Chapter 9 - A Team Approach to Health Care

Question 1

A team of EMTs is caring for a critically injured patient. The team leader advises the EMT that transport will not begin until the patient’s closed forearm fracture is splinted. Utilizing the crew resource management model, the EMT should:

Select one:

A. disregard the team leader’s request and contact medical control for guidance.

B. advise the team leader that immediate transport is more important than splinting.

C. repeat the request back to the team leader and then splint the patient’s arm.

D. ensure that the entire team is aware that transport will be delayed for splinting.

Answer 1

B. advise the team leader that immediate transport is more important than splinting.

Question 2

After spiking a bag of IV fluid for the paramedic, the EMT notices that the drip chamber is too full. The EMT should:

Select one:

A. replace the administration set with a new one.

B. squeeze the IV bag to force fluid into the tubing.

C. let the IV flow rapidly for 20 to 30 seconds.

D. invert the IV bag and squeeze the drip chamber.

Answer 2

D. invert the IV bag and squeeze the drip chamber.

Question 3

EMTs arrive at the scene of an ill person. The EMR, who arrived before the EMTs, advises that the patient had a syncopal episode. The patient is conscious and alert and remains so throughout transport. When transferring patient care to the emergency department nurse, the EMT should advise the nurse that:

Select one:

A. the patient had a reported syncopal episode.

B. she should contact the EMR about the incident.

C. there is no evidence to support the syncopal episode.

D. the EMR was probably mistaken about the episode.

Answer 3

A. the patient had a reported syncopal episode.

Question 4

Health care teams that infrequently train and work together:

Select one:

A. often work better under pressure.

B. need less-explicit verbal direction.

C. are unable to accomplish their tasks.

D. can create delays in patient care.

Answer 4

D. can create delays in patient care.

Question 5

Hyperventilation during the preoxygenation phase of endotracheal intubation:

Select one:

A. provides a better oxygen reserve for the patient.

B. is acceptable if done for fewer than 2 minutes.

C. can cause gastric distention and hypotension.

D. will decrease the likelihood of aspiration.

Answer 5

C. can cause gastric distention and hypotension.

Question 6

If a problem with a team member is not directly or immediately impacting patient care, the team leader should:

Select one:

A. ignore the problem to avoid conflict.

B. contact the medical director at once.

C. engage the team member at once.

D. discuss the problem after the call.

Answer 6

D. discuss the problem after the call.

Question 7

The concept of consistent care across the entire health care team from first patient contact to patient discharge is called:

Select one:

A. the standard of care.

B. the scope of practice.

C. the continuum of care.

D. patient care advocacy.

Answer 7

C. the continuum of care.

Question 8

The effectiveness of pit crew CPR is dependent on:

Select one:

A. rapidly assessing the patient before assigning roles and responsibilities.

B. defining clear roles and responsibilities before the call is received.

C. protocols that allow the EMT to function without medical control.

D. a team leader who is capable of performing all of the patient care tasks.

Answer 8

B. defining clear roles and responsibilities before the call is received.

Question 9

The Microdrip administration delivers 1 mL of fluid for every ____ drops.

Select one:

A. 15

B. 45

C. 10

D. 60

Answer 9

D. 60

Question 10

When the EMT assists a paramedic with an advanced intervention, he or she should recall that the focus of the intervention is on:

Select one:

A. following local protocol.

B. solving a clinical problem.

C. completing the procedure.

D. learning to perform the skill.

Answer 10

B. solving a clinical problem.

Question 11

When working as an independent health care group member, the EMT should expect that he or she:

Select one:

A. does not have to wait for an assignment before performing a task.

B. will rely on the group leader for making virtually all decisions.

C. will be specifically instructed on how to perform a specific task.

D. will receive no support or guidance from an EMS supervisor.

Answer 11

A. does not have to wait for an assignment before performing a task.

Question 12

Which of the following would indicate that the endotracheal tube is NOT in the trachea?

Select one:

A. Absence of sounds over the epigastrium

B. Absence of an end-tidal CO2 waveform

C. Decreased resistance when ventilating

D. Steady increase in the oxygen saturation

Answer 12

B. Absence of an end-tidal CO2 waveform

Question 13

Which of the following would the EMT MOST likely be asked to do when assisting a paramedic with endotracheal intubation?

Select one:

A. Placement of the endotracheal tube

B. Preoxygenation with a BVM

C. Suction under direct laryngoscopy

D. Visualization of the vocal cords

Answer 13

B. Preoxygenation with a BVM

Question 14

You are at a mass-casualty scene and in the process of organizing a group to be responsible for ongoing patient care. In order for the group to be successful:

Select one:

A. individuals have an understanding of how the group will accomplish its goals.

B. individual goals are accomplished.

C. all individuals have the same roles.

D. individuals see this as a one-time exercise and that the group may change.

Answer 14

A. individuals have an understanding of how the group will accomplish its goals.

Question 15

You are attending to a 46-year-old male patient complaining of chest pain. Shortly after you begin to render care, an ALS unit arrives and the transfer of care is made. The decision is made to start an intravenous line and administer medication. You should:

Select one:

A. acknowledge that it is no longer your patient and stand back, allowing the ALS provider to work.

B. clear space and, if necessary, explain the procedure to the patient.

C. ensure that enough assessments have been done to justify the decision.

D. move out of the ALS provider’s way and clear the scene.

Answer 15

B. clear space and, if necessary, explain the procedure to the patient.

Question 16

You are attending to a 66-year-old male patient in cardiac arrest. As you gather history and begin the resuscitation, an Advanced Life Support (ALS) provider arrives on scene. You should:

Select one:

A. continue the resuscitation and provide a patient care report while you work.

B. pause the resuscitation and provide a patient care report as quickly as possible.

C. ensure that CPR is ongoing by the other providers present and then provide a patient care report off to the side.

D. stay focused on the resuscitation and allow the ALS provider to make his or her own assessment.

Answer 16

C. ensure that CPR is ongoing by the other providers present and then provide a patient care report off to the side.

Question 17

You are attending to a 68-year-old female patient in cardiac arrest. An ALS provider arrives shortly after you do and the transfer of care is made. The ALS provider asks that you assist in the endotracheal intubation. As part of this process, you may be required to:

Select one:

A. ventilate and preoxygenate the patient but not handle any of the equipment required for the intubation.

B. visualize the airway and look for any potential complications in advance of the intubation.

C. perform the intubation with assistance.

D. help position the patient for a better view of the airway during the procedure.

Answer 17

D. help position the patient for a better view of the airway during the procedure.

Question 18

You are attending to a patient who was experiencing abdominal pain at a local shopping mall. The patient sitting on a bench and appears in moderate distress. You are met by a first responder at the scene who wishes to provide you with a patient care report. Your best course of action is to:

Select one:

A. listen to the report while you perform a primary survey and render care to the patient.

B. move the responder out of the way and begin patient care.

C. listen to the responder while your partner performs a primary survey.

D. ask the responder to wait and take their report after you have completed a primary survey.

Answer 18

C. listen to the responder while your partner performs a primary survey.

Question 19

You are called to the scene of a 56-year-old female patient who was the driver of a car that struck a telephone pole. The patient is sitting in her vehicle with her seat belt on and the air bag has deployed. A bystander approaches as you arrive and informs you that he is an off-duty firefighter and was first on the scene. The bystander wishes to provide you with a patient care report. You should:

Select one:

A. ask the bystander for any formal identification and listen to the report once it is verified.

B. listen to the report while you perform a primary survey and render care to the patient.

C. ask your partner to perform the primary survey while you listen to the report.

D. ask the bystander to wait and you will take their report after you have finished your assessment.

Answer 19

C. ask your partner to perform the primary survey while you listen to the report.

Question 20

You are organizing a group of EMTs to provide triage in a mass-casualty exercise. In order for the group to be successful, it is essential that:

Select one:

A. individuals understand that their roles will all be accomplished the same way.

B. individuals understand that this is a one-time exercise and that things will change in the field.

C. individual goals are accomplished.

D. individuals have an understanding of how the group will accomplish its goals.

Answer 20

D. individuals have an understanding of how the group will accomplish its goals.

Question 21

After assuming care of a cardiac arrest patient from an EMT, the paramedic should remember that:
Select one:
A. BLS efforts must continue throughout the patient care continuum.

B. ALS interventions are the core interventions around which BLS care is provided.

C. the BLS care provided by the EMT is the “first steps” of ALS care.

D. ALS interventions are fundamentally more critical than BLS interventions.

Answer 21

A. BLS efforts must continue throughout the patient care continuum.

Question 22

Premature diagnosis during a call can be due to what error?
Select one:
A. Anchoring
B. Overconfidence
C. Bias
D. Streamlining

Answer 22

A. Anchoring

Question 23

A man with chest pain tells the EMTs that he hurt his chest 2 weeks ago. The EMTs conclude that the patient likely has a fractured rib or other chest wall injury. At the hospital, the man is diagnosed with acute myocardial infarction. Which of the following decision traps does this scenario depict?
Select one:
A. Overconfidence
B. Anchoring
C. Overestimation
D. Bias

Answer 23

B. Anchoring