SOLVED

11). Commonly found medical therapies for children who are home care patients include all of the following, EXCEPT: A) mechanical ventilators B) feeding tubes C) dialysis shunts D) apnea monitors 12) You have responded to a home where a man is complaining of chest pain. A woman answers the door and states that her husband, a terminal cancer patient, is experiencing chest pain and dyspnea. She says quietly that he only has a “little while left” and she wants him to be comfortable. Your assessment reveals a 66-year-old male in unstable ventricular tachycardia. He is somewhat coherent and is adamant about not going to the hospital to die. What is your best course of action? A) This is a lethal rhythm and requires immediate ACLS. No directives have been produced. Be tactful but treat this patient like any other. B) Try and convert this rhythm and see what happens. If you can get him back into a perfusing normal sinus rhythm, he can sign a release. C) Call medical control and ask for advice. D) Explain to the woman that if she wants him to die at home, not to call 911 and just let nature take its course. 13) You are sent to a home for a cardiac arrest. You find a patient in cardiac arrest who has been under hospice care for end-stage AIDS. The nurse tells you that some family members who were present when the patient went into cardiac arrest felt that not providing care was not a prudent thing to do, so they called 911. She apologizes. A relative interrupts and says she doesn’t care what the nurse says, she wants you to help her brother. What should your next action(s) be? A) Have the nurse provide the DNR. If it is in order, explain to the sister that you are bound to adhere to the orders. B) Provide all the interventions you can. You have no standing not to. C) Tell the sister that it is best to let him go. D) Start CPR and ACLS. Do a round of drugs, then call for orders for field termination of resuscitative efforts. 14) You have responded to a residence, and on arrival you encounter a woman who is visibly upset. She says she is caring for her grandfather, who has a feeding tube, and she “just can’t get the stuff to go in.” You evaluate the problem and find that the PEG tube appears to be blocked. What action should be taken? A) You as a paramedic are not trained to flush or evaluate gastric feeding tubes, so transport to the ER. B) Massage the abdomen. C) Attempt to flush and/or aspirate the tube with a 60-cc syringe. D) Pull the tube out and find the blockage, then flush and reinsert the tube. 15) What is PEEP? A) Positive exhalation and excretion pressure B) Preliminary exhaustive expiratory plan C) Pulmonary expulsion/end perfusion D) Positive end expiratory pressure 16) What is your primary role as an ALS provider when you respond to home health care patients in need of assistance? A) Identify and treat any life-threatening conditions. B) Act as a liaison between the patients and any services they may need. C) Educate the home health care providers on when calling 911 is appropriate. D) Contact the patient’s family and inform them of any problems with the patient’s care. 17) What has been the primary reason for the increase of home health care? A) Increased number of health care professionals B) Medicare rule changes C) Decrease in the number of available hospital beds D) Cost containment 18) Which of the following is NOT a common sign of sepsis? A) Nausea and vomiting B) Fever C) Altered mental status D) Hyperactivity 19) What is Guillain-Barré syndrome? A) A buildup of mucus in the lungs and GI systems B) An autoimmune syndrome thought to be caused by a viral infection C) A rare disease due to breakdown of acetylcholine receptorsD) An increase in organ size 20) What differentiates PEEP, BiPAP, and CPAP in the home-care setting? A) BiPAP and CPAP are for prehospital use only. B) PEEP can only be used with an ETT, while BiPAP and CPAP use a mask. C) BiPAP and CPAP require a special ventilator not available outside the hospital. PEEP can be used on a traditional ventilator and can be seen in home health care situations. D) PEEP can only be used by a respiratory therapist.