Which of the following is typically NOT included when forming a general impression?

• A. Pulse strength
• B. Breathing pattern
• C. Apparent distress
• D. Position

Answer: (A)

The first impression relies on what you can observe in seconds: how the patient looks, whether they’re awake and responsive, their breathing pattern, and their overall posture or position. These cues reveal immediate status and urgency without needing to touch the patient.

Pulse strength, on the other hand, requires palpating the pulse to judge circulation, which is a task done during the circulation assessment rather than the general impression. So while breathing pattern, apparent distress, and position inform the initial, quick assessment, pulse quality is assessed later as you check vital signs and perform the primary survey.