CH 37 Emergencies for Patients with Special Challenges Flashcards
H-1) Which of the following defines obesity?
A. A body mass index of 30 or greater
B. 100 pounds or more above ideal body weight
C. More than 10% above ideal body weight
D. At least 25% above average weight for height
A. A body mass index of 30 or greater
H-2) Which of the following definitions of disability is most complete and accurate?
A. Disability is a physical, emotional, behavioral, or cognitive condition that interferes with a person’s ability to carry out everyday tasks.
B. Disability is a physical impairment that is specifically defined in the Americans with Disabilities Act.
C. Disability is a physical or cognitive condition that interferes with a person’s ability to function in a professional environment.
D. Disability is a physical, emotional, behavioral, or cognitive condition that keeps anyone from doing anything they want to do.
A. Disability is a physical, emotional, behavioral, or cognitive condition that interferes with a person’s ability to carry out everyday tasks.
H-3) According to the Centers for Disease Control and Prevention, which of the following statements regarding developmental disability is true?
A. A developmental disability is always a mental impairment.
B. A developmental disability causes significant impairment of a person’s major life activities.
C. A developmental disability begins after the age of 22.
D. A developmental disability is an acute condition.
B. A developmental disability causes significant impairment of a person’s major life activities.
The Centers for Disease Control and Prevention uses the term developmental disability to mean a chronic (persistent or lasting) mental and/or physical impairment beginning at any age up until 22 years and causing significant impairment in the person’s major life activities.
H-4) Which of the following statements best describes the reason it is important to monitor the oxygen saturation of an obese patient?
A. Obese patients often have respiratory problems.
B. The airway of an obese patient occludes easily.
C. The patient will likely be supine.
D. The first pulse oximetry reading for an obese patient tends to be wrong.
A. Obese patients often have respiratory problems.
Obesity increases the risk of respiratory problems. Very obese patients may have difficulty breathing when they are supine, because of the extra weight that must be moved by the diaphragm during inspiration. If possible, allow the patient to assume a comfortable position for breathing. Monitor the patient’s oxygen saturation, and provide oxygen and ventilatory assistance as needed.
H-5) Which type of instructions is best for a patient with autism? A. Implied B. Humorous C. Simple D. Metaphorical
C. Simple
Simple, clear, precise directions are easiest to follow for persons with autism. For example, say “Sit down here” (pointing at a chair), not “Why don’t you have a seat?” Don’t be sarcastic, use figures of speech, or tell jokes.
H-6) Which of the following statements regarding escalation and meltdown in a patient with autism is true?
A. The increase in tantrum-like behaviors is involuntary.
B. The patient is behaving maliciously in most cases.
C. Changing up an established routine can often reverse the escalation.
D. The most common cause is under-stimulation.
A. The increase in tantrum-like behaviors is involuntary.
Escalation and meltdown, which can occur in a person with an ASD, can be described as an involuntary increase in tantrum-like behaviors. There are several causes of this behavior, with the most common involving sensory, emotional, or cognitive overstimulation; social skills deficits; excessive demands being placed on the individual; interruption of established routines; and being put in a situation that was unexpected or is unpredictable. If a person with an ASD is behaving aggressively or is escalated, it is rarely from what most of us would refer to as malicious or defiant behavior.
H-7) Which of the following questions least involves scope-of-practice considerations when thinking about a problem with a patient’s medical device?
A. ”Do I have the knowledge to fix this problem?”
B. ”Is the problem life-threatening?”
C. ”Is this within my protocols?”
D. ”Do I think this problem is the result of neglect?”
D. ”Do I think this problem is the result of neglect?”
Scope-of-practice considerations involve what is within the EMT’s specific regional and state practices to do. You should confer with medical direction if the treatment or skill required is not something you are trained in or allowed to do under these protocols. If the EMT believes a problem is the result of neglect, that’s important, but not a scope-of-practice issue or related to determining whether an out-of-scope intervention might be required.
H-8) What is the least realistic expectation an EMT might have?
A. The EMT will be proficient in the use of and knowledgeable about any medical device.
B. Becoming familiar with any special healthcare setting in the community will make the EMT better prepared.
C. EMTs may develop plans with the representatives of specialized care facilities to coordinate care during EMS calls.
D. A special healthcare facility’s representative might agree to offer EMTs demonstrations of how the devices for their facility work.
A. The EMT will be proficient in the use of and knowledgeable about any medical device.
It isn’t realistic for an EMT to expect to know and be able to use any medical device that might be encountered in the field, but that doesn’t mean that EMTs will not benefit from taking steps to be better prepared in general for specialized care situations.
H-9) A patient who use a CPAP device for sleep apnea most likely:
A. will need the device to be close at hand at all times.
B. uses the device 24 hours a day.
C. will have frequent emergencies related to the use of the device.
D. uses the device at night.
D. uses the device at night.
A patient who use a CPAP device for sleep apnea most likely use the device at night but does not need it otherwise, and is unlikely to have emergencies specifically related to the device.
H-10) Which of the following patients is at increased risk for developing pneumonia?
A. An adolescent with Down syndrome
B. A spinal cord-injured patient on a ventilator
C. A patient who has been legally blind since birth
D. A child with autism
B. A spinal cord-injured patient on a ventilator
H-11) What is a special consideration that must be made for women who are homeless?
A. They may be victims of domestic and sexual abuse.
B. They typically have mental health problems.
C. They often have HIV/AIDS.
D. They frequently have complications from respiratory disorders.
A. They may be victims of domestic and sexual abuse.
Several serious health problems are related to homelessness: mental health problems, malnutrition, substance abuse problems, HIV/AIDS, tuberculosis, bronchitis and pneumonia, environmental emergencies, wounds, and skin infections. But a special consideration for women who are homeless is that they may be victims of domestic and sexual abuse.
H-12) Which of the following statements best describes an EMT’s responsibility when the EMT suspects that a child has been abused?
A. Accuse the suspected abuser, and notify child protective services to remove the child from the home.
B. Notify the appropriate authorities and the medical personnel who will be assuming care of the patient.
C. Report your suspicions to the patient’s family doctor.
D. Request an ALS response to manage the situation.
B. Notify the appropriate authorities and the medical personnel who will be assuming care of the patient.
It is the responsibility of the EMT to follow your state’s law. As with any suspected case of abuse or neglect, do not make accusations. Do your best to get the patient out of the environment, and report your suspicions according to the requirements of your jurisdiction, at a minimum to the receiving physician.
PT-1) You are called to the residence of a child who has a feeding tube. You are unfamiliar with feeding tubes and how they might affect your care of the child. What is the best resource for quickly learning about the specific feeding tube this patient has? A. Your partner B. Dispatch C. The user guide for the feeding tube D. The child's parents
D. The child’s parents
PT-2) What makes patients with special challenges especially vulnerable to various forms of abuse? A. Their age B. Their access to information C. Their dependence on others D. Their need for special devices
C. Their dependence on others
PT-3) You are caring for a patient with special medical challenges at her home. The patient is noncommunicative. Which of the following is likely to be the best source of information about the advanced medical devices found in the home? A. The patient B. Medical direction C. You and your partner D. The family
D. The family
PT-4) Restraining a patient with autism:
A. is the best way to keep the patient calm.
B. should always be done before transport.
C. is up to the patient’s parents or care provider.
D. should be a last resort.
D. should be a last resort.
PT-5) Which populations are disproportionately represented among the homeless?
A. Families
B. People who are homeless by choice
C. Veterans and minorities
D. People who choose to avoid homeless shelters
C. Veterans and minorities
PT-6) Developmental disorders that affect, among other things, one's abilities to communicate, report medical conditions, self-regulate behaviors, and interact with others to get needs met are: A. bariatrics. B. cognitive disabilities. C. autistic spectrum disorders. D. neuromuscular disorders.
C. autistic spectrum disorders
PT-7) The branch of medicine that deals with the causes of obesity as well as its prevention and treatment is: A. geriatrics. B. bariatrics. C. obstetrics. D. pediatrics.
B. bariatrics.
PT-8) A terminal illness is often: A. swift. B. easily managed. C. reversible. D. costly.
D. costly.
PT-9) Which of the following statements best describes the reason why EMS providers should be knowledgeable about patients with special challenges?
A. EMS providers are involved in routine home healthcare of patients with special medical challenges.
B. EMTs must be able to make emergency repairs or adjustments to life-sustaining equipment.
C. A public health function of EMS is to make routine checks of specialized medical devices.
D. The patient’s preexisting condition can complicate and quickly overwhelm your ability to assess and treat the patient.
D. The patient’s preexisting condition can complicate and quickly overwhelm your ability to assess and treat the patient.
PT-10) If you were transporting a patient still attached to a ventilator, which of the following would you not do?
A. Firmly affix the ventilator to the stretcher
B. Obtain extra help if a bag-valve mask will be used during transport
C. Assume that any ventilator will have enough battery for most ambulance trips
D. Secure the ventilator, to prevent movement in the ambulance
C. Assume that any ventilator will have enough battery for most ambulance trips
PT-11) Which of the following is LEAST likely to be a sign of abuse or neglect?
A. The patient is kept in a dark back room, and is unwashed and undernourished.
B. A patient has multiple injuries in various stages of healing.
C. The story of a patient’s injury is inconsistent with the injury itself.
D. A patient’s tracheostomy tube requires suctioning to clear it of secretions.
D. A patient’s tracheostomy tube requires suctioning to clear it of secretions.
PT-12) A patient with vision impairment:
A. can often navigate familiar environments without help.
B. has a congenital disorder.
C. requires a cane or service animal.
D. should be restrained to avoid injury.
A. can often navigate familiar environments without help.
PT-13) Which of the following statements regarding management of obese patients is true?
A. Laying the patient supine often results in hyperventilation syndrome.
B. They require a tidal volume of 20 ml/kg of body weight.
C. They may present special challenges during lifting and moving.
D. CPAP is contraindicated in morbidly obese patients.
C. They may present special challenges during lifting and moving.
