1. When using the AVPU scale to assess a patient’s level of consciousness, what does the “V” indicate?

2. Which of the following patients should be classified as the HIGHEST transport priority?

3. You are assessing a 72-year-old female who was found unresponsive in her bedroom by her daughter. When you speak loudly, she does not respond. When you pinch her earlobe, she pulls away and moans but does not open her eyes. How should you document her AVPU status?

4. You are dispatched to a motor vehicle collision involving three patients. Patient A is walking around the scene with a bleeding forehead laceration. Patient B is sitting on the curb holding his arm and states he has pain. Patient C is still in the vehicle, unresponsive, with labored breathing. Which patient should be your FIRST priority for assessment and treatment?

5. A 34-year-old male was involved in a motorcycle crash. He opens his eyes when you approach, but he is confused and cannot tell you where he is or what happened. He follows simple commands such as “squeeze my fingers” but keeps asking, “What happened?” repeatedly. How would you describe his mental status?

6. You respond to a residence for a 58-year-old male with difficulty breathing. Upon arrival, you find the patient sitting in a tripod position, using accessory muscles, with audible wheezing. His skin is pale and diaphoretic. He is able to speak in short phrases only. What is the PRIMARY reason this patient should be classified as high transport priority?

7. A 45-year-old female with a history of diabetes is found unresponsive in her kitchen by her husband. He states she took her insulin this morning but may have skipped breakfast. The patient does not respond when you call her name. When you apply a painful stimulus by pinching her trapezius, she extends her arms and legs and makes a groaning sound. Her blood glucose is 32 mg/dL. What does her motor response indicate?

8. You are dispatched to a single-vehicle collision on a rural highway. Upon arrival, you find a 22-year-old male driver who was ejected from the vehicle. He is approximately 30 feet from the car, unresponsive, with obvious deformity to his left thigh and an open wound on his forehead. You note the following during your primary assessment: He does not respond to verbal stimuli. When you apply a painful stimulus, he flexes his arms inward and makes no movement with his legs. His respirations are 8 breaths per minute and shallow. His radial pulse is weak and rapid at 130 bpm. His skin is pale, cool, and diaphoretic. There is a large pool of blood on the ground near his thigh. What is your PRIORITY intervention for this patient?

9. You respond to a nursing home for a 78-year-old female with altered mental status. Staff report she was found unresponsive in her room this morning. Her past medical history includes diabetes, hypertension, atrial fibrillation, and a previous stroke with right-sided weakness. During your assessment, you note the following: She does not respond to her name or loud verbal stimuli. When you apply a painful stimulus to her fingernail bed, she does not respond. Her respirations are irregular, with periods of apnea lasting 10-15 seconds. Her blood pressure is 190/110 mmHg. Her pupils are 4mm and sluggishly reactive. Blood glucose is 142 mg/dL. What does her presentation suggest, and what is your immediate concern?

10. You are first on scene at a house fire with multiple patients. A neighbor tells you three people lived in the home. You encounter the following patients: Patient A is a 35-year-old male sitting on the front lawn coughing. He has singed nasal hairs and soot around his nose and mouth, and his voice is hoarse. Patient B is a 32-year-old female lying on the ground, unresponsive, with second-degree burns covering her face, neck, and anterior chest. Her breathing is rapid and labored at 32 breaths per minute. Patient C is a 6-year-old child being held by a neighbor, crying loudly, with superficial burns on both arms. Fire department has just arrived and is suppressing the fire. Given limited initial resources, which patient should be your FIRST priority for treatment and transport?

11. When performing a primary assessment on an adult patient, which finding indicates inadequate breathing requiring immediate intervention?

12. When using the “MARCH” algorithm during primary assessment of a trauma patient, what does the “A” represent?

13. You are assessing a 68-year-old male with difficulty breathing. He is able to speak in full sentences but appears anxious. His respirations are 22 per minute with adequate chest rise. His skin is warm and dry, and his oxygen saturation is 94% on room air. What is the MOST appropriate initial intervention?

14. You respond to a two-vehicle collision. Upon arrival, you find two patients. Patient A is a 45-year-old driver of the first vehicle, ambulatory at the scene, with a small laceration on his forehead. Patient B is the driver of the second vehicle, still seated behind the wheel, holding her chest and complaining of difficulty breathing. Her skin is pale and diaphoretic. Which patient should be assessed FIRST?

15. A 52-year-old female is found unresponsive in her home. During your primary assessment, you note she has snoring respirations at 8 breaths per minute. Her chest rise is minimally visible. What is your FIRST action?

16. You are assessing a 34-year-old male who fell from a ladder. He is alert and complaining of severe right leg pain. His respirations are 18 per minute with adequate chest rise. His radial pulse is strong at 88 beats per minute. His skin is warm and pink. During your assessment, he suddenly becomes confused and his skin becomes pale and clammy. What should you do FIRST?

17. You are treating an unresponsive 24-year-old male with suspected spinal injury following a diving accident. He has gurgling respirations and you observe blood and secretions in his mouth. What is your IMMEDIATE priority?

18. You respond to a multi-patient incident at a construction site where scaffolding has collapsed. You are the first medical unit on scene. You identify three patients: Patient A is a 55-year-old male lying on the ground, unresponsive, with an obvious deformity to his left thigh and a large laceration on his forehead. His respirations are 6 per minute and shallow. Patient B is a 32-year-old male sitting against a wall, alert, holding his right arm which is bent at an abnormal angle. He is in obvious pain but speaking clearly. Patient C is a 28-year-old female walking around the scene with a bleeding scalp laceration. She is oriented and asking about her coworkers. Fire department personnel are on scene controlling hazards. Which patient should be your FIRST priority and what is your initial intervention?

19. You are caring for a 72-year-old female with a history of COPD who called for worsening shortness of breath. Her family reports she has been ill with a cold for three days. On primary assessment, you find her sitting in a tripod position, using accessory muscles to breathe. She is alert but cannot speak more than one or two words at a time. Her respirations are 32 per minute with visible intercostal retractions. Her skin is cool and diaphoretic. Breath sounds reveal diffuse wheezing in all lung fields. Her oxygen saturation is 88% on room air. What is the MOST appropriate initial management for this patient?

20. You respond to a residence for a “person not feeling well.” Upon arrival, you find a 68-year-old male lying on the couch. His wife states he complained of “indigestion” earlier and has been lying down for two hours. During your primary assessment, you note the following: He responds to verbal stimuli by opening his eyes and mumbling incomprehensible sounds. His respirations are 8 per minute and shallow with poor chest rise. His radial pulse is weak and irregular at approximately 120 beats per minute. His skin is pale, cool, and diaphoretic. His blood pressure is 82/58 mmHg. His wife tells you he has a history of “heart problems” and takes several cardiac medications. What is your PRIORITY intervention and transport decision?

21. A 56-year-old male is unresponsive with sonorous respirations. What should you do FIRST?

22. A 72-year-old female is found unresponsive. When you call her name, she does not respond. When you pinch her shoulder, her eyes open but she does not speak or follow commands. What is her AVPU status?

23. A 4-year-old child is unresponsive. You need to assess circulation. Which pulse should you check?

24. You are assessing a patient’s breathing. You count 12 breaths per minute, with adequate chest rise and bilateral breath sounds. The patient is speaking in full sentences. How would you classify this breathing?

25. You have three patients from a motor vehicle collision. Patient A has a deformed thigh and is screaming in pain. Patient B is unresponsive with sonorous respirations. Patient C is ambulatory with a laceration on the forearm. Which patient is the HIGHEST priority?

26. You approach a patient and immediately notice pale, cool, diaphoretic skin and a weak, thready pulse. What is your general impression?

27. A 34-year-old male was found unresponsive after a suspected overdose. He has gurgling respirations. What should you do?

28. A patient has a blood pressure of 80/50, heart rate of 120, and cool, pale, clammy skin. What do these findings indicate?

29. A patient has a respiratory rate of 6 breaths per minute with minimal chest rise. What should you do?

30. A patient with chest pain has a blood pressure of 90/60, is diaphoretic, and has crushing pain radiating to the left arm. What is the appropriate transport decision?

31. A patient opens his eyes when you call his name, but he is confused and cannot tell you where he is. What is his AVPU status?

32. A 45-year-old trauma patient is unresponsive. What airway maneuver should you use?

33. You are assessing a patient’s breathing. You count 28 breaths per minute with shallow chest rise. The patient appears anxious. What should you do?

34. A 68-year-old male has a weak radial pulse. What should you do to further assess his circulation?

35. Which of the following patients is the HIGHEST priority for immediate transport?

36. During your general impression of a patient, which finding would indicate a potentially critical patient?

37. You arrive at a scene where a patient is lying on the ground after a fall. What should you do FIRST?

38. An unresponsive patient has stridor. What does this indicate?

39. What is a normal capillary refill time in an adult?

40. A pediatric patient has a respiratory rate of 50 with retractions, nasal flaring, and grunting. What is the transport priority?

41. A patient complains of “the worst headache of my life.” What should you suspect?

42. A patient has snoring respirations after being found unresponsive. What is the MOST likely cause?

43. A patient has crackles (rales) heard in both lung bases. What condition does this suggest?

44. A patient has a regular radial pulse of 110 beats per minute. What is this called?

45. You have two patients. Patient A has obvious bilateral femur fractures with severe pain. Patient B is unresponsive with no obvious injuries. Who should be assessed FIRST?

46. A patient can tell you his name but does not know where he is or what day it is. How would you describe his orientation?

47. You approach a patient who is pale, diaphoretic, and clutching his chest. What is your immediate priority?

48. You find an unresponsive adult patient. You do not feel a carotid pulse. What should you do?

49. What is the correct size OPA for a patient if the distance from the corner of the mouth to the earlobe is 8 cm?

50. A patient with difficulty breathing has an SpO2 of 88% on room air. After applying oxygen via non-rebreather at 15 L/min, the SpO2 is still 91%. What should you do?