Chapter 4 Practice
Why does the EMT's scope of practice vary from state to state? A. Local legislation B. EMT preference C. Company insurance D. National standards
A. Local legislation
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 this situation? A. Move the table as little as possible, wearing gloves; notify police on the scene; and document your actions precisely in your patient care report. B. Move the table and get on with your work of caring for the patient. C. Use the table as a place to set your equipment as you are working on the patient. D. Wait until one of the police officers can move the table for you.
A. Move the table as little as possible, wearing gloves; notify police on the scene; and document your actions precisely in your patient care report.
Leaving a patient after initiating care and before the patient has been transferred to someone with equal or greater medical training is known as: A. abandonment. B. res ipsa loquitur. C. negligence. D. in loco parentis.
A. abandonment.
A patient who called 911 is now refusing transport. You should: A. assess the patient, advise the patient of the risks of refusal, and clearly document everything in the patient care report. B. make sure that there is an immediate family member on scene who can sign as a witness to the refusal. C. make sure there is a law enforcement officer to act as a witness on the scene of every patient refusal. D. direct the patient to contact his or her primary care physician for instructions on whether or not to go to the hospital
A. 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: A. begin resuscitation and consider establishing on-line medical direction. B. withhold resuscitation. It is clear the patient is terminally ill, and the family is on scene instructing the crew to withhold care. C. provide the family with a blank DNR and have them fill it out. D. verify that the family on scene is related to the patient by asking for identification. If a family member is immediate family, that person can make health care decisions for the patient.
A. begin resuscitation and consider establishing on-line medical direction.
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: A. expressed consent. B. in loco parentis. C. implied consent. D. proximate cause.
A. expressed consent.
Good Samaritan laws were enacted to: A. protect individuals who try to help people in emergencies. Your answer is correct.B. protect EMS services from lawsuits. C. keep patients from suing ambulance companies for the actions of their employees. D. protect patients from poor health care delivered by health professionals.
A. protect individuals who try to help people in emergencies.
Good Samaritan laws are based on: A. providing care in good faith. B. the patient having no serious injuries. C. being a volunteer EMT. D. having no formal training.
A. providing care in good faith.
Quality improvement relates primarily to: A. standard of care. Your answer is correct.B. state-by-state regulations. C. scope of practice. D. the limits of the EMT job.
A. standard of care.
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: A. tell him that you can pass his contact information along to the privacy officer at your department. B. ask to see his driver's license to verify last names and, if they match, give him the information. C. give the patient the information he is requesting, as he is the patient's son. D. allow him to read the patient care report, as that is public information.
A. tell him that you can pass his contact information along to the privacy officer at your department.
Which of the following is likely to be inscribed on a medical identification device worn as a bracelet? A. Emergency contact B. Allergies C. Date of birth D. Hospital preference
B. Allergies
Which of the following would MOST likely be considered evidence at a crime scene? A. Time of day B. Blood spatter C. Mouthwash D. Mail coupons
B. Blood spatter
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. This is: A. an ethical violation but definitely not a crime. B. a violation of professional ethics and possibly a crime. C. a reasonable judgment call. D. a violation of policy but not an ethical violation.
B. a violation of professional ethics and possibly a crime.
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: A. res ipsa loquitur. B. libelous. C. slanderous. D. proximate causation.
B. libelous.
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: A. call her parents. B. provide the care she needs. C. inform medical direction that you will withhold care. D. wait for the girl to change her mind or lose consciousness.
B. provide the care she needs.
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: A. remove the knife and place it in an evidence bag. B. treat the wound as usual, but notify police that you must transport the weapon with the patient. C. ask the police officer whether it is acceptable for you to leave the knife in place for transport. D. have a police officer remove the knife before you transport.
B. treat the wound as usual, but notify police that you must transport the weapon with the patient.
Which of the following is MOST clearly a HIPAA violation? A. You provide certain health information on the billing copy of the patient care report. B.You provide a personal injury attorney with a copy of a patient care report. C. You provide a copy of the patient care report to a paramedic who is assuming care of your patient at the scene. D. Your agency receives a subpoena authorizing the release of a copy of a patient care report to a plaintiff's attorney.
B.You provide a personal injury attorney with a copy of a patient care report.
Which of the following would MOST likely be considered evidence at a crime scene? A. A paper towel roll B. Movies on DVD C. Footprints D. A child's toy
C. Footprints
At a crime scene, which of the following is the first priority of the EMT? A. Evidence preservation B. Working with police C. Patient care and transport D. Critiquing the scene
C. Patient care and transport
Which of the following could be a source of information to let the EMT know that a patient is an organ donor? A. A piece of notepaper stating that fact B. The on-line physician C. The patient's driver's license D. The statement of a bystander who is the patient's neighbor
C. The patient's driver's license
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. the attorney of record. B. the executor of the estate. C. a health care proxy. D. a patient advocate.
C. a health care proxy.
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: A. notify the family that once CPR has been initiated, you are required to transport the patient. B. complete two more rounds of CPR and then check for a pulse. If there is no pulse, you should stop resuscitation. C. follow your local protocols and contact medical direction if unsure how to proceed. D. have your partner contact the communications center to send law enforcement to the scene, as this is now a legal issue and the officer will make the decision.
C. follow your local protocols and contact medical direction if unsure how to proceed.
Ethical considerations: A. fall outside scope of practice. B. are the sole consideration of scope of practice. C. relate primarily to making patient care and well-being a priority. D. are less important than following regulations.
C. relate primarily to making patient care and well-being a priority.
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: A. proximate causation. B. a patient refusal situation. C. res ipsa loquitur. D. abandonment.
C. res ipsa loquitur.
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: A. libel. B. res ipsa loquitur. C. slander. D. a HIPAA violation.
C. slander
The actions that an EMT is legally allowed to perform while caring for an injured or ill patient are known as: A. the standard of care. B. the standard of practice. C. the scope of practice. D. medical direction.
C. the 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? A. Scope of practice and standard of care B. Quality improvement C. Standard of care D. Scope of practice
D. Scope of practice
An EMT who turns the care of a multisystem trauma patient over to a doctor of dermatology has likely: A. acted on an assumption of implied consent. B. legally and appropriately transferred care. C. violated patient confidentiality laws. D. abandoned the patient.
D. abandoned the patient.
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: A. tell the patient that she can refuse transport, but because you gave her a medication, she has to see a doctor within 24 hours. B. leave after telling the patient that it's not appropriate to abuse the EMS system. C. explain to the patient that she cannot refuse because you have already begun treatment. D. contact medical direction for a consult.
D. contact medical direction for a consult.
You explain a risky procedure to a patient. He says, "As long as it's guaranteed to work, you can do it." You should: A. decide not to use the procedure. B. begin the procedure. C. consult medical direction. D. explain that a risky procedure is not guaranteed.
D. explain that a risky procedure is not guaranteed.
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: A. involuntary transportation. B. expressed consent. C. informed consent. D. implied consent.
D. implied 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 to notify: A. the district attorney's office. B. your EMS chief. C. medical direction. D. law enforcement.
D. law enforcement.