Chapter 37 - Patients with Special Challenges Flashcards
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:
Select one:
A. reset the ventilator by unplugging it for 30 to 60 seconds.
B. disconnect the ventilator and apply a tracheostomy collar.
C. place a call to the home health agency treating this patient.
D. attempt to troubleshoot the mechanical ventilator problem.
B. disconnect the ventilator and apply a tracheostomy collar.
A 70-year-old male complains of shortness of breath. During your assessment, you note that he has bilateral hearing aids. When you ask him questions related to his chief complaint, he does not answer you. You can hear a whistling sound coming from his hearing aids. You should:
Select one:
A. try repositioning the hearing aid or remove it and turn down the volume.
B. recognize that the batteries in his hearing aids are probably depleted.
C. remove his hearing aids, turn up the volume, and replace them in his ears.
D. remove both of his hearing aids and use pencil and paper to communicate.
A. try repositioning the hearing aid or remove it and turn down the volume.
A person is said to be obese when he or she is ________ over his or her ideal weight.
Select one:
A. 30% or more
B. 10% or more
C. 20% or more
D. 40% or more
A. 30% or more
A surgical procedure that creates an opening between the intestine and the surface of the body that allows for the elimination of waste products is called a(n):
Select one:
A. intestinal shunt.
B. colostomy.
C. gastric stoma.
D. gastrostomy.
B. colostomy.
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?
Select one:
A. Attempt to pass a suction catheter into the tube.
B. Listen to breath sounds to assess for a pneumothorax.
C. Look for blood or other secretions in the tube.
D. Check the mechanical ventilator for malfunction.
D. Check the mechanical ventilator for malfunction.
According to the Emergency Medical Treatment and Active Labor Act (EMTALA):
Select one:
A. a patient maintains the legal right to recant his or her consent to emergency treatment, even after signing in to the emergency department.
B. all health care facilities are legally obligated to provide assessment and care only if the patient is critically ill or injured.
C. all health care facilities must provide a medical assessment and required treatment, regardless of the patient’s ability to pay.
D. a health care facility has the right to refuse assessment and treatment to a patient, but only if his or her condition is not deemed critical.
C. all health care facilities must provide a medical assessment and required treatment, regardless of the patient’s ability to pay.
Because a tracheostomy tube bypasses the nose and mouth:
Select one:
A. severe swelling of the trachea and bronchi can occur.
B. secretions can build up in and around the tube.
C. the risk of a local infection is significantly high.
D. bleeding or air leakage may occur around the tube.
B. secretions can build up in and around the tube.
Cerebral palsy is characterized by poorly controlled ________ movement.
Select one:
A. neck
B. eye
C. body
D. extremity
C. body
Common complications associated with central venous catheters include all of the following, EXCEPT:
Select one:
A. clotting of the line.
B. a local infection.
C. bleeding around the line.
D. rupture of a central vein.
D. rupture of a central vein.
Down syndrome is a genetic defect that occurs as the result of:
Select one:
A. a separation of chromosome 21.
B. an extra pair of chromosomes.
C. a sperm that contains 24 chromosomes.
D. a triplication of chromosome 21.
D. a triplication of chromosome 21.
Spina bifida is defined as:
Select one:
A. chronic pressure on the brain caused by excess cerebrospinal fluid.
B. congenital inflammation of the spinal cord, usually in the neck.
C. a birth defect in which the child is born without spinal vertebrae.
D. a birth defect caused by incomplete closure of the spinal column.
D. a birth defect caused by incomplete closure of the spinal column.
The purpose of a ventricular peritoneum shunt is to:
Select one:
A. prevent excess cerebrospinal fluid from accumulating in the brain.
B. monitor pressure within the skull in patients with a head injury.
C. remove fluid from the abdomen of patients with right-sided heart failure.
D. divert excess cerebrospinal fluid to the ventricles of the brain.
A. prevent excess cerebrospinal fluid from accumulating in the brain.
Under what circumstances is a left ventricular assist device used?
Select one:
A. To permanently replace the function of one or both of the ventricles
B. To reduce ventricular pumping force in patients with aortic aneurysms
C. To ensure that the ventricles contract at an adequate and consistent rate
D. As a bridge to heart transplantation while a donor heart is being located
D. As a bridge to heart transplantation while a donor heart is being located
When caring for a patient who is visually impaired, it is important to:
Select one:
A. allow a service dog to remain with the patient at all times, even if the patient is critically ill.
B. stand to the side of the patient when speaking if his or her peripheral vision is impaired.
C. tell him or her what is happening, identify noises, and describe the situation and surroundings.
D. leave items such as canes and walkers at the residence if the patient will be carried on a gurney.
C. tell him or her what is happening, identify noises, and describe the situation and surroundings.
Which of the following conditions would MOST likely be encountered in a patient with cerebral palsy?
Select one:
A. Paralysis
B. Brain tumors
C. Seizure disorder
D. Type 2 diabetes
C. Seizure disorder
Which of the following statements regarding autism is correct?
Select one:
A. The majority of patients with autism do not speak at all.
B. Most cases of autism are diagnosed by 3 years of age.
C. Impairment of motor activity is a classic sign of autism.
D. Autism affects females four times greater than males.
B. Most cases of autism are diagnosed by 3 years of age.
Which of the following statements regarding interaction with the caregiver of a child or adult with special health care needs is correct?
Select one:
A. Before performing an assessment of the patient’s ABCs, the EMT should ask the caregiver about the patient’s medical condition.
B. Communication with the patient’s caregiver or family members is important because they are the most familiar with the patient’s condition.
C. 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.
D. In most cases, it is more appropriate for the EMT to contact medical control prior to speaking with the patient’s primary caregiver.
B. Communication with the patient’s caregiver or family members is important because they are the most familiar with the patient’s condition.
Which of the following statements regarding patients with intellectual disabilities is correct?
Select one:
A. Speaking with the patient’s family is the least effective way to determine how much the patient understands.
B. Patients with intellectual disabilities are susceptible to the same disease processes as other patients.
C. Most patients with intellectual disabilities have normal cognitive function, but abnormal physical features.
D. An intellectual disability differs from mental retardation in that it is the result of a congenital abnormality.
B. Patients with intellectual disabilities are susceptible to the same disease processes as other patients.
Which of the following would be the MOST practical method of communicating with a hearing-impaired patient until his or her hearing aids can be located?
Select one:
A. Using a piece of paper and writing utensil to ask questions
B. Contacting dispatch and requesting a sign language interpreter
C. Using a high-pitched voice while speaking directly into the ear
D. Attempting to use body language to determine the problem
A. Using a piece of paper and writing utensil to ask questions
You are assessing a 440-lb man who complains of shortness of breath and lower back pain. The patient is conscious and alert, his blood pressure is 148/98 mm Hg, and his heart rate is 120 beats/min. Your MOST immediate action should be to:
Select one:
A. ask a member of your team to locate the best route to move him to the ambulance.
B. perform a secondary assessment, focusing on his respiratory system and back.
C. avoid placing him in a supine position if possible and administer oxygen.
D. notify the receiving facility and advise them of the patient’s weight and status.
C. avoid placing him in a supine position if possible and administer oxygen.
EMTs are dispatched for a patient whose central venous catheter is malfunctioning. When they arrive and assess the patient, they find bleeding from the tubing attached to the line. The EMTs should:
carefully remove the catheter and transport.
apply direct pressure to the tubing and transport.
request an ALS ambulance to clamp the tubing.
gently manipulate the catheter to reduce the bleeding.
apply direct pressure to the tubing and transport.
When caring for a morbidly obese patient, you should:
leave him or her in a supine position, as this often facilitates breathing.
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.
establish his or her chief complaint and then communicate your plan to help.
establish his or her chief complaint and then communicate your plan to help.
In contrast to conductive hearing loss, sensorineural hearing loss is caused by:
barotrauma.
nerve damage.
earwax accumulation.
eardrum perforation.
nerve damage.
You receive a call to a residence for an apneic 2-month-old male. When you arrive at the scene, the infant’s mother tells you that her son was born prematurely and that his apnea monitor has alarmed four times in the past 30 minutes. Your assessment of the infant reveals that he is conscious and active. His skin is pink and dry, and he is breathing at an adequate rate and with adequate tidal depth. His oxygen saturation reads 98% on room air. You should:
request an ALS ambulance to transport the infant to the hospital.
advise the mother to observe her son and call 9-1-1 again if necessary.
administer high-flow oxygen and observe for a drop in oxygen saturation.
transport the infant to the hospital and bring the apnea monitor with you.
transport the infant to the hospital and bring the apnea monitor with you.
An important aspect in the assessment of a patient who experienced a previous brain injury involves:
presuming that he or she has cognitive impairment until proven otherwise.
contacting the patient’s physician to determine the extent of the brain injury.
recalling that most patients with a brain injury have other organ dysfunction.
speaking with the patient and family to establish what is considered normal for the patient.
speaking with the patient and family to establish what is considered normal for the patient.
