Chapter 3 - Medical, Legal, and Ethical Issues Flashcards

1
Q

As an EMT, the standards of emergency care are often partially based on:

Select one:

A. Patient care cannot be discredited based on poor documentation.
B. EMTs are not liable for any actions that are accurately documented.
C. It is difficult to prove actions were performed if they are not included in the report.
D. Incomplete reports are common and accepted in EMS.

A

C. It is difficult to prove actions were performed if they are not included in the report.

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2
Q

During your monthly internal quality improvement (QI) meeting, you review several patient care reports (PCRs) with the staff of your EMS system. You identify the patient’s name, age, and sex, and then discuss the treatment that was provided by the EMTs in the field. By taking this approach to the QI process, you:

Select one:

A. violated the patient’s privacy because you should have discussed the information only with the EMTs involved.

B. acted appropriately but must have each EMT sign a waiver stating that he or she will not discuss the cases with others.

C. adequately safeguarded the patient’s PHI because the cases were discussed internally.

D. are in violation of HIPAA because you did not remove the PHI from the PCR beforehand.

A

D. are in violation of HIPAA because you did not remove the PHI from the PCR beforehand.

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3
Q

In which of the following circumstances can the EMT legally release confidential patient information?

Select one:

A. The family requests a copy for insurance purposes
B. The patient is competent and signs a release form
C. A media representative inquires about the patient
D. A police officer requests a copy to place on file

A

B. The patient is competent and signs a release form

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4
Q

In which of the following situations does a legal duty to act clearly exist?

Select one:

A. The EMT hears of a cardiac arrest after his or her shift ends.
B. A call is received 15 minutes prior to shift change.
C. A bystander encounters a victim who is not breathing.
D. The EMT witnesses a vehicle crash while off duty.

A

B. A call is received 15 minutes prior to shift change.

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5
Q

Maintaining the chain of evidence at the scene of a crime should include:

Select one:

A. quickly moving any weapons out of the patient’s sight.
B. making brief notes at the scene and then completing them later.
C. not cutting through holes in clothing that were caused by weapons.
D. placing the patient in a private area until the police arrive.

A

C. not cutting through holes in clothing that were caused by weapons.

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6
Q

Putrefaction is defined as:

Select one:

A. decomposition of the body’s tissues.
B. blood settling to the lowest point of the body.
C. separation of the torso from the rest of the body.
D. profound cyanosis to the trunk and face.

A

A. decomposition of the body’s tissues.

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7
Q

The EMT’s scope of practice within his or her local response area is defined by the:

Select one:

A. medical director.
B. state EMS office.
C. local health district.
D. EMS supervisor.

A

A. medical director.

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8
Q

To help protect patients, EMS agencies are required to have __________.

Select one:

A. public forums with their medical director
B. online access to patient records
C. a privacy officer to answer questions
D. an anonymous reporting system

A

C. a privacy officer to answer questions

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9
Q

When is forcible restraint permitted?

Select one:

A. Only if consent to restrain is given by a family member
B. When the patient poses a significant threat to self or others
C. Anytime that the EMT feels threatened
D. Only if law enforcement personnel have witnessed threatening behavior

A

B. When the patient poses a significant threat to self or others

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10
Q

When performing his or her duties, the EMT is generally expected to:

Select one:

A. exercise reasonable care and act prudently.
B. consistently exceeds the standard of care.
C. function above his or her scope of practice.
D. contact medical control on every EMS call.

A

A. exercise reasonable care and act prudently.

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11
Q

Where would you MOST likely find information regarding a patient’s wishes to be an organ donor?

Select one:

A. Social Security card
B. Voter registration card
C. Insurance card
D. Driver’s license

A

D. Driver’s license

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12
Q

Which aspect of the Health Insurance Portability and Accountability Act (HIPAA) MOST affects EMS personnel?

Select one:

A. Protecting patient privacy
B. Ensuring access to insurance
C. Controlling insurance costs
D. Preventing insurance fraud

A

A. Protecting patient privacy

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13
Q

Which of the following components are needed to prove negligence?

Select one:

A. Duty to act, abandonment, breach of duty, and causation
B. Duty to act, breach of duty, injury/damages, and causation
C. Abandonment, breach of duty, damages, and causation
D. Breach of duty, injury/damages, abandonment, and causation

A

B. Duty to act, breach of duty, injury/damages, and causation

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14
Q

Which of the following general statements regarding consent is correct?

Select one:

A. Expressed consent is valid only if given in writing by a family member.

B. A patient can consent to transport but can legally refuse to be treated.

C. Patients who are intoxicated are generally allowed to refuse treatment.

D. All patients older than 18 years can legally refuse treatment or transport.

A

B. A patient can consent to transport but can legally refuse to be treated.

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15
Q

Which of the following statements about the patient care report is correct?

Select one:

a. It is difficult to prove actions were performed if they are not included in the report.
b. EMTs are not liable for any actions that are accurately documented.
c. Incomplete reports are common and accepted in EMS.
d. Patient care cannot be discredited based on poor documentation.

A

a. It is difficult to prove actions were performed if they are not included in the report.

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16
Q

Which type of consent is involved when a 39-year-old mentally competent female with a severe headache asks you to take her to the hospital?

Select one:

A. Implied
B. Informed
C. Expressed
D. Formal

A

C. Expressed

17
Q

You and your partner arrive at the scene of a major motor vehicle crash. The driver, a young male, is severely entrapped in his car. He has an open head injury and massive facial trauma. He is unresponsive, is not breathing, and does not have a palpable carotid pulse. You should:

Select one:

A. ventilate the patient for 5 minutes and then stop if there is no response.

B. stop any active bleeding and advise dispatch to send a paramedic crew.

C. request the fire department to extricate the patient so you can begin CPR.

D. have your partner check for a pulse to confirm that the patient is deceased.

A

D. have your partner check for a pulse to confirm that the patient is deceased.

18
Q

You are called to attend to an elderly patient with an extensive medical history who is now in cardiac arrest. The patient’s family tells you that the patient has a DNR order. There is no paperwork available but the patient does have a MedicAlert bracelet indicating Do Not Resuscitate. You should:

Select one:

A. transport with minimal care.
B. initiate resuscitation in the absence of paperwork.
C. confirm the patient’s identity and honor the DNR order.
D. confirm the patient identity and then confirm the DNR by calling the MedicAlert Foundation number on the bracelet.

A

D. confirm the patient identity and then confirm the DNR by calling the MedicAlert Foundation number on the bracelet.

19
Q

You arrive at the scene of a motor vehicle-versus-pedestrian accident. The patient, a 13-year-old male, is unconscious and has multiple injuries. As you are treating the child, a law enforcement officer advises you that the child’s parents will be at the scene in approximately 15 minutes. What should you do?

Select one:

A. Begin transport at once and have the parents meet you en route to the hospital.

B. Transport the child immediately and have the parents meet you at the hospital.

C. Treat the child at the scene and wait for the parents to arrive and give consent.

D. Withhold treatment until the parents arrive and give you consent for treatment.

A

B. Transport the child immediately and have the parents meet you at the hospital.

20
Q

You respond to the home of a 59-year-old man who is unconscious; has slow, shallow breathing; and has a weak pulse. The family states that the patient has terminal brain cancer and does not wish to be resuscitated. They further state that there is a DNR order for this patient, but they are unable to locate it. You should:

Select one:

A. begin treatment and contact medical control as needed.

B. honor the patient’s wishes and withhold all treatment.

C. transport the patient without providing any treatment.

D. decide on further action once the DNR order is produced.

A

A. begin treatment and contact medical control as needed.

21
Q

Acting in such a way as to make another person fear immediate bodily harm is called:

Select one:

A. libel.
B. assault.
C. battery.
D. negligence.

A

B. assault.

22
Q

A patient successfully sued your EMS employer and was awarded compensatory and punitive damages. This means the agency was likely found guilty of ___________.

A. gross negligence
B. simple negligence
C. a felony
D. procedural misconduct

A

A. gross negligence

23
Q

Which of the following statements regarding Good Samaritan laws is correct?

A. Such laws provide the EMT with absolute immunity from a lawsuit.
B. Such laws guarantee that the EMT will not be held liable if he or she is sued.
C. Such laws do not protect EMTs who are off duty.
D. Such laws will not protect the EMT in cases of gross negligence.

A

D. Such laws will not protect the EMT in cases of gross negligence.

24
Q

You and your partner are the first to arrive at a potential crime scene with a critically injured patient involved. The scene is safe. Your first priority is to:

A. notify medical control for advice.
B. provide immediate patient care.
C. wait for law enforcement to arrive.
D. determine why the patient was injured.

A

B. provide immediate patient care.

25
Q

You are caring for a patient with pancreatic cancer. The patient is emaciated and only responds to loud verbal stimulus with the occasional moan. He offers no other response. The family tells you that there is no DNR but they do provide you with a Physician Order for Life Sustaining Treatment (POLST), which provides medical orders and is signed by the patient’s physician. As you review the documentation, your partner reports that the patient has stopped breathing and has no carotid pulse.

You should:

A. follow the interventions as listed on the POLST.
B. ignore the POLST and resuscitate the patient as per your existing protocols.
C. contact medical control for guidance.
D. transport the patient immediately with supportive care only.

A

C. contact medical control for guidance.

26
Q

You have been tasked by your medical director with assisting in the development of your EMS agency’s institutional standards. When developing these standards, it is important to:

A. require personnel to transport all patients to the closest hospital.
B. be reasonable and realistic to avoid overburdening EMS personnel.
C. demand that all personnel consistently exceed the standard of care.
D. expect personnel to function beyond their scope of practice if needed.

A

B. be reasonable and realistic to avoid overburdening EMS personnel.

27
Q

You arrive at the scene of an apparent death. When evaluating the patient, which of the following is a definitive sign of death?

A. Absence of a pulse
B. Profound cyanosis
C. Dependent lividity
D. Absent breath sounds

A

C. Dependent lividity

28
Q

Credentialing refers to:

A. the process by which an institution is evaluated and recognized.
B. the process by which the qualifications to practice are determined.
C. the process by which the state grants permission to practice.
D. the list of standards available in an EMS textbook.

A

B. the process by which the qualifications to practice are determined.

29
Q

An EMT would MOST likely be held liable for abandonment if he or she:

A. refused to care for a violent patient who is armed with a knife.
B. remained at the hospital for 30 minutes to give a patient report.
C. did not make provisions for continued care of an injured patient.
D. terminated care of a competent adult patient at his or her request.

A

C. did not make provisions for continued care of an injured patient.

30
Q

The manner in which the EMT must act or behave when caring for a patient is called the:

A. EMT oath.
B. code of ethics.
C. standard of care.
D. scope of practice

A

C. standard of care.

31
Q

You receive a subpoena to testify in court regarding a case that occurred two years ago in which you and your partner did not attempt resuscitation of a cardiac arrest patient. Upon receiving the subpoena, you should:

A. call the district attorney’s office and explain the details of the case.
B. notify the director of your EMS system and obtain legal counsel.
C. attach an official addendum to the original patient care report.
D. contact the patient’s family attempt to resolve the matter with them.

A

B. notify the director of your EMS system and obtain legal counsel.

32
Q

If an action or procedure that was performed on a patient is not recorded on the written report:

A. it was not performed in the eyes of the law.
B. it can be qualified by the EMT in charge.
C. it cannot be used in establishing negligence.
D. it was performed haphazardly by the EMT.

A

A. it was not performed in the eyes of the law.

33
Q

Two EMTs witnessed a call in which a coworker gave adequate medical care but ignored the patient’s emotional needs. The coworker was deliberately rude solely because the patient was thought to be infected with the human immunodeficiency virus (HIV). The EMTs ignored the coworker’s treatment of this patient and took no steps to prevent this behavior from happening again. This lack of action on the part of the two EMTs is considered:

A. legal and ethical.
B. legal but unethical.
C. illegal but ethical.
D. illegal and unethical.

A

B. legal but unethical.

34
Q

For a do not resuscitate (DNR) order to be valid, it must:

A. be dated within the previous 24 months.
B. clearly state the patient’s medical problem.
C. be updated a minimum of every 6 months.
D. be signed by the local justice of the peace.

A

B. clearly state the patient’s medical problem.

35
Q

All of the following are considered to be protected health information (PHI), EXCEPT:

A. patient history.
B. treatment rendered.
C. location of the call.
D. assessment findings.

A

C. location of the call.

36
Q

You suspect that a 6-year-old girl has broken her leg after falling from a swing at a playground. Shortly after you arrive, the child’s mother appears and refuses to allow you to continue treatment. You should:

A. use your authority under the implied consent law.
B. try to persuade the mother that treatment is needed.
C. ask the mother to sign a refusal form and then leave.
D. tell the mother that her refusal is a form of child abuse.

A

B. try to persuade the mother that treatment is needed.