10 free EMT practice questions: Reassessment & Trending

The patient is stable; these are normal variations within acceptable vital sign ranges: Incorrect. These changes are not random variation; the pattern of multiple findings changing together indicates a significant physiologic change.

The patient is improving, as evidenced by the decrease in blood pressure: Incorrect. A slightly lower blood pressure in isolation might suggest improvement, but must be interpreted with all other findings. Rising heart rate and respiratory rate with pale, cool skin indicate the body is compensating, not improving.

The vital signs are within normal limits, so no change in transport priority is needed: Incorrect. While individual values may be within a normal range, the trending pattern together indicates deterioration and instability.

The patient's condition is worsening despite oxygen therapy: Incorrect. All trending parameters show improvement, not deterioration.

The patient is improving and transport can be safely delayed: Incorrect. Patients with respiratory distress require evaluation at the hospital regardless of initial response to therapy; improvement during transport does not eliminate the need for medical evaluation.

The initial vital signs were unreliable and should be disregarded: Incorrect. The initial assessment was accurate. Reassessment trending is clinically meaningful and demonstrates the effect of the EMT's treatment.

Apply firm pressure over the abdomen to relieve the distention: This is the misconception that the stomach air should be pushed back out. Manual decompression of the abdomen is a last-resort measure only, because it invites vomiting and aspiration in an unresponsive patient with an unprotected airway. The instruction is to continue slow ventilation without attempting to expel stomach contents.

Increase the rate to 1 breath every 3 seconds: This is the misconception that a falling oxygen saturation during ventilation means the patient needs more breaths. The rate is already correct for an adult, and the finding is inadequate volume per breath, not too few breaths. Ventilating faster is one of the two ways gastric distention is created, so this makes the distention and the poor chest rise worse.

Squeeze the bag more forcefully with each ventilation: This is the misconception that poor chest rise is solved by squeezing harder. Forceful ventilation is the other recognized cause of gastric distention; the standard is a slow, gentle breath delivered over 1 second, just enough to produce visible chest rise. Adding force pushes more air into the stomach and further limits diaphragm movement.

An anxiety reaction, because the respiratory rate has not changed: This is the misconception that restlessness in a young trauma patient is emotional. Anxiety does not produce pale, cool skin or a pulse that climbs from 92/min to 124/min across ten minutes, and restlessness is itself one of the earliest listed findings of compensated shock rather than an argument against it.

Rising intracranial pressure, because the pulse pressure is widening: This is the inversion a well-prepared student makes: the two directions of pulse pressure change get swapped. A widening pulse pressure belongs to rising intracranial pressure, and this patient's pulse pressure is going the other way, from 52 to 24. Rising intracranial pressure also drives the pulse down rather than up, and the question states there is no head injury.

Stable perfusion, because the systolic pressure has held: This is the misconception that a systolic pressure inside the normal range means perfusion is holding. Blood pressure is often the last measurable value to change in shock, and it is being maintained here by the same vasoconstriction that is raising the diastolic pressure, narrowing the pulse pressure, and making the skin pale and cool.

The patient has settled into ordinary sleep after the reversal: This is the misconception that drowsiness after a reversal is simply the patient resting. Ordinary sleep does not come with a respiratory rate of 6/min, shallow chest movement, an oxygen saturation of 84% on high-flow oxygen, and pupils that have returned to pinpoint. Those findings describe returning respiratory depression, not sleep.

The high-flow oxygen has suppressed the respiratory drive: This is the hypoxic-drive misconception, applied to a patient it was never about. The idea belongs to a small subset of patients with long-standing chronic lung disease, and the question states there is no such history. It also fails on the numbers, because a patient whose oxygen saturation is 84% on high-flow oxygen is not receiving too much oxygen.

An unrecognized head injury from the collapse is now progressing: This is the misconception that a second declining level of consciousness must mean a new structural problem. A progressing head injury would be expected to raise the blood pressure and would not restore pinpoint pupils, and the question states the secondary assessment found no signs of injury. Naming a new diagnosis here would delay recognition of the reversible cause already in front of the EMT.

Begin positive pressure ventilations for the falling reading: This is the misconception that a number on a monitor is by itself an indication to escalate ventilatory support. Positive pressure ventilation is indicated for inadequate breathing, and the question describes unlabored breathing with good chest rise at 22/min in a patient who is answering questions. Escalating on an unreliable reading also displaces attention from the shock that is actually driving the picture.

Record 79% as the oxygen saturation and continue transport: This is the misconception that whatever the device displays is a measurement. A reading that flickers and repeatedly drops signal has not measured anything, and entering it as the oxygen saturation puts a false value into the very trend the reassessment is being performed to build.

Replace the pulse oximeter with a different device before rechecking: This is the misconception that a device producing a bad reading must be a bad device. The limitation here belongs to the patient, not the equipment: the sensor needs a pulsating capillary bed, and vasoconstriction and low perfusion in shock remove it. A second device applied to the same cold fingertip behaves the same way, and swapping equipment costs time.

Improving, because the pulse rate has increased: This reaches the right conclusion for the wrong reason, which is the trap the paired options are built to expose. The rise from 104/min to 126/min is an expected effect of an inhaled beta-agonist, which can increase heart rate and cause palpitations. It is a side effect to note and monitor, not evidence that the treatment is working.

Worsening, because the pulse rate has increased: This is the misconception that a rising pulse always means a deteriorating patient. Read against the rest of the reassessment, which shows full sentences, no accessory muscle use, full chest rise, and a saturation that has risen from 89% to 96%, a pulse that climbed shortly after a bronchodilator was given is the medication, not decompensation.

Worsening, because the respiratory rate has decreased: This is the misconception created by drilling the opposite pattern: a falling respiratory rate in a tiring patient is ominous. That reading depends on the effort falling too, with shallower chest rise and a declining mental status. Here the chest rise is full and the speech has improved from three words to full sentences, so the slower rate reflects less air hunger rather than exhaustion.

Perform one final reassessment and then discontinue further reassessment: Reassessment continues throughout care until the patient is handed off; it is never discontinued in a deteriorating patient.

Continue reassessing every 15 minutes as originally planned: The reassessment interval is set by current patient status, not by the original plan. Once the patient becomes unstable, the interval must shorten to every 5 minutes; staying at 15 minutes would miss important trends.

Stop rechecking vital signs because the patient is deteriorating: Deterioration is exactly when vital signs and mental status must be tracked more closely, not stopped. Ongoing rechecks guide care and transport decisions.

Every 5 minutes during transport: Incorrect. Every 5 minutes is the interval for unstable or critical patients, not a stable one.

Once, at the start of transport: Incorrect. Reassessment is ongoing throughout transport regardless of stability, not a single check at the start.

Only when a new symptom is reported: Incorrect. Reassessment is proactive on a set interval; waiting for the patient to report a change misses findings the patient may not notice, such as a slowly dropping blood pressure.

Reassess vital signs every 15 minutes: You'd pick this if a patient with addressed life threats sounded fully stable. He had life threats that needed treating, which still counts as potentially unstable, so the 15-minute interval is for a patient who was stable from the start, not this one.

Wait until arrival at the hospital to reassess vital signs: You'd pick this if addressing the threats made further checks feel unnecessary. Waiting until arrival misses any trend showing his condition is changing during a 20-minute transport.

Reassess vital signs only if the patient reports new symptoms: You'd pick this if you were relying on him to flag a problem. He can be decompensating before he notices or reports anything, so reassessment can't depend on him speaking up first.