Chapter 4-6
Before asking a patient to sign a refusal form, the paramedic must: A. ensure the patient is aware of the risks of his or her refusal. B. tell the patient that he or she will die without treatment. C. ask a police officer to determine if the patient is competent. D. ask an impartial observer to sign the refusal form first.
A. ensure the patient is aware of the risks of his or her refusal.
Which of the following scenarios MOST accurately depicts abandonment? A. A patient with a possible fracture of the radius wishes to go to the hospital, but does not have transportation, so you arrange for a friend to take him to the emergency department the next day. B. While en route to the hospital with a patient experiencing chest pressure, you encounter a major motor vehicle accident, call the dispatcher to request assistance, and proceed to the hospital with your patient. C. During a mass-casualty incident involving a building collapse, a paramedic triages a patient as being low priority and instructs an EMT to observe the patient and inform the paramedic if the patient's condition deteriorates. D. A mentally competent adult with shortness of breath adamantly refuses to be transported to the hospital via EMS, so you arrange for a friend or family member to stay with the patient and call 9-1-1 if it becomes necessary.
A. A patient with a possible fracture of the radius wishes to go to the hospital, but does not have transportation, so you arrange for a friend to take him to the emergency department the next day.
Which of the following constitutes minimum data that must be included on every patient care report? A. Chief complaint, level of consciousness, vital signs, assessment, and patient's age and gender B. Level of consciousness, field impression, vital signs, assessment, and patient's name and address C. Scene size-up, detailed assessment, blood glucose reading, vital signs, and patient's age D. Chief complaint, vital signs, assessment, tentative field diagnosis, and patient's ethnic background
A. Chief complaint, level of consciousness, vital signs, assessment, and patient's age and gender
Which of the following statements regarding revisions or corrections to a patient care report is correct? A. Only the person who wrote the original report can revise or correct it. B. A patient care report cannot be revised or corrected after submission. C. The original patient care report should be destroyed if a revision is necessary. D. If a report needs revision, the revision must be made within 12 hours.
A. Only the person who wrote the original report can revise or correct it.
A 39-year-old man with severe dehydration requires IV fluid therapy to treat his condition. The patient is conscious, alert, and oriented to person, place, time, and event. You should: A. ask him if you can start an IV and explain the reason for the IV as well as the potential risks of IV therapy. B. start the IV to quickly restore his body fluid balance and then explain to the patient why you started the IV line. C. establish the IV line based on the law of implied consent, because his condition has impaired his decision-making capacity. D. tell the patient that you are going to start an IV on him in order to replenish his body with lost fluid and electrolytes.
A. ask him if you can start an IV and explain the reason for the IV as well as the potential risks of IV therapy.
Data collected from the state EMS office for the purpose of research would likely NOT include: A. average cost per call. B. the nature of all calls. C. call volume per month. D. patient outcomes.
A. average cost per call.
Ethics related to the practice and delivery of health care is called: A. bioethics. B. applied ethics. C. medical morality. D. valued ethics.
A. bioethics.
Current bioethical guidelines regarding the decision not to initiate resuscitation efforts rely mainly on the use of: A. common sense and reasonable judgment. B. flexible algorithms and protocols. C. the personal beliefs of the paramedic. D. criteria established by the local coroner.
A. common sense and reasonable judgment.
The purpose of a closed-ended question is to: A. elicit a specific response from the patient. B. obtain reliable information about a patient's complaint. C. allow the patient to describe what he or she is feeling. D. enable the paramedic to gauge the patient's mentation.
A. elicit a specific response from the patient.
Informed consent involves: A. ensuring that a patient understands the potential risks involved in performing a particular procedure. B. carefully explaining the potential ramifications of refusing emergency medical treatment. C. a patient verbally expressing his or her wishes for you to proceed with emergency medical treatment. D. explaining the rationale for an invasive procedure to a patient after you have already performed it.
A. ensuring that a patient understands the potential risks involved in performing a particular procedure.
A patient who rolls up his or her sleeve so that you can take his or her blood pressure has given you __________ consent. A. expressed B. rational C. informed D. implied
A. expressed
If a conscious patient with decision-making capacity refuses care for a potentially life-threatening condition: A. he or she cannot be treated without a court order. B. you must begin lifesaving treatment at once. C. medical direction can overrule the patient's decision. D. implied consent will allow you to treat the patient.
A. he or she cannot be treated without a court order.
HIPAA mandates that: A. patient information shall not be shared with entities or persons not involved in the care of the patient. B. a patient's personal information must be shared with the patient's immediate family members. C. patient information can only be shared with the receiving physician in the emergency department. D. a penalty will be imposed for any release of any portion of a patient's personal information to any entity.
A. patient information shall not be shared with entities or persons not involved in the care of the patient.
The BEST legal protection for the paramedic is to: A. provide a detailed patient assessment and appropriate medical care, followed by complete and accurate documentation. B. routinely obtain more than the minimum number of continuing education credits required by the state department of health. C. always transport the patient to the hospital of the patient's choice, regardless of the patient's clinical condition. D. treat all patients with respect and remain aware that patients' cultural beliefs may differ from those of the paramedic.
A. provide a detailed patient assessment and appropriate medical care, followed by complete and accurate documentation.
While en route to the scene of a patient in cardiac arrest, the driver of the vehicle in front of you does not hear your siren or see your lights. You should: A. remain at a safe distance behind the vehicle and then pass the vehicle on the left side when it is safe to do so. B. quickly merge to the right, pass the vehicle, and then obtain the vehicle's license plate number. C. get as close to the rear of the vehicle as possible, change the tone of your siren, and flash your headlights. D. turn your siren off and ask the driver of the vehicle to pull over using the public address radio.
A. remain at a safe distance behind the vehicle and then pass the vehicle on the left side when it is safe to do so.
Health care powers of attorney are also called "durable" powers of attorney because they: A. remain in effect once a patient loses decision-making capacity. B. can only be revoked by the patient's personal physician. C. must be in the patient's possession at all times. D. do not require anyone to make decisions on the patient's behalf.
A. remain in effect once a patient loses decision-making capacity.
If your response to a call for a traumatic injury is canceled, you should document: A. the agency or person who canceled the response. B. that the patient refused medical treatment. C. that the patient likely was not seriously injured. D. how the patient will get to a medical facility.
A. the agency or person who canceled the response.
When touching a patient as a form of reassurance, the paramedic should: A. touch the patient on a neutral part of his or her body. B. remember that most patients take offense to being touched. C. not touch the patient if he or she leans toward the paramedic. D. touch the patient in the center of the chest or on the thigh.
A. touch the patient on a neutral part of his or her body.
Components of a thorough patient refusal document include: A. willingness of EMS to return to the scene if the patient changes his or her mind. B. documentation of a complete assessment, even if the patient refused assessment. C. notification of the patient's physician to apprise him or her of the situation. D. assurance by the paramedic that the patient's ability to pay is of no concern.
A. willingness of EMS to return to the scene if the patient changes his or her mind.
A Medical Order for Life-Sustaining Treatment (MOLST) would MOST likely apply to a patient: A. with impending pulmonary failure but who is not in cardiac arrest. B. who has been in cardiac arrest for less than 10 minutes. C. with a terminal illness whose cardiac arrest was witnessed. D. who is in respiratory failure but has decision-making capacity.
A. with impending pulmonary failure but who is not in cardiac arrest.
Implied consent is based on the premise that a patient: A. would consent to care because of the seriousness of his or her injury. B. will die unless emergency medical treatment is provided immediately. C. is of legal age and is able to make rational decisions regarding his or her care. D. would refuse any emergency medical care if he or she were unconscious.
A. would consent to care because of the seriousness of his or her injury.
An advance directive is MOST accurately defined as a: A. written document that expresses the wants, needs, and desires of a patient in reference to his or her future medical care. B. legal document that describes which life-sustaining procedures are to be performed if the patient's condition acutely deteriorates. C. general guideline provided to the paramedic by the medical director that stipulates the level of care provided to terminally ill patients. D. notarized document that is executed by a terminally ill patient's family when the patient develops cardiopulmonary arrest.
A. written document that expresses the wants, needs, and desires of a patient in reference to his or her future medical care.
The first rule of medical practice is to: A. provide medical care. B. do no harm. C. recognize critically ill patients. D. maintain a sympathetic attitude.
B. do no harm.
Which of the following statements includes a pertinent negative? A. "The possible smell of ETOH was noted on the patient." B. "The patient complains of nausea but denies vomiting." C. "The rapid head-to-toe exam revealed abrasions to the chest." D. "The patient rates his pain as an 8 on a scale of 0 to 10."
B. "The patient complains of nausea but denies vomiting."
Which of the following statements would be inappropriate when documenting your care of a patient with an emotional problem? A. "The possible smell of ETOH was noted at the scene." B. "The patient's actions suggest the use of illicit drugs." C. "The patient was uncooperative during the exam." D. "There was no evidence of suicidal behavior."
B. "The patient's actions suggest the use of illicit drugs."
While caring for a critically injured patient at the scene of a motor vehicle crash, an emergency physician bystander stops at the scene to assist. Which of the following procedures performed by the physician would require the physician to accompany the patient to the hospital in the ambulance? A. Orotracheal intubation B. A pericardiocentesis C. Intraosseous cannulation D. ECG interpretation
B. A pericardiocentesis
The wrongful act that gives rise to a civil suit is called: A. liability. B. a tort. C. negligence. D. damage.
B. a tort.
Abandonment occurs when: A. a patient is released and did not require further medical care. B. care of a patient was terminated without his or her consent. C. an emergency nurse takes a verbal report from a paramedic. D. a patient refuses care and subsequently dies of his condition.
B. care of a patient was terminated without his or her consent.
Generally, the paramedic is not at liberty to disregard a physician's order unless: A. it is documented why the order was not carried out. B. carrying out the order will cause harm to the patient. C. the physician is not a licensed emergency physician. D. the physician is not the paramedic's medical director.
B. carrying out the order will cause harm to the patient.
The FIRST principle of communicating by radio is: A. accuracy. B. clarity. C. calmness. D. thoroughness.
B. clarity.
While off duty and outside of your jurisdiction, you encounter a motor vehicle crash. You can see one patient lying motionless on the ground near her overturned vehicle. As an off-duty paramedic, you: A. have a legal responsibility to stop and render aid. B. may feel an ethical obligation to stop and assist. C. should stop if you have an EMS decal on your car. D. should call 9-1-1 but not stop to provide care.
B. may feel an ethical obligation to stop and assist.
If you must deviate from your protocols because of unusual circumstances, you should FIRST: A. document the event. B. notify medical control. C. apprise the receiving hospital. D. advise the patient.
B. notify medical control.
A paramedic who was trained and certified to perform a surgical cricothyrotomy successfully performs the procedure on a patient in the field. However, because the EMS system's medical director does not permit paramedics to perform a needle cricothyrotomy, the paramedic: A. will likely be sued by the medical director. B. performed outside his or her scope of practice. C. did not follow the national standard of care. D. has committed an act of gross negligence.
B. performed outside his or her scope of practice.
If a patient mentions something in passing or avoids answering a specific question, you should: A. defer the question and continue with your interview. B. politely redirect his or her attention to that question. C. ask the patient why he or she did not provide an answer. D. assume that he or she is intentionally hiding something.
B. politely redirect his or her attention to that question.
According to HIPAA, it is acceptable and permissible for hospitals to: A. release patient information to the public health department, regardless of the patient's medical condition. B. share information with the EMS providers about patient outcome for purposes of quality assurance and education. C. disclose information to a patient's family member, provided the family member has proper identification. D. release patient information to the media only if the hospital feels that the patient's condition may cause an epidemic.
B. share information with the EMS providers about patient outcome for purposes of quality assurance and education.
Islamic and Hindu cultures avoid: A. clapping their hands together. B. touching with the left hand. C. sitting with their legs crossed. D. touching the head.
B. touching with the left hand.
All of the following are subjective findings, EXCEPT: A. acute and severe nausea. B. visible blood in the ear canal. C. a persistent dull headache. D. a feeling of impending doom.
B. visible blood in the ear canal.
While en route to a call for an emotionally disturbed patient, law enforcement notifies you by radio that the patient has become extremely violent. You should: A. continue to the scene and assist law enforcement in restraining the patient. B. wait for law enforcement to advise you that they have the patient under control. C. carefully enter the scene and administer a benzodiazepine to sedate the patient. D. advise law enforcement to handcuff the patient and transport him to the hospital.
B. wait for law enforcement to advise you that they have the patient under control.
A patient's wife called 9-1-1 because the patient was complaining of a severe headache and nausea. The patient is conscious and alert, but obviously upset that his wife called 9-1-1 without consulting with him first. As you present the blood pressure cuff, the patient folds his arms and turns away from you. From this patient's actions, you should conclude that: A. consent to treat this patient is implied. B. you do not have consent to treat him. C. he is not mentally competent. D. he will only consent to EMS transport.
B. you do not have consent to treat him.
Which of the following statements is LEAST descriptive when documenting the events of a cardiac arrest call on your patient care report? A. "Intubated with a 7.5-mm ET tube." B. "Gave 1 mg of epinephrine at 1002." C. "Followed ACLS protocols." D. "Inserted 18-gauge IV in right forearm."
C. "Followed ACLS protocols."
Which of the following is an example of slander? A. Documenting that you noted the possible smell of alcohol B. Asking a family member if the patient uses drugs C. Telling the receiving facility that a patient is drunk D. Asking a patient if he or she is under psychiatric care
C. Telling the receiving facility that a patient is drunk
While attempting to resuscitate a middle-aged woman in cardiac arrest, you perform effective CPR but do not evaluate the patient's cardiac rhythm until 10 minutes into the resuscitation attempt. When the cardiac monitor is finally applied, the patient is in asystole. The patient is transported but is pronounced dead upon arrival at the hospital. Which of the following statements regarding this scenario is correct? A. Simple negligence can be established because of the delay in applying the cardiac monitor, but your inaction did not proximately cause her death. B. Your inaction reflects gross negligence and it easily could be established that the patient would have survived if the cardiac monitor had been applied earlier. C. The delay in evaluating the patient's cardiac rhythm constitutes a breach of duty and could be proven to be the proximate cause of her death. D. Although there was a delay in applying the cardiac monitor, you cannot be held liable, because effective CPR was performed throughout the resuscitation attempt.
C. The delay in evaluating the patient's cardiac rhythm constitutes a breach of duty and could be proven to be the proximate cause of her death.
Which of the following is NOT a required element needed to prove negligence? A. An act of omission was the cause of the patient's injury. B. The paramedic committed a breach of duty. C. The patient's condition was life threatening. D. The paramedic or EMS system had a duty to act.
C. The patient's condition was life threatening.
A 17-year-old woman presents with acute abdominal pain while at a party with her husband. You arrive at the scene, assess the patient, and advise her of the need for EMS treatment and transport. However, the patient, who is conscious and alert, refuses EMS treatment and transport and states that her husband will transport her in his car. You should: A. accept her refusal because the fact that she is married makes her emancipated. B. ensure that she has decision-making capacity and then obtain a signed refusal. C. advise her of the potential risks of refusing EMS treatment and transport. D. begin treatment using implied consent, because she is under 18 years of age.
C. advise her of the potential risks of refusing EMS treatment and transport.
Low-band frequencies: A. have a range of up to 500 miles and are not associated with skip interference. B. function at 150 to 175 MHz and have a range that is nearly triple that of high-band frequencies. C. are unpredictable because changes in ionospheric conditions may cause losses in communication. D. have a longer range than high-band frequencie, but are more readily absorbed by rain, trees, and brush.
C. are unpredictable because changes in ionospheric conditions may cause losses in communication.
A 77-year-old man with end-stage COPD and renal failure is found unresponsive by his daughter. Your assessment reveals that the patient is apneic and pulseless. The daughter presents you with an out-of-hospital DNR order; however, the document expired 3 months ago. You should: A. confirm that the order has expired before initiating any patient treatment. B. realize that the patient cannot be resuscitated and notify the coroner. C. begin CPR only and contact medical control for further guidance. D. begin full resuscitative efforts because the DNR order is no longer valid.
C. begin CPR only and contact medical control for further guidance.
Scope of practice is defined as: A. national patient care guidelines established by the federal government. B. protocols agreed upon by a consensus of emergency physicians. C. care that a paramedic is permitted to perform under the certifying state. D. the level of care that an EMS employer allows the paramedic to provide.
C. care that a paramedic is permitted to perform under the certifying state.
If a parent insists on monitoring your conversation with his or her adolescent son or daughter, you should: A. explain to the adolescent that he or she is a minor and that you cannot converse without parental presence. B. suspect that the adolescent has been physically or emotionally abused and confront the parent. C. communicate the situation to the emergency department physician and document it accurately. D. refuse the parent's prerogative and move the patient to the ambulance to continue your conversation.
C. communicate the situation to the emergency department physician and document it accurately.
A legal obligation of public and certain other ambulance services to respond to a call for help in their jurisdiction is called: A. immunity. B. proximate cause. C. duty. D. negligence.
C. duty.
The Good Samaritan law was originally passed in order to: A. encourage paramedics to respond while on duty. B. discourage EMS systems from billing the patient. C. encourage the public to help at emergency scenes. D. provide immunity from liability to the paramedic.
C. encourage the public to help at emergency scenes.
Assault on a patient occurs when the EMS provider: A. carries out a harmful physical act against a patient. B. defames a patient's character in his or her report. C. instills the fear of immediate bodily harm in a patient. D. touches another person without obtaining consent.
C. instills the fear of immediate bodily harm in a patient.
Most civil cases are resolved during a settlement process because: A. the paramedic is found responsible during the discovery phase. B. the plaintiff is typically awarded a larger amount of money. C. it is expensive and time-consuming to take the case to trial. D. trial juries can be very unpredictable and are often misinformed.
C. it is expensive and time-consuming to take the case to trial.
Before you begin to transmit over the radio, you should check the volume and then: A. turn the squelch setting to zero to ensure a good signal. B. key the microphone two or three times to reach the repeater. C. listen to make sure that the channel is clear of traffic. D. press the transmit key for 1 second before talking.
C. listen to make sure that the channel is clear of traffic.
The patient care report: A. should include the paramedic's subjective findings or personal thoughts. B. is only held for a period of 24 months, after which it legally can be destroyed. C. provides for a continuum of patient care upon arrival at the hospital. D. is a legal document and should provide a brief description of the patient.
C. provides for a continuum of patient care upon arrival at the hospital.
In order to ensure that all recorded times associated with an incident are accurate, the paramedic should: A. get a copy of the dispatch log after the call. B. document the time that each event occurs. C. radio the dispatcher after an event occurs. D. frequently glance at his or her watch.
C. radio the dispatcher after an event occurs.
A 40-year-old man presents with bizarre behavior. His speech is slurred and he is very belligerent. His blood glucose level is 35 mg/dL. The patient tells you to get out of his house. You should: A. utilize law enforcement to help restrain the patient so that you can start an IV line and give him dextrose. B. administer oxygen only until you can obtain a court order to start an IV and administer dextrose. C. remain professional and advise the patient that he is not legally capable of refusing EMS treatment. D. monitor the patient's condition for 15 minutes and then begin emergency treatment if he does not improve.
C. remain professional and advise the patient that he is not legally capable of refusing EMS treatment.
While caring for an 80-year-old man with a possible fractured arm, you discover other injury patterns that are suggestive of abuse. The patient is conscious and alert. You should: A. splint the patient's arm and contact his family to determine if they are aware of the fact that he has been physically abused. B. advise the patient that you suspect he has been abused and that you are required by law to report this to the authorities. C. splint the patient's arm, transport him to the hospital, and report your suspicions to the emergency department physician. D. treat the patient's injury appropriately and then obtain his consent to report your suspicions to the emergency department physician.
C. splint the patient's arm, transport him to the hospital, and report your suspicions to the emergency department physician.
A reasonable paramedic should follow the same ______________ that another paramedic in a similar situation would. A. scope of practice B. medical practice act C. standard of care D. wishes of the family
C. standard of care
Ethics is MOST accurately defined as: A. a code of conduct that can be defined by society, religion, or a person, affecting character, conduct, and conscience. B. the professional behavior that a person's peers as well as the general public expect. C. the philosophy of right and wrong, of moral duties, and of ideal professional behavior. D. behavior that is consistent with the law and an attitude that society in general expects.
C. the philosophy of right and wrong, of moral duties, and of ideal professional behavior.
Because minors have no legal status: A. they must always be treated under the law of implied consent. B. you must obtain a court order before you can legally treat them. C. they can neither consent to nor refuse medical care. D. you must obtain consent from both parents before treating.
C. they can neither consent to nor refuse medical care.
A paramedic's actions are considered to be grossly negligent if he or she: A. makes a simple mistake that causes harm to the patient. B. only provides basic life support to a critical patient. C. willfully or wantonly deviates from the standard of care. D. does not consult with online medical control first.
C. willfully or wantonly deviates from the standard of care.
Which of the following patients is NOT an emancipated minor? A. 17-year-old man who is a member of the U.S. armed forces B. 16-year-old woman who is pregnant and lives with her boyfriend C. 18-year-old woman who is pregnant and lives with her grandmother D. 17-year-old woman who goes to college and lives with her parents
D. 17-year-old woman who goes to college and lives with her parents
Which aspect of the HIPAA is MOST pertinent to the paramedic? A. Documenting a thorough patient assessment B. Disclosing patient information to the media C. Recovering funds from insurance companies D. Ensuring that the patient's privacy is protected
D. Ensuring that the patient's privacy is protected
While caring for a conscious and alert 49-year-old man with a suspected myocardial infarction, you start an IV prior to obtaining the patient's consent. This action constitutes: A. assault. B. gross negligence. C. appropriate care. D. battery.
D. battery.
If a patient is reluctant to communicate because he or she feels threatened, the paramedic should: A. maintain a position that is at or slightly above the patient. B. ask a law enforcement officer to help obtain information. C. defer further questioning until the patient appears calm. D. cautiously approach the patient and use open posturing.
D. cautiously approach the patient and use open posturing.
Most EMS agencies require a double signature system any time a: A. medication that alters a patient's physiology is given. B. patient is given more than one dose of any medication. C. patient's condition warrants diversion to a closer hospital. D. controlled substance is checked, used, discarded, or replaced.
D. controlled substance is checked, used, discarded, or replaced.
When the paramedic encounters a patient who has difficulty communicating, he or she should: A. transport the patient and advise the hospital of the situation. B. try to use sign language when asking a specific question. C. suspect that the patient may have a psychiatric condition. D. enlist the help of a family member or primary caregiver.
D. enlist the help of a family member or primary caregiver.
Because a lawsuit may not begin until several years after the paramedic cares for a patient: A. all paramedics should carry malpractice insurance. B. the paramedic should follow up with the patient regularly. C. the paramedic should place an attorney on retainer. D. it is essential to maintain good documentation on any call.
D. it is essential to maintain good documentation on any call.
Documenting a false statement that injures a person's good name or reputation constitutes: A. slander and defamation. B. assault and battery. C. gross negligence. D. libel and defamation.
D. libel and defamation.
A poorly written patient care report: A. often indicates that the paramedic was too busy providing patient care. B. generally results in a lawsuit, even if the patient outcome was favorable. C. is unavoidable during a mass-casualty incident and is generally acceptable. D. may raise questions by others as to the paramedic's quality of patient care.
D. may raise questions by others as to the paramedic's quality of patient care.
If you receive another call before completing the patient care report accurately for the previous call: A. your patient care report must be completed within 36 hours after the call. B. you should submit what you have completed to the receiving facility. C. you should ask the dispatcher to send another paramedic crew to the call. D. pertinent details about the previous call may be omitted inadvertently.
D. pertinent details about the previous call may be omitted inadvertently.
If a patient avoids answering a specific question, you should: A. avoid repeating the question as this may upset the patient. B. conclude that the patient is trying to hide something. C. document that the patient did not answer the question. D. redirect him or her to the question to elicit a response.
D. redirect him or her to the question to elicit a response.
An accurate and legible patient care report: A. is a relatively reliable predictor of the quality of care that the paramedic provided to the patient during the call. B. provides immunity to the paramedic if the patient decides to pursue legal action against the paramedic. C. is not possible on every call, especially if there is more than one patient or the patient is critically ill or injured. D. should be complete to the point where anyone who reads it understands exactly what transpired on the call.
D. should be complete to the point where anyone who reads it understands exactly what transpired on the call.
Eye-to-eye contact with a patient reinforces: A. passive listening. B. sympathy. C. professional courtesy. D. trust and honesty.
D. trust and honesty.
If a patient is unable to tell you who he or she is, where he or she is, and what day of the week it is: A. he or she is most likely scared and unable to remember. B. he or she likely has an intracerebral hemorrhage or lesion. C. you should ask him or her questions that require more thought. D. you should suspect decreased blood flow to the brain.
D. you should suspect decreased blood flow to the brain.