Chapter 36

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

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

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Which of the following does NOT usually contribute to or cause obesity? A. Rapid metabolism B. Genetic predisposition C. High caloric intake D. Low metabolic rate

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

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

30% or more

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

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

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

Check the mechanical ventilator for malfunction.

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

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

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

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

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

Using a piece of paper and writing utensil to ask questions

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

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

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

a cervical spine injury.

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

a triplication of chromosome 21.

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

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

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

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

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

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

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

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

If a patient's mechanical ventilator malfunctions, you should remove the patient from the ventilator and: A. contact medical control. B. place the patient on a nonrebreathing mask. C. begin ventilations with a bag-valve mask. D. place the patient on a nasal cannula.

begin ventilations with a bag-valve mask.

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

body

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

brain

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

colostomy

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

disconnect the ventilator and apply a tracheostomy collar.

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

have extreme difficulty with complex tasks that require many steps.

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

is sick.

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

positioning yourself approximately 18 inches directly in front of the patient.

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

prevent excess cerebrospinal fluid from accumulating in the brain.

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

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

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

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

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

rupture of a central vein.

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

secretions can build up in and around the tube.

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

shunt

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

teeth are misaligned and they have a large tongue.

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

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

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

their limbs are often underdeveloped and are prone to injury.

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

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