Therapeutic Communications

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

A. "What happened the last time you felt this way?"

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

A. Most newer systems use facsimile technology to allow transmission of 12-lead ECGs.

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

A. active listening.

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

A. advise the patient to consult with his or her physician.

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

A. are unpredictable because changes in ionospheric conditions may cause losses in communication.

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. be patient and give the patient time to express his feelings. B. offer suggested responses to facilitate the patient's answer. C. repeat the question, but ask it differently the second time. D. ask another question and revisit the previous question later.

A. be patient and give the patient time to express his feelings.

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

A. give prearrival instructions to the caller.

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. may be necessary if the patient appears to have an altered mental status during your visual assessment of his or her behavior. C. is typically acceptable to the patient, because he or she is often frightened and desperately wants someone to help. D. is unprofessional and ethically unacceptable unless you have obtained consent from the patient's family or primary caregiver.

A. is nonverbally communicating, "You are not important enough or mentally competent enough to be asked for permission."

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

A. is not recommended by the National Incident Management System (NIMS).

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. reflection. B. confrontation. C. facilitation. D. interpretation.

A. reflection.

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

A. treat the patient with the utmost respect at all times.

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. you should ask him or her questions that require more thought. C. he or she is most likely scared and unable to remember. D. he or she likely has an intracerebral hemorrhage or lesion.

A. you should suspect decreased blood flow to the brain.

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. "Can you describe the pain to me?" C. "Does the pain radiate to your arm?" D. "Does the pain feel more like pressure?"

B. "Can you describe the pain to me?"

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

B. "He is very sick, but we are doing everything we can to help him."

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

B. Speaking close to the patient's ear in a calm voice in an extremely noisy situation

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

B. The patient's ethnicity

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

B. The patient's last known oral intake

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

B. include information that you did not provide during your radio report.

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

B. multiplex

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

B. you are trying to obtain medical history information.

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

C. HIV status.

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

C. approach the patient cautiously, while maintaining eye contact.

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

C. cautiously approach the patient and use open posturing.

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

C. elicit a specific response from the patient.

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

C. enlist the help of a family member or primary caregiver.

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. stop the interview until the patient's behavior is less aggressive. C. ensure that another paramedic or EMT is present at all times. D. ask a paramedic of the opposite sex to interview the patient.

C. ensure that another paramedic or EMT is present at all times.

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

C. how frequently a radio wave recurs in a given time.

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

C. listen to make sure that the channel is clear of traffic.

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

C. repeater

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

C. repeater

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

C. simple, brief, and direct.

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

C. the capability of measuring vital signs and ECG tracings and transmitting them to a distant terminal.

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. multiplex system. C. trunking system. D. half-duplex system.

C. trunking system.

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

C. works against effective communication.

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

C. your partner.

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

D. "Does the pain radiate to your arm or jaw?"

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 don't see any abnormalities on your ECG, but you should be evaluated by a physician." C. "I can see that you are obviously upset, but I will provide the best care possible to you." D. "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'm sure that you will be fine, but let us take you to the hospital just to be on the safe side."

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

D. "You're welcome."

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

D. Asians

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

D. The thumbs-up sign

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

D. They should be avoided during a mass-casualty situation.

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

D. clarity.

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.

D. evaluate the patient's neurologic status.

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

D. lack of empathy.

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

D. manage the scene so you can ask such questions quietly and privately.

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

D. redirect him or her to the question to elicit a response.

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.

D. therapeutic communicator.

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

D. translates a telemetry signal into an oscilloscope tracing.

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

D. trunking.

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

D. use a normal conversational tone of voice.