Deck 7: The Challenged Patient

Question 1

Which of the following is NOT a common cause of vision loss?

A) Multiple sclerosis
B) Diabetes
C) Premature birth
D) Cytomegalovirus

Answer 1

Multiple sclerosis

Question 2

You arrive at the scene of a vehicle-versus-pedestrian accident. At the scene, you find a 32-year-old man with an apparent mid-shaft femur fracture. As you introduce yourself, the man tells you that he is blind, and that a police officer took his guide dog a few minutes ago. Regarding the service dog, you should:

A) tell law enforcement to contact animal control, which will hold the dog until the patient is discharged from the hospital.
B) locate the dog and transport it with the patient to the hospital.
C) inform the patient that he should call a family member or friend to come pick up the dog from law enforcement.
D) tell police to transport the dog to the ED, as animals are not allowed inside the ambulance.

Answer 2

locate the dog and transport it with the patient to the hospital.

Question 3

A 22-year-old man has fallen at a local park. He has Down syndrome, and is crying. Which of the following strategies may be helpful when caring for this patient?

A) Speak to the patient as you would to a young child, as he has a cognitive age of 3 to 5 years old.
B) Begin with simple questions to assess the developmental level of the patient.
C) Direct all questions to the patient's caregiver.
D) Treat the patient as you would any adult, so as not to offend him.

Answer 3

Begin with simple questions to assess the developmental level of the patient.

Question 4

Which of the following describes deafness?

A) The inability to hear
B) A defect in the brain that does not allow sound to be processed
C) A congenital defect involving the inner ear
D) The inability to hear under 30 decibels

Question 5

You arrive at the scene to find a patient who has fallen. She appears to be homeless. After introducing yourself, you begin to assess her. However, she states that she does not want your help because she cannot afford it. What would be an appropriate response?

A) "Don't worry, Medicare will cover it."
B) "There is a public hospital that we can bring you to nearby."
C) "I'm sorry to hear that. We'll need to call a lower-cost EMS provider."
D) "You need medical attention; the hospital will work with you to help cover the cost."

Question 6

A 34-year-old man is having trouble breathing. As you introduce yourself, his 7-year-old daughter tells you that he is deaf and communicates via American Sign Language. Which of the following is an appropriate means of communicating with this patient?

A) Write down all questions and give them to the patient.
B) Use gestures speak slowly so the patient can lip read.
C) Ask the daughter to serve as a translator.
D) Use the patient's TTY phone as a virtual translator.

Question 7

What is enucleation?

A) Removal and replacement of the patient's eyeball with a prosthetic eye
B) Corrective laser surgery
C) Loss of vision in one eye due to trauma
D) Removal of the eyeball

Question 8

A school nurse has called EMS because an 8-year-old girl has a fever and is dehydrated. Just after your arrival, the girl's parents arrive. They calmly inform you that they do not believe in Western medicine, and that they will take the girl home to treat her. The child has an altered mental status and appears to be in serious condition. You should:

A) advise the parents of the risks and allow them to sign a refusal of treatment form.
B) provide treatment to the girl under the concept of implied consent.
C) quietly contact law enforcement to assist you in convincing the parents.
D) leave the scene and document that there was no patient contact.

Question 9

Which of the following best describes the etiology of cerebral palsy?

A) A genetic disorder related to the chromosomes
B) German measles, cerebral hypoxia, head injury, or any number of diseases
C) Drug and alcohol abuse by the mother
D) Typhoid, head injury, or rubella

Question 10

The inability of nerve impulses to reach the auditory center of the brain is called:

A) audioneural deafness.
B) conductive deafness.
C) sensorineural deafness.
D) cochlear imbalance.

Question 11

A 5-year-old girl has a high fever and cough. The girl's mother informs you that her daughter has leukemia and finished her most recent round of chemotherapy two days ago. She states that the girl is neutropenic. You recognize that:

A) neutropenia is a common side effect of chemotherapy, but is not a serious concern.
B) neutropenic fevers are always due to pneumonia.
C) neutropenia is a serious condition that often leads to sepsis.
D) neutropenic cough is a side effect of chemotherapy and should be treated with albuterol.

Question 12

Which of the following statements is accurate regarding the care for a child with spina bifida?

A) Most are able to live normal, healthy lives.
B) There is a high chance of a latex allergy, so non-latex equipment should be used.
C) Opiate pain medication is contraindicated.
D) Patients will be quadriplegic, so their wheelchairs must be transported with them.

Question 13

You are assisting with the transport of a bariatric patient who needs to be removed from her top-floor bedroom. Due to the patient's size and weight, multiple resources are being used to get the patient out through an upstairs window. Which of the following considerations should be a top priority in this scenario?

A) Performing the action quickly, so as not to create a spectacle in the neighborhood
B) Minimizing damage to the patient's house and property, even if it means extending the operation
C) Protecting the patient's dignity throughout the process, ensuring her comfort and safety
D) Using as few resources as possible, so as not to deplete the rest of the emergency response system

Question 14

An injury to which cervical vertebra(e) may prevent a person from breathing?

A) C-5-C-7
B) C-1-C-3
C) C-1 only
D) C-3-C-5

Question 15

You are about to transport a cancer patient who complains of dyspnea. She is hemodynamically stable and has a history of asthma. On assessment, you note that she has some diffuse wheezes. You are going to administer an albuterol treatment and your protocol states that you should start an IV when you give a breathing treatment. The patient says that she has very bad veins, but she has an implanted port under the skin of her left chest. What is the best course of action?

A) Administer albuterol only, as there is no urgent need for an IV.
B) Withhold all treatment, as albuterol may negatively interact with her chemotherapy.
C) Contact medical control for orders to access the port before beginning the albuterol treatment.
D) Some implanted ports require special catheters, so try for a peripheral line.

Question 16

A Muslim woman is ill and requires transport to the hospital. The patient's husband is refusing to allow the patient to be examined, as both members of the crew are male. The patient is quiet, but persistently agrees with her husband. How should you respond to this situation?

A) Contact law enforcement, as this is likely partner abuse.
B) Direct all questioning to the patient, encouraging her to come with you to the hospital.
C) Transport the patient without examining her, allowing the husband to ride in the patient compartment with his wife if he wishes.
D) Have the husband take his wife to the hospital, after signing a refusal of care form.

Question 17

You have arrived on the scene of an injured person. The person has been identified by the police as having a hearing impairment. What is the best way to communicate with this person?

A) Use written words or pictures.
B) Ask the patient to turn up their hearing aid.
C) Speak loudly and make hand gestures.
D) Call for an American Sign Language interpreter to meet you at the hospital.

Question 18

A 22-year-old woman is a quadriplegic and requires transport to the hospital for wound on her leg. She is on a portable home ventilator. Which of the following is the best way to transport this patient?

A) Keep the patient on her home ventilator, transporting the equipment with the patient.
B) Call dispatch and ask for a CCT unit that has a transport ventilator.
C) Provide positive-pressure ventilation with a bag-valve device during transport.
D) Disconnect the ventilator and passively oxygenate the patient with a nonrebreather mask.

Question 19

You have responded to a report of an injured person. When you arrive, you find a 55-year-old woman who has fallen and sustained a small laceration to her forehead. She is holding a small dog and asks if she can bring it with her to the hospital. What is the most appropriate action to take regarding transport?

A) Explain to the patient that the ambulance is a sterile area and that she will have to call a friend to come and get the dog.
B) Ask the patient if it is a service dog, and what it is trained to do.
C) Restrain and transport the dog in the front of the ambulance.
D) Transport the dog, but only if she has a carrier for it to ride in.

Question 20

What is the cause of conductive deafness?

A) Any condition that prevents voice or vibration from being transmitted to the brain from the outer ear due to nerve damage
B) A condition that prevents sound from traveling from the inner to the outer ear
C) A decrease in the sensory threshold voltage of the ear
D) Any condition that prevents sound from being transmitted from the external ear to the middle or inner ear

Question 21

You are caring for a male patient who has not spoken to answer any of your questions, but will nod or shake his head. He appears to have a developmental disability. Which of the following is the best way to document this information on your patient care report?

A) "Patient refuses to answer questions."
B) "Patient is non-verbal, but will nod his head yes and no."
C) "Patient is developmentally disabled and unable to speak."
D) "Patient is not responsive to questioning."