1. What does the “P” represent in the AVPU scale used during the primary assessment?

2. According to the pulse-blood pressure correlation taught in EMT courses, what is the minimum estimated systolic blood pressure if a patient has a palpable radial pulse?

3. An EMT arrives on scene to find a 34-year-old male sitting on the curb after a bicycle accident. He is holding his arm, speaking clearly, and appears anxious but is tracking the EMT’s movements. How would the EMT classify this patient’s general impression?

4. During a primary assessment of a 3-year-old child with a fever, the EMT notes a capillary refill time of 4 seconds. What is the most appropriate interpretation of this finding?

5. A 45-year-old male has a deep laceration on his forearm with bright red blood flowing steadily. After applying direct pressure with a sterile dressing for 5 minutes, the bleeding continues to soak through. What should the EMT do next?

6. An EMT is assessing a 67-year-old female found lying in bed at home. When the EMT speaks to her, she opens her eyes and mumbles something unintelligible but does not follow commands or answer questions appropriately. How should the EMT document her level of consciousness using the AVPU scale?

7. An EMT is performing a primary assessment on an unconscious adult patient. The radial pulse is not palpable, but the femoral pulse is present. Based on this finding, what is the estimated minimum systolic blood pressure?

8. EMS is dispatched to a 52-year-old male with chest pain. On arrival, the patient is sitting upright in a chair, clutching his chest, with pale, diaphoretic skin. He is able to speak in short sentences but appears anxious. His wife reports he took nitroglycerin 10 minutes ago with no relief. What is the most accurate general impression and immediate priority?

9. A 28-year-old male was involved in a motorcycle crash. He has a partially amputated right leg below the knee with pulsatile bright red bleeding. The EMT applies direct pressure, but blood continues to spurt. The patient’s skin is pale, cool, and diaphoretic. His radial pulse is absent, but carotid pulse is present. What is the patient’s estimated blood pressure range, and what intervention is most critical?

10. During the primary assessment of a patient with a gunshot wound to the thigh, the EMT notes brisk, dark red bleeding that is pooling rapidly. The patient is alert and oriented. What is the most appropriate initial intervention?

11. During the primary assessment, the “general impression” is formed within the first few seconds of patient contact. What is the PRIMARY purpose of forming this rapid impression?

12. A patient who opens their eyes only when you pinch their shoulder and attempts to push your hand away would be classified as what on the AVPU scale?

13. An EMT responds to a 55-year-old male with shortness of breath. Upon entering the room, the patient is sitting upright in bed, using accessory muscles to breathe, and appears anxious. His skin is pale and diaphoretic. What general impression should the EMT form, and what is the immediate priority?

14. A 24-year-old female is found unresponsive at a party. Friends say she was drinking alcohol and may have taken an unknown substance. When you pinch her trapezius muscle, she extends her arms and legs rigidly. How would you document her AVPU status, and what does this response indicate?

15. You arrive at a motor vehicle collision to find a 30-year-old male driver who was unrestrained. He is walking around the scene and states he feels “fine.” You notice a small contusion on his forehead. His skin is pink, warm, and dry. What is the most accurate general impression?

16. A 70-year-old male with a history of diabetes is found confused at home by his family. When you speak to him, he opens his eyes and looks at you but cannot tell you what day it is or where he is. He is able to state his name. What is his AVPU status and orientation level?

17. An EMT approaches a 42-year-old female complaining of abdominal pain. She is lying on the couch, appears comfortable, is conversing normally, has pink and dry skin, and is responsive to questions. How would the EMT classify this patient’s general impression?

18. A 65-year-old male with a known history of stroke was found on the floor by his wife approximately 2 hours after she last saw him normal. On assessment, he does not open his eyes to voice. When you apply a sternal rub, he extends both arms and legs rigidly with internal rotation of the wrists. His respirations are 8 per minute and irregular. Based on the LOC findings and posturing, what is the MOST likely level of brain dysfunction, and what does this indicate about his prognosis?

19. EMS responds to a 58-year-old male with chest pain. Upon arrival, the patient is sitting upright, clutching his chest, with ashen gray skin color. He is diaphoretic and breathing rapidly but can speak in complete sentences. His wife reports he has a history of hypertension and smoked for 30 years. Based on the general impression, which combination of findings MOST strongly suggests a life-threatening condition requiring immediate intervention?

20. A 23-year-old female is brought to the emergency department by friends who state she was “acting strange” at a concert. On assessment, she does not respond to her name being called loudly. When you apply a painful stimulus to her trapezius, she pulls away and says “stop it.” Her pupils are equal and reactive. Blood glucose is 95 mg/dL. What is her AVPU status, and based on the presentation, what is the MOST likely cause of her altered mental status?

21. When assessing a patient’s breathing during the primary assessment, which finding indicates ADEQUATE ventilation?

22. You are assessing a 45-year-old male who complains of feeling “weak and dizzy.” During your primary assessment, you note his skin is pale, cool, and diaphoretic. His radial pulse is weak and rapid at 118 beats per minute. What do these findings indicate about his circulatory status?

23. A 67-year-old male with a history of COPD is complaining of severe shortness of breath. During your primary assessment, you note he is using accessory muscles, has audible wheezing, and can only speak one or two words at a time. His SpO2 is 86% on room air. What is your IMMEDIATE priority?

24. You respond to a 22-year-old male with a deep laceration to his forearm from broken glass. Bright red blood is spurting from the wound. During your primary assessment, you note his skin is pale and diaphoretic, with a heart rate of 112. What is the MOST appropriate immediate intervention?

25. You are called to a residence for a 4-year-old child who is choking. Upon arrival, you find the child alert but anxious, sitting upright, and making high-pitched noises when inhaling. His skin is pink. What is the MOST appropriate initial action?

26. A 58-year-old female complains of chest pain that started 20 minutes ago. During your primary assessment, you note she is alert but anxious. Her skin is warm and dry. You palpate a radial pulse of 88 that is regular and strong. What is your NEXT immediate action in the primary assessment?

27. You are assessing an unresponsive 34-year-old male. His airway is patent, but you note his breathing is agonal – occasional gasping breaths at a rate of 4 per minute with minimal chest movement. His pulse is present at 72 beats per minute. What is the MOST accurate interpretation of these findings?

28. You respond to a motor vehicle collision on a rural highway. A 32-year-old male was the unrestrained driver in a high-speed head-on collision. Upon arrival, you find him still in the driver’s seat, unconscious. During your rapid primary assessment, you note the following: his airway is open, he has shallow respirations at 12 breaths per minute, his radial pulse is absent but you palpate a weak femoral pulse at 130 beats per minute. His skin is pale, cool, and clammy. You notice significant deformity to his steering wheel and dashboard. What do these primary assessment findings indicate, and what is your immediate priority?

29. You are called to a nursing home for a 78-year-old female with difficulty breathing. Upon arrival, staff report she has a history of congestive heart failure and has been “getting worse all day.” Your primary assessment reveals: she is alert but very anxious, sitting upright in bed in a tripod position, using accessory muscles to breathe. Her respiratory rate is 32 breaths per minute with labored effort. You auscultate crackles (rales) in both lung bases. Her skin is pale and diaphoretic with SpO2 of 89% on room air. She speaks in three-word sentences. What is the MOST appropriate interpretation and initial management?

30. You respond to an industrial accident where a 45-year-old male worker fell 20 feet onto concrete. Bystanders report he landed on his left side and was initially complaining of severe left upper quadrant abdominal pain. When you arrive, he is pale and diaphoretic, lying on the ground. During your primary assessment: Airway is patent, he is speaking but his voice is weak, breathing is rapid at 28 breaths per minute, radial pulse is thready at 118 beats per minute. He reports feeling “dizzy and cold.” You note tenderness and bruising over his left upper abdomen. Based on these findings, what is the MOST likely injury pattern and immediate priority?

31. During the primary assessment, you assess circulation by checking the radial pulse. In an adult patient, what pulse rate range is considered within normal limits?

32. Which of the following patient presentations would be classified as the HIGHEST transport priority?

33. You are assessing a 52-year-old male with chest pain. His radial pulse is strong and regular at 76 beats per minute. His skin is warm, pink, and dry. How would you characterize his circulatory status based on these findings?

34. You respond to a two-vehicle collision. There are three patients. Patient A is walking around with a bleeding hand laceration. Patient B is sitting on the curb, holding his chest, and has labored breathing. Patient C is unconscious and slumped over the steering wheel with visible facial trauma. Using the START triage system, which patient should receive your IMMEDIATE attention?

35. A 34-year-old female complains of dizziness and nausea. During your primary assessment, you note she is alert but pale. Her radial pulse is weak and thready at 112 beats per minute. Her skin is cool and moist. What do these findings suggest about her circulatory status?

36. You respond to a residence for a “diabetic problem.” A 48-year-old male is found on the kitchen floor. He is unresponsive to voice and painful stimuli. His breathing is rapid at 28 breaths per minute. His skin is warm and dry. Blood glucose reads 425 mg/dL. What is this patient’s transport priority?

37. You are assessing a 65-year-old male with a complaint of severe back pain that started suddenly 30 minutes ago. During your primary assessment, you palpate a bounding radial pulse at 98 beats per minute. His blood pressure is 190/110 mmHg. His skin is warm and dry. He reports the pain “tears through to my chest.” What does this circulation assessment suggest?

38. You respond to a nursing home for a “fall.” Upon arrival, staff reports a 78-year-old female fell out of bed approximately 2 hours ago. She was found on the floor and has not moved since. During your primary assessment, you note: she does not respond to voice or painful stimuli, her respirations are irregular at 8 breaths per minute with sonorous respirations, her radial pulse is bounding but irregular at 52 beats per minute, and her blood pressure is 210/120 mmHg. Her pupils are unequal (left 6mm, right 3mm). What is the MOST likely cause and appropriate priority determination?

39. A 22-year-old male was stabbed in the right upper quadrant of the abdomen during a bar fight. He ran two blocks before collapsing. Your primary assessment reveals: he is responsive to painful stimuli only, his respirations are rapid at 32 breaths per minute and shallow, you cannot palpate a radial pulse but feel a weak thready femoral pulse at 130 beats per minute. His skin is pale, cold, and clammy. You note a 3-inch laceration to the RUQ with minimal external bleeding. What is the MOST accurate interpretation of his circulatory status?

40. You respond to a single-vehicle collision on a rural highway. A 35-year-old pregnant female (third trimester) was driving and struck a tree at highway speed. She was unrestrained. Upon arrival, you find her still in the driver’s seat, conscious and screaming about abdominal pain. Her airway is patent, breathing is rapid at 28 breaths per minute, radial pulse is 118 and regular. Her abdomen is tender and rigid with visible bruising across the lower abdomen from the steering wheel impact. She reports feeling “wet” and you note blood on her inner thighs. What are the priority considerations for this patient?

41. Which set of findings BEST describes a patient with a “sick” general impression requiring immediate intervention?

42. You respond to a residence for a 52-year-old male with chest pain. As you enter the room, you immediately notice he is clutching his chest, appears pale and sweaty, and is breathing rapidly. What does this general impression indicate?

43. You are assessing an unresponsive 68-year-old male. You open his airway using the head-tilt, chin-lift maneuver and hear gurgling sounds. What is your IMMEDIATE action?

44. You respond to a local park for a 25-year-old female who was jogging and collapsed. Bystanders are performing CPR when you arrive. As you approach, you note she is motionless on the ground, her skin appears ashen gray, and bystanders report she has no pulse. What is your general impression?

45. A 34-year-old male was involved in a motor vehicle collision. He is unconscious with possible spinal injury. During your primary assessment, you note his airway is partially obstructed by his tongue falling back. Which airway maneuver is MOST appropriate?

46. You are caring for an unresponsive 45-year-old male with inadequate breathing. You need to insert an oropharyngeal airway (OPA). How do you determine the correct size?

47. You respond to a residence for a 70-year-old female with “difficulty breathing.” As you enter, you see her sitting upright in a chair, using accessory muscles, with audible wheezing. Her skin is pale and diaphoretic. She is able to speak only two or three words between breaths. What is the MOST accurate interpretation of her general impression?

48. You are called to a residence for a 62-year-old male with altered mental status. Upon arrival, his wife states he has a history of seizures and was found on the floor this morning unresponsive. Your primary assessment reveals: he is unresponsive to voice and pain, his airway is open, breathing is shallow at 8 breaths per minute, radial pulse is 88 and regular. His skin is pale and dry. You note dried blood on his tongue and bruising on his face consistent with a fall. You attempt to insert an oropharyngeal airway, but he gags when it contacts his posterior pharynx. What is the MOST appropriate action?

49. You respond to a motor vehicle collision involving a single vehicle that struck a utility pole at high speed. The driver, a 28-year-old male, was unrestrained. He has self-extricated and is walking around the scene when you arrive. He tells you “I’m fine, just a little shaken up.” You observe a small laceration on his forehead but no other obvious injuries. He appears alert and is speaking clearly. However, you note his shirt is torn and the steering wheel is deformed. What is the MOST accurate interpretation of this situation?

50. You are assessing a 5-year-old child who was found unresponsive in a swimming pool. Bystanders report the child was underwater for an unknown period. Upon your arrival, the child is unresponsive, not breathing, and has a weak pulse at 60 beats per minute. You open the airway and note water draining from the mouth. After suctioning, you deliver two rescue breaths and see the chest rise. The child remains unresponsive but begins gasping. His pulse is now 52 beats per minute. What is your interpretation and immediate management priority?