Patient Rights and Special Situations in EMS Practice Questions

37 multiple-choice questions on Patient rights and special situations for paramedic and EMT students, from Chapter 4 (Medical, Legal, and Ethical Issues). Read each question, pick your answer, then tap Show answer to check it and read the explanation.

37 practice questions

1. EMTALA primarily requires hospitals to:

   1. A. Set transfer protocols for EMS agencies
   2. B. Accept every EMS transport, even on diversion
   3. C. Report EMS errors to the state
   4. D. Screen and stabilize regardless of payment
   Show answer

   Answer: D. Screen and stabilize regardless of payment

   Hospitals must provide a medical screening exam and stabilize emergency conditions. It also governs appropriate transfers between facilities.

2. An interfacility transfer under EMTALA requires:

   1. A. Approval from the charge nurse alone
   2. B. Physician certification and acceptance
   3. C. Consent from the family only
   4. D. No documentation if stable
   Show answer

   Answer: B. Physician certification and acceptance

   A physician certifies that benefits outweigh risks, and the receiving facility must accept the patient. The sending facility must send records and provide appropriate personnel and equipment.

3. Mandatory reporting requirements commonly include:

   1. A. Drug use disclosed by the patient
   2. B. Suspected abuse and gunshot wounds
   3. C. Every refusal of care against advice
   4. D. All injuries regardless of cause or severity
   Show answer

   Answer: B. Suspected abuse and gunshot wounds

   Common examples include suspected child and elder abuse, gunshot and stab wounds, and certain communicable diseases. Requirements differ by state; know yours. Drug use a patient discloses is generally kept confidential, not reported.

4. When a paramedic suspects child abuse, the correct action is to:

   1. A. Remove the child from the home
   2. B. Treat, document, and report
   3. C. Confront the caregiver about the injuries
   4. D. Delay reporting until proof is obtained
   Show answer

   Answer: B. Treat, document, and report

   Provide care, document objective findings and statements, and report. Reporting requires reasonable suspicion, not proof.

5. Objective documentation of suspected abuse means recording:

   1. A. What you observed and heard
   2. B. Your conclusion that abuse occurred
   3. C. Only the injuries, not statements
   4. D. The caregiver's criminal history
   Show answer

   Answer: A. What you observed and heard

   Record what was said in quotes where possible, without accusations. Conclusions belong to investigators; observations belong to you.

6. At a potential crime scene, the paramedic's priority is:

   1. A. Interviewing witnesses before they leave
   2. B. Preserving evidence before patient contact
   3. C. Patient care, while preserving evidence
   4. D. Photographing the scene for police
   Show answer

   Answer: C. Patient care, while preserving evidence

   Document what was moved. Avoid cutting through holes in clothing and note where items were.

7. Clothing removed from a patient who may be a crime victim should be:

   1. A. Placed in a paper bag for police
   2. B. Sealed in a plastic bag for police
   3. C. Returned to the family at the scene
   4. D. Discarded to prevent contamination
   Show answer

   Answer: A. Placed in a paper bag for police

   Handle it carefully and turn it over per policy. Plastic bags can degrade biological evidence.

8. A sexual assault patient should be:

   1. A. Questioned in detail about the assault
   2. B. Transported only with a police escort
   3. C. Asked to shower before transport
   4. D. Treated privately; told not to wash
   Show answer

   Answer: D. Treated privately; told not to wash

   Treat with privacy and sensitivity, discourage washing or changing when possible, and transport to an appropriate facility. Limit your questions to what care requires.

9. A patient under an involuntary mental health hold:

   1. A. Must be physically restrained
   2. B. Is transported under legal authority
   3. C. Cannot receive medical care en route
   4. D. May refuse transport at will
   Show answer

   Answer: B. Is transported under legal authority

   Follow state law and local protocol. Document the legal basis and who initiated it.

10. Transporting a prisoner requires:

    1. A. No different handling from other patients
    2. B. Removal of all restraints before loading
    3. C. Coordination with the custodial officer
    4. D. A separate unit staffed by police medics
    Show answer

    Answer: C. Coordination with the custodial officer

    Attend to crew safety; usually an officer accompanies the patient. Restraints applied by law enforcement must allow you to assess and treat.

11. A patient who is a Jehovah's Witness and refuses blood products:

    1. A. May refuse blood but accept other care
    2. B. Should receive blood anyway
    3. C. Requires a court order for any care
    4. D. Cannot be treated at all by EMS
    Show answer

    Answer: A. May refuse blood but accept other care

    A capable patient may refuse specific treatments while accepting others. Respect the specific refusal and continue all other care.

12. Physicians on scene who wish to direct care should:

    1. A. Be referred to online medical control
    2. B. Be obeyed without question in all cases
    3. C. Take over care automatically on arrival
    4. D. Be asked to leave so care is not delayed
    Show answer

    Answer: A. Be referred to online medical control

    The physician may need to assume care and accompany the patient. Local protocol usually requires documentation of the physician's identity and involvement.

13. EMTALA applies to:

    1. A. Only individual emergency physicians and staff
    2. B. Medicare hospitals with emergency departments
    3. C. Only private for-profit hospitals
    4. D. Only EMS agencies
    Show answer

    Answer: B. Medicare hospitals with emergency departments

    It applies to hospitals with emergency departments that accept Medicare. Nearly all hospitals qualify.

14. Under EMTALA, a hospital may not:

    1. A. Transfer patients elsewhere
    2. B. Refuse screening over ability to pay
    3. C. Treat patients who lack insurance
    4. D. Accept ambulances on diversion
    Show answer

    Answer: B. Refuse screening over ability to pay

    It may not refuse a screening exam or stabilization based on ability to pay. It was enacted to stop patient dumping.

15. You arrive for an interfacility transfer. The sending ED has no records ready, no physician certification, and has not confirmed that the receiving hospital accepted the patient. What should you do?

    1. A. Transport now and let the hospitals sort out the paperwork
    2. B. Ask that the transfer requirements be completed before you leave
    3. C. Refuse the transfer and return to service
    4. D. Have the patient sign a form releasing you from liability
    Show answer

    Answer: B. Ask that the transfer requirements be completed before you leave

    EMTALA puts these duties on the sending hospital: a physician must certify that the benefits outweigh the risks, the receiving facility must accept, and records must go with the patient. Asking that they be completed protects the patient and the crew. Leaving without them risks arriving at a hospital that has not agreed to take the patient. A patient's signature cannot waive these hospital obligations, and refusing outright abandons the patient's need for transfer.

16. Hospital diversion under EMTALA:

    1. A. Does not permit refusing arrived patients
    2. B. Allows refusing any patient at any time
    3. C. Allows refusing patients on site
    4. D. Is prohibited for all hospitals
    Show answer

    Answer: A. Does not permit refusing arrived patients

    A patient who has arrived, or is in the hospital's own ambulance, cannot be refused. Diversion status does not override arrival.

17. Mandatory reporting laws protect reporters who:

    1. A. Report anything, even knowingly false claims
    2. B. Report anonymously by phone
    3. C. Report only cases later confirmed
    4. D. Report in good faith
    Show answer

    Answer: D. Report in good faith

    Good-faith reporters are protected even if the suspicion proves wrong. Immunity encourages reporting.

18. Suspected elder abuse should be reported to:

    1. A. The receiving hospital only
    2. B. Law enforcement only
    3. C. The patient's family members
    4. D. Adult protective services
    Show answer

    Answer: D. Adult protective services

    Report to adult protective services or the agency designated by state law. Many states also require law enforcement notification.

19. Gunshot and stab wounds typically must be reported to:

    1. A. The receiving hospital only
    2. B. No one; it's confidential
    3. C. Law enforcement
    4. D. The state health department
    Show answer

    Answer: C. Law enforcement

    State law typically requires it.

20. Animal bites are reportable because:

    1. A. They trigger rabies evaluation
    2. B. They let EMS start rabies vaccine
    3. C. They are crimes against the victim
    4. D. Insurance carriers require it
    Show answer

    Answer: A. They trigger rabies evaluation

    They trigger rabies evaluation and animal control action. The health department tracks them. Rabies prophylaxis is decided and started by physicians and public health, not EMS.

21. A patient suspected of impaired driving:

    1. A. Must be reported by EMS in all states
    2. B. Must be restrained until police arrive
    3. C. Cannot be treated without police consent
    4. D. Depends on state reporting law
    Show answer

    Answer: D. Depends on state reporting law

    Reporting may be required depending on state law, and blood draws require legal process. Know your state's rules.

22. Blood draws for law enforcement:

    1. A. Are prohibited in every state
    2. B. Require legal authorization
    3. C. Require only an officer's verbal request
    4. D. Are routine EMS tasks on request
    Show answer

    Answer: B. Require legal authorization

    They are governed by state law and agency policy. Follow policy carefully.

23. You need to expose a stabbing victim's chest. His shirt has a cut over the wound. How should you remove it?

    1. A. Cut around the hole, not through it, and paper-bag the shirt
    2. B. Cut straight through the hole for fastest access
    3. C. Pull the shirt off over his head
    4. D. Cut it off and leave it on the floor
    Show answer

    Answer: A. Cut around the hole, not through it, and paper-bag the shirt

    Cutting around a stab or bullet hole keeps the defect intact for investigators while still exposing the wound quickly. Put the clothing in a paper bag, since plastic traps moisture and degrades biological evidence, and document the chain of custody. Pulling the shirt over his head moves him and may spread contamination. Leaving it on the floor loses the evidence.

24. A sexual assault patient asks if she can use the bathroom and change clothes before you transport her. She has no life-threatening injuries. What is the best response?

    1. A. Allow it without comment, since evidence is not EMS's role
    2. B. Insist firmly that she cannot use the bathroom before transport
    3. C. Explain that waiting preserves evidence, but respect her choice
    4. D. Collect her clothing and swab her yourself before she goes
    Show answer

    Answer: C. Explain that waiting preserves evidence, but respect her choice

    Urinating, washing, and changing can destroy evidence. Explain this gently so she can make an informed choice, offer a sheet or gown, and transport her to a facility with sexual assault nurse examiners. She keeps control: insisting removes her autonomy at a vulnerable moment. EMS does not collect forensic samples. Simply allowing it without explaining the consequences means she decides without the facts.

25. A sexual assault patient's clothing should be:

    1. A. Sealed in plastic bags for the police
    2. B. Washed to remove contaminants
    3. C. Discarded at the scene to limit exposure
    4. D. Kept on, or paper-bagged if removed
    Show answer

    Answer: D. Kept on, or paper-bagged if removed

    Plastic degrades evidence.

26. A man under arrest is handcuffed behind his back. He complains of chest pain and you need a 12-lead and IV access. What is the best approach?

    1. A. Remove the cuffs yourself so you can complete the assessment
    2. B. Skip the 12-lead and IV, since he is in police custody
    3. C. Treat him in the back of the patrol car to maintain custody
    4. D. Ask the officer to re-cuff him in front so you can treat him
    Show answer

    Answer: D. Ask the officer to re-cuff him in front so you can treat him

    A patient in custody still gets the care his condition needs. Officers keep custody and control the restraints, so coordinate with them to reposition the cuffs, with the patient supine or seated rather than prone, to allow assessment. EMS does not take custody or remove police restraints. Limiting care because of custody status, or treating in a patrol car, compromises care and safety.

27. When a prisoner is transported, officers:

    1. A. Hand the restraint keys to the paramedic
    2. B. Transfer custody to the EMS crew
    3. C. Need not accompany the patient
    4. D. Generally accompany and retain custody
    Show answer

    Answer: D. Generally accompany and retain custody

    Officers remain responsible for custody. EMS does not become the custodian.

28. Handcuffs on a patient must:

    1. A. Stay on regardless of care needs
    2. B. Be applied by EMS, not police
    3. C. Be removed before the patient is loaded
    4. D. Allow assessment and quick release
    Show answer

    Answer: D. Allow assessment and quick release

    They must allow access for assessment and treatment and be releasable in an emergency. Negotiate positioning with the officer.

29. An alert adult with a GI bleed tells you she will not accept any blood products for religious reasons but agrees to everything else. How do you proceed?

    1. A. Document the specific refusal and continue all other indicated care
    2. B. Have her sign a refusal of all care and transport
    3. C. Withhold IV fluids as well, out of respect for her beliefs
    4. D. Plan to give blood anyway if she loses consciousness
    Show answer

    Answer: A. Document the specific refusal and continue all other indicated care

    A capable adult may refuse a specific treatment while accepting others. Respect it, document her exact words, and tell the receiving team. A refusal of one thing is not a refusal of everything. Withholding fluids she has not refused is undertreatment. A known, informed refusal remains valid after she loses consciousness, so implied consent does not override it.

30. Treatment of a minor whose parents refuse on religious grounds:

    1. A. Requires no further action
    2. B. May be ordered by a court
    3. C. Always follows parental wishes
    4. D. Is never permitted by law
    Show answer

    Answer: B. May be ordered by a court

    Contact medical control and law enforcement per protocol.

31. Service animals must be:

    1. A. Accommodated whenever possible
    2. B. Caged during transport
    3. C. Muzzled before entering the unit
    4. D. Left behind unless certified on paper
    Show answer

    Answer: A. Accommodated whenever possible

    Coordinate with the receiving hospital. They are not pets under the law. Service animals need no muzzle unless they pose a threat, and no certification papers are required under the ADA.

32. Patients with disabilities are protected by:

    1. A. State disability statutes alone, not federal
    2. B. The Americans with Disabilities Act
    3. C. The HIPAA Privacy Rule only
    4. D. No federal law that applies to EMS
    Show answer

    Answer: B. The Americans with Disabilities Act

    The ADA requires reasonable accommodation. Communication access is part of it.

33. Involuntary psychiatric transport should be documented with:

    1. A. Family statements about the patient
    2. B. A brief note of the hold
    3. C. Transport times and destination only
    4. D. Legal authority and observed behavior
    Show answer

    Answer: D. Legal authority and observed behavior

    Document the legal authority, behavior observed, who initiated the hold, and care provided. These cases are often reviewed.

34. A patient with a court-ordered conservator:

    1. A. Always decides for themselves
    2. B. Must be reported to the court
    3. C. Has a conservator who may decide
    4. D. Cannot be treated at all
    Show answer

    Answer: C. Has a conservator who may decide

    The conservator may hold decision authority depending on the order. Ask what the order covers.

35. Military members in uniform:

    1. A. Cannot refuse care while in uniform
    2. B. Must go to military facilities
    3. C. Have no independent consent rights
    4. D. Have the same rights as others
    Show answer

    Answer: D. Have the same rights as others

    Civilian rules apply.

36. Patients from other countries:

    1. A. Have no right to consent or refuse
    2. B. Need a passport to consent
    3. C. Have the same rights as anyone
    4. D. Must pay before transport
    Show answer

    Answer: C. Have the same rights as anyone

    Immigration status does not affect care. Consent does not depend on documents, and payment is never a condition of emergency care.

37. Which best describes the paramedic's obligation when laws conflict with patient wishes?

    1. A. Follow your own personal values
    2. B. Avoid involvement in the situation
    3. C. Follow the patient's wishes always
    4. D. Follow the law, respectfully
    Show answer

    Answer: D. Follow the law, respectfully

    Respect the patient as much as possible and consult medical control. Mandatory reporting is an example.