Special Assessment Considerations Practice Questions

63 multiple-choice questions on Special assessment considerations 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.

63 practice questions

1. The Pediatric Assessment Triangle consists of:

   1. A. Appearance, work of breathing, skin circulation
   2. B. History, physical exam, and vital signs
   3. C. Alertness, verbal response, and response to pain
   4. D. Airway, breathing, and central circulation
   Show answer

   Answer: A. Appearance, work of breathing, skin circulation

   It forms a general impression without touching the child.

2. Assessment of a small child is usually best performed:

   1. A. Head to toe, like an adult
   2. B. While the child lies flat
   3. C. Toe to head, face last
   4. D. With the caregiver out of the room
   Show answer

   Answer: C. Toe to head, face last

   It reduces fear and improves cooperation. Save the face and head for last.

3. Hypotension in a child is significant because it:

   1. A. Occurs early in shock
   2. B. Is normal in toddlers
   3. C. Is a late finding
   4. D. Is common with fever
   Show answer

   Answer: C. Is a late finding

   Look for tachycardia, delayed capillary refill, and mental status change earlier. Children compensate well until they crash.

4. Assessment of an older adult must account for:

   1. A. Faster heart rate responses in shock
   2. B. Atypical presentations and polypharmacy
   3. C. Findings identical to younger adults
   4. D. A higher pain tolerance than younger adults
   Show answer

   Answer: B. Atypical presentations and polypharmacy

   Ask family what is normal for this patient. Also consider sensory changes and baseline cognition.

5. A patient taking beta blockers may:

   1. A. Show no change in perfusion
   2. B. Lack tachycardia despite blood loss
   3. C. Show exaggerated tachycardia in shock
   4. D. Have higher blood pressure in shock
   Show answer

   Answer: B. Lack tachycardia despite blood loss

   A normal heart rate does not rule out serious problems.

6. Assessment of a bariatric patient may require:

   1. A. No modification of technique
   2. B. Larger cuffs and extra personnel
   3. C. Standard adult equipment in all cases
   4. D. Fewer vital sign checks to save time
   Show answer

   Answer: B. Larger cuffs and extra personnel

   Plan movement before you need to move the patient. Landmarks are also harder to palpate.

7. When a language barrier exists during assessment, the paramedic should:

   1. A. Use a qualified interpreter
   2. B. Rely on gestures and pointing
   3. C. Ask the patient to write in English
   4. D. Skip the history and examine
   Show answer

   Answer: A. Use a qualified interpreter

   Family should be used only as a last resort. Use a telephone service when no interpreter is present.

8. Assessment of a patient with a developmental disability should include:

   1. A. A shortened exam to limit distress
   2. B. Questions directed only to the caregiver
   3. C. Talking with the patient and the caregiver
   4. D. Assuming the patient cannot communicate
   Show answer

   Answer: C. Talking with the patient and the caregiver

   Change from baseline is the key finding. The caregiver describes baseline function.

9. In a patient with an altered mental status, the paramedic should consider:

   1. A. A broad differential of causes
   2. B. Psychiatric illness before other causes
   3. C. Hypoglycemia as the only real concern
   4. D. Intoxication as the most likely cause
   Show answer

   Answer: A. A broad differential of causes

   Memory aids such as AEIOU-TIPS help structure the search. Consider hypoglycemia, hypoxia, stroke, infection, toxins, and trauma.

10. Assessment of a patient who may be a victim of violence requires:

    1. A. Confronting the suspected abuser directly
    2. B. Questioning the patient in front of family members
    3. C. Privacy, careful documentation, and reporting
    4. D. Avoiding the topic to prevent upset
    Show answer

    Answer: C. Privacy, careful documentation, and reporting

    Separate the patient from others when it can be done safely. Be aware of mandatory reporting duties.

11. Trauma assessment differs from medical assessment mainly in that trauma relies more on:

    1. A. The history given by the patient
    2. B. Accounts from family members
    3. C. The physical exam and mechanism
    4. D. The patient's medication list
    Show answer

    Answer: C. The physical exam and mechanism

    Medical patients usually give more information through the history.

12. The single most useful assessment skill for any patient is:

    1. A. Rapid transport to definitive care
    2. B. Advanced monitoring technology
    3. C. A systematic approach, repeated
    4. D. Memorizing protocols word for word
    Show answer

    Answer: C. A systematic approach, repeated

    Systems catch what memory and intuition miss.

13. A 2-year-old is quiet and floppy and does not look at you, with normal breathing and pink skin. Using the Pediatric Assessment Triangle, what is your impression?

    1. A. Normal, since both her breathing and skin color are fine
    2. B. Respiratory distress needing nebulized albuterol
    3. C. Compensated shock from fluid loss
    4. D. Abnormal appearance; suspect a CNS or metabolic cause
    Show answer

    Answer: D. Abnormal appearance; suspect a CNS or metabolic cause

    The PAT judges appearance, work of breathing, and circulation to the skin from across the room. Abnormal appearance alone, with normal breathing and circulation, suggests a primary brain or metabolic problem such as hypoglycemia, a postictal state, toxins, or infection. Check the glucose. Normal breathing rules out respiratory distress, and pink skin argues against shock.

14. Pediatric history is obtained from:

    1. A. Caregiver and child as age allows
    2. B. Prior medical records only
    3. C. The child alone, to avoid bias
    4. D. The caregiver alone in all cases
    Show answer

    Answer: A. Caregiver and child as age allows

    Both.

15. A 6-month-old has a heart rate of 150 and a respiratory rate of 40 while calm. How should you interpret these?

    1. A. Severe tachycardia needing treatment
    2. B. Bradycardia for an infant this age
    3. C. Within normal range for an infant
    4. D. Too fast for any child under age 5
    Show answer

    Answer: C. Within normal range for an infant

    Pediatric vital signs must be read against age-specific norms. For an infant, a heart rate of about 100 to 160 and a respiratory rate of about 30 to 53 are normal (PALS), so 150 and 40 are within range. Adult cutoffs would wrongly label them as tachycardic.

16. A 4-year-old with vomiting has HR 170, capillary refill of 4 seconds, cool hands, and a normal BP. How should you interpret this?

    1. A. No shock is present, since the blood pressure is normal
    2. B. Normal vital signs for a 4-year-old child
    3. C. Compensated shock; treat now, before BP falls
    4. D. Only a mild illness, given the normal BP
    Show answer

    Answer: C. Compensated shock; treat now, before BP falls

    Children maintain blood pressure until late, so tachycardia, delayed capillary refill, and cool extremities with a normal BP mean compensated shock. Hypotension is a late, ominous sign. A heart rate of 170 is far above normal for a 4-year-old, and waiting for BP to fall risks sudden decompensation.

17. Pediatric airway assessment considers:

    1. A. Hyperextension to open the airway
    2. B. The same anatomy as adults have
    3. C. Only the size of the equipment
    4. D. Large tongue and small airway
    Show answer

    Answer: D. Large tongue and small airway

    Neutral position. Positioning needs differ.

18. Pediatric respiratory distress signs include:

    1. A. Pink skin and quiet breathing
    2. B. A normal rate with deep breaths
    3. C. Retractions, flaring, grunting
    4. D. Calm behavior and normal speech
    Show answer

    Answer: C. Retractions, flaring, grunting

    Work of breathing. Head bobbing is another sign.

19. Pediatric shock signs include:

    1. A. Hypotension as the earliest sign
    2. B. Tachycardia and delayed cap refill
    3. C. Bradycardia as an early sign
    4. D. Warm, flushed skin early on
    Show answer

    Answer: B. Tachycardia and delayed cap refill

    Compensation. Altered mental status also appears before hypotension.

20. Pediatric pain assessment uses:

    1. A. Vital sign changes as the measure
    2. B. Age-appropriate scales such as FLACC
    3. C. Adult numeric scales for all ages
    4. D. Observation of crying alone
    Show answer

    Answer: B. Age-appropriate scales such as FLACC

    Age-appropriate. Use FLACC for infants, faces for young children, numeric for older children.

21. Pediatric weight estimation uses:

    1. A. Age alone, without a tape
    2. B. An adult weight formula
    3. C. A length-based tape
    4. D. Visual guessing by the crew
    Show answer

    Answer: C. A length-based tape

    Broselow.

22. An 82-year-old on metoprolol fell and has a heart rate of 72 and a BP of 108/70. Her usual BP is 160/90. How should you interpret this?

    1. A. Possible shock masked by her beta blocker
    2. B. Normal vital signs that rule out shock
    3. C. A sign that her hypertension is under good control
    4. D. Expected after a fall, so no further workup is needed
    Show answer

    Answer: A. Possible shock masked by her beta blocker

    Beta blockers prevent tachycardia, and in a patient whose usual BP is 160/90, a reading of 108/70 is a significant drop. Together they can mean hidden bleeding, for example from a hip fracture or an intracranial injury. Compare with her baseline and treat for possible shock. Normal-looking numbers do not rule it out.

23. Geriatric history requires:

    1. A. The caregiver's account only
    2. B. Extra time and caregiver input
    3. C. The patient's account only
    4. D. Speed to limit scene time
    Show answer

    Answer: B. Extra time and caregiver input

    Patience. Check hearing and vision.

24. Geriatric vital signs may be:

    1. A. Blunted by medications and age
    2. B. Reliable as in younger adults
    3. C. Always abnormal at baseline
    4. D. Irrelevant to the assessment
    Show answer

    Answer: A. Blunted by medications and age

    Interpret cautiously.

25. Geriatric mental status assessment requires:

    1. A. A formal dementia test
    2. B. Orientation questions only
    3. C. Knowing baseline from caregivers
    4. D. Assuming confusion is normal
    Show answer

    Answer: C. Knowing baseline from caregivers

    Change from baseline.

26. Geriatric trauma assessment considers:

    1. A. Low mechanisms causing serious injury
    2. B. Nothing beyond the adult exam
    3. C. Falls as the only concern
    4. D. The same mechanism criteria as adults
    Show answer

    Answer: A. Low mechanisms causing serious injury

    Ground-level falls. Anticoagulants raise bleeding risk.

27. Geriatric skin assessment considers:

    1. A. Skin color as the main finding
    2. B. Fragility, pressure injuries, neglect
    3. C. Nothing beyond the adult exam
    4. D. Skin turgor as a reliable sign of hydration
    Show answer

    Answer: B. Fragility, pressure injuries, neglect

    Look at the back.

28. Pregnancy assessment considers:

    1. A. The fetal heart rate above all else
    2. B. The mother alone, as the fetus follows
    3. C. Nothing beyond the adult exam
    4. D. Mother and fetus, with altered norms
    Show answer

    Answer: D. Mother and fetus, with altered norms

    Two patients. Physiologic changes affect interpretation.

29. Pregnant patients should be positioned:

    1. A. Right side to relieve the vena cava
    2. B. Supine, to ease abdominal assessment
    3. C. Sitting fully upright at all times
    4. D. Left side, or with uterus displaced
    Show answer

    Answer: D. Left side, or with uterus displaced

    Vena cava compression. This applies after 20 weeks.

30. Pregnancy vital signs show:

    1. A. No change from pre-pregnancy values
    2. B. Increased heart rate, decreased BP
    3. C. Slower pulse and rising pressure
    4. D. Steadily rising blood pressure
    Show answer

    Answer: B. Increased heart rate, decreased BP

    Baseline shifts. Blood pressure dips in mid-pregnancy.

31. Hypertension in pregnancy suggests:

    1. A. A normal late-pregnancy change
    2. B. Anxiety about the coming delivery
    3. C. Expected fluid gain of pregnancy
    4. D. Possible preeclampsia
    Show answer

    Answer: D. Possible preeclampsia

    Headache, vision changes, edema. It requires urgent evaluation.

32. Bariatric patient assessment considers:

    1. A. Landmarks, equipment, airway, movement
    2. B. Equipment sizing as the only issue
    3. C. Nothing beyond the standard exam
    4. D. Planning the patient move only
    Show answer

    Answer: A. Landmarks, equipment, airway, movement

    Plan ahead.

33. Bariatric blood pressure requires:

    1. A. Estimating from heart rate
    2. B. A standard adult cuff, pulled extra tight
    3. C. A properly sized cuff or forearm site
    4. D. Skipping BP and using pulse quality
    Show answer

    Answer: C. A properly sized cuff or forearm site

    Wrong cuff is useless.

34. Patients with disabilities should be assessed by:

    1. A. Speaking only to companions
    2. B. The standard approach unchanged
    3. C. Asking how they usually function
    4. D. Assuming limitations exist
    Show answer

    Answer: C. Asking how they usually function

    They are the experts. Ask how they communicate as well.

35. Patients with cognitive impairment should be assessed by:

    1. A. Skipping the history and examining only
    2. B. Assuming the patient lacks capacity
    3. C. Simple language plus caregiver baseline
    4. D. Questioning the caregiver only
    Show answer

    Answer: C. Simple language plus caregiver baseline

    Respect. Speak directly to the patient.

36. Patients with sensory impairment should be assessed by:

    1. A. The standard approach unchanged
    2. B. Speaking louder and more slowly
    3. C. Adapting communication methods
    4. D. Skipping the history entirely
    Show answer

    Answer: C. Adapting communication methods

    Communication access. Use interpreters or written notes.

37. Your Spanish-speaking patient's 9-year-old son offers to interpret. What is the best approach?

    1. A. Let the son interpret all of the medical details for you
    2. B. Speak loudly and slowly in English instead
    3. C. Rely on gestures alone and skip the history
    4. D. Use a qualified interpreter, such as a phone line
    Show answer

    Answer: D. Use a qualified interpreter, such as a phone line

    Children and untrained family members make interpreting errors, may omit sensitive information, and should not carry that burden. Use a qualified interpreter, such as a phone or video service. Volume does not overcome a language barrier, and skipping the history loses essential information. A family member may help only in an immediate emergency.

38. Patients with psychiatric conditions should be assessed by:

    1. A. Skipping the physical exam
    2. B. Assuming a psychiatric cause
    3. C. A full medical assessment
    4. D. Psychiatric assessment only
    Show answer

    Answer: C. A full medical assessment

    Do not anchor. Physical illness is common and often missed.

39. Agitated patients should be assessed for:

    1. A. Behavioral issues needing restraint
    2. B. Hypoxia, low glucose, and head injury
    3. C. Intoxication as the only likely cause
    4. D. A psychiatric cause above all others
    Show answer

    Answer: B. Hypoxia, low glucose, and head injury

    Medical causes of agitation. Also consider intoxication and infection.

40. Intoxicated patients should be assessed for:

    1. A. Masked conditions like head injury
    2. B. Breath alcohol level only
    3. C. Intoxication alone, then release
    4. D. Nothing until they sober up
    Show answer

    Answer: A. Masked conditions like head injury

    Do not assume. Hypoglycemia can also be masked.

41. Patients in custody should be assessed:

    1. A. Only by the officers present
    2. B. Only if they request care
    3. C. Minimally, given security concerns
    4. D. Fully, minding restraint position
    Show answer

    Answer: D. Fully, minding restraint position

    Same standard. Preserve dignity.

42. A woman with facial bruises says she 'walked into a door' while her partner answers every question for her. What is the best approach?

    1. A. Find a way to speak with her privately
    2. B. Accept the partner's account and move on
    3. C. Confront the partner about abuse right away
    4. D. Question her about abuse in front of him
    Show answer

    Answer: A. Find a way to speak with her privately

    Inconsistent injuries and a controlling partner suggest intimate partner violence. Create an opportunity to speak privately (for example, in the ambulance), ask directly but without judgment, document objectively, and follow reporting rules. Accepting the partner's story misses abuse, and confronting him or asking in front of him can endanger her and the crew.

43. Patients at end of life should be assessed:

    1. A. Minimally, to avoid any intrusion
    2. B. Aggressively, as for any other patient
    3. C. Only for their resuscitation status
    4. D. With attention to goals of care
    Show answer

    Answer: D. With attention to goals of care

    What do they want? Comfort matters.

44. Patients with technology dependence, such as ventilators or pumps:

    1. A. Need caregiver input on the device
    2. B. Need no assessment if the device runs
    3. C. Need only a check of the device
    4. D. Need the standard assessment only
    Show answer

    Answer: A. Need caregiver input on the device

    Caregivers are expert. Caregivers know the baseline.

45. Patients with ostomies:

    1. A. Need the appliance removed for exam
    2. B. Need no special consideration at all
    3. C. Must be transported sitting upright
    4. D. Should have stoma and output assessed
    Show answer

    Answer: D. Should have stoma and output assessed

    Protect the appliance.

46. Patients with dialysis access:

    1. A. Should have the access used for IVs
    2. B. Need no special consideration
    3. C. Need the access limb protected
    4. D. Need BP taken in the access arm
    Show answer

    Answer: C. Need the access limb protected

    No BP or IV in that arm. Assess the access for a thrill.

47. Patients with implanted devices such as pacemakers or ICDs:

    1. A. Need no special consideration at all
    2. B. Cannot be defibrillated safely
    3. C. Need pads placed away from the device
    4. D. Need pads placed directly over it
    Show answer

    Answer: C. Need pads placed away from the device

    Ask about recent shocks. Note the device.

48. Patients with ventricular assist devices:

    1. A. Cannot be transported by EMS
    2. B. Have normal palpable pulses
    3. C. May lack a pulse; assess the device
    4. D. Need CPR whenever no pulse is felt
    Show answer

    Answer: C. May lack a pulse; assess the device

    Do not assume arrest. Assess mental status and perfusion.

49. Patients with transplants:

    1. A. Need no special consideration
    2. B. Always run high fevers when infected
    3. C. Have a lower infection risk
    4. D. Are immunosuppressed
    Show answer

    Answer: D. Are immunosuppressed

    Blunted fever. They may present atypically.

50. Patients with sickle cell disease:

    1. A. Need assessment for crisis complications
    2. B. Need only the standard assessment
    3. C. Are usually seeking drugs for pain
    4. D. Need no formal pain assessment
    Show answer

    Answer: A. Need assessment for crisis complications

    Treat pain. Look for crisis triggers and acute chest syndrome.

51. Patients with hemophilia:

    1. A. Need urgent care for any bleeding
    2. B. Need only the standard assessment
    3. C. Need no special care for minor falls
    4. D. Should avoid all IV access
    Show answer

    Answer: A. Need urgent care for any bleeding

    Factor replacement. Head trauma is especially urgent.

52. Patients with autism:

    1. A. Should be examined quickly to limit stress
    2. B. May need sensory accommodation
    3. C. Should keep eye contact throughout
    4. D. Need the standard approach only
    Show answer

    Answer: B. May need sensory accommodation

    Reduce stimulation. Routine and caregiver guidance help. Rushing tends to raise distress, sustained eye contact can be uncomfortable, and many patients need these accommodations rather than a standard approach.

53. Patients with dementia:

    1. A. Need the history from family instead
    2. B. Should be corrected when confused
    3. C. Cannot be assessed reliably
    4. D. Can be assessed with patience
    Show answer

    Answer: D. Can be assessed with patience

    Avoid confrontation. Familiar faces and baseline information help. Speak with the patient directly and use family for the baseline; arguing with or repeatedly correcting a confused patient increases agitation, and patients with dementia can still be assessed reliably with patience.

54. Cultural considerations in assessment include:

    1. A. Religious practices only
    2. B. Language differences only
    3. C. Nothing beyond the standard exam
    4. D. Modesty, eye contact, and touch
    Show answer

    Answer: D. Modesty, eye contact, and touch

    Ask. Also consider who speaks for the patient.

55. Patients from different cultures may:

    1. A. Need a shortened assessment
    2. B. Present identically to everyone else
    3. C. Tend to refuse transport
    4. D. Express pain and illness differently
    Show answer

    Answer: D. Express pain and illness differently

    Avoid stereotypes.

56. Homeless patients should be assessed:

    1. A. Fully, including exposure and infection
    2. B. Mainly for intoxication and withdrawal
    3. C. Minimally, since follow-up care is unlikely
    4. D. Only for injuries from trauma
    Show answer

    Answer: A. Fully, including exposure and infection

    High-risk population. Untreated conditions are common.

57. Veterans may have:

    1. A. Service-related conditions like PTSD
    2. B. No needs beyond standard care
    3. C. Physical injuries but not PTSD
    4. D. Only combat-related wounds
    Show answer

    Answer: A. Service-related conditions like PTSD

    Ask about service.

58. Assessment of patients in disasters:

    1. A. Treats patients in the order found
    2. B. Is the standard individual exam
    3. C. Is more detailed than usual
    4. D. Uses triage for the greatest good
    Show answer

    Answer: D. Uses triage for the greatest good

    Different ethics. In a disaster, triage directs limited resources to do the greatest good for the greatest number, rather than full individual exams or treating patients in the order they are found.

59. The common thread in special assessment considerations is:

    1. A. Skipping steps that don't apply
    2. B. Adapting the systematic approach
    3. C. Speed over thoroughness
    4. D. Using a different protocol for each
    Show answer

    Answer: B. Adapting the systematic approach

    Same framework, adapted. Maintain its structure.

60. Which patient population is most often undertriaged?

    1. A. Older adults
    2. B. Young adults
    3. C. Children
    4. D. Pregnant women
    Show answer

    Answer: A. Older adults

    Awareness. Low mechanisms and atypical presentations are underestimated.

61. Which patient population is most likely to have hidden injuries?

    1. A. Talkative school-age children
    2. B. Alert, oriented adults
    3. C. Intoxicated or altered patients
    4. D. Calm adults with minor complaints
    Show answer

    Answer: C. Intoxicated or altered patients

    Examine thoroughly. They cannot localize pain.

62. Which patient population most requires caregiver input?

    1. A. Alert, healthy adults
    2. B. Competitive athletes
    3. C. Teenagers with minor injuries
    4. D. Infants and the cognitively impaired
    Show answer

    Answer: D. Infants and the cognitively impaired

    Baseline. Technology-dependent patients also need caregiver input.

63. Which assessment principle applies to every special population?

    1. A. Strict protocol use without individual judgment
    2. B. A systematic, respectful, adapted approach
    3. C. Speed above all other priorities
    4. D. An identical approach for everyone
    Show answer

    Answer: B. A systematic, respectful, adapted approach

    Every patient, every time.