Paramedic- Communications/Documentation (Ch5&6)

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40. Which of the following suffixes is used when describing disintegration or destruction? A) -ectomy B) -lysis C) -trophic D) -plasty

Ans: B Page: 166 Type: General Knowledge

17. A(n) __________ receives a weak signal and retransmits it at a higher power on another frequency. A) duplex B) simplex C) repeater D) encoder

Ans: C Page: 122

12. All of the following factors may cause distortion of an ECG signal, EXCEPT: A) muscle tremors. B) loose electrodes. C) severe tachycardia. D) distant transmission range.

Ans: C Page: 125 Type: General Knowledge

23. When transmitting data over the radio, you should NOT disclose the patient's: A) vital signs. B) chief complaint. C) HIV status. D) age and sex.

Ans: C Page: 127 Type: General Knowledge

28. Which of the following patient data is NOT typically communicated during your radio report to the hospital? A) Brief, pertinent history B) Underlying medical conditions C) The patient's ethnicity D) ECG findings

Ans: C Page: 129-130 Type: General Knowledge

29. Which of the following data would a state EMS office be the LEAST likely to require an EMS agency to report? A) Call volume B) Types of calls C) Patient gender D) Patient outcome

Ans: C Page: 151 Type: General Knowledge

12. Which of the following documentation styles would likely be MOST difficult and time-consuming to apply in EMS? A) SOAP method B) CHARTE method C) Body systems approach D) Chronological approach

Ans: C Page: 158 Type: General Knowledge

68. If the paramedic is unable to defuse a hostile patient's anger, the paramedic should: A) restrain the patient and transport at once. B) administer Valium or Haldol for sedation. C) obtain a signed refusal and depart the scene. D) request law enforcement assistance if needed.

Ans: D Page: 138

74. What hand gesture is interpreted in many Arabic and some Latin American cultures as the equivalent of an extended middle finger? A) The OK sign B) A clenched fist C) Waving your hand D) The thumbs-up sign

Ans: D Page: 140-141

15. In order for the paramedic to talk and transmit an ECG simultaneously on one frequency, a __________ system is required. A) duplex B) simplex C) low-band D) multiplex

Ans: D Page: 123 Type: General Knowledge

digital radio

The transmission of information via radio waves using digital (computer) data or analog (voice) signals that have been converted to a digital signal and compressed by a computer. these radios can communicate with other digital radios or analog radios.

Biotelemetry

capability of measuring vital signs and transmitting them to a distant terminal

Minimum Data Set (MDS)

clinical assessment standard that must be documented on every emergency call as set by Medicare, Medicaid, and per the National Highway Traffic Safety Administration

receiver

collects the radio signal and translates it back into data or sound

Hertz (Hz)

cycles or waves per second, a measurement of frequency

Ten-code

A radio transmitter and receiver housed in a single unit; a two-way radio

Landline

Communications system linked by wires, usually in reference to a conventional telephone system

Noise

In radio communications, interference in a radio signal

a radio transmits signals by _________________

electromagnetic waves

Kilohertz (kHz)

1000 Hz, or 1000 cycles per second

Geographic Information System (GIS)

A computer system that maps, stores, organizes, analyzes, and displays geographic data.

Medical Priority Dispatch System (MPDS)

A dispatch system using a specific format to indicate the nature of the emergency and its priority.

Federal Communications Commission (FCC)

A government agency created in 1934 to regulate American radio stations and later expanded to regulate television, wireless communications technologies, and other broadcast media.

Pervasive developmental disorders (PDDs)

A group of disorders that cause delays in many areas of childhood development, such as the development of skills to communicate and interact socially, and may include repetitive body movements and difficulty with changes in routine; includes autism and Asperger syndrome, among others

Encoded

A message is put into a code before it is transmitted

Emergency medical dispatcher (EMD)

A person who receives information and relays that information in an organized manner during the emergency

universal timeout

A planned pause before the beginning of a procedure that improves communication among all personnel involved and reduces preventable errors

SBAR technique

A popular communication tool that standardizes communication during handoff. It stands for situation background assessment and recommendation.

Open-ended question

A question that does not have a yes or no answer, and that does not give the patient specific options from which to choose

Closed-ended question

A question that is specific and focused, demanding either a yes or no answer or an answer chosen from specific options

Trunked Radio System

A sophisticated computer - controlled radio system that uses multiple frequencies and repeaters. usually operating in the 800 and 900 MHz UHF bands

Repeater

A special base station radio that receives messages and signals on one (input) frequency and then automatically retransmits them on a second (output) frequency. typically located on a tower, mountaintop, or tall building.

Remote console

A terminal that receives transmissions of telemetry and voice from the field and transmits messages back, usually through the base station

encoded radio signals

An embedded signal that permits controlled access to the radio transmission. allows multiple users to share frequencies and repeaters.

Enhanced 9-1-1 system

An emergency call-in system in which additional information such as the phone number and location of the caller is recorded automatically through sophisticated telephone technology and the dispatcher need only confirm the information on the screen

2. A backup communication system is especially critical when dealing with: A) mass-casualty incidents. B) motor-vehicle collisions. C) simultaneous EMS calls. D) any critically injured patient.

Ans: A Page: 121

4. A _____________ receives a weak signal and retransmits it at a higher power on another frequency. A) repeater B) base station C) multiplex system D) duplex system

Ans: A Page: 122

8. The term "frequency," as it applies to radio communications, is MOST accurately defined as: A) how frequently a radio wave recurs in a given time. B) a predefined station designed for emergency use only. C) a relatively long wavelength that produces audible sound. D) the number of megahertz per cycle that the radio transmits.

Ans: A Page: 122

19. Which of the following statements regarding the use of cellular telephones and landline telephones is MOST correct? A) Cellular and landline telephones overcome problems caused by overcrowded EMS radio frequencies. B) Cellular phones are more expensive than radios and give a weaker signal. C) Landline phones are in a fixed location and transmit with a simplex system. D) Cellular phones do not rely on a repeater to increase the coverage distance.

Ans: A Page: 124

13. At minimum, sending the 12-lead ECG of a patient with chest pain to the emergency department physician via telemetry would: A) decrease the time from diagnosis to treatment. B) enable the paramedic to begin treatment in the field. C) decrease the likelihood of prehospital cardiac arrest. D) allow the physician to choose the appropriate fibrinolytic.

Ans: A Page: 125

21. The FIRST principle of communicating by radio is: A) clarity. B) accuracy. C) calmness. D) thoroughness.

Ans: A Page: 126-127

33. Using the NATO phonetic alphabet, how should you spell Dr. "Wilson"? A) WHISKEY-INDIA-LIMA-SIERRA-OSCAR-NOVEMBER B) WHISKEY-IDA-LIMA-SAM-OSCAR-NANCY C) WILLIAM-INDIA-LINCOLN-SIERRA-OCEAN-NOVEMBER D) WILLIAM-IDA-LINCOLN-SAM-OCEAN-NANCY

Ans: A Page: 127

24. Which of the following words would be the MOST difficult to hear over the radio? A) Yes B) Negative C) Affirmative D) Received

Ans: A Page: 128

27. When relaying medical information to a physician in person, you should: A) include information that you did not provide during your radio report. B) provide a lengthy, detailed report that includes all patient information. C) ensure that another physician or a nurse is present to avoid confusion. D) routinely give your report at the patient's bedside so he or she can hear.

Ans: A Page: 130

29. When a panicked person calls 9-1-1 for help: A) he or she needs immediate confirmation of having reached the right number. B) the emergency medical dispatcher must answer the phone within four or five rings. C) the dispatcher should not speak to the caller until the caller has calmed down. D) an ambulance should be dispatched before the nature of the problem is known.

Ans: A Page: 131

37. When functioning at a noisy scene, communication will be MOST effective if you: A) move the patient to the ambulance as soon as you can. B) tell noisy patrons or bystanders to be quiet or leave. C) yell into the patient's ear so he or she can hear you. D) find the source of the noise and remove it if possible.

Ans: A Page: 133

42. If a patient is reluctant to communicate because he or she feels threatened, the paramedic should: A) cautiously approach the patient and use open posturing. B) maintain a position that is at or slightly above the patient. C) ask a law enforcement officer to help obtain information. D) defer further questioning until the patient appears calm.

Ans: A Page: 133

43. All of the following are external factors that can affect communication with a patient, EXCEPT: A) lack of empathy. B) language barriers. C) a disruptive scene. D) sensory impairment.

Ans: A Page: 134

48. The purpose of a closed-ended question is to: A) elicit a specific response from the patient. B) enable the paramedic to gauge the patient's mentation. C) obtain reliable information about a patient's complaint. D) allow the patient to describe what he or she is feeling.

Ans: A Page: 134

59. Eye-to-eye contact with a patient reinforces: A) trust and honesty. B) passive listening. C) sympathy. D) professional courtesy.

Ans: A Page: 134

49. Which of the following questions would be appropriate to ask a patient who has no medical training? A) "Do you have any breathing or heart problems?" B) "Have you ever experienced a syncopal episode?" C) "Do you have any endocrine-related illnesses?" D) "Have you ever had an acute myocardial infarction?"

Ans: A Page: 134-135

65. 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) you should suspect decreased blood flow to the brain. B) he or she is most likely scared and unable to remember. C) he or she likely has an intracerebral hemorrhage or lesion. D) you should ask him or her questions that require more thought.

Ans: A Page: 135-136

54. If a patient provides a confusing or disorganized response to your question, you should: A) rephrase the patient's comments with simpler terms and ask if he or she agrees with your synopsis. B) revisit the question later in your assessment and conclude that the patient's mental status is altered. C) attempt to obtain the most pertinent part of the patient's response and continue with further questioning. D) recognize that the patient is likely scared because of the situation and ask him or her to repeat the response.

Ans: A Page: 137

60. 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) touch the patient in the center of the chest or on the thigh. C) remember that most patients take offense to being touched. D) not touch the patient if he or she leans toward the paramedic.

Ans: A Page: 137

71. When the paramedic encounters a patient who has difficulty communicating, he or she should: A) enlist the help of a family member or primary caregiver. B) try to use sign language when asking a specific question. C) suspect that the patient may have a psychiatric condition. D) transport the patient and advise the hospital of the situation.

Ans: A Page: 139

73. Touching a conscious elderly patient in a nursing home without his or her permission: A) is nonverbally communicating, "You are not important enough or mentally competent enough to be asked for permission." B) is typically acceptable to the patient, because he or she is often frightened and desperately wants someone to help. C) may be necessary if the patient appears to have an altered mental status during your visual assessment of his or her behavior. D) is unprofessional and ethically unacceptable unless you have obtained consent from the patient's family or primary caregiver.

Ans: A Page: 140

2. A backup communication system is especially critical when dealing with: A) mass-casualty incidents. B) motor-vehicle collisions. C) simultaneous EMS calls. D) any critically injured patient.

Ans: A Page: 121 Type: General Knowledge

4. A _____________ receives a weak signal and retransmits it at a higher power on another frequency. A) repeater B) base station C) multiplex system D) duplex system

Ans: A Page: 122 Type: General Knowledge

8. The term "frequency," as it applies to radio communications, is MOST accurately defined as: A) how frequently a radio wave recurs in a given time. B) a predefined station designed for emergency use only. C) a relatively long wavelength that produces audible sound. D) the number of megahertz per cycle that the radio transmits.

Ans: A Page: 122 Type: General Knowledge

19. Which of the following statements regarding the use of cellular telephones and landline telephones is MOST correct? A) Cellular and landline telephones overcome problems caused by overcrowded EMS radio frequencies. B) Cellular phones are more expensive than radios and give a weaker signal. C) Landline phones are in a fixed location and transmit with a simplex system. D) Cellular phones do not rely on a repeater to increase the coverage distance.

Ans: A Page: 124 Type: General Knowledge

13. At minimum, sending the 12-lead ECG of a patient with chest pain to the emergency department physician via telemetry would: A) decrease the time from diagnosis to treatment. B) enable the paramedic to begin treatment in the field. C) decrease the likelihood of prehospital cardiac arrest. D) allow the physician to choose the appropriate fibrinolytic.

Ans: A Page: 125 Type: General Knowledge

21. The FIRST principle of communicating by radio is: A) clarity. B) accuracy. C) calmness. D) thoroughness.

Ans: A Page: 126-127 Type: General Knowledge

33. Using the NATO phonetic alphabet, how should you spell Dr. "Wilson"? A) WHISKEY-INDIA-LIMA-SIERRA-OSCAR-NOVEMBER B) WHISKEY-IDA-LIMA-SAM-OSCAR-NANCY C) WILLIAM-INDIA-LINCOLN-SIERRA-OCEAN-NOVEMBER D) WILLIAM-IDA-LINCOLN-SAM-OCEAN-NANCY

Ans: A Page: 127 Type: General Knowledge

24. Which of the following words would be the MOST difficult to hear over the radio? A) Yes B) Negative C) Affirmative D) Received

Ans: A Page: 128 Type: General Knowledge

27. When relaying medical information to a physician in person, you should: A) include information that you did not provide during your radio report. B) provide a lengthy, detailed report that includes all patient information. C) ensure that another physician or a nurse is present to avoid confusion. D) routinely give your report at the patient's bedside so he or she can hear.

Ans: A Page: 130 Type: General Knowledge

29. When a panicked person calls 9-1-1 for help: A) he or she needs immediate confirmation of having reached the right number. B) the emergency medical dispatcher must answer the phone within four or five rings. C) the dispatcher should not speak to the caller until the caller has calmed down. D) an ambulance should be dispatched before the nature of the problem is known.

Ans: A Page: 131 Type: General Knowledge

37. When functioning at a noisy scene, communication will be MOST effective if you: A) move the patient to the ambulance as soon as you can. B) tell noisy patrons or bystanders to be quiet or leave. C) yell into the patient's ear so he or she can hear you. D) find the source of the noise and remove it if possible.

Ans: A Page: 133 Type: General Knowledge

42. If a patient is reluctant to communicate because he or she feels threatened, the paramedic should: A) cautiously approach the patient and use open posturing. B) maintain a position that is at or slightly above the patient. C) ask a law enforcement officer to help obtain information. D) defer further questioning until the patient appears calm.

Ans: A Page: 133 Type: General Knowledge

43. All of the following are external factors that can affect communication with a patient, EXCEPT: A) lack of empathy. B) language barriers. C) a disruptive scene. D) sensory impairment.

Ans: A Page: 134 Type: General Knowledge

48. The purpose of a closed-ended question is to: A) elicit a specific response from the patient. B) enable the paramedic to gauge the patient's mentation. C) obtain reliable information about a patient's complaint. D) allow the patient to describe what he or she is feeling.

Ans: A Page: 134 Type: General Knowledge

59. Eye-to-eye contact with a patient reinforces: A) trust and honesty. B) passive listening. C) sympathy. D) professional courtesy.

Ans: A Page: 134 Type: General Knowledge

49. Which of the following questions would be appropriate to ask a patient who has no medical training? A) "Do you have any breathing or heart problems?" B) "Have you ever experienced a syncopal episode?" C) "Do you have any endocrine-related illnesses?" D) "Have you ever had an acute myocardial infarction?"

Ans: A Page: 134-135 Type: General Knowledge

65. 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) you should suspect decreased blood flow to the brain. B) he or she is most likely scared and unable to remember. C) he or she likely has an intracerebral hemorrhage or lesion. D) you should ask him or her questions that require more thought.

Ans: A Page: 135-136 Type: General Knowledge

54. If a patient provides a confusing or disorganized response to your question, you should: A) rephrase the patient's comments with simpler terms and ask if he or she agrees with your synopsis. B) revisit the question later in your assessment and conclude that the patient's mental status is altered. C) attempt to obtain the most pertinent part of the patient's response and continue with further questioning. D) recognize that the patient is likely scared because of the situation and ask him or her to repeat the response.

Ans: A Page: 137 Type: General Knowledge

60. 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) touch the patient in the center of the chest or on the thigh. C) remember that most patients take offense to being touched. D) not touch the patient if he or she leans toward the paramedic.

Ans: A Page: 137 Type: General Knowledge

71. When the paramedic encounters a patient who has difficulty communicating, he or she should: A) enlist the help of a family member or primary caregiver. B) try to use sign language when asking a specific question. C) suspect that the patient may have a psychiatric condition. D) transport the patient and advise the hospital of the situation.

Ans: A Page: 139 Type: General Knowledge

73. Touching a conscious elderly patient in a nursing home without his or her permission: A) is nonverbally communicating, "You are not important enough or mentally competent enough to be asked for permission." B) is typically acceptable to the patient, because he or she is often frightened and desperately wants someone to help. C) may be necessary if the patient appears to have an altered mental status during your visual assessment of his or her behavior. D) is unprofessional and ethically unacceptable unless you have obtained consent from the patient's family or primary caregiver.

Ans: A Page: 140 Type: General Knowledge

2. All of the following are subjective findings, EXCEPT: A) visible blood in the ear canal. B) a feeling of impending doom. C) a persistent dull headache. D) acute and severe nausea.

Ans: A Page: 149 Type: General Knowledge

4. The patient care report: A) provides for a continuum of patient care upon arrival at the hospital. B) is a legal document and should provide a brief description of the patient. C) should include the paramedic's subjective findings or personal thoughts. D) is only held for a period of 24 months, after which it legally can be destroyed.

Ans: A Page: 149, 151 Type: General Knowledge

16. Radio transmission distances from a mobile transceiver are reduced: A) by fog or light rain. B) over mountainous areas. C) over water or flat terrain. D) with greater than 7.5 W of power.

Ans: B Page: 122

23. Which of the following is a significant benefit of electronic documentation? A) The ability of the data to be shared between health care facilities B) The elimination of the need for a narrative section C) The use of drop-down boxes, which minimizes the possibility for errors D) The ease with which it can be applied during mass-casualty incidents

Ans: A Page: 152-153 Type: General Knowledge

18. When a competent adult patient refuses medical care, it is MOST important for the paramedic to: A) ensure that the patient is well informed about the situation at hand. B) contact medical control and request permission to obtain the refusal. C) perform a detailed physical exam before allowing the patient to refuse. D) obtain a signed refusal from the patient as well as a witness signature.

Ans: A Page: 154 Type: General Knowledge

30. 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

Ans: A Page: 154 Type: General Knowledge

11. Which of the following statements is LEAST descriptive when documenting the events of a cardiac arrest call on your patient care report? A) "Followed ACLS protocols." B) "Intubated with a 7.5-mm ET tube." C) "Gave 1 mg of epinephrine at 1002." D) "Inserted 18-gauge IV in right forearm."

Ans: A Page: 158 Type: General Knowledge

13. Which of the following statements includes a pertinent negative? A) "The patient complains of nausea but denies vomiting." B) "The patient rates his pain as an 8 on a scale of 0 to 10." C) "The possible smell of ETOH was noted on the patient." D) "The rapid head-to-toe exam revealed abrasions to the chest."

Ans: A Page: 158-159 Type: General Knowledge

24. An accurate and legible patient care report: A) should be complete to the point where anyone who reads it understands exactly what transpired on the call. B) is not possible on every call, especially if there is more than one patient or the patient is critically ill or injured. C) is a relatively reliable predictor of the quality of care that the paramedic provided to the patient during the call. D) provides immunity to the paramedic if the patient decides to pursue legal action against the paramedic.

Ans: A Page: 159 Type: General Knowledge

35. Additions or notations added to a completed patient care report by someone other than the original author: A) may raise questions about the confidentiality practices of the EMS agency. B) are generally acceptable, provided the additions are made by a paramedic. C) are not legal and may result in criminal action against the original author. D) must be initialed by the original author or the patient care report will be deemed null and void.

Ans: A Page: 161 Type: General Knowledge

10. Which of the following incident times is NOT commonly documented on the patient care report? A) Time of primary assessment B) Time of departure from the scene C) Time of arrival at the hospital D) Time of medication administration

Ans: A Page: 163 Type: General Knowledge

38. Blepharospasm is defined as spasm of the: A) eyelids. B) jaw muscles. C) gallbladder. D) wrist joint.

Ans: A Page: 165 Type: General Knowledge

9. Low-band frequencies: A) have a range of up to 500 miles and are not associated with skip interference. B) are unpredictable because changes in ionospheric conditions may cause losses in communication. C) function at 150 to 175 MHz and have a range that is nearly triple that of high-band frequencies. D) have a longer range than high-band frequencies, but are more readily absorbed by rain, trees, and brush.

Ans: B Page: 122

10. The ability of multiple agencies or systems to share the same radio frequency is called: A) a duplex. B) trunking. C) patching. D) telemetry.

Ans: B Page: 123

14. Cellular telephones are more advantageous than regular two-way radios in that cellular telephones: A) enable laypeople to call 9-1-1 for a minimal service charge. B) incorporate GPS technology to help rescuers find the patient. C) can transmit long distances with the use of a mobile antenna. D) do not utilize computer technology and are less likely to fail.

Ans: B Page: 124

22. When transmitting information via radio, you should: A) break long messages into 60-second segments. B) use a normal conversational tone of voice. C) speak with your voice slightly elevated. D) keep your mouth 1" from the microphone.

Ans: B Page: 127

32. Before you begin to transmit over the radio, you should check the volume and then: A) press the transmit key for 1 second before talking. B) listen to make sure that the channel is clear of traffic. C) turn the squelch setting to zero to ensure a good signal. D) key the microphone two or three times to reach the repeater.

Ans: B Page: 127

26. The use of ten-codes over the radio: A) should be carried out whenever possible to ensure effective communication. B) is not recommended by the National Incident Management System (NIMS). C) increases the likelihood of miscommunication during the radio transmission. D) is prohibited by the Federal Communications Commission and should be avoided.

Ans: B Page: 128

40. Which of the following statements regarding ten-codes is correct? A) All EMS agencies utilize a universal ten-code system. B) They should be avoided during a mass-casualty situation. C) The purpose of ten-codes is to ensure transmission clarity. D) Most services use ten-codes for regular day-to-day operations.

Ans: B Page: 128

3. Notification of EMS usually occurs when: A) EMTs contact an emergency medical dispatcher. B) a bystander notifies the dispatcher via telephone. C) a sick or injured patient presents to your EMS station. D) law enforcement requests assistance via two-way radio.

Ans: B Page: 131

31. If the EMD suspects that your patient has a life-threatening emergency, the EMD should make you aware of the situation and then: A) dispatch law enforcement to the scene. B) give prearrival instructions to the caller. C) ask the caller to put the patient on the phone. D) obtain the caller's name and physical address.

Ans: B Page: 132

34. Repeating the key parts of a patient's responses to your questions demonstrates: A) sympathy. B) active listening. C) passive communication. D) an exchange of information.

Ans: B Page: 133

38. If you want reliable answers to personal questions, you should: A) tell the patient that his or her responses to your questions are confidential. B) manage the scene so you can ask such questions quietly and privately. C) request law enforcement presence when asking a personal question. D) tell the patient that personal questions are a routine part of your exam.

Ans: B Page: 133

52. Which of the following questions would MOST likely reveal a hidden medical condition when communicating with a patient who has a severe headache? A) "Are you having difficulty seeing objects?" B) "What happened the last time you felt this way?" C) "Have you recently experienced any head trauma?" D) "Do you have a family history of severe headaches?"

Ans: B Page: 133, 135

45. Interpersonal communication is MOST accurately defined as the: A) ability to communicate while under extreme stress. B) exchange of information between two or more persons. C) dialogue that occurs between a paramedic and a patient. D) removal of an emotional barrier while communicating.

Ans: B Page: 134

47. It is important to remember that if a patient is not personally sensitive to modesty because of an impaired mental state: A) this will not influence your care. B) the patient's family likely will be. C) then he or she will not care about your treatment. D) protecting his or her privacy is of lesser concern.

Ans: B Page: 134

53. If a patient avoids answering a specific question, you should: A) conclude that the patient is trying to hide something. B) redirect him or her to the question to elicit a response. C) document that the patient did not answer the question. D) avoid repeating the question as this may upset the patient.

Ans: B Page: 136

58. A patient states, "I can't catch my breath," and the paramedic responds, "You say you can't catch your breath, ma'am'?" This is an example of: A) facilitation. B) reflection. C) confrontation. D) interpretation.

Ans: B Page: 136

63. After asking a patient a question about how he is feeling today, you sense that he is having difficulty putting his feelings into words. You should: A) ask another question and revisit the previous question later. B) be patient and give the patient time to express his feelings. C) repeat the question, but ask it differently the second time. D) offer suggested responses to facilitate the patient's answer.

Ans: B Page: 136

64. If a patient mentions something in passing or avoids answering a specific question, you should: A) assume that he or she is intentionally hiding something. B) politely redirect his or her attention to that question. C) ask the patient why he or she did not provide an answer. D) defer the question and continue with your interview.

Ans: B Page: 136

77. When attempting to interview a patient with a behavioral crisis, you should: A) use closed-ended questions to obtain his or her medical history. B) approach the patient cautiously, while maintaining eye contact. C) avoid eye contact with the patient, as this may agitate him or her. D) set "ground rules" regarding what you expect from him or her.

Ans: B Page: 137

37. Which of the following prefixes means "pertaining to a gland"? A) chole- B) aden(o)- C) blast(o)- D) arthro-

Ans: B Page: 165 Type: General Knowledge

69. When communicating with older patients, it is MOST important to remember that: A) many older patients lose the ability to understand simple terminology, thus requiring the paramedic to gear his or her questions accordingly. B) their illnesses may be more complex because they may have more than one disease process and may be taking several medications concurrently. C) the ability to hear and see is naturally impaired due to the process of aging, and the paramedic must accommodate these disabilities appropriately. D) older patients are generally poor historians regarding their medical history, and the paramedic should interview a family member or friend instead.

Ans: B Page: 138

78. During the course of your interview, your patient begins making sexual innuendos to you. You should: A) defer further questioning and simply transport the patient. B) ensure that another paramedic or EMT is present at all times. C) stop the interview until the patient's behavior is less aggressive. D) ask a paramedic of the opposite sex to interview the patient.

Ans: B Page: 138

70. If a parent insists on monitoring your conversation with his or her adolescent son or daughter, you should: A) suspect that the adolescent has been physically or emotionally abused and confront the parent. B) communicate the situation to the emergency department physician and document it accurately. C) refuse the parent's prerogative and move the patient to the ambulance to continue your conversation. D) explain to the adolescent that he or she is a minor and that you cannot converse without parental presence.

Ans: B Page: 139

75. Many _________ believe that touching the head may put their soul in jeopardy. A) Thais B) Asians C) Muslims D) Somalis

Ans: B Page: 141

76. Islamic and Hindu cultures avoid: A) touching the head. B) touching with the left hand. C) clapping their hands together. D) sitting with their legs crossed.

Ans: B Page: 141

16. Radio transmission distances from a mobile transceiver are reduced: A) by fog or light rain. B) over mountainous areas. C) over water or flat terrain. D) with greater than 7.5 W of power.

Ans: B Page: 122 Type: General Knowledge

9. Low-band frequencies: A) have a range of up to 500 miles and are not associated with skip interference. B) are unpredictable because changes in ionospheric conditions may cause losses in communication. C) function at 150 to 175 MHz and have a range that is nearly triple that of high-band frequencies. D) have a longer range than high-band frequencie, but are more readily absorbed by rain, trees, and brush.

Ans: B Page: 122 Type: General Knowledge

10. The ability of multiple agencies or systems to share the same radio frequency is called: A) a duplex. B) trunking. C) patching. D) telemetry.

Ans: B Page: 123 Type: General Knowledge

14. Cellular telephones are more advantageous than regular two-way radios in that cellular telephones: A) enable laypeople to call 9-1-1 for a minimal service charge. B) incorporate GPS technology to help rescuers find the patient. C) can transmit long distances with the use of a mobile antenna. D) do not utilize computer technology and are less likely to fail.

Ans: B Page: 124 Type: General Knowledge

22. When transmitting information via radio, you should: A) break long messages into 60-second segments. B) use a normal conversational tone of voice. C) speak with your voice slightly elevated. D) keep your mouth 1" from the microphone.

Ans: B Page: 127 Type: General Knowledge

32. Before you begin to transmit over the radio, you should check the volume and then: A) press the transmit key for 1 second before talking. B) listen to make sure that the channel is clear of traffic. C) turn the squelch setting to zero to ensure a good signal. D) key the microphone two or three times to reach the repeater.

Ans: B Page: 127 Type: General Knowledge

26. The use of ten-codes over the radio: A) should be carried out whenever possible to ensure effective communication. B) is not recommended by the National Incident Management System (NIMS). C) increases the likelihood of miscommunication during the radio transmission. D) is prohibited by the Federal Communications Commission and should be avoided.

Ans: B Page: 128 Type: General Knowledge

40. Which of the following statements regarding ten-codes is correct? A) All EMS agencies utilize a universal ten-code system. B) They should be avoided during a mass-casualty situation. C) The purpose of ten-codes is to ensure transmission clarity. D) Most services use ten-codes for regular day-to-day operations.

Ans: B Page: 128 Type: General Knowledge

3. Notification of EMS usually occurs when: A) EMTs contact an emergency medical dispatcher. B) a bystander notifies the dispatcher via telephone. C) a sick or injured patient presents to your EMS station. D) law enforcement requests assistance via two-way radio.

Ans: B Page: 131 Type: General Knowledge

31. If the EMD suspects that your patient has a life-threatening emergency, the EMD should make you aware of the situation and then: A) dispatch law enforcement to the scene. B) give prearrival instructions to the caller. C) ask the caller to put the patient on the phone. D) obtain the caller's name and physical address.

Ans: B Page: 132 Type: General Knowledge

34. Repeating the key parts of a patient's responses to your questions demonstrates: A) sympathy. B) active listening. C) passive communication. D) an exchange of information.

Ans: B Page: 133 Type: General Knowledge

38. If you want reliable answers to personal questions, you should: A) tell the patient that his or her responses to your questions are confidential. B) manage the scene so you can ask such questions quietly and privately. C) request law enforcement presence when asking a personal question. D) tell the patient that personal questions are a routine part of your exam.

Ans: B Page: 133 Type: General Knowledge

52. Which of the following questions would MOST likely reveal a hidden medical condition when communicating with a patient who has a severe headache? A) "Are you having difficulty seeing objects?" B) "What happened the last time you felt this way?" C) "Have you recently experienced any head trauma?" D) "Do you have a family history of severe headaches?"

Ans: B Page: 133, 135 Type: General Knowledge

45. Interpersonal communication is MOST accurately defined as the: A) ability to communicate while under extreme stress. B) exchange of information between two or more persons. C) dialogue that occurs between a paramedic and a patient. D) removal of an emotional barrier while communicating.

Ans: B Page: 134 Type: General Knowledge

47. It is important to remember that if a patient is not personally sensitive to modesty because of an impaired mental state: A) this will not influence your care. B) the patient's family likely will be. C) then he or she will not care about your treatment. D) protecting his or her privacy is of lesser concern.

Ans: B Page: 134 Type: General Knowledge

53. If a patient avoids answering a specific question, you should: A) conclude that the patient is trying to hide something. B) redirect him or her to the question to elicit a response. C) document that the patient did not answer the question. D) avoid repeating the question as this may upset the patient.

Ans: B Page: 136 Type: General Knowledge

58. A patient states, "I can't catch my breath," and the paramedic responds, "You say you can't catch your breath, ma'am'?" This is an example of: A) facilitation. B) reflection. C) confrontation. D) interpretation.

Ans: B Page: 136 Type: General Knowledge

63. After asking a patient a question about how he is feeling today, you sense that he is having difficulty putting his feelings into words. You should: A) ask another question and revisit the previous question later. B) be patient and give the patient time to express his feelings. C) repeat the question, but ask it differently the second time. D) offer suggested responses to facilitate the patient's answer.

Ans: B Page: 136 Type: General Knowledge

64. If a patient mentions something in passing or avoids answering a specific question, you should: A) assume that he or she is intentionally hiding something. B) politely redirect his or her attention to that question. C) ask the patient why he or she did not provide an answer. D) defer the question and continue with your interview.

Ans: B Page: 136 Type: General Knowledge

77. When attempting to interview a patient with a behavioral crisis, you should: A) use closed-ended questions to obtain his or her medical history. B) approach the patient cautiously, while maintaining eye contact. C) avoid eye contact with the patient, as this may agitate him or her. D) set "ground rules" regarding what you expect from him or her.

Ans: B Page: 137 Type: General Knowledge

69. When communicating with older patients, it is MOST important to remember that: A) many older patients lose the ability to understand simple terminology, thus requiring the paramedic to gear his or her questions accordingly. B) their illnesses may be more complex because they may have more than one disease process and may be taking several medications concurrently. C) the ability to hear and see is naturally impaired due to the process of aging, and the paramedic must accommodate these disabilities appropriately. D) older patients are generally poor historians regarding their medical history, and the paramedic should interview a family member or friend instead.

Ans: B Page: 138 Type: General Knowledge

78. During the course of your interview, your patient begins making sexual innuendos to you. You should: A) defer further questioning and simply transport the patient. B) ensure that another paramedic or EMT is present at all times. C) stop the interview until the patient's behavior is less aggressive. D) ask a paramedic of the opposite sex to interview the patient.

Ans: B Page: 138 Type: General Knowledge

70. If a parent insists on monitoring your conversation with his or her adolescent son or daughter, you should: A) suspect that the adolescent has been physically or emotionally abused and confront the parent. B) communicate the situation to the emergency department physician and document it accurately. C) refuse the parent's prerogative and move the patient to the ambulance to continue your conversation. D) explain to the adolescent that he or she is a minor and that you cannot converse without parental presence.

Ans: B Page: 139 Type: General Knowledge

75. Many _________ believe that touching the head may put their soul in jeopardy. A) Thais B) Asians C) Muslims D) Somalis

Ans: B Page: 141 Type: General Knowledge

76. Islamic and Hindu cultures avoid: A) touching the head. B) touching with the left hand. C) clapping their hands together. D) sitting with their legs crossed.

Ans: B Page: 141 Type: General Knowledge

26. HIPAA mandates that: A) a patient's personal information must be shared with the patient's immediate family members. B) patient information shall not be shared with entities or persons not involved in the care of the patient. C) a penalty will be imposed for any release of any portion of a patient's personal information to any entity. D) patient information can only be shared with the receiving physician in the emergency department.

Ans: B Page: 150-151 Type: General Knowledge

28. Which of the following laws or entities requires that a statement of medical necessity be clearly documented on a patient care report? A) HIPAA B) Medicare C) Medicaid D) State law

Ans: B Page: 151 Type: General Knowledge

7. The National Emergency Medical Services Information System (NEMSIS): A) defines the scope of practice for all levels of EMS provider. B) collects relevant data from each state and uses it for research. C) is a nationwide billing system that any EMS provider can use. D) defines the minimum data that must be collected on each call.

Ans: B Page: 151 Type: General Knowledge

31. If a patient with decision-making capacity adamantly refuses treatment for an injury or condition that clearly requires immediate medical attention, the paramedic should: A) request law enforcement assistance at once. B) contact online medical control for guidance. C) make other arrangements for patient transport. D) ask the patient to sign a refusal of treatment form.

Ans: B Page: 155 Type: General Knowledge

15. The accuracy of your patient care report depends on all of the following factors, EXCEPT: A) including all pertinent event times. B) the severity of the patient's condition. C) the thoroughness of the narrative section. D) documenting any extenuating circumstances.

Ans: B Page: 159-160 Type: General Knowledge

16. If you receive another call before completing the patient care report accurately for the previous call: A) you should submit what you have completed to the receiving facility. B) pertinent details about the previous call may be omitted inadvertently. C) your patient care report must be completed within 36 hours after the call. D) you should ask the dispatcher to send another paramedic crew to the call

Ans: B Page: 160 Type: General Knowledge

34. If the paramedic is unable to complete his or her patient care report before departing the emergency department, he or she should: A) leave, at a minimum, the patient's name and age, but recognize that the physician will perform his or her own exam. B) leave an abbreviated form with pertinent data with the receiving provider and complete the patient care report as soon as possible. C) obtain the emergency department fax number and transmit the completed patient care report within 12 hours after delivering the patient. D) advise the receiving provider that he or she will return to the emergency department with the completed patient care report within 24 hours.

Ans: B Page: 160 Type: General Knowledge

21. Which of the following statements regarding revisions or corrections to a patient care report is correct? A) The original patient care report should be destroyed if a revision is necessary. B) Only the person who wrote the original report can revise or correct it. C) A patient care report cannot be revised or corrected after submission. D) If a report needs revision, the revision must be made within 12 hours.

Ans: B Page: 161 Type: General Knowledge

3. In order to ensure that all recorded times associated with an incident are accurate, the paramedic should: A) frequently glance at his or her watch. B) radio the dispatcher after an event occurs. C) document the time that each event occurs. D) get a copy of the dispatch log after the call.

Ans: B Page: 163 Type: General Knowledge

9. It is MOST important for the paramedic to exercise extreme care when using medical abbreviations because: A) medical abbreviations change frequently. B) many abbreviations have more than one meaning. C) even correctly used abbreviations often cause confusion. D) insurance companies do not pay if unapproved abbreviations are used.

Ans: B Page: 164 Type: General Knowledge

18. A base station decoder within the emergency department: A) amplifies the voice signal from the field transmitter. B) is used to increase the range of the radio transmission. C) translates a telemetry signal into an oscilloscope tracing. D) converts a low-band frequency to a high-band frequency.

Ans: C Page: 122

5. The combination of two or more signals, which allows the paramedic to talk and transmit an ECG simultaneously on one frequency, is called a: A) simplex system. B) trunking system. C) multiplex system. D) half-duplex system.

Ans: C Page: 123

7. Which of the following statements regarding 12-lead ECG telemetry is correct? A) Telemetry over UHF frequencies enables transmission and analysis of all 12 leads. B) Telemetry has never proven to increase diagnosis times for patients with a cardiac event. C) Most newer systems use facsimile technology to allow transmission of 12-lead ECGs. D) A decoder is required to ensure that voice communication does not filter out the ECG.

Ans: C Page: 124-126

12. All of the following factors may cause distortion of an ECG signal, EXCEPT: A) muscle tremors. B) loose electrodes. C) severe tachycardia. D) distant transmission range.

Ans: C Page: 125

23. When transmitting data over the radio, you should NOT disclose the patient's: A) vital signs. B) chief complaint. C) HIV status. D) age and sex.

Ans: C Page: 127

28. Which of the following patient data is NOT typically communicated during your radio report to the hospital? A) Brief, pertinent history B) Underlying medical conditions C) The patient's ethnicity D) ECG findings

Ans: C Page: 129-130

36. When a patient repeatedly apologizes to you because he or she is incontinent, you should say: A) "I understand your embarrassment, but it is okay." B) "Don't worry about it because we see this all the time." C) "You don't have to apologize; that's what we're here for." D) "Given the situation, your incontinence is understandable."

Ans: C Page: 133

41. Which of the following actions demonstrates that the paramedic has his or her emotions under control? A) Taking notes while repeating some of the patient's statements back to him or her B) Obtaining the patient's medical history while administering emergency treatment C) Speaking close to the patient's ear in a calm voice in an extremely noisy situation D) Frequently reassuring a seriously injured patient that everything will be okay

Ans: C Page: 133

46. Which of the following questions is the MOST effective when inquiring about a patient's chest pain? A) "Is the pain sharp or dull?" B) "Does the pain feel more like pressure?" C) "Can you describe the pain to me?" D) "Does the pain radiate to your arm?"

Ans: C Page: 134

51. It would be MOST appropriate to ask a patient a closed-ended question when: A) the question requires the patient to think. B) you are using complex medical terminology. C) you are trying to obtain medical history information. D) you are attempting to establish the quality of a patient's pain.

Ans: C Page: 134-135

57. If a patient provides an inappropriate response to a paramedic's question, it should be assumed that the patient: A) is frightened by the situation. B) does not wish to communicate. C) has impaired cerebral function. D) is not willing to cooperate.

Ans: C Page: 135-136

61. An elderly man states that he is sad and depressed because his wife recently died of cancer. Which of the following statements from the paramedic demonstrates empathy? A) "I understand why you are sad, and I am sad for you. Is there anything I can do to make you feel better?" B) "I'm sorry to hear about your wife, but you should take comfort in the fact that she is in a better place." C) "I'm sorry, sir. I don't know how I would feel in your situation, but I am sure it would be similar." D) "Your wife's death is very tragic, but perhaps going to the hospital will provide you with some relief."

Ans: C Page: 136

66. Stereotyping an elderly, very young, or hostile patient during your attempt to communicate with him or her: A) yields relatively accurate information. B) is proper under certain circumstances. C) works against effective communication. D) is an effective means of communicating.

Ans: C Page: 137

67. Which of the following statements is an example of providing false reassurance? A) "Your condition does not appear to be life-threatening at the present time, but that could change." B) "I can see that you are obviously upset, but I will provide the best care possible to you." C) "I'm sure that you will be fine, but let us take you to the hospital just to be on the safe side." D) "I don't see any abnormalities on your ECG, but you should be evaluated by a physician."

Ans: C Page: 137

72. When communicating with a patient whose cultural background differs from the paramedic's, it is MOST important for the paramedic to: A) agree with the patient's cultural differences. B) know the specifics about the patient's culture. C) treat the patient with the utmost respect at all times. D) use his or her own culture as the sole reference.

Ans: C Page: 139-140

17. A(n) __________ receives a weak signal and retransmits it at a higher power on another frequency. A) duplex B) simplex C) repeater D) encoder

Ans: C Page: 122 Type: General Knowledge

18. A base station decoder within the emergency department: A) amplifies the voice signal from the field transmitter. B) is used to increase the range of the radio transmission. C) translates a telemetry signal into an oscilloscope tracing. D) converts a low-band frequency to a high-band frequency.

Ans: C Page: 122 Type: General Knowledge

5. The combination of two or more signals, which allows the paramedic to talk and transmit an ECG simultaneously on one frequency, is called a: A) simplex system. B) trunking system. C) multiplex system. D) half-duplex system.

Ans: C Page: 123 Type: General Knowledge

7. Which of the following statements regarding 12-lead ECG telemetry is correct? A) Telemetry over UHF frequencies enables transmission and analysis of all 12 leads. B) Telemetry has never proven to increase diagnosis times for patients with a cardiac event. C) Most newer systems use facsimile technology to allow transmission of 12-lead ECGs. D) A decoder is required to ensure that voice communication does not filter out the ECG.

Ans: C Page: 124-126 Type: General Knowledge

36. When a patient repeatedly apologizes to you because he or she is incontinent, you should say: A) "I understand your embarrassment, but it is okay." B) "Don't worry about it because we see this all the time." C) "You don't have to apologize; that's what we're here for." D) "Given the situation, your incontinence is understandable."

Ans: C Page: 133 Type: General Knowledge

41. Which of the following actions demonstrates that the paramedic has his or her emotions under control? A) Taking notes while repeating some of the patient's statements back to him or her B) Obtaining the patient's medical history while administering emergency treatment C) Speaking close to the patient's ear in a calm voice in an extremely noisy situation D) Frequently reassuring a seriously injured patient that everything will be okay

Ans: C Page: 133 Type: General Knowledge

46. Which of the following questions is the MOST effective when inquiring about a patient's chest pain? A) "Is the pain sharp or dull?" B) "Does the pain feel more like pressure?" C) "Can you describe the pain to me?" D) "Does the pain radiate to your arm?"

Ans: C Page: 134 Type: General Knowledge

51. It would be MOST appropriate to ask a patient a closed-ended question when: A) the question requires the patient to think. B) you are using complex medical terminology. C) you are trying to obtain medical history information. D) you are attempting to establish the quality of a patient's pain.

Ans: C Page: 134-135 Type: General Knowledge

57. If a patient provides an inappropriate response to a paramedic's question, it should be assumed that the patient: A) is frightened by the situation. B) does not wish to communicate. C) has impaired cerebral function. D) is not willing to cooperate.

Ans: C Page: 135-136 Type: General Knowledge

61. An elderly man states that he is sad and depressed because his wife recently died of cancer. Which of the following statements from the paramedic demonstrates empathy? A) "I understand why you are sad, and I am sad for you. Is there anything I can do to make you feel better?" B) "I'm sorry to hear about your wife, but you should take comfort in the fact that she is in a better place." C) "I'm sorry, sir. I don't know how I would feel in your situation, but I am sure it would be similar." D) "Your wife's death is very tragic, but perhaps going to the hospital will provide you with some relief."

Ans: C Page: 136 Type: General Knowledge

66. Stereotyping an elderly, very young, or hostile patient during your attempt to communicate with him or her: A) yields relatively accurate information. B) is proper under certain circumstances. C) works against effective communication. D) is an effective means of communicating.

Ans: C Page: 137 Type: General Knowledge

67. Which of the following statements is an example of providing false reassurance? A) "Your condition does not appear to be life-threatening at the present time, but that could change." B) "I can see that you are obviously upset, but I will provide the best care possible to you." C) "I'm sure that you will be fine, but let us take you to the hospital just to be on the safe side." D) "I don't see any abnormalities on your ECG, but you should be evaluated by a physician."

Ans: C Page: 137 Type: General Knowledge

72. When communicating with a patient whose cultural background differs from the paramedic's, it is MOST important for the paramedic to: A) agree with the patient's cultural differences. B) know the specifics about the patient's culture. C) treat the patient with the utmost respect at all times. D) use his or her own culture as the sole reference.

Ans: C Page: 139-140 Type: General Knowledge

1. Which of the following is a subjective finding? A) Pale, cool, clammy skin B) Obvious respiratory distress C) A complaint of chest pressure D) Blood pressure of 110/60 mm Hg

Ans: C Page: 149 Type: General Knowledge

6. Data collected from the state EMS office for the purpose of research would likely NOT include: A) patient outcomes. B) the nature of all calls. C) average cost per call. D) call volume per month.

Ans: C Page: 149, 151 Type: General Knowledge

27. According to HIPAA, it is acceptable and permissible for hospitals to: A) disclose information to a patient's family member, provided the family member has proper identification. B) release patient information to the public health department, regardless of the patient's medical condition. C) share information with the EMS providers about patient outcome for purposes of quality assurance and education. D) release patient information to the media only if the hospital feels that the patient's condition may cause an epidemic.

Ans: C Page: 150 Type: General Knowledge

5. The MOST significant problem associated with making up your own medical abbreviations and documenting them on the patient care report is: A) insurance denial. B) a potential lawsuit. C) an error in patient care. D) confusion at the hospital.

Ans: C Page: 150 Type: General Knowledge

17. Prior to submitting a patient care report to the receiving hospital, it is MOST important for: A) your partner to review the report to ensure accuracy. B) the EMS medical director to review the report briefly. C) the paramedic who authored the report to review it carefully. D) the quality assurance team to review the report for accuracy.

Ans: C Page: 160 Type: General Knowledge

22. 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) may raise questions by others as to the paramedic's quality of patient care. D) is unavoidable during a mass-casualty incident and is generally acceptable

Ans: C Page: 161 Type: General Knowledge

36. If you make an error when completing a written patient care report, you should: A) circle the error, initial it, and write the correct information next to it. B) not alter the original patient care report and write the correct information on an addendum. C) use different colored ink when drawing a single line through the error. D) leave the error, but write the correct information in parentheses next to it.

Ans: C Page: 162 Type: General Knowledge

15. In order for the paramedic to talk and transmit an ECG simultaneously on one frequency, a __________ system is required. A) duplex B) simplex C) low-band D) multiplex

Ans: D Page: 123

11. Biotelemetry is MOST accurately defined as: A) linking two frequencies together so that the paramedic and physician can converse directly. B) a common radio frequency assigned to EMS by the Federal Communications Commission. C) the ability of more than one public safety agency to share the same radio frequency during a crisis. D) the capability of measuring vital signs and ECG tracings and transmitting them to a distant terminal.

Ans: D Page: 124

20. When communicating medical information via radio, you should be: A) thorough yet rapid. B) comprehensive but brief. C) as expeditious as possible. D) simple, brief, and direct.

Ans: D Page: 126

25. When transmitting your radio report to the hospital, you should: A) use ten-codes whenever possible. B) allow the patient to hear the report. C) answer questions with the word "yes." D) not be sitting right next to the patient.

Ans: D Page: 128

1. When providing patient care, it is MOST important that you maintain effective communication with: A) the dispatcher. B) bystanders. C) medical control. D) your partner.

Ans: D Page: 130

30. Which of the following details is of LEAST importance for the EMD to obtain from the caller? A) The exact location of the patient B) An estimate of the situation's severity C) The caller's telephone number D) The patient's last known oral intake

Ans: D Page: 131-132

6. Under the instructions of a good EMD, a layperson should be able to: A) obtain a blood pressure. B) assess a patient's pupils. C) immobilize a person's spine. D) perform chest compressions.

Ans: D Page: 132

35. When a patient thanks you, your MOST appropriate response should be: A) "Any time." B) "That's okay." C) "No problem." D) "You're welcome."

Ans: D Page: 133

39. Conveying calm, unmistakable, genuine concern for someone you have never met before is the MOST essential challenge as a(n): A) sympathetic listener. B) competent paramedic. C) effective history taker. D) therapeutic communicator.

Ans: D Page: 133

44. Maintaining eye contact with a patient enables the paramedic to: A) rapidly gain any patient's trust. B) defuse a potentially violent situation. C) relay the seriousness of the situation. D) evaluate the patient's neurologic status.

Ans: D Page: 134

50. Which of the following is NOT an example of an open-ended question? A) "How did you feel when you awoke today?" B) "Can you tell me how this all started?" C) "Can you describe the pain you are feeling?" D) "Does the pain radiate to your arm or jaw?"

Ans: D Page: 134

62. Statements such as, "Please say more," or, "Please feel welcome to tell me about that," are examples of: A) reflection. B) clarification. C) sympathy. D) facilitation.

Ans: D Page: 136

55. If a patient asks for your advice regarding a treatment decision that his or her physician made, you should: A) only give advice if you disagree with the physician. B) give your opinion, but state that you are not a physician. C) obtain specific information about the physician's decision. D) advise the patient to consult with his or her physician.

Ans: D Page: 137

56. If the wife of a critically ill man asks you if her husband is going to die, the MOST appropriate response should be: A) "The situation appears grim, but you should not lose all hope." B) "It is possible, and you should prepare yourself for the worst." C) "That question is best answered by the physician at the hospital." D) "He is very sick, but we are doing everything we can to help him."

Ans: D Page: 137

11. Biotelemetry is MOST accurately defined as: A) linking two frequencies together so that the paramedic and physician can converse directly. B) a common radio frequency assigned to EMS by the Federal Communications Commission. C) the ability of more than one public safety agency to share the same radio frequency during a crisis. D) the capability of measuring vital signs and ECG tracings and transmitting them to a distant terminal.

Ans: D Page: 124 Type: General Knowledge

20. When communicating medical information via radio, you should be: A) thorough yet rapid. B) comprehensive but brief. C) as expeditious as possible. D) simple, brief, and direct.

Ans: D Page: 126 Type: General Knowledge

25. When transmitting your radio report to the hospital, you should: A) use ten-codes whenever possible. B) allow the patient to hear the report. C) answer questions with the word "yes." D) not be sitting right next to the patient.

Ans: D Page: 128 Type: General Knowledge

30. Which of the following details is of LEAST importance for the EMD to obtain from the caller? A) The exact location of the patient B) An estimate of the situation's severity C) The caller's telephone number D) The patient's last known oral intake

Ans: D Page: 131-132 Type: General Knowledge

6. Under the instructions of a good EMD, a layperson should be able to: A) obtain a blood pressure. B) assess a patient's pupils. C) immobilize a person's spine. D) perform chest compressions.

Ans: D Page: 132 Type: General Knowledge

35. When a patient thanks you, your MOST appropriate response should be: A) "Any time." B) "That's okay." C) "No problem." D) "You're welcome."

Ans: D Page: 133 Type: General Knowledge

39. Conveying calm, unmistakable, genuine concern for someone you have never met before is the MOST essential challenge as a(n): A) sympathetic listener. B) competent paramedic. C) effective history taker. D) therapeutic communicator.

Ans: D Page: 133 Type: General Knowledge

44. Maintaining eye contact with a patient enables the paramedic to: A) rapidly gain any patient's trust. B) defuse a potentially violent situation. C) relay the seriousness of the situation. D) evaluate the patient's neurologic status.

Ans: D Page: 134 Type: General Knowledge

50. Which of the following is NOT an example of an open-ended question? A) "How did you feel when you awoke today?" B) "Can you tell me how this all started?" C) "Can you describe the pain you are feeling?" D) "Does the pain radiate to your arm or jaw?"

Ans: D Page: 134 Type: General Knowledge

62. Statements such as, "Please say more," or, "Please feel welcome to tell me about that," are examples of: A) reflection. B) clarification. C) sympathy. D) facilitation.

Ans: D Page: 136 Type: General Knowledge

55. If a patient asks for your advice regarding a treatment decision that his or her physician made, you should: A) only give advice if you disagree with the physician. B) give your opinion, but state that you are not a physician. C) obtain specific information about the physician's decision. D) advise the patient to consult with his or her physician.

Ans: D Page: 137 Type: General Knowledge

56. If the wife of a critically ill man asks you if her husband is going to die, the MOST appropriate response should be: A) "The situation appears grim, but you should not lose all hope." B) "It is possible, and you should prepare yourself for the worst." C) "That question is best answered by the physician at the hospital." D) "He is very sick, but we are doing everything we can to help him."

Ans: D Page: 137 Type: General Knowledge

68. If the paramedic is unable to defuse a hostile patient's anger, the paramedic should: A) restrain the patient and transport at once. B) administer Valium or Haldol for sedation. C) obtain a signed refusal and depart the scene. D) request law enforcement assistance if needed.

Ans: D Page: 138 Type: General Knowledge

74. What hand gesture is interpreted in many Arabic and some Latin American cultures as the equivalent of an extended middle finger? A) The OK sign B) A clenched fist C) Waving your hand D) The thumbs-up sign

Ans: D Page: 140-141 Type: General Knowledge

25. Which of the following statements contains objective and subjective information? A) "The patient's behavior was consistent with alcohol intoxication." B) "The patient's pulse was rapid and weak and he was diaphoretic." C) "The patient's wife stated that he began feeling ill a few hours ago." D) "The patient appeared confused and stated that he had a headache."

Ans: D Page: 150-151 Type: General Knowledge

19. For purposes of refusing medical care, a patient's mental status may be considered impaired if he or she: A) is notably frightened. B) makes a derogatory comment. C) is not sure of the exact time. D) makes nonsensical statements.

Ans: D Page: 155-156 Type: General Knowledge

32. Components of a thorough patient refusal document include: A) assurance by the paramedic that the patient's ability to pay is of no concern. B) notification of the patient's physician to apprise him or her of the situation. C) documentation of a complete assessment, even if the patient refused assessment. D) willingness of EMS to return to the scene if the patient changes his or her mind.

Ans: D Page: 157 Type: General Knowledge

20. If your response to a call for a traumatic injury is canceled, you should document: A) that the patient refused medical treatment. B) how the patient will get to a medical facility. C) that the patient likely was not seriously injured. D) the agency or person who canceled the response.

Ans: D Page: 158 Type: General Knowledge

33. Most EMS agencies require a double signature system any time a: A) medication that alters a patient's physiology is given. B) patient's condition warrants diversion to a closer hospital. C) patient is given more than one dose of any medication. D) controlled substance is checked, used, discarded, or replaced.

Ans: D Page: 158 Type: General Knowledge

14. When documenting a statement made by the patient or others at the scene, you should: A) document the exact time that the statement was made. B) include the statement in an addendum to your run report. C) translate the statement into appropriate medical terminology. D) place the exact statement in quotation marks in the narrative.

Ans: D Page: 159-160 Type: General Knowledge

8. The MOST effective way to maintain your own knowledge of standard medical terminology is to: A) read the patient care reports that your peers write. B) memorize the standard terms used by your EMS system. C) participate in a QA process that reviews patient care reports. D) review the anatomy and physiology chapter of a textbook.

Ans: D Page: 163 Type: General Knowledge

41. Which of the following describes a female patient who takes acetaminophen and has an enlarged liver? A) ♂>; NTG; cholestasis B) ♀+; ASA; splenomegaly C) ♂>; NaHCO3; nephritis D) ♀+; APAP; hepatomegaly

Ans: D Page: 165-173 Type: General Knowledge

39. The prefix trans- in "transcutaneous cardiac pacing" indicates that you are pacing ________ the skin. A) beneath B) within C) around D) across

Ans: D Page: 166 Type: General Knowledge

radio dead spots

Areas where mobile or portable radios are unable to communicate with a repeater

CHARTE method

Chief Complaint, History, Assessment, Rx Treatment, transport, Exceptions

1. When providing patient care, it is MOST important that you maintain effective communication with: A) the dispatcher. B) bystanders. C) medical control. D) your partner.

D) your partner. Ans: D Page: 130 Type: General Knowledge

Wavelength

Distance in a propagating wave from one point to the corresponding point on the next wave

transceivers

Electronic devices that can receive and send signals. (Two-Way radio)

Interpersonal communications

Exchange of information between two or more persons

Federal Communications Commission (FCC)

Federal agency that has jurisdiction over interstate and international telephone and telegraph services and satellite communications, all of which may involve EMS activity

Emergency medical dispatch

First aid instructions given by specially trained dispatchers to callers over the telephone while an ambulance is en route to the call

Frequency

In radio communications, the number of cycles per second of a signal; inversely related to the wavelength

Telemedicine

Involves the use of video, audio, and computer systems to provide medical and/or health care services.

Cellular telephones

Low-power portable radios that communicate through an interconnected series of repeater stations called "cells"

Near miss event

Medical error that is recognized before any harm is done to patient eg. patient prescribed lethal dose of medication but error is caught by pharmacist

Multiplex

Method by which simultaneous transmission of voice and ECG signals can be achieved over a single radio frequency

Simplex

Method of radio communication using a single frequency that enables transmission reception of voice or an ECG signal but is incapable of simultaneous transmission and reception

Digital radio

Microwave transmission of digital signals through space or the atmosphere instead of transmission by radio waves

Repeater

Miniature transmitter that picks up a radio signal and rebroadcasts it, extending the range of a radio communications system

pertinent negatives

Negative findings that warrant no care or intervention.

automatic crash notification (ACN)

On-board computer systems in motor vehicles that automatically send telemetry data to a monitoring service in the event of a crash, which then relays the data to emergency responders; also called advanced automatic crash notification

Megahertz (MHz)

One million Hz, or one million cycles per second.

Gigahertz (GHz)

One thousand MHz, or one billion cycles per second.

Project 25 (P25)

P25 radio protocols include built in methods to access mutual aid. P25 called for a 700 MHz frequency to be built in to modern radios so that agencies can communicate regardless of the frequency they use for internal radio traffic, or radio manufacturer.

Very high frequency (VHF) band

Portion of the radio frequency spectrum between 30 and 150 mHz

Ultrahigh frequency (UHF) band

Portion of the radio frequency spectrum between 300 and 3000 mHz

Interoperability

Public safety communications systems which are compatible across all local, tribal, state, and federal agencies.

very high frequency (VHF) band

Radio frequencies between 30 and 300 MHz; the VHF spectrum is further divided into "high" and "low" bands.

Duplex

Radio system using more than one frequency to permit simultaneous transmission and reception

narrow band

Reassignment of frequencies by the Federal Communications Commission to a 12.5 megahertz spacing, now required for all emergency medical services and public safety radio systems. This doubled the number of frequencies available for public safety and EMS use.

SOAP method

S: subjective O: objective A: assessment P: plan

Trunking

Sharing of radio frequencies by multiple agencies or systems

Simplex

Single-frequency radio; transmissions can occur in either direction but not simultaneously in both; when one party transmits, the other can only receive, and the party that is transmitting is unable to receive. normally restricted to line-of-sight or short-range communications.

All radio and television communications in the US are regulated by _____________

The FCC

duplex

The ability to transmit and receive simultaneously by using two frequencies. one to transmit and one to receive.

multiplex

The ability to transmit audio and data signals through the use of more than one communications channel. most common in FM radio and bio-telemetry.

Crew Resource Management (CRM)

The effective use of all resources including personnel, training procedures and equipment to achieve the highest possible level of safety

Ultra High Frequency (UHF) Band

The portion of the radio frequency spectrum between 300 MHz to 3.0 GHz

Dispatch

To send to a specific destination or to send on a task

Hertz (Hz)

Unit of frequency equal to 1 cycle per second

therapeutic communication

Verbal and nonverbal communication techniques that encourage patients to express their feelings and to achieve a positive relationship.

SafeCom

a communications program of the U.S. Department of Homeland Security that provides research and guidance to emergency response agencies regarding the development of interoperable communications systems.

radio waves

a type of electromagnetic radiation that may be encoded to carry a wide variety of information

the most commonly used backup system is:

an alternate radio system. Typically one that relies on basic technology such as VHF, UHF simplex and duplex radios and redundant repeaters.

repeaters utilize paired radio frequencies to:

bypass obstacles such as hills, and extend the range of portable transceivers.

objective information

factual information collected using the senses of sight, hearing, smell, and touch; also called signs

The FCC requires that:

frequencies allocated for public safety and EMS communications can only be used for that purpose.

subjective information

information that a person cannot or did not observe, but is based on something that is told to the person that may or may not be true; also called symptoms.

What the FCC does:

issues radio licenses, allocates frequencies, develops technical standards, establishes and enforces rules and regulations for operating radio equipment.

Mobile Transceivers

mounted in vehicles and aircraft. output power can vary from 5-50W, and can have a line-of-sight range of up to 15 miles

empathy

putting yourself in the patient's position

HIPAA requires that:

reasonable administrative, technical, and physical safeguards be in place to aid in the protection of patient information.

The National Emergency Medical Services Information System (NEMSIS)

stores standardized EMS data from each individual state.

transmitter

takes data or sound, converts it to a radio signal, and transmits it on the designated frequency

carrier wave

the basic radio wave onto which a signal is encoded

public safety access point

the location to which 911 calls are routed to. may or may not serve as the dispatch center

radio frequency

the number of times per second a radio wave oscillates.

medical necessity

the process of establishing the medical need for medical services. standard used by medicare

confrontation

the technique of making the patient aware that something is not consistent with his or her story.

Portable Transceivers

the transmitter output is low, between 1-5W. small antennas limit the range to 3-5 miles. most operate on one band and have either single or multi channel capabilities.

Goal of NEMSIS

to define EMS care by collecting data to improve patient care, indicating equipment needs, and defining a standard of care across the nation

dispatch definition

to send to a specific location, or to send on a task

CTCSS- Continuous Tone Coded Squelch System

transmits a continuous inaudible tone and regular radio signal. to receive the message, a CTCSS decoder must be set to that specific tone to receive information.

Base stations

transmitter output of up to 275W. the most powerful radios in the communication system. have a fixed location and large antennas.


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