Free EMT Primary Assessment Practice Test – Part 3

1. During your rapid assessment of a patient, you form a general impression within the first few seconds. What is the PRIMARY purpose of this initial general impression?

2. During a primary assessment, you check for a radial pulse. If the radial pulse is palpable, what minimum systolic blood pressure (SBP) can you estimate?

3. You arrive at the scene of a motor vehicle collision. A 45-year-old male is sitting on the curb, holding his chest. He appears anxious, his skin is pale and diaphoretic, and he is speaking in short sentences. What does your general impression suggest about this patient?

4. During the primary assessment of an unresponsive adult, you find no radial pulse but a weak carotid pulse. The patient’s skin is cool, pale, and dry. What is your estimated systolic blood pressure and what does this finding indicate?

5. You are assessing a 3-year-old child at a playground. The child is sitting upright, crying loudly, and has pink, warm skin. The parent reports the child fell off a swing and hurt her arm. Based on your general impression, how would you categorize this patient?

6. A 67-year-old female presents with chest pain and difficulty breathing. During your primary assessment, you note her skin is cool, pale, and diaphoretic. Her radial pulse is weak and rapid at 118 beats per minute. She is alert but anxious. What is your primary assessment interpretation of her circulatory status?

7. You are treating a 32-year-old construction worker with a deep laceration to his right thigh. Bright red blood is spurting from the wound. During your circulation assessment, you note a strong radial pulse of 100, warm pink skin, and the patient is alert. What is your IMMEDIATE priority?

8. You respond to a residence for a “person not feeling well.” Upon entering, you observe a 58-year-old male slumped in a chair, appearing drowsy. His wife states he has been “acting strange” for the past hour. As you approach, you note his breathing appears labored with visible use of accessory muscles, his skin has a bluish tint around the lips, and he responds only to verbal stimulus with confused speech. Analyze this general impression and determine your immediate priority.

9. A 22-year-old male was stabbed in the left upper quadrant of the abdomen. During your primary assessment, his initial vital signs were: alert, radial pulse 110, skin cool and pale. After 5 minutes of transport, you reassess and find: he is now only responsive to painful stimulus, his radial pulse is no longer palpable, but carotid pulse remains present, and his skin is now cold and clammy. Interpret these findings and determine the most appropriate action.

10. You respond to a nursing home for a 78-year-old female with “altered mental status.” On arrival, staff report she was found unresponsive in bed this morning. Your general impression reveals an elderly female lying motionless in bed. She does not respond to your voice. When you squeeze her shoulder firmly, she grimaces but does not open her eyes. Her skin is pale and very cool to touch, and you note mottling on her arms and legs. Her breathing is irregular with periods of apnea lasting 10-15 seconds. Analyze this general impression and determine the most likely clinical picture.

11. Which of the following correctly describes the AVPU scale component where a patient opens their eyes and responds appropriately when you say their name?

12. Which airway adjunct is appropriate for a patient who is semi-conscious with an intact gag reflex?

13. A 45-year-old male is found lying on the ground after a witnessed fall. He does not open his eyes when you approach, but when you firmly squeeze his trapezius muscle, he opens his eyes and tries to push your hand away. How would you document his AVPU status?

14. You are assessing a 68-year-old female with possible stroke. She is able to speak but has significant drooling and difficulty swallowing. Her voice sounds “wet” and gurgling. What does this indicate about her airway status?

15. A 22-year-old male was involved in a motor vehicle collision. When you arrive, he is unresponsive to your voice. You apply a painful sternal rub and he extends his arms and legs outward with his head arched back. What is his AVPU status, and what condition does this motor response suggest?

16. You are treating an unresponsive 34-year-old female with a suspected drug overdose. Her respirations are 6 per minute and shallow. You attempt to insert an OPA but she gags when you place it at the back of her throat. What should be your next action?

17. A 19-year-old male was found unresponsive at a party. Friends report he was drinking alcohol and may have taken unknown pills. His eyes open when you apply a trapezius squeeze, he mutters incomprehensible sounds, and he pulls away from the painful stimulus. Using the Glasgow Coma Scale, what is his motor score?

18. A 72-year-old male with a history of stroke presents with labored breathing. During your assessment, you note stridorous sounds during inspiration, significant accessory muscle use, and the patient is unable to speak more than one or two words at a time. His oxygen saturation is 86% on room air. What is your priority intervention?

19. You respond to a 56-year-old male who fell from a ladder. He is unresponsive to all stimuli (AVPU: U). His GCS is 4 (E1, V1, M2). Breathing is irregular and noisy. You note clear fluid draining from his left ear. What is the MOST appropriate sequence of interventions for this patient?

20. A 28-year-old female was ejected from a vehicle during a rollover collision. On your arrival, she is alert but confused, speaking in short phrases with visible blood in her mouth. Her GCS is 12 (E3, V3, M6). Breath sounds are present bilaterally but you hear gurgling with each respiration. Her SpO2 is 90% on room air. After initiating spinal motion restriction, what is the MOST appropriate immediate intervention?

21. Which of the following patients should be classified as a “load-and-go” priority based solely on the general impression?

22. When forming a general impression of a patient, which combination of findings suggests a “sick” appearance requiring immediate intervention?

23. You arrive at a motor vehicle collision and find a 35-year-old male driver walking around the scene. He states he is “fine” but you notice he has a small laceration on his forehead. He is speaking clearly and appears calm. What is the most appropriate action?

24. A 5-year-old child is found sitting upright on a couch, leaning forward with drooling and stridor. The child appears anxious and is not speaking. What does this general impression indicate?

25. Which statement best explains why compensated shock can be missed during initial assessment?

26. You approach a 72-year-old female who appears to be sleeping in bed. She does not respond to your voice but withdraws from a sternal rub. Her skin is cool and pale, and her breathing appears shallow. What is your general impression?

27. A patient with a suspected heart attack is speaking full sentences, has pink warm skin, and denies shortness of breath. However, he reports chest pressure that began 20 minutes ago. How should this patient be prioritized?

28. You are assessing a 28-year-old male involved in a motorcycle crash. He was wearing a helmet. His vital signs are BP 118/78, pulse 110, respirations 24. He is alert and answers questions appropriately. He has a visible deformity to his left thigh. Skin is pink, warm, and dry. Based on this information, which statement best describes this patient’s priority status?

29. A 4-year-old child is brought to you by a panicked parent. The child has had a fever for two days and today became lethargic. On your general impression, the child is lying on the parent’s shoulder, not resisting, with rapid breathing and mottled skin. The child briefly opens eyes when you speak but does not track you. What is your impression and immediate action?

30. You respond to a call for a 55-year-old male with “weakness.” On arrival, you find him sitting in a chair, speaking clearly but with a slight facial droop. He states he felt “funny” this morning and has had trouble holding his coffee cup with his right hand. Vital signs are stable. He lives alone and wants to stay home. What is your assessment and action?

31. What is the normal capillary refill time in an adult patient under standard assessment conditions?

32. A 45-year-old male was involved in a motor vehicle collision. He is anxious and complains of abdominal pain. His skin is pale, cool, and diaphoretic. His radial pulse is rapid and thready. Which stage of shock is this patient most likely experiencing?

33. You are assessing a 68-year-old female who was found unresponsive by her family. When you speak loudly to her, she does not respond. When you pinch her earlobe, she moans but does not open her eyes or follow commands. Using the AVPU scale, what is her level of consciousness?

34. A 32-year-old male has a deep laceration to his forearm with significant bleeding. You have applied direct pressure and a pressure dressing. The bleeding has slowed but his radial pulse is barely palpable and very rapid. What should you do next?

35. A 54-year-old diabetic male is found confused and combative. Family states he took his usual insulin this morning but then “didn’t eat much breakfast.” His skin is cool and diaphoretic. What is the most likely cause of his altered mental status?

36. You are assessing a 3-year-old child who fell from a swing. The child is crying loudly and reaching for his parent. His skin is pink, warm, and dry. Capillary refill is less than 2 seconds. What is this child’s circulatory status?

37. A 22-year-old female with type 1 diabetes is found by her roommate in bed, unresponsive. The roommate reports the patient was “sick with a fever yesterday and didn’t eat much.” Assessment reveals: unresponsive to painful stimuli, rapid deep respirations, dry and warm skin, and a fruity odor on her breath. Her radial pulse is rapid but strong. Which condition should you suspect, and what is the priority intervention?

38. A 70-year-old male presents with sudden onset of right-sided facial drooping, inability to speak clearly (slurred speech), and weakness in his right arm. Using the Cincinnati Prehospital Stroke Scale, what do these findings indicate?

39. You are called to assess a 5-year-old child who fell from a second-story window. On arrival, the child appears pale and is sitting quietly, not crying. The parent says, “He was screaming earlier but now he’s acting fine.” The child’s capillary refill is 4 seconds, skin is cool and clammy, and his heart rate is 160. How would you interpret these findings?

40. A trauma patient is unresponsive to verbal and painful stimuli, has mottled and cold skin, and no palpable peripheral pulses. You can barely detect a faint carotid pulse. Based on these findings, which stage of shock is this patient in, and what does this indicate about their prognosis?

41. Which of the following is the correct sequence for managing a patient’s airway during primary assessment?

42. Which of the following patients should be identified as a priority patient requiring immediate transport?

43. A 67-year-old male with severe COPD presents with acute respiratory distress. He is using accessory muscles, cannot speak in full sentences, and has SpO2 of 89% on room air. He appears exhausted. What makes this patient a priority?

44. A 28-year-old female is found unconscious after a motor vehicle collision. She has a large hematoma on her forehead, unequal pupils, and is only responsive to painful stimuli with decerebrate posturing. Why is rapid transport critical for this patient?

45. A 5-year-old child presents with severe respiratory distress. The parent reports the child has had a barking cough and fever for two days. You observe suprasternal and intercostal retractions, nasal flaring, and stridor. The child is sitting upright and appears anxious. SpO2 is 91% on room air. What is your priority action?

46. You are assessing a 55-year-old male who called 911 for chest pain. During your primary assessment, you note: blood pressure 88/52 mmHg, heart rate 118 bpm, respiratory rate 24, SpO2 92% on room air, and pale, diaphoretic skin. He reports the pain began 30 minutes ago and describes it as “crushing” pressure radiating to his left arm. What findings qualify this patient as a priority?

47. A 34-year-old male is having a severe allergic reaction after being stung by a bee. He presents with facial swelling, difficulty speaking, a rapid onset of stridor, and widespread hives. His SpO2 is 90% on room air, and he is using accessory muscles to breathe. Which intervention takes priority?

48. A 72-year-old female fell down a flight of stairs. During your primary assessment, you note she is confused and only responds to verbal stimuli with inappropriate words. Her left pupil is 6mm and non-reactive; her right pupil is 3mm and reactive. She has a large contusion on the left side of her head. Blood pressure is 170/100 mmHg, heart rate is 52 bpm, and respiratory rate is 14 with irregular pattern. What is your interpretation of these findings, and what is your priority action?

49. A 19-year-old male was found unconscious at a party. Friends state he was drinking alcohol and may have taken “something else.” His respirations are 6 per minute with shallow chest rise, his pulse is 58 and weak, and his skin is pale, cool, and cyanotic around the lips. His pupils are 2mm and reactive. You open his airway with a head-tilt, chin-lift maneuver, but his breathing does not improve. What is your immediate priority, and why?

50. You are dispatched to a 26-year-old female, 34 weeks pregnant, who was the restrained driver in a moderate-speed motor vehicle collision. During your primary assessment, she complains of abdominal pain and appears anxious. Her vital signs are: BP 100/70 mmHg, HR 108 bpm, RR 22, SpO2 96%. She has a contusion across her lower abdomen from the seatbelt. While her vital signs are stable, why is this patient considered a priority?