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Flashcards in Paramedic School FINAL final Deck (249)
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1

While starting an IV on a patient complaining of abdominal pain, you inadvertently get stuck with the needle before you can place it in the sharps container. You should:
A) continue with patient care, report the incident to your infection control officer, and schedule an appointment with your physician.
B) complete your care of the patient, wash the affected area as soon as you reach the hospital, and report the incident to your supervisor.
C) ask the driver to pull over, assume the role of driver, continue on to the hospital, and see a physician in the emergency department.
D) immediately clean the affected area with isopropyl alcohol, ask the patient if he has any infectious diseases, and report the incident to your supervisor.

B

2

A DNR order is MOST accurately defined as a:
A) written order designed to tell health care providers when resuscitation is or is not appropriate.
B) legal document that is executed by the patient while he or she still has decision-making capacity.
C) written or oral directive that stipulates the care that a patient should receive at the end of his or her life.
D) legal document signed by at least two physicians that prohibits resuscitative efforts in terminally ill patients.

A

3

The husband of a terminally ill woman called 9-1-1 because he thinks his wife is about to die. The patient has a valid living will and an out-of-hospital DNR order. You should:
A) ask the husband why he called EMS if his wife is not to be resuscitated.
B) assume that the husband has revoked the DNR order and begin treatment.
C) contact medical control and request permission to provide emergency care.
D) treat the husband and his wife with respect and provide emotional support.

D

4

A 77-year-old man with end-stage COPD and renal failure is found unresponsive by his daughter. Your assessment reveals that the patient is apneic and pulseless. The daughter presents you with an out-of-hospital DNR order; however, the document expired 3 months ago. You should:
A) begin CPR only and contact medical control for further guidance.
B) realize that the patient cannot be resuscitated and notify the coroner.
C) begin full resuscitative efforts because the DNR order is no longer valid.
D) confirm that the order has expired before initiating any patient treatment.

A

5

During the attempted resuscitation of a 79-year-old man in cardiac arrest, a young man arrives at the scene and asks you to cease resuscitative efforts. He further tells you that the patient has entrusted him to make all of his medical decisions. You should:
A) continue full resuscitative efforts and ask the man if the patient has a living will and if he has documentation naming him as the person authorized to make decisions.
B) limit your resuscitative efforts to basic life support only and cease resuscitation altogether if the man can present a valid advance directive.
C) cease all resuscitative efforts, contact medical control, and advise medical control that a surrogate decision maker is present and has requested you to stop.
D) advise the man that, because he does not have valid documentation that he is authorized to make decisions for the patient, you must continue resuscitation.

A

6

Although the technicalities of EMS DNR orders vary from state to state, they all:
A) are completely irrevocable by the patient's immediate family members.
B) require the patient to wear a DNR insignia such as a bracelet or necklace.
C) are designed to tell EMS providers when resuscitation is or is not appropriate.
D) must be renewed every 5 years or they will expire and become null and void.

C

7

You are caring for a 66-year-old man with terminal cancer. He is conscious and alert without evidence of mental incapacitation. You offer him oxygen, but he refuses to accept it, stating “Just let me die with dignity!” You should:
A) tell him that the oxygen is crucial in preventing him from experiencing cardiac arrest.
B) respect the patient's wishes and ask him if he wants to be transported to the hospital.
C) contact medical control and request permission to treat without the patient's consent.
D) recognize that patients with terminal illnesses do not have decision-making capacity.

B

8

Patients with decision-making capacity:
A) cannot refuse EMS treatment and transport after they have given consent for it.
B) have the right to refuse all or part of the emergency medical care offered to them.
C) must agree to EMS transport if they give consent for emergency medical treatment.
D) cannot withdraw consent unless their conditions are deemed to be non-life-threatening.

B

9

Because minors have no legal status:
A) they can neither consent to nor refuse medical care.
B) you must obtain consent from both parents before treating.
C) they must always be treated under the law of implied consent.
D) you must obtain a court order before you can legally treat them.

A

10

Because minors have no legal status:
A) they can neither consent to nor refuse medical care.
B) you must obtain consent from both parents before treating.
C) they must always be treated under the law of implied consent.
D) you must obtain a court order before you can legally treat them.

B

11

If a mentally competent adult refuses emergency medical treatment, your FIRST action should be to:
A) call medical control and seek further guidance.
B) determine if his or her condition is life-threatening.
C) assume the refusal is from fear and begin treatment.
D) try to determine why he or she is refusing treatment.

D

12

Before asking a patient to sign a refusal form, the paramedic must:
A) ask an impartial observer to sign the refusal form first.
B) tell the patient that he or she will die without treatment.
C) ensure the patient is aware of the risks of his or her refusal.
D) ask a police officer to determine if the patient is competent.

C

13

Health care powers of attorney are also called “durable” powers of attorney because they:
A) must be in the patient's possession at all times.
B) can only be revoked by the patient's personal physician.
C) remain in effect once a patient loses decision-making capacity.
D) do not require anyone to make decisions on the patient's behalf.

C

14

When functioning at a crime scene, it is important for the paramedic to:
A) collect and safeguard any and all evidence.
B) carefully question witnesses as to what they saw.
C) use caution and not disturb the scene unnecessarily.
D) avoid performing patient care until cleared by the police.

C

15

If the paramedic is unable to complete his or her patient care report before departing the emergency department, he or she should:
A) leave, at a minimum, the patient's name and age, but recognize that the physician will perform his or her own exam.
B) leave an abbreviated form with pertinent data with the receiving provider and complete the patient care report as soon as possible.
C) obtain the emergency department fax number and transmit the completed patient care report within 12 hours after delivering the patient.
D) advise the receiving provider that he or she will return to the emergency department with the completed patient care report within 24 hours.

B

16

HIPAA mandates that:
A) a patient's personal information must be shared with the patient's immediate family members.
B) patient information shall not be shared with entities or persons not involved in the care of the patient.
C) a penalty will be imposed for any release of any portion of a patient's personal information to any entity.
D) patient information can only be shared with the receiving physician in the emergency department.

B

17

According to HIPAA, it is acceptable and permissible for hospitals to:
A) disclose information to a patient's family member, provided the family member has proper identification.
B) release patient information to the public health department, regardless of the patient's medical condition.
C) share information with the EMS providers about patient outcome for purposes of quality assurance and education.
D) release patient information to the media only if the hospital feels that the patient's condition may cause an epidemic.

C

18

The hypoxic drive, a backup system to control breathing, is stimulated when:
A) arterial PaO2 levels decrease.
B) arterial PaCO2 levels increase.
C) arterial PaO2 levels increase.
D) arterial PaCO2 levels decrease.

A

19

What happens when the PaCO2 of the arterial blood increases?
A) pH increases and respirations increase
B) pH decreases and respirations decrease
C) pH increases and respirations decrease
D) pH decreases and respirations increase

D

20

The primary respiratory stimulus in a healthy adult is a(n):
A) decreased arterial oxygen level.
B) increased arterial carbon dioxide level.
C) increased pH level of the venous blood.
D) decreased venous level of carbon dioxide.

B

21

What happens when systemic vasoconstriction occurs?
A) Preload decreases.
B) Afterload increases.
C) Afterload and preload increase.
D) Afterload and preload decrease.

B

22

What physiologic reaction occurs when a person's blood sugar level falls?
A) The pancreas secretes more insulin.
B) More glycogen is stored in the liver.
C) Glucagon production is increased.
D) The pancreatic beta cells become hyperactive.

C

23

Insulin and glucagon are produced in specialized groups of cells in the pancreas known as the:
A) adrenal islets.
B) islets of Langerhans.
C) medullary cortex.
D) adrenal medulla.

B

24

In response to shock or stress, sympathetic nervous system stimulation causes:
A) vasoconstriction.
B) slowing of the heart rate.
C) increased gastrointestinal function.
D) shunting of blood to the body's periphery.

A

25

All of the following are functions of the parasympathetic nervous system, EXCEPT:
A) constriction of the pupils.
B) lowering of the blood pressure.
C) decreased gastrointestinal function.
D) mediating arousal in males and females.

C

26

During your assessment of a patient, you note that he is bradycardic, hypotensive, and salivating. These clinical findings suggest:
A) sympathetic nervous system stimulation.
B) parasympathetic nervous system stimulation.
C) sympathetic nervous system depression.
D) parasympathetic nervous system depression.

B

27

Excessive stimulation of the parasympathetic nervous system will result in:
A) hypertension.
B) bradycardia.
C) hyperactivity.
D) diaphoresis.

B

28

Stimulation of alpha receptors of the sympathetic nervous system results in:
A) tachycardia.
B) bronchodilation.
C) peripheral vasodilation.
D) peripheral vasoconstriction

D

29

Which of the following statements regarding type O blood is correct?
A) It contains no surface antigens.
B) It contains type A surface antigens.
C) It contains type B surface antigens.
D) It contains both type A and B surface antigens.

A

30

A protein of the immune system that recognizes foreign substances is called a(n):
A) bilirubin.
B) antigen.
C) pathogen.
D) antibody.

D