3.Medical, Legal, Ethical Issues

Chapter 3 Multiple Choice 1. A. B. C. D. To minimize the risk of litigation, the EMT should always: transport patients to the hospital of their choice. provide competent care that meets current standards. use universal precautions with every patient encounter. utilize at least four personnel when moving a patient. 2. A. B. C. D. Which of the following general statements regarding consent is MOST correct? A patient can consent to transport but can legally refuse to be treated. Patients who are intoxicated are generally allowed to refuse treatment. Expressed consent is valid only if given in writing by a family member. All patients older than 18 years can legally refuse treatment or transport. 3. A. B. C. D. 4. A. B. C. D. 5. A. B. C. D. What 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? formal implied informed expressed Which of the following scenarios MOST accurately depicts informed consent? A patient advises an EMT of why he or she is refusing care. An EMT advises a patient of the risks of receiving treatment. An EMT initiates immediate care for an unconscious adult. A patient is advised by an EMT of the risks of refusing care. Which of the following types of consent allows treatment of a patient who is unconscious or mentally incapacitated? actual implied informed expressed 6. A. B. C. D. 7. A. B. C. D. 8. A. B. C. D. 9. A. B. C. D. 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 9-1-1; a coworker did. He further states that he does not want to be treated or transported to the hospital. You should: ensure that he is aware of the risks of refusing medical care. err in the best interest of the patient and transport him at once. have him sign a refusal of care form and then return to service. tell him that he is having a heart attack and needs medical care. 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. What type of consent is her agreement considered? implied informed expressed minorÕs In many states, a minor may be treated as an adult for the purpose of consenting to or refusing medical treatment if the minor: possesses a valid driverÕs license. is mentally competent and able to refuse. has a poor relationship with his or her parents. is self-supporting and lives by him- or herself. 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 childÕs parents will be at the scene in approximately 15 minutes. What should you do? Transport the child immediately and have the parents meet you at the hospital. Treat the child at the scene and wait for the parents to arrive and give consent. Begin transport at once and have the parents meet you en route to the hospital. Withhold treatment until the parents arrive and give you consent for treatment. 10. 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 patientÕs 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 them provide any treatment. D. administer oxygen only until you receive parental consent for further treatment. 11. You are treating a man with a closed head injury following an assault by a burglar. The patient, who has slurred speech, becomes verbally abusive and tells you to leave him alone. You should: A. ask a police officer to transport the patient to the hospital. B. allow him to refuse treatment since the injury was not his fault. C. proceed with treatment and utilize law enforcement if necessary. D. have the police arrest him so that you can legally begin treatment. 12. 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 patientÕs request but continue to transport him. B. have the patient sign a refusal form and return him to his office. C. request that the police place the patient under protective custody. D. assess whether or not the patientÕs mental condition is impaired. 13. Shortly after loading 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. He 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. A mentally competent adult can withdraw his or her consent to treat at any time. B. Any patient who refuses EMS treatment must legally sign a patient refusal form. C. Because of your suspicions, the best approach is to transport him to the hospital. D. Once a patient is in the ambulance, he or she cannot legally refuse EMS treatment. 14. 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 childÕs mother appears and refuses to allow you to continue treatment. You should: A. use your authority under the implied consent law. B. try to persuade the mother that treatment is needed. C. ask the mother to sign a refusal form and then leave. D. tell the mother that her refusal is a form of child abuse. 15. In which of the following circumstances can the EMT legally release confidential patient information? A. a police officer requests a copy to place on file B. the family requests a copy for insurance purposes C. a media representative inquires about the patient D. the patient is competent and signs a release form 16. Your BEST protection against legal liability when a competent patient refuses EMS care and transport is to: A. advise medical control of the situation. B. err on the side of caution and transport. C. ensure that the family is aware of the risks. D. thoroughly document the entire event. 17. What section of the Health Insurance Portability and Accountability Act (HIPAA) MOST affects EMS personnel? A. controlling insurance cost B. protecting patient privacy C. preventing insurance fraud D. ensuring access to insurance 18. Which of the following is NOT considered to be protected health information (PHI)? A. patient history B. treatment rendered C. location of the call D. assessment findings 19. 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 patientÕs 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. acted appropriately but must have each EMT sign a waiver stating that he or she will not discuss the cases with others. B. adequately safeguarded the patientÕs PHI because the cases were discussed internally. C. are in violation of HIPAA because you did not remove the PHI from the PCR beforehand. D. violated the patientÕs privacy because you should have only discussed the information with the EMTs who provided it. 20. In order for a do not resuscitate (DNR) order to be valid, it must: A. be dated within the previous 24 months. B. clearly state the patientÕs medical problem. C. be updated a minimum of every 6 months. D. be signed by the local justice of the peace. 21. 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. begin resuscitation at once. B. contact medical control first. C. determine the patientÕs illness. D. notify the coroner immediately. 22. You respond to the home of a 59-year-old man who is unconscious, has slow, shallow breathing, and has a weak pulse. The family states that the patient has terminal brain cancer and does not wish to be resuscitated. They further state that there is a DNR order for this patient; however, they are unable to locate it. You should: A. begin treatment and contact medical control as needed. B. honor the patientÕs wishes and withhold all treatment. C. transport the patient without providing any treatment. D. decide on further action once the DNR order is produced. 23. You and your partner arrive at the scene of a major motor vehicle crash. The driver, a young male, is severely entrapped in his car. He has an open head injury and massive facial trauma. He is unresponsive, is not breathing, and does not have a palpable carotid pulse. You should: A. stop any active bleeding and advise dispatch to send a paramedic crew. B. ventilate the patient for 5 minutes and then stop if there is no response. C. request the fire department to extricate the patient so you can begin cardiopulmonary resuscitation (CPR). D. have your partner check for a pulse to confirm that the patient is deceased. 24. You arrive at the scene of an apparent death. When evaluating the patient, which of the following is a definitive sign of death? A. absence of a pulse B. profound cyanosis C. dependent lividity D. absent breath sounds 25. Putrefaction is defined as: A. decomposition of the bodyÕs tissues. B. profound cyanosis to the trunk and face. C. blood settling to the lowest point of the body. D. separation of the torso from the rest of the body. 26. Where would you MOST likely find information regarding a patientÕs wishes to be an organ donor? A. driverÕs license B. insurance card C. Social Security card D. voter registration card 27. At the scene of a mass-casualty incident, you identify a patient as an organ donor. When triaging the other patients, you: A. should transport the donor patient before critical patients. B. may have to assign the donor patient a lower triage priority. C. should use a separate ambulance to transport the donor patient. D. must assign the donor the highest priority regardless of injuries. 28. The EMTÕs scope of practice within his or her local response area is defined by the: A. medical director. B. state EMS office. C. EMS supervisor. D. local health district. 29. The manner in which the EMT must act or behave when caring for a patient is called the: A. EMT oath. B. code of ethics. C. standard of care. D. scope of practice. 30. As an EMT, the performance of your duties will be compared to that of: A. another EMT. B. the general public. C. the medical director. D. a paramedic supervisor. 31. You have been tasked by your medical director to assist in the development of your EMS agencyÕs institutional standards. When developing these standards, it is important to: A. require personnel to transport all patients to the closest hospital. B. be reasonable and realistic to avoid overburdening your personnel. C. demand that all personnel consistently exceed the standard of care. D. expect personnel to function beyond their scope of practice if needed. 32. 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. function above his or her scope of practice. D. exercise reasonable care and act prudently. 33. In which of the following situations does the EMT NOT have a legal duty to act? A. a response to the residence of a patient who fell B. a response to a motor vehicle crash while off duty C. a response to an injured patient while off duty D. Local policy requires you to assist in any emergency. 34. Which of the following MOST accurately defines negligence? A. transport of a mentally incompetent patient against his or her will B. deviation from the standard of care that may result in further injury C. transferring patient care to a provider with a lower level of training D. providing care that is consistent with care provided by other EMTs 35. Which of the following components are needed to prove negligence? A. abandonment, breach of duty, damages, and causation B. duty to act, abandonment, breach of duty, and causation C. duty to act, breach of duty, injury/damages, and causation D. breach of duty, injury/damages, abandonment, and causation 36. When caring for a 65-year-old male with respiratory distress, you place him in a comfortable position but do not apply oxygen. The patientÕs condition continues to deteriorate and he develops cardiac arrest and dies at the hospital. This scenario is an example of: A. assault. B. battery. C. negligence. D. abandonment. 37. 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. A physician assumes patient care from an EMT. D. An EMT gives a verbal report to an emergency room nurse. 38. While transporting a stable patient with chest pain to the hospital, you come across a major motor vehicle crash involving several critically injured patients. Your MOST appropriate action should be to: A. ask a bystander to remain with your patient as you treat the crash victims. B. remain at the scene until law enforcement and another ambulance arrive. C. stop and triage the patients while your partner remains in the ambulance. D. continue transporting your patient and notify the dispatcher of the crash. 39. An EMT would MOST likely be held liable for abandonment if he or she: A. refused to care for a violent patient who is armed with a knife. B. remained at the hospital for 30 minutes to give a patient report. C. did not make provisions for continued care of an injured patient. D. terminated care of a competent adult patient at his or her request. 40. Acting in such a way as to make another person fear immediate bodily harm is called: A. libel. B. assault. C. battery. D. negligence. 41. Which of the following statements regarding the Good Samaritan law is correct? A. It provides the EMT immunity from a lawsuit. B. It guarantees that the EMT will not be held liable if he or she is sued. C. The law does not protect EMTs who are off duty. D. It will not protect the EMT in cases of gross negligence. 42. If an action or procedure that was performed on a patient is not recorded on the written report: A. it was not performed in the eyes of the law. B. it can be qualified by the EMT in charge. C. it cannot be used in establishing negligence. D. it was performed haphazardly by the EMT. 43. In the eyes of the court, an incomplete or untidy patient care form indicates: A. that inadequate patient care was administered. B. potential falsification of the patient care form. C. that thorough documentation was not required. D. that the EMT was too busy providing patient care. 44. Which of the following situations requires you to notify the appropriate authorities? A. cardiac arrest B. drug overdose C. attempted suicide D. accidental knife wound 45. You and your partner are the first to arrive at a potential crime scene with a critically injured patient involved. The scene is safe. Your first priority is to: A. notify medical control for advice. B. provide immediate patient care. C. wait for law enforcement to arrive. D. determine why the patient was injured. 46. Maintaining the chain of evidence at the scene of a crime should include: A. quickly moving any weapons out of the patientÕs sight. B. placing the patient in a private area until the police arrive. C. making brief notes at the scene and then completing them later. D. not cutting through holes in clothing that were caused by weapons. 47. You are dispatched to an apartment complex for 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. obtain permission from law enforcement before moving anything. B. quickly move the coffee table so you can access and treat the patient. C. treat the patient where he is so that you do not destroy any evidence. D. drag the patient into a larger area so that you can begin treatment. 48. Two EMTs witnessed a call in which a coworker gave adequate medical care but ignored the patientÕs 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 coworkerÕs treatment of this patient and took no steps to prevent this behavior from happening again. This lack of action on the part of the two EMTs is considered: A. legal and ethical. B. legal but unethical. C. illegal but ethical. D. illegal and unethical. 49. While transporting a woman with diabetes, you inadvertently give her oral glucose even though her blood glucose level was high. You reassess the patient and note that her condition did not change; she remained stable. You should: A. document the error and report it to your supervisor. B. notify law enforcement so they can file an incident report. C. contact medical control and notify him or her of the error. D. exclude this from the PCR since it did not harm the patient. 50. 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. advise your partner that you cannot provide care to this patient. B. wait for the backup ambulance while your partner performs CPR. C. obtain permission from medical control to not attempt resuscitation. D. begin two-rescuer CPR and apply the automated external defibrillator (AED) as soon as possible.