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2023 Test bank for Emergency Care 14th Edition by Daniel Limmer, Michael F. O'Keefe andEdward T. Dickinson Test Bank
- Which of the following refers to a program or process for evaluating and improving the effectiveness of an EMS system? A) Quality improvement B) System effectiveness management C) Process Improvement Plan (PIP) D) Total quality system - A) CORRECT. Quality improvement (QI) consists of continuous self-review with the purpose of identifying aspects of the EMS system that require improvement, with subsequent action plans to make subsequent changes. B) INCORRECT. System effectiveness management does not refer to a program of evaluating and improving an EMS system. C) INCORRECT. A program or process for evaluating and improving the effectiveness of an EMS system is not referred to as a Process Improvement Program. D) INCORRECT. The term "total quality system" does not refer to a program for improving the effectiveness of EMS systems.
- Which of the following groups is credited with developing the earliest documented emergency medical service? A) The Spanish B) The Egyptians C) The Mayans D) The French - Explanation: A) INCORRECT. The Spanish did not develop the first documented emergency medical service; the French did in the 1700s. B) INCORRECT. Although known for progress in technical areas, the Egyptians were not responsible for the first documented emergency medical service. In 1790, the French first began transporting wounded soldiers away from battlefields and to waiting medical care. C) INCORRECT. The earliest documented emergency medical service was in France in 1790, nearly a thousand years after the Mayan civilization disappeared.
D) CORRECT. The earliest documented emergency medical service was in 1790 when the French began transporting wounded soldiers from the scenes of battle to waiting physicians.
- In 1966 the National Highway Safety Act charged which of the following agencies with the development of emergency medical service standards? A) U.S. Department of Transportation B) U.S. Department of the Interior C) U.S. Department of Health Services D) U.S. Department of Homeland Security - Explanation: A) CORRECT. In 1966 the National Highway Safety Act charged the United States Department of Transportation (DOT) with developing EMS standards and assisting the states to upgrade the quality of their prehospital emergency care. B) INCORRECT. The U.S. Department of the Interior is charged with the management and conservation of federal land and the country's natural resources. The Department of Transportation was charged with developing EMS standards. C) INCORRECT. Although the U.S. Department of Health and Human Services is charged with protecting the health of all Americans, the United States Department of Transportation was assigned the task of developing emergency medical service standards. D) INCORRECT. Although the U.S. Department of Homeland Security is tasked with protecting the nation from threats, it was established in 2002 and did not exist in 1966. It was the U.S. Department of Transportation that was charged with developing EMS standards.
- Centralized coordination of emergency medical access, transportation, and care most refers to which of the following? A) Emergency preparedness plan B) Trauma system C) Resource management D) Central deployment - Explanation: A) INCORRECT. Emergency preparedness plans are usually developed to guide the actions of a specific group of people at the outset of an emergency, with the goal of protecting people and/or property. They generally will not address the specifics of medical care or transport.
C) To have trained personnel understand the limitations of their training and "do no harm," while providing prompt transport to the hospital D) To have trained personnel knowledgeable in all aspects of prehospital care - Explanation: A) CORRECT. The modern Emergency Medical Services (EMS) system has been developed to get trained personnel to patients as quickly as possible and to provide emergency care on the scene, en route to the hospital, and at the hospital until care is assumed by the hospital staff. B) INCORRECT. In addition to having trained personnel able to help patients on scene, the modern Emergency Medical Services (EMS) system also aims to provide that same assistance while en route to the hospital and at the hospital until hospital staff can take over care. C) INCORRECT. Although understanding limitations and doing "no harm" are important aspects of an emergency care provider's job, the modern Emergency Medical Services (EMS) system was developed to get trained personnel to patients as quickly as possible and to provide emergency care on the scene, en route to the hospital, and at the hospital until care is assumed by the hospital staff. D) INCORRECT. Although knowledge is an important aspect of an emergency care provider's job, the modern Emergency Medical Services (EMS) system was specifically developed to get trained personnel to patients as quickly as possible and to provide emergency care on the scene, en route to the hospital, and at the hospital until care is assumed by the hospital staff.
- What has the modern emergency medical services (EMS) system been developed to provide? A) Prehospital care B) Prompt emergency response C) Safe emergency transportation D) Trained medical personnel - Explanation: A) CORRECT. In 1966 the National Highway Safety Act charged the United States Department of Transportation (DOT) with assisting the states in upgrading the quality of their prehospital emergency care. B) INCORRECT. Prompt responses are an important part of any EMS system, but not what they were specifically developed to provide. C) INCORRECT. Safe emergency transportation is only part of what modern EMS systems were developed for.
D) INCORRECT. Modern EMS systems were designed to provide more than just trained medical personnel.
- Which of the following is the most common gateway for hospital services for patients who need emergency medical assistance? A) Emergency department B) Emergency medical services system C) Surgical services department D) Emergency medical dispatch center - Explanation: A) CORRECT. The emergency department serves as the gateway for the rest of the services offered by a hospital. B) INCORRECT. The EMS system is not generally involved with hospital services other than the emergency department. C) INCORRECT. Although an important component of a hospital's services, not all emergency medical patients will require surgery. D) INCORRECT. An emergency medical dispatch center coordinates transports to the hospitals, but is not involved in determining or promoting specific hospital services.
- Which of the following BEST describes a communication system capable of identifying the number and location of the phone from which a caller is calling? A) Data display 911 B) Priority dispatch 911 C) Enhanced 911 D) Advanced 911 - Explanation: A) INCORRECT. Data display 911 does not refer to a system capable of identifying a caller's location. B) INCORRECT. Priority dispatch 911 would refer more to an internal communication center protocol than a system for displaying locations and phone numbers. C) CORRECT. An enhanced 911 system has the capability of automatically identifying the caller's phone number and location. D) INCORRECT. Advanced 911 is an emergency texting system rather than a system for locating callers.
A) Advanced EMT B) Paramedic C) Emergency Medical Responder D) EMT - Explanation: A) CORRECT. The Advanced EMT (AEMT) provides basic-level care and transportation as well as some advanced-level care, such as use of advanced airway devices, monitoring of blood glucose levels, and administration of some medications, which may include intravenous and intraosseous administration. B) INCORRECT. The Paramedic performs all of the skills of the EMT and AEMT plus advanced-level skills. The Paramedic provides the most advanced level of prehospital care. C) INCORRECT. The first level of EMS training (Emergency Medical Responder) is primarily focused on activating the EMS system and immediate care for life- threatening injuries. D) INCORRECT. EMTs provide basic-level medical and trauma care but cannot manage advanced airways or administer medications.
- What level of emergency medical training provides the most advanced pre- hospital care? A) Advanced EMT B) Emergency Medical Responder C) Emergency Medical Technician D) Paramedic - Explanation: A) INCORRECT. The AEMT provides basic-level care and transportation as well as some advanced-level care in the pre-hospital setting. B) INCORRECT. Emergency Medical Responders are trained to activate the EMS system, provide immediate care for life-threatening injuries, control the scene, and prepare for the arrival of the ambulance. C) INCORRECT. EMTs provide basic-level medical and trauma care and transportation to a medical facility. D) CORRECT. The Paramedic performs all of the skills of the EMT and AEMT plus advanced-level skills. The Paramedic provides the most advanced level of prehospital care.
- Which of the following is the primary responsibility of the EMT?
A) Protect and stabilize the patient B) Communicate with other responders on the scene C) Maintain personal health and safety D) Provide emergency care - Explanation: A) INCORRECT. Although protecting and stabilizing the patient is an important aspect of the EMT's job, maintaining personal health and safety first is the priority. B) INCORRECT. Communicating with other emergency responders is necessary for effective scene safety and coordination, but the first priority for any EMT is to ensure their own health and safety. C) CORRECT. It is not possible to help a patient if you are not physically capable or are injured while performing your job, so your first responsibility is to keep yourself healthy and safe. D) INCORRECT. Providing emergency care is the EMT's purpose, but maintaining her own personal health and safety is the EMT's primary responsibility.
- What BEST defines the evaluation of the patient's condition in order to provide emergency care? A) Patient access B) Patient assessment C) Medical intervention D) Patient advocacy - Explanation: A) INCORRECT. Patient access means getting to the patient's location. B) CORRECT. Patient assessment is used to find out enough about what is wrong with your patient to be able to provide the appropriate emergency care. C) INCORRECT. A medical intervention is the care provided once what is wrong with the patient has been determined. D) INCORRECT. Patient advocacy is speaking up for the patient.
- 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 of care. This process is known as which of the following? A) Transfer of care B) Breach of duty
B) INCORRECT. Law enforcement personnel can be an important part of scene safety, but they are not necessarily responsible for the safety of EMS crews. C) CORRECT. It is the responsibility of all EMS crew members to keep themselves, the patient(s), and bystanders safe. D) INCORRECT. The triage officer is not solely responsible for the on-scene safety of EMS providers.
- Which of the following BEST describes a person who speaks up on behalf of the patient and supports his cause? A) Guardian B) Assistant C) Advocate D) Representative - Explanation: A) INCORRECT. A guardian is generally someone who is legally responsible for a patient, whether or not they support or advocate for them. B) INCORRECT. A person who assists a patient with tasks may not necessarily speak up for the patient or support them in seeking better care. C) CORRECT. EMTs should be advocates for their patients, speaking up for them and supporting them in getting appropriate care. D) INCORRECT. The term "representative" does not indicate the same level of personal involvement in a patient's care and outcome as an "advocate" has. EMTs should always see themselves as advocates for their patients.
- To be compassionate and empathetic, to be accurate with interviews, and to inspire confidence are all examples of which of the personal traits of a quality EMT? A) Able to listen to others B) Pleasant C) Judgmental but fair D) Emotionally stable - Explanation: A) CORRECT. To be compassionate and empathetic, to be accurate with interviews, and to inspire confidence are examples of the ability to listen to others. B) INCORRECT. Inspiring confidence and helping to calm the sick and injured are examples of being pleasant.
C) INCORRECT. Being nonjudgmental and fair means treating all patients equally regardless of race, religion, or culture. D) INCORRECT. Emotional stability is the ability to overcome the unpleasant aspects of an emergency so that needed care may be rendered and any uneasy feelings that exist afterward may be resolved.
- Which of the following is a physical trait necessary for performing the duties of an EMT? A) Nonjudgmental and fair B) Ability to lift and carry 200 pounds C) Ability to speak clearly D) Ability to remain calm in stressful situations - Explanation: A) INCORRECT. Being nonjudgmental and fair are important personal attributes for an EMT to have, but they are not physical traits. B) INCORRECT. An EMT would not be expected to lift or carry over 125 pounds, so it would not be considered a necessary ability to carry 200 pounds. C) CORRECT. An important requirement of an EMT is to have the physical ability to give and receive oral and written instructions. D) INCORRECT. An EMT's ability to remain calm in stressful situations is a critical personal trait.
- Which of the following is a personality trait required of EMTs? A) Ability to lift and carry 125 pounds B) Awareness of problems with color vision C) Ability to dominate the patient D) Control of personal habits - Explanation: A) INCORRECT. A physical ability is not a personality trait. B) INCORRECT. Awareness of a physical problem, such as color vision, is not related to the qualities that make up a person's character. C) INCORRECT. Although the ability to dominate others may be considered a personality trait, it is not one required to be an EMT. D) CORRECT. To reduce the chances of providing improper care or causing patient discomfort, EMTs should be able to control their personal habits appropriately.
- Which of the following is a personal trait an EMT should demonstrate? A) Self-starter B) Strong student C) Strong communication D) Good eyesight - Explanation: A) CORRECT. One of the personal traits of an effective EMT is that of being a self-starter. B) INCORRECT. Being a strong student is a good quality, but personal traits relate to the behavior and demeanor of the EMT, not her strength in a particular task. C) INCORRECT. Strong communication is obviously important for an EMT, but it is the result of certain personal traits (respectful, able to listen, controlled in tone, etc.) — not a personal trait itself. D) INCORRECT. Good eyesight is a critical physical trait for an EMT to have.
- What is NOT one the common settings that an EMT may work in? A) Rural/wilderness settings B) Ambulance services C) Hospitals D) Fire departments - Explanation: A) INCORRECT. One common setting that EMTs work in is rural/wilderness settings. B) INCORRECT. One common setting that EMTs work in is ambulance services. C) CORRECT. EMTs do not work in a hospital. D) INCORRECT. One common setting that EMTs work in is fire departments.
- The National Registry of Emergency Medical Technicians (NREMT) was founded to establish which of the following? A) An education curriculum for EMT courses B) Quality oversight of emergency medical services practices C) National standards for emergency medical services personnel D) Quality improvement and quality assurance programs for emergency medical services - Explanation: A) INCORRECT. Although EMT course curricula are based on the standards provided by the NREMT, the National Registry was not founded to create them. B) INCORRECT. The NREMT created the standards used for modern EMS, but the organization does not oversee or determine the quality of provided services.
C) CORRECT. In 1970, the National Registry of Emergency Medical Technicians (NREMT) was founded to establish national standards within the industry. D) INCORRECT. The NREMT developed the professional standards for emergency care personnel, but is not involved in quality improvement or any assurance of the care provided.
- You have just come on duty. The EMT on the previous shift complains to you that the QI manager was 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 so important. What is the best answer you could give him? A) Vital signs are something you have to fill out because the state requires it. B) The recording of three sets of vital signs demonstrates that you were trending the patient's condition. C) It is important you show the QI manager that you are a team player. D) The report looks better when all the boxes are filled out. - Explanation: A) INCORRECT. The local or state governmental authority may or may not require three sets of vital signs; regardless, this should not be the primary reason to document them. B) CORRECT. Recording three sets of vital signs demonstrates that the EMT is reassessing the patient at the appropriate periodic intervals, which is important when providing care for a patient. C) INCORRECT. Teamwork is an important trait in an EMT, but is not the driving factor for recording vital signs. D) INCORRECT. QI is not concerned with how the report looks, but rather that the information in the report is complete and accurate.
- Why is it important for EMTs to participate in quality improvement programs? A) To ensure that individuals making false calls for EMS are prosecuted B) To identify problem employees and create a corrective action plan C) To identify problems and develop a plan to prevent their recurrence D) To ensure adequate personnel are available for emergencies - Explanation: A) INCORRECT. The aim of any EMS quality improvement program is to continually improve the care and operations within the system — not to identify challenges with particular individuals in the community. EMTs play a critical part
feedback from patients and the hospital staff, continuing your education, and which of the following? A) Writing protocols and standing orders B) Maintaining your equipment C) Providing quality care D) Being a member of the QI committee - Explanation: A) INCORRECT. The Medical Director is responsible for writing protocols and standing orders. B) CORRECT. Maintaining equipment properly is an important role the EMT plays in the quality improvement process. C) INCORRECT. Providing quality care is an expectation of all EMTs, but it not part of the quality improvement process. D) INCORRECT. Although it can be beneficial, being a member of the QI committee is not an expected role for an EMT in the quality improvement process.
- Which of the following is a role of the EMT in the quality improvement process? A) Taking responsibility for the actions of one's partner B) Writing complete patient care reports C) Critiquing performance of one's partner D) Assuring personal safety - Explanation: A) INCORRECT. The primary roles of an EMT in quality improvement include; preparing carefully written documentation, involvement in the system's quality improvement process, obtaining feedback from patients and hospital staff, maintaining equipment, and continuing education. Taking responsibility for the actions of others is not a part of the quality improvement process. B) CORRECT. Since much of an EMS system's clinical quality improvement data comes from patient care documentation, ensuring that each report is complete and accurate is a very important part of an EMT's involvement in quality improvement. C) INCORRECT. Critiquing the performance of other emergency responders is not a primary role for EMTs in the quality improvement process. An EMT can best assist the process by preparing carefully written documentation, being involved in the system's quality improvement process, obtaining feedback from patients and hospital staff, maintaining equipment, and continuing his education. D) INCORRECT. Although assuring personal safety is a very important responsibility for EMTs, it is not a role in the quality improvement process.
Continuing education, equipment maintenance, gathering feedback from patients and hospital staff, preparing complete and accurate patient documentation, and getting involved in the EMS system's structured quality improvement program are all examples of roles for the EMT in a QI process.
- Who assumes the ultimate responsibility for patient care rendered by the EMT? A) EMS supervisor B) EMT C) Director of quality assurance D) Medical Director - Explanation: A) INCORRECT. Although an EMS supervisor can be involved, the EMS service's Medical Director assumes ultimate responsibility for the care provided by an EMT. B) INCORRECT. Since every EMT operates under the license of the EMS service's Medical Director it is the Medical Director, not the EMT, who is ultimately responsible for the patient care. C) INCORRECT. In every EMS service or agency, the Medical Director is ultimately responsible for the patient care provided by the EMTs. D) CORRECT. The Medical Director of an EMS agency or service is ultimately responsible for all patient care because the EMTs work under the Medical Director's license.
- The application of oxygen for a patient who is short of breath without having to contact the physician in the emergency department is an example of which of the following? A) On-line medical direction B) Standards of care C) Standing orders D) Breach of duty - Explanation: A) INCORRECT. On-line medical directions are orders from an on-duty physician given by radio or phone. B) INCORRECT. Standards of care refer to the expected actions of an EMT as compared to a reasonable person with the same level of training and in the same situation. It is not related to the authorization of specific skills. C) CORRECT. Standing orders are physician issued policies or protocols that authorize EMTs to perform particular skills in certain situations.
D) CORRECT. A standing order is a policy or protocol issued by a Medical Director that authorizes EMTs and others to perform particular skills in certain situations. Page Ref: 13
- You and another new EMT are studying your local protocols. The other EMT notices that you may give oral glucose without utilizing on-line medical control, but you must get an on-line order from a physician before assisting a patient in taking his nitroglycerin for chest pain. The EMT asks you why some drugs require on-line medical control while others do not. What is the best answer to give him? A) Glucose is only sugar so it cannot hurt the patient. B) The physician does not trust EMTs. C) The patient's nitroglycerin might be expired. D) The physician wants to be sure it is appropriate for the patient. - Explanation: A) INCORRECT. Although glucose is sugar and relatively safe, it can be harmful if given to an unresponsive patient. But ultimately, this answer does not explain why not to give nitroglycerin without a physician's order. B) INCORRECT. The reason protocols are written is not because physicians do not trust EMTs; they are written because EMTs do not have the advanced training that physicians have. C) INCORRECT. Although medications may be expired, this does not require contacting medical control to confirm. D) CORRECT. Nitroglycerin, although indicated for most chest pain patients, is not appropriate for all cardiac patients. The physician, with his advanced training, is better suited to make that determination.
- You respond to a 35 - year-old male patient who fell 50 feet from a bluff. Your authority to provide emergency care is an extension of the Medical Director's license to practice medicine. You are acting as a(n) of the Medical Director. A) subordinate B) employee C) designated agent D) extension - Explanation: A) INCORRECT. Being a subordinate of the Medical Director does not provide any authority to provide emergency care.
B) INCORRECT. An EMS system's Medical Director does not directly employ EMTs, and simply being an employee does not provide the authority to providecare. C) CORRECT. An EMT at a basic or advanced level is operating as a designatedagent of the Medical Director. D) INCORRECT. An EMT does not provide care as an extension of the Medical Director.
- A fellow EMT is talking with the Medical Director at a staff meeting. The EMT states that the neighboring 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 they work ten times better. The EMT wants the Medical Director to approve the bandages for use in their ambulances. The Medical Director responds to the EMT by saying he will not approve the bandages until he can prove they are worth the additional cost. How can the EMT best prove the worth of the special bandages? A) Have a member of the other ambulance service call the Medical Director to provide firsthand information on how the special bandages are much better. B) Call the manufacturer of the special bandage and request literature to give to the Medical Director. C) Perform a literature search to see what studies have been done on the special bandages and report the findings to the Medical Director. D) Order a small number of the special bandages and compare them side-by-side to the regular bandages. - Explanation: A) INCORRECT. Firsthand accounts or anecdotal information do not provide any actual scientific proof that the special bandages are superior. B) INCORRECT. Literature from the manufacturer is designed to sell the bandages and will only present the positives of the bandages without any negative information. C) CORRECT. Finding objective, unbiased, evidence-based research that validates the claims of the special bandage is the only way to actually prove that the special bandages are superior. D) INCORRECT. Product testing of the bandages is a good idea to determine how the bandages will work for that particular service, but does not provide proof that they are actually better.
