EMT Chapter 3 Medical, Legal, and Ethical Issues

Which of the following types of consent allows treatment of a patient who is unconscious or mentally incapacitated?

A. Implied

B. Actual

C. Expressed

D. Informed

A. implied

You are dispatched to the residence of a person who frequently calls 911 for nonemergency care. You should:

A. respond under the assumption that an acute emergency exists.

B. refuse the call, but thoroughly document the patient's circumstances.

C. ask the dispatcher to send law enforcement before you respond.

D. defer the call to a local private ambulance company.

C. ask the dispatcher to send law enforcement before you respond

While transporting a stable patient with chest pain to the hospital, you come across a major motor vehicle crash involving several critically injured patients. You should:

A. stop and triage the patients while your partner remains in the ambulance.

B. continue transporting your patient and notify the dispatcher of the crash.

C. remain at the scene until law enforcement and another ambulance arrive.

D. ask a bystander to remain with your patient as you treat the crash victims.

B. continue transporting your patient and notify the dispatcher of the crash

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

A. state EMS office.

B. local health district.

C. medical director.

D. EMS supervisor.

C. medical director

In many states, a minor may be treated as an adult for the purpose of consenting to or refusing medical treatment if the minor:

A. possesses a valid driver's license.

B. is mentally competent and able to refuse.

C. is self-supporting and lives by him- or herself.

D. has a poor relationship with his or her parents.

C. is self-supporting and lives by him- or herself

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. expect personnel to function beyond their scope of practice if needed.

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

D. demand that all personnel consistently exceed the standard of car

C. be reasonable and realistic to avoid overburdening EMS personnel

When you and your partner arrive at the residence of a man in cardiac arrest, you immediately recognize the patient as the drunk driver who killed your brother several years earlier. A backup ambulance is en route to the scene. You should:

A. obtain permission from medical control to not attempt resuscitation.

B. begin two-rescuer CPR and apply the AED as soon as possible.

C. advise your partner that you cannot provide care to this patient.

D. wait for the backup ambulance while your partner performs CPR.

B. begin two-rescuer CPR and apply the AED as soon as possible

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

A. Absent breath sounds

B. Dependent lividity

C. Absence of a pulse

D. Profound cyanosis

B. dependent lividity

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

A. consistently exceed the standard of care.

B. contact medical control on every EMS call.

C. exercise reasonable care and act prudently.

D. function above his or her scope of practice.

C. exercise reasonable care and act prudently

Which of the following components are needed to prove negligence?

A. Breach of duty, injury/damages, abandonment, and causation

B. Abandonment, breach of duty, damages, and causation

C. Duty to act, abandonment, breach of duty, and causation

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

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

Which of the following scenarios most accurately depicts abandonment?

A. A paramedic transfers patient care to an EMT.

B. An AEMT transfers patient care to a paramedic.

C. An EMT gives a verbal report to an emergency room nurse.

D. A physician assumes patient care from an EMT

A. a paramedic transfers patient care to an EMT

In the eyes of the courts, an incomplete or untidy patient care form indicates:

A. thorough documentation was not required.

B. the EMT was too busy providing patient care to fill out the form.

C. inadequate patient care was administered.

D. potential falsification of the patient care form.

C. inadequate patient care was administered

Shortly after you load your patient, a 50-year-old man with abdominal pain, into the ambulance, he tells you that he changed his mind and does not want to go to the hospital. The patient is conscious and alert and has no signs of mental incapacitation. You are suspicious that the man has a significant underlying condition and feel strongly that he should go to the hospital. Which of the following statements regarding this situation is correct?

A. Once the patient is in the ambulance, he cannot legally refuse EMS treatment.

B. A mentally competent adult can withdraw his or her consent to treat at any time.

C. Any patient who refuses EMS treatment must legally sign a patient refusal form.

D. Because of your suspicions, the best approach is to transport him to the hospital.

B. a mentally competent adult can withdraw his or her consent to treat at any time

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

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

B. Such laws guarantee that the EMT will not be held liable if he or she is sued.

C. Such laws provide the EMT with absolute immunity from a lawsuit.

D. Such laws do not protect EMTs who are off duty.

A. such laws will not protect the EMT in cases of gross negligence

You are dispatched to an apartment complex to respond to a shooting. Law enforcement personnel are present and have the suspect in custody. You find the patient lying in a narrow space between the couch and coffee table of his small apartment. He is semiconscious and has a large gunshot wound to his chest. You should:

A. drag the patient into a larger area so that you can begin treatment.

B. treat the patient where he is so that you do not destroy any evidence.

C. quickly move the coffee table so you can access and treat the patient.

D. obtain permission from law enforcement before moving anything.

C. quickly move the coffee table so you can access and treat the patient

Putrefaction is defined as:

A. blood settling to the lowest point of the body.

B. decomposition of the body's tissues.

C. profound cyanosis to the trunk and face.

D. separation of the torso from the rest of the body.

B. decomposition of the body's tissues

Which of the following general statements regarding consent is correct?

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

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

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

D. A patient can consent to transport but can legally refuse treatment.

D. a patient can consent to transport but can legally refuse treatment

Which of the following scenarios is an example of informed consent?

A. A patient is advised by an EMT of the risks of refusing care.

B. An EMT advises a patient of the risks of receiving treatment.

C. An EMT initiates immediate care for an unconscious adult.

D. A patient advises an EMT of why he or she is refusing care.

B. an EMT advises a patient of the risks of receiving treatment

You are dispatched to an office building for a 49-year-old male with chest pain. When you arrive at the scene, you find the patient to be conscious and alert but in obvious pain. He tells you that he did not call 911; a coworker did. He further states that he does not want to be treated or transported to the hospital. You should:

A. err in the best interest of the patient and transport him at once.

B. ensure that he is aware of the risks of refusing medical care.

C. tell him that he is having a heart attack and needs medical care.

D. have him sign a refusal of care form and then return to service.

B. ensure that he is aware of the risks of refusing medical care

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. terminated care of a competent adult patient at his or her request.

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

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

You suspect that a pregnant 16-year-old girl has a broken leg after she was hit by a car. You explain that you plan to splint her leg, and she agrees to treatment. Which of the following types of consent describes her agreement?

A. Minor's

B. Informed

C. Implied

D. Expressed

D. Expressed

When faced with a situation in which a patient is in cardiac arrest and a valid living will or DNR order cannot be located, you should:

A. notify the coroner immediately.

B. begin resuscitation at once.

C. contact medical control first.

D. determine the patient's illness

B. begin reuscitation at once

You are dispatched to a middle school for a 16-year-old female experiencing an asthma attack. She is conscious and alert but in severe respiratory distress. The school nurse informs you that she has tried several times to contact the patient's parents but has not been successful. You should:

A. provide treatment up to your level of training and transport the child at once.

B. recognize that you cannot begin treatment without expressed parental consent.

C. transport the child to the closest hospital and let the staff there provide any treatment.

D. administer oxygen only until you receive parental consent for further treatment.

A. provide treatment up to your level of training and transport the child at once

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. try to persuade the mother that treatment is needed.

B. use your authority under the implied consent law.

C. tell the mother that her refusal is a form of child abuse.

D. ask the mother to sign a refusal form and then leave.

A. try to persuade the mother that treatment is needed

As an EMT, the performance of your duties will be compared to that of:

A. the general public.

B. the medical director.

C. another EMT.

D. a paramedic supervisor.

C. another EMT

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

A. be signed by the local justice of the peace.

B. clearly state the patient's medical problem.

C. be dated within the previous 24 months.

D. be updated a minimum of every 6 months.

B. clearly stated the patient's medical problem

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

A. Social Security card

B. Voter registration card

C. Insurance card

D. Driver's license

D. driver's license

A patient regains consciousness en route from his office to the emergency department. The patient tells you that he feels fine and does not want to go to the hospital. Under these circumstances, you should:

A. document the patient's request but continue to transport him.

B. request that the police place the patient under protective custody.

C. have the patient sign a refusal form and return him to his office.

D. assess whether the patient's mental condition is impaired.

D. assess whether the patient's mental condition is impaired

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

A. Ensuring access to insurance

B. Preventing insurance fraud

C. Protecting patient privacy

D. Controlling insurance costs

C. protecting patient privacy

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

A. quickly moving any weapons out of the patient's sight.

B. making brief notes at the scene and then completing them later.

C. placing the patient in a private area until the police arrive.

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

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

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

A. A media representative inquires about the patient

B. The patient is competent and signs a release form

C. The family requests a copy for insurance purposes

D. A police officer requests a copy to place on file

B. the patient is competent and signs a release form

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. wait for law enforcement to arrive.

B. provide immediate patient care.

C. determine why the patient was injured.

D. notify medical control for advice.

B. provide immediate patient care

Which of the following most accurately defines negligence?

A. Deviation from the standard of care that might result in further injury

B. Providing care that is consistent with care provided by other EMTs

C. Transferring patient care to a provider with a lower level of training

D. Transport of a mentally incompetent patient against his or her will

A. deviation from the standard of care that might result in further injury

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:

A. adequately safeguarded the patient's PHI because the cases were discussed internally.

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

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

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

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

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?

A. Formal

B. Implied

C. Expressed

D. Informed

C. expressed

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?

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

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

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

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

A. transport the child immediately and have the parents meet you at the hospital

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

A. The EMT witnesses a vehicle crash while off duty.

B. A bystander encounters a victim who is not breathing.

C. The EMT hears of a cardiac arrest after his or her shift ends.

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

D. a call is received 15 minutes prior to shift change

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. illegal and unethical.

B. legal but unethical.

C. legal and ethical.

D. illegal but ethical.

B. legal but unethical

Which of the following situations requires you to notify the appropriate authorities?

A. Drug overdose

B. Cardiac arrest

C. Attempted suicide

D. Accidental knife wound

C. attempted suicide

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

A. libel.

B. negligence.

C. battery.

D. assault.

D. assault