Emergency Care (EMT), 13th Edition Test Bank

Name: Emergency Care (EMT), 13th Edition Test Bank
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Author: Olivia Parker

Master difficult topics with Emergency Care (EMT), 13th Edition Test Bank, offering targeted practice for your exams.

Olivia Parker

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ExamName___________________________________MULTIPLE CHOICE. Choose the one alternative that best completes the statement or answers the question.1)Which of the following BEST describes a communication system capable of identifying the numberand location of the phone from which a caller is calling?1)A)Enhanced 911B)Advanced 911C)Data display 911D)Priority dispatch 911Answer:AExplanation:A)CORRECT. An enhanced 911 system has the capability of automatically identifyingthe caller's phone number and location.B)INCORRECT. Advanced 911 is an emergency texting system rather than a systemfor locating callers.C)INCORRECT. Data display 911 does not refer to a system capable of identifying acaller's location.D)INCORRECT. Priority dispatch 911 would refer more to an internalcommunication center protocol than a system for displaying locations and phonenumbers.2)Which of the following is the most common gateway for hospital services for patients who needemergency medical assistance?2)A)Emergency medical dispatch centerB)Emergency medical services systemC)Surgical services departmentD)Emergency departmentAnswer:DExplanation:A)INCORRECT. An emergency medical dispatch center coordinates transports to thehospitals, but is not involved in determining or promoting specific hospitalservices.B)INCORRECT. The EMS system is not generally involved with hospital servicesother than the emergency department.C)INCORRECT. Although an important component of a hospital's services, not allemergency medical patients will require surgery.D)CORRECT. The emergency department serves as the gateway for the rest of theservices offered by a hospital.3)The National Registry of Emergency Medical Technicians (NREMT) was founded to establishwhich of the following?3)A)Quality oversight of emergency medical services practicesB)Quality improvement and quality assurance programs for emergency medical servicesC)An education curriculum for EMT coursesD)National standards for emergency medical services personnelAnswer:DExplanation:A)INCORRECT. The NREMT created the standards used for modern EMS, but theorganization does not oversee or determine the quality of provided services.B)INCORRECT. The NREMT developed the professional standards for emergencycare personnel, but is not involved in quality improvement or any assurance of thecare provided.C)INCORRECT. Although EMT course curricula are based on the standardsprovided by the NREMT, the National Registry was not founded to create them.D)CORRECT. In 1970, the National Registry of Emergency Medical Technicians(NREMT) was founded to establish national standards within the industry.1

4)What is NOT one the common settings that an EMT may work in?4)A)Ambulance servicesB)Rural/wilderness settingsC)Fire departmentsD)HospitalsAnswer:DExplanation:A)INCORRECT. One common setting that EMTs work in is ambulance services.B)INCORRECT. One common setting that EMTs work in is rural/wilderness settings.C)INCORRECT. One common setting that EMTs work in is fire departments.D)CORRECT. EMTs do not work in a hospital.5)What BEST describes the level of EMS training that emphasizes use of advanced airway devicesandsomeprehospital medication administration?5)A)Advanced EMTB)EMTC)Emergency Medical ResponderD)ParamedicAnswer:AExplanation:A)CORRECT. The Advanced EMT (AEMT) provides basic-level care andtransportation as well as some advanced-level care, such as use of advancedairway devices, monitoring of blood glucose levels, and administration of somemedications, which may include intravenous and intraosseous administration.B)INCORRECT. EMTs provide basic-level medical and trauma care but cannotmanage advanced airways or administer medications.C)INCORRECT. The first level of EMS training (Emergency Medical Responder) isprimarily focused on activating the EMS system and immediate care forlife-threatening injuries.D)INCORRECT. The Paramedic performs all of the skills of the EMT and AEMT plusadvanced-level skills. The Paramedic provides the most advanced level ofprehospital care.6)Which of the following agencies is responsible for establishing EMS system assessment programs?6)A)Department of Health and Human Services (HHS)B)National Highway Traffic Safety Administration (NHTSA)C)United States Health Services Agency (HSA)D)National Transportation Safety Board (NTSB)Answer:BExplanation:A)INCORRECT. The Department of Health and Human Services (HHS) is notresponsible for EMS system assessment programs.B)CORRECT. The National Highway Traffic Safety Administration (NHTSA)Technical Assistance Program has established assessment programs with setstandards for EMS systems.C)INCORRECT. The United States Department of Health and Human Services has nooversight of EMS systems.D)INCORRECT. The National Transportation Safety Board (NTSB) does not establishEMS system assessment programs.2

7)Upon arrival at the hospital, the EMT advises hospital personnel of the patient's condition,observations from the scene, treatment rendered, and other pertinent data to assure continuity ofcare. This process is known as which of the following?7)A)Definitive careB)Transfer of careC)End of tourD)Breach of dutyAnswer:BExplanation:A)INCORRECT. Definitive care refers to the type of care ultimately needed by apatient, not to the process of transferring the patient to hospital staff.B)CORRECT. Providing the receiving hospital staff with information on the patient'scondition, observations of the scene, and other pertinent data so that there will becontinuity of care is part of thetransfer of careprocess.C)INCORRECT. The end of tour generally refers to the end of a scheduled EMS shiftand is not related to patient care.D)INCORRECT. A breach of duty occurs when an EMT has a responsibility to carefor a patient and does not follow through.8)What is the minimum level of certification required of ambulance personnel responsible for directpatient care?8)A)Emergency Medical TechnicianB)Emergency Ambulance DriverC)Emergency Medical ResponderD)Advanced EMTAnswer:AExplanation:A)CORRECT. In most areas, the Emergency Medical Technician (EMT) is consideredthe minimum level of certification for ambulance personnel.B)INCORRECT. Most ambulance personnel are expected to be at the EMT level orhigher.C)INCORRECT. An Emergency Medical Responder (EMR) is below the EMTcertification level, and below the minimum usually expected for ambulancepersonnel.D)INCORRECT. Advanced EMTs have a higher level of certification than what iscommonly required as the minimum for ambulance personnel.3

9)You and your new EMT partner arrive first on the scene of a single car rollover on the shoulder of abusy highway. You pull off in a safe location and just as you stop the ambulance, your partnerthrows the passenger door open, steps out of the truck, and begins jogging through the scattereddebris toward the overturned car. You shout for him to stop and he looks back at you, but thencontinues to the vehicle and begins assessing the driver. Later, as you are restocking in theambulance bay of the local trauma center your partner tells you that he thinks you actedunprofessionally by shouting at him. What is thebestway to respond?9)A)An EMT should never hurry to assist a patient.B)The On-Duty Supervisor should be called.C)New EMTs should expect partners to yell at them occasionally.D)Shouting was an attempt to protect the EMT from a potentially unsafe scene.Answer:DExplanation:A)INCORRECT. Emergency medical care sometimes does require responders to actquickly, but never when it places others on scene in danger.B)INCORRECT. It is important for EMT partners to be able to communicateeffectively and professionally when debriefing calls. Generally, a Supervisorshould only become involved if the EMTs cannot resolve a conflict themselves or ifthey need a specific question answered.C)INCORRECT. Although sometimes the noise level of a situation requiresresponders to raise their voices to be heard, expecting to be yelled at simplybecause one is a new EMT is not professional or correct.D)CORRECT. Quickly entering a dangerous scene without taking proper precautionswill create additional risks. A professional EMT should always be concerned aboutthe safety of everyone on scene; not just themselves and the patients, but otherresponders as well. In this case, shouting at the EMT was an appropriate attempt toprevent him from entering an unsafe situation.10)Which of the following is a personal trait an EMT should demonstrate?10)A)Strong communicationB)Good eyesightC)Self-starterD)Strong studentAnswer:CExplanation:A)INCORRECT. Strong communication is obviously important for an EMT, but it istheresultof certain personal traits (respectful, able to listen, controlled in tone, etc.)Nnot a personal trait itself.B)INCORRECT. Good eyesight is a criticalphysicaltrait for an EMT to have.C)CORRECT. One of the personal traits of an effective EMT is that of being aself-starter.D)INCORRECT. Being a strong student is a good quality, butpersonal traitsrelate tothe behavior and demeanor of the EMT, not her strength in a particular task.4

11)Which of the following BEST describes a person who speaks up on behalf of the patient andsupports his cause?11)A)GuardianB)AdvocateC)AssistantD)RepresentativeAnswer:BExplanation:A)INCORRECT. A guardian is generally someone who is legally responsible for apatient, whether or not they support or advocate for them.B)CORRECT. EMTs should be advocates for their patients, speaking up for them andsupporting them in getting appropriate care.C)INCORRECT. A person who assists a patient with tasks may not necessarily speakup for the patient or support them in seeking better care.D)INCORRECT. The term "representative" does not indicate the same level ofpersonal involvement in a patient's care and outcome as an "advocate" has. EMTsshould always see themselves as advocates for their patients.12)The application of oxygen for a patient who is short of breath without having to contact thephysician in the emergency department is an example of which of the following?12)A)Standards of careB)Breach of dutyC)On-line medical directionD)Standing ordersAnswer:DExplanation:A)INCORRECT. Standards of care refer to the expected actions of an EMT ascompared to a reasonable person with the same level of training and in the samesituation. It is not related to the authorization of specific skills.B)INCORRECT. A breach of duty occurs when an EMT has a responsibility to carefor a patient and does not follow through.C)INCORRECT. On-line medical directions are orders from an on-duty physiciangiven by radio or phone.D)CORRECT. Standing orders are physician issued policies or protocols thatauthorize EMTs to perform particular skills in certain situations.13)Which of the following is a physical trait necessary for performing the duties of an EMT?13)A)Ability to speak clearlyB)Ability to remain calm in stressful situationsC)Ability to lift and carry 200 poundsD)Nonjudgmental and fairAnswer:AExplanation:A)CORRECT. An important requirement of an EMT is to have the physical ability togive and receive oral and written instructions.B)INCORRECT. An EMT's ability to remain calm in stressful situations is a criticalpersonal trait.C)INCORRECT. An EMT would not be expected to lift or carry over 125 pounds, so itwould not be considered a necessary ability to carry 200 pounds.D)INCORRECT. Being nonjudgmental and fair are important personal attributes foran EMT to have, but they are not physical traits.5

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14)What BEST describes the level of EMS training that emphasizes activation of the EMS system andprovides immediate care for life-threatening problems?14)A)Emergency Medical DispatcherB)EMTC)Emergency Medical ResponderD)Cardiac care responderAnswer:CExplanation:A)INCORRECT. The Emergency Medical Dispatcher is responsible for coordinatingthe appropriate EMS response and potentially providing important instructions tothe person calling for assistance.B)INCORRECT. EMTs provide basic-level medical and trauma care andtransportation to a medical facility.C)CORRECT. The emphasis of an Emergency Medical Responder is on activating theEMS system and providing immediate care for life-threatening injuries,controlling the scene, and preparing for the arrival of the ambulance.D)INCORRECT. A cardiac care responder is not a recognized level of EMS training.15)Which of the following is a role of the EMT in the quality improvement process?15)A)Writing complete patient care reportsB)Assuring personal safetyC)Critiquing performance of one's partnerD)Taking responsibility for the actions of one's partnerAnswer:AExplanation:A)CORRECT. Since much of an EMS system's clinical quality improvement datacomes from patient care documentation, ensuring that each report is complete andaccurate is a very important part of an EMT's involvement in quality improvement.B)INCORRECT. Although assuring personal safety is a very important responsibilityfor EMTs, it is not a role in the quality improvement process. Continuingeducation, equipment maintenance, gathering feedback from patients and hospitalstaff, preparing complete and accurate patient documentation, and gettinginvolved in the EMS system's structured quality improvement program are allexamples of roles for the EMT in a QI process.C)INCORRECT. Critiquing the performance of other emergency responders is not aprimary role for EMTs in the quality improvement process. An EMT can best assistthe process by preparing carefully written documentation, being involved in thesystem's quality improvement process, obtaining feedback from patients andhospital staff, maintaining equipment, and continuing his education.D)INCORRECT. The primary roles of an EMT in quality improvement include;preparing carefully written documentation, involvement in the system's qualityimprovement process, obtaining feedback from patients and hospital staff,maintaining equipment, and continuing education. Taking responsibility for theactions of others is not a part of the quality improvement process.6

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16)What level of emergency medical training provides the most advanced pre-hospital care?16)A)Advanced EMTB)ParamedicC)Emergency Medical TechnicianD)Emergency Medical ResponderAnswer:BExplanation:A)INCORRECT. The AEMT provides basic-level care and transportation as well assome advanced-level care in the pre-hospital setting.B)CORRECT. The Paramedic performs all of the skills of the EMT and AEMT plusadvanced-level skills. The Paramedic provides the most advanced level ofprehospital care.C)INCORRECT. EMTs provide basic-level medical and trauma care andtransportation to a medical facility.D)INCORRECT. Emergency Medical Responders are trained to activate the EMSsystem, provide immediate care for life-threatening injuries, control the scene, andprepare for the arrival of the ambulance.17)After delivering a patient to the emergency department, you discuss with hospital staff the detailsof your care and ask for suggestions to improve your care. This is an example of your role in whichof the following?17)A)Continuing educationB)Transfer of careC)Quality improvementD)Patient advocacyAnswer:CExplanation:A)INCORRECT. Continuing education is ongoing structured training designed tosupplement the EMT's original course.B)INCORRECT. Transfer of care is the process of turning care of a patient over tothose with higher levels of training.C)CORRECT. Continuous self-review through numerous means with the purpose ofidentifying aspects of the system that require improvement is known as qualityimprovement.D)INCORRECT. A patient advocate is the person who speaks up for the patient andpleads her cause.18)Which of the following refers to a program or process for evaluating and improving theeffectiveness of an EMS system?18)A)Total quality systemB)Quality improvementC)Process Improvement Plan (PIP)D)System effectiveness managementAnswer:BExplanation:A)INCORRECT. The term "total quality system" does not refer to a program forimproving the effectiveness of EMS systems.B)CORRECT. Quality improvement (QI) consists of continuous self-review with thepurpose of identifying aspects of the EMS system that require improvement, withsubsequent action plans to make subsequent changes.C)INCORRECT. A program or process for evaluating and improving theeffectiveness of an EMS system is not referred to as a Process Improvement

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19)The EMT's role in the quality improvement process includes becoming involved in the qualityprocess, keeping carefully written documentation, obtaining feedback from patients and thehospital staff, continuing your education, and which of the following?19)A)Being a member of the QI committeeB)Providing quality careC)Maintaining your equipmentD)Writing protocols and standing ordersAnswer:CExplanation:A)INCORRECT. Although it can be beneficial, being a member of the QI committee isnot an expected role for an EMT in the quality improvement process.B)INCORRECT. Providing quality care is an expectation of all EMTs, but it not partof the quality improvement process.C)CORRECT. Maintaining equipment properly is an important role the EMT plays inthe quality improvement process.D)INCORRECT. The Medical Director is responsible for writing protocols andstanding orders.20)You and your EMT partner are assigned to spend a day at the senior center where you are toinspect the rooms and common areas for fall hazards. Your partner is upset that he is not in theambulance where the "action is." He complains that "looking for loose rugs" is a waste of his time.What would be the best response to his complaints?20)A)Injury prevention in the community is an important component of EMS.B)It minimizes the number of 911 calls late at night.C)It is good practice for the next emergency call.D)It makes the taxpayers happy.Answer:AExplanation:A)CORRECT. Illness and injury prevention is an important component of EMS asEMTs are always in the field, and the role of EMS in public health is expected toonly increase in the future.B)INCORRECT. Blood pressure screening clinics do not impact the number of latenight 911 calls.C)INCORRECT. EMTs should already have competency in blood pressure techniquesprior to hosting any screening clinics.D)INCORRECT. Although community relations are important, it is not the primaryreason for checking blood pressures.21)Which of the following is a personality trait required of EMTs?21)A)Ability to dominate the patientB)Awareness of problems with color visionC)Control of personal habitsD)Ability to lift and carry 125 poundsAnswer:CExplanation:A)INCORRECT. Although the ability to dominate others may be considered apersonality trait, it is not one required to be an EMT.B)INCORRECT. Awareness of a physical problem, such as color vision, is not relatedto the qualities that make up a person's character.C)CORRECT. To reduce the chances of providing improper care or causing patientdiscomfort, EMTs should be able to control their personal habits appropriately.D)INCORRECT. A physical ability is not a personality trait.8

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22)Which of the following is a component of patient advocacy?22)A)Granting patient wishes and not reporting spousal abuse to the authoritiesB)Building rapport with the patient during transport to the hospitalC)Immobilizing the neck of a patient with a possible spinal injuryD)Providing oxygen to a patient that is short of breathAnswer:BExplanation:A)INCORRECT. Patient advocacy isnotsupporting a patient whose wishes willultimately be harmful or against the law.B)CORRECT. Building rapport with the patient is a critical component of advocacy.Without it, the EMT won't be able to know the patient's needs or challengesenough to effectively speak on their behalf.C)INCORRECT. This is simply an example of patient care. Advocacy is working tounderstandthe patient so that the EMT can speak up for them and promote theirneeds.D)INCORRECT. Advocacy is about truly understanding the patient and speaking upfor them to promote the best care possible, not simply providing an intervention.23)To be compassionate and empathetic, to be accurate with interviews, and to inspire confidence areall examples of which of the personal traits of a quality EMT?23)A)Emotionally stableB)Able to listen to othersC)Judgmental but fairD)PleasantAnswer:BExplanation:A)INCORRECT. Emotional stability is the ability to overcome the unpleasant aspectsof an emergency so that needed care may be rendered and any uneasy feelings thatexist afterward may be resolved.B)CORRECT. To be compassionate and empathetic, to be accurate with interviews,and to inspire confidence are examples of the ability to listen to others.C)INCORRECT. Being nonjudgmental and fair means treating all patients equallyregardless of race, religion, or culture.D)INCORRECT. Inspiring confidence and helping to calm the sick and injured areexamples of being pleasant.24)Which of the following BEST describes a list of steps the EMT should perform while assessing andmanaging emergency medical situations?24)A)On-line medical directionB)ProtocolsC)Standard operating proceduresD)Standing ordersAnswer:BExplanation:A)INCORRECT. On-line medical direction consists of orders from the on-dutyphysician given directly to an EMT in the field by radio or telephone.B)CORRECT. Protocols, which are developed by an agency's Medical Director, arelists of steps for assessment and interventions to be performed in differentsituations.C)INCORRECT. Standard operating procedures are a collection of policies aroundEMS agency operations and generally do not apply specifically to medicalassessment or management.D)INCORRECT. Standing orders, also called off-line medical direction, allow EMTsto give certain medications or perform certain procedures without speaking to theMedical Director or another physician.9

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25)Which of the following is the primary responsibility of the EMT?25)A)Maintain personal health and safetyB)Provide emergency careC)Protect and stabilize the patientD)Communicate with other responders on the sceneAnswer:AExplanation:A)CORRECT. It is not possible to help a patient if you are not physically capable orare injured while performing your job, so yourfirstresponsibility is to keepyourself healthy and safe.B)INCORRECT. Providing emergency care is the EMT'spurpose, but maintaining herown personal health and safety is the EMT's primaryresponsibility.C)INCORRECT. Although protecting and stabilizing the patient is an importantaspect of the EMT's job, maintaining personal health and safetyfirstis the priority.D)INCORRECT. Communicating with other emergency responders is necessary foreffective scene safety and coordination, but thefirstpriority for any EMT is toensure their own health and safety.26)Who is responsible for on-scene safety of EMS providers?26)A)Triage officerB)All crew membersC)Traffic directorD)Law enforcementAnswer:BExplanation:A)INCORRECT. The triage officer is not solely responsible for the on-scene safety ofEMS providers.B)CORRECT. It is the responsibility of all EMS crew members to keep themselves,the patient(s), and bystanders safe.C)INCORRECT. The on-scene safety of EMS providers is not the responsibility of atraffic director.D)INCORRECT. Law enforcement personnel can be an important part of scene safety,but they are not necessarily responsible for the safety of EMS crews.27)You have just come on duty. The EMT on the previous shift complains to you that the QI managerwas giving him grief because he did not document three sets of vital signs on the patient record.The EMT is angry and does not understand why documenting three sets of vital signs is soimportant. What is the best answer you could give him?27)A)Vital signs are something you have to fill out because the state requires it.B)It is important you show the QI manager that you are a team player.C)The report looks better when all the boxes are filled out.D)The recording of three sets of vital signs demonstrates that you were trending the patient'scondition.Answer:DExplanation:A)INCORRECT. The local or state governmental authority may or may not requirethree sets of vital signs; regardless, this should not be the primary reason todocument them.B)INCORRECT. Teamwork is an important trait in an EMT, but is not the drivingfactor for recording vital signs.C)INCORRECT. QI is not concerned with how the report looks, but rather that theinformation in the report is complete and accurate.D)CORRECT. Recording three sets of vital signs demonstrates that the EMT is

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28)What BEST defines the evaluation of the patient's condition in order to provide emergency care?28)A)Medical interventionB)Patient advocacyC)Patient accessD)Patient assessmentAnswer:DExplanation:A)INCORRECT. A medical intervention is the care provided once what is wrongwith the patient has been determined.B)INCORRECT. Patient advocacy is speaking up for the patient.C)INCORRECT. Patient access means getting to the patient's location.D)CORRECT. Patient assessment is used to find out enough about what is wrongwith your patient to be able to provide the appropriate emergency care.29)In 1966 the National Highway Safety Act charged which of the following agencies with thedevelopment of emergency medical service standards?29)A)U.S. Department of Homeland SecurityB)U.S. Department of the InteriorC)U.S. Department of TransportationD)U.S. Department of Health ServicesAnswer:CExplanation:A)INCORRECT. Although the U.S. Department of Homeland Security is tasked withprotecting the nation from threats, it was established in 2002 and did not exist in1966. It was the U.S. Department of Transportation that was charged withdeveloping EMS standards.B)INCORRECT. The U.S. Department of the Interior is charged with the managementand conservation of federal land and the country's natural resources. TheDepartment of Transportation was charged with developing EMS standards.C)CORRECT. In 1966 the National Highway Safety Act charged the United StatesDepartment of Transportation (DOT) with developing EMS standards andassisting the states to upgrade the quality of their prehospital emergency care.D)INCORRECT. Although the U.S. Department of Health and Human Services ischarged with protecting the health of all Americans, the United States Departmentof Transportation was assigned the task of developing emergency medical servicestandards.30)During the new employee orientation, the training officer meets with the new EMTs and explainsto them the monthly training schedule and the classes they must attend for EMT recertification.One of the new EMTs asks the training officer why they have to keep taking EMT courses if theyalready passed the EMT examination. What is the best answer?30)A)EMS is constantly evolving in response to evidence-based research.B)It looks good to a jury should the service be sued.C)EMTs forget everything once they pass the EMT exam.D)The state requires the training.Answer:AExplanation:A)CORRECT. Evidence-based scientific research is what drives changes in EMS.New and improved treatment techniques are derived from this research and theEMT needs to keep abreast of these dynamic changes to his profession.B)INCORRECT. Although continuing education can demonstrate to a jury that theservice is providing adequate training, one of the goals of continuing education isto prevent lawsuits from happening in the first place, rather than to look good oncea lawsuit has been filed.C)INCORRECT. Continuing education does provide EMTs with a good review ofrarely used material; however, it is not accurate that EMTs forget everything oncethey pass the EMT exam.D)INCORRECT. Although continuing education is mandated by most states, it is notthe reason continuing education is performed.11

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31)A fellow EMT is talking with the Medical Director at a staff meeting. The EMT states that theneighboring ambulance service is carrying special clotting bandages for serious bleeding wounds.The special bandages cost five times as much as the regular bandages, but the EMT claims theywork ten times better. The EMT wants the Medical Director to approve the bandages for use intheir ambulances. The Medical Director responds to the EMT by saying he will not approve thebandages until he can prove they are worth the additional cost. How can the EMT best prove theworth of the special bandages?31)A)Perform a literature search to see what studies have been done on the special bandages andreport the findings to the Medical Director.B)Call the manufacturer of the special bandage and request literature to give to the MedicalDirector.C)Order a small number of the special bandages and compare them side-by-side to the regularbandages.D)Have a member of the other ambulance service call the Medical Director to provide firsthandinformation on how the special bandages are much better.Answer:AExplanation:A)CORRECT. Finding objective, unbiased, evidence-based research that validates theclaims of the special bandage is the only way to actually prove that the specialbandages are superior.B)INCORRECT. Literature from the manufacturer is designed to sell the bandagesand will only present the positives of the bandages without any negativeinformation.C)INCORRECT. Product testing of the bandages is a good idea to determine how thebandages will work for that particular service, but does not provide proof that theyare actually better.D)INCORRECT. Firsthand accounts or anecdotal information do not provide anyactual scientific proof that the special bandages are superior.32)You respond to a 35-year-old male patient who fell 50 feet from a bluff. Your authority to provideemergency care is an extension of the Medical Director's license to practice medicine. You are actingas a(n) ________ of the Medical Director.32)A)designated agentB)subordinateC)employeeD)extensionAnswer:AExplanation:A)CORRECT. An EMT at a basic or advanced level is operating as a designated agentof the Medical Director.B)INCORRECT. Being a subordinate of the Medical Director does not provide anyauthority to provide emergency care.C)INCORRECT. An EMS system's Medical Director does not directly employ EMTs,and simply being an employee does not provide the authority to provide care.D)INCORRECT. An EMT does not provide care as an extension of the MedicalDirector.12

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33)Why is it important for EMTs to participate in quality improvement programs?33)A)To identify problems and develop a plan to prevent their recurrenceB)To ensure that individuals making false calls for EMS are prosecutedC)To identify problem employees and create a corrective action planD)To ensure adequate personnel are available for emergenciesAnswer:AExplanation:A)CORRECT. EMS quality improvement programs consist of continuous self-reviewwith the purpose of identifying aspects of the system that require improvement.Once a problem is identified, a plan is developed and implemented to preventfurther occurrences of the same problem. It is critical that EMTs participate in thisprocess because they usually have the best visibility to challenges within thesystem and can provide valuable insight into how to improve.B)INCORRECT. The aim of any EMS quality improvement program is to continuallyimprove the care and operations within the system — not to identify challengeswith particular individuals in the community. EMTs play a critical part in qualityimprovement by identifying areas in need of improvement, participating in theimprovement process and supporting the changes.C)INCORRECT. EMTs should participate in Quality Improvement (QI) programs toassist in bettering their EMS systems and processes, not to pinpoint and createaction plans for specific individuals.D)INCORRECT. An EMT's participation in an EMS quality improvement program isnot necessarily about adequate staffing. It is about the EMT helping to identify andfixanycomponents in the system that cause inefficiencies and challenges to patientcare.34)You and another new EMT are studying your local protocols. The other EMT notices that you maygive oral glucose without utilizing on-line medical control, but you must get an on-line order froma physician before assisting a patient in taking his nitroglycerin for chest pain. The EMT asks youwhy some drugs require on-line medical control while others do not. What is the best answer togive him?34)A)Glucose is only sugar so it cannot hurt the patient.B)The physician does not trust EMTs.C)The physician wants to be sure it is appropriate for the patient.D)The patient's nitroglycerin might be expired.Answer:CExplanation:A)INCORRECT. Although glucose is sugar and relatively safe, it can be harmful ifgiven to an unresponsive patient. But ultimately, this answer does not explain whynot to give nitroglycerin without a physician's order.B)INCORRECT. The reason protocols are written is not because physicians do nottrust EMTs; they are written because EMTs do not have the advanced training thatphysicians have.C)CORRECT. Nitroglycerin, although indicated for most chest pain patients, is notappropriate for all cardiac patients. The physician, with his advanced training, isbetter suited to make that determination.D)INCORRECT. Although medications may be expired, this does not requirecontacting medical control to confirm.13

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35)What has the modern emergency medical services (EMS) system been developed to provide?35)A)Prompt emergency responseB)Prehospital careC)Safe emergency transportationD)Trained medical personnelAnswer:BExplanation:A)INCORRECT. Prompt responses are an important part of any EMS system, but notwhat they were specifically developed to provide.B)CORRECT. In 1966 the National Highway Safety Act charged the United StatesDepartment of Transportation (DOT) with assisting the states in upgrading thequality of their prehospital emergency care.C)INCORRECT. Safe emergency transportation is only part of what modern EMSsystems were developed for.D)INCORRECT. Modern EMS systems were designed to provide more than justtrained medical personnel.36)A written authorization for an EMS provider to perform a particular skill in a specific situation isa(n):36)A)standard of care.B)standing order.C)on-line protocol.D)direct medical order.Answer:BExplanation:A)INCORRECT. Standard of care refers to the expected actions of an EMT ascompared to a reasonable person with the same level of training and in the samesituation. It is not related to the authorization of specific skills.B)CORRECT. A standing order is a policy or protocol issued by a Medical Directorthat authorizes EMTs and others to perform particular skills in certain situations.C)INCORRECT. Any "on-line" direction indicates a verbal order from a physician toan EMT, usually by phone or radio.D)INCORRECT. A direct medical order would generally come from a physician in aspecific situation and is considered "on-line" direction.14

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37)Which of the following BEST describes the purpose of the modern emergency medical services(EMS) system?37)A)To have trained personnel knowledgeable in all aspects of prehospital careB)To have trained personnel respond quickly and provide emergency care on the scene, duringtransport, and at the hospitalC)To have trained personnel understand the limitations of their training and "do no harm,"while providing prompt transport to the hospitalD)To have trained personnel capable of assessing and caring for injured and ill patients on thesceneAnswer:BExplanation:A)INCORRECT. Although knowledge is an important aspect of an emergency careprovider's job, the modern Emergency Medical Services (EMS) system wasspecifically developed to get trained personnel to patients as quickly as possibleand to provide emergency care on the scene, en route to the hospital, and at thehospital until care is assumed by the hospital staff.B)CORRECT. The modern Emergency Medical Services (EMS) system has beendeveloped to get trained personnel to patients as quickly as possible and toprovide emergency care on the scene, en route to the hospital, and at the hospitaluntil care is assumed by the hospital staff.C)INCORRECT. Although understanding limitations and doing "no harm" areimportant aspects of an emergency care provider's job, the modern EmergencyMedical Services (EMS) system was developed to get trained personnel to patientsas quickly as possible and to provide emergency care on the scene, en route to thehospital, and at the hospital until care is assumed by the hospital staff.D)INCORRECT. In addition to having trained personnel able to help patients onscene, the modern Emergency Medical Services (EMS) system also aims to providethat same assistance while en route to the hospital and at the hospital until hospitalstaff can take over care.38)Who assumes the ultimate responsibility for patient care rendered by the EMT?38)A)Director of quality assuranceB)EMTC)Medical DirectorD)EMS supervisorAnswer:CExplanation:A)INCORRECT. In every EMS service or agency, the Medical Director is ultimatelyresponsible for the patient care provided by the EMTs.B)INCORRECT. Since every EMT operates under the license of the EMS service'sMedical Director it is the Medical Director,not the EMT, who is ultimatelyresponsible for the patient care.C)CORRECT. The Medical Director of an EMS agency or service is ultimatelyresponsible for all patient care because the EMTs work under the MedicalDirector's license.D)INCORRECT. Although an EMS supervisor can be involved, the EMS service'sMedical Director assumes ultimate responsibility for the care provided by an EMT.15

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39)Which of the following groups is credited with developing the earliest documented emergencymedical service?39)A)The SpanishB)The FrenchC)The MayansD)The EgyptiansAnswer:BExplanation:A)INCORRECT. The Spanish did not develop the first documented emergencymedical service; the French did in the 1700s.B)CORRECT. The earliest documented emergency medical service was in 1790 whenthe French began transporting wounded soldiers from the scenes of battle towaiting physicians.C)INCORRECT. The earliest documented emergency medical service was in Francein 1790, nearly a thousand years after the Mayan civilization disappeared.D)INCORRECT. Although known for progress in technical areas, the Egyptians werenot responsible for the first documented emergency medical service. In 1790, theFrench first began transporting wounded soldiers away from battlefields and towaiting medical care.40)Centralized coordination of emergency medical access, transportation, and care most refers towhich of the following?40)A)Resource managementB)Central deploymentC)Emergency preparedness planD)Trauma systemAnswer:AExplanation:A)CORRECT. Resource management refers to the centralized coordination of anemergency response so that all victims have equal access to basic emergency careand are transported by certified personnel, in a licensed and equipped ambulance,to an appropriate facility.B)INCORRECT. The centralized coordination of emergency medical access,transportation, and care within an EMS system is not referred to as centraldeployment.C)INCORRECT. Emergency preparedness plans are usually developed to guide theactions of a specific group of people at the outset of an emergency, with the goal ofprotecting people and/or property. They generally will not address the specifics ofmedical care or transport.D)INCORRECT. A trauma system is an organized, coordinated effort betweenfacilities and responders within a defined geographic area to deliver a full range ofcare to injured patients. It does not address the coordination of basic (non-trauma)emergency care or transportation.41)Which of the following best describes training that supplements the EMT's original training andthat is usually taken in regular intervals?41)A)RecertificationB)EMT training programC)Distance educationD)Continuing educationAnswer:DExplanation:A)INCORRECT. Recertification refers to the renewal of an EMT certificate, notspecifically to regular ongoing training.B)INCORRECT. An EMT training program is the initial certification course, not thesupplemental training that follows it.C)INCORRECT. Distance education refers to thewaytraining or courses aredelivered, not specifically to the topic.D)CORRECT. Ongoing education that supplements an EMT's original training iscalled Continuing Education (CE).16

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ExamName___________________________________MULTIPLE CHOICE. Choose the one alternative that best completes the statement or answers the question.1)Which of the following does NOT occur during inspiration?1)A)Chest cavity increases in sizeB)Intercostal muscles contractC)Diaphragm lowersD)Diaphragm relaxesAnswer:DExplanation:A)INCORRECT. During inhalation, the ribs move upward and outward; theexpanding size of the chest cavity then causes air to flow into the lungs.B)INCORRECT. During the process of inspiration, the intercostal muscles contract.C)INCORRECT. The diaphragm lowers during inspiration.D)CORRECT. The diaphragm does not relax during inspiration; it contracts toexpand the size of the chest cavity.2)Which of the following is the most proper dose of inhaled medication the EMT can assist thepatient with administering?2)A)One sprayB)As needed until respiratory status improvesC)The number of sprays directed by medical controlD)Two spraysAnswer:CExplanation:A)INCORRECT. Each patient situation is different, and one spray may not beadequate.B)INCORRECT. Sometimes the inhaled medication will not be effective, andcontinuing to administer it indefinitely is not proper patient care.C)CORRECT. EMTs should always follow medical direction (whether verbal orwritten in standing orders) when assisting patients with inhaled medication.D)INCORRECT. Two sprays may work with some patients but not with others.3)In which of the following circumstances is medical direction necessary when assisting a patientwith the use of a prescribed inhaler?3)A)Patient has already overused the inhaler before your arrival.B)Medical control is not necessary since assistance with inhaled medications is in the EMTscope of practice.C)Medical control is necessary in all situations in which an EMT assists with a prescribedinhaler.D)The inhaler belongs to another family member, not the patient.Answer:CExplanation:A)INCORRECT. Patient use of the inhaler prior to EMS arrival does not negate therequirement for medical direction before assisting the patient with using it again.B)INCORRECT. Assisting a patient with a prescribed inhaler without medicaldirection is not within an EMT's scope of practice.C)CORRECT. EMTs will need to get permission from medical direction beforehelping any patient use an inhaler. This can be accomplished by phone/radio or bystanding order, depending on local protocols.D)INCORRECT. An inhaler prescribed to someone other than the patient shoulddefinitely not be administered without specific medical direction.1

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4)Your patient is a 15-year-old male with a history of multiple prior hospitalizations for asthma.Upon your arrival the patient responds only to painful stimuli and is making very weakrespiratory effort. Which of the following should you do next?4)A)Contact medical control.B)Assist the patient's ventilations with a bag-valve-mask device and supplemental oxygen.C)Assist the patient with his inhaler.D)Check the patient's oxygen saturation level.Answer:BExplanation:A)INCORRECT. There is no specific reason to contact medical control, and delayingcare would be detrimental.B)CORRECT. This patient needs immediate ventilatory assistance with supplementaloxygen.C)INCORRECT. It would be ineffective to help an unresponsive, inadequatelybreathing patient with an inhaler.D)INCORRECT. Obtaining a pulse oximetry reading on this patient would not be apriority.5)Your patient is a 24-year-old woman with asthma who is struggling to breathe and is veryagitated. She has cyanosis of her lips and nail beds, and is cool and clammy to the touch. When youattempt to assist her ventilations with a bag-valve-mask device, she becomes combative andrepeatedly pushes the mask away from her face. Which of the following is the BEST option?5)A)Use a nasal cannula to administer supplemental oxygen.B)Wait for the patient's level of consciousness to decrease so that she can no longer resist yourattempts to ventilate.C)Have your partner restrain the patient's hands so you can ventilate her.D)Begin transport immediately and contact medical control for advice.Answer:DExplanation:A)INCORRECT. Although better than no supplemental oxygen, applying a nasalcannula to this patient is not the EMT's best option.B)INCORRECT. Allowing a patient to become unresponsive before providing care isdangerous and not appropriate care.C)INCORRECT. Restraining a patient to provide ventilations is never appropriate.D)CORRECT. In the rare circumstance when a patient with inadequate breathing isconscious enough to fight artificial ventilation, transport immediately and consultmedical direction.2

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Emergency Care (EMT), 13th Edition Test Bank

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