Chapter 14 Critical thinking and Clinical Decision Making Flashcards Preview

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Flashcards in Chapter 14 Critical thinking and Clinical Decision Making Deck (34)
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1. After gathering information from the patient, scene, and any bystanders, you must next:
A) formulate a care plan based on the information.
B) determine which information is valid and which may be invalid.
C) synthesize the information to form a thought process.
D) determine the most likely cause of the patient's problem.

Ans: B
Page: 695
Type: General Knowledge


2. Synthesizing information about a patient with multiple medical conditions involves:
A) determining the validity of each of the patient's medical problems.
B) ruling out each condition as the cause of the patient's chief complaint.
C) determining the patient's perception of his or her multiple conditions.
D) assessing each condition's potential for having a life-threatening impact.

Ans: D
Page: 696
Type: General Knowledge


3. The care plan that you implement based on your working field diagnosis of a patient is almost always defined by:
A) your EMS system's patient care protocols or standing orders.
B) your previous experience with patients who had a similar condition.
C) direct orders from the physician at the receiving medical facility.
D) a combination of your and your partner's knowledge and experience.

Ans: A
Page: 696
Type: General Knowledge


4. Protocols, or standing orders, specify the paramedic's performance parameters, which:
A) allow the paramedic to function autonomously on every EMS call.
B) outline the care that is provided after contacting online medical control.
C) limit the skills that the paramedic can perform in his or her EMS system.
D) define what the paramedic can or cannot do without direct medical control.

Ans: D
Page: 696
Type: General Knowledge


5. The main disadvantage of patient care algorithms is that they:
A) are revised or updated too frequently.
B) are often overridden by medical control.
C) only address classic patient presentations.
D) discourage contact with direct medical control.

Ans: C
Page: 696
Type: General Knowledge


6. If a patient's clinical presentation is not addressed in a specific algorithm, the paramedic must:
A) focus exclusively on the patient's ABCs.
B) determine what is in the patient's best interest.
C) perform a comprehensive head-to-toe exam.
D) provide supportive care and transport promptly.

Ans: B
Page: 696
Type: General Knowledge


7. Documenting difficulties such as darkness, limited access, and unruly crowds that you encounter while caring for a patient is MOST important because it:
A) paints a mental picture for the receiving physician.
B) is used to help substantiate delayed on-scene times.
C) will help justify the patient care decisions you make.
D) provides legal immunity if the patient decides to sue.

Ans: C
Page: 699
Type: General Knowledge


8. Which of the following scenarios is the BEST example of independent decision making?
A) Controlling severe bleeding from an open wound, establishing an IV to maintain perfusion, and contacting medical control en route to the hospital
B) Selecting the appropriate patient care algorithm from your protocol book when treating a middle-aged male patient with symptomatic bradycardia
C) Definitively diagnosing a patient with cholecystitis who has right upper quadrant abdominal pain and nausea that began shortly after eating a meal
D) Contacting medical control and requesting permission to administer adenosine to a patient with a heart rate of 190 beats/min and a stable blood pressure

Ans: A
Page: 697
Type: General Knowledge


9. In order to be a competent and effective paramedic, it is MOST important for you to:
A) be familiar with patient care algorithms and guidelines.
B) possess the knowledge to diagnose a patient definitively.
C) have a high success rate of IV insertions and intubations.
D) think and perform quickly and effectively under pressure.

Ans: D
Page: 697-698
Type: General Knowledge


10. Once you determine that your patient is sick, you must next:
A) provide aggressive care.
B) quantify how sick he or she is.
C) contact online medical control.
D) transport him or her immediately.

Ans: B
Page: 698
Type: General Knowledge


11. Which of the following conditions or situations is the BEST example of a critical life threat that needs immediate care?
A) An early onset of renal insufficiency
B) A patient with multiple disease etiologies
C) Acute presentation of a chronic condition
D) Open head injury with exposed brain tissue

Ans: C
Page: 698
Type: General Knowledge


12. In EMS, the process of concept formation involves:
A) determining the validity of obtained data.
B) gathering information about your patient.
C) knowing which treatment algorithm to use.
D) interpreting a patient's signs and symptoms.

Ans: B
Page: 698
Type: General Knowledge


13. Knowledge of anatomy, physiology, and pathophysiology is MOST important during the ________________ stage of critical thinking.
A) data interpretation
B) concept formation
C) reflection in action
D) application of principle

Ans: A
Page: 699
Type: General Knowledge


14. Comments such as “I can't believe you called EMS for this!”:
A) show a lack of compassion and interest in providing the best possible care.
B) demonstrate an illegal act for which the paramedic will be held accountable.
C) are commonly made by paramedics with less than 5 years of field experience.
D) are typically ignored by the patient because he or she is frightened at the time.

Ans: A
Page: 699
Type: General Knowledge


15. A negative attitude about any patient or patient care situation:
A) constitutes negligence and carries legal ramifications with it.
B) is usually not sensed by the patient because he or she is frightened.
C) is often observed in paramedics with many years of experience.
D) almost guarantees that the care you provide will be suboptimal.

Ans: D
Page: 699
Type: General Knowledge


16. A working diagnosis is MOST accurately defined as:
A) a reliable yet unofficial diagnosis of the patient.
B) your interpretation of the patient's vital sign values.
C) what you feel is the cause of your patient's problem.
D) a firm explanation for the patient's symptomatology.

Ans: C
Page: 699
Type: General Knowledge


17. Which of the following scenarios MOST accurately depicts reflection in action?
A) Noting a patient's heart rate before you administer any medication
B) Obtaining a room air pulse oximetry reading before applying oxygen
C) Reassessing a patient's blood pressure after administering nitroglycerin
D) Administering aspirin and then immediately applying a cardiac monitor

Ans: C
Page: 699-700
Type: General Knowledge


18. The MOST effective way for the paramedic to avoid tunnel vision is to:
A) perform a secondary assessment on every patient he or she encounters.
B) keep an open mind to all of the possible causes of the patient's problem.
C) reassess all patients at least every 15 minutes until patient care is transferred.
D) possess a detailed knowledge of anatomy, physiology, and pathophysiology.

Ans: B
Page: 700
Type: General Knowledge


19. _______________ occurs after a call is over and commonly is associated with the run review or critique.
A) Reflection in action
B) Reflection on action
C) Data interpretation
D) Application of principle

Ans: B
Page: 700-701
Type: General Knowledge


20. Uncertainty regarding the specific cause of a patient's problem is called:
A) medical ambiguity.
B) a working diagnosis.
C) the general impression.
D) the differential diagnosis.

Ans: A
Page: 701
Type: General Knowledge


21. Which of the following situations is MOST challenging with regard to your critical thinking and decision-making skills?
A) A rigid abdomen and signs of shock
B) An elderly patient with prolonged asystole
C) A driver who passed out and then struck a tree
D) Isolated tibia/fibula fracture from minor trauma

Ans: C
Page: 701
Type: General Knowledge


22. The hormonal effects associated with the fight-or-flight response can affect your performance as a paramedic by:
A) decreasing your visual acuity.
B) enhancing your critical thinking skills.
C) affecting your reflexes negatively.
D) diminishing your ability to concentrate.

Ans: D
Page: 701
Type: General Knowledge


23. Which of the following actions has the LEAST impact on the paramedic's ability to think under pressure?
A) Taking a moment to stop and think
B) Taking a moment to scan the situation
C) Staying calm and maintaining mental control
D) Memorizing all patient care algorithms

Ans: D
Page: 701-702
Type: General Knowledge


24. When reading the scene, the paramedic must remember that:
A) noting the mechanism of injury is the first element to evaluate.
B) scene information becomes unavailable once transport is initiated.
C) safety issues must be addressed while you are caring for the patient.
D) bystanders are a reliable source of information regarding an incident.

Ans: B
Page: 702
Type: General Knowledge


25. Which of the following is NOT a typical element to evaluate when reading the scene of a motor vehicle crash?
A) The person at fault
B) Access and exit routes
C) Environmental conditions
D) Overall safety of the situation

Ans: A
Page: 702
Type: General Knowledge


26. Which of the following would have the LEAST impact on the care you provide to a patient who fell?
A) The height of the fall
B) How the patient landed
C) Object from which the patient fell
D) On what the patient landed

Ans: C
Page: 702
Type: General Knowledge


27. When you introduce yourself to your patient and ask why 9-1-1 was called, the patient looks at you, shakes your hand, and answers your questions appropriately. From these findings, you can gather that the patient:
A) has not experienced a traumatic injury.
B) has a Glasgow Coma Scale score of 15.
C) will likely not require medication therapy.
D) does not have a life-threatening condition.

Ans: B
Page: 702-703
Type: General Knowledge


28. When a patient advises you of his or her chief complaint, you should:
A) quickly perform a head-to-toe exam to identify immediate life threats.
B) carefully evaluate all of the medications the patient is taking.
C) obtain a 12-lead ECG to rule out a cardiac-related cause of the problem.
D) ascertain whether this is a new problem or worsening of a preexisting condition.

Ans: D
Page: 703
Type: General Knowledge


29. When caring for a critically ill patient, three or more sets of vital signs will allow you to:
A) determine how fast the patient's condition is deteriorating and whether cardiac arrest is imminent.
B) assess trends and to reassess whether the patient's condition is stabilizing, getting better, or getting worse.
C) quantify that the patient's condition is stabilizing, even if he or she has an altered level of consciousness.
D) determine what body system is in dysfunction, which will further facilitate the provision of specific care.

Ans: B
Page: 703
Type: General Knowledge


30. After addressing any life threats in the order in which you find them, you should next:
A) consider the worst-case scenario that could be causing the patient's symptoms and either rule it out or rule it in.
B) determine the most common and statistically probable cause for the patient's current signs and symptoms.
C) formulate a working field diagnosis on the basis of what you discovered in the initial assessment of the patient.
D) provide symptomatic care and promptly transport the patient to an appropriate medical treatment facility.

Ans: A
Page: 703
Type: General Knowledge