Chapter 5: Communications

What is the purpose of a universal timeout? A. It allows time for all providers to silently review important aspects of a procedure with minimal distraction. B. It enables the paramedic to contact medical control and request permission to perform a high-risk procedure. C. It enables the paramedic in charge to do his or her job by ensuring that all other personnel at the scene remain silent. D. It allows the paramedic to provide better care by removing all bystanders and unnecessary personnel from the scene.

A. It allows time for all providers to silently review important aspects of a procedure with minimal distraction.

Which system is required in order for the paramedic to talk and transmit an ECG simultaneously on one frequency? A. Multiplex B. Duplex C. Simplex D. Low-band

A. Multiplex

Which of the following is a drawback of using the ten-code system when communicating by radio? A. The meaning of the codes vary by jurisdiction. B. They are difficult to hear over the radio. C. They do not convey accurate information. D. They disclose too much information.

A. The meaning of the codes vary by jurisdiction.

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

A. The patient's ethnicity

After asking a patient a question about how she is feeling today, you sense that she is having difficulty putting her feelings into words. You should: A. be patient and give the patient time to express her 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 her feelings.

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

A. clarity.

At minimum, sending the 12-lead ECG of a patient with chest pain to the emergency department physician via telemetry would: A. decrease the time from diagnosis to treatment. B. allow the physician to choose the appropriate fibrinolytic. C. decrease the likelihood of prehospital cardiac arrest. D. enable the paramedic to begin treatment in the field.

A. decrease the time from diagnosis to treatment.

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

A. elicit a specific response from the patient.

During the course of your interview, your patient begins making sexual innuendos to you. You should: A. ensure that another paramedic or EMT is present at all times. B. ask a paramedic of the opposite sex to interview the patient. C. stop the interview until the patient's behavior is less aggressive. D. defer further questioning and simply transport the patient.

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

Statements such as, "Please say more." or "Please feel welcome to tell me about that," are examples of: A. facilitation. B. reflection. C. clarification. D. sympathy.

A. facilitation.

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. dispatch law enforcement to the scene. C. obtain the caller's name and physical address. D. ask the caller to put the patient on the phone.

A. give prearrival instructions to the caller.

Cellular telephones are more advantageous than regular two-way radios because cellular telephones: A. incorporate GPS technology to help rescuers find the patient. B. enable laypeople to call 9-1-1 for a minimal service charge. C. can transmit long distances with the use of a mobile antenna. D. do not utilize computer technology and are less likely to fail.

A. incorporate GPS technology to help rescuers find the patient.

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. should be carried out whenever possible to ensure effective communication. D. is prohibited by the Federal Communications Commission (FCC) and should be avoided.

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

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

A. repeater

The use of specialized computer terminals and networks that permit secure two-way transmission of sound, video, ECG tracings, and other diagnostic data is called: A. telemedicine. B. telemetry. C. interoperability. D. trunking.

A. telemedicine.

It is important to remember that if a patient is not personally sensitive to modesty because of an impaired mental state: A. the patient's family likely will be. B. this will not influence your care. C. then he or she will not care about your treatment. D. protecting his or her privacy is of lesser concern.

A. the patient's family likely will be.

When touching a patient as a form of reassurance, the paramedic should: A. touch the patient on a neutral part of his or her body. B. touch the patient in the center of the chest or on the thigh. C. not touch the patient if he or she leans toward the paramedic. D. remember that most patients take offense to being touched.

A. touch the patient on a neutral part of his or her body.

Sitting a chair next to a patient when conducting your interview promotes: A. trust. B. professionalism. C. empathy. D. authority.

A. trust.

If a patient feels threatened and is reluctant to communicate, cautiously approach the patient and: A. use open posturing B. cross your arms. C. elevate your voice. D. use hand gestures.

A. use open posturing

An elderly man states that he is sad and depressed because his wife recently died of cancer. Which of the following statements from the paramedic demonstrates empathy? A. "I understand why you are sad, and I am sad for you. Is there anything I can do to make you feel better?" B. "I'm sorry, sir. I don't know how I would feel in your situation, but I am sure it would be similar." C. "Your wife's death is very tragic, but perhaps going to the hospital will provide you with some relief." D. "I'm sorry to hear about your wife, but you should take comfort in the fact that she is in a better place."

B. "I'm sorry, sir. I don't know how I would feel in your situation, but I am sure it would be similar."

Using the International Radiotelephony Phonetic Alphabet, how should you spell "Wilson"? A. WILLIAM-INDIA-LINCOLN-SIERRA-OCEAN-NOVEMBER B. WHISKEY-INDIA-LIMA-SIERRA-OSCAR-NOVEMBER C. WHISKEY-IDA-LIMA-SAM-OSCAR-NANCY D. WILLIAM-IDA-LINCOLN-SAM-OCEAN-NANCY

B. WHISKEY-INDIA-LIMA-SIERRA-OSCAR-NOVEMBER

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

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

If a parent insists on monitoring your conversation with his or her adolescent son or daughter, you should: A. suspect that the adolescent has been physically or emotionally abused and confront the parent. B. communicate the situation to the emergency department physician and document it accurately. C. refuse the parent's prerogative and move the patient to the ambulance to continue your conversation. D. explain to the adolescent that he or she is a minor and that you cannot converse without parental presence.

B. communicate the situation to the emergency department physician and document it accurately.

When transmitting data over the radio, do not disclose the patient's: A. vital signs. B. date of birth C. chief complaint. D. age and sex.

B. date of birth

The process of formulating the words or ideas to be sent and formatting the information for transmission is called: A. interoperability. B. encoding. C. biotelemetry. D. decoding.

B. encoding.

Maintaining eye contact with a patient enables the paramedic to: A. relay the seriousness of the situation. B. evaluate the patient's neurologic status. C. defuse a potentially violent situation. D. rapidly gain the patient's trust.

B. evaluate the patient's neurologic status.

If a patient is reluctant to share personal information with you, you should: A. ask a law enforcement officer to obtain the information B. explain why you need his or her name and date of birth. C. advise the patient that treatment cannot begin without it. D. defer all questions and simply transport to the hospital.

B. explain why you need his or her name and date of birth.

The use of telemetry to confirm cardiac rhythms before treatment: A. is required in most modern EMS systems because a cardiologist must confirm the cardiac rhythm before treatment begins. B. is less common because most EMS systems rely on paramedics to assess the cardiac rhythm and make independent treatment decisions. C. is not used for 12-lead ECG transmission because interference and artifact makes identification of a STEMI difficult. D. is no longer the standard of care because treatment algorithms exist that assist the paramedic in identifying the cardiac rhythm.

B. is less common because most EMS systems rely on paramedics to assess the cardiac rhythm and make independent treatment decisions.

If a patient mentions something in passing or avoids answering a specific question, you should: A. defer the question and continue with your interview. B. politely redirect his or her attention to that question. C. assume that he or she is intentionally hiding something. O D. ask the patient why he or she did not provide an answer.

B. politely redirect his or her attention to that question.

Islamic and Hindu cultures avoid: A. sitting with their legs crossed. B. touching with the left hand. C. touching the head. D. clapping their hands together.

B. touching with the left hand.

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

B. you are trying to obtain medical history information.

Which of the following questions would be most effective when inquiring about a patient's chest pain? A. "Is the pain sharp or dull?" B. "Does the pain feel more like pressure?" C. "Can you describe the pain to me?" D. "Does the pain radiate to your arm?"

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

Which of the following questions would be appropriate to ask a patient who has no medical training? A. "Do you have any endocrine-related illnesses?" B. "Have you ever experienced a syncopal episode?" C. "Do you have any breathing or heart problems?" D. "Have you ever had an acute myocardial infarction?"

C. "Do you have any breathing or heart problems?"

Which of the following is an example of a closed-ended question? A. "Can you tell me how this all started?" B. "Can you describe the pain you are feeling?" C. "Does the pain radiate to your arm or jaw?" D. "How did you feel when you awoke today?"

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

Which of the following statements conveys empathy? A. "So if I understand you correctly, you say that you want to kill yourself." B. "I understand exactly how you feel. In time, this will work out." C. "I understand how difficult this must be. I'm here to help you." D. "Based on my assessment, I think you may be having a heart attack."

C. "I understand how difficult this must be. I'm here to help you."

Members of which culture believe that touching the head may put their soul in jeopardy? A. Muslims B. Thais C. Asians D. Somalis

C. Asians

Which of the following is indicative of a patient who is about to attack you? A. Large physical body size B. Disorganized speech C. Clenched facial muscles D. Uncontrolled crying

C. Clenched facial muscles

What is the benefit of communicating over an assigned tactical channel? A. It enables you to transmit personally identifiable information. B. It ensures that communication is only with law enforcement. C. It leaves the main dispatch channel open for other radio traffic. D. It ensures that no outside party can monitor your communication.

C. It leaves the main dispatch channel open for other radio traffic.

When asking a man a question about his chest pain, he responds in a disorganized manner. What should you do? A. Proceed under the assumption that he is impaired by drugs or alcohol. B. Defer that particular question until the patient is delivered to the hospital. C. Put his response into simpler terms and asks if he agrees with your synopsis. D. Rephrase your question using medical terminology to elicit a reliable response.

C. Put his response into simpler terms and asks if he agrees with your synopsis.

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

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

Notification of EMS usually occurs when: A. law enforcement requests assistance via two-way radio. B. EMTs contact an emergency medical dispatcher. C. a bystander notifies the dispatcher via telephone. D. a sick or injured patient presents to your EMS station.

C. a bystander notifies the dispatcher via telephone.

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

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

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

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

Before you begin to transmit over the radio, you should check the volume and then: A. press the transmit key for 1 second before talking. 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. turn the squelch setting to zero to ensure a good signal.

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

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

C. reflection.

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

C. trunking.

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

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

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 can see that you are obviously upset, but I will provide the best care possible to you." C. "I don't see any abnormalities on your ECG, but you should be evaluated by a physician." 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 relaying critical information using the situation, background, assessment, and recommendation (SBAR) technique, which component would address the question, "What got us to this point?" A. Recommendation B. Situation C. Assessment D. Background

D. Background

Automatic crash notification (AC) systems can provide which of the following information about a car crash? A. Severity of injuries B. Principle direction of force at the impact point C. Number of individuals involved D. Geographic location of the crash

D. Geographic location of the crash

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

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

Paramedics respond to a dimly lit bar for a woman with chest pain. The jukebox is playing and several patrons are present. What should they do? A. Ask the bartender to turn on the lights and turn off the music. B. Assess the patient only after moving her to the ambulance. C. Order the patrons to leave the scene and begin their assessment. D. Move the patient to the restroom and begin their assessment.

D. Move the patient to the restroom and begin their assessment.

Which of the following details are not necessary for the EMD to obtain from the caller? A. An estimate of the situation's severity B. The exact location of the patient C. The caller's telephone number D. The patient's last known oral intake

D. The patient's last known oral intake

Which of the following words can be easily missed in transmission? A. Negative B. Received C. Affirmative D. Yes

D. Yes

Ethnocentrism is defined as the: A. study of different cultures and cultural practices. B. standards to which a particular culture is held. C. acknowledgment of one's cultural practices. D. belief that one's own culture is superior to others.

D. belief that one's own culture is superior to others.

Mobile transceivers: A. have transmission output power of less than 5 watts. B. do not require an externally mounted antenna. C. are hand-carried devices used for on-scene operations. D. can have a line-of-sight range of up to 15 miles.

D. can have a line-of-sight range of up to 15 miles.

If a patient is reluctant to communicate because he or she feels threatened, the paramedic should: A. maintain a closed posture as this will convey authority. B. keep his or her hands to the side and move slowly. C. cross his or her arms and take five steps backward. D. cautiously approach the patient with palms facing out.

D. cautiously approach the patient with palms facing out.

When attempting to interview a potentially violent patient, you should: A. set "ground rules" regarding what you expect from him or her. B. avoid eye contact with the patient, as this may agitate him or her. C. use closed-ended questions to obtain his or her medical history. D. ensure that you are positioned between the patient and the door.

D. ensure that you are positioned between the patient and the door.

Compared to lower-frequency bands, higher-frequency bands: A. have a longer transmission range. B. are not effective for public safety use. D C. are not regulated by the FCC. D. generally have less interference.

D. generally have less interference.

A backup communication system is especially critical when dealing with: A. simultaneous EMS calls. B. motor vehicle collisions. C. any critically injured patient. D. mass-casualty incidents.

D. mass-casualty incidents.

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

D. multiplex system.

If a patient gives you a confusing or disorganized response, try: A. diplomatically telling the patient what you think you heard and believe is going on. B. asking the patient to explain what he or she means. C. redirecting the patient's attention. D. putting the patient's comments into simpler terms and see if he or she agrees with your summary.

D. putting the patient's comments into simpler terms and see if he or she agrees with your summary.

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

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

If the paramedic is unable to defuse a hostile patient's anger, the paramedic should: A. restrain the patient and transport at once. B. administer Valium or Haldol for sedation. C. obtain a signed refusal and depart the scene. D. request law enforcement personnel at the scene.

D. request law enforcement personnel at the scene.

In urban settings, radio dead spots often occur in areas with: A. bodies of water. B. high cell phone use. C. a lot of trees. D. tall buildings.

D. tall buildings.

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

D. the capability to measure vital signs and ECG tracings and transmit them to a distant terminal.

When communicating with older patients, it is important to remember that: A. many older patients lose the ability to understand simple terminology, thus requiring the paramedic to frame his or her questions accordingly. B. older patients are generally poor historians regarding their medical history, and the paramedic should interview a family member or friend instead. C. the ability to hear and see is typically impaired due to the process of aging, and the paramedic must accommodate these disabilities appropriately. D. their illnesses may be more complex because they may have more than one disease process and may be taking several medications concurrently.

D. their illnesses may be more complex because they may have more than one disease process and may be taking several medications concurrently.

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

D. works against effective communication.