Mosby's Paramedic Textbook, 3rd Edition

Test Bank

Chapter 1: Emergency Medical Services Systems: Roles and Responsibilities

MULTIPLE CHOICE

	1.	A network of services coordinated to provide aid and medical assistance from primary response to definitive care is referred to as which of the following?
A.	EMS system	
B.	Health maintenance organization	
C.	Advanced life support	
D.	Medical transportation system	

ANS:	A	REF:	7	OBJ:	1-1.1

	2.	Which of the following terms refers to a process by which an authority grants permission to engage in an activity that would otherwise be unlawful?
A.	Licensure	
B.	Certification	
C.	Registration	
D.	Professionalism	

ANS:	A	REF:	11	OBJ:	1-1.1

	3.	Which of the following terms refers to the process by which a competent authority provides a document verifying that the individual has met predetermined qualifications to participate in an activity?
A.	Licensure	
B.	Certification	
C.	Registration	
D.	Professionalism	

ANS:	B	REF:	11	OBJ:	1-1.1

	4.	The act of placing one's name in a book of record is referred to as which of the following?

A.	Licensure	
B.	Registration	
C.	Certification	
D.	Professionalism	

ANS:	B	REF:	11	OBJ:	1-1.1

	5.	Which of the following contributes to the existence of a profession?
A.	Four-year degree from a college or university	
B.	Membership in an organization promoting the profession	
C.	Specialized body of knowledge	
D.	High salary expectations for members of the profession	

ANS:	C	REF:	11	OBJ:	1-1.1

	6.	Which of the following most accurately describes the term professionalism?
A.	Adherence to standards of conduct	
B.	Charge for services rendered	
C.	Uniform standards of appearance	
D.	Public trust in the individual	

ANS:	A	REF:	11	OBJ:	1-1.1, 1-1.17		

	7.	A medical director reviewing written EMS care paperwork is completing what kind of review?
A.	Retrospective review	
B.	Concurrent review	
C.	Peer review	
D.	Mortality review	

ANS:	A	REF:	16	OBJ:	1-1.23, 1-1.24		

	8.	The practice of physician participation in education, equipment selection, and development of protocols for EMS systems is best described by which of the following terms?
A.	Medical direction	
B.	Physician extension	
C.	Administrative interface	
D.	Medical conscience	

ANS:	A	REF:	15	OBJ:	1-1.23, 1-1.24		

	9.	Which of the following terms refers to guidelines that define the scope of prehospital intervention practiced by emergency care providers?
A.	Treatment protocols	
B.	Standing orders	
C.	Off-line medical control	
D.	Standard operating procedures	

ANS:	A	REF:	15	OBJ:	1-1.1

	10.	Which of the following documents called for the preparation of nationally acceptable texts and courses of instruction for rescue squads, police, and ambulance personnel in 1966?
A.	Accidental Death and Disability: The Neglected Disease of Modern Society	
B.	Emergency Medical Services Agenda for the Future	
C.	Emergency Medical Services Systems Act	
D.	Public Safety Officers’ Act	

ANS:	A	REF:	4	OBJ:	1-1.2

	11.	During which of the following time frames were the most funds distributed by the federal government to assist regional EMS system development?
A.	1950-1966	
B.	1968-1981	
C.	1983-1991	
D.	1995-2000	

ANS:	B	REF:	5	OBJ:	1-1.2

	12.	Which of the following is an attribute of an EMS system identified by the Emergency Medical Services Agenda for the Future?
A.	Nationally standardized treatment protocols	
B.	Prevention activities	
C.	Provision of advanced life support	
D.	Capitated finance structures	

ANS:	B	REF:	6	OBJ:	1-1.14

	13.	Which of the following is a national organization that verifies competency for EMTs and paramedics by preparing and conducting examinations?
A.	NREMT	
B.	NAEMT	
C.	NHTSA	
D.	NAEMSP	

ANS:	A	REF:	10	OBJ:	1-1.3, 1-1.11		

	14.	Which of the following is the federal agency with jurisdiction over emergency medical services systems?
A.	NREMT	
B.	NAEMT	
C.	NHTSA	
D.	NAEMSP	

ANS:	C	REF:	4	OBJ:	1-1.3, 1-1.13		

	15.	Which of the following characteristics differentiates EMT-paramedics from other recognized levels of EMS training?
A.	Advanced training in emergency vehicle operations	
B.	Advanced training in pediatrics	
C.	Advanced training in drug therapy	
D.	Advanced training in special-needs populations	

ANS:	C	REF:	10	OBJ:	1-1.4

	16.	Which of the following best describes the paramedic when he or she is acting as a health care professional?
A.	Judges patients based on personal experiences	
B.	Works well with one of four teammates	
C.	Unconcerned with personal hygiene	
D.	Displays honesty in all actions	

ANS:	D	REF:	13	OBJ:	1-1.5, 1-1.15, 1-1.16, 1-1.17

	17.	Attending continuing education sessions demonstrates which of the following characteristics of the paramedic as a health care professional?
A.	Empathy	
B.	Time management	
C.	Self-motivation	
D.	Patient advocacy	

ANS:	C	REF:	13	OBJ:	1-1.9, 1-1.16		

	18.	Which of the following is provided by national EMS groups?
A.	Collective bargaining	
B.	A unified voice for EMS providers	
C.	Continuous Quality Improvement (CQI) for EMS providers	
D.	Development of national standard curricula	

ANS:	B	REF:	10	OBJ:	1-1.3, 1-1.11		

	19.	Which of the following best describes the role of the National Registry of EMTs?
A.	Collective bargaining	
B.	A unified voice for EMS providers	
C.	Verification of the competency of EMS providers	
D.	Development of national standard curricula	

ANS:	C	REF:	10	OBJ:	1-1.3, 1-1.11		

	20.	National standard curricula for EMS providers are established by which of the following agencies?
A.	Federal Emergency Management Agency	
B.	Occupational Safety and Health Administration	
C.	National Highway Traffic Safety Administration	
D.	Department of Health and Human Services	

ANS:	C	REF:	11	OBJ:	1-1.13

	21.	Which of the following is considered to be a component of the EMS system, according to NTHSA’s Ten System Elements?
A.	Private physicians’ offices	
B.	Long-term care facilities	
C.	Community colleges	
D.	Trauma centers	

ANS:	D	REF:	8	OBJ:	1-1.14

	22.	Which of the following behaviors would demonstrate the professional attribute of integrity?
A.	Accurately documenting a medication error performed by a partner	
B.	Omitting references in the medical records to cocaine use on a chest pain call for a popular local leader	
C.	Assisting a colleague in hiding a mistake that did not affect patient care	
D.	Intentionally misplacing a run report for a patient who cannot afford the bill	

ANS:	A	REF:	13	OBJ:	1-1.15, 1-1.16, 1-1.17	

	23.	A paramedic makes special efforts to keep family members apprised of progress during a cardiac arrest. This demonstrates which of the following characteristics?
A.	Self-motivation	
B.	Empathy	
C.	Careful delivery of service	
D.	Respect	

ANS:	B	REF:	13	OBJ:	1-1.15, 1-1.16, 1-1.17	

	24.	Which of the following behaviors by a paramedic is the best example of self-motivation?
A.	Trusting personal judgments	
B.	Listening actively and accurately	
C.	Accepting constructive criticism	
D.	Ensuring that uniforms are clean	

ANS:	C	REF:	13	OBJ:	1-1.15, 1-1.16, 1-1.17	

	25.	Which of the following actions by a paramedic best demonstrates the characteristic of personal hygiene?
A.	Maintaining hair length above the collar	
B.	Ensuring that uniforms are clean	
C.	Avoiding dangling earrings while on duty	
D.	Wearing gloves while performing patient care	

ANS:	B	REF:	13	OBJ:	1-1.15, 1-1.16, 1-1.17	

	26.	Which of the following behaviors by a paramedic demonstrates self-confidence?
A.	Completing assessment and treatment plans without consulting a partner	
B.	Not needing to confirm drug dosages prior to administration of any medication	
C.	Insisting on on-line medical control for clearly indicated standing orders	
D.	Trusting personal judgment on the need for endotracheal intubation	

ANS:	D	REF:	13	OBJ:	1-1.15, 1-1.16, 1-1.17	

	27.	Encouraging citizens’ involvement in the EMS system achieves which of the following goals?
A.	Creating informed and independent advocates	
B.	Encouraging the use of emergency resources for routine care	
C.	Allowing for more effective disaster response	
D.	Increasing positive media coverage	

ANS:	A	REF:	14	OBJ:	1-1.19, 1-1.20		

	28.	Which of the following is the least likely benefit of paramedics’ teaching in the community?
A.	Improved integration with other public safety agencies	
B.	Improved community health	
C.	Improved community awareness of EMS	
D.	Improved reimbursement	

ANS:	D	REF:	14	OBJ:	1-1.19

	29.	A paramedic participates in a study in which all patients over the age of 55 are asked if they take an aspirin daily. This type of research is called:
A.	Descriptive research	
B.	Experimental research	
C.	Retrospective research	
D.	Manipulative research	

ANS:	A	REF:	17	OBJ:	1-1.36

	30.	Which of the following is generally required for publication in a peer-reviewed journal?
A.	Publication of results by a national news organization	
B.	Reporting of all findings using the Utstein style	
C.	Evaluation by an institutional review board	
D.	Inclusion of at least 100 patients	

ANS:	C	REF:	19	OBJ:	1-1.36, 1-1.37		

	31.	Which of the following would indicate that a research project was carried out in an ethical manner?
A.	Publication of results by a national news organization	
B.	Publication of findings in an EMS trade magazine	
C.	Evaluation by an institutional review board	
D.	Review by a program advisory board	

ANS:	C	REF:	19	OBJ:	1-1.36, 1-1.37		

	32.	Which of the following research design characteristics would be used to help prevent selection bias?
A.	Randomization of subjects	
B.	Cross sectional design	
C.	Quantitative analysis	
D.	Prospective data collection	

ANS:	A	REF:	17	OBJ:	1-1.36, 1-1.37		

	33.	Which of the following research design characteristic carries the highest risk of participant bias?
A.	Single-blinded	
B.	Double-blinded	
C.	Triple-blinded	
D.	Unblinded	

ANS:	D	REF:	18	OBJ:	1-1.36, 1-1.37		

	34.	An EMS system is considering a new medication for inclusion in its protocols. The medication is tested for the next 3 months and then its benefits are evaluated. What type of research is being conducted?
A.	Observational	
B.	Prospective	
C.	Retrospective	
D.	Descriptive	

ANS:	B	REF:	17	OBJ:	1-1.18, 1-1.34, 1-1.36, 1-1.37

	35.	A paramedic is in a study in which he or she gives a patient a coded vial of medication but doesn’t know what medication is being given. The patient is also unaware of which medication is being administered. This type of study is called:
A.	Secrecy of administration	
B.	Double-blinded	
C.	Patient-concealing	
D.	Covered medication	

ANS:	B	REF:	18	OBJ:	1-1.36, 1-1.37		

	36.	An EMS system is participating in a study of a new treatment for chest pain. Which type of consent is likely to be employed in this study?
A.	Informed consent	
B.	Cohort consent	
C.	Consent at a distance	
D.	Surrogate consent	

ANS:	A	REF:	17	OBJ:	1-1.36

	37.	A paramedic is placing the needs of the patient before his or her self-interest is displaying:
A.	Empathy	
B.	Self-confidence	
C.	Patient advocacy	
D.	Integrity	

ANS:	C	REF:	13	OBJ:	1-1.15, 1-1.16		

	38.	A continuous quality improvement (CQI) project aims to standardize the care of patients with chest pain while integrating the care in the prehospital environment with emergency department care. Which focus area of CQI best describes this project?
A.	Satisfaction of patients	
B.	Information and analysis	
C.	Process management	
D.	EMS system results	

ANS:	C	REF:	16	OBJ:	1-1.29, 1-1.30		

	39.	Quality assurance (QA) differs from continuous quality improvement (CQI) in that CQI:
A.	Identifies deviations from a standard and makes corrections	
B.	Is less rigid and considers many factors	
C.	Focuses on punitive action	
D.	Focuses on the individual and not on the system	

ANS:	B	REF:	16	OBJ:	1-1.29

	40.	Which of the following would be the least valuable component of a continuous quality improvement (CQI) program?
A.	Comparison of individual paramedic IV success rates	
B.	Chart reviews of all cardiac-arrest-patient care records	
C.	Patient satisfaction surveys	
D.	New procedures for airway management	

ANS:	A	REF:	16	OBJ:	1-1.29

	41.	The treatment protocols for an EMS system require consultation with a physician at the base hospital prior to the administration of certain medications. This requirement is an example of:
A.	On-line medical direction	
B.	On-scene medical direction	
C.	Standing orders	
D.	Retrospective off-line medical direction	

ANS:	A	REF:	15	OBJ:	1-1.29

	42.	On-line medical direction provides which of the following benefits?
A.	Patient-specific care	
B.	Standardized care	
C.	Delayed CQI	
D.	System-wide perspective	

ANS:	A	REF:	15	OBJ:	1-1.24

	43.	Off-line medical direction provides which of the following benefits?
A.	Patient-specific care	
B.	Individual attention to the strengths of a particular paramedic	
C.	Standardized care	
D.	Allowance for unique circumstances	

ANS:	C	REF:	15	OBJ:	1-1.24

	44.	A paramedic is called to a physician’s office to provide care and transport to a patient suffering extreme respiratory distress. The patient's personal physician is present. Which of the following would be the most appropriate choice of action by the paramedic?
A.	Follow orders from the patient's personal physician	
B.	Refuse to provide care outside of established treatment protocols	
C.	Combine the patient’s physician’s orders with established protocols	
D.	Immediately transport and provide care en route	

ANS:	B	REF:	15	OBJ:	1-1.28

	45.	Participation in the development of which of the following policies would be the most appropriate role for a physician medical director?
A.	Disciplinary	
B.	Personnel selection	
C.	Billing	
D.	Vehicle operation	

ANS:	B	REF:	15	OBJ:	1-1.23, 1-1.24		

	46.	Which of the following responsibilities would be considered a primary responsibility of the paramedic?
A.	Documentation	
B.	Advocating citizen involvement	
C.	Support of primary care	
D.	Professional development	

ANS:	A	REF:	14	OBJ:	1-1.22

	47.	A paramedic is assisting the medical director with the development of a new treatment protocol. The medical director asks the paramedic to conduct an observational study of the treatment protocol. Which of the following courses of action would be closest to the expectations of the medical director?
A.	Survey other EMS systems and describe the protocols used by each	
B.	Pilot the new protocol and assess outcome before and after the change	
C.	Divide crews into two groups, one using the new protocol and one using the old protocol, and compare the outcomes of the groups	
D.	Change the protocol in incremental steps, assessing the impact of each incremental change	

ANS:	A	REF:	17	OBJ:	1-1.34, 1-1.36, 1-1.37	

	48.	A paramedic is asked to review a research paper. If the paramedic were interested in assessing the process used to select and randomize patients during the trial, which section of the paper would most likely contain relevant information?
A.	Abstract	
B.	Methods	
C.	Conclusions	
D.	Discussion	

ANS:	B	REF:	20	OBJ:	1-1.36

	49.	A paramedic participating in a research experiment contacts medical direction to allow the physician to administer informed consent to the subject. This type of consent is called:
A.	Stepped consent	
B.	Consent at a distance	
C.	Cohort consent	
D.	Implied consent	

ANS:	B	REF:	19	OBJ:	1-1.35, 1-1.36		

	50.	During which of the following situations is professional conduct not expected of the paramedic?
A.	On a response, driving an ambulance to the scene of an emergency	
B.	At a duty station, not currently assigned to a unit responsible for coverage	
C.	Off duty and not readily identifiable as a paramedic	
D.	Professionalism is expected during all situations	

ANS:	D	REF:	12	OBJ:	1-1.15