Ch. 4

Question 1

Which of the following refers to the set of regulations that defines what the AEMT is permitted to do and the limitations placed on him?

A) Scope of practice
B) Legal standards of practice
C) Protocols and standing orders
D) Professional standards

Answer 1

A) Scope of practice

Page Ref: 61
Objective: 4.2 Describe your responsibilities as an Advanced EMT with respect to scope of practice, standard of care, and medical direction.

Question 2

The service medical director is responsible for:

A) providing direct patient care.
B) hiring EMS personnel for the service.
C) providing licensure for prehospital personnel.
D) managing inappropriate medical conduct by service AEMTs.

Answer 2

D) managing inappropriate medical conduct by service AEMTs.

Page Ref: 62
Objective: 4.2 Describe your responsibilities as an Advanced EMT with respect to scope of practice, standard of care, and medical direction.

Question 3

Your patient is a 40-year-old known diabetic who was found unconscious at work by a coworker. What type of consent allows you to treat this patient?

A) Consent for treatment of minor emergencies
B) Consent for mentally incompetent adults
C) Expressed consent
D) Implied consent

Answer 3

D) Implied consent

Page Ref: 63
Objective: 4.10 Given a scenario, determine the type of patient consent that applies.

Question 4

Your patient is a 45-year-old man suffering from chest pain. Upon arrival, the patient is pale, sweaty, and short of breath. The patient is angry with his daughter for calling 911. He says that he had some spicy sausage for breakfast and has indigestion. Which of the following is an appropriate means of getting the patient the care he needs?

A) Try to find out why the patient does not want to go to the hospital so you can respond to his objections and possibly get him to consent going to the hospital.
B) Call the patient’s neighbors and tell them that you have been called to the patient’s house, but he is now refusing care.
C) Inform the patient that if he does not agree to treatment, you will have to take him against his will because he has a potentially life-threatening problem.
D) Tell the patient that his pain is likely caused by his diet, then suggest he take an antacid and go to bed.

Answer 4

A) Try to find out why the patient does not want to go to the hospital so you can respond to his objections and possibly get him to consent going to the hospital.

Page Ref: 63
Objective: 4.12 Apply the concept of the right to self-determination to issues of consent and advance directives.

Question 5

The branch of philosophy that tries to answer questions about notions of what is good and bad and what is right and wrong is called:

A) morality.
B) ethics.
C) libel.
D) justice.

Answer 5

B) ethics.

Page Ref: 60
Objective: 4.1 Define key terms introduced in this chapter.

Question 6

Which of the following provides some protection from liability for emergency care provided in good faith?

A) Code of Ethics
B) Malpractice Act
C) Good Samaritan law
D) Emergency Care statute

Answer 6

C) Good Samaritan law

Page Ref: 71
Objective: 4.7 Describe the purpose of and typical protections afforded by Good Samaritan laws.

Question 7

You are called to treat a 65-year-old man who has collapsed and is complaining of chest pain, which you suspect is of cardiac origin. Which of the following BEST illustrates failure to meet the standard of care?

A) Starting an IV on the patient
B) Obtaining a set of vital signs
C) Failing to administer nitroglycerin
D) Administering aspirin

Answer 7

C) Failing to administer nitroglycerin

Page Ref: 69
Objective: 4.8 Given a scenario, identify circumstances that may allow a claim of negligence to be established.

Question 8

Which of the following would be an example of res ipsa loquitur?

A) You leave a patient at the hospital without giving a patient care report to the nurse.
B) You deliver 50% dextrose to a patient through a vein that is not patent, which causes tissue damage.
C) You fail to respond when dispatched to a wreck on the interstate.
D) You refuse to transport a patient who you think has AIDS.

Answer 8

B) You deliver 50% dextrose to a patient through a vein that is not patent, which causes tissue damage.

Page Ref: 69
Objective: 4.6 Give examples of legal situations involving tort and criminal issues.

Question 9

You arrive at a scene where a 24-year-old male patient has suffered a broken arm from a bicycle accident. He is in a great deal of pain, but refuses treatment and transport. Under the law, you must honor his decision if he:

A) is mentally competent and understands what he is doing.
B) is free of any life-threatening injuries or conditions.
C) signs a form releasing the AEMT from liability.
D) has a witness to the refusal of treatment form.

Answer 9

A) is mentally competent and understands what he is doing.

Page Ref: 62
Objective: 4.10 Given a scenario, determine the type of patient consent that applies.

Question 10

Which of the following BEST indicates that informed consent has been obtained?

A) The AEMT administers oxygen because the patient has chest pain and shortness of breath.
B) The patient agrees to oxygen therapy after being told it will decrease his chest pain.
C) The AEMT tells the patient that all patients are given oxygen.
D) The patient doesn’t want oxygen but the AEMT tells him he has to have it.

Answer 10

B) The patient agrees to oxygen therapy after being told it will decrease his chest pain.

Page Ref: 63
Objective: 4.10 Given a scenario, determine the type of patient consent that applies.

Question 11

Stopping care without ensuring that another appropriately credentialed health care provider will take over care is called:

A) neglect.
B) refusal.
C) battery.
D) abandonment.

Answer 11

D) abandonment.

Page Ref: 65-66
Objective: 4.13 Describe how to avoid claims of assault, battery, abandonment, false imprisonment/kidnapping, and defamation.

Question 12

Negligence is based on duty to act, breach of duty, damages, and:

A) proximate cause.
B) termination of care.
C) expressed consent.
D) liability.

Answer 12

A) proximate cause.

Page Ref: 69
Objective: 4.9 Discuss several ways to defend yourself against claims of negligence.

Question 13

In which of the following cases would there be a case for negligence based on cause of damages?

A) You drop a patient from a stretcher but he wasn’t injured.
B) You start an IV which causes an infection, and the patient has to have surgery to repair it.
C) The patient suffered a spinal injury from an MVC, but he refused spinal immobilization.
D) A CHF patient has difficulty breathing and has to be intubated at the hospital but does not survive.

Answer 13

B) You start an IV which causes an infection, and the patient has to have surgery to repair it.

Page Ref: 69
Objective: 4.9 Discuss several ways to defend yourself against claims of negligence.

Question 14

Telling a patient that you will stick him with a really big needle if he doesn’t settle down is an example of:

A) battery.
B) slander.
C) assault.
D) negligence.

Answer 14

C) assault.

Page Ref: 66
Objective: 4.13 Describe how to avoid claims of assault, battery, abandonment, false imprisonment/kidnapping, and defamation.

Question 15

You are caring for a patient who refuses treatment and transport. However, you are unsure whether he is capable of a rational decision. You should:

A) transport the patient anyway.
B) have the patient sign a refusal form.
C) consult with medical direction.
D) have a family member sign the refusal form.

Answer 15

C) consult with medical direction.

Page Ref: 62
Objective: 4.10 Given a scenario, determine the type of patient consent that applies.

Question 16

An alert and oriented patient complaining of a severe headache is refusing treatment and transport. After signing a refusal form, she begins to seize and goes unconscious. You should do which of the following?

A) Contact medical direction for permission to treat.
B) Honor the patient’s wishes and leave the scene.
C) Have the patient’s family transport the patient to the hospital.
D) Provide care under the doctrine of implied consent.

Answer 16

D) Provide care under the doctrine of implied consent.

Page Ref: 63
Objective: 4.10 Given a scenario, determine the type of patient consent that applies.

Question 17

You are called to a park for a 10-year-old boy who has fallen from a slide and broken his arm. The bone is angulated, and he is in a lot of pain. He states that his mother is at work, and he doesn’t know the phone number. You should:

A) treat the boy under the doctrine of implied consent.
B) not treat the boy until you contact to his mother.
C) obtain permission from the park director.
D) have the police take custody of the boy and give permission to treat.

Answer 17

A) treat the boy under the doctrine of implied consent.

Page Ref: 65
Objective: 4.10 Given a scenario, determine the type of patient consent that applies.

Question 18

A 62-year-old alcoholic has fallen and sustained a head injury. He states he does not want to be treated and becomes combative when you try to examine him. Your BEST course of action would be to:

A) transport him against his will.
B) treat him under the doctrine of implied consent.
C) restrain him so that you can assess him.
D) contact medical direction.

Answer 18

D) contact medical direction.

Page Ref: 63
Objective: 4.11 Evaluate factors that should be considered when determining a patient’s decision-making capacity and in situations where the use of force or patient restraint is being contemplated.

Question 19

The AEMT recognizes that the HIPAA legislation limits his ability to do which of the following?

A) Share medical information regarding a patient.
B) Bill for services rendered.
C) Obtain refusals on patients who do not have insurance.
D) Transport a patient to the hospital of their choice.

Answer 19

A) Share medical information regarding a patient.

Page Ref: 71
Objective: 4.16 Discuss the application of EMTALA and HIPAA legislation to the practice of EMS.

Question 20

Presumptive signs of death include all of the following EXCEPT:

A) rigor mortis.
B) profound cyanosis.
C) dependent lividity.
D) decomposition.

Answer 20

B) profound cyanosis.

Page Ref: 67
Objective: 4.17 Identify presumptive signs of death.

Question 21

Which of the following deaths would require contact with law enforcement?

A) A patient who died as a result of chronic emphysema
B) A patient who has shot himself
C) The death of a terminally ill patient
D) A cardiac patient who dies en route to the hospital

Answer 21

B) A patient who has shot himself

Page Ref: 67
Objective: 4.19 Identify situations in which law enforcement or the medical examiner’s office should be notified.

Question 22

All of the following are incidents that require mandatory reporting EXCEPT a(n):

A) boy who has been bitten by a dog.
B) child who has been abused.
C) patient who has used illegal drugs.
D) patient with a gunshot wound.

Answer 22

C) patient who has used illegal drugs.

Page Ref: 72
Objective: 4.14 Identify situations in which Advanced EMTs may be mandatory reporters of suspected crimes or other legally reportable situations.

Question 23

You are pulling into the hospital with a patient with a behavioral emergency who continually seeks treatment at this particular hospital. Before you can unload the patient, a physician comes out and tells you that you must take the patient to another hospital and that he can’t be seen here. This is best classified as a(n):

A) violation of the patient consent.
B) HIPAA violation.
C) violation of the Ryan White CARE Act.
D) EMTALA violation.

Answer 23

D) EMTALA violation.

Page Ref: 71
Objective: 4.16 Discuss the application of EMTALA and HIPAA legislation to the practice of EMS.

Question 24

Which of the following is not one of the EMT’s responsibilities at a crime scene?

A) Identifying any potential suspects
B) Securing his own safety
C) Taking notes regarding possible evidence that was moved
D) Preserving evidence for trial

Answer 24

A) Identifying any potential suspects

Page Ref: 72
Objective: 4.20 Discuss legal considerations in the response to crime scenes and the care of both crime victims and suspects.

Question 25

While treating a patient involved in a shooting at the patient’s vacation home, which of the following actions will NOT interfere with the investigation of a crime scene?

A) Cutting through a bullet hole in the patient’s clothing
B) Using the bathroom
C) Using the patient’s phone
D) Following the same path as other providers

Answer 25

D) Following the same path as other providers

Page Ref: 72
Objective: 4.21 Identify items that may be considered evidence at a crime scene.

Question 26

Which of the following incidents is the EMT legally required to report to law enforcement?

A) You suspect the wife of the patient you are treating for chest pain has been smoking marijuana.
B) Your patient is an 18-year-old student who consumed large amounts of alcohol at a fraternity party.
C) Your patient is a 17-year-old who broke his left arm, and tells you his parents are at work.
D) Your patient has facial and head injuries and states that her husband beat her with a hammer.

Answer 26

D) Your patient has facial and head injuries and states that her husband beat her with a hammer.

Page Ref: 72-73
Objective: 4.14 Identify situations in which Advanced EMTs may be mandatory reporters of suspected crimes or other legally reportable situations.

Question 27

Which of the following actions is NOT permitted by an advance directive?

A) Providing only comfort measures, such as pain medication
B) Withholding CPR if cardiac arrest is not witnessed
C) Refusing to allow long-term life support measures, such as a ventilator or feeding tube
D) Assisting with a suicide via a medication overdose

Answer 27

D) Assisting with a suicide via a medication overdose

Page Ref: 66-67
Objective: 4.12 Apply the concept of the right to self-determination to issues of consent and advance directives.

Question 28

You are on the scene with a 72-year-old man with chest pain. The patient is complaining of shortness of breath but also refuses to go to the hospital, even after multiple attempts urging him to go. Which of the following should you do next?

A) Stay with the patient until he loses consciousness.
B) Fully inform the patient about his situation and the implications of refusing care.
C) Inform the patient that he is having a “heart attack” and must be taken to the hospital for evaluation.
D) Contact medical direction for orders to restrain the patient.

Answer 28

B) Fully inform the patient about his situation and the implications of refusing care.

Page Ref: 63
Objective: 4.12 Apply the concept of the right to self-determination to issues of consent and advance directives.

Question 29

You respond to a bus accident with multiple patients. As you arrive at the scene, you are approached by a local politician who states that his wife has been involved in the accident. He tells you that if you will take care of her first, he will ensure that you get the promotion you are up for. This becomes what type of decision for you as an EMT?

A) Legal
B) Financial
C) Ethical
D) Medical

Answer 29

C) Ethical

Page Ref: 60
Objective: 4.3 Given a variety of ethical dilemmas, discuss the issues that must be considered in each situation.

Question 30

While documenting a call, you add a false statement about a local doctor. This could constitute which of the following?

A) Libel
B) Slander
C) Degradation of character
D) HIPAA violation

Answer 30

A) Libel

Page Ref: 70
Objective: 4.6 Give examples of legal situations involving tort and criminal issues.

Question 31

The EMT’s obligation to provide care to a patient either as a formal or ethical responsibility is known as which of the following?

A) Legal responsibility
B) Scope of practice
C) Duty to act
D) Standard of care

Answer 31

C) Duty to act

Page Ref: 69
Objective: 4.1 Define key terms introduced in this chapter.

Question 32

A male AEMT was discussing a patient’s medical condition with a female EMT who works for another service. She then repeated this information to others, and it got back to the patient. Regarding confidentiality, which of the following is TRUE?

A) The male AEMT could be charged with slander.
B) The female EMT committed an EMTALA violation.
C) Both providers violated EMTALA regulations.
D) The male AEMT violated the HIPAA law.

Answer 32

D) The male AEMT violated the HIPAA law.

Page Ref: 71
Objective: 4.15 Differentiate between instances in which you can and cannot legally share a patient’s protected health information; 4.16 Discuss the application of EMTALA and HIPAA legislation to the practice of EMS.

Question 33

You are providing care to a 54-year-old patient complaining of chest pain. The patient asks to speak to you privately. He tells you he is taking Cialis® for erectile dysfunction, and his wife does not know he is taking it. He does not want his wife to find out. As you are putting the EMS bags back in the ambulance, the wife corners you and insists that you tell her what her husband said. What should you do?

A) You should tell her. As his spouse, she is legally entitled to know his medical information.
B) You should not tell her. There is no reason to humiliate your patient by disclosing his embarrassing condition.
C) You should not tell her. By law, your conversation with your patient is confidential.
D) You should tell her. He may be having an affair without her knowledge, and she needs to be tested for sexually transmitted diseases.

Answer 33

C) You should not tell her. By law, your conversation with your patient is confidential.

Page Ref: 71
Objective: 4.16 Discuss the application of EMTALA and HIPAA legislation to the practice of EMS.

Question 34

In which of the following situations is it legal to share information about treatment you provided to a patient?

A) The triage nurse at the ED asks about the care provided to the patient.
B) The patient gives verbal consent to release information to a friend.
C) The patient’s lawyer requests the information over the phone.
D) You are asked by a coworker who knows the patient.

Answer 34

A) The triage nurse at the ED asks about the care provided to the patient.

Page Ref: 71
Objective: 4.15 Differentiate between instances in which you can and cannot legally share a patient’s protected health information.

Question 35

Which of the following is TRUE regarding disclosure of protected health information?

A) You can discuss a patient as long as you can’t be overheard.
B) You can give the information to the billing office.
C) You may discuss a patient with your spouse so she understands your stress.
D) You can have other medics read your run reports.

Answer 35

B) You can give the information to the billing office.

Page Ref: 71
Objective: 4.15 Differentiate between instances in which you can and cannot legally share a patient’s protected health information.

Question 36

The medical principle of primum non nocere described in the EMT oath charges the EMS provider to:

A) first do no harm.
B) consider others first.
C) remain objective.
D) maintain diligence.

Answer 36

A) first do no harm.

Page Ref: 60
Objective: 4.4 Discuss the application of the EMT Oath and professional ethics to the practice of EMS.

Question 37

Which of the following circumstances would a provider MOST likely be covered by Good Samaritan laws?

A) A nurse working her shift at the hospital during a disaster
B) An AEMT who stops at a vehicle accident while on vacation
C) A volunteer paramedic manning an emergency response vehicle
D) A physician who works overtime to see critical patients

Answer 37

B) An AEMT who stops at a vehicle accident while on vacation

Page Ref: 71
Objective: 4.7 Describe the purpose of and typical protections afforded by Good Samaritan laws.

Question 38

Which of the following scenarios could allow a successful claim of negligence against the EMS provider?

A) A paramedic administers the wrong drug and the patient suffers adverse effects.
B) A patient refuses to be spinal immobilized and incurs a permanent spinal injury.
C) The AEMT forgets to apply oxygen to a patient with a broken arm.
D) An EMT decides not to stop at the scene of an accident where someone died.

Answer 38

A) A paramedic administers the wrong drug and the patient suffers adverse effects.

Page Ref: 69
Objective: 4.8 Given a scenario, identify circumstances that may allow a claim of negligence to be established.

Question 39

Which of the following situations BEST illustrates the act of abandonment?

A) The AEMT resuscitates a patient who has a DNR order which has been signed by his physician.
B) An EMT transports a patient to the emergency department but does not advise the ED staff.
C) An EMT begins to provide care to a patient, and then turn’s patient care over to a paramedic.
D) An off-duty paramedic sees a vehicle collision with probable injuries but does not stop to help.

Answer 39

B) An EMT transports a patient to the emergency department but does not advise the ED staff.

Page Ref: 66
Objective: 4.13 Describe how to avoid claims of assault, battery, abandonment, false imprisonment/kidnapping, and defamation.

Question 40

The type of law that defines certification or licensure requirements for the advanced EMTs are:

A) administrative law.
B) tort law.
C) civil law.
D) criminal law.

Answer 40

A) administrative law.

Page Ref: 61
Objective: 4.5 Give examples of federal and state laws affecting the practice of EMS.

Question 41

Which of the following is defined as “the granting of official permission by a governmental agency to practice in a regulated occupation or profession”?

A) Certification
B) Registration
C) Licensure
D) Authorization

Answer 41

C) Licensure

Page Ref: 61
Objective: 4.1 Define key terms introduced in this chapter.