Chapter 37

Question 1

A 13-year-old child is on a home ventilator. The parents called because the mechanical ventilator is malfunctioning, and the child has increasing respiratory distress. You should:
place a call to the home health agency treating this patient.
attempt to troubleshoot the mechanical ventilator problem.
disconnect the ventilator and apply a tracheostomy collar.
reset the ventilator by unplugging it for 30 to 60 seconds.

Answer 1

disconnect the ventilator and apply a tracheostomy collar.

Question 2

According to the ‘E’ in the DOPE mnemonic, which of the following actions should you perform to troubleshoot inadequate ventilation in a patient with a tracheostomy tube?
Look for blood or other secretions in the tube.
Listen to breath sounds to assess for a pneumothorax.
Attempt to pass a suction catheter into the tube.
Check the mechanical ventilator for malfunction.

Answer 2

Check the mechanical ventilator for malfunction.

Question 3

Airway management can be challenging in patients with Down syndrome because their:
mandible is large, which inhibits a mask-to-face seal.
teeth are misaligned, and they have a large tongue.
occiput is round, which causes flexion of the neck.
tongue is relatively small and falls back in the throat.

Answer 3

teeth are misaligned, and they have a large tongue.

Question 4

A tube from the brain to the abdomen that drains excessive cerebrospinal fluid is called a:
CS tube.
shunt.
cerebral bypass.
G-tube.

Answer 4

shunt.

Question 5

Cerebral palsy is a condition that results from damage or injury to the:
spinal cord.
peripheral nervous system.
voluntary muscles.
brain.

Answer 5

brain.

Question 6

Common associated conditions in patients with spina bifida include all of the following, except:
loss of bladder control.
spastic limb movement.
hydrocephalus.
extreme latex allergy.

Answer 6

spastic limb movement.

Question 7

Common complications associated with central venous catheters include all of the following, except:
clotting of the line.
rupture of a central vein.
bleeding around the line.
a local infection.

Answer 7

rupture of a central vein.

Question 8

EMS personnel would most likely be called to the residence of a patient receiving home health care when the home care provider:
must confirm that a specific intervention is required.
needs simple assistance in providing patient care.
has recognized a change in the patient’s health status.
has a question that is specific to the patient’s condition.

Answer 8

has recognized a change in the patient’s health status.

Question 9

EMTs are dispatched for a fall. The patient, a 16-year-old female with Down syndrome, is experiencing difficulty walking and says that her fingers ‘feel like needles.’ The EMTs should suspect:
hydrocephalus.
an intracranial hemorrhage.
a seizure.
a cervical spine injury.

Answer 9

a cervical spine injury.

Question 10

EMTs are dispatched for a patient in cardiac arrest. When they arrive, they find that the patient is pulseless, apneic, and wearing an external defibrillator vest. In this situation, the EMTs should:
apply the AED pads over the vests’ pads.
wait 5 minutes prior to using the AED.
perform CPR and leave the vest in place.
quickly remove the vest and perform CPR.

Answer 10

perform CPR and leave the vest in place.

Question 11

General care for a patient with a tracheostomy tube includes all of the following, except:
maintaining the patient in a position of comfort when possible.
suctioning the tube as needed to clear a thick mucous plug.
removing the tube if the area around it appears infected.
ensuring adequate oxygenation and ventilation at all times.

Answer 11

removing the tube if the area around it appears infected.

Question 12

If suctioning of the tracheostomy tube is necessary, the EMT should:
insert the suction catheter to a depth of no more than 15 cm and set the suction unit to 140 mm Hg.
attach a bag-valve mask to the tracheostomy tube and hyperventilate the patient for 2 minutes.
attempt to use the patient’s suction device first because it is probably already sized correctly.
instill 20 mL of saline into the tracheostomy tube and suction for no longer than 20 seconds.

Answer 12

attempt to use the patient’s suction device first because it is probably already sized correctly.

Question 13

The purpose of a ventricular peritoneum shunt is to:
remove fluid from the abdomen of patients with right-sided heart failure.
prevent excess cerebrospinal fluid from accumulating in the brain.
monitor pressure within the skull in patients with a head injury.
divert excess cerebrospinal fluid to the ventricles of the brain.

Answer 13

prevent excess cerebrospinal fluid from accumulating in the brain.

Question 14

Under what circumstances is a left ventricular assist device used?
To reduce ventricular pumping force in patients with aortic aneurysms
To ensure that the ventricles contract at an adequate and consistent rate
As a bridge to heart transplantation while a donor heart is being located
To permanently replace the function of one or both of the ventricles

Answer 14

As a bridge to heart transplantation while a donor heart is being located

Question 15

When caring for a morbidly obese patient, you should:
ask the patient if he or she knows what led to his or her obesity problem.
call for ALS backup because obese patients are at high risk for heart attack.
leave him or her in a supine position, as this often facilitates breathing.
establish his or her chief complaint and then communicate your plan to help.

Answer 15

establish his or her chief complaint and then communicate your plan to help.

Question 16

When caring for a patient who is visually impaired, it is important to:
leave items such as canes and walkers at the residence if the patient will be carried on a gurney.
stand to the side of the patient when speaking if his or her peripheral vision is impaired.
tell him or her what is happening, identify noises, and describe the situation and surroundings.
allow a service dog to remain with the patient at all times, even if the patient is critically ill.

Answer 16

tell him or her what is happening, identify noises, and describe the situation and surroundings.

Question 17

When interacting with an intellectually disabled patient, the best approach is to:
speak primarily with the patient’s family to establish the degree of disability.
position yourself slightly above the patient’s level to reduce his or her anxiety.
approach the patient as a team to reassure him or her that you are there to help.
ask your team members to wait until you can establish a rapport with the patient.

Answer 17

ask your team members to wait until you can establish a rapport with the patient.

Question 18

Which of the following statements regarding gastrostomy (gastric) tubes is correct?
Patients with a gastrostomy tube might still be at risk for aspiration.
Gastrostomy tubes are used for patients who cannot digest food.
Most gastrostomy tubes are temporary and are not sutured in place.
Gastrostomy tubes are placed directly into the small intestine.

Answer 18

Patients with a gastrostomy tube might still be at risk for aspiration.

Question 19

Which of the following statements regarding interaction with the caregiver of a child or adult with special health care needs is correct?
In most cases, it is more appropriate for the EMT to contact medical control prior to speaking with the patient’s primary caregiver.
Before performing an assessment of the patient’s ABCs, the EMT should ask the caregiver about the patient’s medical condition.
Communication with the patient’s caregiver or family members is important because they are the most familiar with the patient’s condition.
In general, the EMT should only speak with a certified home health care provider because he or she is the expert on the patient’s illness.

Answer 19

Communication with the patient’s caregiver or family members is important because they are the most familiar with the patient’s condition.

Question 20

According to the Emergency Medical Treatment and Active Labor Act (EMTALA):
all healthcare facilities must provide a medical assessment and required treatment, regardless of the patient’s ability to pay.
a healthcare facility has the right to refuse assessment and treatment to a patient, but only if his or her condition is not deemed critical.
a patient maintains the legal right to recant his or her consent to emergency treatment, even after signing in to the emergency department.
all healthcare facilities are legally obligated to provide assessment and care only if the patient is critically ill or injured.

Answer 20

all healthcare facilities must provide a medical assessment and required treatment, regardless of the patient’s ability to pay.