Mixed Deck — All CPC Topics Flashcards

Informed consent requires that a patient understands all of the following EXCEPT:

Answer: The cost of all alternative treatments in detail

Informed consent requires disclosure of the nature of the intervention, risks/benefits, available alternatives, and the right to refuse. While general cost information may be relevant, itemized cost details of all alternatives are not a legally required element of informed consent.

Which organization administers the federal Supplemental Nutrition Assistance Program (SNAP), commonly used to address food insecurity in community paramedicine patients?

Answer: U.S. Department of Agriculture (USDA)

SNAP (formerly Food Stamps) is administered by the U.S. Department of Agriculture's Food and Nutrition Service (USDA/FNS), not HHS. Community paramedics refer food-insecure patients to SNAP enrollment assistance.

A community paramedic is reviewing immunization records for a 65-year-old patient who has never received a pneumococcal vaccine. Which vaccine(s) should be recommended?

Answer: PCV15 or PCV20 followed by PPSV23 if PCV15 was used

Current CDC guidance recommends PCV15 or PCV20 for pneumococcal-naive adults 65+; if PCV15 is used, PPSV23 should follow at least one year later.

A community paramedic identifies a chronic wound that has been present for 12 weeks with no measurable reduction in size. According to evidence-based practice, this wound should be reassessed for:

Answer: Biofilm presence, uncontrolled underlying disease, wound misclassification, or need for advanced therapies

A wound with no healing progress at 12 weeks indicates a 'stalled wound' requiring systematic reassessment: biofilm formation, uncontrolled comorbidities (diabetes, PAD, malnutrition), missed infection, wound misclassification, or need for advanced therapies (NPWT, growth factors, skin substitutes).

During a home visit, a patient shows a community paramedic an herbal supplement they recently started. Which of the following supplements has the MOST clinically significant interaction with warfarin?

Answer: St. John's Wort

St. John's Wort is a potent inducer of CYP450 enzymes and P-glycoprotein, significantly reducing warfarin blood levels and increasing the risk of thrombotic events.

A community paramedic performs a pulse oximetry reading on a patient with COPD and records SpO2 of 88%. The patient is asymptomatic at rest. Per standard COPD management guidelines, what is the appropriate oxygen saturation TARGET for this patient?

Answer: Titrate oxygen to maintain SpO2 88–92%

For COPD patients, oxygen should be titrated to maintain SpO2 88–92% (target 90%). High-flow oxygen may suppress hypoxic drive and cause hypercapnic respiratory failure in CO2-retaining patients.

When performing a home medication review, which of the following is MOST important to assess in an elderly patient taking multiple medications?

Answer: Fall risk related to medications such as sedatives, antihypertensives, and diuretics

Medications such as sedatives, antihypertensives, and diuretics are among the most common contributors to fall risk in elderly patients, making fall risk assessment a top priority.

A patient with COPD has a FEV1/FVC ratio of 0.62 and a post-bronchodilator FEV1 of 55% predicted. According to GOLD classification, this patient is classified as:

Answer: GOLD 2 — Moderate

GOLD classification by FEV1 (post-bronchodilator, FEV1/FVC <0.70): GOLD 1 ≥80%, GOLD 2 50–79%, GOLD 3 30–49%, GOLD 4 <30%. An FEV1 of 55% predicted falls within GOLD 2 (Moderate).

When performing a home safety assessment for a patient at risk for falls, which environmental modification has the STRONGEST evidence for fall reduction?

Answer: Removing trip hazards and installing grab bars in the bathroom

Removing trip hazards and installing grab bars are the most evidence-supported environmental interventions shown to reduce falls in older adults at home.

Critical Incident Stress Debriefing (CISD) is BEST described as:

Answer: A structured small-group process conducted 24–72 hours post-incident to process reactions

CISD is a structured, time-limited group discussion led by trained peers or mental health professionals to process emotional reactions to critical incidents.

Which of the following is the CORRECT order of the 'spectrum of prevention' from least to most population-level impact?

Answer: Individual counseling → community education → policy change

The spectrum of prevention moves from individual-level interventions (least population impact) through community education to policy change, which has the broadest and most sustained population health impact.

Which of the following is the BEST example of a 'upstream' social determinant intervention for reducing asthma hospitalizations?

Answer: Advocating for housing code enforcement to reduce indoor allergens

Housing code enforcement addresses the root cause—substandard housing with mold and pests—rather than managing the downstream clinical consequence.

According to USPSTF guidelines, at what age should average-risk adults begin colorectal cancer screening?

Answer: 45 years

The USPSTF updated its recommendation in 2021 to begin colorectal cancer screening at age 45 for average-risk adults, down from the previous age of 50.

Which level of disinfection is required for semi-critical medical equipment that contacts intact mucous membranes but does not penetrate tissue?

Answer: High-level disinfection

Semi-critical items that contact mucous membranes require high-level disinfection, which kills all microorganisms except high levels of bacterial spores.

Which community organization might assist a patient facing eviction?

Answer: Local housing authority

A local housing authority is a government agency or non-profit organization specifically established to address housing needs within a community. They can provide assistance with rental subsidies, emergency housing, eviction prevention services, and referrals to other housing support programs. Connecting patients facing eviction with this resource is crucial for their stability and overall well-being.

A community paramedic is conducting a wellness visit for a 52-year-old male smoker with a 30 pack-year history. Per USPSTF guidelines, which screening is MOST indicated for this patient?

Answer: Annual low-dose CT (LDCT) of the chest

USPSTF recommends annual low-dose CT (LDCT) lung cancer screening for adults aged 50–80 with a 20+ pack-year smoking history who currently smoke or quit within the past 15 years.

When assessing a 78-year-old patient for cognitive impairment during a home visit, which brief cognitive screening tool is most commonly used?

Answer: Mini-Cog (3-word recall + clock draw)

The Mini-Cog (3-item recall + clock-drawing test) is a validated, brief (3-minute) cognitive screening tool designed for primary care and community settings. It has excellent sensitivity and specificity for detecting dementia in diverse populations.

A community paramedic notices a patient has untreated dental pain that is worsening a poorly controlled diabetic condition. What navigation step BEST addresses this?

Answer: Refer the patient to a federally qualified health center (FQHC) or dental school clinic offering sliding-scale fees

FQHCs and dental school clinics offer affordable dental care on a sliding-scale basis for uninsured or underinsured patients.

A patient tells a community paramedic they stopped taking their antihypertensive because 'it makes me dizzy.' The community paramedic should FIRST:

Answer: Acknowledge the concern, assess for orthostatic hypotension, and notify the supervising physician

Validating the patient's concern, clinically assessing for orthostatic hypotension, and reporting to the physician ensures the side effect is properly evaluated before any change to the regimen.

A community paramedic identifies an elderly patient living alone who reports difficulty preparing meals and managing medications. Which program MOST specifically addresses these needs?

Answer: Medicaid waiver home and community-based services (HCBS)

Medicaid HCBS waiver programs specifically fund in-home support services — including meal preparation, medication management, personal care, and homemaker services — for eligible elderly and disabled individuals, allowing them to remain in their homes.