Prehospital Emergency Care CH3 Medical, Legal, and Ethical Issues

1) A patient with diabetes has an elevated blood sugar (545 mg/dL) and based on your assessment of his condition, will require an injection of insulin. Your EMT partner also has diabetes and administers insulin injections to himself throughout the day as needed. Although the Scope of Practice lists nothing about EMTs giving insulin, your partner administers the insulin injection to the patient. The patient's blood sugar comes down and her condition improves. Given this information, which statement is true?

A) It was permissible for your partner to give the insulin since he has diabetes and knows how to give the injections.

B) Since the patient benefited from the insulin, your partner acted appropriately.

C) Because your partner used the patient's insulin rather than his own, he cannot be reprimanded.

D) Your partner violated the Scope of Practice and may have his certification revoked.

Answer: D

2) You have moved to another state and wish to work as an EMT. In your previous state of employment, EMTs were allowed to administer a specific set of drugs. To determine whether EMTs can administer drugs in your new state of residence, you should review the:

A) State Emergency Medical Technicians' Scope of Practice

B) National EMS Scope of Practice Model.

C) National EMS Education Standards.

D) State Emergency Medical Services Act.

Answer: A

3) What best illustrates the EMT's failure to meet the standard of care when treating a patient with chest pain?

A) Failing to assist the patient in taking her heart palpitation medication

B) Failing to notify the patient's primary care physician

C) Failing to give the patient oxygen

D) Failing to start an IV on the patient

Answer: C

4) The EMT shows understanding of the standard of care when they state:

A) "The standard of care is a state law that describes which actions the EMT can and cannot legally perform."

B) "The standard of care is a measure of whether the right assessment and care have been provided to the patient."

C) "The standard of care is a document that outlines the curriculum to which all EMT programs in the United States must subscribe."

D) "The standard of care is state law that requires the EMS to respond and render care in emergency and nonemergency situations."

Answer: B

5) A 77-year-old female is unresponsive but breathing and with a pulse. On the scene, a family member hands you an official document stating that the patient does not want feeding tubes, ventilators, or other long-term life support equipment to keep her alive. There is no mention of whether to administer lifesaving drugs or withhold cardiopulmonary resuscitation. The EMT would recognize this document as a(n):

A) Durable power of attorney.

B) Living will document.

C) "Do Not Resuscitate" (DNR) order.

D) "Involuntary Resuscitation" order.

Answer: B

6) You have been called to a home for an alert and oriented female with terminal lung cancer. At the home, the daughter, who has her mother's durable power of attorney, states that she wants her mother transported to the hospital. The patient, who is alert and oriented, does not want to go. Which statement indicates that the EMT is acting both appropriately and legally in this conflict?

A) "Since your daughter has the durable power of attorney, she has the legal right to make all decisions; therefore, we have to take you to the hospital."

B) "As the person with your durable power of attorney, your daughter has the legally vested right to make your decisions"

C) "I know that you have the durable power of attorney, but your mother is alert and oriented so we cannot legally take her against her will."

D) "I will need to call the police so that they can determine what to do."

Answer: C

7) A patient with a terminal disease is unresponsive, not breathing, and without a pulse. The family states that the patient has a "Do Not Resuscitate" (DNR) order signed by her medical doctor, but they cannot find the current one. All they can find is a previous DNR that expired eight months ago. The EMT should:

A) Wait for family to locate the DNR.

B) Pronounce the patient deceased.

C) Have the family sign a refusal of care form.

D) Start cardiopulmonary resuscitation.

Answer: D

8) You have been dispatched to a residence for an 88-year-old female who is in and out of consciousness. The family provides you with a valid "Do Not Resuscitate" (DNR) order. Assessment of the patient shows her to be very confused with a low blood pressure and low oxygen level. Which action would be appropriate given the situation?

A) Administer supplemental oxygen

B) Provide transport but no additional care

C) Provide care only if the patient's heart stops beating

D) Have the patient or family member sign a refusal of care form and clear the scene

Answer: A

9) The EMT shows they understand "Do Not Resuscitate" (DNR) orders and living wills when they state:

A) "A living will is a form of DNR; only a living will states exactly how the patient wants to be resuscitated."

B) "A DNR applies to resuscitation issues only, such as when a patient stops breathing or the heart ceases to beat, whereas a living will pertains to long-term life support care and equipment."

C) "If a patient has a valid DNR, the EMT should withhold all care and transport the patient to the hospital. If a living will is present, the EMT should do exactly what it says."

D) "If the patient has a living will, it can legally be used as a substitute for a DNR order by the EMT as long as it is properly dated and signed."

Answer: B

10) What action best indicates that informed consent has been obtained?

A) The EMT administers oxygen because the patient is having chest pain and appears short of breath.

B) The patient agrees to oxygen therapy after being told it may help decrease their chest pain but may dry their nose, causing discomfort.

C) The EMT tells the patient that they will need oxygen because they are having chest pain, which could be a sign of a heart attack.

D) The patient is given oxygen because they are having chest pain and was the one who placed the 911 call for help.

Answer: B

11) A 62-year-old male is short of breath. The EMT asks the patient if it would be okay to assess him, including taking his vital signs. The patient agrees by nodding the head "yes." As such, which is true?

A) Informed consent has been obtained by the EMT.

B) The EMT has obtained expressed consent.

C) The patient can be transported without further permission.

D) The EMT has gained implied consent.

Answer: B

12) The EMT gains the greatest protection from consent-related legal issues by (select best answer):

A) Documenting the patient's capacity and consent for treatment on the prehospital care report.

B) Notifying the emergency physician or medical direction of the patient's current consent status.

C) Having his or her partner serve as a witness to the consent if the patient lacks capacity.

D) Asking the patient twice if it is okay to assess and treat him or her.

Answer: A

13) Which patient may be treated under the guideline of implied consent?

A) A 2-year-old boy who fell down a flight of stairs and whose parents want him taken to the hospital.

B) An unresponsive 33-year-old female who is suspected of taking recreational drugs.

C) An adult patient with chest pain and shortness of breath who is refusing treatment and transport by EMS

D) A 47-year-old female with severe abdominal pain who is refusing transport after placing the call to 911 for help.

Answer: B

14) An alert and oriented patient complaining of a severe headache is refusing all treatment as well as transport by the EMTs. After having signed the refusal, the patient suddenly seizes and becomes unresponsive prior to EMS providers leaving the home. The EMT should:

A) Contact medical direction for permission to treat.

B) Honor the patient's wishes and leave the scene.

C) Place the patient into the family's car for transport to the hospital.

D) Provide care under the guideline of implied consent.

Answer: D

15) You have been dispatched for a 15-year-old female with a headache. On scene, you find the patient holding her 6-month-old son in her arms. This young mother states that she has had a migraine headache for two days and would like to be transported to the hospital for further evaluation. As an EMT, you should:

A) Obtain a parent's consent to treat the patient, given her age.

B) Refuse transport since the patient does not have a true emergency.

C) Assess and transport the patient as she desires.

D) Treat the patient under the doctrine of implied consent.

Answer: C

16) In a community park near his home, a 10-year-old boy has fallen from the top of a slide. His right wrist is deformed and he is in pain. He states that he lives with his mother and she is working. He does not know her work number. The EMT's best action would be to:

A) Treat the patient under the guidelines of implied consent.

B) Do not treat the patient until his mother can be contacted.

C) Obtain permission from the park director.

D) Have the police take custody of the boy and give permission to treat.

Answer: A

17) An adult male patient with the capacity to make his own decisions has cardiac-type chest pain and is refusing all treatment. What would be the EMT's most appropriate response?

A) "I will need to have you sign this refusal of care form and a family member sign as a witness."

B) "Before you refuse, I need to tell you that this could be a heart attack and you could die."

C) "Since you are oriented and rational, it is your right to refuse. Please sign this refusal of care form."

D) "I am sorry, but since 911 was called, we must transport you to the hospital. You can refuse treatment there."

Answer: B

18) An intoxicated 72-year-old male with an alcoholic history has fallen at home and has a laceration on the back of his head. He states that he does not want treatment and becomes combative when you try to talk to or assess him. What is your next best course of action?

A) Transport him against his will, but do not provide treatment

B) Have him sign a refusal of care form

C) Contact medical direction

D) Transport him by permission of family

Answer: C

19) A 46-year-old man who is conscious and has the capacity to make a rational decision is refusing treatment despite crushing chest pain and shortness of breath. He states that the hospital will not do anything for him and he does not want you to treat or transport him. The EMT should recognize that the:

A) Patient has a right to refuse treatment and transport.

B) Police will need to be called so the patient can be transported in custody. C) Patient will need to be transported against his will.

D) Patient's family can give consent to transport the patient.

Answer: A

20) Your best protection when an alert and oriented patient with the capacity to make rational decisions refuses EMS care or transport is to:

A) Inform the patient's family physician of what happened.

B) Have your partner sign the refusal form as a witness.

C) Contact the patient at a later time to see how she is doing.

D) Completely and thoroughly document the incident.

Answer: D

21) A male patient who has the capacity to make rational decisions, although he is dizzy, complains of a headache, and then vomits, declines your care and will not sign the refusal of care form. What is your best action?

A) Document that the patient refuses to sign and leave

B) Have a family member sign as a witness to the refusal

C) Have your partner sign on behalf of the patient

D) Inform the patient that by law he must sign the form

Answer: B

22) For negligence to be proven, what must be present?

A) Duty to act, breach of duty, injury, proximate cause

B) Duty to act, breach of duty, battery, foreseeability

C) Assault, breach of duty, damage, and then abandonment

D) Harm to the patient, false imprisonment, duty to act

Answer: A

23) Which of these actions constitutes a breach of the EMT's duty, placing him or her at risk for the charge of negligence?

A) Transporting an alert and oriented patient who does not want transport to the hospital

B) Applying oxygen to a patient who is not complaining of shortness of breath

C) Obtaining an informed and signed refusal of care form from an alert and oriented patient with abdominal pain

D) Obtaining a refusal of care from a patient without obtaining vital signs

Answer: D

24) A patient's spouse, who is a doctor, states that an EMT is negligent because he put his wife on low-concentration oxygen when she should have gotten high-concentration oxygen. The patient was having chest pain that was later determined to be caused by anxiety. She was released from the emergency department later in the day. Which statement is true?

A) Negligence can be proven because the protocol states high-concentration oxygen should be given.

B) Negligence cannot be proven since the EMT responded to the call and did render care.

C) The EMT cannot be proven negligent because that patient suffered no harm or damage.

D) Negligence is a distinct possibility since the patient was transported and treated in the emergency department.

Answer: C

25) While transferring a female patient from her house to the ambulance on the wheeled cot, one of the EMTs slips on a patch of ice and falls. The stretcher overturns, and the patient suffers a broken wrist as a result. She files a lawsuit in civil court alleging negligence. For the patient, what will be the most difficult component of negligence to prove?

A) Proximate cause

B) Duty to act

C) Damage

D) Implied consent

Answer: A

26) You have arrived at the emergency department with a patient complaining of nausea. The department is extremely busy and you are waiting to give a verbal report to the nurse or doctor. While waiting, dispatch contacts you over the radio and states that you are needed for a critically injured child that was hit by a car. Your best action would be to:

A) Take the call and come back to give the report at a later time.

B) Provide the certified nurse's aide with a report of the patient's condition.

C) Go to the nurse's station and provide the registered nurse with a quick oral report.

D) Leave the patient in the emergency department and respond to the call

Answer: C

27) You are by the side of a female patient who has overdosed on a drug. She is conscious but very combative and noncompliant with your requests. Which statement made by the EMT best suggests the EMT is committing assault?

A) "You win. I cannot get your blood pressure and the doctor is going to yell at me. I am going to blame you."

B) "If that is the way you are going to behave, then I am no longer going to try to get your blood pressure."

C) "If you throw up in the back of my ambulance, I will use your shirt to clean it up. Just think about that for a minute."

D) "If you do not let me get your blood pressure, I will take off the oxygen and you will suffocate."

Answer: D

28) Despite a male patient's protest that he does not want his blood pressure taken, the EMT places a BP cuff on his arm and takes his blood pressure. The EMT states: "See? It is just as I suspected—your blood pressure is sky high. You really need to be seen in the emergency department." The patient states he did not realize that his blood pressure was that high. In terms of battery, which statement is true?

A) Since the BP was elevated and treatment must be provided, battery cannot be charged.

B) The patient could charge the EMT with battery, regardless of his blood pressure reading.

C) The patient could charge the EMT with assault, not battery.

D) Because the patient knows the result of the BP, the EMT is safe from battery.

Answer: B

29) A homeless female patient is sick and is refusing transport. The patient is alert and clearly has the capacity to understand her situation and make a rational decision, but the temperature tonight will be near zero. The EMT picks up the patient and puts her on the cot. The patient continues to refuse to allow treatment and transport, despite the EMT's explanation that it will be warm in the hospital and she will be fed. The patient is transported. What could the EMT be charged with?

A) Assault

B) Abandonment

C) Negligence

D) False imprisonment

Answer: D

30) While off duty, an EMT happens upon the scene of a motor vehicle collision in which a car rolled over the side of an embankment. A young man has been seriously injured; he appears unresponsive and is bleeding from the head and face. The EMT is alone with his infant baby daughter in the car and cannot leave her to provide help. Therefore, the EMT alerts 911 of the emergency and remains in his car with his daughter until EMS arrive. Later in the week, he finds out that the patient died. Which statement is true regarding this incident?

A) The EMT had no duty to act and cannot be held liable for the man's death.

B) The EMT had a legal obligation to help and can be held liable for the death.

C) The EMT violated the state standard of care by not providing some form of care.

D) The EMT must go to court and explain that he did not help because of his daughter.

Answer: A

31) In which situation would the Good Samaritan law protect the EMT?

A) The EMT forgets to provide oxygen to a patient with chest pain and the patient suffers a heart attack as a result.

B) A patient is paralyzed from the waist down because an off-duty EMT did not take the appropriate measures in caring for him.

C) A paramedic orders an EMT to administer a medication that the EMT legally may not give, and the patient dies as a result.

D) An off-duty EMT stops at the scene of an auto collision and provides proper care, but the patient dies anyway.

Answer: D

32) Which action best illustrates an EMT upholding a high ethical standard?

A) Administering oxygen to patients who are short of breath

B) Providing care that goes beyond the scope of practice

C) Treating alcoholics and drug addicts with respect

D) Informing other health care providers of patients in the community with AIDS

Answer: C

33) A local politician has been involved in a motor vehicle collision. Witnesses state that they saw this man leave a bar, and repeatedly stumbled until he got to his vehicle. Then, just two miles down the road, he struck a utility pole head on. At the scene and throughout transport, the patient is confused and combative. When you are leaving the hospital, a reporter asks you what happened. You state that it looks as though the politician may be drunk, but you are not sure. Your statement is printed in the newspaper. Later, it is determined that the man was not drunk, but rather has diabetes and had low blood sugar at the time of the accident. Which charge could the politician levy against you?

A) Slander

B) Assault

C) Battery

D) Litigation

Answer: A

34) There has been a very serious motor vehicle collision involving a high-profile judge seeking reelection. The judge's car was traveling at a high rate of speed and crossed the center line, striking and killing a motorcyclist. Newspaper reporters are on location, asking you to describe what happened. Which statement is most appropriate?

A) "The judge was involved, but I cannot tell you anything that happened."

B) "The judge was in the car that hit and killed the motorcyclist."

C) "There has been a serious accident in which a person was killed."

D) "The accident was not bad, so please leave the scene."

Answer: C

35) A woman calls the station and asks if you transported a patient named Patricia Gardner earlier in the day. She says that she is her friend and wants to know if she is okay. An appropriate response would be:

A) "I can tell you that she was transported to the hospital, but I cannot tell you why."

B) "Although I do not doubt that you are her friend, I cannot release that information."

C) "I cannot tell you that, but her family is at home and they can give you more information."

D) "She was treated for chest pain, but I cannot release her diagnosis for admission."

Answer: B

36) The EMT recognizes that the Health Insurance Portability and Accountability Act (HIPAA) limits the EMT's ability to:

A) Share patient-specific medical information with others.

B) Bill for services provided by the Emergency Medical Services system.

C) Obtain refusals of care from patients who do not have medical insurance.

D) Transport patients to the hospitals of their choice.

Answer: A

37) You are pulling into the ambulance bay at a local hospital. On board, you have a patient with behavioral problems who continually seeks treatment at this particular hospital. Before the patient can be unloaded, the physician comes out and states that the patient must be taken to another hospital. As an EMT, you should:

A) Take the patient to the facility specified by the doctor.

B) Call the supervisor to report a Health Insurance Portability and Accountability Act (HIPAA) violation.

C) Recognize a violation of the Emergency Medical Treatment and Labor Act (EMTALA) statute.

D) Ask the patient which hospital he wants to be taken to.

Answer: C

38) A young male patient has suffered a gunshot wound to the head. Realizing that there is little chance for survival, the EMT notes that the patient is a potential organ donor. The patient is unresponsive and breathing four times per minute on the scene. The EMT initiates positivepressure ventilation. En route to the hospital, the patient stops breathing and loses a pulse. Since the patient is a potential organ donor, the EMT should:

A) Stop any and all resuscitation measures since this is a trauma arrest.

B) Provide the same resuscitation as for a person who is not an organ donor.

C) Ventilate the patient but not provide chest compressions.

D) Perform CPR but not use the automated external defibrillator.

Answer: B

39) A 20-year-old male has been stabbed in the abdomen. Assessment reveals him to be unresponsive with shallow breathing and a low blood pressure. Which instructions will you provide to your new EMT partner given that the patient has been involved in a crime?

A) "I am not worried about potential evidence. I am just worried about the patient."

B) "Do not worry about documenting the crime scene in your report. The police report will reflect that information."

C) "We are not to move the patient to the stretcher until the police are done photographing the scene."

D) "When cutting his shirt off, make sure not to cut through the area where the knife penetrated through the clothing."

Answer: D

40) The highest priority for the EMT working on a patient when approaching the scene of a crime is:

A) Preserving potential evidence.

B) Ensuring personal safety.

C) Administering quality patient care.

D) Providing medical information to law enforcement.

Answer: B

41) EMS providers must report which of these suspected events to law enforcement (Select the answer which is most correct)?

A) Alcohol abuse and elder abuse

B) Drug addiction and drug-related crimes

C) Neglect or physical abuse of a child

D) Refusal of EMS services

Answer: C

42) During orientation, an EMT is told that owing to the nature of their employment, they are covered by sovereign immunity. Based on this statement, the EMT must:

A) Be immune from claims of negligence.

B) Work for a public EMS agency.

C) Work for a nonprofit, privately owned hospital.

D) Provide services for a volunteer EMS agency.

Answer: B

43) In discussing an EMS response that involved potential negligence, your medical director asks you to determine whether the statute of limitations is active. As a knowledgeable EMT, you understand that you will need to determine which of these?

A) The exact action committed that is the basis for a negligence charge

B) If there is a proximate cause that can be linked to the bad outcome

C) If the allowed time for the patient to file a lawsuit has passed

D) The amount of money that can be awarded to the patient and family

Answer: C

44) A 22-year-old female has been sexually assaulted and taken to the emergency department. With regard to the release of confidential medical information, which individual would most likely be allowed to receive information related to the patient's injuries without her consent?

A) State police

B) Patient's mother

C) Patient's boyfriend

D) Crisis counselor

Answer: A

45) A male EMT was discussing a patient's medical condition with a female EMT from a different service. The woman then repeated this information to others, which eventually made its way back to the patient. Regarding issues of confidentiality, which of the statements is true?

A) The male EMT could be changed with slander

B) The female EMT committed an EMTALA violation

C) Both EMTs violated EMTALA regulations

D) The male EMT violated the HIPAA law.

Answer: D

46) A female patient who was transported by EMS for a laceration on her arm is suing the service and the hospital because her laceration became infected, resulting in loss of the extremity. However, it becomes known that the patient was appropriately treated by EMS and the emergency department, but failed to seek follow-up medical care at a health clinic and did not take the antibiotics that were prescribed to her. Which element would most likely be used by the medical community as a defense in this case?

A) Res ipsa loquitur

B) Proximate cause

C) Contributory negligence

D) Intentional tort

Answer: C

47) You have been called to transfer a trauma patient from a rural hospital emergency department to the emergency department of a large urban medical center. Which action will best decrease your chance of becoming involved in an Emergency Medical Treatment and Labor Act (EMTALA) violation?

A) Obtaining a copy of the patient's insurance and billing information

B) Taking vital signs every 5 minutes during transport

C) Determining the exact location to which the patient is to be transported

D) Assessing the patient for stability prior to transfer

Answer: D

48) You are approached by a college student who states that their college is working with a physician on a project that examines the types of violent trauma occurring within your jurisdiction. They then ask you if they may see copies of all patient care reports that involved patients who were either stabbed or shot. Who would be the best person to contact regarding this request?

A) Your service's medical director

B) Your service's privacy officer

C) The physician overseeing the research project

D) The state department of EMS

Answer: B

49) You have been called to a ER to transfer a 67-year-old male to another facility. At the ER, the doctor informs you that the patient have requested the transfer because his Dr. is affiliated with the other hospital. The patient is receiving an antibiotic through an IV. Although your state does allow EMTs to perform nonemergent transports of patients receiving normal saline through an IV, it doesn't allow transport of patients receiving IV meds. When informed of this restriction, the physician states that the antibiotic will be done in 10 minutes and that he will give written permission to start the transport while the medication is infusing. Which EMT action would be most appropriate at this time?

A) Transfer the patient once all the medication is infused.

B) Stop the IV infusion and transport the patient.

C) Follow the Dr.'s order as long as he writes and signs it.

D)HIPAA violation and refuse the transport.

Answer: A

A medic was late in re-registering and now, according to the state EMS agency, must function as an EMT until all requirements are satisfied. As an EMT, she is on the scene of a MVA and taking care of a critically injured teenager. While waiting for a medic to arrive, she starts an IV since the patient is so critical and is worried about the patient surviving, but does not hang the IV fluid that will be used to help the patient. This is immediately done by another medic once they arrive. Which of these is true?

A) The medic/EMT violated the scope of practice but cannot be held accountable since the patient was stabilized.

B) The medic/EMT did not violate the scope of practice since she is experienced with IV

C) The medic/EMT violated the scope of practice and can be held accountable even though the patient survived.

D) The medic/EMT did not violated the scope of practice since the patient was critically injured.

Answer: C

51) A pregnant woman is choking inside a local restaurant. Who has the most compelling legal duty to act?

A) An off-duty EMT who just finished eating and is headed to the bathroom

B) EMTs from another county eating lunch after dropping off a patient at a local hospital

C) A supervisor who just came into the restaurant and is on a week's vacation

D) A retired paramedic who just finished eating and is paying his bill

Answer: B

52) You are an off-duty EMT and have come across a motor vehicle collision. A car has crashed head-on into a utility pole. There is moderate damage to the vehicle and the driver is walking about the scene. You stop and assess the patient. He has a large bruise on his arm and is complaining of abdominal pain where the seat belt contacted his body. Emergency Medical Responders (EMRs) are on the scene, and a responding ambulance has a 2-minute ETA. At this point, you realize that:

A) You cannot leave until another EMT or paramedic arrives to assume care.

B) You can leave the scene since the patient is stable and EMS is 2 minutes away.

C) You can only transfer care to a paramedic once he or she arrives on scene.

D) You can transfer care to EMRs since EMS has been notified and an ambulance is 2 minutes from the scene.

Answer: A

53) You have been asked to review a legal case in which a patient intentionally overdosed on heroin and then died after EMS responders arrived. Those responders did not have a bag-valve mask to ventilate the non-breathing patient, so the patient was not ventilated until a second EMS unit arrived. The evidence indicates that the EMT and paramedic both signed their morning equipment check indicating that they had inspected the ambulance and had all the necessary equipment to do their job. In this case, you would realize:

A) The EMT and paramedic can seek protection under the Good Samaritan law.

B) The EMT and paramedic will most likely be charged with contributory negligence.

C) The EMT and paramedic are not responsible because the patient intentionally overdosed.

D) The EMT and paramedic were negligent in caring for the patient.

Answer: D

54) Involuntary consent would most likely apply to:

A) A 23-year-old prisoner with a laceration to the right cheek and refusing care.

B) An alert and oriented 34-year-old male who is coughing up blood and refusing care.

C) A 3-year-old boy found wandering in the street with abrasions and cuts on his bare feet.

D) A confused elderly woman who is in the presence of the person with her acting power of attorney.

Answer: A

55) A plaintiff is suing an EMT in civil court for alleged improper care and resultant injury. In this situation, which is true?

A) The government is the lead agency that is prosecuting the EMT.

B) The EMT is facing a very serious criminal charge.

C) If found guilty, the EMT will face jail time or probation.

D) If the suit is successful, the plaintiff will most likely be awarded money.

Answer: D

56) Regarding an EMT's duty to act, the relationship between an EMT and a patient starts:

A) Once the EMT is dispatched to the call.

B) Once the EMT makes physical contact with the patient.

C) Once the patient consents to be treated.

D) Once the EMT begins to provide physical care.

Answer: B

57) Your legal right to function as an EMT is contingent upon:

A) Following standing orders and protocols, as approved by medical direction.

B) Avoiding civil liability.

C) Completing an approved EMT program.

D) Gaining paid employment by a public Emergency Medical Services system.

Answer: A

58) You have been called for a 96-year-old female with altered mental status. At the scene, you find that the patient is unresponsive, not breathing, and pulseless. The family provides you with a valid Do Not Resuscitate (DNR) order. What could you document as a presumptive sign of her death?

A) Closed eyes

B) Poor or weak reflexes

C) Agonal breathing

D) Absent blood pressure

Answer: D

59) Your Emergency Medical Services station has been designated a Baby Safe-Haven. As such, you know that:

A) A mother or father can drop an unharmed baby off and leave with no questions asked.

B) You are legally required to provide basic supplies (e.g., bottles and diapers) to the mother or father.

C) A mother or father can bring a baby to the station for basic care issues.

D) You are legally required to provide the mother or father with resources to assist in the care of the baby.

Answer: A

60) The EMT correctly understands a "Physician Orders for Life-Sustaining Treatment" (POLST) document when he states:

A) "A POLST must be signed by the court system and the patient and is valid for a period of no more than 5 years."

B) "A POLST legally empowers another person to make health care decisions for the patient in the event he or she cannot do so."

C) "A POLST is designed to allow a patient to choose the desired type of care prior to the need for resuscitation."

D) "A POLST is the same as a 'Do Not Resuscitate' order, with the difference being that the physician does not have to sign it."

Answer: C

61) What is the primary difference between the EMT's scope of practice and the EMT's standard of care?

A) The scope is what the EMT should do; the standard is what the EMT is legally bound to do.

B) The scope includes which actions the EMT can legally take, while the standard of care is what an EMT should do in an Emergency Medical Services system with similar training and protocols.

C) The scope of practice is decided by the medical director, while the standard of care is defined by state regulations.

D) There is no clinically relevant difference between the scope of practice and the standard of care, as both define what the EMT should do in the exact same situation.

Answer: B

62) A state's Good Samaritan law would not protect the health care provider(s) in which of these situations?

A) When an EMT is working for a volunteer EMS system and performs an act of gross negligence

B) When an EMT is off duty, but stops to assist at a motor vehicle collision and functions in good faith

C) When the EMT stops to help a collapsed person at a park while off duty by providing CPR, but the patient still dies

D) When a nurse or physician who is off duty stops to assist at an EMS call where paid EMTs are present, but the patient still dies

Answer: A

63) In any situation in which a question arises regarding the scope or direction of care the Emergency Medical Technician (EMT) should provide to a patient, the EMT should:

A) Notify the on-duty Emergency Medical Services supervisor.

B) Provide no treatment so as to "not cause harm," and transport the patient.

C) Contact medical direction at the receiving facility to which the patient is being transported.

D) Summon an advanced life support (ALS) intercept and allow the paramedics to make the care decisions.

Answer: C

64) What is the primary difference between ethics and morals?

A) Ethics are what the EMT should do, whereas morals are what the EMT will do.

B) Ethics is a branch of philosophy that studies morality, whereas morals are concepts of "right and wrong."

C) Morals are what the EMT should do, whereas ethics are what the EMT will do.

D) Morals define the expectations for professional occupations, whereas ethics are regulations written into state law defining what those expectations are.

Answer: B

65) If an individual is bringing a lawsuit against your EMS system for perceived improper care, which type of liability action will it probably be?

A) Civil

B) State

C) Criminal

D) Federal

Answer: A

66) You have extricated a male patient who was entrapped in a rollover car wreck. During your immediate on-scene management, you removed the patient's clothing and started CPR. During this time, a police officer retrieved the driver's license from the patient's pants and advises you that they are an organ donor. Given this information, which statement is true?

A) The patient should be treated in the same way en route to the hospital as a nondonor.

B) The patient cannot be an organ donor now since he was arrested prior to reaching the hospital.

C) The EMTs should initiate cooling measures to increase the longevity of the patient's organs.

D) The patient should be hyperventilated and hyperoxygenated along with receiving CPR to increase the longevity of his organs.

Answer: A

67) You have responded to a "man down" call one winter morning. Upon arrival, you find an elderly male patient lying parallel to the sidewalk, in a bank of shoveled snow. It appears as if the man was walking and either tripped or fell into the snowbank. The patient is in cardiac arrest. In this scenario, which finding would not be considered a presumptive sign of death?

A) Closed eyes

B) No pupillary response

C) Low body temperature

D) Absent reflexes

Answer: C

68) The concept of understanding if an action is fundamentally "right" versus fundamentally "wrong" as it pertains to others, best defines?

A) Ethics

B) Obligations

C) Mortality

D) Morals

Answer: D

69) An EMT is currently enrolled in a paramedic program and is half way completed. He is also working part time as an EMT for some extra money and patient exposure. One day he is in the back with a patient who just went into cardiac arrest. The EMT knows how to intubate since this has already been covered in class. What should the EMT do?

A) Intubate the patient

B) Do not intubate the patient

C) Contact medical direction for permission to intubate

D) Intubate the patient but then remove the endotracheal tube before entering the ED

Answer: B

70) Select the elements needed to prove negligence (but no more than three).

A) Duty to act

B) Proximate cause

C) Damages

D) Assault and battery

E) Lack of patient capacity

Answer: A, B, C

3 multiple choice options