medical, legal, ethical, and documentation

75. Which of the following scenarios is considered by most states to be a medical examiner case? A) Any violent or unexpected death B) Death of a criminal who is on probation C) Death of a person under 45 years of age D) Any patient who dies outside the hospital

A) Any violent or unexpected death

11. Which of the following statements is LEAST descriptive when documenting the events of a cardiac arrest call on your patient care report? A) "Followed ACLS protocols." B) "Intubated with a 7.5-mm ET tube." C) "Gave 1 mg of epinephrine at 1002." D) "Inserted 18-gauge IV in right forearm."

A) "Followed ACLS protocols."

13. Which of the following statements includes a pertinent negative? A) "The patient complains of nausea but denies vomiting." B) "The patient rates his pain as an 8 on a scale of 0 to 10." C) "The possible smell of ETOH was noted on the patient." D) "The rapid head-to-toe exam revealed abrasions to the chest."

A) "The patient complains of nausea but denies vomiting."

88. Which of the following scenarios MOST accurately depicts abandonment? A) A patient with a possible fracture of the radius wishes to go to the hospital, but does not have transportation, so you arrange for a friend to take him to the emergency department the next day. B) While en route to the hospital with a patient experiencing chest pressure, you encounter a major motor vehicle accident, call the dispatcher to request assistance, and proceed to the hospital with your patient. C) During a mass-casualty incident involving a building collapse, a paramedic triages a patient as being low priority and instructs an EMT to observe the patient and inform the paramedic if the patient's condition deteriorates. D) A mentally competent adult with shortness of breath adamantly refuses to be transported to the hospital via EMS, so you arrange for a friend or family member to stay with the patient and call 9-1-1 if it becomes necessary.

A) A patient with a possible fracture of the radius wishes to go to the hospital, but does not have transportation, so you arrange for a friend to take him to the emergency department the next day

53. Which of the following statements regarding certification is correct? A) Certification is evidence that an individual has a certain level of credentials based on hours of training and examination. B) A certified health care provider has been granted the authority and privilege to practice medicine in a certain municipality. C) Certification is a process in which a certifying entity attests to the fact that the health care provider has mastered a certain skill set. D) Unlike a licensed health care provider, a certified health care provider is not required to obtain continuing education hours.

A) Certification is evidence that an individual has a certain level of credentials based on hours of training and examination.

30. Which of the following constitutes minimum data that must be included on every patient care report? A) Chief complaint, level of consciousness, vital signs, assessment, and patient's age and gender B) Level of consciousness, field impression, vital signs, assessment, and patient's name and address C) Scene size-up, detailed assessment, blood glucose reading, vital signs, and patient's age D) Chief complaint, vital signs, assessment, tentative field diagnosis, and patient's ethnic background

A) Chief complaint, level of consciousness, vital signs, assessment, and patient's age and gender

114. If a mortally injured patient's wishes regarding organ donation are not known: A) Consent should be obtained from a family member. B) it should be assumed that the patient would consent. C) a physician can legally authorize donation of organs. D) a court order is required to initiate the procurement process.

A) Consent should be obtained from a family member.

23. Which of the following is a significant benefit of electronic documentation? A) The ability of the data to be shared between health care facilities B) The elimination of the need for a narrative section C) The use of drop-down boxes, which minimizes the possibility for errors D) The ease with which it can be applied during mass-casualty incidents

A) The ability of the data to be shared between health care facilities

86. While attempting to resuscitate a middle-aged woman in cardiac arrest, you perform effective CPR but do not evaluate the patient's cardiac rhythm until 10 minutes into the resuscitation attempt. When the cardiac monitor is finally applied, the patient is in asystole. The patient is transported but is pronounced dead upon arrival at the hospital. Which of the following statements regarding this scenario is correct? A) The delay in evaluating the patient's cardiac rhythm constitutes a breach of duty and could be proven to be the proximate cause of her death. B) Simple negligence can be established because of the delay in applying the cardiac monitor, but your inaction did not proximately cause her death. C) Your inaction reflects gross negligence and it easily could be established that the patient would have survived if the cardiac monitor had been applied earlier. D) Although there was a delay in applying the cardiac monitor, you cannot be held liable, because effective CPR was performed throughout the resuscitation attempt.

A) The delay in evaluating the patient's cardiac rhythm constitutes a breach of duty and could be proven to be the proximate cause of her death.

19. Which of the following statements regarding the paramedic-physician relationship is correct? A) The paramedic will be held accountable for his or her own actions. B) The physician is not authorized to restrict the paramedic's practice. C) State EMS legislation is responsible for appointing medical directors. D) The physician is legally accountable for actions taken by an employer.

A) The paramedic will be held accountable for his or her own actions.

10. Which of the following incident times is NOT commonly documented on the patient care report? A) Time of primary assessment B) Time of departure from the scene C) Time of arrival at the hospital D) Time of medication administration

A) Time of primary assessment

47. Proximate cause is MOST accurately defined as: A) a link between the paramedic's improper action and the patient's injury. B) an action on the part of the paramedic that improved the patient's condition. C) a direct relationship between the mechanism of injury and the patient's injury. D) an act of ordinary or gross negligence that resulted in further harm to the patient.

A) a link between the paramedic's improper action and the patient's injury.

6. The wrongful act that gives rise to a civil suit is called: A) a tort. B) damage. C) liability. D) negligence.

A) a tort.

93. A 17-year-old woman presents with acute abdominal pain while at a party with her husband. You arrive at the scene, assess the patient, and advise her of the need for EMS treatment and transport. However, the patient, who is conscious and alert, refuses EMS treatment and transport and states that her husband will transport her in his car. You should: A) advise her of the potential risks of refusing EMS treatment and transport. B) begin treatment using implied consent, because she is under 18 years of age. C) ensure that she has decision-making capacity and then obtain a signed refusal. D) accept her refusal because the fact that she is married makes her emancipated.

A) advise her of the potential risks of refusing EMS treatment and transport.

91. A 39-year-old man with severe dehydration requires IV fluid therapy to treat his condition. The patient is conscious, alert, and oriented to person, place, time, and event. You should: A) ask him if you can start an IV and explain the reason for the IV as well as the potential risks of IV therapy. B) tell the patient that you are going to start an IV on him in order to replenish his body with lost fluid and electrolytes. C) start the IV to quickly restore his body fluid balance and then explain to the patient why you started the IV line. D) establish the IV line based on the law of implied consent, because his condition has impaired his decision-making capacity.

A) ask him if you can start an IV and explain the reason for the IV as well as the potential risks of IV therapy.

27. Provisions of the medical practice act include all of the following, EXCEPT: A) assigning medical directors to EMS systems. B) defining minimum qualifications of the paramedic. C) establishing a means of certification for the paramedic. D) defining the skills that the paramedic legally can perform.

A) assigning medical directors to EMS systems.

124. A 77-year-old man with end-stage COPD and renal failure is found unresponsive by his daughter. Your assessment reveals that the patient is apneic and pulseless. The daughter presents you with an out-of-hospital DNR order however, the document expired 3 months ago. You should: A) begin CPR only and contact medical control for further guidance. B) realize that the patient cannot be resuscitated and notify the coroner. C) begin full resuscitative efforts because the DNR order is no longer valid. D) confirm that the order has expired before initiating any patient treatment.

A) begin CPR only and contact medical control for further guidance.

101. Ethics related to the practice and delivery of health care is called: A) bioethics. B) valued ethics. C) applied ethics. D) medical morality.

A) bioethics.

117. Resuscitation efforts would MOST likely be ceased in the prehospital setting on a patient with: A) blunt trauma arrest. B) witnessed cardiac arrest. C) an extensive cardiac history. D) hypothermic cardiac arrest.

A) blunt trauma arrest.

125. During the attempted resuscitation of a 79-year-old man in cardiac arrest, a young man arrives at the scene and asks you to cease resuscitative efforts. He further tells you that the patient has entrusted him to make all of his medical decisions. You should: A) continue full resuscitative efforts and ask the man if the patient has a living will and if he has documentation naming him as the person authorized to make decisions. B) limit your resuscitative efforts to basic life support only and cease resuscitation altogether if the man can present a valid advance directive. C) cease all resuscitative efforts, contact medical control, and advise medical control that a surrogate decision maker is present and has requested you to stop. D) advise the man that, because he does not have valid documentation that he is authorized to make decisions for the patient, you must continue resuscitation.

A) continue full resuscitative efforts and ask the man if the patient has a living will and if he has documentation naming him as the person authorized to make decisions.

24. EMS-enabling legislation: A) defines how EMS is structured. B) appoints a system's medical director. C) defines a physician's scope of practice. D) develops local or regional EMS protocols.

A) defines how EMS is structured.

119. The first rule of medical practice is to: A) do no harm. B) provide medical care. C) maintain a sympathetic attitude. D) recognize critically ill patients.

A) do no harm.

54. When an administrative agency proposes a licensing action in a state that licenses paramedics, the agency must notify the paramedic of the actions that allegedly constituted the infraction. This is a part of: A) due process. B) licensure revocation. C) licensure suspension. D) the appeal process.

A) due process.

41. A legal obligation of public and certain other ambulance services to respond to a call for help in their jurisdiction is called: A) duty. B) immunity. C) negligence. D) proximate cause.

A) duty.

18. When a competent adult patient refuses medical care, it is MOST important for the paramedic to: A) ensure that the patient is well informed about the situation at hand. B) contact medical control and request permission to obtain the refusal. C) perform a detailed physical exam before allowing the patient to refuse. D) obtain a signed refusal from the patient as well as a witness signature.

A) ensure that the patient is well informed about the situation at hand.

36. If a paramedic is on duty and receives a 9-1-1 call in his or her jurisdiction: A) he or she is not covered by the Good Samaritan law. B) the Good Samaritan law will provide limited immunity. C) state law requires that he or she respond within 5 minutes. D) he or she cannot be held liable if a fee is not charged to the patient.

A) he or she is not covered by the Good Samaritan law.

107. People who call 9-1-1 at the moment of a loved one's death MOST often need: A) information and support. B) sympathy and reassurance. C) medical care for themselves. D) assurance that everything will be okay.

A) information and support.

74. Most states require the paramedic to report all of the following cases, EXCEPT: A) injury to the elderly. B) drug-related injuries. C) prehospital childbirth. D) domestic violence.

A) injury to the elderly.

12. Documenting a false statement that injures a person's good name or reputation constitutes: A) libel and defamation. B) assault and battery. C) slander and defamation. D) gross negligence.

A) libel and defamation.

35. Additions or notations added to a completed patient care report by someone other than the original author: A) may raise questions about the confidentiality practices of the EMS agency. B) are generally acceptable, provided the additions are made by a paramedic. C) are not legal and may result in criminal action against the original author. D) must be initialed by the original author or the patient care report will be deemed null and void.

A) may raise questions about the confidentiality practices of the EMS agency.

80. A paramedic who was trained and certified to perform a surgical cricothyrotomy successfully performs the procedure on a patient in the field. However, because the EMS system's medical director does not permit paramedics to perform a needle cricothyrotomy, the paramedic: A) performed outside his or her scope of practice. B) has committed an act of gross negligence. C) will likely be sued by the medical director. D) did not follow the national standard of care.

A) performed outside his or her scope of practice.

4. The patient care report: A) provides for a continuum of patient care upon arrival at the hospital. B) is a legal document and should provide a brief description of the patient. C) should include the paramedic's subjective findings or personal thoughts. D) is only held for a period of 24 months, after which it legally can be destroyed.

A) provides for a continuum of patient care upon arrival at the hospital.

24. An accurate and legible patient care report: A) should be complete to the point where anyone who reads it understands exactly what transpired on the call. B) is not possible on every call, especially if there is more than one patient or the patient is critically ill or injured. C) is a relatively reliable predictor of the quality of care that the paramedic provided to the patient during the call. D) provides immunity to the paramedic if the patient decides to pursue legal action against the paramedic.

A) should be complete to the point where anyone who reads it understands exactly what transpired on the call.

98. While caring for an 80-year-old man with a possible fractured arm, you discover other injury patterns that are suggestive of abuse. The patient is conscious and alert. You should: A) splint the patient's arm, transport him to the hospital, and report your suspicions to the emergency department physician. B) advise the patient that you suspect he has been abused and that you are required by law to report this to the authorities. C) splint the patient's arm and contact his family to determine if they are aware of the fact that he has been physically abused. D) treat the patient's injury appropriately and then obtain his consent to report your suspicions to the emergency department physician.

A) splint the patient's arm, transport him to the hospital, and report your suspicions to the emergency department physician.

17. Every decision regarding patient care that a paramedic makes should be based on the: A) standards of good medical care. B) patient's perception of the problem. C) patient's family's personal requests. D) possible legal ramifications involved.

A) standards of good medical care.

66. General criteria for determining a patient's mental competence include all of the following, EXCEPT: A) the absence of cardiac dysrhythmias. B) an appropriate response to questions. C) blood glucose levels within normal limits. D) the absence of a head injury or other trauma.

A) the absence of cardiac dysrhythmias.

4. When a person experiences an injury and seeks redress for that injury: A) the judicial process must determine who was responsible. B) it is usually the paramedic who is found grossly negligent. C) it must be established that the injury led to a bad outcome. D) he or she must prove that the standard of care was provided.

A) the judicial process must determine who was responsible.

31. Historically, most EMTALA violations occurred when: A) the patient did not have medical insurance. B) paramedics transported a woman in active labor. C) paramedics functioned above their scope of practice. D) hospitals refused to accept clinically stable patients.

A) the patient did not have medical insurance.

71. When determining the most appropriate hospital to which to transport a patient, the paramedic's FIRST consideration should be: A) the patient's clinical condition. B) the wishes of the patient or family. C) traffic conditions and similar variables. D) whether or not the patient has insurance.

A) the patient's clinical condition.

99. Ethics is MOST accurately defined as: A) the philosophy of right and wrong, of moral duties, and of ideal professional behavior. B) the professional behavior that a person's peers as well as the general public expect. C) behavior that is consistent with the law and an attitude that society in general expects. D) a code of conduct that can be defined by society, religion, or a person, affecting character, conduct, and conscience.

A) the philosophy of right and wrong, of moral duties, and of ideal professional behavior.

60. Because minors have no legal status: A) they can neither consent to nor refuse medical care. B) you must obtain consent from both parents before treating. C) they must always be treated under the law of implied consent. D) you must obtain a court order before you can legally treat them.

A) they can neither consent to nor refuse medical care.

67. If a patient has a potentially life-threatening illness or injury and there is any doubt as to his or her decision-making capacity, the paramedic should: A) treat and transport, even if it is against the patient's will. B) obtain a court order and then begin emergency treatment. C) have the patient arrested and placed in protective custody. D) obtain consent from a family member to treat the patient.

A) treat and transport, even if it is against the patient's will.

2. All of the following are subjective findings, EXCEPT: A) visible blood in the ear canal. B) a feeling of impending doom. C) a persistent dull headache. D) acute and severe nausea.

A) visible blood in the ear canal.

59. Implied consent is based on the premise that a patient: A) would consent to care because of the seriousness of his or her injury. B) will die unless emergency medical treatment is provided immediately. C) is of legal age and is able to make rational decisions regarding his or her care. D) would refuse any emergency medical care if he or she were unconscious.

A) would consent to care because of the seriousness of his or her injury.

51. An advance directive is MOST accurately defined as a: A) written document that expresses the wants, needs, and desires of a patient in reference to his or her future medical care. B) legal document that describes which life-sustaining procedures are to be performed if the patient's condition acutely deteriorates. C) notarized document that is executed by a terminally ill patient's family when the patient develops cardiopulmonary arrest. D) general guideline provided to the paramedic by the medical director that stipulates the level of care provided to terminally ill patients.

A) written document that expresses the wants, needs, and desires of a patient in reference to his or her future medical care.

108. A DNR order is MOST accurately defined as a: A) written order designed to tell health care providers when resuscitation is or is not appropriate. B) legal document that is executed by the patient while he or she still has decision-making capacity. C) written or oral directive that stipulates the care that a patient should receive at the end of his or her life. D) legal document signed by at least two physicians that prohibits resuscitative efforts in terminally ill patients.

A) written order designed to tell health care providers when resuscitation is or is not appropriate.

9. Criminal laws most likely to apply to paramedics include all of the following, EXCEPT: A) assault. B) battery. C) false imprisonment. D) inadequate patient care.

D) inadequate patient care.

40. Which of the following suffixes is used when describing disintegration or destruction? A) -ectomy B) -lysis C) -trophic D) -plasty

B) -lysis

39. Which of the following situations is an example of an act of commission? A) The paramedic charges for his or her services. B) A paramedic sutures a patient's lacerated arm. C) An EMT fails to splint a possible leg fracture. D) A physician transfers patient care to a paramedic.

B) A paramedic sutures a patient's lacerated arm.

79. While caring for a critically injured patient at the scene of a motor vehicle crash, an emergency physician bystander stops at the scene to assist. Which of the following procedures performed by the physician would require the physician to accompany the patient to the hospital in the ambulance? A) ECG interpretation B) A pericardiocentesis C) Orotracheal intubation D) Intraosseous cannulation

B) A pericardiocentesis

34. Which of the following statements regarding emergency vehicle laws is correct? A) The Star of Life insignia permits an ambulance to run a red light or stop sign if it is safe. B) All state statutes require emergency vehicles to be operated in a safe and prudent manner. C) An ambulance must use its lights and siren when transporting any acutely ill or injured patient. D) Most states allow an emergency vehicle to exceed the speed limit by 20 MPH if it is safe to do so.

B) All state statutes require emergency vehicles to be operated in a safe and prudent manner.

73. Prior to administering nitroglycerin to a patient with chest pain, the patient denies the use of erectile dysfunction (ED) drugs when asked, even though he took an ED drug a few hours earlier. After being given the nitroglycerin, the patient experiences severe hypotension and almost dies. Which of the following could the paramedic use as a potential defense if the patient attempts to sue? A) Patient incompetence B) Contributory negligence C) Plausible deniability D) Qualified immunity

B) Contributory negligence

50. What is the main legal risk of providing a tiered-response EMS system? A) Ambulance crashes at intersections as ALS and BLS providers simultaneously respond to the scene B) Exposure to liability if the BLS crew makes an improper determination that a patient does not need ALS care C) Lengthy response times for the BLS crew if ALS providers wait too long before determining that they need help D) Premature canceling of a BLS crew by an on-scene paramedic who performs an improper assessment of the patient

B) Exposure to liability if the BLS crew makes an improper determination that a patient does not need ALS care

68. Which of the following statements regarding a psychiatric patient who is refusing transport is MOST correct? A) Medical control has the authority to order paramedics to forcibly restrain and transport any psychiatric patient. B) If the patient's life is not in danger, only a police officer can authorize paramedics to restrain and transport the patient. C) It is generally agreed that any psychiatric patient should be transported against his or her will for evaluation by a psychiatrist. D) Family members can authorize involuntary commitment, including forcibly transporting the patient against his or her will.

B) If the patient's life is not in danger, only a police officer can authorize paramedics to restrain and transport the patient.

28. Which of the following laws or entities requires that a statement of medical necessity be clearly documented on a patient care report? A) HIPAA B) Medicare C) Medicaid D) State law

B) Medicare

121. Which of the following statements regarding ethics in the workplace is correct? A) Acknowledging a patient's cultural beliefs is a low priority if he or she is critically ill or injured. B) Off-duty misconduct on the part of the paramedic may lessen the public's confidence in EMS in general. C) EMS has long been recognized and funded in the same manner as the other health care professions. D) Paramedics are accountable only to the EMS system's medical director and to the director of EMS operations.

B) Off-duty misconduct on the part of the paramedic may lessen the public's confidence in EMS in general.

21. Which of the following statements regarding revisions or corrections to a patient care report is correct? A) The original patient care report should be destroyed if a revision is necessary. B) Only the person who wrote the original report can revise or correct it. C) A patient care report cannot be revised or corrected after submission. D) If a report needs revision, the revision must be made within 12 hours.

B) Only the person who wrote the original report can revise or correct it.

21. Which of the following is an example of a protocol? A) Radio orders B) Standing orders C) Online medical control D) Verbal order by a physician

B) Standing orders

13. Which of the following is an example of slander? A) Asking a family member if the patient uses drugs B) Telling the receiving facility that a patient is drunk C) Asking a patient if he or she is under psychiatric care D) Documenting that you noted the possible smell of alcohol

B) Telling the receiving facility that a patient is drunk

76. While caring for a conscious and alert 49-year-old man with a suspected myocardial infarction, you start an IV prior to obtaining the patient's consent. This action constitutes: A) appropriate care. B) assault. C) battery. D) gross negligence.

C) battery.

40. Which of the following is NOT a required element needed to prove negligence? A) The paramedic committed a breach of duty. B) The patient's condition was life threatening. C) The paramedic or EMS system had a duty to act. D) An act of omission was the cause of the patient's injury.

B) The patient's condition was life threatening.

37. Which of the following prefixes means "pertaining to a gland"? A) chole- B) aden(o)- C) blast(o)- D) arthro-

B) aden(o)-

8. Most lawsuits against EMS providers result from: A) unethical acts. B) ambulance collisions. C) substandard patient care. D) gross infractions of the law.

B) ambulance collisions.

116. Interventions that have been proven by studies to be of no benefit to the patient in cardiac arrest: A) are illegal for the paramedic to perform. B) are not medically or ethically indicated. C) are commonly authorized by medical control. D) should be performed unless the family objects.

B) are not medically or ethically indicated.

106. If a physician insists that you perform an intervention that you are not properly trained to perform, it would be MOST appropriate to: A) perform the ordered intervention to the best of your ability. B) ask the physician if he or she can suggest another alternative. C) refuse to perform the intervention and follow your protocols. D) ask the physician to talk you through the procedure over the phone.

B) ask the physician if he or she can suggest another alternative.

7. The National Emergency Medical Services Information System (NEMSIS): A) defines the scope of practice for all levels of EMS provider. B) collects relevant data from each state and uses it for research. C) is a nationwide billing system that any EMS provider can use. D) defines the minimum data that must be collected on each call.

B) collects relevant data from each state and uses it for research.

127. You have been attempting resuscitation of a middle-aged woman for approximately 15 minutes however, she has not responded to any of your treatment. There is no evidence of hypothermia or drug ingestion, and the cardiac monitor shows asystole. You should: A) determine if she has an advance directive. B) consider terminating your resuscitative efforts. C) perform CPR only and try to contact her family. D) pronounce the patient dead and call the coroner.

B) consider terminating your resuscitative efforts.

77. Without obtaining her consent, you transport a mentally competent young woman to the hospital because you suspect she is experiencing internal bleeding. This action: A) is defensible in a court of law. B) constitutes false imprisonment. C) reflects an act of gross negligence. D) is justifiable because of your suspicions.

B) constitutes false imprisonment.

31. If a patient with decision-making capacity adamantly refuses treatment for an injury or condition that clearly requires immediate medical attention, the paramedic should: A) request law enforcement assistance at once. B) contact online medical control for guidance. C) make other arrangements for patient transport. D) ask the patient to sign a refusal of treatment form.

B) contact online medical control for guidance.

57. Informed consent involves: A) carefully explaining the potential ramifications of refusing emergency medical treatment. B) ensuring that a patient understands the potential risks involved in performing a particular procedure. C) a patient verbally expressing his or her wishes for you to proceed with emergency medical treatment. D) explaining the rationale for an invasive procedure to a patient after you have already performed it.

B) ensuring that a patient understands the potential risks involved in performing a particular procedure.

56. Patients with decision-making capacity: A) cannot refuse EMS treatment and transport after they have given consent for it. B) have the right to refuse all or part of the emergency medical care offered to them. C) must agree to EMS transport if they give consent for emergency medical treatment. D) cannot withdraw consent unless their conditions are deemed to be non-life-threatening.

B) have the right to refuse all or part of the emergency medical care offered to them.

63. If a conscious patient with decision-making capacity refuses care for a potentially life-threatening condition: A) you must begin lifesaving treatment at once. B) he or she cannot be treated without a court order. C) implied consent will allow you to treat the patient. D) medical direction can overrule the patient's decision.

B) he or she cannot be treated without a court order.

111. The surrogate decision maker: A) must be an immediate family member of the patient. B) is legally obligated to make decisions as the patient would want. C) must recertify his or her decision-making status every 10 years D) can make decisions for a patient who has decision-making capacity.

B) is legally obligated to make decisions as the patient would want.

84. While on duty, a paramedic unit stops at the scene of a traffic accident to which it has not been dispatched. During the course of providing patient care, one of the paramedics purposely manipulates the patient's neck to elicit a painful response. This paramedic: A) is protected by the Good Samaritan law because he was not officially dispatched to the scene of the accident. B) is not a Good Samaritan and did not perform as any other paramedic with similar training would have performed. C) is not protected by the Good Samaritan law but provided treatment that is consistent with the accepted standard of care. D) cared for the patient in a manner consistent with his scope of practice and is not liable for the patient's injury or injuries.

B) is not a Good Samaritan and did not perform as any other paramedic with similar training would have performed.

16. Most civil cases are resolved during a settlement process because: A) the plaintiff is typically awarded a larger amount of money. B) it is expensive and time-consuming to take the case to trial. C) the paramedic is found responsible during the discovery phase. D) trial juries can be very unpredictable and are often misinformed.

B) it is expensive and time-consuming to take the case to trial.

34. If the paramedic is unable to complete his or her patient care report before departing the emergency department, he or she should: A) leave, at a minimum, the patient's name and age, but recognize that the physician will perform his or her own exam. B) leave an abbreviated form with pertinent data with the receiving provider and complete the patient care report as soon as possible. C) obtain the emergency department fax number and transmit the completed patient care report within 12 hours after delivering the patient. D) advise the receiving provider that he or she will return to the emergency department with the completed patient care report within 24 hours.

B) leave an abbreviated form with pertinent data with the receiving provider and complete the patient care report as soon as possible.

9. It is MOST important for the paramedic to exercise extreme care when using medical abbreviations because: A) medical abbreviations change frequently. B) many abbreviations have more than one meaning. C) even correctly used abbreviations often cause confusion. D) insurance companies do not pay if unapproved abbreviations are used.

B) many abbreviations have more than one meaning.

85. While off duty and outside of your jurisdiction, you encounter a motor vehicle crash. You can see one patient lying motionless on the ground near her overturned vehicle. As an off-duty paramedic, you: A) should call 9-1-1 but not stop to provide care. B) may feel an ethical obligation to stop and assist. C) have a legal responsibility to stop and render aid. D) should stop if you have an EMS decal on your car.

B) may feel an ethical obligation to stop and assist

14. The initial complaint filed against a paramedic or EMS system by a dissatisfied patient: A) is typically detailed and contains specific information about what went wrong. B) may not contain specific information about what the patient thinks went wrong. C) does not include the name of the paramedic or EMS system who is being sued. D) must be reviewed by a judge in order to determine if the complaint is justified.

B) may not contain specific information about what the patient thinks went wrong.

29. If your EMS system receives a subpoena for a patient's protected health information, it would be MOST appropriate to: A) disclose the information requested by the subpoena. B) notify legal counsel before releasing any information. C) refuse to disclose any of the patient's protected information. D) obtain the patient's consent before releasing any information.

B) notify legal counsel before releasing any information.

26. HIPAA mandates that: A) a patient's personal information must be shared with the patient's immediate family members. B) patient information shall not be shared with entities or persons not involved in the care of the patient. C) a penalty will be imposed for any release of any portion of a patient's personal information to any entity. D) patient information can only be shared with the receiving physician in the emergency department.

B) patient information shall not be shared with entities or persons not involved in the care of the patient.

103. Patient autonomy is MOST accurately defined as the: A) court's support and upholding of the rights of a patient with regard to health care decisions. B) patient's right to direct his or her own care and to decide how end-of-life care should be provided. C) inability of the patient to refuse medical treatment once he or she has given appropriate consent. D) right of the patient to determine which medications the paramedic should administer for a given situation.

B) patient's right to direct his or her own care and to decide how end-of-life care should be provided.

16. If you receive another call before completing the patient care report accurately for the previous call: A) you should submit what you have completed to the receiving facility. B) pertinent details about the previous call may be omitted inadvertently. C) your patient care report must be completed within 36 hours after the call. D) you should ask the dispatcher to send another paramedic crew to the call.

B) pertinent details about the previous call may be omitted inadvertently.

2. The BEST legal protection for the paramedic is to: A) always transport the patient to the hospital of the patient's choice, regardless of the patient's clinical condition. B) provide a detailed patient assessment and appropriate medical care, followed by complete and accurate documentation. C) routinely obtain more than the minimum number of continuing education credits required by the state department of health. D) treat all patients with respect and remain aware that patients' cultural beliefs may differ from those of the paramedic.

B) provide a detailed patient assessment and appropriate medical care, followed by complete and accurate documentation.

3. In order to ensure that all recorded times associated with an incident are accurate, the paramedic should: A) frequently glance at his or her watch. B) radio the dispatcher after an event occurs. C) document the time that each event occurs. D) get a copy of the dispatch log after the call.

B) radio the dispatcher after an event occurs.

95. You are called to a community center for a 40-year-old woman who is "acting strange." Upon your arrival, you assess the patient and determine that she is conscious, alert, and oriented to person, place, time, and event. She does not appear to be mentally impaired. Her oxygen saturation is 99% on room air and her blood glucose level is 112 mg/dL. The patient's husband tells you that his wife has bipolar disorder and takes medication for it. The patient tells you that she is fine and does not want to go to the hospital. You should: A) contact online medical control and request permission to transport the patient against her will because of her bipolar disorder. B) recognize that this patient has decision-making capacity at the present time and that you cannot force her to go to the hospital. C) transport the patient against her will, but only if it can be established that she has been noncompliant with her bipolar medication. D) advise the patient that, because of her history of bipolar disorder, she does not have the legal capacity to refuse EMS treatment and transport.

B) recognize that this patient has decision-making capacity at the present time and that you cannot force her to go to the hospital.

122. You are caring for a 66-year-old man with terminal cancer. He is conscious and alert without evidence of mental incapacitation. You offer him oxygen, but he refuses to accept it, stating "Just let me die with dignity!" You should: A) tell him that the oxygen is crucial in preventing him from experiencing cardiac arrest. B) respect the patient's wishes and ask him if he wants to be transported to the hospital. C) contact medical control and request permission to treat without the patient's consent. D) recognize that patients with terminal illnesses do not have decision-making capacity.

B) respect the patient's wishes and ask him if he wants to be transported to the hospital.

26. A reasonable paramedic should follow the same ______________ that another paramedic in a similar situation would. A) scope of practice B) standard of care C) wishes of the family D) medical practice act

B) standard of care

45. When determining whether or not a paramedic's actions were consistent with the standard of care, the court would be LEAST likely to: A) speak with other paramedics who have the same training. B) talk to patients to whom the paramedic has provided care in the past. C) subpoena the paramedic's instructor and the text he or she used. D) request a copy of the paramedic's standard operating procedures.

B) talk to patients to whom the paramedic has provided care in the past.

62. The BEST way for the paramedic to evaluate a patient's decision-making capacity is to: A) determine if the patient knows what care is appropriate for the situation. B) talk to the patient to determine if he or she understands what is happening. C) confirm that the patient is at least 18 years of age or otherwise emancipated. D) ensure that pulse oximetry and blood glucose readings are within normal limits.

B) talk to the patient to determine if he or she understands what is happening.

44. If an EMS agency's call volume is too heavy to allow response within an appropriate time frame: A) the agency no longer has a legal duty to respond. B) the agency is obligated to use mutual aid resources. C) off-duty personnel are legally obligated to respond. D) all area hospitals must be made aware of the situation.

B) the agency is obligated to use mutual aid resources.

35. When an ambulance collides with a citizen's vehicle at an intersection: A) it is because the citizen failed to yield the right of way. B) the driver of the ambulance may be charged criminally. C) most state laws provide immunity to the EMS vehicle. D) EMS providers are rarely found at fault in civil lawsuits.

B) the driver of the ambulance may be charged criminally.

15. The accuracy of your patient care report depends on all of the following factors, EXCEPT: A) including all pertinent event times. B) the severity of the patient's condition. C) the thoroughness of the narrative section. D) documenting any extenuating circumstances.

B) the severity of the patient's condition.

96. While en route to a call for an emotionally disturbed patient, law enforcement notifies you by radio that the patient has become extremely violent. You should: A) continue to the scene and assist law enforcement in restraining the patient. B) wait for law enforcement to advise you that they have the patient under control. C) carefully enter the scene and administer a benzodiazepine to sedate the patient. D) advise law enforcement to handcuff the patient and transport him to the hospital.

B) wait for law enforcement to advise you that they have the patient under control.

90. A patient's wife called 9-1-1 because the patient was complaining of a severe headache and nausea. The patient is conscious and alert, but obviously upset that his wife called 9-1-1 without consulting with him first. As you present the blood pressure cuff, the patient folds his arms and turns away from you. From this patient's actions, you should conclude that: A) he is not mentally competent. B) you do not have consent to treat him. C) consent to treat this patient is implied. D) he will only consent to EMS transport.

B) you do not have consent to treat him.

61. Which of the following patients is NOT an emancipated minor? A) 17-year-old man who is a member of the U.S. armed forces B) 16-year-old woman who is pregnant and lives with her boyfriend C) 17-year-old woman who goes to college and lives with her parents D) 18-year-old woman who is pregnant and lives with her grandmother

C) 17-year-old woman who goes to college and lives with her parents

1. Which of the following is a subjective finding? A) Pale, cool, clammy skin B) Obvious respiratory distress C) A complaint of chest pressure D) Blood pressure of 110/60 mm Hg

C) A complaint of chest pressure

82. Which of the following scenarios reflects a violation of EMTALA? A) A registration clerk asks you if the patient has insurance. B) An emergency department provides stabilization care only. C) A hospital transfers an unstable patient to another facility. D) Paramedics transport a woman in labor to the closest hospital.

C) A hospital transfers an unstable patient to another facility.

48. Which of the following statements regarding the harm element of a negligence lawsuit is MOST correct? A) The burden of proof for establishing harm rests with the defendant. B) Serious injury must have occurred in order for harm to be established. C) A loss of earning capacity is a form of harm that the patient may claim. D) Loss of income is the most common form of harm proven in a lawsuit.

C) A loss of earning capacity is a form of harm that the patient may claim.

70. Which of the following general statements regarding violent patients is correct? A) You must rule out hypoglycemia before restraining a violent patient. B) Ideally, violent patients should be restrained in a face-down position. C) Benzodiazepines are acceptable to use as a means of chemical restraint. D) Most patients become violent because of a severe psychiatric condition.

C) Benzodiazepines are acceptable to use as a means of chemical restraint

12. Which of the following documentation styles would likely be MOST difficult and time-consuming to apply in EMS? A) SOAP method B) CHARTE method C) Body systems approach D) Chronological approach

C) Body systems approach

28. Which aspect of the HIPAA is MOST pertinent to the paramedic? A) Documenting a thorough patient assessment B) Recovering funds from insurance companies C) Ensuring that the patient's privacy is protected D) Disclosing patient information to the media

C) Ensuring that the patient's privacy is protected

29. Which of the following data would a state EMS office be the LEAST likely to require an EMS agency to report? A) Call volume B) Types of calls C) Patient gender D) Patient outcome

C) Patient gender

102. Which of the following general statements is correct? A) When faced with an ethical dilemma, you should ask yourself, "What is in my best interest?" B) A patient's religious beliefs should be respected but should not affect how you provide care. C) The EMT code of ethics simply amplifies the concept of being concerned for the welfare of others. D) If you place your welfare ahead of the patient's, you will rarely commit an unethical act in medical care.

C) The EMT code of ethics simply amplifies the concept of being concerned for the welfare of others.

5. Which of the following general statements regarding medical law is correct? A) Medical providers with fewer than 5 years of experience are at highest risk of being sued. B) A poor patient outcome typically means that the medical provider was grossly negligent. C) The patient or survivor must prove all elements of negligence before a lawsuit will be successful. D) A medical liability lawsuit will only be successful if the patient's outcome was unfavorable.

C) The patient or survivor must prove all elements of negligence before a lawsuit will be successful.

120. Conducting EMS research studies on critically ill or injured patients without their informed consent is: A) inappropriate. B) ethically acceptable. C) a true ethical dilemma. D) legal under the law of implied consent.

C) a true ethical dilemma.

87. You deliver a 61-year-old man with abdominal pain to a busy emergency department. A staff nurse instructs you to take the patient to the triage area where he will be tended to later. She further tells you that after you leave a copy of your patient care report with the clerk, you are free to leave. You should: A) do as the nurse instructs you and thoroughly document the incident to ensure you are not accused of abandonment. B) leave the patient in the triage area, give your patient care report to the clerk and tell the clerk to keep an eye on the patient. C) advise the nurse that you will remain with the patient until the nurse has taken your verbal report and properly assumed care of the patient. D) transfer the patient to a gurney in a highly visible area, advise the nurse of what you did, and give the nurse a copy of your patient care report.

C) advise the nurse that you will remain with the patient until the nurse has taken your verbal report and properly assumed care of the patient.

5. The MOST significant problem associated with making up your own medical abbreviations and documenting them on the patient care report is: A) insurance denial. B) a potential lawsuit. C) an error in patient care. D) confusion at the hospital.

C) an error in patient care.

110. Although the technicalities of EMS DNR orders vary from state to state, they all: A) are completely irrevocable by the patient's immediate family members. B) require the patient to wear a DNR insignia such as a bracelet or necklace. C) are designed to tell EMS providers when resuscitation is or is not appropriate. D) must be renewed every 5 years or they will expire and become null and void.

C) are designed to tell EMS providers when resuscitation is or is not appropriate.

92. You arrive at the scene of a motor-vehicle-versus-pedestrian accident. The patient is a 12-year-old girl who was struck by a car while riding her bike. She is conscious but combative. She has a large hematoma on her leg and several hematomas to her forehead. As a police officer attempts to contact the child's parents, you should: A) provide supportive care only but do not transport the child until the parents arrive and give consent. B) closely monitor the child's condition and begin emergency treatment after obtaining consent from both parents. C) assume that her parents would consent to emergency treatment and initiate the appropriate care for the child. D) withhold all emergency care until you have obtained consent from at least one of her parents via telephone.

C) assume that her parents would consent to emergency treatment and initiate the appropriate care for the child.

6. Data collected from the state EMS office for the purpose of research would likely NOT include: A) patient outcomes. B) the nature of all calls. C) average cost per call. D) call volume per month.

C) average cost per call.

97. You arrive at the scene of a shooting. The patient, a 19-year-old man, has a gunshot wound to the side of his head with a large amount of exposed brain matter. Further assessment reveals that the patient is apneic and pulseless. Law enforcement personnel advise you that the person who shot the patient is in their custody. You should: A) begin resuscitative measures at once and contact the patient's family to determine if he is an organ donor. B) begin CPR immediately, cover the wound with a bulky dressing, and prepare to transport the patient. C) avoid unnecessary contact with the patient and document the findings of your visual assessment of the patient and scene. D) place plastic bags over the patient's hands, apply a cardiac monitor to confirm asystole, and notify the coroner's office.

C) avoid unnecessary contact with the patient and document the findings of your visual assessment of the patient and scene.

126. You arrive at the scene of a major motor vehicle crash. The patient, a 29-year-old man, is in cardiac arrest from a severe head injury and has been receiving bystander CPR for approximately 10 minutes. A law enforcement official advises you that the patient's driver's license identifies him as an organ donor. You should: A) recognize that none of the patient's vital organs are appropriate for donation and ask the bystanders to stop CPR. B) continue to attempt resuscitation of the patient because his liver, kidneys, and heart are likely viable for harvesting. C) begin full resuscitative efforts and transport the patient to a trauma center because certain tissues may be viable for harvesting. D) continue basic life support only until law enforcement can notify a family member of the patient and obtain consent for organ donation.

C) begin full resuscitative efforts and transport the patient to a trauma center because certain tissues may be viable for harvesting.

49. Abandonment occurs when: A) a patient is released and did not require further medical care. B) an emergency nurse takes a verbal report from a paramedic. C) care of a patient was terminated without his or her consent. D) a patient refuses care and subsequently dies of his condition.

C) care of a patient was terminated without his or her consent

115. Current bioethical guidelines regarding the decision not to initiate resuscitation efforts rely mainly on the use of: A) flexible algorithms and protocols. B) the personal beliefs of the paramedic. C) common sense and reasonable judgment. D) criteria established by the local coroner.

C) common sense and reasonable judgment.

23. If a conflict arises between a paramedic and a physician bystander in the field, the paramedic should: A) become subordinate to the physician. B) involve law enforcement in the incident. C) contact medical control to seek resolution. D) politely ask the physician to leave the scene.

C) contact medical control to seek resolution.

33. A hospital that is in violation of EMTALA: A) is fined by the health insurance company. B) is responsible to the state board of health. C) could forfeit all of its Medicare funding. D) must pay a monetary settlement to the patient.

C) could forfeit all of its Medicare funding.

37. The Good Samaritan law was originally passed in order to: A) encourage paramedics to respond while on duty. B) discourage EMS systems from billing the patient. C) encourage the public to help at emergency scenes. D) provide immunity from liability to the paramedic.

C) encourage the public to help at emergency scenes.

65. Before asking a patient to sign a refusal form, the paramedic must: A) ask an impartial observer to sign the refusal form first. B) tell the patient that he or she will die without treatment. C) ensure the patient is aware of the risks of his or her refusal. D) ask a police officer to determine if the patient is competent.

C) ensure the patient is aware of the risks of his or her refusal.

11. Transporting a competent adult patient without his or her consent would MOST likely result in allegations of: A) assault. B) battery. C) false imprisonment. D) criminal trespassing.

C) false imprisonment.

42. If an off-duty paramedic stops at the scene of a motor vehicle crash, the paramedic: A) does not have a legal duty to provide care. B) must accompany the patient to the hospital. C) has a legal obligation to provide patient care. D) is legally protected by the Good Samaritan law.

C) has a legal obligation to provide patient care.

22. A bystander physician who assists the paramedic at the scene is not required to accompany the patient in the ambulance unless the physician: A) is a board-certified emergency physician. B) does not assume responsibility for the patient's care. C) has performed procedures above the paramedic's level. D) practices at the hospital to which the patient is transported.

C) has performed procedures above the paramedic's level.

1. One of the major differences between laws and ethics is that laws: A) allow a person to determine right from wrong. B) are usually broken because of an unethical act. C) have sanctions for violation that are enforceable. D) are reflective of a person's moral responsibilities.

C) have sanctions for violation that are enforceable.

22. A poorly written patient care report: A) often indicates that the paramedic was too busy providing patient care. B) generally results in a lawsuit, even if the patient outcome was favorable. C) may raise questions by others as to the paramedic's quality of patient care. D) is unavoidable during a mass-casualty incident and is generally acceptable.

C) may raise questions by others as to the paramedic's quality of patient care.

18. If you must deviate from your protocols because of unusual circumstances, you should FIRST: A) advise the patient. B) document the event. C) notify medical control. D) apprise the receiving hospital.

C) notify medical control.

109. Health care powers of attorney are also called "durable" powers of attorney because they: A) must be in the patient's possession at all times. B) can only be revoked by the patient's personal physician. C) remain in effect once a patient loses decision-making capacity. D) do not require anyone to make decisions on the patient's behalf.

C) remain in effect once a patient loses decision-making capacity.

55. The concept of consent refers to all of the following, EXCEPT the: A) patient's age. B) patient's mental capacity. C) severity of the patient's injury. D) patient's ability to make rational decisions.

C) severity of the patient's injury.

27. According to HIPAA, it is acceptable and permissible for hospitals to: A) disclose information to a patient's family member, provided the family member has proper identification. B) release patient information to the public health department, regardless of the patient's medical condition. C) share information with the EMS providers about patient outcome for purposes of quality assurance and education. D) release patient information to the media only if the hospital feels that the patient's condition may cause an epidemic.

C) share information with the EMS providers about patient outcome for purposes of quality assurance and education.

81. While providing care to a seriously ill public official who is semiconscious, a media representative arrives at the scene and inquires about the patient's condition. You should: A) give the media representative the patient's name and age only. B) advise the media representative to obtain the information at the hospital. C) tell the media representative that you cannot disclose any information. D) obtain consent from the patient before releasing any personal information.

C) tell the media representative that you cannot disclose any information.

17. Prior to submitting a patient care report to the receiving hospital, it is MOST important for: A) your partner to review the report to ensure accuracy. B) the EMS medical director to review the report briefly. C) the paramedic who authored the report to review it carefully. D) the quality assurance team to review the report for accuracy.

C) the paramedic who authored the report to review it carefully.

72. When functioning at a crime scene, it is important for the paramedic to: A) collect and safeguard any and all evidence. B) carefully question witnesses as to what they saw. C) use caution and not disturb the scene unnecessarily. D) avoid performing patient care until cleared by the police.

C) use caution and not disturb the scene unnecessarily.

36. If you make an error when completing a written patient care report, you should: A) circle the error, initial it, and write the correct information next to it. B) not alter the original patient care report and write the correct information on an addendum. C) use different colored ink when drawing a single line through the error. D) leave the error, but write the correct information in parentheses next to it.

C) use different colored ink when drawing a single line through the error.

7. In a medical liability suit involving a paramedic, the plaintiff: A) must prove that the paramedic broke an established law. B) is the paramedic and is generally represented by a lawyer. C) usually seeks compensation for the injury he or she sustained. D) must convince 6 of 12 jurors to agree with his or her position.

C) usually seeks compensation for the injury he or she sustained.

25. Which of the following statements contains objective and subjective information? A) "The patient's behavior was consistent with alcohol intoxication." B) "The patient's pulse was rapid and weak and he was diaphoretic." C) "The patient's wife stated that he began feeling ill a few hours ago." D) "The patient appeared confused and stated that he had a headache."

D) "The patient appeared confused and stated that he had a headache."

78. Which of the following statements would be inappropriate when documenting your care of a patient with an emotional problem? A) "There was no evidence of suicidal behavior." B) "The patient was uncooperative during the exam." C) "The possible smell of ETOH was noted at the scene." D) "The patient's actions suggest the use of illicit drugs."

D) "The patient's actions suggest the use of illicit drugs."

30. Which of the following is addressed in the EMTALA? A) Discouraging private individuals from suing if a hospital has violated the law B) Allowing a woman who is in active labor to be transported to a distant hospital C) Requiring EMS to transport all patients to the closest medical treatment facility D) Preventing medical facilities from denying medical screening and stabilization

D) Preventing medical facilities from denying medical screening and stabilization

39. The prefix trans- in "transcutaneous cardiac pacing" indicates that you are pacing ________ the skin. A) beneath B) within C) around D) across

D) across

25. Scope of practice is defined as: A) protocols agreed upon by a consensus of emergency physicians. B) the level of care that an EMS employer allows the paramedic to provide. C) national patient care guidelines established by the federal government. D) care that a paramedic is permitted to perform under the certifying state.

D) care that a paramedic is permitted to perform under the certifying state.

20. Generally, the paramedic is not at liberty to disregard a physician's order unless: A) the physician is not the paramedic's medical director. B) the physician is not a licensed emergency physician. C) it is documented why the order was not carried out. D) carrying out the order will cause harm to the patient.

D) carrying out the order will cause harm to the patient.

33. Most EMS agencies require a double signature system any time a: A) medication that alters a patient's physiology is given. B) patient's condition warrants diversion to a closer hospital. C) patient is given more than one dose of any medication. D) controlled substance is checked, used, discarded, or replaced.

D) controlled substance is checked, used, discarded, or replaced.

32. When transferring a patient between medical facilities, it is MOST important for the paramedic to: A) ensure that all appropriate paperwork, x-rays, and lab results are delivered to the receiving facility. B) request another paramedic if the patient's clinical condition is too unstable for one paramedic to manage effectively. C) request that a member of the patient's family accompanies the patient in case the patient cannot speak for himself or herself. D) ensure that a physician or nurse accompanies the patient if the patient requires care beyond the paramedic's scope of practice.

D) ensure that a physician or nurse accompanies the patient if the patient requires care beyond the paramedic's scope of practice.

58. A patient who rolls up his or her sleeve so that you can take his or her blood pressure has given you __________ consent. A) implied B) informed C) rational D) expressed

D) expressed

112. A person wishes to be an organ donor. He or she must: A) have a documented terminal illness. B) be at least 21 years of age in most states. C) have this delineated on his or her driver's license. D) have witnessed informed consent, usually in writing.

D) have witnessed informed consent, usually in writing.

43. If a volunteer paramedic has signed up to work a shift for an EMS system: A) he or she does not have a legal obligation to act. B) the Good Samaritan law provides limited immunity. C) he or she must be a third responder on the ambulance. D) he or she is obligated to respond to calls during the shift.

D) he or she is obligated to respond to calls during the shift.

105. If a paramedic receives an order from a physician that he or she feels is detrimental to the patient's best interests, the paramedic should: A) carry out the order, but factually and carefully document the event. B) not carry out the order and discuss the issue with the physician later. C) tell the patient that the physician's order is appropriate for him or her. D) immediately discuss with the physician why the paramedic feels that way.

D) immediately discuss with the physician why the paramedic feels that way.

10. Assault on a patient occurs when the EMS provider: A) defames a patient's character in his or her report. B) touches another person without obtaining consent. C) carries out a harmful physical act against a patient. D) instills the fear of immediate bodily harm in a patient.

D) instills the fear of immediate bodily harm in a patient.

15. Because a lawsuit may not begin until several years after the paramedic cares for a patient: A) the paramedic should place an attorney on retainer. B) all paramedics should carry malpractice insurance. C) the paramedic should follow up with the patient regularly. D) it is essential to maintain good documentation on any call.

D) it is essential to maintain good documentation on any call.

113. If a patient experiences prolonged hypotension or requires prolonged CPR, his or her _________ would be inappropriate for organ or tissue donation. A) skin B) corneas C) bones D) kidneys

D) kidneys

89. You respond to a skilled nursing facility for a patient who is not breathing. When you arrive, you assess the patient, a 78-year-old man, and confirm apnea. However, the patient has a rapid carotid pulse. The charge nurse advises you that, according to the patient's family, the patient is not to be resuscitated. You should: A) not attempt any form of resuscitation and ask the charge nurse to notify the patient's family immediately. B) remain at the scene, begin artificial ventilations, but discontinue if the family arrives and presents a valid DNR order. C) contact medical control and request authorization to provide palliative care only and transport the patient to the hospital. D) maintain the patient's airway, begin artificial ventilations, and transport the patient to the closest appropriate medical facility.

D) maintain the patient's airway, begin artificial ventilations, and transport the patient to the closest appropriate medical facility.

19. For purposes of refusing medical care, a patient's mental status may be considered impaired if he or she: A) is notably frightened. B) makes a derogatory comment. C) is not sure of the exact time. D) makes nonsensical statements.

D) makes nonsensical statements.

14. When documenting a statement made by the patient or others at the scene, you should: A) document the exact time that the statement was made. B) include the statement in an addendum to your run report. C) translate the statement into appropriate medical terminology. D) place the exact statement in quotation marks in the narrative.

D) place the exact statement in quotation marks in the narrative.

83. While en route to the scene of a patient in cardiac arrest, the driver of the vehicle in front of you does not hear your siren or see your lights. You should: A) quickly merge to the right, pass the vehicle, and then obtain the vehicle's license plate number. B) turn your siren off and ask the driver of the vehicle to pull over using the public address radio. C) get as close to the rear of the vehicle as possible, change the tone of your siren, and flash your headlights. D) remain at a safe distance behind the vehicle and then pass the vehicle on the left side when it is safe to do so.

D) remain at a safe distance behind the vehicle and then pass the vehicle on the left side when it is safe to do so.

94. A 40-year-old man presents with bizarre behavior. His speech is slurred and he is very belligerent. His blood glucose level is 35 mg/dL. The patient tells you to get out of his house. You should: A) administer oxygen only until you can obtain a court order to start an IV and administer dextrose. B) utilize law enforcement to help restrain the patient so that you can start an IV line and give him dextrose. C) monitor the patient's condition for 15 minutes and then begin emergency treatment if he does not improve. D) remain professional and advise the patient that he is not legally capable of refusing EMS treatment.

D) remain professional and advise the patient that he is not legally capable of refusing EMS treatment.

3. The judicial branch at the state level is responsible for: A) establishing and defining the law. B) carrying out and administering the laws. C) reporting to the governor in the state capitol. D) resolving disputes based on interpretation of law.

D) resolving disputes based on interpretation of law.

104. If a patient makes a decision regarding his or her own health care and the paramedic does not agree with that decision, the paramedic should: A) ensure that the EMS medical director agrees with the patient's decision. B) accept the patient's decision, but advise him or her that you do not agree. C) try to convince the patient that the decision is not in his or her best interest. D) respect the patient's wishes, assuming he or she has decision-making capacity.

D) respect the patient's wishes, assuming he or she has decision-making capacity.

8. The MOST effective way to maintain your own knowledge of standard medical terminology is to: A) read the patient care reports that your peers write. B) memorize the standard terms used by your EMS system. C) participate in a QA process that reviews patient care reports. D) review the anatomy and physiology chapter of a textbook.

D) review the anatomy and physiology chapter of a textbook.

52. If a severely injured patient who will likely not survive is identified as being an organ donor, the paramedic: A) must keep the patient warm to keep his or her organs viable. B) must determine whether or not the patient is legally brain dead. C) should recall that severe trauma disqualifies a patient as a donor. D) should contact medical control for guidance as to how to proceed.

D) should contact medical control for guidance as to how to proceed.

20. If your response to a call for a traumatic injury is canceled, you should document: A) that the patient refused medical treatment. B) how the patient will get to a medical facility. C) that the patient likely was not seriously injured. D) the agency or person who canceled the response.

D) the agency or person who canceled the response.

69. If a paramedic is attacked by a violent patient: A) the paramedic is legally permitted to defend himself or herself with the use of deadly force. B) the law allows the paramedic to use a knife or firearm as a means of self-defense against the attacker. C) the paramedic will not be held legally accountable if the attack was the result of patient provocation. D) the paramedic may respond with force that is equal to or slightly greater than the force offered by the patient.

D) the paramedic may respond with force that is equal to or slightly greater than the force offered by the patient.

38. According to the qualified immunity doctrine, the paramedic can be held liable only if: A) he or she volunteers as a paramedic and receive no remuneration for his or her medical services. B) the medical care that he or she provided was not consistent with what a physician would have provided. C) he or she was not employed by a governmental entity at the time an incident or violation occurred. D) the plaintiff proves that the paramedic violated a clearly established law about which he or she should have known.

D) the plaintiff proves that the paramedic violated a clearly established law about which he or she should have known.

123. The husband of a terminally ill woman called 9-1-1 because he thinks his wife is about to die. The patient has a valid living will and an out-of-hospital DNR order. You should: A) ask the husband why he called EMS if his wife is not to be resuscitated. B) assume that the husband has revoked the DNR order and begin treatment. C) contact medical control and request permission to provide emergency care. D) treat the husband and his wife with respect and provide emotional support.

D) treat the husband and his wife with respect and provide emotional support.

64. If a mentally competent adult refuses emergency medical treatment, your FIRST action should be to: A) call medical control and seek further guidance. B) determine if his or her condition is life-threatening. C) assume the refusal is from fear and begin treatment. D) try to determine why he or she is refusing treatment.

D) try to determine why he or she is refusing treatment.

46. A paramedic's actions are considered to be grossly negligent if he or she: A) does not consult with online medical control first. B) only provides basic life support to a critical patient. C) makes a simple mistake that causes harm to the patient. D) willfully or wantonly deviates from the standard of care.

D) willfully or wantonly deviates from the standard of care.

32. Components of a thorough patient refusal document include: A) assurance by the paramedic that the patient's ability to pay is of no concern. B) notification of the patient's physician to apprise him or her of the situation. C) documentation of a complete assessment, even if the patient refused assessment. D) willingness of EMS to return to the scene if the patient changes his or her mind.

D) willingness of EMS to return to the scene if the patient changes his or her mind.

118. A Medical Order for Life-Sustaining Treatment (MOLST) would MOST likely apply to a patient: A) who is in respiratory failure but has decision-making capacity. B) who has been in cardiac arrest for less than 10 minutes. C) with a terminal illness whose cardiac arrest was witnessed. D) with impending pulmonary failure but who is not in cardiac arrest.

D) with impending pulmonary failure but who is not in cardiac arrest.

100. When caring for any patient, it is important to remember that: A) the patient likely shares the same moral standards that you do. B) your moral standards should affect the way you treat the patient. C) the patient's wishes and your moral standards are often the same. D) your moral standards may conflict with the patient's best interests.

D) your moral standards may conflict with the patient's best interests.

41. Which of the following describes a female patient who takes acetaminophen and has an enlarged liver? A) ♂> NTG cholestasis B) ♀+ ASA splenomegaly C) ♂> NaHCO3 nephritis D) ♀+ APAP hepatomegaly

D) ♀+ APAP hepatomegaly

38. Blepharospasm is defined as spasm of the: A) eyelids. B) jaw muscles. C) gallbladder. D) wrist joint.

eyelids.