Test Bank - Prehospital Emergency Care,
11th Edition (Mistovich, 2018),
Chapter 1-46
,Prehospital Emergency Care, 11e (Mistovich et al.)
Chapter 1 Emergency Care Systems, Research, and Public Health
1) What is a primary purpose of the modern-day EMS system?
A) Provide a means of transport to and from the hospital
B) Ensure that all members of society have equal access to hospitals
C) Decrease the incidence of death and disability related to injury and illness
D) Provide emergency health care services to medically underserved areas
Answer: C
Diff: 2 Page Ref: 7
Objective: 1-2
2) Most authorities agree that the modern-day EMS system evolved after the release of which
document?
A) The Emergency Medical Services Act of 1973
B) The white paper "Accidental Death and Disability: The Neglected Disease of Modern
Society" in 1966
C) The American Heart Association's Guidelines for Cardiac Resuscitation
D) Emergency Medical Services: Agenda for the Future, in 1996
Answer: B
Diff: 1 Page Ref: 3
Objective: 1-2
3) An Emergency Medical Responder comes to you and states that he would like to work for
your emergency ambulance service on a full-time basis. Knowing the National EMS Scope of
Practice Model, you inform him of which element?
A) He will be able to take care of only patients with non-life-threatening complaints
B) He will first need approval from your ambulance service's medical director
C) He will be able to work only with an Advanced EMT or paramedic
D) He will first have to become an Emergency Medical Technician
Answer: D
Diff: 1 Page Ref: 6-7
Objective: 1-1
4) As defined by the National EMS Scope of Practice Model, the four levels of EMS
practitioners include:
A) Ambulance drivers
B) EMS medical director
C) Paramedics
D) Emergency medical dispatchers
Answer: C
Diff: 1 Page Ref: 6-7
Objective: 1-3
,5) An Emergency Medical Responder (EMR) approaches you and states that he is interested in
becoming an EMT. Specifically, he asks what he will be able to do as an EMT that he cannot
presently do as an EMR. You respond by saying he will be able to:
A) Administer some medications
B) Assist in emergency childbirth
C) Use an automated external defibrillator
D) Obtain vital signs
Answer: A
Diff: 1 Page Ref: 6-7
Objective: 1-5
6) You have been dispatched for a 61-year-old female in cardiac arrest. Emergency Medical
Responders (EMRs) are on scene. In your community, all EMS practitioners are trained
according to the National EMS Scope of Practice Model. Given this, which type of care do you
expect the EMRs to be providing?
A) Emergency medication administration
B) Automated external defibrillation
C) Intravenous therapy
D) Reading an electrocardiogram
Answer: B
Diff: 2 Page Ref: 6
Objective: 1-5
7) An EMT with your service states that she desires to become a paramedic because she wants to
provide advanced care. Under the National EMS Scope of Practice Model, which one of these
types of care will she be able to provide as a paramedic that she cannot provide as an EMT?
A) Automated blood pressure monitoring
B) Assistance with emergency childbirth
C) Interfacility transports
D) IV therapy
Answer: D
Diff: 1 Page Ref: 7
Objective: 1-5
8) Which statement made by an EMT requires immediate intervention by a superior or the
service supervisor?
A) "I always wear my seat belt whenever I am in the patient compartment of the ambulance,
unless I have to remove it to care for a patient."
B) "I drive as fast as I can to get to the scene of an emergency, especially if a child is sick or
injured according to dispatch information."
C) "When I am driving with lights and sirens, I instruct my partner that he will need to handle all
radio communications."
D) "I put exam gloves on for every patient I contact, even if he or she does not have a known or
suspected infectious disease."
Answer: B
Diff: 1 Page Ref: 9
Objective: 1-7
,9) Which statement shows that the EMT has a good understanding of her role and
responsibilities related to being an EMT?
A) "The patient's needs come before anyone else's needs."
B) "At the scene of an emergency, my responsibility is to get to the patient no matter what."
C) "My safety comes first, and then the patient's safety."
D) "As an EMT, I recognize that the public's safety comes before the safety of me or my
partner."
Answer: C
Diff: 2 Page Ref: 8-9
Objective: 1-7
10) An ambulance with two EMTs arrives in front of a house for an unknown medical
emergency. On scene, bystanders report that a female patient was beaten by her husband in the
driveway and then dragged back into the house. They state that the patient appeared unconscious
and was bleeding from the head. Which action would the EMTs perform next?
A) Do not enter the scene until it has been controlled by law enforcement
B) Quietly enter the home and quickly move the patient to the ambulance
C) Remove the husband from the house, then provide emergency care to the wife
D) Enter the home to protect the patient while waiting for the police to arrive
Answer: A
Diff: 2 Page Ref: 9
Objective: 1-7
11) Why is EMS in a unique position to contribute significantly to mobile integrated health care?
A) EMS providers are familiar with and capable of functioning in the out-of-hospital
environment
B) Ambulances are easily identified
C) The community trusts uniformed health care providers
D) EMS providers are familiar with the many routes of medication administration
Answer: A
Diff: 1 Page Ref: 17
Objective: 1-15
,12) You have arrived on the scene of a motor vehicle collision. A car has gone off the road and
into a utility pole. The pole is broken and wires are hanging just above the car. You do not see
any sparking or arcing of the wires. The driver of the car is slumped over the steering wheel and
not moving. Several bystanders around the car are yelling for you to help. Which steps represent
the correct order of your response?
A) Clear the bystanders, allow the fire department to secure the wires, access the patient,
extricate the patient, transport
B) Access the patient, clear the bystanders, allow the fire department to secure the wires,
extricate the patient, transport
C) Clear the bystanders, access the patient, extricate the patient, transport, allow the fire
department to secure the wires
D) Access the patient, allow the fire department to secure the wires, clear the bystanders,
extricate the patient, transport
Answer: A
Diff: 2 Page Ref: 8-9
Objective: 1-7
13) Once a scene is free of safety hazards, the EMT must recognize and focus on the needs of
the:
A) Rescuers
B) Patient
C) Family
D) Bystanders
Answer: B
Diff: 1 Page Ref: 9
Objective: 1-7
14) You have been asked to sit on your service's quality improvement (QI) committee. As a
knowledgeable EMT, you recognize that in this role you will be involved in projects that are
primarily designed to:
A) Communicate with insurance companies for increased reimbursement
B) Recruit and educate EMTs about the Emergency Medical Services profession
C) Develop ways in which the delivery of emergency care can be improved
D) Identify and reeducate EMTs who routinely do not provide proper care
Answer: C
Diff: 2 Page Ref: 13
Objective: 1-10
15) What would be a logical project to be undertaken and developed by a quality improvement
(QI) committee?
A) Termination of EMTs who are chronically late to work
B) A program by which pay raises are based on performance and attitude
C) Community fundraiser to raise money for new EMS equipment
D) Monthly continuing education programs in which seldom-used skills are practiced
Answer: D
Diff: 2 Page Ref: 14
Objective: 1-10
,16) You are interviewing for the position of EMT with a busy urban service. This morning you
are to meet with the service's medical director. You have been told that she likes it when
applicants ask questions about her role as the medical director. Related to her responsibilities as
medical director, which question is most appropriate?
A) "How do you determine the wages that the EMTs are paid?"
B) "How do you determine the number and location of ambulances within the system?"
C) "How often are the emergency care protocols updated?"
D) "Do you assign the daily chores that must be completed around the stations?"
Answer: C
Diff: 2 Page Ref: 12
Objective: 1-9
17) To be a medical director of an ambulance service, which requirement must the interested
individual satisfy?
A) Licensed physician
B) Emergency physician with surgical experience
C) Physician who was a paramedic
D) Physician with a college degree in EMS
Answer: A
Diff: 1 Page Ref: 12
Objective: 1-9
18) As an EMT, which requirement must be met so that you can provide routine and emergency
medical care to the sick and injured, as an extension of the medical director's authority?
A) Prior medical experience
B) A service medical director
C) A knowledgeable partner
D) A safe driving record
Answer: B
Diff: 1 Page Ref: 12
Objective: 1-9
19) It has been some time since you were involved in the care of a pediatric patient. You decide
to review the assessment and treatment basics that your medical director requires. To review this
information, which resource should you consult first?
A) Emergency Medical Responders
B) Reputable websites
C) Emergency department nurses
D) Service protocols
Answer: D
Diff: 1 Page Ref: 13
Objective: 1-9
,20) Before the EMT contacts medical direction for authorization to assist a patient with shortness
of breath in using her metered-dose inhaler, protocols state that the EMT must first attempt to
provide relief by administering oxygen if the pulse oximeter reading is less than 94%. You
recognize that the administration of oxygen is best described as a(n):
A) Standing order
B) On-line medical direction
C) Direct permission
D) Quality improvement
Answer: A
Diff: 2 Page Ref: 13
Objective: 1-9
21) If a patient with chest pain takes a daily aspirin, your medical director wants the EMT to
contact an emergency department physician first before administering additional aspirin. The act
of contacting the emergency department physician by phone or radio for permission to
administer additional aspirin is an example of:
A) Quality improvement
B) On-line medical direction
C) Off-line medical direction
D) Indirect medical control
Answer: B
Diff: 2 Page Ref: 13
Objective: 1-1
22) At the scene of a minor motor vehicle collision, you are attending to a female patient who
complains of head and neck pain. A crowd has gathered to watch the action. What will the
observing public most likely remember about the role EMS portrayed?
A) The number of emergency vehicles that showed up
B) The color of the ambulances
C) If the EMTs were all wearing the same color uniforms
D) EMTs who were yelling and cursing loudly at the fire department to hurry up and get the
patient out of the car
Answer: D
Diff: 2 Page Ref: 11
Objective: 1-8
23) You work in a community that has an "enhanced" 911 system. Given this, which is true
about such a system?
A) The physical location of the landline used to make the 911 call is displayed to the call taker
B) The EMS system uses EMTs, Advanced EMTs, and paramedics
C) The fire department responds simultaneously with EMS
D) The total response time for EMS will rarely exceed 9 minutes
Answer: A
Diff: 1 Page Ref: 5
Objective: 1-4
,24) Which patient would most benefit from calling an enhanced 911 system from the home
phone?
A) Patient with chest pain
B) Patient with sudden onset of confusion
C) Patient requiring advanced medical care
D) Patient who cannot reach the phone
Answer: B
Diff: 2 Page Ref: 5
Objective: 1-4
25) A 14-year-old boy has fallen through a plate glass window and is bleeding heavily from a
laceration to his arm. His panicked mother has called 911 for help. Since the 911 operators are
also emergency medical dispatchers, what sort of assistance will they be able to provide?
A) Simultaneous notification of the hospital
B) Whether the EMS response is covered by medical insurance
C) Instructions on how to control bleeding
D) The names of the EMTs who are responding
Answer: C
Diff: 2 Page Ref: 5
Objective: 1-3
26) Which be an EMS public health initiative?
A) Educating the public on the benefit of wearing seat belts
B) Volunteering time to help raise money for a sick child and his family
C) Providing volunteer emergency ambulance service 24 hours a day, 7 days a week
D) Purchasing new equipment to better help those persons who experience a medical emergency
Answer: A
Diff: 2 Page Ref: 16
Objective: 1-14
27) Your service's medical director would like to explore the idea of EMTs using special
transport ventilators when caring for patients who require assistance with their breathing. When
using an evidence-based medicine approach, what should you do first?
A) Go to a local hospital to see which kind of ventilators it uses
B) Contact vendors that sell ventilators and ask for price quotations
C) Select specific EMTs to conduct a field trial of particular ventilators
D) Search the medical literature for research related to this topic
Answer: D
Diff: 2 Page Ref: 14
Objective: 1-13
,28) You are by the side of a confused patient who has diabetes and a low blood sugar level. You
know that the patient needs orally administered sugar, so following your service's guidelines, you
call the physician on duty at the hospital emergency department and request permission to
administer it. This request is an example of:
A) Standing orders
B) On-line medical direction
C) Medical cooperation
D) Off-line medical direction
Answer: B
Diff: 1 Page Ref: 12
Objective: 1-1
29) Which statement about emergency medical services in the United States is true?
A) The EMS system is controlled and governed by the National Highway Transport and Safety
Administration (NHTSA)
B) The federal government oversees all aspects of EMS in the United States
C) Each state has governmental control of its own EMS system, independent of the federal
government
D) The U.S. Department of Health and Human Services establishes curricula for all levels of
EMS education
Answer: C
Diff: 2 Page Ref: 4
Objective: 1-3
30) The county dispatch center where you work employs emergency medical dispatchers
(EMDs) as call takers. Using EMDs as opposed to a person who is just a "call taker" enables the
dispatch center to:
A) Process all emergency calls, including those asking for police, fire, and EMS assistance
B) Provide medical instructions to the caller prior to the arrival of EMS personnel
C) Use computer technology when dispatching the closest ambulance
D) Properly utilize an enhanced 911 call-taking system
Answer: B
Diff: 2 Page Ref: 5
Objective: 1-3
31) A 40-year-old man has been seriously injured in a car crash. He is unresponsive and has what
you believe to be a collapsed lung. Additionally, his left leg is severely deformed with heavy
bleeding and his vital signs are unstable. A passenger in the car informs you that the patient has
diabetes and significant heart problems. Given this information, what is the best destination for
this patient, assuming all of the facilities are the same distance away?
A) Cardiac center
B) Spine injury center
C) Trauma center
D) Stroke center
Answer: C
Diff: 2 Page Ref: 7
Objective: 1-6
, 32) You have arrived at the scene of a medical emergency and find a woman lying on the floor
of a grocery store. As you approach her, you know that your first priority as an EMT is:
A) Personal safety
B) Patient care
C) Public safety
D) Patient advocacy
Answer: A
Diff: 1 Page Ref: 8
Objective: 1-11
33) A female jogger has collapsed on a trail at a public park. A crowd of curious onlookers have
collected and are watching as the EMT examines the patient for any life-threatening conditions.
After determining that there are none and the patient is stable, the EMT acts as a patient advocate
by:
A) Informing the crowd that the patient appears to be okay
B) Transporting the patient to the hospital using lights and sirens
C) Continuing care despite the crowd's presence
D) Asking curious onlookers to leave the scene
Answer: D
Diff: 2 Page Ref: 10
Objective: 1-7
34) At a public 911 center meeting, a concerned woman asks whether voice over Internet
Protocol (VoIP) can be used to access the community emergency operations center. You would
inform her that:
A) Internet providers are encouraged to provide 911 access, but are not required by law, so the
dispatch center may have to get an address from the caller
B) Internet providers are required to provide their own 911 call-taker service to subscribers
C) Internet providers must provide a callback number and physical location of the phone from
which the 911 call was placed
D) Internet providers are required to employ EMDs who can provide medical instructions prior
to arrival of EMS
Answer: C
Diff: 2 Page Ref: 6
Objective: 1-4
35) What would the EMT recognize as an advantage of the 911 universal number?
A) It is able to track the locations of all emergency vehicles in an EMS system
B) It is a common number through which to request EMS, law enforcement, and fire services
C) It is less expensive to operate than a 7- or 10-digit telephone number
D) It is the most easily remembered 3-digit combination of numbers
Answer: B
Diff: 1 Page Ref: 5
Objective: 1-4