Chapter 45 Patients With Special Challenges Flashcards Preview

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Flashcards in Chapter 45 Patients With Special Challenges Deck (91)
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1

1. When determining the optimal method to communicate with, assess, treat, and transport a patient with a special health care challenge, the paramedic should:
A) routinely call medical control before talking to a caregiver.
B) demonstrate confidence and enlist the expertise of the patient.
C) recall that caregivers are often upset and therefore unreliable.
D) remain professional and obtain initial information from a caregiver.

Ans: B
Page: 2122
Type: General Knowledge

2

2. Approximately 70% of all child abuse or neglect cases involve:
A) females over 8 years of age.
B) an otherwise healthy child.
C) males under 6 years of age.
D) substance abuse by the perpetrator

Ans: D
Page: 2124
Type: General Knowledge

3

3. Which of the following patient populations is at GREATEST risk for abuse or neglect?
A) Females between 6 and 12 years of age
B) Children with chronic medical conditions
C) Adolescents who rebel against their parents
D) Males between 2 and 14 years of age

Ans: B
Page: 2124
Type: General Knowledge

4

4. Which of the following types of maltreatment is perhaps the MOST common?
A) Neglect
B) Physical abuse
C) Sexual abuse
D) Abandonment

Ans: A
Page: 2124
Type: General Knowledge

5

5. Which of the following types of maltreatment involves isolating the victim from others, resulting in a substantial change in the victim's behavior or cognitive function?
A) Neglect
B) Abandonment
C) Emotional abuse
D) Sexual exploitation

Ans: C
Page: 2124
Type: General Knowledge

6

6. A man leaves his 4-year-old child home alone while he plays golf with his friends. This is an example of:
A) assault.
B) neglect.
C) abandonment.
D) emotional abuse.

Ans: C
Page: 2125
Type: General Knowledge

7

7. Which of the following behaviors or actions should make you the MOST suspicious that a caregiver has abused his or her child?
A) Asking other siblings to leave the room while the child is examined
B) Demanding that you take the child to the hospital as soon as possible
C) Difficulty recalling the last time the child was seen by a physician
D) Offering unsolicited explanations for abnormal physical exam findings

Ans: D
Page: 2125
Type: General Knowledge

8

8. Which of the following injury patterns is MOST suggestive of child abuse?
A) Burns with splash marks
B) Bruises on the abdomen
C) Bruises on the lower leg
D) Laceration to the chin

Ans: B
Page: 2125
Type: General Knowledge

9

9. Difficulty walking or sitting, nightmares, and bedwetting are MOST suggestive of:
A) neglect.
B) sexual abuse.
C) physical abuse.
D) emotional abuse.

Ans: B
Page: 2126
Type: General Knowledge

10

10. Which of the following statements regarding Mongolian spots is correct?
A) They resemble bruises and are found most commonly on the back and buttocks.
B) They are abnormal bruising patterns on the back and are an indicator of abuse.
C) They indicate abnormal bleeding and are associated with a high mortality rate.
D) They are bruiselike patterns that most often appear in severely premature infants.

Ans: A
Page: 2126-2127
Type: General Knowledge

11

11. You are assessing a 6-year-old Asian child who presents with a fever. During your assessment, you note red, flat, rounded lesions on the child's torso. This finding is MOST indicative of:
A) cupping.
B) coining.
C) physical abuse.
D) phytophotodermatitis.

Ans: A
Page: 2127
Type: General Knowledge

12

12. During your assessment of a 4-year-old female, you find injury patterns that are highly suggestive of abuse. The child's mother is present; she is apprehensive and is hesitant to allow you to transport her daughter. Your MOST appropriate action should be to:
A) ask the mother to leave the room so that you can ask the girl if the injuries that she has were intentionally inflicted by someone else.
B) advise the mother that the child's injuries are inconsistent with accidental trauma and let her know that the child needs to be transported.
C) ask your partner to retrieve an extra set of latex-free gloves from the ambulance, as this will enable him or her to discreetly call the police.
D) act as though you are not suspicious, but call the child's father and inquire about the relationship between the child and her mother.

Ans: C
Page: 2127
Type: Critical Thinking

13

13. When caring for a patient with suspected abuse or neglect, your FIRST priority should be to:
A) summon law enforcement personnel to the scene.
B) provide an immediate assessment of the patient.
C) remove the patient from the abusive environment.
D) take deliberate action to ensure your own safety.

Ans: D
Page: 2127-2128
Type: General Knowledge

14

14. Your assessment of an elderly man gives you reason to suspect that he has been abused. The patient does not appear to have any life-threatening injuries. His son, who is the only family member present at the scene, asks you if he can accompany his father in the back of the ambulance during transport. You should:
A) ask the son why he wants to accompany his father in the ambulance.
B) allow the son to accompany his father in the back of the ambulance.
C) advise the son to follow the ambulance in his own personal vehicle.
D) remain at the scene until law enforcement arrives and questions the son.

Ans: B
Page: 2128
Type: Critical Thinking

15

15. Which of the following statements would be appropriate when documenting a case of suspected abuse?
A) “The patient's injury is not consistent with an accident.”
B) “The injury was reported to have occurred at 1420 hours.”
C) “The abdominal exam of the patient was within normal limits.”
D) “There was a gross discrepancy between the caregivers' stories.”

Ans: B
Page: 2128-2129
Type: General Knowledge

16

16. A terminal illness is MOST accurately defined as a(n):
A) disease process that is expected to cause death within 6 months, verified by a physician.
B) disease that will ultimately cause death due to a lack of effective medical treatment.
C) disease that is fatal in greater than 50% of a given population, even with timely treatment.
D) disease process that will ultimately require ongoing treatment in order to prevent death.

Ans: A
Page: 2129
Type: General Knowledge

17

17. Some patients with a terminal illness will continue aggressive medical treatment, hoping for a statistically improbable recovery or attempting to prolong life as much as possible. This is called:
A) hospice care.
B) curative care.
C) palliative care.
D) investigational care.

Ans: B
Page: 2129
Type: General Knowledge

18

18. When a patient is receiving palliative care, medical care:
A) ceases, and the disease process is allowed to continue until the point of death.
B) ceases, and efforts focus on relieving pain until the point at which the patient dies.
C) continues, although aggressive, invasive, and uncomfortable interventions cease.
D) continues, and only minimally invasive procedures are performed to prolong life.

Ans: C
Page: 2130
Type: General Knowledge

19

19. Which of the following are often the primary tasks for paramedics who are caring for a patient with a terminal illness?
A) Airway care and thermal management
B) ECG monitoring and antidysrhythmic therapy
C) Antibiotic and antipyretic therapy
D) Pain assessment and management

Ans: D
Page: 2130
Type: General Knowledge

20

20. The purpose of hospice care is to:
A) render quality care to patients with a debilitating but temporary disease.
B) provide quality end-of-life care through pain and symptom management.
C) restore a person to his or her maximum physical and emotional potential.
D) render around-the-clock intensive care to prevent cardiopulmonary arrest.

Ans: B
Page: 2130
Type: General Knowledge

21

21. Morbid obesity is defined as a body mass index that is:
A) greater than 30 kg/m2.
B) between 30 and 39.9 kg/m2.
C) between 40 and 49.9 kg/m2.
D) greater than 50 kg/m2.

Ans: C
Page: 2130
Type: General Knowledge

22

22. Which of the following would be considered a primary cause of obesity?
A) Lack of exercise
B) Hormonal changes
C) Genetic predisposition
D) Low basal metabolic rate

Ans: A
Page: 2131
Type: General Knowledge

23

23. Which of the following factors complicates airway management in an obese patient?
A) Larger upper airway
B) Limited neck mobility
C) Smaller patient head size
D) Proportionately small tongue

Ans: B
Page: 2131
Type: General Knowledge

24

24. Bag-mask ventilation of the obese patient would MOST likely be ineffective when the patient is:
A) supine.
B) apneic.
C) semisitting.
D) in reverse Trendelenburg.

Ans: A
Page: 2131
Type: General Knowledge

25

25. Assumptions by the paramedic based on stereotypes of a particular communicable disease:
A) will maximize the paramedic's safety.
B) are a violation of the patient's privacy.
C) will expose the paramedic to legal action.
D) serve only to undermine patient care efforts.

Ans: D
Page: 2132
Type: General Knowledge

26

26. Adult patients who have a tracheostomy tube in place and are ventilator-dependent should receive:
A) cool, dry air through the ventilator circuit.
B) deep tracheal suctioning every other day.
C) humidification and heating of inspired air.
D) ventilation at a rate of 20 to 24 breaths/min.

Ans: C
Page: 2132-2133
Type: General Knowledge

27

27. The inner cannula of a tracheostomy tube:
A) should be equipped with a cuff if used in pediatric patients.
B) has a 15-mm port that can be attached to a ventilator circuit.
C) is the larger tube that passes directly into the patient's trachea.
D) should only be removed during tracheostomy tube replacement

Ans: B
Page: 2133
Type: General Knowledge

28

28. A fenestrated tracheostomy tube:
A) should be used for patients who require constant support from a ventilator.
B) is not equipped with an inflatable cuff and is secured in place with sutures.
C) allows the patient to speak, breathe, or clear secretions from the upper airway.
D) requires a special adapter in order to be compatible with a ventilation device.

Ans: C
Page: 2133
Type: General Knowledge

29

29. Which of the following interventions is especially important when caring for a patient with a tracheostomy tube?
A) Suctioning
B) Mask ventilation
C) Hyperventilation
D) Head positioning

Ans: A
Page: 2132-2133
Type: General Knowledge

30

30. When suctioning and cleaning the tracheostomy of a ventilator-dependent patient, it is MOST important to:
A) keep the patient well oxygenated.
B) have a new tube readily available.
C) suction for no longer than 5 seconds.
D) soak the inner cannula in sterile water.

Ans: A
Page: 2134-2135
Type: General Knowledge