Chapter 4 Medical, Legal, and Ethical Issues
Which of the following scenarios reflects a violation of EMTALA? A. A hospital transfers an unstable patient to another facility B. A registration clerk asks you if the patient has insurance C. Paramedics transport a woman in labor to the closest hospital D. An emergency department provides stabilization care only
A. A hospital transfers an unstable patient to another facility
Which of the following statements regarding the harm element of a negligence lawsuit is correct? A. A loss of earning capacity is a form of harm that the patient may claim. B. The burden of proof for establishing harm rests with the defendant. C. Serious injury must have occurred in order for harm to be established. D. Loss of income is the most common form of harm proven in a lawsuit.
A. A loss of earning capacity is a form of harm that the patient may claim.
Which of the following scenarios is an example of 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. 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. C. 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. 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 scenarios is considered by most states to be a medical examiner case? A. Any violent or unexpected death B. Death of a person under 45 years of age C. Death of a criminal who is on probation D. Any patient who dies outside the hospital
A. Any violent or unexpected death
Which of the following is a factor that may prevent a patient from making an informed refusal? A. Drug or alcohol intoxication B. Appropriate response to questions C. Blood glucose levels within normal limits D. Absence of cardiac dysrhythmias
A. Drug or alcohol intoxication
A patient who rolls up his or her sleeve so that you can take his or her blood pressure has given you which type of consent? A. Expressed B. Rational C. Implied D. Informed
A. Expressed
Which of the following statements regarding a psychiatric patient who is refusing transport is correct? A. If the patient's life is not in danger, only a police officer can authorize paramedics to restrain and transport the patient. B. It is generally agreed that any psychiatric patient should be transported against his or her will for evaluation by a psychiatrist. C. Family members can authorize involuntary commitment, including forcibly transporting the patient against his or her will. D. Medical control has the authority to order paramedics to forcibly restrain and transport any psychiatric patient.
A. If the patient's life is not in danger, only a police officer can authorize paramedics to restrain and transport the patient.
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. Pericardiocentesis B. Intraosseous cannulation C. Orotracheal intubation D. ECG interpretation
A. Pericardiocentesis
Which of the following is addressed in the EMTALA? A. Preventing medical facilities from denying medical screening and stabilization B. Discouraging private individuals from suing if a hospital has violated the law C. Requiring EMS to transport all patients to the closest medical treatment facility D. Allowing a woman who is in active labor to be transported to a distant hospital
A. Preventing medical facilities from denying medical screening and stabilization
Which of the following is an example of a protocol? A. Standing orders B. Online medical control C. Verbal order by a physician D. Radio orders
A. Standing orders
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 systole. The patient is transported but is pronounced dead upon arrival at the hospital. Which of the following statements regarding this scenario is correct? A. 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. 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. Although there was a delay in applying the cardiac monitor, you cannot be held liable, because effective CPR was performed throughout the resuscitation attempt. D. Simple negligence can be established
A. 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 a required element needed to prove negligence? A. The paramedic committed a breach of duty. B. An act of omission did not cause of the patient's injury. C. The paramedic was not on duty. D. The patient's condition was life threatening.
A. The paramedic committed a breach of duty.
Proximate cause is defined as: A. a link between the paramedic's improper action and the patient's injury. B. an act of ordinary or gross negligence that resulted in further harm to the patient. C. a direct relationship between the mechanism of injury and the patient's injury. D. an action on the part of the paramedic that improved the patient's condition.
A. a link between the paramedic's improper action and the patient's injury.
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. tell the patient that you are going to start an IV on him in order to replenish his body with lost fluid and electrolytes. D. establish the IV line based on the law of implied consent, because his condition has impaired his decision- making capacity.
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.
If a physician insists that you perform an intervention that you are not properly trained to perform, it would be appropriate to: A. ask the physician if he or she can suggest another alternative. B. perform the ordered intervention to the best of your ability. C. refuse to perform the intervention and follow your protocols. D. ask the physician to talk you through the procedure over the phone.
A. ask the physician if he or she can suggest another alternative.
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. begin CPR only and contact medical control for further guidance. B. confirm that the order has expired before initiating any patient treatment. C. realize that the patient cannot be resuscitated and notify the coroner. D. begin full resuscitative efforts because the DNR order is no longer valid.
A. begin CPR only and contact medical control for further guidance.
Abandonment occurs when: A. care of a patient was terminated without his or her consent. B. a patient refuses care and subsequently dies of his condition. C. an emergency nurse takes a verbal report from a paramedic. D. a patient is released and did not require further medical care.
A. care of a patient was terminated without his or her consent.
Without obtaining her consent, you transport a mentally competent young woman to the hospital because you suspect she is experiencing internal bleeding. This action: A. constitutes false imprisonment. B. is defensible in a court of law. C. is justifiable because of your suspicions. D. reflects an act of gross negligence.
A. constitutes false imprisonment.
If a conflict arises between a paramedic and a physician bystander in the field, the paramedic should: A. contact medical control to seek resolution. B. become subordinate to the physician. C. politely ask the physician to leave the scene. D. involve law enforcement in the incident.
A. contact medical control to seek resolution.
When an administrative agency proposes a licensing action in a state that licenses paramedics, the agency must notify the paramedic of the actions that allegedly constituted the infraction. This is a part of: A. due process. B. the appeal process. C. licensure revocation. D. licensure suspension.
A. due process.
The Good Samaritan law was originally passed in order to: A. encourage the public to help at emergency scenes. B. discourage EMS systems from billing the patient. C. encourage paramedics to respond while on duty. D. provide immunity from liability to the paramedic.
A. encourage the public to help at emergency scenes.
If a paramedic receives an order from a physician that he or she feels is detrimental to the patient's best interests, the paramedic should: A. immediately discuss with the physician why the paramedic feels that way. B. carry out the order, but factually and carefully document the event. C. not carry out the order and discuss the issue with the physician later. D. tell the patient that the physician's order is appropriate for him or her.
A. immediately discuss with the physician why the paramedic feels that way.
Assault on a patient occurs when the EMS provider: A. instills the fear of immediate bodily harm in a patient. B. defames a patient's character in his or her report. C. touches another person without obtaining consent. D. carries out a harmful physical act against a patient.
A. instills the fear of immediate bodily harm in a patient.
The surrogate decision maker: A. is legally obligated to make decisions as the patient would want. B. must be an immediate family member of the patient. C. must recertify his or her decision-making status every 10 years. D. can make decisions for a patient who has decision-making capacity.
A. is legally obligated to make decisions as the patient would want.
Most civil cases are resolved during a settlement process because: A. it is expensive and time consuming to take the case to trial. B. the paramedic is found responsible during the discovery phase. C. trial juries can be very unpredictable and are often misinformed. D. the plaintiff is typically awarded a larger amount of money.
A. it is expensive and time consuming to take the case to trial.
Documenting a false statement that injures a person's good name or reputation constitutes: A. libel and defamation. B. assault and battery. C. gross negligence. D. slander and defamation.
A. libel and defamation.
The initial complaint filed against a paramedic or EMS system by a dissatisfied patient: A. may not contain specific information about what the patient thinks went wrong. B. is typically detailed and contains specific information about what went wrong. C. must be reviewed by a judge in order to determine if the complaint is justified. D. does not include the name of the paramedic or EMS system that is being sued.
A. may not contain specific information about what the patient thinks went wrong.
If you must deviate from your protocols because of unusual circumstances, you should first: A. notify medical control. B. document the event. C. apprise the receiving hospital. D. advise the patient.
A. 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. performed outside his or her scope of practice. B. has committed an act of gross negligence. C. will likely be sued by the medical director. D. did not follow the national standard of care.
A. performed outside his or her scope of practice.
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. turn your siren off and ask the driver of the vehicle to pull over using the public address radio. C. get as close to the rear of the vehicle as possible, change the tone of your siren, and flash your headlights. D. quickly merge to the right, pass the vehicle, and then obtain the vehicle's license plate number.
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.
You are caring for a 66-year-old man with terminal cancer. He is conscious and alert without evidence of mental incapacitation. You offer him oxygen, but he refuses to accept it, stating, "Just let me die with dignity!" You should: A. respect the patient's wishes and ask him if he wants to be transported to the hospital. B. recognize that patients with terminal illnesses do not have decision-making capacity. C. tell him that the oxygen is crucial in preventing him from experiencing cardiac arrest. D. contact medical control and request permission to treat without the patient's consent.
A. respect the patient's wishes and ask him if he wants to be transported to the hospital.
If a patient makes a decision regarding his or her own health care and the paramedic does not agree with that decision, the paramedic should: A. respect the patient's wishes, assuming he or she has decision-making capacity. B. try to convince the patient that the decision is not in his or her best interest. C. accept the patient's decision, but advise him or her that you do not agree. D. ensure that the EMS medical director agrees with the patient's decision.
A. respect the patient's wishes, assuming he or she has decision-making capacity.
If a severely injured patient who will likely not survive is identified as being an organ donor, the paramedic: A. should contact medical control for guidance as to how to proceed. B. should recall that severe trauma disqualifies a patient as a donor. C. must determine whether or not the patient is legally brain dead. D. must keep the patient warm to keep his or her organs viable.
A. should contact medical control for guidance as to how to proceed.
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, transport him to the hospital, and report your suspicions to the emergency department physician. B. splint the patient's arm and contact his family to determine if they are aware of the fact that he has been physically abused. C. advise the patient that you suspect he has been abused and that you are required by law to report this to the authorities. D. treat the patient's injury appropriately and then obtain his consent to report your suspicions to the emergency department physician.
A. splint the patient's arm, transport him to the hospital, and report your suspicions to the emergency department physician.
If an EMS agency's call volume is too heavy to allow response within an appropriate time frame: A. the agency is obligated to use mutual aid resources. B. all area hospitals must be made aware of the situation. C. the agency no longer has a legal duty to respond. D. off-duty personnel are legally obligated to respond.
A. the agency is obligated to use mutual aid resources.
When an ambulance collides with a citizen's vehicle at an intersection: A. the driver of the ambulance may be charged criminally. B. EMS providers are rarely found at fault in civil lawsuits. C. most state laws provide immunity to the EMS vehicle. D. it is because the citizen failed to yield the right of way.
A. the driver of the ambulance may be charged criminally.
Which of the following statements regarding ethics in the workplace is correct? A. EMS has long been recognized and funded in the same manner as the other health care professions. B. Off-duty misconduct on the part of the paramedic may lessen the public's confidence in EMS in general. C. Acknowledging a patient's cultural beliefs is a low priority if he or she is critically ill or injured. D. Paramedics are accountable only to the EMS system's medical director and to the director of EMS operations.
B. Off-duty misconduct on the part of the paramedic may lessen the public's confidence in EMS in general.
Which of the following statements regarding the paramedic-physician relationship is correct? A. The physician is not authorized to restrict the paramedic's practice. B. The paramedic will be held accountable for his or her own actions. C. State EMS legislation is responsible for appointing medical directors. D. The physician is legally accountable for actions taken by an employer.
B. The paramedic will be held accountable for his or her own actions.
The wrongful act that gives rise to a civil suit is called: A. liability. B. a tort. C. negligence. D. damage.
B. a tort.
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. ensure that she has decision-making capacity and then obtain a signed refusal. B. advise her of the potential risks of refusing EMS treatment and transport. C. begin treatment using implied consent, because she is under 18 years of age. D. accept her refusal because the fact that she is married makes her emancipated.
B. advise her of the potential risks of refusing EMS treatment and transport.
You arrive at the scene of a motor vehicle versus pedestrian accident. The patient is a 12-year-old girl who was struck by a car while riding her bike. She is conscious but combative. She has a large hematoma on her leg and several hematomas to her forehead. As a police officer attempts to contact the child's parents, you should: A. provide supportive care only but do not transport the child until the parents arrive and give consent. B. assume that her parents would consent to emergency treatment and initiate the appropriate care for the child. C. closely monitor the child's condition and begin emergency treatment after obtaining consent from both parents. D. withhold all emergency care until you have obtained consent from at least one of her parents via telephone.
B. assume that her parents would consent to emergency treatment and initiate the appropriate care for the child.
Ethics related to the practice and delivery of health care is called: A. valued ethics. B. bioethics. C. applied ethics. D. medical morality.
B. bioethics.
Current bioethical quidelines regarding the decision not to initiate resuscitation efforts rely mainly on the use of: A. criteria established by the local coroner. B. common sense and reasonable judgment. C. flexible algorithms and protocols. D. the paramedic's personal beliefs.
B. common sense and reasonable judgment.
If a mortally injured patient's wishes regarding organ donation are not known: A. a physician can legally authorize donation of organs. B. consent should be obtained from a family member. C. a court order is required to initiate the procurement process. O D. it should be assumed that the patient would consent.
B. consent should be obtained from a family member.
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. duty. C. proximate cause. D. negligence.
B. duty.
Before asking a patient to sign a refusal form, the paramedic must: A. ask an impartial observer to sign the refusal form first. B. ensure the patient is aware of the risks of his or her refusal. C. ask a police officer to determine if the patient is competent. D. tell the patient that he or she will die without treatment.
B. ensure the patient is aware of the risks of his or her refusal.
Informed consent involves: A. a patient verbally expressing his or her wishes for you to proceed with emergency medical treatment. B. ensuring that a patient understands the potential risks involved in performing a particular procedure. C. carefully explaining the potential ramifications of refusing emergency medical treatment. D. explaining the rationale for an invasive procedure to a patient after you have already performed it.
B. ensuring that a patient understands the potential risks involved in performing a particular procedure.
Transporting a competent adult patient without his or her consent would likely result in allegations of: A. criminal trespassing. B. false imprisonment. C. assault. D. battery.
B. false imprisonment.
People who call 9-1-1 at the moment of a loved one's death most often need: A. sympathy and reassurance. B. information and support. C. assurance that everything will be okay. D. medical care for themselves.
B. information and support.
If a patient experiences prolonged hypotension or requires prolonged CPR, his or her inappropriate for organ or tissue donation. A. skin B. kidneys C. corneas D. bones
B. kidneys
You respond to a skilled nursing facility for a patient who is not breathing. When you arrive, you assess the patient, a 78-year-old man, and confirm apnea. However, the patient has a rapid carotid pulse. The charge nurse advises you that, according to the patient's family, the patient is not to be resuscitated. You should: A. remain at the scene, begin artificial ventilations, but discontinue if the family arrives and presents a valid DNR order. B. maintain the patient's airway, begin artificial ventilations, and transport the patient to the closest appropriate medical facility. C. not attempt any form of resuscitation and ask the charge nurse to notify the patient's family immedigtely. D. contact medical control and request authorization to provide palliative care only and transport the patient to the hospital.
B. maintain the patient's airway, begin artificial ventilations, and transport the patient to the closest appropriate
Patient autonomy is defined as the: A. court's support and upholding of the rights of a patient with regard to health care decisions. B. patient's right to direct his or her own care and to decide how end-of-life care should be provided. C. right of the patient to determine which medications the paramedic should administer for a given situation. D. inability of the patient to refuse medical treatment once he or she has given appropriate consent.
B. patient's right to direct his or her own care and to decide how end-of-life care should be provided.
You are called to a community center for a 40-year-old woman who is "acting strange." Upon your arrival, you assess the patient and determine that she is conscious, alert, and oriented to person, place, time, and event. She does not appear to be mentally impaired. Her oxygen saturation is 99% on room air and her blood glucose level is 112 mg/dL. The patient's husband tells you that his wife has bipolar disorder and takes medication for it. The patient tells you that she is fine and does not want to go to the hospital. You should: A. advise the patient that, because of her history of bipolar disorder, she does not have the legal capacity to refuse EMS treatment and transport. B. recognize that this patient has decision-making capacity at the present time and that you cannot force her to go to the hospital. C. transport the patient against her will, but only if it can be established that she has been noncompliant with
B. recognize that this patient has decision-making capacity at the present time and that you cannot force her to go to the hospital.
Health care powers of attorney are also called "durable" powers of attorney because they: A. must be in the patient's possession at all times. B. remain in effect once a patient loses decision-making capacity. C. can only be revoked by the patient's personal physician. D. do not require anyone to make decisions on the patient's behalf.
B. remain in effect once a patient loses decision-making capacity.
The best way for the paramedic to evaluate a patient's decision-making capacity is to: A. ensure that pulse oximetry and blood glucose readings are within normal limits. B. talk to the patient to determine if he or she understands what is happening. C. confirm that the patient is at least 18 years of age or otherwise emancipated. D. determine if the patient knows what care is appropriate for the situation.
B. talk to the patient to determine if he or she understands what is happening.
According to the qualified immunity doctrine, the paramedic can be held liable only if: A. he or she was not employed by a governmental entity at the time an incident or violation occurred. B. the plaintiff proves that the paramedic violated a clearly established law about which he or she should have known. C. the medical care that he or she provided was not consistent with what a physician would have provided. D. he or she volunteers as a paramedic and receives no remuneration for his or her medical services.
B. the plaintiff proves that the paramedic violated a clearly established law about which he or she should have known.
If a patient has a potentially life threatening illness or injury and there is any doubt as to his or her decision-making capacity, the paramedic should: A. have the patient arrested and placed in protective custody. B. treat and transport, even if it is against the patient's will. C. obtain consent from a family member to treat the patient. D. obtain a court order and then begin emergency treatment.
B. treat and transport, even if it is against the patient's will.
If a mentally competent adult refuses emergency medical treatment, your first action should be to: A. call medical control and seek further guidance. B. try to determine why he or she is refusing treatment. C. assume the refusal is from fear and begin treatment. D. determine if his or her condition is life threatening.
B. try to determine why he or she is refusing treatment.
In a medical liability suit involving a paramedic, the plaintiff: A. must convince 6 of 12 jurors to agree with his or her position. B. usually seeks compensation for the injury he or she sustained. C. is the paramedic and is generally represented by a lawyer. D. must prove that the paramedic broke an established law.
B. usually seeks compensation for the injury he or she sustained.
Implied consent is based on the premise that a patient: A. is of legal age and is able to make rational decisions regarding his or her care. B. would consent to care because of the seriousness of his or her injury. C. will die unless emergency medical treatment is provided immediately. D. would refuse any emergency medical care if he or she were unconscious.
B. would consent to care because of the seriousness of his or her injury.
A DNR order is defined as a(n): A. oral directive that is executed by the patient while he or she still has decision-making capacity. B. written order designed to tell health care providers when resuscitation is or is not appropriate. C. written or oral directive that stipulates the care that a patient should receive at the end of his or her life. D. legal document signed by at least four physicians that prohibits resuscitative efforts in terminally ill patients.
B. written order designed to tell health care providers when resuscitation is or is not appropriate.
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 was uncooperative during the exam. C. "The patient's actions suggest the use of illicit drugs. D. "There was no evidence of suicidal behavior."
C. "The patient's actions suggest the use of illicit drugs.
Which of the following patients is an emancipated minor? A. 17-year-old man who works more than 20 hours a week B. 16-year-old woman who lives with her boyfriend C. 17-year-old woman who has a child, lives on her own, and is financially independent D. 17-year-old woman who goes to college and lives with her parents
C. 17-year-old woman who has a child, lives on her own, and is financially independent
Which of the following statements regarding emergency vehicle laws is correct? A. Most states allow an emergency vehicle to exceed the speed limit by 20 miles per hour if it is safe to do so. B. An ambulance must use its lights and siren when transporting any acutely ill or injured patient. C. All state statutes require emergency vehicles to be operated in a safe and prudent manner. D. The Star of Life insignia permits an ambulance to run a red light or stop sign if it is safe.
C. All state statutes require emergency vehicles to be operated in a safe and prudent manner.
Which of the following is an example of a quid pro quo type of sexual harassment? A. An employer knowingly allows an employee to be continually harassed by coworkers. B. An employer creates an offensive practice related to sex that makes the employee uncomfortable. C. An employer promises the employee a raise if he or she engages in sexual intercourse. D. An employer refuses to investigate a claim of sexual harassment from an employee.
C. An employer promises the employee a raise if he or she engages in sexual intercourse.
Which of the following statements regarding certification is correct? A. Unlike a licensed health care provider, a certified health care provider is not required to obtain continuing education hours. B. A certified health care provider has been granted the authority and privilege to practice medicine in a certain municipality. C. Certification is evidence that an individual has a certain level of credentials based on hours of training and examination. D. Certification is a process in which a certifying entity attests to the fact that the health care provider has mastered a certain skill set.
C. Certification is evidence that an individual has a certain level of credentials based on hours of training and examination.
Prior to administering nitroglycerin to a patient with chest pain, the patient denies the use of erectile dysfunction (ED) drugs when asked, even though he took an ED drug a few hours earlier. After being given the nitroglycerin, the patient experiences severe hypotension and almost dies. Which of the following could the paramedic use as a potential defense if the patient attempts to sue? A. Qualified immunity B. Plausible deniability C. Contributory negligence D. Patient incompetence
C. Contributory negligence
What is the main legal risk of providing a tiered-response EMS system? A. Ambulance crashes at intersections as ALS and BLS providers simultaneously respond to the scene B. Lengthy response times for the BLS crew if ALS providers wait too long before determining that they need help C. Exposure to liability if the BLS crew makes an improper determination that a patient does not need ALS care D. Premature canceling of a BLS crew by an on-scene paramedic who performs an improper assessment of the patient
C. Exposure to liability if the BLS crew makes an improper determination that a patient does not need ALS care
Which of the following charges are infrequently prosecuted in EMS? A. Assault B. Battery C. False imprisonment D. Inadequate patient care
C. False imprisonment
Which of the following represents what a reasonable paramedic in a similar situation would do? A. Scope of practice B. Medical practice act C. Standard of care D. Wishes of the family
C. Standard of care
Which of the following statements regarding medical law is correct? A. A poor patient outcome typically means that the medical provider was grossly negligent. B. A medical liability lawsuit will only be successful if the patient's outcome was unfavorable. C. The patient or survivor must prove all elements of negligence before a lawsuit will be successful. D. Medical providers with fewer than 5 years of experience are at highest risk of being sued.
C. The patient or survivor must prove all elements of negligence before a lawsuit will be successful.
Which of the following can impede your ability to give patients the information they need to make an informed decision? A. The patient's marital status B. The patient's gender C. The patient's emotional state D. The patient's race or ethnicity
C. The patient's emotional state
Although the technicalities of EMS DNR orders vary from state to state, they all: A. must be renewed every 5 years or they will expire and become null and void. B. require the patient to wear a DNR insignia such as a bracelet or necklace. C. are designed to tell EMS providers when resuscitation is or is not appropriate D. are completely irrevocable by the patient's immediate family members.
C. are designed to tell EMS providers when resuscitation is or is not appropriate
Interventions that have been proven by studies to be of no benefit to the patient in cardiac arrest: A. are commonly authorized by medical control. B. should be performed unless the family objects. C. are not medically or ethically indicated. D. are illegal for the paramedic to perform.
C. are not medically or ethically indicated.
You arrive at the scene of a shooting. The patient, a 19-year-old woman, has a gunshot wound to the side of her head with a large amount of exposed brain matter. Further assessment reveals that the patient is apneic and pulseless. Law enforcement personnel advise you that the person who shot the patient is in their custody. You should: A. begin CPR immediately, cover the wound with a bulky dressing, and prepare to transport the patient. B. place plastic bags over the patient's hands, apply a cardiac monitor to confirm systole, and notify the coroner's office. C. avoid unnecessary contact with the patient and document the findings of your visual assessment of the patient and scene. D. begin resuscitative measures at once and contact the patient's family to determine if she is an organ donor.
C. avoid unnecessary contact with the patient and document the findings of your visual assessment of the patient and scene.
You have been attempting resuscitation of a middle-aged woman for approximately 20 minutes; however, she has not responded to any of your treatment. There is no evidence of hypothermia or drug ingestion, and the cardiac monitor shows systole. You should: A. perform CPR only and try to contact her family. B. pronounce the patient dead and call the coroner. C. consider terminating your resuscitative efforts. D. determine if she has an advance directive.
C. consider terminating your resuscitative efforts.
During the attempted resuscitation of a 79-year-old man in cardiac arrest, a young man arrives at the scene and asks you to cease resuscitative efforts. He further tells you that the patient has entrusted him to make all of his medical decisions. You should: A. limit your resuscitative efforts to basic life support only and cease resuscitation altogether if the man can present a valid advance directive. B. advise the man that, because he does not have valid documentation that he is authorized to make decisions for the patient, you must continue resuscitation. C. continue full resuscitative efforts and ask the man if the patient has a living will and if he has documentation naming him as the person authorized to make decisions. D. cease all resuscitative efforts, contact medical control, and advise medical control that a surrogate decision maker is present and has requested you to stop.
C. continue full resuscitative efforts and ask the man if the patient has a living will and if he has documentation naming him as the person authorized to make decisions.
A hospital that is in violation of EMTALA: A. must pay a monetary settlement to the patient. B. is responsible to the state board of health. C. could forfeit all of its Medicare funding. D. is fined by the health insurance company.
C. could forfeit all of its Medicare funding.
EMS-enabling legislation: A. appoints a system's medical director. B. defines a physician's scope of practice. C. defines how EMS is structured. D. develops local or regional EMS protocols.
C. defines how EMS is structured.
The first rule of medical practice is to: A. recognize critically ill patients. B. maintain a sympathetic attitude. C. do no harm. D. provide medical care.
C. do no harm.
If an off-duty paramedic stops at the scene of a motor vehicle crash, the paramedic: A. does not have a legal duty to provide care. B. must accompany the patient to the hospital. C. has a legal obligation to provide patient care. D. is not legally protected by the Good Samaritan law.
C. has a legal obligation to provide patient care.
A bystander physician who assists the paramedic at the scene is not required to accompany the patient in the ambulance unless the physician: A. does not assume responsibility for the patient's care. B. is a board-certified emergency physician. C. has performed procedures above the paramedic's level. D. practices at the hospital to which the patient is transported.
C. has performed procedures above the paramedic's level.
A person wishes to be an organ donor. He or she must: A. have a documented terminal illness. B. be at least 21 years of age in most states. C. have witnessed informed consent, usually in writing. D. have this delineated on his or her driver's license.
C. have witnessed informed consent, usually in writing.
If a volunteer paramedic has signed up to work a shift for an EMS system: A. he or she does not have a legal obligation to act. B. he or she must be a third responder on the ambulance. C. he or she is obligated to respond to calls during the shift. D. the Good Samaritan law provides limited immunity.
C. he or she is obligated to respond to calls during the shift.
While providing care to a seriously ill public official who is semiconscious, a media representative arrives at the scene and asks about the patient's condition. You should: A. give the media representative the patient's name and age only. B. advise the media representative to obtain the information at the hospital. C. tell the media representative that you cannot disclose any information. D. obtain consent from the patient before releasing any personal information.
C. tell the media representative that you cannot disclose any information.
When a person experiences an injury and seeks redress for that injury: A. it is usually the paramedic who is found grossly negligent. B. it must be established that the injury led to a bad outcome. C. the judicial process must determine who was responsible. D. he or she must prove that the standard of care was provided.
C. the judicial process must determine who was responsible.
If a paramedic is attacked by a violent patient: A. the paramedic will not be held legally accountable if the attack was the result of patient provocation. B. the paramedic is legally permitted to defend himself or herself with the use of deadly force. C. the paramedic may respond with force that is equal to or slightly greater than the force offered by the patient. D. the law allows the paramedic to use a knife or firearm as a means of self-defense against the attacker.
C. the paramedic may respond with force that is equal to or slightly greater than the force offered by the patient.
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. carefully enter the scene and administer a benzodiazepine to sedate the patient. C. wait for law enforcement to advise you that they have the patient under control. D. advise law enforcement to handcuff the patient and transport her to the hospital.
C. wait for law enforcement to advise you that they have the patient under control.
Generally, the paramedic is not at liberty to disregard a physician's order unless: A. the physician is not the paramedic's medical director. B. the physician is not a licensed emergency physician. C. it is documented why the order was not carried out. D. carrying out the order will cause harm to the patient.
D) carrying out the order will cause harm to the patient.
Provisions of the medical practice act include which of the following? A. Protecting electronic health information B. Disclosing medical information when necessary for payment or billing purposes C. Defining minimum qualifications of the paramedic D. Assigning medical directors to EMS systems
D. Assigning medical directors to EMS systems
Which of the following general statements regarding violent patients is correct? A. You must rule out hypoglycemia before restraining a violent patient. B. Most patients become violent because of a severe psychiatric condition. C. Ideally, violent patients should be restrained in a facedown position. D. Benzodiazepines are acceptable to use as a means of chemical restraint.
D. Benzodiazepines are acceptable to use as a means of chemical restraint.
Most states require the paramedic to report which of the following cases? A. Childbirth occurring in the hospital B. Motor vehicle accidents C. Injury to the elderly D. Drug-related injuries
D. Drug-related injuries
Which of the following is an example of slander? A. Asking a patient if he or she is under psychiatric care B. Asking a family member if the patient uses drugs C. Documenting that you noted the possible smell of alcohol D. Telling the receiving facility that a patient is drunk
D. Telling the receiving facility that a patient is drunk
Which of the following statements is correct? A. A patient's religious beliefs should be respected but should not affect how you provide care. B. If you place your welfare ahead of the patient's, you will rarely commit an unethical act in medical care. C. When faced with an ethical dilemma, you should ask yourself, "What is in my best interest?" D. The EMT code of ethics simply amplifies the concept of being concerned for the welfare of others.
D. The EMT code of ethics simply amplifies the concept of being concerned for the welfare of others.
Conducting MS research studies on critically ill or injured patients without their informed consent is: A. appropriate. B. ethically acceptable. C. legal under the law of implied consent. D. a real ethical dilemma.
D. a real ethical dilemma.
You deliver a 61-year-old man with abdominal pain to a busy emergency department. A staff nurse instructs you to take the patient to the triage area where he will be tended to later. She further tells you that after you leave a copy of your patient care report with the clerk, you are free to leave. You should: A. transfer the patient to a gurney in a highly visible area, advise the nurse of what you did, and give the nurse a copy of your patient care report. B. do as the nurse instructs you and thoroughly document the incident to ensure you are not accused of abandonment. C. leave the patient in the triage area, give your patient care report to the clerk, and tell the clerk to keep an eye on the patient. D. advise the nurse that you will remain with the patient until the nurse has taken your verbal report and properly assumed care of the patient.
D. advise the nurse that you will remain with the patient until the nurse has taken your verbal report and properly assumed care of the patient.
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. gross negligence. B. appropriate care. C. assault. D. battery.
D. battery.
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. the level of care that an EMS employer allows the paramedic to provide. D. care that a paramedic is permitted to perform under the certifying state.
D. care that a paramedic is permitted to perform under the certifying state.
Most lawsuits against EMS providers result from: A. unethical acts. B. substandard patient care C. gross infractions of the law. D. emergency vehicle crashes.
D. emergency vehicle crashes.
When transferring a patient between medical facilities, it is important for the paramedic to: A. request another paramedic if the patient's clinical condition is too unstable for one paramedic to manage effectively. B. request a basic life support ambulance. C. request that a member of the patient's family accompanies the patient. D. ensure that a physician or nurse accompanies the patient if the patient requires care beyond the paramedic's scope of practice
D. ensure that a physician or nurse accompanies the patient if the patient requires care beyond the paramedic's scope of practice
If a conscious patient with decision-making capacity refuses care for a potentially life-threatening condition: A. implied consent will allow you to treat the patient. B. medical direction can overrule the patient's decision. C. you must begin lifesaving treatment at once. D. he or she cannot be treated without a court order.
D. he or she cannot be treated without a court order.
While on duty, a paramedic unit stops at the scene of a traffic accident to which it has not been dispatched. During the course of providing patient care, one of the paramedics purposely manipulates the patient's neck to elicit a painful response. This paramedic: A. is protected by the Good Samaritan law because he was not officially dispatched to the scene of the accident. B. is not protected by the Good Samaritan law but provided treatment that is consistent with the accepted standard of care. C. cared for the patient in a manner consistent with his scope of practice and is not liable for the patient's injury or injuries. D. is not protected by the Good Samaritan law and did not perform as any other paramedic with similar training would have performed.
D. is not protected by the Good Samaritan law and did not perform as any other paramedic with similar training would have performed.
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 place an attorney on retainer. C. the paramedic should follow up with the patient regularly. D. it is essential to maintain good documentation on any call.
D. it is essential to maintain good documentation on any call.
Under the OSHA Act of 1970, an EMS employer must: A. terminate an employee who was exposed to a bloodborne pathogen. B. ensure that the employee's family is vaccinated for a reasonable fee. C. provide a one-time training session that addresses bloodborne pathogens. D. make the hepatitis B vaccine available to the employee at no charge.
D. make the hepatitis B vaccine available to the employee at no charge.
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. should stop if you have an EMS decal on your car. C. should call 9-1-1 but not stop to provide care. D. may feel an ethical obligation to stop and assist.
D. may feel an ethical obligation to stop and assist.
If your EMS system receives a subpoena for a patient's protected health information, you should: A. obtain the patient's consent before releasing any information. B. refuse to disclose any of the patient's protected information. C. disclose the information requested by the subpoena. D. notify legal counsel before releasing any information.
D. notify legal counsel before releasing any information.
The best legal protection for the paramedic is to: A. treat all patients with respect and remain aware that patients' cultural beliefs may differ from those of the paramedic. B. always transport the patient to the hospital of the patient's choice, regardless of the patient's clinical condition. C. routinely obtain more than the minimum number of continuing education credits required by the state department of health. D. provide a detailed patient assessment and appropriate medical care, followed by complete and accurate documentation.
D. provide a detailed patient assessment and appropriate medical care, followed by complete and accurate documentation.
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. monitor the patient's condition for 15 minutes and then begin emergency treatment if he does not improve. B. utilize law enforcement to help restrain the patient so that you can start an IV line and give him dextrose. C. administer oxygen only until you can obtain a court order to start an IV and administer dextrose. D. remain professional and advise the patient that he is not legally capable of refusing EMS treatment.
D. remain professional and advise the patient that he is not legally capable of refusing EMS treatment.
When determining whether a paramedic's actions were consistent with the standard of care, court discussion will be based on: A. the testimonies of patients to whom the paramedic has provided care in the past. B. the testimonies of other paramedics who have the same training. C. a copy of the paramedic's standard operating procedures D. the paramedic's documentation and testimony.
D. the paramedic's documentation and testimony.
Historically, most EMTALA violations occurred when: A. paramedics functioned above their scope of practice. B. paramedics transported a woman in active labor. C. hospitals refused to accept clinically stable patients. D. the patient did not have medical insurance.
D. the patient did not have medical insurance.
When determining the most appropriate hospital to which to transport a patient, the paramedic's first consideration should be: A. the wishes of the patient or family. B. whether or not the patient has insurance. C. traffic conditions and similar variables. D. the patient's clinical condition.
D. the patient's clinical condition.
Ethics can be defined as: A. the professional behavior that a person's peers as well as the general public expect. B. a code of conduct that can be defined by society, religion, or a person, affecting character, conduct, and conscience. C. behavior that is consistent with the law and an attitude that society in general expects. D. the philosophy of right and wrong, of moral duties, and of ideal professional behavior.
D. 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 consent from both parents before treating. C. you must obtain a court order before you can legally treat them. D. they can neither consent to nor refuse medical care
D. they can neither consent to nor refuse medical care
The husband of a terminally ill woman called 9-1-1 because he thinks his wife is about to die. The patient has a valid living will and an out-of-hospital DR order. You should: A. contact medical control and request permission to provide emergency care. B. ask the husband why he called EMS if his wife is not to be resuscitated. C. assume that the husband has revoked the DNR order and begin treatment. D. treat the husband and his wife with respect and provide emotional support.
D. treat the husband and his wife with respect and provide emotional support.
When functioning at a crime scene, it is important for the paramedic to: A. carefully question witnesses as to what they saw. B. avoid performing patient care until cleared by the police. C. collect and safeguard any and all evidence. D. use caution and not disturb the scene unnecessarily.
D. use caution and not disturb the scene unnecessarily.
A paramedic's actions are considered to be grossly negligent if he or she: A. only provides basic life support to a critical patient. B. makes a simple mistake that causes harm to the patient. C. does not consult with online medical control first. D. willfully or wantonly deviates from the standard of care.
D. willfully or wantonly deviates from the standard of care.
A Medical Order for Life-Sustaining Treatment (MOLST) would most likely apply to a patient: A. who is in respiratory failure but has decision-making capacity. B. with a terminal illness whose cardiac arrest was witnessed. C. who has been in cardiac arrest for less than 10 minutes. D. with impending pulmonary failure but who is not in cardiac arrest.
D. with impending pulmonary failure but who is not in cardiac arrest.
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. he will only consent to EMS transport. B. consent to treat this patient is implied. C. he is not mentally competent. D. you do not have consent to treat him.
D. you do not have consent to treat him.
