Chapter 34 Patients with Special Challenges

A person is said to be obese when he or she is ________ over his or her ideal weight. A. 40% to 50% B. 20% to 30% C. 10% to 15% D. 5% to 10%

The correct answer is: 20% to 30%

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

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

The correct answer is: Most cases of autism are diagnosed by 3 years of age.

Which of the following conditions would MOST likely cause a patient to slur words, speak very slowly, or speak in a monotone? A. cerebral palsy B. advanced age C. visual impairment D. Parkinson disease

The correct answer is: Parkinson disease

Which of the following statements regarding patients with developmental disabilities is correct? A. Most patients with developmental disabilities have normal cognitive function, but abnormal physical features. B. A developmental disability differs from mental retardation in that it is the result of a congenital abnormality. C. Patients with developmental 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.

The correct answer is: Patients with developmental disabilities are susceptible to the same disease processes as other patients.

A significant number of patients with cerebral palsy also have: A. type 2 diabetes. B. a seizure disorder. C. brain tumors. D. paralysis.

The correct answer is: a seizure disorder.

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

The correct answer is: a triplication of chromosome 21.

According to the Emergency Medical Treatment and Active Labor Act (EMTALA): A. all health care facilities are legally obligated to provide assessment and care only if the patient is critically ill or injured. B. a patient maintains the legal right to recant his or her consent to emergency treatment, even after signing in to the emergency department. C. all health care facilities must provide a medical assessment and required treatment, regardless of the patient's ability to pay. D. 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.

The correct answer is: all health care facilities must provide a medical assessment and required treatment, regardless of the patient's ability 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. ask a member of your team to locate the best route to move him to the ambulance. B. notify the receiving facility and advise them of the patient's weight and status. C. perform a secondary assessment, focusing on his respiratory system and back. D. avoid placing him in a supine position if possible and administer oxygen.

The correct answer is: avoid placing him in a supine position if possible and administer oxygen.

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

The correct answer is: body

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

The correct answer is: chronic seizure disorders.

Two thirds of children born with Down syndrome have: A. congenital heart disease. B. unilateral paralysis. C. intracranial bleeding. D. diabetes mellitus.

The correct answer is: congenital heart disease.

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

The correct answer is: establish his or her chief complaint and then communicate your plan to help.

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

The correct answer is: harness.

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

The correct answer is: has recognized a change in the patient's health status.

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

The correct answer is: have extreme difficulty with complex tasks that require many steps.

For which of the following conditions would you MOST likely encounter a ventricular peritoneum shunt? A. cerebral palsy B. hydrocephalus C. subdural hematoma D. heart failure

The correct answer is: hydrocephalus

You respond to a residence for a 9-year-old female with Down syndrome who is sick. When you arrive at the scene and assess the patient, you determine that she is unresponsive and has gurgling respirations. You should: A. insert an oropharyngeal airway and begin assisting her ventilations with a bag-mask device. B. open her airway with the jaw-thrust maneuver and assess the rate and depth of her breathing. C. immediately apply high-flow oxygen via a nonrebreathing mask and then assess her pulse rate. D. open her airway with a manual maneuver, suction her oropharynx, and insert a simple airway adjunct.

The correct answer is: open her airway with a manual maneuver, suction her oropharynx, and insert a simple airway adjunct.

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

The correct answer is: positioning yourself approximately 18″ directly in front of the patient.

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

The correct answer is: prevent excess cerebrospinal fluid from accumulating in the brain.

Which of the following does NOT usually contribute to or cause obesity? A. genetic predisposition B. high caloric intake C. rapid metabolism D. low metabolic rate

The correct answer is: rapid metabolism

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

The correct answer is: 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. a local infection. B. clotting of the line. C. bleeding around the line. D. rupture of a central vein.

The correct answer is: rupture of a central vein.

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

The correct answer is: 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. CS tube. C. shunt. D. G-tube.

The correct answer is: shunt.

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

The correct answer is: spastic limb movement.

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

The correct answer is: speaking with the patient and family to establish what is considered normal for the patient.

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

The correct answer is: their limbs are often underdeveloped and are 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 4 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. administer high-flow oxygen and observe for a drop in oxygen saturation. B. advise the mother to observe her son and call 9-1-1 again if necessary. 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.

The correct answer is: 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. using a high-pitched voice while speaking directly into the ear B. using a piece of paper and writing utensil to ask questions C. attempting to use body language to determine the problem D. contacting dispatch and requesting a sign language interpreter

The correct answer is: using a piece of paper and writing utensil to ask questions