Unit 1

In the recovery position, the patient is:

on his or her side

Which of the following is a specific example of the Mobile Integrated Healthcare (MIH) model?

The paramedic administers a patient's flu vaccination

In which of the following circumstances can the MT legally release confidential patient information?

The patient is competent and signs a release form

Which of the following statements regarding the different stages of the grieving process is correct?

The stages of the grieving process might occur simultaneously.

Which of the following statements regarding HIV is correct?

There is no vaccine against HIV infection.

When is forcible restraint permitted?

When the patient poses a significant threat to self or others

Physiologic manifestations of stress include:

perspiration, increased blood glucose levels, and dilated pupils.

The final stage of death and dying most commonly takes the form of:

acceptance.

You are transporting an elderly woman who has possibly experienced a stroke. She is obviously scared but is unable to talk and cannot move the entire right side of her body. In addition to providing the medical care that she needs, you should:

acknowledge that she is scared and tell her that you will take good care of her.

When caring for the parents of a child who has died of leukemia, the EMT should:

acknowledge the death of their child in private.

After receiving online orders from medical control to perform a patient care intervention, you should:

repeat the order to medical control word for word.

The best way to reduce your risk of contracting a work-related disease following exposure is to:

activate your department's infection control plan as soon as possible.

You are transporting a 40-year-old male with respiratory distress. The patient tells you that he recently had a positive tuberculosis (TB skin test and is currently being evaluated for possible TB. You should:

apply a nonrebreathing mask on the patient and a high-efficiency particulate air (HEPA) respirator on yourself.

During your monthly internal quality improvement (Ql) meeting, you review several patient care reports (PCRs) with the staff of your EMS system. You identify the patient's name, age, and sex, and then discuss the treatment that was provided by the EMTs in the field. By taking this approach to the Ql process, you:

are in violation of HIPAA because you did not remove the PHI from the PCR beforehand.

You are dispatched to the residence of a person who frequently calls 911 for nonemergency care. You should:

ask the dispatcher to send law enforcement before you respond

A 4-year-old boy had an apparent seizure. He is conscious and calm and is sitting on his mother's lap. His father is sitting in a nearby chair. The child's mother suddenly begins crying uncontrollably, which causes the child to start crying. You should:

ask the father to hold the child so you can assess him while your partner tries to calm the mother

You and your partner respond to the residence of a 66-year-old male with shortness of breath. As you are assessing the patient, his wife tells you that he was recently diagnosed with lung cancer. The patient is verbally abusive and tells you that failure of the healthcare system caused his disease. Which stage of the grieving process is this patient's behavior consistent with?

anger

When you begin an oral report, you should state the patient's age, sex, and:

chief complaint

If it is not possible to adequately clean your ambulance at the hospital following a call, you should:

clean the ambulance at your station in a designated area that is well ventilated

Your EMS system uses a computerized PCR in which you fill in the information electronically and then send it to the emergency department via a secure Internet server. The PC has a comprehensive series of drop-down boxes, which are used to identify your assessment findings and specify the treatment that you provided; it also has a section for your narrative. When completing your PC after a call, you should:

complete a thorough and accurate narrative because drop-down boxes cannot provide all of the information that needs to be documented.

Immediately after being dispatched to a residence for an elderly patient with diabetic complications, you should:

confirm with dispatch that you received the call information.

When considering one's personal life, it is important for the EMT to realize that:

family or friends might not understand the stress associated with EMS.

Typical components of an oral patient report include all of the following, except:

the set of baseline vital signs taken at the scene.

The official transfer of patient care does not occur until the EMT:

gives an oral report to the emergency room physician or nurse.

You and your partner arrive at the scene of a major motor vehicle crash. The driver, a young male, is severely entrapped in his car. He has an open head injury and massive facial trauma. He is unresponsive, not breathing, and does not have a palpable carotid pulse. You should:

have your partner check for a pulse to confirm that the patient is deceased.

deals with the well-being of the EMT, career progression, and EMT compensation.

human resources department

You and your partner are EMTs who have been dispatched to stand by at the scene of a residential fire. While standing next to the ambulance observing the firefighters, you see a woman frantically moving around in her burning house. You should:

immediately notify the incident commander or safety officer.

EMs such as firefighters, law enforcement officers, and park rangers are an integral part of the EMS system because:

they often arrive at the scene before the ambulance and EMTs.

Your best protection against legal liability when a patient with decision-making capacity refuses EMS care and transport is to:

thoroughly document the entire event.

During your assessment of a patient with a chest injury, you note that only one side of his chest moves when he breathes. How should you describe his chest movement?

unilateral

You and your partner are dispatched to a residence for an "ill person." When you arrive, you find that the patient, a 44-year-old man, does not speak English. There are no relatives or bystanders present who can act as an interpreter. You should:

use short, simple questions and point to specific parts of your body to try to determine the source of the patient's complaint.

At the scene of a motor vehicle crash, you determine that there are two critically injured patients and that another ambulance is needed. You attempt to contact the dispatcher with your portable radio but are unsuccessful. You should:

use the mobile radio in the ambulance to contact dispatch.

When communicating information over the radio, you should:

use the words "affirmative" and "negative" instead of "yes" or "no."

If you use a waterless handwashing substitute in the field, it is important to:

wash your hands with soap and water at the hospital

While trying to make a family member feel better after a loved one has died, your partner states, I know how you are feeling." The family members might view this as:

your partner's attempt to diminish their grief..

A patient has bilateral femur fractures. This means that:

both femurs are fractured.

A 60-year-old man complains of chest pain. He is conscious, alert, and denies shortness of breath. Which of the following questions would be the most appropriate to ask him?

"Do you have any heart problems or take any medications?"

Which of the following statements would not be appropriate to say to the family of a dying patient?

"Things will get better in time."

In which of the following situations does a legal duty to act clearly exist?

A call is received 15 minutes prior to shift change.

Which of the following would provide the MT with the best cover in a situation involving active gunfire?

A concrete barricade

Shortly after you load your patient, a 50-year-old man with abdominal pain, into the ambulance, he tells you that he changed his mind and does not want to go to the hospital. The patient is conscious and alert and has no signs of mental incapacitation. You are suspicious that the man has a significant underlying condition and feel strongly that he should go to the hospital. Which of the following statements regarding this situation is correct?

A mentally competent adult can withdraw his or her consent to treat at any time.

Which of the following statements regarding a patient refusal is correct?

A mentally competent adult has the legal right to refuse EMS care and transport.

Why are prehospital emergency care guidelines updated on a regular basis?

Additional information and evidence indicate that the effectiveness of certain interventions has changed.

Which of the following scenarios most accurately depicts a posttraumatic stress disorder (PTSD) reaction?

An EMT becomes distracted at the scene of a motor vehicle crash involving the same type of car in which a child was previously killed.

Which of the following statements regarding the MS medical director and an EM's scope of practice is correct?

An EMT's scope of practice may be expanded by the medical director after proper training and state approval.

A trauma patient has a gunshot wound to the left side of the chest, away from the nipple. How should the injury location be described?

Anterolateral

A proximal humeral fracture is one that is located:

At the upper part of the humerus

Which of the following skills would a layperson most likely be trained to perform before the arrival of EMS?

Bleeding control using a tourniquet

Which type of stress reaction occurs when an EMT is exposed to many insignificant stressors over a period of several months or years?

Cumulative stress reaction

Which of the following is an effective stress management strategy?

Developing a social network outside of EMS

Your partner, a veteran EMT with whom you have worked regularly for the past four years, seems unusually agitated during a call involving an elderly patient. Upon arrival back at your station, you note the obvious smell of alcohol on his breath. What should you do?

Discreetly report your suspicions to your supervisor.

You are dispatched to the residence of an Asian family for a child with a high fever. When you assess the child, you note that he has numerous red marks on his back. The child's parents explain that these marks represent coining a traditional Asian healing practice in which hot coins are rubbed on the back. You should:

Document this on your patient care report and advise the emergency department staff of what the child's parents told you

Where would you most likely find information regarding a patient's wishes to be an organ donor?

Driver's license

Which type of consent is involved when a 39-year-old, mentally competent female with a severe headache asks you to take her to the hospital?

Expressed

You are transporting a 54-year-old male in respiratory arrest. An EM is driving the ambulance as you and your partner are caring for the patient. What is the most logical way of notifying the hospital?

Have the driver contact dispatch and relay the patient information to the hospital

Which of the following statements regarding a "dedicated line" is correct?

It is a constantly open line of communication that cannot be accessed by outside users

The person who is responsible for authorizing EMTs to perform emergency medical care in the field is the:

Medical Director

EMT training in nearly every state meets or exceeds the guidelines recommended by the:

National Highway Traffic Safety Administration (NHTSA)

A patient has kidney disease that is causing him severe pain. What condition does he have and what would be administered for his pain?

Nephropathy; analgesic

Which of the following statements regarding the hepatitis B vaccine is correct?

OSHA requires that your employer offer you the vaccine free of charge

You arrive at the scene of a motor vehicle-versus-pedestrian accident. The patient, a 13-year-old male, is unconscious and has multiple injuries. As you are treating the child, a law enforcement officer advises you that the child's parents will be at the scene in approximately 15 minutes. What should you do?

Transport the child immediately and have the parents meet you at the hospital.

Medical control gives you an order that seems inappropriate for the patient's condition. After confirming that you heard the physician correctly, you should:

advise the physician that the order is unclear and ask for clarification.

During your assessment of a 20-year-old man with a severe headache and nausea, you ask him when his headache began, but he does not answer your question immediately. You should:

allow him time to think about the question and respond to it.

A patient lacerated the dorsal aspect of his hand. This means that the injury is:

back of hand

When faced with a situation in which a patient is in cardiac arrest and a valid living will or DR order cannot be located, you should:

begin resuscitation at once

While transporting a woman with diabetes, you inadvertently give her oral glucose even though her blood glucose level was high. You reassess the patient and note that her condition did not change; she remained stable. You should:

contact medical control and notify him or her of the error

While transporting a stable patient with chest pain to the hospital, you come across a major motor vehicle crash involving several critically injured patients. You should:

continue transporting your patient and notify the dispatcher of the crash

You are assessing a woman who was thrown from a horse. She is located in a large field and you can see that a thunderstorm is rapidly approaching. Suddenly, you feel your skin begin to tingle and the hair on your arms stands on end. The ambulance is located about 30 yards away. You should:

crouch down in a position so that only your feet are touching the ground.

Determination of exposure is an important component of an infection control plan because it:

defines who is at risk for contact with blood and body fluids and which tasks pose a risk of exposure.

You are caring for a 35-year-old female with pregnancy-related complications. She is clearly experiencing significant stress and is crying uncontrollably. Your most appropriate action would be to:

demonstrate courtesy and speak with a professional tone of voice

It is especially important for MS personnel to develop non-adversarial relationships with their coworkers because they:

depend on one another for their safety.

A woman amputated the tip of her finger. Which directional term should be used to describe her injury location?

distal

After delivering your patient to the hospital, you sit down to complete the handwritten PR. When documenting the patient's last blood pressure reading, you inadvertently write 120/60 instead of 130/70. To correct this mistake, you should:

draw a single horizontal line through the error, initial it, and write the correct data next to it.

Where would you most likely find information regarding a patient's wishes to be an organ donor?

driver's license

Which of the following components are needed to prove negligence?

duty to act, breach of duty, injury/damages, and causation

The compliance monitoring component of an infection control plan should:

ensure that employees understand what they should do and why it is important.

You are dispatched to an office building for a 49-year-old male with chest pain. When you arrive at the scene, you find the patient to be conscious and alert but in obvious pain. He tells you that he did not call 911; a coworker did. He further states that he does not want to be treated or transported to the hospital. You should:

ensure that he is aware of the risks of refusing medical care

When performing his or her duties, the EMT is generally expected to:

exercise reasonable care and act prudently

You are assessing a middle-aged man with chest pain that you suspect is caused by a cardiac problem. The patient tells you that he does not want to go to the hospital and insists that you leave him alone. You should:

explain the seriousness of the situation to him, but avoid causing undue alarm.

According to the National EMS Scope of Practice Model, an EMT would require special permission from the medical director and the state EMS office to:

insert a peripheral intravenous catheter

If an action or procedure that was performed on a patient is not recorded on the written report:

it was not performed, according to the eyes of the law.

As an EMT, it is important to remember that the signs and symptoms of cumulative stress:

may not be obvious or present all the time.

You are caring for a 40-year-old female who was involved in a motor vehicle crash. Her husband, who was driving the vehicle, was killed. When the patient asks you if her husband is all right, you should:

let clergy or hospital staff relay the bad news if possible.

All of the following are considered to be protected health information (PHI), except:

location of the call

You are dispatched to the scene of a crash involving a large tanker truck. While you are en route, dispatch advises you that there are multiple patients and that the fire department is en route as well. As you approach the scene, you should:

maintain a safe distance and try to read the placard with binoculars.

Which of the following is not a function of the Federal Communications Commission (FCC)?

maintaining communications equipment on the ambulance

You are summoned to a convalescent center for an 88-year-old female with an altered mental status. A staff nurse advises you that the patient has terminal cancer, and her physician stated that she would probably die within the next few hours; a valid do not resuscitate (DR) order is presented to you. When caring for this patient, you should:

make her comfortable and provide emotional support.

At the scene of an automobile crash, a utility pole has been broken, and power lines are lying across the car. The patients inside the car are conscious. You should:

mark off a danger zone around the downed lines.

As an EMT, you may be authorized to administer aspirin to a patient with chest pain based on:

medical director approval

When caring for a 65-year-old male with respiratory distress, you place him in a comfortable position but do not apply oxygen. The patient's condition continues to deteriorate: He develops cardiac arrest and dies at the hospital. This scenario is an example of:

negligence

According to Occupational Safety and Health Administration (OSHA) regulations, an employer must:

offer a workplace environment that reduces the risk for exposure.

You are treating a man who was assaulted and has a closed-head injury. The patient, who has slurred speech, becomes verbally abusive and tells you to leave him alone. You should:

proceed with treatment and utilize law enforcement for assistance if necessary.

You are dispatched to a middle school for a 16-year-old female experiencing an asthma attack. She is conscious and alert but in severe respiratory distress. The school nurse informs you that she has tried several times to contact the patient's parents but has not been successful. You should:

provide treatment up to your level of training and transport the child at once.

Relative to the ankle, the knee is:

proximal

When treating a patient who is trapped in a vehicle and covered with broken glass, it is best to wear:

puncture-proof leather gloves over your latex gloves.

Upon arriving at the scene of a motor vehicle crash, you note that two small cars collided head-on; the occupants are still in their vehicles. The fire department is in the process of stabilizing the vehicles and law enforcement personnel are directing traffic. After parking the ambulance at a safe distance, you and your partner should:

put on high-visibility safety vests

You are dispatched to an apartment complex to respond to a shooting. Law enforcement personnel are present and have the suspect in custody. You find the patient lying in a narrow space between the couch and coffee table of his small apartment. He is semiconscious and has a large gunshot wound to his chest. You should:

quickly move the coffee table so you can access and treat the patient

A 75-year-old male with a terminal illness has died at home. As you and your partner enter the residence, a family member becomes verbally abusive, pushes you, and states that you took too long to get there. You should:

retreat and notify law enforcement personnel.

You arrive at the scene of a domestic violence situation. As you approach the doorway of the apartment, you hear screaming and the statement, "He has a gun!". Your most appropriate action should be to:

seek a safe place and request law enforcement assistance.

While you are on duty, your partner asks you out on a date and touches you in an inappropriate location without your consent. You should:

tell your partner to stop and report the incident to your supervisor.

According to the Centers for Disease Control and Prevention (CDC, recommended immunizations and tests include a:

tetanus/diphtheria/pertussis booster every 10 years.