Deck 46: Patients With Special Challenges

Question 1

Your pediatric patient appears fearful and shrinks back when you try to start your assessment. You find multiple contusions, faded bruises, and a broken rib. The mother says the child fell on the playground and that he takes a while to warm up to strangers. You should suspect

A) physical abuse.
B) neglect.
C) emotional abuse
D) sexual abuse.

Answer 1

physical abuse.

Question 2

Select the BEST response: You arrive on the scene of a call to find an 8 year old male who has different stages of bruising on his chest, back, and around his eye. The child appears fearful when you try to start your assessment and flinches away from you. The parent says the child fell outside while playing and is very shy. You should

A) ask the parent to hold the child while you conduct your assessment.
B) ask the parent whether the child has ever been emotionally or physically abused.
C) talk with the child about each step of the assessment before you perform it.
D) report your suspicion of physical abuse to the appropriate authority.

Answer 2

report your suspicion of physical abuse to the appropriate authority.

Question 3

Name calling, shaming, rejection, withholding love, and threatening a child are all examples of

A) sexual abuse
B) physical abuse
C) child neglect
D) emotional abuse

Answer 3

emotional abuse

Question 4

Malnourishment, an unsafe living environment, a lack of adult supervision, and untreated soft tissue injuries in a child are all possible indicators of

A) emotional abuse
B) child neglect
C) sexual abuse
D) physical abuse

Question 5

While examining an African-American toddler, you find bluish areas on his back and stomach, which have the appearance of bruising. This discoloration is a sign of

A) Mongolian spots.
B) marks from coining.
C) coxsackie.
D) impetigo.

Question 6

You are assessing an Asian toddler whose mother says he has been coughing and has chest congestion. You find a row of flushed, irritated skin on both sides of his spine. The mother says she rubs coins on his back to relieve his symptoms. You should

A) document the mother's treatment as "coining" and continue your assessment.
B) warn her that she may be making her child's illness worse.
C) suspect child abuse by the mother and report it to the local agency.
D) inform her that rubbing coins on her child cannot relieve his symptoms.

Question 7

Your elderly patient is malnourished and wearing inadequate clothing for the current temperature. She is lying on soiled bedding and there is a strong smell of urine throughout the house. Her care giving daughter tells you that her mother refuses to get out of bed most days, won't do any housekeeping, and is not taking her medication. You should

A) politely notify the daughter that you suspect abuse and are required to report it.
B) note in your report that you believe the patient is self-abusive and needs further assessment.
C) accuse the daughter of abusing her mother and warn her that you will report her.
D) report your suspicion of neglect to medical direction and the local abuse agency.

Question 8

You are called to the home of a 23 year old woman who has signs of an opiate overdose, and there is drug paraphernalia on the table. A 4 year old boy is also present, and you notice that he is thin and smells faintly of urine. You suspect that the child may be a victim of

A) child abandonment.
B) child neglect.
C) physical abuse.
D) sexual abuse.

Question 9

EMS is often the primary route that _________ use to access healthcare services.

A) pregnant women
B) bariatric adults
C) elderly patients
D) homeless patients

Question 10

A premature infant, who has recently been released from the hospital, has a strap equipped with sensors on her chest. This strap is a(n)

A) ventricular shunt
B) PICC line
C) home ventilator
D) apnea monitor

Question 11

Select the BEST response: Bleeding, infection and dislodgment from coughing or patient movement are complications that can occur with the use of a

A) PICC line
B) ventricular shunt
C) gastrostomy tube
D) tracheostomy tube

Question 12

You are called to the home of a diabetic patient who has a gastrostomy tube in place. The tube has become dislodged and there is light bleeding at the site. You should

A) administer positive-pressure ventilation with 100%.
B) provide insulin to prevent hypoglycemia from occurring.
C) ask her to assume a position of comfort during your assessment.
D) lie the patient on her right side with her head elevated during transport.

Question 13

Which of the following is used to give medications and nutritional solutions directly into the venous circulation?

A) Ventricular shunt
B) PICC line
C) Gastrostomy tube
D) Tracheostomy tube

Question 14

Which type of care is provided once a physician certifies that a patient has less than six months to live?

A) Hospice
B) Home care
C) Technology-dependent
D) Assisted

Question 15

Select the BEST response: Which of the following would a patient diagnosed with Hydrocephalus use in his care?

A) Tracheostomy tube
B) Central line
C) Peripherally inserted central catheter
D) Ventricular shunt

Question 16

You have provided care for a child whom you believe is a victim of sexual abuse. In your documentation you should

A) paraphrase as best as you can to record what the parent told you.
B) document your physical exam findings and the home environment.
C) describe your opinion of what you think is occurring in the situation.
D) detail your suspicions and reasons for believing abuse has occurred.

Question 17

Female genitourinary problems, hypertension, musculoskeletal problems, and skin and ear disorders are all common illnesses among which of the following groups?

A) Bariatric patients
B) Physically abused elderly
C) Homeless patients
D) Neglected children

Question 18

__________ is the branch of medicine that deals with the causes, prevention, and treatment of obesity and weight-related health problems.

A) Endocrinology
B) Geriatrics
C) Bariatrics
D) Gastroenterology

Question 19

Your teenage patient is very distrustful of you and will not tell you how she received a black eye in school. She has dirty, ripped clothing, and very poor personal hygiene. You should

A) limit physical contact when performing the assessment and ask her what happened.
B) ask to speak with her parents and share your concerns about her condition.
C) suspect that she may be homeless and offer her resources to help her.
D) inform her that you are unable to help her if she does not provide an accurate history.

Question 20

Which of the following types of care relieves symptoms of disease, such as pain, nausea, and vomiting, but does not aim to cure the disease?

A) Symptomatic
B) Hospital
C) Technology-assisted
D) Palliative

Question 21

Your patient is apneic, pulseless, and has terminal cancer. His daughter says he has a DNR and is searching the home office for it. The wife says that there is no DNR and asks you to begin CPR. You should

A) provide resuscitation efforts until the DNR is located and verified.
B) provide supportive care until the DNR is found and verified.
C) wait until the DNR is found before determining your course of action.
D) apply oxygen and request emergency transportation with an ALS team.

Question 22

Your 50 year old morbidly obese patient who is hypotensive needs immediate transportation to the hospital. You should

A) use a standard backboard, making sure to bend your knees and keep the weight close to your body.
B) place him in a position of comfort when preparing him for transport.
C) use a bariatric stretcher to transport him to the ambulance.
D) have him walk to the ambulance rather than carrying him.

Question 23

Which of the following is used to remove excess cerebrospinal fluid within the brain?

A) Peripherally inserted central catheter
B) Central line
C) Tracheostomy tube
D) Ventricular shunt