CHAPTER 4 STUDY GUIDE
Which of the following situations involves a HIPAA violation?
An EMT discusses patient cases with his physician.
Which of the following situations BEST illustrates the act of abandonment by the EMT?
An EMT transports a patient to the emergency department, leaves the patient in the waiting room, but does not advise the ED staff.
If the EMT is in doubt as to whether a patient in cardiac arrest should be resuscitated, which of the following is the best decision?
Begin resuscitative measures.
Sharing information about a patient's medical history with your neighbor after you hear a call on a radio scanner would constitute which of the following?
Breach of confidentiality
You are on the scene with a 72-year-old male patient with chest pain. The patient is complaining of shortness of breath but also refuses to go to the hospital, even after multiple attempts urging him to go. Which of the following should you do next?
Fully inform the patient about his situation and the implications of refusing care.
Laws that have been developed by states to minimize the risk of individuals being held liable for providing emergency care to victims of illness or injury are called:
Good Samaritan laws
Which of the following information may be important to law enforcement officers investigating a crime scene?
How you gained access to the scene
What is an EMT's primary ethical consideration?
Making patient care and the patient's well-being a priority
You respond to the report of an unconscious female patient. You can acquire important medical information about the patient through which of the following?
Medical identification device
As you enter a hectic possible crime scene, you find that a coffee table is blocking your access to the patient. Which of the following is the BEST way to manage thissituation?
Move the table as little as possible, wearing gloves; notify police on the scene; and document your actions precisely in your patient care report.
You arrive on the scene of a 55-year-old male patient. The patient's wife called 911 because he is having chest pains. The patient is very angry with his wife for calling 911 because he states he only has heartburn and adamantly refuses any treatment or transport. After signing the patient refusal form, the patient collapses and goes into sudden cardiac arrest. The wife is crying uncontrollably and begging you to do something. What should you do?
Provide emergency care under implied consent.
Which statement is TRUE? A. Standard of care refers generally to what you will do; scope of practice refers to what you did do. B. Standard of care refers generally to what you legally can do; scope of practice refers to what you ethically can do. C. Standard of care refers generally to what you should not do; scope of practice refers to what you should do. D. Standard of care refers generally to what you should do; scope of practice refers to what you can do
Standard of care refers generally to what you should do; scope of practice refers to what you can do.
Two EMTs respond to the scene of a syncopal episode. A 50-year-old patient passed out and cut his lip. The EMTs talk the patient out of an expensive ambulance ride and suggest he will save money by driving himself to urgent care instead. The patient agrees and signs a refusal form. The patient dies from sudden cardiac arrest at home the following day. Which of the following statements is true?
The EMTs may be negligent if there is evidence of proximate cause.
A patient sues an EMT for negligence, citing that the EMT failed to act appropriately in caring for the patient, that the patient suffered from the EMT's negligence, and the EMT violated the standard of care for the specific situation. The patient claims to have feared bodily harm at the time of the incident in question. Which of the following of the patient's claims is NOT required to prove a claim of negligence against an EMT?
The patient was in fear of bodily harm at the time of the incident.
Which of the following would MOST likely be considered evidence at a crime scene?
The position in which the patient is found
Which of the following statements is true concerning protection by Good Samaritan laws?
The purpose of Good Samaritan laws is to protect people who are trying to help in an emergency.
In which of the following situations is it legal to share information about treatment you provided to a patient?
The triage nurse at the emergency department asks about the care you provided to the patient.
In which of the following situations should an EMT withhold resuscitative measures from a patient in cardiac arrest?
The patient's caregiver presents a DNR order signed by the patient and his physician.
Which of the following is MOST clearly a HIPAA violation?
You provide a personal injury attorney with a copy of a patient care report.
You are treating an elderly male patient in the back of your ambulance. En route, the patient becomes unresponsive. Upon arrival, the ED nurse asks you several questions about his condition. What should you do, and why?
You should answer her questions because you may legally share the patient's medical condition with other pertinent health care providers.
You are providing care to a 54-year-old male patient complaining of chest pain. The patient asks to speak to you privately. He tells you he is taking Cialis for erectiledysfunction, and his wife does not know he is taking it. He does not want his wife to find out. As you are putting the EMS bags back in the ambulance, the wife corners you and insists that you tell her what her husband said. What should you do, and why?
You should not tell her. By law, your conversation with your patient is confidential.
Which of the following incidents is it likely for the EMT to be legally required to report to law enforcement?
Your patient has facial and head injuries and states that her husband beat her with a screwdriver.
The person who is legally designated to make health care decisions for the patient if the patient is unable to do so is called:
a health care proxy
Good Samaritan laws dictate that:
a rescuer must provide care in good faith, to the level of that rescuer's training, and to the best of that rescuer's ability.
You suspect that a pediatric patient is being abused. You decide not to report this to the appropriate authorities because the parent is very upset and remorseful. Thisis:
a violation of professional ethics and possibly a crime.
An EMT who turns the care of a multisystem trauma patient over to a doctor of dermatology has likely
abandoned the patient
Leaving a patient after initiating care and before the patient has been transferred to someone with equal or greater medical training is known as:
abandonment
Wheeling a non-emergency patient into the hospital emergency department, placing him in a bed, and leaving without transferring care directly to ED staff constitutes:
abandonment
A legal document allowing the health care provider to withhold resuscitation from a chronically or terminally ill patient is the known as:
advance directive
documents signed by a patient that communicate his or her wishes regarding medical care are called:
advance directives
The Health Insurance Portability and Accountability Act (HIPAA):
allows you to discuss patient-specific information only with individuals with whom it is medically necessary to do so
What is the term for placing a person in fear of bodily harm?
assault
A patient who called 911 is now refusing transport. You should:
assess the patient, advise the patient of the risks of refusal, and clearly document everything in the patient care report.
EMS is on the scene of the cardiac arrest of a terminally ill cancer patient. The family states that the patient has a valid DNR but they are unable to locate it. The family is upset and adamant that the patient does not want resuscitation. The EMS crew should:
begin resuscitation and consider establishing on-line medical direction.
Your patient is a 10-year-old boy who suffered a possible fractured arm while rollerblading at a friend's house. Which of the following is the BEST way to obtain consent for treatment?
call the patients mother at work
A 13-year-old patient involved in a collision who appears to be under the influence of drugs refuses care. Regarding the issue of providing care to this patient, you must consider that this patient:
cant legally refuse care
You are on the scene with a patient who is complaining of chest pain, and you have administered medication. Your partner brings in the stretcher, and the patient tells you that she does not want to be transported to the ED. You should:
contact medical direction for a consult.
You respond to a bus accident with multiple patients. As you arrive at the scene, you are approached by a local politician who states that his wife has been involved. He tells you that if you will take care of her first, he will ensure that you get the promotion you are up for. This is what type of decision for you as an EMT?
ethical
You explain a risky procedure to a patient. He says, "As long as it's guaranteed to work, you can do it." You should:
explain that a risky procedure is not guranteed
When an EMT takes the time to ask permission from a conscious adult to do an assessment and procedures, this is respecting the legal principle of:
expressed consent
Which type of consent must be used by the EMT when seeking to treat a mentally competent adult?
expressed consent
While treating a patient involved in a shooting at the patient's vacation home, which of the following actions is unlikely to interfere with the investigation of a crimescene?
failing to take notes on scene
You and your partner have arrived on the scene of a person injured as a result of a gunshot wound during a burglary. When police later arrive and secure the scene, one of the police tells you to file a complete report describing what you saw when you arrived on scene, as required by law in your area. You should:
file the report and leave out no details
Which of the following would MOST likely be considered evidence at a crime scene?
fingerprints
You are on the scene of a cardiac arrest. You have begun resuscitation as family members arrive and present you with a valid DNR order. You should:
follow your local protocols and contact medical direction if unsure how to proceed.
The concept of res ipsa loquitur would be MOST relevant to a situation involving:
harm to a patient in the care of EMTs
A patient appears to be in the midst of a psychotic episode and is unable to make a rational decision about consenting to emergency care. The EMT may care for the patient on the basis of:
implied consent
Your patient is a 40-year-old known diabetic who was found unconscious at work by a coworker. What type of consent allows you to treat this patient?
implied consent
In a kindergarten, the teachers can give consent for EMT care of their students. Which form of consent applies here?
in loco parentis
You respond to a middle school for a 12-year-old male patient who has been hit by a car. You get consent to treat the patient from the school principal. What concept allows the principal to speak for the parents?
in loco parentis
You are on the scene of a motor vehicle collision where a patient's car struck a utility pole. Witnesses reported to you that the patient was unconscious after the impact. However, the patient is now conscious, alert and oriented, and refusing care and transport. You should:
inform the patient of your concern and try to persuade her to go to the ED and receive treatment
You proceed to treat a patient who has consented to care, but you have NOT explained the risks and benefits of what you are going to do. This is MOST likely a violation of:
informed consent
You are at the scene of a patient with obvious signs of traumatic death. You are required by law in your state to report violent deaths. Your duty as an EMT is tonotify:
law enforcement
A patient is injured but refuses to be transported by ambulance. He is competent to make decisions, and you have exhausted all avenues to convince him to betransported, so you have him sign a refusal of treatment form. This form is intended to release you from
liability for not providing care.
If an EMT were to release information about how intoxicated a patient was onto a social networking site, this could be considered
libel
While documenting a call, you add a false statement that was made about a local doctor. This could constitute which of the following?
libel
You document on your run sheet that your patient with altered mental status is "just another drunk." This would likely be considered:
libel
You are transporting a patient from a doctor's office and see that the patient has not been well cared for. On your documentation, you write that the doctor seemed to be "a quack." This comment could be viewed as
libelous
Why does the EMT's scope of practice vary from state to state?
local legislation
A patient injured in a car chase from the police is conscious and issuing threats to the police and EMS personnel on the scene. He attempted to physically strike your partner while you and your partner were providing the patient with care. The police assist you in restraining the patient, and you secure him safely in a stretcher with straps across his arms and legs. Your primary duty in this situation is to
monitor the patient's status and vital signs carefully and frequently.
You observe what appears to be elder abuse in a call to a nursing home. You have a clear:
moral obligation to report the abuse.
An EMT fails to properly care for a patient despite having a duty to act. The EMT is most likely guilty of:
negligence
While providing patient care at a secured crime scene, you should:
not cut through holes in clothing that might have been caused by bullets or stabbing.
You have just arrived at the station to start your shift, and you notice that your partner is asleep in a chair. You proceed to check out your ambulance. Your partner comes in drinking a cup of coffee, and you notice that she has a strong alcohol smell on her breath. Your duty as an EMT is to:
notify dispatch that you are out of service and have your supervisor come to meet you.
You are transporting a victim from a motor vehicle collision, and the patient's condition is deteriorating rapidly. From your experience, you do not think this patient will survive transport. You noticed on the patient's driver's license that the patient is an organ donor. You can help to facilitate the patient's wishes by:
notifying medical direction of the patient's organ donor status.
At a crime scene, which of the following is the first priority of the EMT?
patient care and transport
Good Samaritan laws were enacted to
protect individuals who try to help people in emergencies
A suicidal 14-year-old who has critically injured herself is trying to get you to withhold care. She is screaming that she wants to die and that you should not touch her or come near her. You should:
provide the care that she needs
Good Samaritan laws are based on:
providing care in good faith
Which of the following is the EMT's primary responsibility at a secured crime scene?
providing patient care
Ethical considerations:
relate primarily to making patient care and well-being a priority
A 42-year-old patient who is mentally competent has refused care but appears to be experiencing respiratory difficulty. He demands you get into your ambulance and go. You should:
remain on the scene and try to persuade the patient to consent to care.
A photo of a pair of EMTs on a call shows them laughing and looking casual and relaxed a few feet away from a patient in apparent distress. This would most likely be used to demonstrate:
res ipsa loquitur.
The actions and care that are legally allowed for the EMT are called the:
scope of practice
The administration of oxygen and the application of spinal immobilization are part of which of the following for the EMT?
scope of practice
What is a set of regulations and ethical considerations that define the extent and limits of the EMT's job?
scope of practice
Which is concerned generally with what you can do, as opposed to what you should do and how you should do it?
scope of practice
Which of the following refers to the set of regulations that defines the legal actions expected of and limitations placed on the EMT?
scope of practice
You are at the dinner table with your crew and mention to everyone that a coworker on the opposite shift is moving up the administration chain quickly, probably because she's sleeping with the company CEO. This comment could be considered
slander
Quality improvement relates primarily to:
standard of care
The care that would be expected to be provided to the same patient under the same circumstances by another EMT who had received the same training is called the:
standard of care
You have been under a lot of family stress lately, and you have not been sleeping well. When you got to work this morning, you realized that you had forgotten to place your badge on your uniform shirt. You tell your partner that you cannot seem to think clearly. Your partner tells you that he is concerned about your well-being. After hearing this, you know that your duty as an EMT is to:
take off work until you can straighten out your family problem and make sure that you are mentally prepared to work.
You have just returned to the station after completing a call in which you transported an elderly female patient to the hospital for nausea and vomiting. Upon exiting the ambulance, you are approached by an adult male who indicates that the patient you just transported was his mother and he wants to know the details of the run. You should:
tell him that you can pass his contact information along to the privacy officer at your department.
What may interfere with an EMT's ability to care for a patient at a crime scene?
the police want to interview the patient
The actions that an EMT is legally allowed to perform while caring for an injured or ill patient are known as
the scope of practice
Even if the Good Samaritan laws in a particular state cover the actions of EMTs as rescuers, they can still be held liable and are NOT protected by these laws if:
their actions demonstrate gross negligence.
If emergency care providers discover that a seriously injured patient is an organ donor, they should:
treat the patient the same as a nondonor
You are caring for a patient who was stabbed. During your assessment, you find a small knife impaled in one of the stab wounds. You determine that removing the weapon now would be dangerous for the patient. You should:
treat the wound as usual, but notify police that you must transport the weapon with the patient
Your patient is a 45-year-old man who is suffering from chest pain. Upon your arrival, the patient is pale, sweaty, and seems short of breath. The patient is angry with his daughter for calling 911. He says that he had some spicy sausage for breakfast and has indigestion, and he doesn't want to go to the hospital. Which of the following is an appropriate means of getting the patient the care he need
try to find out why the patient doesn't want to go to the hospital
You have not breached a patient's confidentiality if
you only share information specific to that patient when medically necessary
