Medical- Legal aspects of out of hospital care

Question 1

1) A paramedic who transports patients without their consent or other legal authority would most likely be subject to charges of:

A) false imprisonment.

B) abandonment.

C) defamation.

D) negligence.

Answer 1

false imprisonment

Question 2

2) A document that is signed by a physician and that outlines the life-sustaining measures that may or may not be taken when a patient’s heart and respiratory functions have ceased is a:

A) DNR order.

B) power of attorney.

C) living will.

D) statement of last rites.

Answer 2

a DNR order

Question 3

3) Injuring a person’s name or character through malicious spoken statements is called:

A) misfeasance.

B) perjury.

C) libel.

D) slander.

Answer 3

slander

Question 4

4) Your patient is a 16-year-old male with a reported history of ingesting 8 to 10 beers over the preceding 2 hours. He fell while jumping on a trampoline, striking his head on the metal framing of the trampoline. There was no reported loss of consciousness, but the patient has a laceration to the occipital area of the head. The patient is alert and oriented to person, time, and place but fails to show appropriate concern for his injury and has slurred speech. The parents are unavailable. Which of the following is the best course of action?

A) Treat the patient under the doctrine of implied consent of the parents.

B) Treat the patient as an emancipated minor and allow him to decide whether he wants treatment and transport.

C) Have the patient arrested for underage drinking, and obtain the consent of law enforcement to treat the patient.

D) Use the doctrine of res ipsa loquitur to support your decision to either treat and release or treat and transport.

Answer 4

treat the patient under the doctrine of implied consent of the parents

Question 5

5) A civil wrong committed by one individual against another is a:

A) breach of duty.

B) misdemeanor.

C) felony.

D) tort.

Answer 5

tort

Question 6

6) Which of the following is NOT a valid reason for releasing confidential patient information?

A) A judge signs a court order requesting the information.

B) A newspaper reporter promises not to reveal his source.

C) The patient’s other medical care providers have a need to know.

D) The patient’s insurance company needs the information for filing and reimbursement purposes

Answer 6

a newspaper reporter promises not to reveal his source

Question 7

7) EMT-P Smith came to work feeling very tired and decided to nap before doing his equipment and vehicle checklist. After about 45 minutes the tones went off, and EMT-P Smith and his EMT-B partner, Jones, were dispatched for a seizure. The patient was still actively seizing when they arrived at the scene. Smith discovered that the previous shift had used all the Valium and failed to replace it. As a result, Smith could administer no medication to stop the seizure. Ultimately, the patient stopped seizing and suffered no apparent adverse consequences. Which of the following elements to establish negligence is missing in this case?

A) Consent

B) Breach of duty

C) Actual damages

D) Duty to act

Answer 7

actual damages

Question 8

8) The granting of permission by a governmental body for a qualified individual to engage in a particular profession or occupation is known as:

A) licensure.

B) registration.

C) reciprocity.

D) certification.

Answer 8

licensure

Question 9

9) Malfeasance, misfeasance, and nonfeasance are three types of:

A) aggravated assault.

B) breach of duty.

C) negligence.

D) criminal acts.

Answer 9

breach of duty

Question 10

10) ________ often occurs in patients who have used CNS depressants and results from the patient being in a physical position that interferes with his airway or with ventilation.

A) Res ipsa loquitur

B) Excited delirium

C) Restraint asphyxia

D) Defamation

Answer 10

restraint asphyxia

Question 11

12) You are called to a scene for a report of “an unconscious man.” When you arrive at the scene, the patient is conscious and alert, sitting on the front stairs with neighbors around him. He says he doesn’t know what happened but is “Okay now, just a little woozy.” You ask if you can assess him, but he refuses. You make several attempts to get him to change his mind, pointing out possible causes of the problem and possible consequences of refusing. He still says no, and you ask the neighbors if they can help the patient change his mind. Finally, you get the patient to sign a release from liability form and have it witnessed by one of the neighbors. As you leave, you document the call and your efforts to convince the patient to accept assessment/care. What else should you have done with this patient before leaving the scene?

A) Consulted with medical direction online

B) Advised the patient that he could call EMS again if the problem recurs

C) Urged the patient’s neighbors to stay with him

D) All of the above

Answer 11

all of the above

Question 12

13) The category of law that deals with issues involving conflicts between two or more parties, such as personal injury cases, contract disputes, and matrimonial issues, is ________ law.

A) criminal

B) civil

C) common

D) magistrate

Answer 12

civil

Question 13

14) When faced with unruly or violent patients who pose threats to themselves, paramedics, or others, the paramedic may control the patients by using:

A) reasonable physical force.

B) pepper spray.

C) handcuffs.

D) a Taser.

Answer 13

reasonable physical force

Question 14

15) When a court orders that a prisoner receive treatment the prisoner does not want, the treatment is based on ________ consent.

A) involuntary

B) expressed

C) proximate

D) ex parte

Answer 14

involuntary

Question 15

16) Which of the following laws is designed to allow the paramedic who has been potentially exposed to an infectious disease access to the medical records of the patient to whom the paramedic was exposed?

A) The Ryan White CARE Act

B) EMTALA

C) HIPAA

D) Good Samaritan laws

Answer 15

the Ryan White care act

Question 16

17) There are ethical and societal limits to the interactions between paramedics or other health care personnel and the patients they serve. These are called:

A) employment laws.

B) professional boundaries.

C) scope of practice.

D) standard of care.

Answer 16

professional boundaries

Question 17

18) Which of the following occurrences is LEAST likely to require mandatory legal reporting by the paramedic?

A) Public intoxication

B) Abuse of the elderly

C) Child endangerment

D) Spousal battery

Answer 17

public intoxication

Question 18

19) A patient has been treated by paramedics for a sprained wrist. En route to the hospital, she suffers a stroke. What is the likely outcome of a negligence lawsuit brought by the patient?

A) The suit would succeed because this was a foreseeable event.

B) The suit would fail because the plaintiff could not demonstrate that the paramedics’ actions were the proximate cause of the stroke.

C) The suit would succeed because the paramedics had a duty to act and the patient suffered actual damages.

D) The suit would fail because the plaintiff failed to demonstrate malice on the part of the plaintiffs.

Answer 18

the suit would fail because the plaintiff could not demonstrate that the paramedics actions were the proximate cause of the stroke

Question 19

20) When a paramedic treats an unconscious patient, the provision of treatment is based on ________ consent.

A) implied

B) expressed

C) res ipsa loquitur

D) primum non nocere

Answer 19

implied

Question 20

21) When a patient care report is found to be incomplete or inaccurate, the paramedic should:

A) erase or white out the incorrect information and write in the correct facts.

B) add a dated and signed written amendment to the original report.

C) file a completely new report with the correct information.

D) cross out the incorrect information so that it cannot be read and add the correct information to the bottom of the report, dating and signing it.

Answer 20

add a dated and signed written amendment to the original report

Question 21

22) The unilateral termination of the paramedic-patient relationship by the paramedic without assurance that an equal or greater level of care will continue is known as:

A) misfeasance.

B) abandonment.

C) assault.

D) battery.

Answer 21

abandonment

Question 22

23) The degree of care, skill, and judgment that would be expected of any similarly trained, reasonable paramedic acting under similar circumstances is called the:

A) test of prudent actions.

B) standard of care.

C) duty to act.

D) scope of practice.

Answer 22

standard of care

Question 23

24) DNR orders, durable powers of attorney, and living wills are forms of:

A) standards of care.

B) protocols.

C) advance directives.

D) medical orders.

Answer 23

advanced directives

Question 24

25) Which of the following statements about civil suits regarding torts is generally TRUE?

A) The burden of proof rests on the defendant.

B) The plaintiff seeks to recover damages from the defendant.

C) Guilt must be proven beyond a shadow of a reasonable doubt.

D) Intent to harm must be proven.

Answer 24

the plaintiff seeks to recover damages from the defendant

Question 25

26) A physician has ordered you to give a medication that you believe will harm your patient. Which of the following should you do?

A) Question the physician but carry out the order if the physician insists.

B) Contact a supervisor in the EMS system and request a second opinion.

C) Carry out the ordered treatment but note your objection in the patient care report.

D) Question the physician, refuse to carry out the order if the physician insists you do so, and document the incident.

Answer 25

question the physician, refuse to carry out the order if the physician insists you do so and document the incident

Question 26

27) You have responded to a physician’s office for a terminal cancer patient in cardiac arrest. The physician says, “This is a chemical code only. Just give the meds, but don’t intubate or do CPR.” Which of the following should you do?

A) Tell the physician you are bound to treat the patient according to protocol. If the physician would like you to do something different, she must take complete responsibility for patient care.

B) Comply with her orders on the scene to avoid a confrontation, but initiate appropriate care once you are in the back of the ambulance.

C) Tell the physician you cannot comply with her orders under any circumstances, and then file a report with the state medical licensing board about her negligence in this case.

D) Because this is the patient’s personal physician, you must comply with her orders.

Answer 26

tell the physician you are bound to treat the patient according to protocol if the physician would like you to do something different she must take complete responsibility for the patient

Question 27

28) Protecting those at risk is an example of a paramedic’s ________ duty.

A) legal

B) medical-legal

C) ethical

D) moral

Answer 27

ethical

Question 28

29) Which of the following is best described as the unlawful touching of another individual without the individual’s consent?

A) Battery

B) Malpractice

C) Negligence

D) Assault

Answer 28

battery

Question 29

30) Paramedic Davis and his partner, EMT-I Smothers, are eating lunch in the hospital cafeteria and discussing the details of a call they ran last week on well-known news anchor Adam Best. Unbeknownst to Davis and Smothers, Mr. Best’s co-anchor is sitting directly behind them listening to the details. Which of the following best describes the actions of Davis and Smothers?

A) Slander

B) Breach of confidentiality

C) Negligence

D) Libel

Answer 29

breach of confidentiality

Question 30

31) Which of the following is an example of good documentation?

A) Vital information is kept secret between you and your partner.

B) You use as many abbreviations as possible.

C) It is done prior to patient care.

D) It is thorough.

Answer 30

it is thorough

Question 31

32) An action or inaction by a paramedic that causes or worsens damages suffered by a patient is called the ________ of the damages.

A) precipitating agent

B) potential agent

C) primary cause

D) proximate cause

Answer 31

proximate cause

Question 32

33) Most of the laws that OSHA can use to enact regulations and statutes are ________ laws.

A) constitutional

B) legislative

C) administrative

D) common

Answer 32

administrative

Question 33

34) All of the following are matters of civil law, EXCEPT:

A) homicide.

B) marriage.

C) malpractice.

D) negligence.

Answer 33

homicide

Question 34

35) The four elements needed to sustain a charge of negligence against a paramedic are:

A) duty to act, actual damages, malicious intent, and significant harm.

B) breach of duty, actual damages, malicious intent, and reckless disregard of results.

C) duty to act, breach of that duty, actual damages, and proximate cause.

D) breach of duty, violation of EMS codes, proximate cause, and failure to document the action.

Answer 34

duty to act, breach of that duty, actual damages, and proximate cause

Question 35

36) Legal responsibility for a situation is known as:

A) liability.

B) primum non nocere.

C) negligence.

D) res ipsa loquitur.

Answer 35

liability

Question 36

37) Which of the following is TRUE in the event that off-duty paramedics provide advanced life-support interventions at an emergency scene?

A) They are protected by Good Samaritan laws in all states.

B) It is permissible as long as they have valid certification or licensure in that state.

C) They will be granted immunity from negligence as long as they follow the standard of care.

D) They may be charged with practicing medicine without a license.

Answer 36

they may be charged with practicing medicine without a license

Question 37

38) “Case” law and “judge-made” law are other names for ________ law.

A) constitutional

B) common

C) legislative

D) administrative

Answer 37

common

Question 38

39) A paramedic performs an intervention on a patient that is contrary to current practices. The patient suffers an injury as a result of that intervention. This is an example of:

A) malfeasance.

B) misfeasance.

C) nonfeasance.

D) antifeasance.

Answer 38

malfeasance

Question 39

40) A written statement of a patient’s preference for future medical care is a(n):

A) power of attorney.

B) patient narrative.

C) deposition.

D) advance directive.

Answer 39

advanced directive

Question 40

41) OSHA’s development of requirements to be followed at hazardous materials emergencies is an example of ________ law.

A) legislative

B) constitutional

C) common

D) administrative

Answer 40

administrative

Question 41

42) In a lawsuit in which a paramedic has been charged with negligence, the paramedic is called the:

A) suspect

B) plaintiff

C) defendant

D) magistrate

Answer 41

defendant

Question 42

43) The duties and skills paramedics are allowed and expected to perform while carrying out their jobs are called the:

A) National Standard Curriculum.

B) standing orders.

C) scope of practice.

D) treatment guidelines.

Answer 42

scope of practice

Question 43

44) Which of the following is NOT one of the common elements of Good Samaritan laws offering protection to people who assist at scenes of medical emergencies?

A) The person acted in good faith.

B) The person was not grossly negligent.

C) The person accepted no payment for his services.

D) The person attempted to contact qualified emergency personnel.

Answer 43

the person attempted to contact qualified emergency personnel

Question 44

45) The type of consent that must be obtained from a conscious, competent adult patient before a paramedic can begin treatment is called ________ consent.

A) implied

B) voluntary

C) ex officio

D) informed

Answer 44

informed

Question 45

46) Your patient is a competent adult who has given permission for treatment and transport. You have loaded the patient into the ambulance, but just before you are ready to leave the scene, she changes her mind and says she does not want to go to the hospital. Which of the following statements about this situation is TRUE?

A) You must obtain an emergency detention order to continue treatment.

B) She cannot withdraw consent after having given it.

C) She can now be treated using implied consent.

D) She can withdraw consent.

Answer 45

she can withdraw consent

Question 46

47) A patient is involved in a car crash. When the paramedics arrive, he complains of neck pain but refuses to let the paramedics immobilize his spine. The paramedics explain the risks of refusing treatment and have the patient sign a release-from-liability form. The patient suffers minor neurological damage and later sues, charging negligence on the part of the paramedics. Which of the following best explains why the patient is NOT likely to be awarded damages?

A) There was contributory negligence on the part of the patient.

B) The paramedics did not have a duty to act.

C) There was no violation of the standard of care.

D) A monetary award cannot be assigned to the damages.

Answer 46

there was a contributory negligence on the part of the patient

Question 47

48) A paramedic may treat an unconscious diabetic patient by relying on:

A) res ipsa loquitur.

B) implied consent.

C) primum non nocere.

D) informed consent.

Answer 47

implied consent

Question 48

49) Which of the following is NOT a component of a civil suit?

A) Imprisonment

B) Incident

C) Investigation

D) Discovery

Answer 48

imprisonment

Question 49

50) Injuring a person’s name or character through false written statements is known as:

A) misfeasance.

B) libel.

C) slander.

D) perjury.

Answer 49

libel

Question 50

51) You are treating a patient who you think needs an IV of lactated Ringer’s. The patient, however, says he is frightened of needles and refuses to give his consent. If you display the IV catheter and bring it toward the patient, you may be charged with:

A) negligence.

B) assault.

C) battery.

D) libel.

Answer 50

assault

Question 51

52) Generally, a patient under age 18 can be considered an emancipated minor in all of the following situations EXCEPT when the patient is a:

A) 16-year-old female who is the parent of a 1-year-old child.

B) 16-year-old living in foster care.

C) 17-year-old who is in the military.

D) 16-year-old female who is pregnant.

Answer 51

16 year old female who is pregnant

Question 52

53) Which of the following is NOT an important action to take when preserving physical evidence at a crime scene?

A) Once a crime scene has been deemed safe, initiate patient contact and medical care.

B) Do not move or touch anything at a crime scene unless it is necessary to do so for patient care.

C) Above all, protect yourself and the safety of other EMS personnel.

D) Report suspected child or elder abuse to the proper authorities.

Answer 52

report suspected child or elder abuse to the proper authorities