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WorksheetsChapter 3 and 4 EMT Review
Total questions: 73
Worksheet time: 37mins
To minimize the risk of litigation, the EMT should:
always transport patients to the hospital of their choice.
provide competent care that meets current standards.
use universal precautions with every patient encounter.
utilize at least four personnel when moving a patient.
Which of the following general statements regarding consent is correct?
A patient can consent to transport but can legally refuse treatment.
Patients who are intoxicated are generally allowed to refuse treatment.
Expressed consent is valid only if given in writing by a family member.
All patients older than 18 years can legally refuse treatment or transport.
Which type of consent is involved when a 39-year-old, mentally competent female with a severe headache asks you to take her to the hospital?
Formal
Implied
Informed
Expressed
Which of the following scenarios is an example of informed consent?
A patient advises an EMT of why he or she is refusing care.
An EMT advises a patient of the risks of receiving treatment.
An EMT initiates immediate care for an unconscious adult.
A patient is advised by an EMT of the risks of refusing care.
Which of the following types of consent allows treatment of a patient who is unconscious or mentally incapacitated?
Actual
Implied
Informed
Expressed
You are dispatched to an office building for a 49-year-old male with chest pain. When you arrive at the scene, you find the patient to be conscious and alert but in obvious pain. He tells you that he did not call 911; a coworker did. He further states that he does not want to be treated or transported to the hospital. You should:
ensure that he is aware of the risks of refusing medical care.
err in the best interest of the patient and transport him at once.
have him sign a refusal of care form and then return to service.
tell him that he is having a heart attack and needs medical care.
You suspect that a pregnant 16-year-old girl has a broken leg after she was hit by a car. You explain that you plan to splint her leg, and she agrees to treatment. Which of the following types of consent describes her agreement?
Implied
Informed
Expressed
Minor’s
In many states, a minor may be treated as an adult for the purpose of consenting to or refusing medical treatment if the minor:
possesses a valid driver’s license.
is mentally competent and able to refuse.
has a poor relationship with his or her parents.
is self-supporting and lives by him- or herself.
You arrive at the scene of a motor vehicle-versus-pedestrian accident. The patient, a 13-year-old male, is unconscious and has multiple injuries. As you are treating the child, a law enforcement officer advises you that the child’s parents will be at the scene in approximately 15 minutes. What should you do?
Transport the child immediately and have the parents meet you at the hospital.
Treat the child at the scene and wait for the parents to arrive and give consent.
Begin transport at once and have the parents meet you en route to the hospital.
Withhold treatment until the parents arrive and give you consent for treatment.
You are dispatched to a middle school for a 16-year-old female experiencing an asthma attack. She is conscious and alert but in severe respiratory distress. The school nurse informs you that she has tried several times to contact the patient’s parents but has not been successful. You should:
provide treatment up to your level of training and transport the child at once.
recognize that you cannot begin treatment without expressed parental consent.
transport the child to the closest hospital and let the staff there provide any treatment.
administer oxygen only until you receive parental consent for further treatment.
You are treating a man who was assaulted and has a closed-head injury. The patient, who has slurred speech, becomes verbally abusive and tells you to leave him alone. You should:
ask a police officer to transport the patient to the hospital.
allow the patient to refuse treatment because the injury was not his fault.
proceed with treatment and utilize law enforcement for assistance if necessary.
have the police arrest the patient so that you can legally begin treatment.
A patient regains consciousness en route from his office to the emergency department. The patient tells you that he feels fine and does not want to go to the hospital. Under these circumstances, you should:
document the patient’s request but continue to transport him.
have the patient sign a refusal form and return him to his office.
request that the police place the patient under protective custody.
assess whether the patient’s mental condition is impaired.
Shortly after you load your patient, a 50-year-old man with abdominal pain, into the ambulance, he tells you that he changed his mind and does not want to go to the hospital. The patient is conscious and alert and has no signs of mental incapacitation. You are suspicious that the man has a significant underlying condition and feel strongly that he should go to the hospital. Which of the following statements regarding this situation is correct?
A mentally competent adult can withdraw his or her consent to treat at any time.
Any patient who refuses EMS treatment must legally sign a patient refusal form.
Because of your suspicions, the best approach is to transport him to the hospital.
Once the patient is in the ambulance, he cannot legally refuse EMS treatment.
You suspect that a 6-year-old girl has broken her leg after falling from a swing at a playground. Shortly after you arrive, the child’s mother appears and refuses to allow you to continue treatment. You should:
use your authority under the implied consent law.
try to persuade the mother that treatment is needed.
ask the mother to sign a refusal form and then leave.
tell the mother that her refusal is a form of child abuse.
In which of the following circumstances can the EMT legally release confidential patient information?
A police officer requests a copy to place on file
The family requests a copy for insurance purposes
A media representative inquires about the patient
The patient is competent and signs a release form
Your best protection against legal liability when a patient with decision-making capacity refuses EMS care and transport is to:
advise medical control of the situation.
err on the side of caution and transport.
ensure that the family is aware of the risks.
thoroughly document the entire event.
Which aspect of the Health Insurance Portability and Accountability Act (HIPAA) most affects EMS personnel?
Controlling insurance costs
Protecting patient privacy
Preventing insurance fraud
Ensuring access to insurance
All of the following are considered to be protected health information (PHI), except:
patient history.
treatment rendered.
location of the call.
assessment findings.
During your monthly internal quality improvement (QI) meeting, you review several patient care reports (PCRs) with the staff of your EMS system. You identify the patient's name, age, and sex, and then discuss the treatment that was provided by the EMTs in the field. By taking this approach to the QI process, you:
acted appropriately but must have each EMT sign a waiver stating that he or she will not discuss the cases with others.
adequately safeguarded the patient's PHI because the cases were discussed internally.
are in violation of HIPAA because you did not remove the PHI from the PCR beforehand.
violated the patient's privacy because you should have discussed the information only with the EMTs involved.
For a do not resuscitate (DNR) order to be valid, it must:
be dated within the previous 24 months.
clearly state the patient's medical problem.
be updated a minimum of every 6 months.
be signed by the local justice of the peace.
When faced with a situation in which a patient is in cardiac arrest and a valid living will or DNR order cannot be located, you should:
begin resuscitation at once.
contact medical control first.
determine the patient's illness.
notify the coroner immediately.
You respond to the home of a 59-year-old man who is unconscious with slow, shallow breathing and a weak pulse. The family states that the patient has terminal brain cancer and does not wish to be resuscitated. They further state that there is a DNR order for this patient, but they are unable to locate it. You should:
begin treatment and contact medical control as needed.
honor the patient's wishes and withhold all treatment.
transport the patient without providing any treatment.
decide on further action once the DNR order is produced.
You and your partner arrive at the scene of a major motor vehicle crash. The driver, a young male, is severely entrapped in his car. He has an open head injury and massive facial trauma. He is unresponsive, not breathing, and does not have a palpable carotid pulse. You should:
stop any active bleeding and advise dispatch to send a paramedic crew.
ventilate the patient for five minutes and then stop if there is no response.
request the fire department to extricate the patient so you can begin CPR.
have your partner check for a pulse to confirm that the patient is deceased.
You arrive at the scene of an apparent death. When evaluating the patient, which of the following is a definitive sign of death?
Absence of a pulse
Profound cyanosis
Dependent lividity
Absent breath sounds
Putrefaction is defined as:
decomposition of the body’s tissues.
profound cyanosis to the trunk and face.
blood settling to the lowest point of the body.
separation of the torso from the rest of the body.
Where would you most likely find information regarding a patient’s wishes to be an organ donor?
Driver’s license
Insurance card
Social Security card
Voter registration card
When is forcible restraint permitted?
Anytime that the EMT feels threatened
Only if consent to restrain is given by a family member
When the patient poses a significant threat to self or others
Only if law enforcement personnel have witnessed threatening behavior
The EMT’s scope of practice within his or her local response area is defined by the:
medical director.
state EMS office.
EMS supervisor.
local health district.
The manner in which the EMT must act or behave when caring for a patient is called the:
EMT oath.
code of ethics.
standard of care.
scope of practice.
As an EMT, the performance of your duties will be compared to that of:
another EMT.
the general public.
the medical director.
a paramedic supervisor.
You have been tasked by your medical director with assisting in the development of your EMS agency’s institutional standards. When developing these standards, it is important to:
require personnel to transport all patients to the closest hospital.
be reasonable and realistic to avoid overburdening EMS personnel.
demand that all personnel consistently exceed the standard of care.
expect personnel to function beyond their scope of practice if needed.
When performing his or her duties, the EMT is generally expected to:
consistently exceed the standard of care.
contact medical control on every EMS call.
function above his or her scope of practice.
exercise reasonable care and act prudently.
In which of the following situations does a legal duty to act clearly exist?
The EMT witnesses a vehicle crash while off duty.
A call is received 15 minutes prior to shift change.
The EMT hears of a cardiac arrest after his or her shift ends.
A bystander encounters a victim who is not breathing.
Which of the following most accurately defines negligence?
Transport of a mentally incompetent patient against his or her will
Deviation from the standard of care that might result in further injury
Transferring patient care to a provider with a lower level of training
Providing care that is consistent with care provided by other EMTs
Which of the following components are needed to prove negligence?
Abandonment, breach of duty, damages, and causation
Duty to act, abandonment, breach of duty, and causation
Duty to act, breach of duty, injury/damages, and causation
Breach of duty, injury/damages, abandonment, and causation
When caring for a 65-year-old male with respiratory distress, you place him in a comfortable position but do not apply oxygen. The patient’s condition continues to deteriorate; he develops cardiac arrest and dies at the hospital. This scenario is an example of:
assault.
battery.
negligence.
abandonment.
Which of the following scenarios most accurately depicts abandonment?
A paramedic transfers patient care to an EMT.
An AEMT transfers patient care to a paramedic.
A physician assumes patient care from an EMT.
An EMT gives a verbal report to an emergency room nurse.
While transporting a stable patient with chest pain to the hospital, you come across a major motor vehicle crash involving several critically injured patients. You should:
ask a bystander to remain with your patient as you treat the crash victims.
remain at the scene until law enforcement and another ambulance arrive.
stop and triage the patients while your partner remains in the ambulance.
continue transporting your patient and notify the dispatcher of the crash.
An EMT would most likely be held liable for abandonment if he or she:
refused to care for a violent patient who is armed with a knife.
remained at the hospital for 30 minutes to give a patient report.
did not make provisions for continued care of an injured patient.
terminated care of a competent adult patient at his or her request.
Acting in such a way as to make another person fear immediate bodily harm is called:
libel.
assault.
battery.
negligence.
Which of the following statements regarding Good Samaritan laws is correct?
Such laws provide the EMT with absolute immunity from a lawsuit.
Such laws guarantee that the EMT will not be held liable if he or she is sued.
Such laws do not protect EMTs who are off duty.
Such laws will not protect the EMT in cases of gross negligence.
If an action or procedure that was performed on a patient is not recorded on the written report:
it was not performed, according to the eyes of the law.
it can be qualified by the EMT in charge.
it cannot be used in establishing negligence.
it was performed haphazardly by the EMT.
In the eyes of the courts, an incomplete or untidy patient care form indicates:
inadequate patient care was administered.
potential falsification of the patient care form.
thorough documentation was not required.
the EMT was too busy providing patient care to fill out the form.
Which of the following situations requires you to notify the appropriate authorities?
Cardiac arrest
Drug overdose
Attempted suicide
Accidental knife wound
You and your partner are the first to arrive at a potential crime scene with a critically injured patient involved. The scene is safe. Your first priority is to:
notify medical control for advice.
provide immediate patient care.
wait for law enforcement to arrive.
determine why the patient was injured.
Maintaining the chain of evidence at the scene of a crime should include:
quickly moving any weapons out of the patient’s sight.
placing the patient in a private area until the police arrive.
making brief notes at the scene and then completing them later.
not cutting through holes in clothing that were caused by weapons.
You are dispatched to an apartment complex to respond to a shooting. Law enforcement personnel are present and have the suspect in custody. You find the patient lying in a narrow space between the couch and coffee table of his small apartment. He is semiconscious and has a large gunshot wound to his chest. You should:
obtain permission from law enforcement before moving anything.
quickly move the coffee table so you can access and treat the patient.
treat the patient where he is so that you do not destroy any evidence.
drag the patient into a larger area so that you can begin treatment.
Two EMTs witnessed a call in which a coworker gave adequate medical care but ignored the patient’s emotional needs. The coworker was deliberately rude solely because the patient was thought to be infected with the human immunodeficiency virus (HIV). The EMTs ignored the coworker’s treatment of this patient and took no steps to prevent this behavior from happening again. This lack of action on the part of the two EMTs is considered:
legal and ethical.
legal but unethical.
illegal but ethical.
illegal and unethical.
While transporting a woman with diabetes, you inadvertently give her oral glucose even though her blood glucose level was high. You reassess the patient and note that her condition did not change; she remained stable. You should:
document the error and report it to your supervisor.
notify law enforcement so they can file an incident report.
contact medical control and notify them of the error.
exclude this intervention from the PCR because it did not harm the patient.
When you and your partner arrive at the residence of a man in cardiac arrest, you immediately recognize the patient as the drunk driver who killed your brother several years earlier. A backup ambulance is en route to the scene. You should:
advise your partner that you cannot provide care to this patient.
wait for the backup ambulance while your partner performs CPR.
obtain permission from medical control to not attempt resuscitation.
begin two-rescuer CPR and apply the AED as soon as possible.
You receive a subpoena to testify in court regarding a case that occurred two years ago in which you and your partner did not attempt resuscitation of a cardiac arrest patient. Upon receiving the subpoena, you should:
call the district attorney’s office and explain the details of the case.
notify the director of your EMS system and obtain legal counsel.
attach an official addendum to the original patient care report.
contact the patient’s family in an attempt to resolve the matter with them.
You are dispatched to the residence of a person who frequently calls 911 for nonemergency care. You should:
defer the call to a local private ambulance company.
respond under the assumption that an acute emergency exists.
ask the dispatcher to send law enforcement before you respond.
refuse the call, but thoroughly document the patient’s circumstances.
Which of the following patients has decision-making capacity and can legally refuse emergency medical treatment?
A 29-year-old alert and oriented adult who can explain the risks and consequences of refusing care.
A 70-year-old with altered mental status after a head injury who cannot recall events.
A 16-year-old with a painful injury whose parent is not present and who is not emancipated.
A 45-year-old intoxicated patient who slurs speech and cannot describe possible consequences of refusal.
Ethnocentrism is defined as:
understanding that people from different cultural backgrounds respond to pain and stress differently.
suspecting that a person has an ulterior motive based on the tone of his or her voice when answering a question.
subconsciously forcing your cultural values onto a patient because you believe that your own values are more acceptable.
considering your own cultural values as more important when interacting with people of a different culture.
You are dispatched to the residence of an Asian family for a child with a high fever. When you assess the child, you note that he has numerous red marks on his back. The child's parents explain that these marks represent coining—a traditional Asian healing practice in which hot coins are rubbed on the back. You should:
advise the child's parents that this is a harmful practice and is considered a form of child abuse in the United States.
acknowledge and respect this practice as a cultural belief, but advise the child's parents that it has no healing power.
document this finding on your patient care report and advise the emergency department staff of what the child's parents told you.
advise the emergency department physician that you believe the child was intentionally abused by his parents.
You are assessing a 75-year-old woman with mild shortness of breath. As you are asking her questions about her chief complaint and medical history, you progressively move closer and closer to her. In doing this, it is important to remember that:
placing yourself in the patient's personal space is relaying to her that you can be trusted.
as you physically get closer to the patient, a greater and greater sense of trust must be established.
it is necessary to enter an older person's intimate space because the elderly are typically hearing impaired.
a patient's personal space should not be violated, regardless of any barriers that might hamper communication.
A 60-year-old man complains of chest pain. He is conscious, alert, and denies shortness of breath. Which of the following questions would be the most appropriate to ask him?
"Were you exerting yourself when the chest pain began?"
"Does the pain in your chest move to either of your arms?"
"Does the pain in your chest feel like a stabbing sensation?"
"Do you have any heart problems or take any medications?"
You are caring for a 52-year-old man who complains of chest discomfort. The patient is a retired paramedic and is very anxious because he thinks he is having a heart attack. Which of the following statements would be appropriate?
"It is possible that you are experiencing a heart attack. I am going to give you four baby aspirin to chew and swallow."
"I notice that you are a retired paramedic, so I'm sure you will understand all of the things that we will be doing to you."
"This is nothing to worry about. Please try to stay calm. The physician at the hospital will probably not find any signs of a heart problem."
"We need to take you to the ED stat. We will give you ASA and NTG en route and then reassess your vitals. Do you have any questions?"
Calming and reassuring an anxious patient can be facilitated by:
maintaining eye contact with the patient whenever possible.
using medical terminology to ensure the patient understands.
positioning yourself at a level that is higher than the patient.
withholding unpleasant information until arrival at the hospital.
During your assessment of a 20-year-old man with a severe headache and nausea, you ask him when his headache began, but he does not answer your question immediately. You should:
repeat your question because he probably did not hear you.
allow him time to think about the question and respond to it.
ask him if he frequently experiences severe headaches and nausea.
tell him that you cannot help him unless he answers your questions.
In which of the following manners should you act and speak with a patient?
Passive
Authoritative
Loud and official
Calm and confident
When you are communicating with an older patient, it is important to remember that:
your questions should focus exclusively on the patient’s obvious problem.
most older people think clearly and are capable of answering questions.
hostility and confusion should be presumed to be due to the patient’s age.
speaking loudly and distinctly will ensure that the patient can hear you.
A 4-year-old boy had an apparent seizure. He is conscious and calm and is sitting on his mother’s lap. His father is sitting in a nearby chair. The child’s mother suddenly begins crying uncontrollably, which causes the child to start crying. You should:
ask the child to hold the child so you can assess him while your partner tries to calm the mother.
give the child a favorite toy or blanket to hold onto and perform your assessment to the best of your ability.
reassure the child’s mother that seizures in children are very common and that there is nothing to worry about.
attempt to calm the child’s mother, but avoid separating her from her child because this will increase her anxiety.
Which of the following statements regarding communication with a child is correct?
Most children are intrigued by strangers wearing uniforms.
The EMT should give the child minimal information to avoid scaring him or her.
Standing over a child often increases his or her level of anxiety.
Unlike adults, children cannot see through lies or deceptions.
Communicating with hearing-impaired patients can be facilitated by doing all of the following, except:
shining a light on your face when you are in a darkened environment.
elevating the tone of your voice and exaggerating word pronunciation.
placing yourself in a position to ensure that the patient can see your lips.
providing pen and paper if the patient prefers to write his or her response.
When communicating with a visually impaired patient, you should:
determine the degree of the patient’s impairment.
expect the patient to have difficulty understanding.
recall that most visually impaired patients are blind.
possess an in-depth knowledge of sign language.
bystanders present who can act as an interpreter. You should:
give the patient oxygen, assess his vital signs, and transport him to the hospital in a position of comfort.
speak to the patient with a moderately louder voice to facilitate his ability to understand what you are saying.
use short, simple questions and point to specific parts of your body to try to determine the source of the patient’s complaint.
refrain from performing any assessment or treatment until you can contact someone who can function as an interpreter.
As you are wheeling your patient through the emergency department doors, you receive another call for a major motor vehicle crash. You should:
place the patient in a high-visibility area and then respond to the call.
inform the admissions clerk of the situation and then respond at once.
leave a copy of the run form with a nurse and then respond to the call.
respond only after giving a verbal patient report to a nurse or physician.
The official transfer of patient care does not occur until the EMT:
gives a radio report to the receiving medical facility.
notifies the admitting clerk of the patient’s arrival at the hospital.
informs dispatch of the patient’s arrival at the emergency department.
gives an oral report to the emergency room physician or nurse.
When you begin an oral report, you should state the patient’s age, sex, and:
chief complaint.
any known allergies.
past medical history.
the emergency care given.
Typical components of an oral patient report include all of the following, except:
the chief complaint or mechanism of injury.
important medical history not previously given.
the set of baseline vital signs taken at the scene.
the patient’s response to treatment you provided.
The patient care report (PCR) ensures:
availability of research data.
legal protection.
quality assurance.
continuity of care.
Your EMS system uses a computerized PCR in which you fill in the information electronically and then send it to the emergency department via a secure Internet server. The PCR has a comprehensive series of drop-down boxes, which are used to identify your assessment findings and specify the treatment that you provided; it also has a section for your narrative. When completing your PCR after a call, you should:
defer the narrative only if the information in the drop-down boxes accurately reflects the assessment and treatment that you performed.
complete a thorough and accurate narrative because drop-down boxes cannot provide all of the information that needs to be documented.
enter all of the pertinent information of the electronic PCR, but then print it out and provide a copy to the emergency department staff.
avoid documenting personally identifiable information, such as the patient’s name, because the PCR could be intercepted during transmission.
