Chapter 37 Patients With Special Challenges:

maternal age diagnoses

35

You should suspect respiratory difficulty in a patient with damage to the spinal cord at or above which​ level? A. C3 to C5 B. L4 to L5 C. T10 to T12 D. T1 to T2

A. C3 to C5

Which of the following statements regarding cerebral palsy is correct? A. Conditions such as brain injury at birth, postpartum infections, and fetal hypoxia can cause cerebral palsy. B. Most cases of cerebral palsy develop within the first 10 years of life and are typically caused by meningitis. C. Approximately 25% of patients with cerebral palsy possess some varying degrees of developmental delay. D. A key clinical feature of cerebral palsy is paralysis of the respiratory muscles, which confines the patient to a ventilator.

A. Conditions such as brain injury at birth, postpartum infections, and fetal hypoxia can cause cerebral palsy.

Which of the following mnemonics is helpful when you are dealing with a tracheostomy tube obstruction? A. DOPE B. DUMBELS C. PEARRL D. PASTE

A. DOPE (Displaced, dislodged, or damaged tube; Obstructed tube [secretions, blood, mucus, vomitus]; Pneumothorax; Equipment failure [kinked tubing, ventilator malfunction, empty oxygen supply]) can help you remember the possible causes of an airway obstruction and correct the problem.

Down syndrome patients are at an increased risk for medical complications. Which of the following is NOT one of those potential complications? A. Respiratory complications B. Cardiovascular complications C. Gastrointestinal complications D. Endocrine complications

A. Respiratory complications

Of the​ following, who is the FIRST person you should rely on when obtaining the history of a patient with cognitive​ impairment? A. The patient B. The​ patient's physician C. A family member D. The​ patient's caregiver

A. The patient

The patient starts to perform a self-stimulating activity. You should: A. allow the patient to continue as long as she does not hurt herself. B. speak loudly and tell her to stop. C. restrain her. D. turn on a radio to distract her.

A. allow the patient to continue as long as she does not hurt herself.

When interacting with a developmentally disabled patient, the best approach is to: Select one: A. ask your team members to wait until you can establish a rapport with the patient. B. approach the patient as a team to reassure him or her that you are there to help. C. position yourself slightly above the patient's level to reduce his or her anxiety. D. speak primarily with the patient's family to establish the degree of disability.

A. ask your team members to wait until you can establish a rapport with the patient.

You are assessing a 440-lb man who complains of shortness of breath and lower back pain. The patient is conscious and alert, his blood pressure is 148/98 mm Hg, and his heart rate is 120 beats/min. Your MOST immediate action should be to: A. avoid placing him in a supine position if possible and administer oxygen. B. notify the receiving facility and advise them of the patient's weight and status. C. perform a secondary assessment, focusing on his respiratory system and back. D. ask a member of your team to locate the best route to move him to the ambulance. Correct Answer

A. avoid placing him in a supine position if possible and administer oxygen.

Cerebral palsy is a condition that results from damage or injury to the: A. brain. B. spinal cord. C. voluntary muscles. D. peripheral nervous system.

A. brain.

Vagal nerve stimulators may be an alternative treatment to medication for patients with: A. chronic seizure disorders. B. inherently slow heart rates. C. certain psychiatric conditions. D. chronic muscle pain and fatigue.

A. chronic seizure disorders.

Patients with autism: A. have extreme difficulty with complex tasks that require many steps. B. prefer to maintain eye contact with whomever is talking with them. C. often speak with speech patterns that alternate in tone and speed. D. use and understand nonverbal means of communicating messages.

A. have extreme difficulty with complex tasks that require many steps.

If you are having difficulty gaining the patient's trust, you should: A. look around for a favorite toy or object and ask the patient about it. B. let the parent or caregiver talk on behalf of the patient. C. transport the patient without intervention. D. obtain a signed refusal from the patient.

A. look around for a favorite toy or object and ask the patient about it.

In contrast to an automated implanted cardioverter/defibrillator, an internal cardiac pacemaker: A. regulates the patient's heart rate if it falls below a preset value. B. delivers a shock to the heart if the rate becomes exceedingly fast. C. is implanted under the skin in the left upper abdominal quadrant. D. will only activate if it detects rhythms such as ventricular fibrillation.

A. regulates the patient's heart rate if it falls below a preset value.

When enlisting the help of an interpreter who signs, it is important for you to ask the interpreter to: A. report exactly what the patient signs and not to add any commentary B. voice what he or she is signing while communicating with the patient C. document the answers to the questions that the patient has responded to D. avoid any kind of lip movement while he or she is signing with the patient

A. report exactly what the patient signs and not to add any commentary

A ventricular atrium shunt drains excess fluid from the ventricles of the brain into the: A. right atrium of the heart. B. left atrium of the heart. C. right ventricle of the heart. D. left ventricle of the heart.

A. right atrium of the heart.

A tube from the brain to the abdomen that drains excessive cerebrospinal fluid is called a: A. shunt. B. G-tube. C. CS tube. D. cerebral bypass.

A. shunt.

Airway management can be challenging in patients with Down syndrome because their: A. teeth are misaligned and they have a large tongue. B. occiput is round, which causes flexion of the neck. C. tongue is relatively small and falls back in the throat. D. mandible is large, which inhibits a mask-to-face seal.

A. teeth are misaligned and they have a large tongue.

The tip of a central venous catheter rests in the: A. vena cava. B. left atrium. C. right ventricle. D. pulmonary vein.

A. vena cava.

What does the Emergency Medical Treatment and Active Labor Act (EMTALA) dictate? All EMTs must have a basic level of training to administer aid to a patient in the field. All patients are allowed the right to treatment and/or transport. All health care facilities must provide a medical assessment and treatment, regardless of the patient's ability to pay. All health care facilities must provide a medical assessment and treatment, regardless of the patient's mental or physical limitations.

All health care facilities must provide a medical assessment and treatment, regardless of the patient's ability to pay.

Which of the following is a developmental disorder characterized by impairment of social interaction? Down syndrome Autism Cerebral palsy Spina bifida

Autism

_____________ is a developmental disorder characterized by impairment of social interaction. Autism Bipolar disorder Cerebral palsy Down syndrome

Autism

When caring for patients with cerebral palsy, it is important to remember that: A) they are unable to walk and are totally dependent upon you. B) their limbs are often underdeveloped and are prone to injury. C) hearing aids are usually ineffective for patients with hearing loss. D) most patients have the ability to walk, but have an unsteady gait.

B) their limbs are often underdeveloped and are prone to injury.

Which of these devices may be required by a patient as a result of high spinal cord​ paralysis? A. An implanted​ cardioverter-defibrillator B. A mechanical ventilator C. Dialysis D. An implanted port

B. A mechanical ventilator

Under what circumstances is a left ventricular assist device used? A. To permanently replace the function of one or both of the ventricles B. As a bridge to heart transplantation while a donor heart is being located C. To reduce ventricular pumping force in patients with aortic aneurysms D. To ensure that the ventricles contract at an adequate and consistent rate

B. As a bridge to heart transplantation while a donor heart is being located

While you are attempting to take the patient's blood pressure, another call comes across your radio. The patient covers her ears and starts to cry. What does this indicate? A. Tactile sensitivity B. Auditory sensitivity C. Poor patient management D. Abuse

B. Auditory sensitivity

Which choice should you keep in mind when interacting with a patient who has a developmental​ disability? A. Despite difficulty​ speaking, learning and intelligence generally are not affected. B. Patients with developmental disability generally retain the ability to derive meaning from body language and tone of voice. C. Communicate with the patient through his caregivers. D. Explanations of what you are doing will confuse the patient.

B. Patients with a developmental disability generally retain the ability to derive meaning from body language and tone of voice.

Which of the following statements regarding patients with developmental disabilities is correct? A. Speaking with the patient's family is the least effective way to determine how much the patient understands. B. Patients with developmental disabilities are susceptible to the same disease processes as other patients. C. A developmental disability differs from mental retardation in that it is the result of a congenital abnormality. D. Most patients with developmental disabilities have normal cognitive function, but abnormal physical features.

B. Patients with developmental disabilities are susceptible to the same disease processes as other patients.

Which of the following statements regarding patients with intellectual disabilities is correct? A. Speaking with the patient's family is the least effective way to determine how much the patient understands. B. Patients with intellectual disabilities are susceptible to the same disease processes as other patients. C. An intellectual disability differs from mental retardation in that it is the result of a congenital abnormality. D. Most patients with intellectual disabilities have normal cognitive function, but abnormal physical features.

B. Patients with intellectual disabilities are susceptible to the same disease processes as other patients.

The patient is cautious around new people. How should you proceed with your assessment? A. Start at the head. B. Start distal to proximal. C. Do not perform a patient assessment in this case. D. Take the patient's blood pressure first.

B. Start distal to proximal.

Which of the following statements is NOT true regarding patients with autism? A. They fail to use or understand nonverbal communication. B. They will talk with normal tone and speech patterns. C. They may have extreme difficulty with complex tasks that require many steps. D. They have difficulty making eye-to-eye contact.

B. They will talk with normal tone and speech patterns.

Which of the following would be the MOST practical method of communicating with a hearing-impaired patient until his or her hearing aids can be located? A. Attempting to use body language to determine the problem B. Using a piece of paper and writing utensil to ask questions C. Using a high-pitched voice while speaking directly into the ear D. Contacting dispatch and requesting a sign language interpreter

B. Using a piece of paper and writing utensil to ask questions

Spina bifida is MOST accurately defined as: A. congenital inflammation of the spinal cord, usually in the neck. B. a birth defect caused by incomplete closure of the spinal column. C. a birth defect in which the child is born without spinal vertebrae. D. chronic pressure on the brain caused by excess cerebrospinal fluid.

B. a birth defect caused by incomplete closure of the spinal column.

Spina bifida is defined as: A. congenital inflammation of the spinal cord, usually in the neck. B. a birth defect caused by incomplete closure of the spinal column. C. a birth defect in which the child is born without spinal vertebrae. D. chronic pressure on the brain caused by excess cerebrospinal fluid.

B. a birth defect caused by incomplete closure of the spinal column.

Characteristic anatomic features of Down syndrome include: A. a proportionately small tongue. B. a round head with a flat occiput. C. bulging eyes and a large face. D. long hands with wide fingers.

B. a round head with a flat occiput.

According to the Emergency Medical Treatment and Active Labor Act (EMTALA): A. all health care facilities are legally obligated to provide assessment and care only if the patient is critically ill or injured. B. all healthcare facilities must provide a medical assessment and required treatment, regardless of the patient's ability to pay. C. a healthcare facility has the right to refuse assessment and treatment to a patient, but only if his or her condition is not deemed critical. D. a patient maintains the legal right to recant his or her consent to emergency treatment, even after signing in to the emergency department.

B. all healthcare facilities must provide a medical assessment and required treatment, regardless of the patient's ability to pay.

When assessing or providing care to a patient with a developmental disability, you should: A. explain procedures while in the process of performing them. B. be observant for signs of fear or reluctance from the patient. C. move swiftly and deliberately to quickly accomplish the task. D. frequently reassure him or her that everything will be okay.

B. be observant for signs of fear or reluctance from the patient.

When assessing or providing care to a patient with an intellectual disability, you should: A. explain procedures while in the process of performing them. B. be observant for signs of fear or reluctance from the patient. C. move swiftly and deliberately to quickly accomplish the task. D. frequently reassure him or her that everything will be okay.

B. be observant for signs of fear or reluctance from the patient.

A surgical procedure that creates an opening between the intestine and the surface of the body that allows for elimination of waste products is called a(n): Select one: A. gastrostomy. B. colostomy. C. gastric stoma. D. intestinal shunt.

B. colostomy.

A 13-year-old child is on a home ventilator. The parents called because the ventilator is malfunctioning and the child has increasing respiratory distress. You should: Select one: A. place a call to the home health agency treating this patient. B. disconnect the ventilator and use a bag-mask device. C. attempt to troubleshoot the ventilator problem. D. reset the ventilator by unplugging it for 30 to 60 seconds.

B. disconnect the ventilator and use a bag-mask device.

For which of the following conditions would you MOST likely encounter a ventricular peritoneum shunt? A. heart failure B. hydrocephalus C. cerebral palsy D. subdural hematoma

B. hydrocephalus

By placing one hand on top of your head and the other hand over your abdomen, you are asking a hearing-impaired patient if he or she: A. is hurt B. is sick C. needs help D. is nauseated

B. is sick

By placing one hand on your head and the other hand over your abdomen, you are asking a hearing-impaired patient if he or she: A. is hurt. B. is sick. C. needs help. D. is nauseated.

B. is sick.

In contrast to conductive hearing loss, sensorineural hearing loss is caused by: A. barotrauma. B. nerve damage. C. earwax accumulation. D. eardrum perforation.

B. nerve damage.

Which of the following does NOT usually contribute to or cause obesity? Select one: A. genetic predisposition B. rapid metabolism C. high caloric intake D. low metabolic rate

B. rapid metabolism

Common associated conditions in patients with spina bifida include all of the following, EXCEPT: A. hydrocephalus. B. spastic limb movement. C. extreme latex allergy. D. loss of bladder control.

B. spastic limb movement.

What do vagal nerve stimulators do? Keep seizures from occurring Keep the airway clear from secretions Act as an alternative treatment to medicine Both A and C

Both A and C

Upon arrival at the home, what is the first question you should ask the parent or caregiver? A. "Could you please leave the room?" B. "Can you give me a detailed history of the patient's autism?" C. "What can you tell me about the patient's normal functional level? What makes her feel secure?" D. "Can you please head to the hospital?"

C. "What can you tell me about the patient's normal functional level? What makes her feel secure?"

A person is said to be obese when he or she is ________ over his or her ideal weight. A. 10% or more B. 20% or more C. 30% or more D. 40% or more

C. 30% or more

According to the "E" in the DOPE mnemonic, which of the following actions should you perform to troubleshoot inadequate ventilation in a patient with a tracheostomy tube? A. Look for blood or other secretions in the tube. B. Attempt to pass a suction catheter into the tube. C. Check the mechanical ventilator for malfunction. D. Listen to breath sounds to assess for a pneumothorax.

C. Check the mechanical ventilator for malfunction.

Which of the following statements regarding hearing aids is correct? A. Over time, hearing aids can restore normal hearing. B. In-the-canal hearing aids fit in the outer part of the ear. C. Hearing aids cannot restore hearing to normal levels. D. A whistling sound indicates correct hearing aid placement.

C. Hearing aids cannot restore hearing to normal levels.

Which choice is LEAST likely as a health care implication of poverty and​ homelessness? A. The homeless and impoverished do not have access to prescription medications to control chronic health conditions. B. There is a higher rate of physical abuse against the homeless and impoverished. C. Homeless patients can receive the same quality of health care by utilising the emergency department for their health needs. D. The homeless often experience delays in diagnosis of chronic medical problems.

C. Homeless patients can receive the same quality of health care by utilising the emergency department for their health needs.

When treating a patient with spina bifida, which of the following is most likely to produce anaphylaxis? A. Aspirin B. Iodine C. Latex D. Sulfa drugs

C. Latex

Which of the following statements regarding autism is correct? A. Autism affects females four times greater than males. B. The majority of patients with autism do not speak at all. C. Most cases of autism are diagnosed by 3 years of age. D. Impairment of motor activity is a classic sign of autism.

C. Most cases of autism are diagnosed by 3 years of age.

Of these​ problems, which is second only to smoking as a cause of preventable​ death? A. Diabetes B. Trauma C. Obesity D. Heart disease

C. Obesity

Which of the following conditions would MOST likely cause a patient to slur words, speak very slowly, or speak in a monotone? A. advanced age B. cerebral palsy C. Parkinson disease D. visual impairment

C. Parkinson disease

Which of the following statements regarding gastrostomy (gastric) tubes is correct? A. Gastrostomy tubes are placed directly into the small intestine. B. Most gastrostomy tubes are temporary and are not sutured in place. C. Patients with a gastrostomy tube may still be at risk for aspiration. D. Gastrostomy tubes are used for patients who cannot digest food.

C. Patients with a gastrostomy tube may still be at risk for aspiration.

Which of the following statements is NOT true regarding the care of a patient with cerebral palsy? A. Do not assume these patients are mentally disabled. B. Limbs are often underdeveloped and are prone to injury. C. Walkers or wheelchairs should not be taken in the ambulance. D. Be prepared to care for a seizure if one occurs.

C. Walkers or wheelchairs should not be taken in the ambulance.

What is the best position in which to transport an obese patient? A. Supine B. Prone C. With the head elevated D. With the feet elevated

C. With the head elevated Large patients will often have difficulty breathing in a supine position. When safe and appropriate to do so, elevate the head of the stretcher when transporting patients with obesity.

EMTs are dispatched for a fall. The patient, a 16-year-old female with Down syndrome, is experiencing difficulty walking and says that her fingers "feel like needles." The EMTs should suspect: A. a seizure. B. an intracranial haemorrhage. C. a cervical spine injury. D. hydrocephalus.

C. a cervical spine injury.

Down syndrome is a genetic defect that occurs as the result of: A. an extra pair of chromosomes. B. a separation of chromosome 21. C. a triplication of chromosome 21. D. a sperm that contains 24 chromosomes.

C. a triplication of chromosome 21.

When asking the patient questions, you should: A. ask her open-ended questions. B. ask her multiple questions in a row. C. ask her simple, direct questions. D. direct all questions to the parent or caregiver

C. ask her simple, direct questions.

If suctioning of the tracheostomy tube is necessary, the EMT should: A. attach a bag-mask device to the tracheostomy tube and hyperventilate the patient for 2 minutes. B. instill 20 mL of saline into the tracheostomy tube and suction for no longer than 20 seconds. C. attempt to use the patient's suction device first because it is probably already sized correctly. D. insert the suction catheter to a depth of no more than 15-cm and set the suction unit to 140 mm Hg.

C. attempt to use the patient's suction device first because it is probably already sized correctly.

Cerebral palsy is characterized by poorly controlled ________ movement. A. eye B. neck C. body D. extremity

C. body

Because hearing-impaired patients typically have more difficulty hearing high-frequency sounds, it is important for you to: A. try basic sign language first. B. speak in a monotone voice. C. lower the pitch of your voice. D. increase the pitch of your voice.

C. lower the pitch of your voice.

General techniques for communicating with hearing-impaired patients include: Select one: A. exaggerating your lip movements to ensure the patient understands. B. removing any hearing aids and using pen and paper to ask questions. C. positioning yourself approximately 18" directly in front of the patient. D. speaking directly into the patient's ear with an increased voice pitch.

C. positioning yourself approximately 18" directly in front of the patient.

The purpose of a ventricular peritoneum shunt is to: Select one: A. remove fluid from the abdomen of patients with right heart failure. B. monitor pressure within the skull in patients with a head injury. C. prevent excess cerebrospinal fluid from accumulating in the brain. D. divert excess cerebrospinal fluid to the ventricles of the brain.

C. prevent excess cerebrospinal fluid from accumulating in the brain.

Because a tracheostomy tube bypasses the nose and mouth: Select one: A. the risk of a local infection is significantly high. B. bleeding or air leakage may occur around the tube. C. secretions can build up in and around the tube. D. severe swelling of the trachea and bronchi can occur.

C. secretions can build up in and around the tube.

A 70-year-old male complains of shortness of breath. During your assessment, you note that he has bilateral hearing aids. When you ask him questions related to his chief complaint, he does not answer you. You can hear a whistling sound coming from his hearing aids. You should: A. recognise that the batteries in his hearing aids are probably depleted. B. remove his hearing aids, turn up the volume, and replace them in his ears. C. try repositioning the hearing aid or remove it and turn down the volume. D. remove both of his hearing aids and use pencil and paper to communicate.

C. try repositioning the hearing aid or remove it and turn down the volume.

When caring for a patient with a previous head injury, you should: A. speak in a loud, commanding tone. B. expect the patient to be able to walk. C. watch the patient for signs of anxiety. D. never consider restraining the patient.

C. watch the patient for signs of anxiety.

What does the DOPE mnemonic help you to recognize? Causes of airway obstruction Risk factors for patients using technology assistance Questions to ask patients with pacemakers A vagal nerve stimulator

Causes of airway obstruction

What improves a patient's quality of life shortly before death? Home care Hospice care Comfort care Health care

Comfort care

As a general​ rule, what action should you take when you encounter medical technology you are NOT familiar with when caring for a​ patient? A. Turn off the equipment in preparation for transport. B. Take the equipment with the patient. C. Disable any alarms on the equipment in preparation for transport. D. Ask the patient and caregivers about the device.

D. Ask the patient and caregivers about the device.

Which of the following statements regarding interaction with the caregiver of a child or adult with special health care needs is correct? A. In most cases, it is more appropriate for the EMT to contact medical control prior to speaking with the patient's primary caregiver. B. Before performing an assessment of the patient's ABCs, the EMT should ask the caregiver about the patient's medical condition. C. In general, the EMT should only speak with a certified home health care provider because he or she is the expert on the patient's illness. D. Communication with the patient's caregiver or family members is important because they are the most familiar with the patient's condition.

D. Communication with the patient's caregiver or family members is important because they are the most familiar with the patient's condition.

Which of these conditions is NOT common amongst hospice patients? A. AIDS B. Cancer C. Cystic fibrosis D. Crohn's disease

D. Crohn's disease

Which of the following conditions would MOST likely be encountered in a patient with cerebral palsy? A. Paralysis B. Brain tumors C. Type 2 diabetes D. Seizure disorder

D. Seizure disorder

Which of the following is the LEAST likely reason why impoverished patients are at an increased risk of medical​ conditions? A. Poor nutrition and environmental extremes increase the likelihood of illness. B. The poor often must choose between receiving health care and buying food. C. Lack of access to preventative health services. D. The poor often choose to spend money on alcohol and drugs instead of medical care.

D. The poor often choose to spend money on alcohol and drugs instead of medical care.

When responding to a report of a patient with difficulty​ breathing, you find a man in his 60s in a hospital bed in his home. There is a​ small, round tube that exits from a​ patient's neck, through which he is breathing. Which of these devices does the patient MOST likely​ have? A. Airway catheter B. Dual lumen catheter C. Endotracheal tube D. Tracheostomy tube

D. Tracheostomy tube

Which of the following statements does BEST describe morbid obesity? A. Being unable to bear your own body weight. B. Weighing over 300 lb. C. Weighing 25 per cent than a person's ideal weight. D. Weighing 100 lb. more than a​ person's ideal weight.

D. Weighing 100 lb. more than a​ person's ideal weight.

A significant number of patients with cerebral palsy also have: A. paralysis. B. brain tumors. C. type 2 diabetes. D. a seizure disorder.

D. a seizure disorder.

Two thirds of children born with Down syndrome have: A. diabetes mellitus. B. intracranial bleeding. C. unilateral paralysis. D. congenital heart disease.

D. congenital heart disease.

When caring for a morbidly obese patient, you should: A. leave him or her in a supine position, as this often facilitates breathing. B. ask the patient if he or she knows what led to his or her obesity problem. C. call for ALS backup because obese patients are at high risk for heart attack. D. establish his or her chief complaint and then communicate your plan to help.

D. establish his or her chief complaint and then communicate your plan to help.

A service dog is easily identified by its: A. size. B. breed. C. color. D. harness.

D. harness.

EMS personnel would MOST likely be called to the residence of a patient receiving home health care when the home care provider: Select one: A. has a question that is specific to the patient's condition. B. needs simple assistance in providing patient care. C. must confirm that a specific intervention is required. D. has recognised a change in the patient's health status.

D. has recognised a change in the patient's health status.

You respond to a residence for a 9-year-old female with Down syndrome who is sick. When you arrive at the scene and assess the patient, you determine that she is unresponsive and has gurgling respirations. You should: A. insert an oropharyngeal airway and begin assisting her ventilations with a bag-mask device B. open her airway with the jaw-thrust maneuver and assess the rate and depth of her breathing C. immediately apply high-flow oxygen via a nonrebreathing mask and then assess her pulse rate D. open her airway with a manual manoeuvre, suction her oropharynx, and insert a simple airway adjunct

D. open her airway with a manual manoeuvre, suction her oropharynx, and insert a simple airway adjunct

Autism is MOST accurately defined as a: A. psychiatric condition related to an imbalance of serotonin in the brain. B. mental disability caused by insufficient cognitive development of the brain. C. congenital condition caused by factors such as malnutrition or birth complications. D. pervasive developmental disorder characterized by impairment of social interaction.

D. pervasive developmental disorder characterized by impairment of social interaction.

General care for a patient with a tracheostomy tube includes all of the following, EXCEPT: Select one: A. ensuring adequate oxygenation and ventilation at all times. B. maintaining the patient in a position of comfort when possible. C. suctioning the tube as needed to clear a thick mucous plug. D. removing the tube if the area around it appears to be infected.

D. removing the tube if the area around it appears to be infected.

Common complications associated with central venous catheters include all of the following, EXCEPT: A. a local infection. B. clotting of the line. C. bleeding around the line. D. rupture of a central vein.

D. rupture of a central vein.

An important aspect in the assessment of a patient who experienced a previous brain injury involves: A. presuming that he or she has cognitive impairment until proven otherwise. B. contacting the patient's physician to determine the extent of the brain injury. C. recalling that most patients with a brain injury have other organ dysfunction. D. speaking with the patient and family to establish what is considered normal for the patient.

D. speaking with the patient and family to establish what is considered normal for the patient.

When caring for a patient who is visually impaired, it is important to: Select one: A. leave items such as canes and walkers at the residence if the patient will be carried on a gurney. B. allow a service dog to remain with the patient at all times, even if the patient is critically ill. C. stand to the side of the patient when speaking if his or her peripheral vision is impaired. D. tell him or her what is happening, identify noises, and describe the situation and surroundings.

D. tell him or her what is happening, identify noises, and describe the situation and surroundings.

You receive a call to a residence for an apneic 2-month-old male. When you arrive at the scene, the infant's mother tells you that her son was born prematurely and that his apnea monitor has alarmed 4 times in the past 30 minutes. Your assessment of the infant reveals that he is conscious and active. His skin is pink and dry, and he is breathing at an adequate rate and with adequate tidal depth. His oxygen saturation reads 98% on room air. You should: A. request an ALS ambulance to transport the infant to the hospital. B. advise the mother to observe her son and call 9-1-1 again if necessary. C. administer high-flow oxygen and observe for a drop in oxygen saturation. D. transport the infant to the hospital and bring the apnea monitor with you.

D. transport the infant to the hospital and bring the apnea monitor with you.

You are at the home of an elderly man who has a tracheostomy tube and is on mechanical ventilation. His ventilator has malfunctioned. Once you disconnect the ventilator, what should you do? Deliver 100% oxygen through a nonrebreathing mask. Use a nasal cannula to deliver oxygen. Deliver oxygen using a face mask over the stoma. Transport the patient to a critical care facility immediately.

Deliver oxygen using a face mask over the stoma.

Which of the following is the best source of information when you are dealing with an autistic patient? The patient Family members/caregivers The attending doctor Medical control

Family members/caregivers

What device is placed directly into the stomach to feed patients? Colostomy Ileostomy Gastrostomy tube Central venous catheter

Gastrostomy tube

Which of the following may be difficult to perform on a patient with Down syndrome? CPR Pulse oximetry Splinting Intubation

Intubation

When you are treating a patient with spina bifida, which of the following is most likely to produce anaphylaxis? Aspirin Iodine Latex Sulfa drugs

Latex

Which of the following techniques should you use when you are communicating with a patient who has autism? Exaggerate your lip movements. Speak normally and provide simple, one-step directions. Speak loudly into the patient's ear. You and your partner should talk to the patient together.

Speak normally and provide simple, one-step directions.

What does the TEAM acronym stand for? Trust Every Available Member Take Evasive Action Monitoring Treat, Evaluate, Administer, Monitor Test Extension and Abduction Motion

Trust Every Available Member

A patient with epilepsy is likely to have which of the following medical devices? Central venous catheter LVAD Shunt Vagus nerve stimulator

Vagus nerve stimulator

What is the best way to transport an obese patient? Supine Prone With the head elevated With the feet elevated

With the head elevated

Patients with Down syndrome often have

a large tongue and small oral and nasal cavities.

The Emergency Medical Treatment and Active Labor Act (EMTALA) states that: patients should only be treated if they can pay for care. all patients must be treated regardless of their ability to pay for care. only those with serious injuries can be treated without payment for care. only certain facilities can treat patients who cannot pay for care.

all patients must be treated regardless of their ability to pay for care.

EMTs are dispatched for a patient whose central venous catheter is malfunctioning. When they arrive and assess the patient, they find bleeding from the tubing attached to the line. The EMTs should:

apply direct pressure to the tubing and transport.

The "reverse stethoscope" technique is used to

assist you when communicating with a patient who has a hearing loss.

Gastrostomy Tube

eating tube

Conductive hearing loss is caused by

faulty transmission of sound waves.

Known risk factors for Down syndrome include: smoking. traumatic brain injury at birth. increased maternal age. lack of vitamin B.

increased maternal age.

An important part of the assessment process for a patient with special needs is to: interact with the caregiver. interact with the patient. talk to the manufacturer of the equipment being used. transport immediately.

interact with the caregiver.

EMTs are dispatched for a patient in cardiac arrest. When they arrive, they find that the patient is pulseless and apneic and is wearing an external defibrillator vest. In this situation, the EMTs should:

perform CPR and leave the vest in place.

Nerve damage to the inner ear results in: conductive hearing loss. sensorineural deafness. tinnitus. otitis media.

sensorineural deafness.