Chapter 3-2 - Medical, Legal, and Ethical Issues (Test Questions)

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Critical Thinking

Question Answer
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...
     A.) ensure that he is aware of the risks of refusing medical care.
     B.) err in the best interest of the patient and transport him at once.
     C.) have him sign a refusal of care form and then return to service.
     D.) tell him that he is having a heart attack and needs medical care.
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 child’s parents will be at the scene in approximately 15 minutes. What should you do?
     A.) Transport the child immediately and have the parents meet you at the hospital.
     B.) Treat the child at the scene and wait for the parents to arrive and give consent.
     C.) Begin transport at once and have the parents meet you en route to the hospital.
     D.) Withhold treatment until the parents arrive and give you consent for treatment.
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 patient’s 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.
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.
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 patient’s 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 patient’s mental condition is impaired.
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.
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 child’s 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.
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 patient’s 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 patient’s 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 patient’s privacy because you should have only discussed the information with the EMTs who provided it.
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 patient’s wishes and withhold all treatment.
     C.) transport the patient without providing any treatment.
     D.) decide on further action once the DNR order is produced.
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.
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.
You have been tasked by your medical director to assist in the development of your EMS agency’s 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.
When caring for a 65-year-old male with respiratory distress, you place him in a comfortable position but do not apply oxygen. The patient’s 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.
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.
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.
Two EMTs witnessed a call in which a coworker gave adequate medical care but ignored the patient’s 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 coworker’s 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.
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.
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.
In many states, a minor may be treated as an adult for the purpose of consenting to or refusing medical treatment if the minor...
     A.) possesses a valid driver’s license.
     B.) is mentally competent and able to refuse.
     C.) has a poor relationship with his or her parents.
     D.) is self-supporting and lives by him- or herself.
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

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