Chapter 3 quiz Flashcards
The EMT correctly understands a Physician Orders for Life Sustaining Treatment document when he states:
A)”A POLST must be signed by the court system patient and is valid for a period of no more than 5 years.”
B)”A POLST is the same as a Do Not Resuscitate order, with the difference being that the physician does not have to sign it.”
C) “A POLST is designed to allow a patient to choose the desired type of care prior to the need for resuscitation.”
D) “A POLST legally empowers another person to make health care decisions for him or her in the event he or she cannot do so.”
C) “A POLST is designed to allow a patient to choose the desired type of care prior to the need for resuscitation.”
There has been a very serious motor vehicle collision involving a high-profile judge seeking reelection. The judge was traveling at a high rate of speed and crossed the center line, striking and killing a motorcyclist. Newspaper reporters are on location, asking you to describe what happened. Which one of the following statements is most appropriate?
A) “The accident was not bad, so please leave the scene.”
B) “The judge was in the car that hit and killed the motorcyclist.”
C) “The judge was involved, but I cannot tell you anything that happened.”
D) “There has been a serious accident in which a person was killed.”
D) “There has been a serious accident in which a person was killed.”
The EMT shows understanding of the standard of care when he states:
A) “The standard of care is a measure of whether or not the right assessment and care have been provided to the patient.”
B) “The standard of care is a document that outlines the curriculum to which all EMT programs in the United States must subscribe.”
C) “The standard of care is state law that requires the EMS to respond and render care in emergency and nonemergency situations.”
D) “The standard of care is a state law that describes what actions the EMT can and cannot legally perform.”
A) “The standard of care is a measure of whether or not the right assessment and care have been provided to the patient.”
You are off duty and have come across a motor vehicle collision. A car has crashed head-on into a utility pole. There is moderate damage to the vehicle and the driver is walking about the scene. You stop and assess the patient. He has a large bruise on his arm and is complaining of abdominal pain where the seat belt contacted his body. Emergency Medical Responders (EMRs) are on scene and a responding ambulance has a 2-minute ETA. At this point, you realize that:
A) you cannot leave until another EMT or paramedic arrives to assume care.
B) you can leave the scene since the patient is stable and EMS is 2 minutes away.
C) you can transfer care to EMRs since EMS is notified and 2 minutes from the scene.
D) you can only transfer care to a paramedic once he or she arrives on scene.
A) you cannot leave until another EMT or paramedic arrives to assume care.
Which one of the following best illustrates the EMT’s failure to meet the standard of care when treating a patient with chest pain?
A) Assisting the patient in taking his heart medication
B) Starting an IV on the patient
C) Failing to notify the patient’s primary care physician
D) Failing to give the patient oxygen
D) Failing to give the patient oxygen
A diabetic patient has an elevated blood sugar (545 mg/dL) and requires an injection of insulin. Your EMT partner is also a diabetic and administers insulin injections to himself throughout the day as needed. Although the Scope of Practice lists nothing about EMTs giving insulin, your partner administers the insulin injection to the patient. The patient’s blood sugar comes down and her condition improves. Which of the following is true?
A) Because your partner used the patient’s insulin rather than his own, he cannot be reprimanded.
B) It was permissible for your partner to give the insulin since he is diabetic and knows how.
C) Since the patient benefited from the insulin, your partner acted appropriately.
D) Your partner violated the Scope of Practice and may have his certification revoked.
D) Your partner violated the Scope of Practice and may have his certification revoked.
A patient who is extremely dizzy and vomiting declines your care and will not sign the refusal form. Your best action would be to:
A) have your partner sign on behalf of the patient.
B) inform the patient that by law he must sign the form.
C) have a family member sign as a witness to the refusal.
D) document that the patient refuses to sign and leave.
C) have a family member sign as a witness to the refusal.
Your best protection when a patient refuses care or transport is to:
A) contact the patient at a later time to see how he is doing.
B) have your partner sign the refusal form as a witness.
C) completely and thoroughly document the incident.
D) inform the patient’s family physician of what happened.
C) completely and thoroughly document the incident.
A 62-year-old male is short of breath. The EMT asks the patient if it would be okay to assess him, including taking his vital signs. The patient agrees. Which one of the following is true?
A) Informed consent has been obtained by the EMT.
B) The patient can be transported without further permission.
C) The EMT has obtained expressed consent.
D) A witness is needed for the patient’s consent.
C) The EMT has obtained expressed consent.
For negligence to be proven, which of the following must be present?
A) Duty to act, injury, proximate cause
B) Assault, breach of duty, damage
C) Duty to act, breach of duty, battery
D) Harm to the patient, false imprisonment, duty to act
A) Duty to act, injury, proximate cause
An alert and oriented patient complaining of a severe headache is refusing all treatment as well as transport by the EMTs. After having signed the refusal, the patient suddenly seizes and becomes unresponsive. The EMT should:
A) contact medical direction for permission to treat.
B) provide care under the guideline of implied consent.
C) honor the patient’s wishes and leave the scene.
D) place the patient into the family’s car for transport to the hospital.
B) provide care under the guideline of implied consent.
A 77-year-old female is unresponsive, but breathing and with a pulse. On scene, a family member hands you an official document stating that the patient does not want feeding tubes, ventilators, or other long-term life support equipment to keep her alive. There is no mention of whether to administer life-saving drugs or withhold cardiopulmonary resuscitation. The EMT would recognize this document as a(n): A) Do Not Resuscitate (DNR) order. B) implied consent. C) living will document. D) durable power of attorney.
C) living will document.
A competent adult patient with chest pain is refusing all treatment. Which one of the following indicates the EMT’s most appropriate response?
A) “Before you refuse, I need to tell you that this could be a heart attack and you could die.”
B) “Since you are competent and rational, it is your right to refuse. Please sign this refusal form.”
C) “I will need to have you sign this refusal form and a family member sign as a witness.”
D) “I am sorry, but since 911 was called, we must transport you to the hospital. You can refuse treatment there.”
A) “Before you refuse, I need to tell you that this could be a heart attack and you could die.”
The EMT shows he understands Do Not Resuscitate (DNR) orders and a living will when he states:
A) “A living will is a form of DNR; only a living will states exactly how the patient wants to be resuscitated.”
B) “A DNR applies to resuscitation issues only, like when a patient stops breathing or the heart ceases to beat.”
C) “If a patient has a valid DNR, the EMT should withhold all care and transport the patient to the hospital.”
D) “If the patient has a living will, it can legally be used as a substitute for a Do Not Resuscitate order.”
B) “A DNR applies to resuscitation issues only, like when a patient stops breathing or the heart ceases to beat.”
Which one of the following patients may be treated under the guideline of implied consent?
A) An adult patient with chest pain and shortness of breath who is refusing treatment and transport by EMS
B) An unresponsive 33-year-old female who is treated by EMS after overdosing on a street drug
C) A 2-year-old boy who fell down a flight of stairs and whose parents want him taken to the hospital
D) A 47-year-old female with severe abdominal pain who is refusing transport after placing the call to 911 for help
B) An unresponsive 33-year-old female who is treated by EMS after overdosing on a street drug
The EMT gains the greatest protection from consent-related legal issues by:
A) notifying the emergency physician or medical direction of the patient’s consent.
B) having his or her partner serve as a witness to the consent.
C) documenting the patient’s consent for treatment on the prehospital care report.
D) asking the patient twice if it is okay to assess and treat him or her.
C) documenting the patient’s consent for treatment on the prehospital care report.
A patient with a terminal disease is unresponsive, not breathing, and without a pulse. The family states that the patient has a Do Not Resuscitate (DNR) order signed by her medical doctor, but they cannot find it. The EMT should:
A) start cardiopulmonary resuscitation.
B) pronounce the patient deceased.
C) have the family sign a refusal of care form.
D) wait for family to locate the DNR.
A) start cardiopulmonary resuscitation.
A 46-year-old man who is conscious, competent, and rational is refusing treatment despite crushing chest pain and shortness of breath. He states that the hospital will not do anything for him and he does not want you to treat or transport him. The EMT should recognize that the:
A) patient has a right to refuse treatment and transport.
B) patient will need to be transported against his will.
C) police will need to be called so the patient can be transported in custody.
D) patient’s family can give consent to transport the patient.
A) patient has a right to refuse treatment and transport.
An intoxicated 72-year-old male with an alcoholic history has fallen and has a laceration on the back of his head. He states that he does not want treatment and becomes combative when you try to talk to or assess him. Your best course of action would be to:
A) transport him by permission of family.
B) contact medical direction.
C) transport him against his will.
D) have him sign a refusal.
B) contact medical direction.
In a community park, a 10-year-old boy has fallen from the top of a slide. His right wrist is deformed and he is in pain. He states that he lives with his mother and she is working. He does not know her work number. The EMT’s best action would be to:
A) treat the patient under the guidelines of implied consent.
B) obtain permission from the park director.
C) do not treat the patient until his mother can be contacted.
D) have the police take custody of the boy and give permission to treat.
A) treat the patient under the guidelines of implied consent.
You have been dispatched for a 15-year-old female with a headache. On scene, the patient is found holding her daughter in her arms. She states that she has had a migraine headache for two days and would like to be transported to the hospital for further evaluation. As an EMT you would:
A) refuse transport since the patient does not have a true emergency.
B) treat her under the doctrine of implied consent.
C) obtain a parent’s consent to treat her, given her age.
D) assess and transport the patient as she desires.
D) assess and transport the patient as she desires.
Which one of the following best indicates that informed consent has been obtained?
A) The patient is given oxygen because he is having chest pain and was the one who placed the 911 call for help.
B) The patient agrees to oxygen therapy after being told it may help decrease his chest pain but may dry his nose, causing discomfort.
C) The EMT administers oxygen because the patient is having chest pain and appears short of breath.
D) The EMT tells the patient that he will need oxygen because he is having chest pain, which could be a sign of a heart attack.
B) The patient agrees to oxygen therapy after being told it may help decrease his chest pain but may dry his nose, causing discomfort.
You have been called to a home for an alert and oriented female with terminal lung cancer. At the home, the daughter, who is her mother’s durable power of attorney, states that she wants her mother transported to the hospital. The patient, who is alert and oriented, does not want to go. Which of the following statements indicates that the EMT is acting both appropriately and legally in this conflict?
A) “Since it appears there is a conflict of opinion here, I will need to call the police so that they can determine what to do.”
B) “Since your daughter is the durable power of attorney, she has the legal right to make all decisions; therefore, we have to take you to the hospital.”
C) “I know that you are the durable power of attorney, but your mother is alert and oriented so we cannot legally take her against her will.”
D) “As your durable power of attorney, your daughter has the legally vested right to make your decisions; however, let us ask your husband what he thinks.”
C) “I know that you are the durable power of attorney, but your mother is alert and oriented so we cannot legally take her against her will.”
A 20-year-old male has been stabbed in the abdomen. Assessment reveals him to be unresponsive with shallow breathing and a low blood pressure. Which of the following instructions will you provide to your new EMT partner given that the patient has been involved in a crime?
A) “Do not worry about documenting the crime scene in your report. The police report will reflect that information.”
B) “We are not to move the patient to the stretcher until the police are done photographing the scene.”
C) “I am not worried about potential evidence. I am just worried about the patient.”
D) “When cutting his shirt off, make sure not to cut through the area where the knife penetrated.”
D) “When cutting his shirt off, make sure not to cut through the area where the knife penetrated.”