Free EMT Primary Assessment Practice Test – Part 6

1. The AVPU scale is used during the primary assessment to rapidly evaluate a patient’s level of consciousness. What does each letter in AVPU represent?

2. When assessing circulation in an adult patient during the primary assessment, what is the normal range for a resting heart rate?

3. A 52-year-old male is found lying on a park bench. When you approach and call his name, he slowly opens his eyes but does not speak. He closes his eyes again when you stop talking. What is his AVPU classification?

4. You are assessing a 35-year-old female with abdominal pain. During your primary assessment, you palpate her radial pulse and find it weak and thready at 112 beats per minute. Her skin is pale, cool, and slightly moist. What do these findings most likely indicate?

5. A 68-year-old female with diabetes is found confused by her family. When you assess her, she looks at you when you speak but cannot tell you her name, where she is, or what day it is. She does not respond to questions appropriately but does not require any stimulus to keep her eyes open. What is her AVPU status and orientation level?

6. You respond to a 28-year-old male who crashed his motorcycle. During your primary assessment, you cannot palpate a radial pulse but can feel a weak carotid pulse. His skin is pale, cool, and clammy. What is the significance of the absent radial pulse with present carotid pulse?

7. A 19-year-old male was found unresponsive at a party. When you pinch his trapezius muscle, he pulls his arm away and mumbles something unintelligible. His pupils are equal and reactive to light. What is his AVPU status, and what does his response to pain indicate?

8. You respond to a construction site where a 45-year-old male fell 15 feet onto concrete. Coworkers state he landed on his back and complained of severe back pain before becoming “drowsy.” On primary assessment, his airway is patent with clear breath sounds bilaterally. His respirations are 24 per minute. You note a heart rate of 52 beats per minute, and his skin is warm and dry. His blood pressure is 90/60 mmHg. He responds to verbal stimuli but is confused. Based on these findings, what type of shock is MOST likely, and what finding supports this diagnosis?

9. You are dispatched to a residence for a 72-year-old male with altered mental status. The family reports he was “fine this morning” but has become progressively more confused over the past 6 hours. On assessment, he does not respond to his name being called loudly. When you apply a sternal rub, he extends both arms and legs rigidly with internal rotation of his wrists. His respirations are irregular at 10 per minute. His blood glucose is 118 mg/dL. What is the MOST accurate interpretation of his AVPU status and neurological findings?

10. You respond to a motor vehicle collision involving a 30-year-old restrained driver who struck the steering wheel. During your primary assessment, you note the following: his airway is patent, he is breathing rapidly at 28 breaths per minute, and his radial pulse is weak and rapid at 120 beats per minute. His skin is pale, cool, and diaphoretic. You notice bruising across his chest from the seatbelt and a displaced segment of his lower ribs that moves paradoxically with breathing. His blood pressure is 88/64 mmHg. Based on these primary assessment findings, what is the MOST likely cause of his shock, and what is the immediate priority?

11. When using the “sick versus not sick” approach during the primary assessment, which of the following clinical findings would MOST strongly classify a patient as “sick”?

12. You respond to a 45-year-old male with chest pain. Upon entering the room, you observe him clutching his chest, sitting upright, with ashen gray skin. He is diaphoretic and speaks only in two-word sentences. What is your general impression and immediate action?

13. You arrive at a house fire with three victims. Patient A is walking and coughing. Patient B is sitting, alert, with burns to both arms. Patient C is unconscious with soot around the nose and mouth and singed nasal hairs. Which patient should be your highest priority?

14. An EMT arrives at the bedside of a 72-year-old female with pneumonia. The patient is lying supine, appears cyanotic around the lips, and is using accessory muscles to breathe. She is diaphoretic and unable to speak. What general impression should be formed?

15. You respond to a two-vehicle collision. Driver A is ambulatory with neck pain. Driver B is trapped in the vehicle with an obvious deformity to the thigh and is screaming in pain. A passenger in Driver B’s vehicle is unresponsive with a weak, thready pulse. Which patient is your highest priority?

16. You are called to a residence for a 5-year-old child with fever. Upon arrival, the child is sitting on the parent’s lap, alert, crying appropriately, and has pink, warm skin. The parent reports the child has had fever for two days. What is your general impression?

17. At a nursing home, you are called for an 82-year-old male with altered mental status. The staff reports he was normal at breakfast but is now unresponsive. His skin is pale, cool, and dry. Blood glucose is 180 mg/dL. He has a history of diabetes and atrial fibrillation. Which condition should be your PRIMARY concern for immediate intervention?

18. You respond to a residence for a 34-year-old female with severe headache. Upon arrival, she describes the headache as “the worst of my life” and says it began suddenly 30 minutes ago while she was watching television. She is alert but appears anxious and has photophobia. Her blood pressure is 168/94 mmHg, pulse is 88, respirations 18. She has no significant medical history. During your assessment, you note her right eyelid is drooping and her right pupil is dilated. Based on these findings, what is your assessment and transport priority?

19. You respond to a 56-year-old male with difficulty breathing. Upon entering the apartment, you note a strong smell of urine. The patient is sitting in a recliner, appears cachectic, and has a barrel-shaped chest. He is using accessory muscles and pursed-lip breathing. His skin is pale with a bluish tint around the lips. He can only speak one word at a time. He has an oxygen tank nearby but appears too weak to adjust it. What is your general impression, most likely diagnosis, and immediate priority?

20. You arrive at a motor vehicle collision involving a minivan and a truck. There are four patients. A 6-year-old child in the minivan is crying loudly and has a visible laceration to the forehead. The 35-year-old mother is ambulatory but holding her abdomen and states she is “fine.” The 70-year-old grandfather is unresponsive with a large hematoma to the forehead and unequal pupils. The truck driver is walking around the scene complaining of back pain. Based on your primary assessment and triage principles, how should you prioritize these patients?

21. What is the normal respiratory rate range for a resting adult patient?

22. When using the AVPU scale, a patient who opens their eyes and looks around when you enter the room but does not respond to your questions would be documented as:

23. A 67-year-old male with a history of COPD is complaining of shortness of breath. His respiratory rate is 28, SpO2 reads 89% on room air, and he is using accessory muscles. You auscultate his lungs and hear diffuse expiratory wheezes. What is your PRIORITY intervention for this patient?

24. You are assessing a 34-year-old female who was found by her roommate after an unknown period of time. She does not open her eyes when you call her name, but when you tap her shoulder, her eyes open and she says “What’s happening?” She cannot tell you where she is or what day it is. How should you document her AVPU and orientation status?

25. You are treating an unresponsive 52-year-old male with suspected opioid overdose. His respiratory rate is 6 breaths per minute with shallow chest rise. His SpO2 is 82% on room air. After administering naloxone 0.4mg IM, what is your MOST important immediate intervention?

26. A 45-year-old male is involved in a motor vehicle collision. He is extricated from the vehicle and placed on a backboard. When you approach, you note that he is speaking clearly and states, “My neck really hurts.” During your primary assessment, you ask him to squeeze your fingers and wiggle his toes. He follows all commands appropriately. What does this indicate about his neurological status?

27. A 28-year-old male is found unconscious at a construction site. Assessment reveals: unresponsive to voice and pain, respiratory rate 4/minute with minimal chest rise, stridorous sounds on inspiration, and obvious facial trauma with blood in the airway. After manually clearing visible blood from his mouth, his breathing does not improve. What is the MOST appropriate sequence of interventions?

28. You respond to a residence for a 58-year-old female with altered mental status. Her husband states she has a history of diabetes, hypertension, and “mini-strokes.” She was found on the floor this morning, confused and unable to move her right arm. Assessment reveals: eyes open when you call her name, she follows simple commands but cannot speak clearly, right-sided facial droop, and right arm weakness. Blood glucose is 142 mg/dL. Which interpretation of her AVPU status and likely condition is MOST accurate?

29. A 72-year-old female with a history of congestive heart failure presents with severe respiratory distress. Her family called 911 because she “couldn’t breathe.” Assessment reveals: respiratory rate 32, SpO2 84% on room air, audible crackles when she breathes, pink frothy sputum, and 2+ pitting edema to both ankles. She is sitting upright, clutching the bed rails, and can only speak one or two words between breaths. What is the pathophysiology causing her respiratory distress, and what intervention is MOST appropriate?

30. You are dispatched to a possible overdose. A 22-year-old male is found in his bedroom by his mother. Assessment reveals: unresponsive to all stimuli (voice, touch, pain), respiratory rate 8 with shallow tidal volume, pulse 52, blood pressure 88/54, skin pale and cool, and pupils 2mm and reactive. His mother reports he has been depressed recently and she found an empty bottle of “nerve pills” on his nightstand. Based on the primary assessment findings, what is the MOST likely cause of his presentation, and what is your immediate management priority?

31. During the primary assessment, which pulse site should be palpated in an unresponsive adult patient when the radial pulse is not palpable?

32. You respond to a 35-year-old male with a severe allergic reaction after a bee sting. His face is swollen, he has stridor, and his blood pressure is 84/50 mmHg with a heart rate of 128 beats per minute. His skin is pale, cool, and clammy. During your primary assessment, what do these circulation findings indicate?

33. You arrive at a motor vehicle collision with three patients. Patient A is a 28-year-old female walking around the scene with a minor forehead laceration, complaining of a headache. Patient B is a 45-year-old male sitting on the ground, holding his chest, breathing rapidly with visible bruising on his steering wheel. Patient C is a 22-year-old male lying motionless on the ground with a large scalp laceration. Based on your general impression, which patient should be assessed first?

34. You are assessing a 68-year-old female with a history of atrial fibrillation who complains of sudden onset of weakness and dizziness. Her blood pressure is 88/54 mmHg, heart rate is 156 and irregular, and her skin is cool and pale. She is alert but appears anxious. What is the MOST likely cause of her circulatory compromise?

35. You respond to a residential fire with multiple occupants. Firefighters bring you four patients. Patient 1 is a 6-year-old child with singed nasal hairs and hoarse voice. Patient 2 is a 34-year-old pregnant female at 32 weeks gestation with minor burns to her arms. Patient 3 is a 72-year-old male with chest pain and a history of cardiac stents. Patient 4 is a 28-year-old male with a fractured ankle who is ambulatory. Based on the general impression, who is the highest priority?

36. A 24-year-old male was stabbed in the left upper quadrant of the abdomen. During your primary assessment, he is alert but anxious. His skin is pale, cool, and diaphoretic. His heart rate is 124 beats per minute, and his blood pressure is 102/68 mmHg. What stage of shock is this patient most likely experiencing?

37. You are called to a nursing home for an 82-year-old male who fell 4 hours ago. Staff report he “seems fine” and has been resting in bed. His vital signs are BP 134/82, pulse 76, respirations 16. He denies pain. However, you note he is on warfarin for atrial fibrillation. Despite normal vital signs and no complaints, why should this patient be considered high priority?

38. You respond to a construction site where a 42-year-old male fell 15 feet and landed on his left side on concrete. Bystanders state he initially complained of severe left abdominal pain but now says he “feels fine.” During your primary assessment, you note: he is alert and oriented, skin is pale but warm, heart rate 112, BP 118/76, respiratory rate 22. He has bruising over his left flank and reports mild left shoulder pain. He wants to refuse transport. What is your clinical interpretation and most appropriate action?

39. You arrive at a restaurant where a patron collapsed. Bystanders report the 55-year-old male was eating when he suddenly grabbed his throat, turned blue, and became unresponsive. During your primary assessment, you find him supine on the floor, unresponsive, with cyanosis around his lips. He is not breathing. You attempt to ventilate with a BVM, but the chest does not rise. You reposition the head and try again—still no chest rise. What is your immediate priority action?

40. You respond to a 28-year-old female at 36 weeks gestation who was involved in a motor vehicle collision. She was a restrained driver in a moderate-speed collision. During your primary assessment, she is alert and oriented, complaining of abdominal pain and mild vaginal bleeding. Her vital signs are: BP 92/60 mmHg, heart rate 108, respiratory rate 20. Her skin is warm and pink. She reports feeling the baby move normally. Based on these findings, what is your assessment of her circulatory status and priority level?

41. Which set of findings during your initial general impression would classify a patient as “not sick” and allow time for a more detailed assessment?

42. When assessing circulation during the primary assessment, at which location should you palpate for a pulse in an unresponsive infant?

43. You respond to a residence for a 62-year-old male with “difficulty breathing.” As you enter the room, you observe him sitting on the edge of the bed in a tripod position, using accessory muscles, with visible diaphoresis on his forehead. He attempts to speak but can only manage one or two words between breaths. Based on your general impression, what is your immediate priority?

44. You are assessing a 55-year-old male who fell from a ladder. During your primary assessment, you note a deep laceration on his thigh with dark red blood steadily flowing from the wound. His skin is pale and cool, and his radial pulse is rapid at 112 beats per minute. What is your IMMEDIATE priority?

45. You arrive at a motor vehicle collision involving a single vehicle that struck a utility pole. The driver, a 28-year-old female, is out of the vehicle and walking around. She appears alert and tells you she is “fine” and just wants to go home. You notice a small bruise on her forehead and torn clothing. What should your general impression tell you about this patient?

46. A 70-year-old female complains of dizziness and weakness. During your primary assessment, you find her skin is pale, cool, and diaphoretic. Her radial pulse is irregular and thready at 92 beats per minute. She reports a history of “heart problems.” What do these findings suggest about her circulatory status?

47. You respond to a “person down” call at a shopping mall. When you arrive, you find a 45-year-old male lying on the floor. Bystanders report he suddenly collapsed while walking. Your primary assessment reveals: he is unresponsive to voice and pain, has snoring respirations at 8 breaths per minute, his skin is flushed and warm, and his radial pulse is strong at 68 beats per minute. Based on your general impression and primary assessment, what is the MOST likely underlying problem?

48. You are called to a construction site for a worker who was crushed between two vehicles. Upon arrival, you find a 38-year-old male lying on the ground. He is alert but anxious. His airway is patent, breathing is rapid at 30 breaths per minute, and you note his skin is pale, cool, and diaphoretic. His radial pulse is absent, but you palpate a weak femoral pulse at 130 beats per minute. What is the MOST accurate interpretation of his circulatory status?

49. You respond to a nursing home for an 82-year-old female with “altered mental status.” Staff report she was “completely normal yesterday” but this morning was found unresponsive in bed. Your primary assessment reveals: she does not open her eyes to voice, but withdraws from painful stimuli; her breathing is rapid at 24 breaths per minute with adequate tidal volume; her skin is warm and dry; her radial pulse is 88 and regular. Her blood glucose is 245 mg/dL. Based on your general impression and primary assessment, what is the MOST likely explanation for her altered mental status?

50. You respond to a restaurant where a 52-year-old male has collapsed. Bystanders report he was eating dinner when he suddenly stood up, clutched his chest, and fell to the ground. When you arrive, you find him unresponsive with no respirations and no pulse. You begin CPR and apply the AED. The AED analyzes and advises “no shock advised.” You resume CPR. After 2 minutes, you reassess and find the patient has a weak carotid pulse but remains unresponsive with agonal gasps. His skin is pale and cool. What is the MOST appropriate interpretation and next action?