Primary Assessment Practice Questions

79 multiple-choice questions on Primary assessment 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.

79 practice questions

1. The purpose of the primary assessment is to:

   1. A. Establish a working field diagnosis
   2. B. Obtain the complete medical history
   3. C. Document baseline findings for the ED
   4. D. Find and treat immediate life threats
   Show answer

   Answer: D. Find and treat immediate life threats

   It is repeated whenever the patient's condition changes.

2. The correct order of the primary assessment is:

   1. A. History, vital signs, then physical exam
   2. B. Impression, LOC, then ABCs and priority
   3. C. Vital signs, airway, then secondary exam
   4. D. Airway, history, vitals, and transport
   Show answer

   Answer: B. Impression, LOC, then ABCs and priority

   General impression, level of consciousness, airway, breathing, circulation, then priority or disability. Massive hemorrhage may be addressed first in trauma.

3. In the AVPU scale, the P stands for:

   1. A. Responds to pain
   2. B. Pain-free at rest
   3. C. Pupils react to light
   4. D. Pulse is palpable
   Show answer

   Answer: A. Responds to pain

   Alert, Verbal, Painful, Unresponsive.

4. A patient who opens their eyes only when their name is called is:

   1. A. Alert and oriented
   2. B. Unresponsive
   3. C. Responsive to verbal
   4. D. Responsive to pain
   Show answer

   Answer: C. Responsive to verbal

   Describe the actual response as well as the letter.

5. The first step when the airway is compromised in an unresponsive patient without trauma is:

   1. A. Suctioning the airway
   2. B. Bag-mask ventilation
   3. C. Head tilt-chin lift
   4. D. Inserting an advanced airway
   Show answer

   Answer: C. Head tilt-chin lift

   Use a jaw-thrust when spinal injury is suspected.

6. Assessment of breathing during the primary assessment includes:

   1. A. Auscultating all lung fields carefully
   2. B. Counting an exact rate over a full minute
   3. C. Obtaining a capnography waveform
   4. D. Whether breathing is present and adequate
   Show answer

   Answer: D. Whether breathing is present and adequate

   Evaluate rate, depth, and effort. Adequacy matters more than an exact number at this stage.

7. Signs of inadequate breathing include:

   1. A. Poor chest rise and accessory muscle use
   2. B. Clear and equal lung sounds bilaterally
   3. C. A rate of 16 with good chest rise
   4. D. Speaking in full, clear sentences
   Show answer

   Answer: A. Poor chest rise and accessory muscle use

   Other signs include very fast or slow rates and altered mental status. Treat inadequate breathing with ventilation, not just oxygen.

8. Circulation is assessed in the primary assessment by checking:

   1. A. Pulse, skin, and major bleeding
   2. B. Heart sounds by auscultation
   3. C. Blood pressure and a 12-lead ECG
   4. D. Capillary refill time alone
   Show answer

   Answer: A. Pulse, skin, and major bleeding

   Check pulse presence and quality; skin color, temperature, and moisture; and major bleeding. A carotid pulse is checked in the unresponsive adult.

9. Capillary refill is most reliable:

   1. A. In smokers
   2. B. In young children
   3. C. In older adults
   4. D. In hypothermic adults
   Show answer

   Answer: B. In young children

   In children it is a useful indicator of peripheral perfusion. Ambient temperature and age affect its accuracy.

10. Life-threatening external bleeding found in the primary assessment should be:

    1. A. Left for the ED to manage
    2. B. Documented and reassessed
    3. C. Controlled immediately
    4. D. Addressed after the airway
    Show answer

    Answer: C. Controlled immediately

    Exsanguination can kill faster than airway compromise. Direct pressure, then a tourniquet for extremity bleeding.

11. The D in a primary assessment commonly refers to:

    1. A. Disability, a brief neuro check
    2. B. Destination, the receiving hospital
    3. C. Diagnosis, a working impression
    4. D. Drugs, the current medication list
    Show answer

    Answer: A. Disability, a brief neuro check

    AVPU or GCS plus pupils and gross motor function.

12. Exposure during the primary assessment means:

    1. A. Cutting clothes only over painful areas
    2. B. Waiting to undress until the hospital
    3. C. Exposing areas needed to find threats
    4. D. Removing all clothing in every case
    Show answer

    Answer: C. Exposing areas needed to find threats

    Expose what is needed to find life threats while preventing heat loss and protecting privacy. Cover the patient again promptly.

13. A patient is considered high priority when they have:

    1. A. A high heart rate as the only finding
    2. B. Any complaint of pain, even mild
    3. C. Difficulty breathing or signs of shock
    4. D. A long history of chronic disease
    Show answer

    Answer: C. Difficulty breathing or signs of shock

    High-priority findings include poor general impression, unresponsiveness, difficulty breathing, shock, severe pain, or uncontrolled bleeding. High priority means expedited transport decisions.

14. For an unresponsive medical patient, the assessment should proceed with:

    1. A. A full head-to-toe physical exam
    2. B. A history before any physical exam
    3. C. A focused exam of the complaint area
    4. D. Vital signs only, deferring the exam
    Show answer

    Answer: A. A full head-to-toe physical exam

    The patient cannot report symptoms, so a full-body exam follows the primary assessment. Family, bystanders, and the scene supply the history.

15. For a responsive medical patient, the assessment usually focuses on:

    1. A. History and a focused exam
    2. B. A full head-to-toe physical exam
    3. C. Serial vital signs alone
    4. D. A complete neurologic exam
    Show answer

    Answer: A. History and a focused exam

    The exam focuses on the chief complaint. History often contributes more than the physical exam in medical patients.

16. The primary assessment should be repeated:

    1. A. Only after each medication given
    2. B. Once per call, at first contact
    3. C. Whenever the condition changes
    4. D. Only on arrival at the hospital
    Show answer

    Answer: C. Whenever the condition changes

    Repeat it whenever the patient's condition changes and at each reassessment. New life threats appear during transport.

17. In a trauma patient with massive extremity hemorrhage, the modern approach places:

    1. A. Full exposure before any intervention
    2. B. Airway first regardless of bleeding
    3. C. Breathing first, then bleeding control
    4. D. Bleeding control before or with airway
    Show answer

    Answer: D. Bleeding control before or with airway

    This is the basis of the X-ABC or MARCH sequence.

18. Oxygen during the primary assessment should be:

    1. A. Withheld until vital signs are taken
    2. B. Given only if saturation is below 80%
    3. C. Titrated to condition and saturation
    4. D. Given to every patient at 15 L/min
    Show answer

    Answer: C. Titrated to condition and saturation

    High concentrations are reserved for hypoxia and specific conditions. Ventilation is required when breathing is inadequate, not just oxygen.

19. The primary assessment is sometimes called the:

    1. A. Secondary survey or rapid trauma exam
    2. B. Detailed or comprehensive exam
    3. C. Initial assessment or primary survey
    4. D. Focused history and physical exam
    Show answer

    Answer: C. Initial assessment or primary survey

    Terminology varies.

20. A trauma patient has no external bleeding, a deformed thigh, a GCS of 14, and a respiratory rate of 36 with poor chest rise. What should you address first?

    1. A. The deformed thigh
    2. B. The GCS of 14
    3. C. The patient's medical history
    4. D. The inadequate breathing
    Show answer

    Answer: D. The inadequate breathing

    The primary assessment finds and treats immediate life threats in priority order. Inadequate ventilation is an immediate threat, so support breathing first. A closed deformity and a mildly reduced GCS are reassessed afterward, and the history belongs to the secondary assessment.

21. The primary assessment should take:

    1. A. 60 to 90 seconds if stable
    2. B. Exactly 30 seconds, always
    3. C. About 10 minutes in most patients
    4. D. About 5 minutes per patient
    Show answer

    Answer: A. 60 to 90 seconds if stable

    About 60 to 90 seconds in a stable patient, longer if interventions are needed. Rapid but thorough.

22. Forming a general impression occurs:

    1. A. After the SAMPLE history is complete
    2. B. At handoff to the hospital team
    3. C. At the start of the primary assessment
    4. D. After the first set of vital signs
    Show answer

    Answer: C. At the start of the primary assessment

    First seconds.

23. Assessing responsiveness begins with:

    1. A. Checking pupil response
    2. B. Checking the carotid pulse
    3. C. Speaking to the patient
    4. D. Applying a sternal rub
    Show answer

    Answer: C. Speaking to the patient

    Speak and observe the response; verbal stimulus comes before painful stimulus.

24. A patient who responds appropriately to questions is:

    1. A. Alert and likely oriented
    2. B. Confused but responsive
    3. C. Responsive to verbal only
    4. D. Responsive to pain only
    Show answer

    Answer: A. Alert and likely oriented

    A for alert. Confirm orientation with further questions.

25. Alert and oriented times four refers to:

    1. A. Eyes, voice, motor, and pupils
    2. B. Person, place, time, and event
    3. C. Name, age, address, and phone
    4. D. Pulse, pressure, pupils, and pain
    Show answer

    Answer: B. Person, place, time, and event

    Document which were correct.

26. A patient who moans to a painful stimulus is:

    1. A. Responsive to pain
    2. B. Responsive to verbal
    3. C. Alert but confused
    4. D. Unresponsive
    Show answer

    Answer: A. Responsive to pain

    P on AVPU.

27. A patient who does not respond to painful stimulus is:

    1. A. Responsive to verbal
    2. B. Alert but confused
    3. C. Responsive to pain
    4. D. Unresponsive
    Show answer

    Answer: D. Unresponsive

    U on AVPU.

28. Painful stimulus is applied by:

    1. A. Pinching the skin of the arm
    2. B. Rubbing the back of the hand firmly
    3. C. Shouting loudly in the ear
    4. D. Trapezius pinch or sternal rub
    Show answer

    Answer: D. Trapezius pinch or sternal rub

    Use a trapezius pinch, sternal rub, or nail bed pressure. Avoid causing injury. Skin pinches can bruise without giving a reliable response, rubbing the hand is too weak a stimulus, and shouting tests the verbal level rather than pain.

29. The Glasgow Coma Scale eye component scores:

    1. A. 1 to 3
    2. B. 1 to 4
    3. C. 1 to 5
    4. D. 1 to 6
    Show answer

    Answer: B. 1 to 4

    Spontaneous is 4.

30. The GCS verbal component scores:

    1. A. 1 to 5
    2. B. 1 to 6
    3. C. 1 to 4
    4. D. 1 to 3
    Show answer

    Answer: A. 1 to 5

    Oriented is 5.

31. The GCS motor component scores:

    1. A. 1 to 5
    2. B. 1 to 4
    3. C. 1 to 6
    4. D. 1 to 3
    Show answer

    Answer: C. 1 to 6

    Obeys commands is 6.

32. A GCS of 8 or less suggests:

    1. A. Severe impairment
    2. B. Mild impairment
    3. C. Moderate impairment
    4. D. Normal mentation
    Show answer

    Answer: A. Severe impairment

    A GCS of 8 or less implies inability to protect the airway: GCS 8, intubate, as the saying goes.

33. A GCS of 13 to 15 suggests:

    1. A. Moderate impairment
    2. B. Mild impairment
    3. C. Deep coma
    4. D. Severe impairment
    Show answer

    Answer: B. Mild impairment

    Still monitor for deterioration.

34. Airway assessment in a talking patient:

    1. A. Requires routine suctioning
    2. B. Confirms the airway is open
    3. C. Can be skipped entirely
    4. D. Requires an oral airway
    Show answer

    Answer: B. Confirms the airway is open

    A speaking patient has an open airway at that moment. Reassess.

35. Signs of airway obstruction include:

    1. A. Clear speech and normal voice
    2. B. Wheezing heard only on exhalation
    3. C. Coughing with good air exchange
    4. D. Snoring, gurgling, or stridor
    Show answer

    Answer: D. Snoring, gurgling, or stridor

    Absent air movement is the most severe sign. Each sound suggests a cause.

36. Snoring respirations suggest:

    1. A. Tongue obstruction
    2. B. A foreign body
    3. C. Fluid in the airway
    4. D. Bronchospasm
    Show answer

    Answer: A. Tongue obstruction

    Partial obstruction by the tongue. Reposition.

37. Gurgling suggests:

    1. A. Fluid in the airway
    2. B. Tongue obstruction
    3. C. Bronchospasm in the lungs
    4. D. Laryngeal edema
    Show answer

    Answer: A. Fluid in the airway

    Fluid in the airway requires suction.

38. Stridor suggests:

    1. A. Upper airway narrowing
    2. B. Lower airway bronchospasm
    3. C. Fluid in the airway
    4. D. Tongue obstruction
    Show answer

    Answer: A. Upper airway narrowing

    Causes include swelling, foreign body, or infection. Act fast.

39. Airway management begins with:

    1. A. Suctioning the oropharynx
    2. B. Manual positioning maneuvers
    3. C. Endotracheal intubation
    4. D. Inserting an airway adjunct
    Show answer

    Answer: B. Manual positioning maneuvers

    Simple first.

40. The jaw thrust is used when:

    1. A. Suction is needed for fluid
    2. B. The patient has no gag reflex
    3. C. Spinal injury is suspected
    4. D. The patient is awake and talking
    Show answer

    Answer: C. Spinal injury is suspected

    It avoids neck extension.

41. Basic airway adjuncts include:

    1. A. Endotracheal tubes
    2. B. Cricothyrotomy kits
    3. C. Supraglottic devices
    4. D. Oral and nasal airways
    Show answer

    Answer: D. Oral and nasal airways

    OPA for unresponsive without gag; NPA tolerated more.

42. An unresponsive patient breathes 14 times per minute, but the chest barely rises and the SpO2 is 85%. What should you do?

    1. A. Apply a nonrebreather mask at 15 L/min
    2. B. Apply a nasal cannula at 2 L/min
    3. C. Insert an oral airway and keep observing him
    4. D. Assist ventilation with a bag-valve mask
    Show answer

    Answer: D. Assist ventilation with a bag-valve mask

    Adequate breathing needs adequate rate and depth. A normal rate with minimal chest rise means low tidal volume and hypoventilation, which is confirmed by the hypoxia. Ventilate with a BVM and oxygen. Oxygen by nasal cannula or nonrebreather does not fix poor tidal volume, and an airway adjunct by itself does not move air.

43. Adequate breathing has:

    1. A. A slow, deep, irregular pattern
    2. B. Any rate, as long as some air is moving
    3. C. Normal rate, depth, rhythm, and effort
    4. D. A fast rate with shallow depth
    Show answer

    Answer: C. Normal rate, depth, rhythm, and effort

    All elements.

44. A respiratory rate under 8 in an adult:

    1. A. Requires assisted ventilation
    2. B. Is normal for a resting adult
    3. C. Needs only close monitoring
    4. D. Needs high-flow oxygen only
    Show answer

    Answer: A. Requires assisted ventilation

    It is inadequate. Bag-mask ventilate.

45. A respiratory rate over 30 in an adult:

    1. A. Suggests respiratory distress
    2. B. Needs no action if SpO2 is normal
    3. C. Is ideal for clearing carbon dioxide
    4. D. Is normal for an anxious adult
    Show answer

    Answer: A. Suggests respiratory distress

    Ventilation may be inadequate. Assess depth and effort.

46. Shallow breathing with a normal rate:

    1. A. Needs no intervention
    2. B. May be inadequate
    3. C. Is the most efficient
    4. D. Is always adequate
    Show answer

    Answer: B. May be inadequate

    Low tidal volume can make it inadequate. Watch chest rise.

47. Assisted ventilation is indicated when:

    1. A. Breathing is absent or inadequate
    2. B. The patient is anxious and tachypneic
    3. C. Saturation drops below 94 percent
    4. D. Supplemental oxygen is unavailable
    Show answer

    Answer: A. Breathing is absent or inadequate

    Oxygen alone does not fix hypoventilation.

48. Oxygen is indicated when:

    1. A. Chest pain occurs with an SpO2 of 98%
    2. B. Anxiety occurs with a normal SpO2
    3. C. The patient has a history of COPD
    4. D. The patient is hypoxic or at risk
    Show answer

    Answer: D. The patient is hypoxic or at risk

    Give oxygen to patients who are hypoxic or at risk of hypoxia, and titrate to saturation to avoid both hypoxia and hyperoxia. Current AHA guidance does not support routine oxygen for chest pain with a normal SpO2, anxiety with a normal saturation calls for coaching rather than oxygen, and a COPD history alone is not an indication (when oxygen is needed in COPD, titrate to about 88-92%).

49. Circulation assessment in a responsive adult begins with:

    1. A. Femoral pulse
    2. B. Blood pressure
    3. C. Carotid pulse
    4. D. Radial pulse
    Show answer

    Answer: D. Radial pulse

    Presence suggests a systolic pressure above about 80.

50. Circulation assessment in an unresponsive adult begins with:

    1. A. Capillary refill
    2. B. Radial pulse
    3. C. Carotid pulse
    4. D. Blood pressure
    Show answer

    Answer: C. Carotid pulse

    Check for no more than 10 seconds.

51. Circulation assessment in an infant uses the:

    1. A. Carotid pulse
    2. B. Brachial pulse
    3. C. Femoral pulse
    4. D. Radial pulse
    Show answer

    Answer: B. Brachial pulse

    The neck is too short.

52. A weak, rapid pulse suggests:

    1. A. Hypothermia
    2. B. Shock
    3. C. Hypertension
    4. D. Bradycardia
    Show answer

    Answer: B. Shock

    Compensation: a weak, rapid pulse reflects a low stroke volume with a faster rate to hold up output, as in shock. Hypothermia slows the pulse, hypertension usually gives a strong pulse, and bradycardia is by definition slow.

53. Absent radial pulse with a present carotid pulse suggests:

    1. A. Significant hypotension
    2. B. Severe hypertension
    3. C. Mild dehydration
    4. D. Normal blood pressure
    Show answer

    Answer: A. Significant hypotension

    Roughly below 80 systolic.

54. Skin assessment includes:

    1. A. Temperature and capillary refill
    2. B. Color, temperature, and moisture
    3. C. Color and wound appearance only
    4. D. Color, turgor, and hair growth
    Show answer

    Answer: B. Color, temperature, and moisture

    Three elements.

55. Cool, pale, moist skin suggests:

    1. A. Classic heat stroke
    2. B. Normal perfusion
    3. C. Poor perfusion or shock
    4. D. Fever from infection
    Show answer

    Answer: C. Poor perfusion or shock

    Shock or sympathetic activation: catecholamines cause vasoconstriction and sweating.

56. Hot, dry skin suggests:

    1. A. Normal perfusion
    2. B. Mild hypothermia
    3. C. Heat stroke or fever
    4. D. Compensated shock
    Show answer

    Answer: C. Heat stroke or fever

    Thermoregulation failure.

57. Hot, moist skin suggests:

    1. A. Normal resting state
    2. B. Compensated hypovolemic shock
    3. C. Fever or heat exhaustion
    4. D. Early hypothermia
    Show answer

    Answer: C. Fever or heat exhaustion

    Sweating.

58. Cyanosis appears first in:

    1. A. The thighs and lower legs
    2. B. Lips, nail beds, and mucosa
    3. C. The forehead and cheeks
    4. D. The chest and abdomen
    Show answer

    Answer: B. Lips, nail beds, and mucosa

    Lips, nail beds, and mucous membranes. Central versus peripheral.

59. Major bleeding is controlled by:

    1. A. Pressure points proximal to wound
    2. B. Direct pressure, then a tourniquet
    3. C. Elevation above the heart
    4. D. Ice packs applied to the wound
    Show answer

    Answer: B. Direct pressure, then a tourniquet

    Use a tourniquet for extremity hemorrhage or wound packing for junctional wounds. Tourniquets save lives.

60. A tourniquet should be applied:

    1. A. Directly over the nearest joint
    2. B. Only after all else has failed
    3. C. Loosely, to preserve distal pulses
    4. D. Tight enough to stop arterial bleeding
    Show answer

    Answer: D. Tight enough to stop arterial bleeding

    Place it high and tight or 2 to 3 inches above the wound. Note the time.

61. Wound packing is used for:

    1. A. Scalp lacerations
    2. B. Abdominal eviscerations
    3. C. Open chest wounds
    4. D. Junctional wounds
    Show answer

    Answer: D. Junctional wounds

    Junctional wounds (groin, axilla, neck) where a tourniquet cannot be applied. Eviscerated organs are covered with a moist sterile dressing, not packed, scalp bleeding usually responds to direct pressure, and open chest wounds need an occlusive dressing.

62. During the primary assessment of an unresponsive trauma patient, which check belongs under 'D'?

    1. A. A detailed history of medications and allergies
    2. B. A distal pulse check on every extremity
    3. C. Placement of defibrillation pads on the chest
    4. D. GCS or AVPU, pupils, and gross movement
    Show answer

    Answer: D. GCS or AVPU, pupils, and gross movement

    D (disability) is a brief neurologic check: level of consciousness by AVPU or GCS, pupils, and gross motor and sensory function. The medication history belongs to the secondary assessment. Distal pulses are part of circulation and the extremity exam, and defibrillation is a circulation intervention in cardiac arrest.

63. The E in ABCDE refers to:

    1. A. Exposure and environment
    2. B. Equipment and extrication
    3. C. Emergency transport
    4. D. Evaluation and evacuation
    Show answer

    Answer: A. Exposure and environment

    Find hidden injuries, prevent hypothermia.

64. A trauma patient on a cold, windy roadside needs a full exposure to look for injuries. What is the best approach?

    1. A. Skip the exposure to prevent hypothermia
    2. B. Expose fully on the road and leave uncovered
    3. C. Expose in the warm ambulance, then cover
    4. D. Expose only the areas the patient points to
    Show answer

    Answer: C. Expose in the warm ambulance, then cover

    Expose enough to find injuries, but protect against hypothermia, which worsens bleeding, and protect privacy. Moving to the warm ambulance and covering promptly does both. Skipping the exposure misses wounds, leaving the patient uncovered causes heat loss, and patients with distracting injuries or altered mental status cannot reliably point to every injury.

65. Priority determination follows:

    1. A. The secondary assessment
    2. B. The first vital signs
    3. C. The primary assessment
    4. D. The SAMPLE history
    Show answer

    Answer: C. The primary assessment

    Decide transport urgency.

66. Which patient is the highest priority for rapid transport?

    1. A. A 30-year-old with an isolated wrist deformity
    2. B. A 60-year-old with chest pain and a BP of 80/50
    3. C. A 25-year-old whose minor scalp cut has stopped bleeding
    4. D. A 40-year-old with mild back pain after lifting
    Show answer

    Answer: B. A 60-year-old with chest pain and a BP of 80/50

    High-priority patients include those with a poor general impression, unresponsiveness, difficulty breathing, shock, chest pain with hypotension, uncontrolled bleeding, or severe pain. Chest pain with a BP of 80/50 suggests cardiogenic shock or another time-critical cause. The other patients are stable and can be assessed more fully on scene.

67. Low-priority patients:

    1. A. Can be assessed more thoroughly on scene
    2. B. Can have the primary assessment skipped safely
    3. C. Need reassessment every 5 minutes
    4. D. Never need ambulance transport
    Show answer

    Answer: A. Can be assessed more thoroughly on scene

    They are stable, so time allows a more thorough assessment on scene. Every patient still gets a primary assessment, and stable patients are reassessed about every 15 minutes rather than every 5.

68. While assessing a stabbing victim's breathing, you find an open chest wound bubbling with each breath. When should you seal it?

    1. A. After the full secondary assessment
    2. B. Once vital signs have been recorded
    3. C. On arrival at the trauma center
    4. D. Immediately, before moving on
    Show answer

    Answer: D. Immediately, before moving on

    Life threats found during the primary assessment are treated the moment they are found. An open pneumothorax needs an occlusive dressing, preferably vented, right away, and then you watch for tension physiology. Delaying until after the secondary assessment, vital signs, or arrival lets the patient deteriorate.

69. The order of the primary assessment may change when:

    1. A. The patient is fully conscious
    2. B. Never, since the order is fixed
    3. C. Massive hemorrhage or cardiac arrest
    4. D. The patient is stable and talking
    Show answer

    Answer: C. Massive hemorrhage or cardiac arrest

    CAB in cardiac arrest; bleeding first in trauma.

70. In cardiac arrest, the primary assessment emphasizes:

    1. A. Compressions first
    2. B. Two rescue breaths first
    3. C. Obtaining a history first
    4. D. Opening the airway first
    Show answer

    Answer: A. Compressions first

    Compressions first, then airway and breathing: perfusion before oxygenation.

71. A pulse check should last:

    1. A. No more than 10 seconds
    2. B. At least 30 seconds to be sure
    3. C. 5 seconds only
    4. D. 1 minute
    Show answer

    Answer: A. No more than 10 seconds

    Begin compressions if uncertain.

72. The primary assessment of an unresponsive medical patient includes:

    1. A. Vital signs before the airway
    2. B. ABCs and a rapid scan for clues
    3. C. A full history from family first
    4. D. Airway check only, then transport
    Show answer

    Answer: B. ABCs and a rapid scan for clues

    Assess airway, breathing, and circulation, and look for clues such as medical alert tags. Look for the cause.

73. Which finding during primary assessment requires the most urgent action?

    1. A. Tachycardia at 110
    2. B. Absent breathing
    3. C. Pale, cool skin
    4. D. Severe anxiety
    Show answer

    Answer: B. Absent breathing

    Ventilate.

74. Which finding is a life threat?

    1. A. Mild dyspnea
    2. B. A large bruise
    3. C. Stridor
    4. D. A sprained ankle
    Show answer

    Answer: C. Stridor

    Upper airway obstruction kills quickly.

75. A patient with a weak pulse, pale skin, and altered mental status is:

    1. A. Having a hypertensive emergency
    2. B. Hypoglycemic with normal perfusion
    3. C. Simply dehydrated
    4. D. In decompensated shock
    Show answer

    Answer: D. In decompensated shock

    High priority. A weak pulse and pale skin show poor perfusion, and altered mental status shows the brain is no longer adequately perfused, which marks decompensated shock. A hypertensive emergency does not produce a weak pulse, and a weak pulse with pale skin is not normal perfusion. Dehydration can cause shock, but these findings call for treating shock now.

76. The primary assessment of a pediatric patient uses:

    1. A. Observation only, without touching
    2. B. The adult approach, scaled down
    3. C. The Pediatric Assessment Triangle
    4. D. ABCs only, with no observation
    Show answer

    Answer: C. The Pediatric Assessment Triangle

    The Pediatric Assessment Triangle is followed by the ABCs. Appearance first.

77. An unresponsive overdose patient has gurgling respirations. What is the first airway action?

    1. A. Insert an oral airway right away
    2. B. Suction the airway, then reassess
    3. C. Begin ventilating with a BVM now
    4. D. Apply high-flow oxygen by face mask
    Show answer

    Answer: B. Suction the airway, then reassess

    Gurgling means fluid in the upper airway. Position the patient and suction first. Inserting an adjunct or ventilating with a BVM before clearing the fluid can push vomit or secretions into the lungs, and oxygen by mask does nothing for an obstructed airway.

78. The most common cause of airway obstruction in an unresponsive patient is:

    1. A. Airway swelling
    2. B. Vomitus
    3. C. A foreign body
    4. D. The tongue
    Show answer

    Answer: D. The tongue

    Positioning fixes it.

79. Which statement about the primary assessment is accurate?

    1. A. It is done only once per call
    2. B. It is only for trauma patients
    3. C. It applies to every patient
    4. D. It is skipped for minor complaints
    Show answer

    Answer: C. It applies to every patient

    Every patient, every time.