Paramedic Care: Principles & Practice, 4th edition
Bledsoe/ Porter/ Cherry
Volume 1 Introduction to Paramedicine
Chapter 2 EMS Systems
1) Which of the following certification levels is currently NOT recognized by the National EMS
Scope of Practice model?
A) Paramedic
B) Emergency Medical Responder
C) Emergency Medical Technician
D) Critical Care Paramedic
2) The rules or standards that govern the conduct of members of a particular group or profession
are called:
A) Licensure
B) Morals
C) Protocols
D) Ethics
3) A physician not affiliated with the responding EMS system who takes part in patient care with
system paramedics at an emergency scene is called a(n):
A) Surrogate medical director
B) Volunteer physician
C) Intervening physician
D) Interloping physician
4) The National EMS Education Instructional Guidelines are divided into three domains of
learning. The affective domain refers to which of the following?
A) Critical thinking and decision making
B) Recall of basic facts and information
C) Physical skills used for patient care
D) Attitudes, values, and emotions
5) Which of the following National Highway Traffic Safety Administration (NHTSA) elements
of EMS systems deals with issues of equal access to acceptable emergency care for all patients?
A) Human resources and training
B) Public information and education
C) Resource management
D) Trauma systems
6) Which of the following is NOT typically a role of the medical director in an EMS system?
A) Participating in quality improvement
B) Educating and training personnel
C) Employee scheduling
D) Participating in personnel and equipment selection
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7) The person who is legally responsible for all clinical and patient care aspects of an EMS
system is the:
A) Quality improvement coordinator
B) Medical director
C) System administrator
D) Battalion chief
8) Medical policies, procedures, and practices that a system medical director has established in
advance of a call are called:
A) Automated medical direction
B) Off-line medical oversight
C) Remote medical direction
D) On-line medical direction
9) In 1980 the revision “KKK-A-1822A” involved:
A) Primarily addressing electrical systems, signage, and safety
B) Guidelines to improve occupant protection in the patient compartment
C) Changes based on the National Institute for Occupational Safety and Health standards
D) Improving ambulance electrical systems by designing a low-amp lighting system to replace
antiquated light bars and beacons
10) In most states which of the following grants EMS personnel recognition that they have met
certain qualifications?
A) Registration
B) Qualification
C) Certification
D) Authorization
11) Paramedics carry out their tasks in the prehospital setting as designated agents of the:
A) EMS system director
B) EMS system medical director
C) EMS program director
D) Hospital nursing director
12) The process by which a governmental agency grants permission to engage in a given
occupation to an applicant who has attained the degree of competency required to ensure the
public’s protection is called:
A) Reciprocity
B) Licensure
C) Registration
D) Certification
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13) The desirable conduct or qualities that characterize a practitioner in a particular field or
occupation are called professional:
A) Principles
B) Ethics
C) Guidelines
D) Etiquette
14) Which of the following elements of an EMS system is NOT needed to ensure the best
possible patient care?
A) Resources management
B) Medical direction
C) Ambulance billing
D) Public information
15) Which of the following best describes the practice of evidence-based medicine?
A) Basing all treatments on the patient’s signs and symptoms
B) Combining clinical expertise with the best available clinical evidence
C) Using clinical judgment to know when you should deviate from protocols
D) Using published reports of research to change practice
16) Which of the following situations is NOT typically addressed by EMS system protocols?
A) Triage
B) Requirements for continuing education
C) Transfer to appropriate facilities
D) Mode of patient transportation
17) Few areas of the United States provided adequate prehospital care until:
A) After World War II
B) After the Gulf War
C) The late 1960s
D) The mid-1950s
18) The process by which an agency in one state grants automatic certification or licensing to a
paramedic who is certified or licensed by an agency in another state is called:
A) Professional courtesy
B) Immunity
C) Recertification
D) Reciprocity
19) Direct access to medical consultation is a feature of:
A) A tiered response system
B) An off-line medical oversight
C) The incident command system
D) An on-line medical direction
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20) In which of the following ways can paramedics play a significant part in EMS research?
A) Collecting data accurately and completely
B) Changing patient-care practices based on unique research outcomes
C) Volunteering their patients for drug trials
D) Experimenting with different ways of managing patients
21) Components of a paramedic’s education include all of the following, EXCEPT:
A) Refresher courses
B) Continuing education
C) Initial education
D) Disciplinary action
22) Guidelines developed by the National Highway Traffic Safety Administration (NHTSA) for
quality improvement in EMS systems include all of the following, EXCEPT:
A) Regulation and policy
B) Financial auditing
C) Communications
D) Quality improvement
23) Key events in the historical development of EMS include all of the following, EXCEPT the:
A) 1973 EMS Systems Act
B) 1988 Statewide EMS Technical Assistance Program
C) 1975 Cater-Benson Reform Act
D) 1981 COBRA Act
24) Which of the following is the publication that first focused attention on the problem of motor
vehicle deaths?
A) KKK-A-1822
B) Injury in America: A Continuing Public Health Problem
C) Accidental Death and Disability: The Neglected Disease of Modern Society
D) A Leadership Guide to Quality Improvement for Emergency Medical Services Systems
25) Which of the following pieces of legislation had a significant NEGATIVE impact on EMS
funding?
A) The Emergency Medical Services Systems Act
B) The National Highway Safety Act
C) The Consolidated Omnibus Budget Reconciliation Act (COBRA)
D) The Emergency Medical Treatment and Active Labor Act (EMTALA)
26) No EMS system should be without which of the following items?
A) An independent communication system
B) One reserve ambulance for every active ambulance in the fleet
C) A large network of volunteers
D) A disaster plan
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27) As a rule, which of the following services should be present in trauma systems within an
EMS system?
A) Trauma center
B) Burn center
C) Pediatrics
D) Orthopedics
28) When you complete your paramedic course and pass the National Registry examination, you
will:
A) Be certified to practice as a paramedic in your state
B) Be certified to practice as a paramedic in any state
C) Be licensed to practice as a paramedic in your state
D) Still need to complete your state’s certification or licensure process
29) The future enhancement of EMS is strongly dependent on:
A) The ability to outline the logistics affecting research
B) Obtaining approval for patient-consent procedures
C) Availability of quality research
D) Being able to collect raw data
30) Paramedics can improve their knowledge and skills through an evaluation by others of equal
rank and skills, known as:
A) Tenure tracking
B) Debriefing
C) Peer review
D) Performance appraisal
31) Which of the following best describes the purpose of the KKK specifications?
A) To standardize EMS dispatching terminology
B) To specify quality improvement procedures
C) To state the physical standards required of paramedics
D) To standardize the design of ambulances
32) Entering a person’s name and relevant information in a particular record maintained by an
organization is best described as:
A) Registration
B) Reciprocity
C) Certification
D) Licensure
33) As defined by the National Highway Transportation Safety Agency (NHTSA), which of the
following is NOT a component of an EMS system?
A) System of quality improvement
B) Public information and education
C) Human resources and training
D) A public advisory council
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34) Which of the following best describes a comprehensive network of personnel, equipment,
and resources established to deliver aid and emergency medical care to the community?
A) Trauma system
B) EMS system
C) Medical direction
D) ALS system
35) Although termed certification by many states, the governmental agency’s permission to
engage in a profession actually constitutes:
A) Registration
B) Licensure
C) Authorization
D) Reciprocity
36) The established policies and procedures of an EMS system that provide a standardized
approach to common patient problems and a consistent level of medical care are known as:
A) Codes of action and response
B) Clinical protocols
C) Standard operating procedures
D) Standing orders
37) One area of EMS that will rely especially heavily on research is:
A) Communications
B) Transportation
C) Human resources
D) Funding
38) Which of the following choices best explains the difference between an EMT-Intermediate
and an EMT-Paramedic?
A) Licensure versus certification
B) Scope of knowledge
C) The legal requirement for medical direction
D) Scope of practice
39) Reasons to be involved with a professional membership organization include all of the
following, EXCEPT to:
A) Stay abreast of changes within the profession
B) Share ideas with other providers
C) Interact with members from other parts of the country
D) Get patches, shirts, and stickers with the organization’s logo
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40) With regard to medical authorization, which of the following best describes the role of a
paramedic in providing prehospital care?
A) He relies on the delegated practice of a licensed physician medical director.
B) He relies on the delegated practice of any licensed health-care practitioners, such as physician
assistants, nurse practitioners, nurses, and dentists.
C) He relies on the delegated practice of a licensed nurse.
D) He relies on the autonomous medical practitioner.
41) Which of the following are likely subjects of standing orders or protocols?
A) How to handle DNR orders
B) Procedures that can only be done with a direct order
C) When to use air transport versus ground transport
D) All of the above
42) Which of the following is NOT one of the three basic elements of citizen involvement in
EMS?
A) Recognizing an emergency
B) Providing financial support for EMS agencies
C) Initiating basic life-support procedures
D) Accessing the EMS system
43) The first use of a prehospital system of triage and transport took place:
A) In large cities in the nineteenth-century United States
B) During the U.S. Civil War
C) During the Napoleonic Wars
D) In ancient Mesopotamia
44) An example of a quality improvement activity in EMS is:
A) Peer review of patient care
B) Letting coworkers learn from their mistakes rather than trying to make suggestions during a
call
C) Disciplinary action for patient-care issues
D) Underdocumenting the number of attempts needed to start an IV
45) The Institute of Medicine published Emergency Medical Services for Children in:
A) 1993
B) 1984
C) 1969
D) 1977
46) Sending multiple levels of emergency care personnel to the same incident is called a:
A) Mass-casualty incident
B) Helicopter EMS
C) Tiered response
D) Chain of survival
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47) An occupation in which the practitioners have a competence in a specialized body of
knowledge or skills that has been recognized by some organization or agency is called a:
A) Profession
B) Career
C) Vocation
D) Trade
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