigate further
    4. D. Trust the history over the findings
    Show answer

    Answer: C. Document both and investigate further

    Both are data.

55. The history of a trauma patient focuses on:

    1. A. Detailed past medical history first
    2. B. Family history of bleeding disorders
    3. C. Mechanism, LOC, and anticoagulant use
    4. D. Social and occupational history
    Show answer

    Answer: C. Mechanism, LOC, and anticoagulant use

    What happened?

56. Asking a trauma patient about loss of consciousness:

    1. A. Matters only in severe trauma
    2. B. Is unnecessary if the patient is alert
    3. C. Is irrelevant once a CT is planned
    4. D. Helps gauge head injury severity
    Show answer

    Answer: D. Helps gauge head injury severity

    Witnesses help.

57. Asking about anticoagulant use in trauma:

    1. A. Is irrelevant to field decisions
    2. B. Matters only in elderly patients
    3. C. Is unnecessary in minor trauma
    4. D. Greatly changes bleeding risk
    Show answer

    Answer: D. Greatly changes bleeding risk

    Bleeding risk.

58. Why should you ask a patient with a wound when the last tetanus booster was given?

    1. A. It matters mainly for deep puncture wounds
    2. B. It is unnecessary for minor clean wounds
    3. C. It guides hospital tetanus prophylaxis
    4. D. It determines field wound irrigation
    Show answer

    Answer: C. It guides hospital tetanus prophylaxis

    The hospital uses the time since the last tetanus booster to decide on prophylaxis: with a complete primary series, a booster is given if more than 10 years have passed since the last dose for a clean, minor wound, or more than 5 years for a dirty or major wound; an unknown or incomplete series also needs vaccine, plus tetanus immune globulin for dirty wounds (CDC). Because even clean minor wounds can need a booster, it matters for more than deep punctures, and wounds are irrigated in the field whatever the tetanus status.

59. Documentation of history should:

    1. A. Omit negatives to keep it concise
    2. B. Capture pertinent positives and negatives
    3. C. Interpret findings into a diagnosis
    4. D. Summarize in the provider's own words
    Show answer

    Answer: B. Capture pertinent positives and negatives

    Use the patient's quotes when possible. Both matter.

60. Pertinent negatives for chest pain include:

    1. A. Denies dyspnea, nausea, or diaphoresis
    2. B. Reports pain that worsens with exertion
    3. C. Reports pain radiating to the jaw
    4. D. Normal blood pressure and heart rate
    Show answer

    Answer: A. Denies dyspnea, nausea, or diaphoresis

    Narrows the differential.

61. History taking in a critical patient:

    1. A. Completed in full before any treatment
    2. B. Abbreviated to what changes immediate care
    3. C. Delegated to the receiving physician
    4. D. Omitted entirely until hospital arrival
    Show answer

    Answer: B. Abbreviated to what changes immediate care

    Gather more during transport. Prioritize.

62. The best history is obtained by:

    1. A. Interviewing family members instead
    2. B. A standardized checklist alone
    3. C. Listening and clarifying questions
    4. D. Rapid closed questions in sequence
    Show answer

    Answer: C. Listening and clarifying questions

    Confirm your understanding with the patient. Conversation.

63. Which element is most important in the history of a possible stroke?

    1. A. Time last known well
    2. B. Smoking and alcohol use
    3. C. Prior surgeries and illnesses
    4. D. Family history of stroke
    Show answer

    Answer: A. Time last known well

    Determines treatment eligibility. Time last known well decides eligibility for thrombolytics and thrombectomy. Smoking, past history, and family history add context but do not change that time-critical decision.

64. Which element is most important in the history of possible ACS?

    1. A. Smoking history alone
    2. B. Last oral intake and meal timing
    3. C. Onset, character, and risk factors
    4. D. Family history of heart disease alone
    Show answer

    Answer: C. Onset, character, and risk factors

    Prior cardiac history matters too. Time and risk: onset, character of the pain, and cardiac risk factors drive the ACS impression. Smoking or family history by itself is one risk factor among many, and last oral intake rarely changes immediate cardiac care.

65. Which element is most important in the history of a seizure?

    1. A. Recent diet and caffeine intake
    2. B. Family history of seizures only
    3. C. Occupation and recent work hours
    4. D. Seizure history, meds, and duration
    Show answer

    Answer: D. Seizure history, meds, and duration

    Ask what preceded the seizure. First seizure versus known.

66. Which element is most important in the history of overdose?

    1. A. Prior detox or rehab admissions
    2. B. What, how much, when, and why
    3. C. Family history of addiction
    4. D. Occupation and access to drugs
    Show answer

    Answer: B. What, how much, when, and why

    Intent matters too. The substance, amount, timing, and reason guide treatment and poison center advice. Family history, prior treatment admissions, and access to drugs add background but do not direct immediate care.

67. Which element is most important in the history of abdominal pain in a woman?

    1. A. Family history of bowel disease
    2. B. Prior abdominal surgeries and hospital stays
    3. C. Last menstrual period and pregnancy
    4. D. Recent bowel movement pattern
    Show answer

    Answer: C. Last menstrual period and pregnancy

    Ectopic. Ectopic pregnancy must be considered in any woman of childbearing age with abdominal pain, so ask about the last menstrual period and possible pregnancy. Surgical, bowel, and family history are useful but come after excluding a ruptured ectopic.