EMT Chapter 37 Patients with Special Challenges

Which of the following statements regarding cerebral palsy is correct? A. Conditions such as brain injury at birth, postpartum infections, and fetal hypoxia can cause cerebral palsy. B. Most cases of cerebral palsy develop within the first 10 years of life and are typically caused by meningitis. C. A key clinical feature of cerebral palsy is paralysis of the respiratory muscles, which confines the patient to a ventilator. D. Approximately 25% of patients with cerebral palsy possess some varying degrees of developmental delay.

A. Conditions such as brain injury at birth, postpartum infections, and fetal hypoxia can cause cerebral palsy.

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

A. as a bridge to heart transplantation while a donor heart is being located

When interacting with an intellectually disabled patient, the best approach is to: A. ask your team members to wait until you can establish a rapport with the patient. 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. position yourself slightly above the patient's level to reduce his or her anxiety.

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

When caring for a morbidly obese patient, you should: A. establish his or her chief complaint and then communicate your plan to help. B. ask the patient if he or she knows what led to his or her obesity problem. C. call for ALS backup because obese patients are at high risk for heart attack. D. leave him or her in a supine position, as this often facilitates breathing.

A. establish his or her chief complaint and then communicate your plan to help

For which of the following conditions would you most likely encounter a ventricular peritoneum shunt? A. Hydrocephalus B. Epidural hematoma C. Subdural hematoma D. Cerebral palsy

A. hydrocephalus

Autism is defined as a: A. pervasive developmental disorder characterized by impairment of social interaction. B. mental disability caused by insufficient cognitive development of the brain. C. congenital condition caused by factors such as malnutrition or birth complications. D. psychiatric condition related to an imbalance of serotonin in the brain.

A. pervasive developmental disorder characterized by impairment of social interaction

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

A. rupture of a central vein

Common associated conditions in patients with spina bifida include all of the following, except: A. spastic limb movement. B. hydrocephalus. C. loss of bladder control. D. extreme latex allergy.

A. spastic limb movement

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. try repositioning the hearing aid or remove it and turn down the volume. B. recognize that the batteries in his hearing aids are probably depleted. 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.

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

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 healthcare facilities must provide a medical assessment and required treatment, regardless of the patient's ability to pay. C. all healthcare facilities are legally obligated to provide assessment and care only if the patient is critically ill or injured. D. a healthcare facility has the right to refuse assessment and treatment to a patient, but only if his or her condition is not deemed critical.

B. all healthcare facilities must provide a medical ssessment and required treatment, regardless of the patients abiity to pay

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. notify the receiving facility and advise them of the patient's weight and status. 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. perform a secondary assessment, focusing on his respiratory system and back.

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

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. gastric stoma. B. colostomy. C. intestinal shunt. D. gastrostomy.

B. 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. reset the ventilator by unplugging it for 30 to 60 seconds. B. disconnect the ventilator and apply a tracheostomy collar. C. attempt to troubleshoot the mechanical ventilator problem. D. place a call to the home health agency treating this patient.

B. disonnect the ventilator and apply a trachestomy collar

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

B. have extreme difficulty with complex tasks the require many steps

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

B. shunt

Characteristic anatomic features of Down syndrome include: A. long hands with wide fingers. B. bulging eyes and a large face. C. a round head with a flat occiput. D. a proportionately small tongue.

C, a round head with a flat occiput

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

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

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. an intracranial hemorrhage. B. a seizure. C. a cervical spine injury. D. hydrocephalus.

C. a cervical spine injury

Vagus nerve stimulators may be an alternative treatment to medication for patients with: A. chronic muscle pain and fatigue. B. inherently slow heart rates. C. chronic seizure disorders. D. certain psychiatric conditions.

C. chronic seizure disorders

EMS personnel would most likely be called to the residence of a patient receiving home health care when the home care provider: A. has a question that is specific to the patient's condition. B. needs simple assistance in providing patient care. C. has recognized a change in the patient's health status. D. must confirm that a specific intervention is required.

C. has recognized a change in the patients health status

Which of the following statements regarding hearing aids is correct? A. Over time, hearing aids can restore normal hearing. B. In-the-canal hearing aids fit in the outer part of the ear. C. Hearing aids cannot restore hearing to normal levels. D. A whistling sound indicates correct hearing aid placement.

C. hearing aids cannot restore hearing to normal levels

In contrast to conductive hearing loss, sensorineural hearing loss is caused by: A. earwax accumulation. B. barotrauma. C. nerve damage. D. eardrum perforation.

C. nerve damage

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

C. removing the tube if the area around it appears 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. avoid any kind of lip movement while he or she is signing with the patient. C. report exactly what the patient signs and not to add any commentary. D. 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

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

C. secretions can build up in and around the tube

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. leave items such as canes and walkers at the residence if the patient will be carried on a gurney. C. tell him or her what is happening, identify noises, and describe the situation and surroundings. D. 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

When caring for patients with cerebral palsy, it is important to remember that: A. most patients can walk but have an unsteady gait. B. they cannot walk and are totally dependent upon you. C. their limbs are often underdeveloped and prone to injury. D. hearing aids are usually ineffective for patients with hearing los

C. their limbs are often underdeveloped and prone to injury

You receive a call to a residence for an apneic 2-month-old male. When you arrive at the scene, the infant's mother tells you that her son was born prematurely and that his apnea monitor has alarmed four times in the past 30 minutes. Your assessment of the infant reveals that he is conscious and active. His skin is pink and dry, and he is breathing at an adequate rate and with adequate tidal depth. His oxygen saturation reads 98% on room air. You should: A. advise the mother to observe her son and call 9-1-1 again if necessary. B. administer high-flow oxygen and observe for a drop in oxygen saturation. C. transport the infant to the hospital and bring the apnea monitor with you. D. request an ALS ambulance to transport the infant to the hospital.

C. transport the infant to the hospital and bring the apnea monitor with you

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

C. using a piece of paper and writing utensil to ask questions

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

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

EMTs are dispatched for a patient whose central venous catheter is malfunctioning. When they arrive and assess the patient, they find bleeding from the tubing attached to the line. The EMTs should: A. gently manipulate the catheter to reduce the bleeding. B. carefully remove the catheter and transport. C. request an ALS ambulance to clamp the tubing. D. apply direct pressure to the tubing and transport.

D. apply direct pressure to the tubing and transport

The tip of a central venous catheter rests in the: 51. 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. In most cases, it is more appropriate for the EMT to contact medical control prior to speaking with the patient's primary caregiver. C. Before performing an assessment of the patient's ABCs, the EMT should ask the caregiver about the patient's medical condition. D. Communication with the patient's caregiver or family members is important because they are the most familiar with the patient's condition.

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

A service dog is easily identified by its: A. size. B. color. C. breed. D. harness.

D. harness

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. try basic sign language first. C. speak in a monotone voice. D. lower the pitch of your voice.

D. lower the pitch of your voice

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

D. positioning yourself approximately 18" directly in front of the patient

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

D. seizure disorder

An important aspect in the assessment of a patient who experienced a previous brain injury involves: A. contacting the patient's physician to determine the extent of the brain injury. B. presuming that he or she has cognitive impairment until proven otherwise. C. recalling that most patients with a brain injury have other organ dysfunction. D. speaking with the patient and family to establish what is considered normal for the patient.

D. speaking with the patient and family to establish what is considered normal for the patient

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

a. brain

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

c. prevent excess cerebrospinal fluid from accumulating in the brain

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

d. body