Chapter 36 Patients With Special Challenges

25 July 2022
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Autism is defined as a:
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pervasive developmental disorder characterized by impairment of social interaction.
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Characteristic anatomic features of Down syndrome include:
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a round head with a flat occiput.
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You respond to a residence for a 9-year-old female with Down syndrome who is sick. When you arrive at the scene and assess the patient, you determine that she is unresponsive and has gurgling respirations. You should:
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open her airway with a manual maneuver, suction her oropharynx, and insert a simple airway adjunct.
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An important aspect in the assessment of a patient who experienced a previous brain injury involves:
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speaking with the patient and family to establish what is considered normal for the patient.
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In contrast to conductive hearing loss, sensorineural hearing loss is caused by:
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nerve damage.
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A service dog is easily identified by its:
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harness.
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Which of the following statements regarding hearing aids is correct?
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Hearing aids cannot restore hearing to normal levels.
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Which of the following statements regarding cerebral palsy is correct?
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Conditions such as brain injury at birth, postpartum infections, and fetal hypoxia can cause cerebral palsy.
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Common associated conditions in patients with spina bifida include all of the following, EXCEPT:
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spastic limb movement.
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When caring for a morbidly obese patient, you should:
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establish his or her chief complaint and then communicate your plan to help.
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If suctioning of the tracheostomy tube is necessary, the EMT should:
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attempt to use the patient's suction device first because it is probably already sized correctly.
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You receive a call to a residence for an apneic 2-month-old male. When you arrive at the scene, the infant's mother tells you that her son was born prematurely and that his apnea monitor has alarmed four times in the past 30 minutes. Your assessment of the infant reveals that he is conscious and active. His skin is pink and dry, and he is breathing at an adequate rate and with adequate tidal depth. His oxygen saturation reads 98% on room air. You should:
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transport the infant to the hospital and bring the apnea monitor with you.
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In contrast to an automated implanted cardioverter/defibrillator, an internal cardiac pacemaker:
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regulates the patient's heart rate if it falls below a preset value.
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The tip of a central venous catheter rests in the:
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vena cava.
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Which of the following statements regarding gastrostomy (gastric) tubes is correct?
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Patients with a gastrostomy tube may still be at risk for aspiration.
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For which of the following conditions would you MOST likely encounter a ventricular peritoneum shunt?
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Hydrocephalus
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Vagal nerve stimulators may be an alternative treatment to medication for patients with:
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chronic seizure disorders.
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EMS personnel would MOST likely be called to the residence of a patient receiving home health care when the home care provider:
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has recognized a change in the patient's health status.
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EMTs are dispatched for a patient in cardiac arrest. When they arrive, they find that the patient is pulseless and apneic and is wearing an external defibrillator vest. In this situation, the EMTs should:
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perform CPR and leave the vest in place.
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EMTs are dispatched for a patient whose central venous catheter is malfunctioning. When they arrive and assess the patient, they find bleeding from the tubing attached to the line. The EMTs should:
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apply direct pressure to the tubing and transport.
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A 13-year-old child is on a home ventilator. The parents called because the mechanical ventilator is malfunctioning and the child has increasing respiratory distress. You should:
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A. disconnect the ventilator and apply a tracheostomy collar.
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A 70-year-old male complains of shortness of breath. During your assessment, you note that he has bilateral hearing aids. When you ask him questions related to his chief complaint, he does not answer you. You can hear a whistling sound coming from his hearing aids. You should:
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B. try repositioning the hearing aid or remove it and turn down the volume.
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A person is said to be obese when he or she is ________ over his or her ideal weight.
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D. 30% or more
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A surgical procedure that creates an opening between the intestine and the surface of the body that allows for elimination of waste products is called a(n):
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colostomy
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According to the "E" in the DOPE mnemonic, which of the following actions should you perform to troubleshoot inadequate ventilation in a patient with a tracheostomy tube?
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A. Check the mechanical ventilator for malfunction.
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According to the Emergency Medical Treatment and Active Labor Act (EMTALA):
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A. all health care facilities must provide a medical assessment and required treatment, regardless of the patient's ability to pay.
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Because a tracheostomy tube bypasses the nose and mouth:
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B. secretions can build up in and around the tube.
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Cerebral palsy is characterized by poorly controlled ________ movement.
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body
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Common complications associated with central venous catheters include all of the following, EXCEPT:
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B. rupture of a central vein.
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Down syndrome is a genetic defect that occurs as the result of:
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D. a birth defect caused by incomplete closure of the spinal column.
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The purpose of a ventricular peritoneum shunt is to:
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C. prevent excess cerebrospinal fluid from accumulating in the brain.
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Under what circumstances is a left ventricular assist device used?
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C. As a bridge to heart transplantation while a donor heart is being located
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When caring for a patient who is visually impaired, it is important to:
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C. tell him or her what is happening, identify noises, and describe the situation and surroundings.
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Which of the following conditions would MOST likely be encountered in a patient with cerebral palsy?
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A. Seizure disorder
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Which of the following statements regarding autism is correct?
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B. Most cases of autism are diagnosed by 3 years of age.
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Which of the following statements regarding interaction with the caregiver of a child or adult with special health care needs is correct?
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A. Communication with the patient's caregiver or family members is important because they are the most familiar with the patient's condition.
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Which of the following statements regarding patients with intellectual disabilities is correct?
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D. Patients with intellectual disabilities are susceptible to the same disease processes as other patients.
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Which of the following would be the MOST practical method of communicating with a hearing-impaired patient until his or her hearing aids can be located?
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C. Using a piece of paper and writing utensil to ask questions
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You are assessing a 440-lb man who complains of shortness of breath and lower back pain. The patient is conscious and alert, his blood pressure is 148/98 mm Hg, and his heart rate is 120 beats/min. Your MOST immediate action should be to:
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B. avoid placing him in a supine position if possible and administer oxygen.