Nremt Emt Level Quiz: Patient Reassessment And Ongoing Care

What this quiz covers

This quiz focuses on Patient Reassessment And Ongoing Care, giving you a quick way to practice the rules, question types, and explanations that matter most for Nremt Emt Level.

How to use this quiz

Try each quiz question before looking at the correct answer. Use the explanations to review missed ideas, then come back to similar questions until the pattern feels familiar.

Question 1

1. Patient reports feeling less confused and more alert than before (correct answer)
2. Blood glucose reading shows a slight increase from initial measurement
3. Patient's skin has become less diaphoretic and feels warmer
4. Vital signs have returned to completely normal baseline ranges

Explanation: Improved mental status (less confusion, more alert) is the best indicator that oral glucose is effectively treating hypoglycemia. While blood glucose increase is good, mental status is the key clinical indicator. Less diaphoresis and warmer skin are positive but less specific. Vital signs may not immediately return to normal even with effective treatment.

Question 2

1. Every 15 minutes throughout the transport period (correct answer)
2. Every 5 minutes throughout the transport period
3. Every 10 minutes throughout the transport period
4. Only when the patient's condition appears to change

Explanation: Stable patients should be reassessed every 15 minutes during transport to monitor for changes in condition. This allows for early detection of deterioration while not being excessive for stable patients. Every 5 minutes is the interval for unstable patients. Every 10 minutes is not a standard interval. Waiting only for apparent changes is inadequate as subtle deterioration may be missed.

Question 3

1. The reservoir bag completely deflates during each inspiration taken (correct answer)
2. Patient reports the mask feels tight against their face
3. SpO2 reading has improved from 89% to 96% since application
4. Patient is breathing at a rate of 20 respirations per minute

Explanation: If the reservoir bag completely deflates during inspiration, the oxygen flow rate is too low and needs to be increased to maintain adequate oxygen concentration. The bag should deflate only slightly with each breath. A tight-fitting mask is appropriate for proper seal. Improved SpO2 indicates effective treatment. A respiratory rate of 20 is within normal range.

Question 4

1. Patient becomes more alert and begins asking questions about location
2. Blood pressure increases slightly from baseline due to patient anxiety
3. Patient's level of consciousness decreases and she becomes less responsive (correct answer)
4. Patient reports a headache and requests something for the pain

Explanation: Decreasing level of consciousness in a post-ictal patient may indicate status epilepticus, head injury, or other serious complications requiring immediate intervention and possible ALS intercept. Increasing alertness is expected during recovery. Slight BP increase from anxiety is not immediately concerning. Headache is common post-ictally and doesn't require immediate intervention.

Question 5

1. To gather additional history information that was missed initially
2. To identify changes in patient condition and treatment effectiveness (correct answer)
3. To practice assessment skills for continuing education requirements
4. To provide reassurance to the patient during the transport period

Explanation: The primary purpose of reassessment is to identify changes in patient condition and evaluate whether treatments are working effectively, allowing for timely interventions. While additional history may be gathered, this is secondary. Reassessment is not for skills practice. Patient reassurance is a benefit but not the primary purpose.

Question 6

1. Patient reports the headache has decreased in intensity since transport began
2. Blood pressure has decreased from 180/100 to 160/90 during transport
3. Facial droop has progressed to include complete paralysis of one side (correct answer)
4. Patient's speech has improved and is now clear and understandable

Explanation: Progression of neurological deficits (worsening facial droop to complete paralysis) indicates evolving stroke and may require immediate notification to receiving hospital and possible diversion to stroke center. Decreased headache could indicate improvement. Slight BP decrease is not immediately concerning. Improved speech would be a positive finding.

Question 7

1. Use a 1-10 numeric pain scale and compare to baseline (correct answer)
2. Ask if the pain is better, worse, or the same as before
3. Observe facial expressions and body language for pain indicators only
4. Ask detailed questions about the exact location and character changes

Explanation: A numeric pain scale (1-10) provides objective, measurable data that can be compared to baseline measurements for trending. This is the standard approach in EMS. Yes/no questions are less specific. Observation alone without patient input is inadequate. Detailed character questions are more appropriate for initial assessment, not ongoing reassessment.

Question 8

1. Within 2-3 minutes of medication administration for immediate effects
2. After 5-10 minutes to allow for absorption and onset (correct answer)
3. Wait until arrival at hospital for complete evaluation
4. Continuously monitor without specific time intervals for changes

Explanation: Oral medications typically require 5-10 minutes for absorption and onset of effects, making this the appropriate timeframe for reassessment of effectiveness. 2-3 minutes is too soon for oral medications (appropriate for IV medications). Waiting until hospital arrival delays important assessment. Continuous monitoring without specific intervals lacks systematic approach and documentation standards.

Question 9

1. Only document significant changes from the initial assessment findings
2. Record complete vital signs and assessment findings at each interval (correct answer)
3. Document reassessment only if the patient's condition deteriorates during transport
4. Note the time of reassessment but detailed findings are optional

Explanation: Complete vital signs and assessment findings should be documented at each reassessment interval to provide a complete picture of patient trending and care provided. This creates a legal record and helps receiving facilities understand the patient's course. Documenting only changes misses important trending information. Documentation only for deterioration misses improvement or stability. Time alone without findings is inadequate documentation.

Question 10

1. Remove the blood-soaked dressing and apply a fresh clean bandage
2. Apply additional dressing material over the existing blood-soaked bandage (correct answer)
3. Apply a tourniquet proximal to the bleeding site immediately
4. Document the finding and increase pressure on the existing dressing

Explanation: Additional dressing material should be applied over existing bandages to maintain clot formation and avoid disrupting any clots that may have formed. Removing the original dressing can disrupt clot formation and worsen bleeding. A tourniquet should only be used for severe extremity bleeding when direct pressure fails. Simply documenting without action doesn't address continued bleeding.

Question 11

1. Respiratory effort and skin color for signs of positional compromise (correct answer)
2. Pain levels at the original injury site for changes
3. Blood pressure changes due to anxiety from immobilization procedures
4. Neurological status changes in the affected spinal distribution only

Explanation: Spinal immobilization can compromise respiratory effort due to positioning and strapping, making breathing assessment critical during reassessment. Skin color changes may indicate respiratory compromise or circulation issues from strapping. While pain monitoring is important, respiratory compromise is more immediately life-threatening. BP changes from anxiety are less critical. Neurological assessment should include all areas, not just the affected distribution.

Question 12

1. Every 15 minutes to avoid disrupting ongoing care
2. Every 5 minutes to monitor for rapid changes (correct answer)
3. Every 10 minutes to maintain adequate monitoring
4. Continuously without specific time intervals for assessment

Explanation: Unstable patients require reassessment every 5 minutes during transport due to their potential for rapid deterioration. This frequent monitoring allows for quick detection of changes and prompt intervention. Every 15 minutes is appropriate for stable patients but inadequate for unstable ones. Every 10 minutes is not a standard interval. Continuous monitoring without formal reassessment intervals lacks the systematic approach needed for proper documentation and care.

Question 13

1. The patient's skin color remains pale but warm to touch
2. Chest rise and fall is visible with each ventilation delivered (correct answer)
3. The bag-mask device requires significant force to compress adequately
4. Heart rate has increased from the baseline measurement taken initially

Explanation: Visible chest rise and fall with each ventilation indicates effective bag-mask ventilation and adequate air exchange. Pale skin suggests continued poor oxygenation. Difficulty compressing the bag may indicate airway obstruction or improper seal. Increased heart rate could indicate hypoxia or stress, not effective ventilation.

Question 14

1. Mental status and level of consciousness changes (correct answer)
2. Vital signs including blood pressure and pulse rate
3. Effectiveness of treatments already provided to patient
4. Chief complaint and any changes in pain levels

Explanation: Mental status and level of consciousness should be assessed first during reassessment as changes can indicate serious deterioration requiring immediate intervention. This follows the same priority as primary assessment (mental status before ABCs in conscious patients). While vital signs, treatment effectiveness, and chief complaint changes are important, mental status changes are the most critical indicator of patient deterioration.

Question 15

1. The child is becoming more comfortable with your presence and treatment
2. Normal response to stress relief after the initial trauma and excitement
3. Possible head injury with increasing intracranial pressure developing gradually (correct answer)
4. Fatigue from the traumatic event and normal childhood sleep patterns

Explanation: In pediatric trauma patients, a change from crying to sleepiness can indicate developing head injury with increased intracranial pressure. Children often present differently than adults with head injuries. Becoming comfortable would not typically cause sleepiness. Stress relief should not cause concerning sleepiness in a trauma setting. While fatigue is possible, head injury must be ruled out first in this context.

Question 16

1. Oral glucose has worn off and blood sugar has dropped again (correct answer)
2. Patient is experiencing a side effect from the oral glucose administered
3. Normal response as the patient recovers from the hypoglycemic episode
4. Possible head injury that was masked by the initial hypoglycemia

Explanation: Oral glucose provides temporary treatment for hypoglycemia, and blood sugar can drop again as the glucose is metabolized, especially if the patient hasn't eaten. This requires repeat blood glucose check and possible additional treatment. Oral glucose rarely has side effects causing altered mental status. Confusion and lethargy are not normal recovery signs. While head injury is possible, recurrent hypoglycemia is more likely given the history.

Question 17

1. Hives have completely disappeared from all areas of the body
2. Respiratory effort has improved and wheezing has decreased significantly (correct answer)
3. Patient reports feeling nervous and jittery since receiving the medication
4. Blood pressure has increased above normal baseline readings for patient

Explanation: Improved respiratory effort and decreased wheezing indicate that epinephrine is effectively treating the bronchospasm component of the allergic reaction. Hives may take longer to resolve than respiratory symptoms. Nervousness and jittery feelings are expected side effects of epinephrine. Increased BP is a side effect, not necessarily an indicator of effectiveness for the allergic reaction.

Question 18

1. Normal anxiety response to the traumatic incident and transport
2. Spinal cord injury progression causing new neurological symptoms
3. Straps or backboard positioning causing circulation compromise to extremities (correct answer)
4. Head injury that was not initially detected during assessment

Explanation: New numbness in fingers combined with agitation suggests that the straps or positioning are too tight, compromising circulation. This is a common complication of spinal immobilization that requires immediate correction. While anxiety is possible, the numbness is a key physical finding. Spinal cord injury progression would more likely cause bilateral symptoms. Head injury would present with altered mental status rather than just agitation with specific numbness.

Question 19

1. Increase the oxygen flow rate or change delivery method immediately
2. Check the pulse oximeter probe placement and patient movement first (correct answer)
3. Document the change and continue current oxygen therapy unchanged
4. Prepare for immediate assisted ventilation with bag-mask device

Explanation: Before making treatment changes based on pulse oximetry, the EMT should first verify the accuracy of the reading by checking probe placement, patient movement, nail polish, or other factors that can cause false readings. If the reading is accurate, then oxygen adjustments would be appropriate. Documentation without verification is inadequate. Bag-mask ventilation would only be needed if the patient shows signs of respiratory failure.

Question 20

1. The oxygen therapy is working effectively and should be continued
2. The patient's condition is improving and requires no intervention changes
3. Possible CO2 retention causing respiratory drive suppression in COPD patient (correct answer)
4. Normal response to supplemental oxygen in elderly patients with breathing difficulty

Explanation: In COPD patients, high-flow oxygen can suppress respiratory drive through CO2 retention, causing dangerously slow breathing despite improved SpO2. This requires immediate intervention such as reducing oxygen flow or assisting ventilations. The improved SpO2 alone doesn't indicate effective treatment if respiratory rate is too low. This is not a normal response and requires action.