Secondary Assessment

When you take a SAMPLE history, what does the E prompt you to ask about?

You ask a 57-year-old man with chest pain, "Does the pain go anywhere else, like your arm, jaw or back?" Which part of OPQRST does this cover?

A 7-year-old boy fell from a swing and hurt his forearm. He is alert and talking. What is the best way to assess the severity of his pain?

The mother of an 8-month-old girl says the baby has been vomiting since last night. Which question best helps you judge whether the baby is becoming dehydrated?

A 15-year-old girl has lower abdominal pain. Her mother stays at her side. You need to ask about her menstrual history and sexual activity. What is the best approach?

An 82-year-old man is confused and cannot name his medications. His kitchen counter has several prescription bottles. What should you do with this information?

A 67-year-old man in severe respiratory distress can speak only 2 to 3 words at a time. How should you obtain his history?

A 64-year-old woman is short of breath. Which of her answers belongs under the P (pertinent past history) in SAMPLE?

A 46-year-old woman tells you she is allergic to penicillin. Which follow-up question adds the most useful information?

A coworker saw a 49-year-old man collapse in a warehouse. The patient is now awake and confused. Which question to the coworker is most useful for the history?

You ask a 41-year-old woman with a headache, "How long have you had this headache?" Which part of OPQRST does this question cover?

A 30-year-old man smells strongly of alcohol after falling down stairs. He insists he did not hit his head, but you find a swelling on his scalp. How should you treat his history?

A 59-year-old woman says she takes "no medications." Which follow-up question is most useful?

A 45-year-old woman who is deaf and reads lips has twisted her ankle. How should you communicate while taking her history?

While gently feeling a 33-year-old man's deformed thigh after a motorcycle crash, you feel a grating sensation. What is this finding, and what does it suggest?

A 9-month-old boy has had diarrhea for 2 days. During your exam you notice the soft spot on top of his head is sunken. What does this finding suggest?

A 3-year-old girl has had vomiting and fever. Her hands and feet are cool, and capillary refill takes 4 seconds. What does this finding suggest?

During a rapid trauma exam of a 40-year-old man injured in a crash, which findings are you specifically looking for when you examine his neck?

After a fall, a 37-year-old woman has clear fluid draining from her right ear. What should you do about the drainage?

An unresponsive 50-year-old man has a head injury. His right pupil is dilated and does not react to light, while the left is normal. What does this finding most likely mean?

A 45-year-old woman's abdomen is rigid and tender in all four quadrants after a car crash. What should you do with this finding?

A 12-year-old boy fell on his outstretched hand, and his right wrist looks slightly swollen. What is the best way to judge whether it is swollen or deformed?

A 68-year-old man with a history of lung disease is short of breath. Which focused exam best fits his complaint?

A 58-year-old man was alert and oriented after a fall. On reassessment 10 minutes later he is confused and keeps asking the same questions. What is the best action?

A 22-year-old man has neck pain after diving into shallow water. He is alert. How should you check motor function and sensation?