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Region VIII EMS Systems
February 2017 – CE Post-Quiz
SOP White Pages
1. Which of the following is true about a POLST?
A) It is a signed medical order that only dictates what actions should be taken after the
patient is in cardiac arrest
B) It is only valid if it is signed by the patient
C) It can be signed by physicians, advanced practice nurses, some medical students and
physicians assistants
D) If properly executed, it negates the need for a patient to appoint a Power of Attorney
for Health Care
2. True / False – In Illinois, a POLST form is not necessary to provide guidance if the patient
becomes incapacitated due to cardiac arrest, if a properly executed living will is in place.
3. If multiple DNR / POLST forms are present and the patient is in cardiac arrest, EMS should:
A) Honor the one signed by the patient, in the event that there are forms signed by other
individuals
B) Honor the form with the most recent date
C) Honor the form that is printed on colored paper, in the event there are multiple forms
and some are black on white
D) Honor only the pink form, since that is the latest recommended color
4. Which of the following best describes Section B of the IL POLST form as revised in 2016:
A) Medical Interventions – how to perform a “slow code” in the event that the patient was
ambiguous about their resuscitation wishes
B) CPR – what level of interventions to perform if the patient is not breathing but has a
pulse
C) Medically Administered Nutrition
D) Medical Interventions – what to do if the patient has a pulse and/or is breathing
5. Which of the following persons CAN NOT sign section D DOCUMENTATION OF DISCUSSION,
consenting to the POLST?
A) Patient
B) Parent of minor
C) Agent under Power of Attorney
D) Health care surrogate decision maker
E) Patient’s primary physician
6. True / False – In Illinois, an attending physician may authorize surrogate decision makers to
make decisions for patients who lack decisional capacity, even if they are not authorized as
a health care agent under Power of Attorney for Health Care.
Region VIII EMS Systems
February 2017 – CE Post-Quiz
SOP White Pages
7. True / False – In Illinois, the only legal order for non-resuscitation is the use of the
recognized IL POLST form – no other written order can be accepted as an order to not
resuscitate a patient.
8. Per the Adult Initial Medical Care SOP, which of the following is the target SpO2 for most
patients?
A) 94-98%
B) 92-94%
C) 100%
D) > 90%
9. Which of the following is the best alternative site for pulse oximetry probe placement in the
event a finger is not practicable?
A) Ear lobes
B) Chest wall
C) Wrist
D) Chin
10. Which of the following is the most common factor(s) that can effect accuracy of pulse
oximetry reading?
A) Motion, poor lighting
B) Ambient light, moisture
C) Press-on nails, coffee
D) Skin pigmentation, ambient light
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11. EMS responds to a 15 year old with complaints of mid-sternal back pain radiating between
the scapula for 1 hour. Past medical history includes Marfan syndrome, and he currently is
taking a beta blocker. Vital signs are Pulse 108, BP 138/92, RR 20, SpO2 98% on room air.
You suspect his pain may be caused by:
A) Aortic dissection
B) Acute chest syndrome
C) Pericarditis
D) Pleurisy
Region VIII EMS Systems
February 2017 – CE Post-Quiz
SOP White Pages
12. Along with pain which is characterized as pleuritic and retrosternal, this sign may also be
present with spontaneous pneumomediastinum:
A) Odynophagia
B) Gastroesophageal reflux
C) Esophageal spasm
D) Subcutaneous emphysema
13. Which of the following are common symptoms of exercise induced asthma?
A) Rales, rhonchi
B) Decreased exercise tolerance / endurance, chest tightness
C) Acid reflux, coughing
D) Sore throat, pedal edema
14. You are called to an extended care facility for a patient who passed out following insertion
of a central venous catheter. The patient is a 55 year old male who was having a subclavian
double lumen catheter placed. He is conscious but disoriented, GCS 14, vitals BP 80/50, P
128, R 20. Which of the following IS CORRECT per SOP?
A) EMS can use the catheter for any IV fluid or medication, as long as someone on the crew
is familiar with the device
B) EMS can regulate the rate of an IV bag (such as administering a fluid bolus) that is
initiated by the RN or physician at the originating facility
C) EMS can use the CV catheter only for resuscitation medications, unless Medical Control
approves
D) Under no conditions can EMS have anything to do with a venous catheter they did not
insert
15. True / False – Early notification of Medical Control is not necessary as long as the transport
time is under ten minutes
16. On the above patient, you begin CPR and apply the cardiac monitor, with a finding of
pulseless ventricular tachycardia. You defibrillate the patient which results in ventricular
fibrillation. As CPR continues, the patient’s daughter returns and produces what appears to
be a valid POLST order. Per SOP, which of the following should be your next action?
A) Contact Medical Control and follow any orders received
B) Once CPR is begun, it cannot be stopped. Continue resuscitation.
C) CPR may be withdrawn without contacting Medical Control
D) The POLST is valid only if there is a note about what to in the event CPR was begun prior
to the POLST being presented.
Region VIII EMS Systems
February 2017 – CE Post-Quiz
SOP White Pages
17. You are called to a single family residence for a bed-bound elderly male patient reported to
be unresponsive. The caller and only other person there is a neighbor who “was just asked
to come over and sit with him for a few minutes” while a family member went to the store.
The patient has a GCS of 3, is making agonal glottic movements but has no effective
respirations, has no palpable pulse. The neighbor says he knows the patient did not want
CPR but does not know the location of a POLST or DNR paperwork. Which of the following
is your correct action?
A) Begin resuscitation
B) Withhold resuscitative efforts until the family member returns to clarify
C) Withhold resuscitation based on the neighbors statement
D) Do CPR only and begin transport
18. True / False – A Power of Attorney for Healthcare is only valid in Illinois if a judge or
attorney executes it
19. True / False – A Power of Attorney for Healthcare requires one or more successor agents be
specified to back up the primary agent, in order to be valid.
20. Which of the following IS TRUE about Power of Attorney / Surrogates and their interaction
with EMS?
A) Healthcare decisions of the Power of Attorney or Surrogate are limited to signing a
POLST form
B) If more than one Power of Attorney successor listed on the form are present on the
scene, the oldest person to be listed is in charge
C) There are NO situations in which a surrogate can give instructions directly to the EMS
providers
D) The only use for Power of Attorney is to execute a living will
21. Regarding Illinois Admission Petitions, which of the following is the most likely situation
under which the hospital might ask EMS to become involved?
A) Documenting what someone else told them that the patient had said
B) Documenting what EMS heard or saw, similar to what EMS would write in their PCR
narrative
C) Completing the entire petition, since nobody from the hospital was involved in the initial
contact
D) Completing only the portion of the petition marked FOR EMS OR AMBULANCE DRIVER
USE
Region VIII EMS Systems
February 2017 – CE Post-Quiz
SOP White Pages
22. Per SOP, which of the following IS NOT an indication for the use of atropine in the adult
patient?
A) Symptomatic bradycardia
B) Asystole / PEA
C) Muscarinic / organophosphate poisoning
D) Nerve gas auto-injector
23. What portion of the autonomic nervous system does atropine have its primary action on?
A) Sympathetic
B) Parasympathetic
C) Musculoskeletal
D) Neurovascular
24. Which of the following IS NOT characteristic of sinus arrest / sinus block?
A) P-waves precede most QRS complexes
B) Irregular R-R interval
C) Irregularly irregular
D) The usual heart rate is 60-100 bpm
25. Which of the following characteristically has a short gap, usually only missing one beat, and
resumes on the same cadence?
A) Sinus arrest
B) Sinus block