Chapter 2: Workforce Safety and Wellness (Part 1)
Which of the following statements is MOST consistent with the bargaining phase of the grieving process?
A. "I will be compliant with all my medications if I can just see my grandson graduate." B. "I understand that my death is inevitable and I am ready to die when the time comes." C. "The doctors must be wrong in their diagnosis because I have always been healthy." D. "It is because of our lousy health care system that I developed this brain tumor."
A critical incident stress debriefing should be conducted no longer than ________ hours following the incident.
A. 12 B. 72 C. 6 D. 24
If a mask cannot be placed on a coughing patient, the Centers for Disease Control and Prevention (CDC) recommend that you maintain a distance of at least ________ feet if possible.
A. 2 B. 4 C. 5 D. 3
Which of the following statements regarding a patient with a behavioral crisis is correct?
A. A past history of violence is an unreliable indicator of future violence. B. People who say that they are "hearing voices" are usually bluffing you. C. A quiet patient is not as likely to attack you as one who is screaming. D. Depression accounts for a very small percentage of violent attacks.
Which of the following scenarios MOST accurately depicts a posttraumatic stress disorder (PTSD) reaction?
A. An EMT is emotionally exhausted and depressed after a school bus crash involving critical injuries and the death of several children. B. An EMT with many years of field experience becomes irritable with her coworkers and experiences headaches and insomnia. C. An EMT becomes distracted at the scene of a motor vehicle crash involving the same type of car in which a child was previously killed. D. A newly certified EMT becomes extremely nauseated and diaphoretic at the scene of an incident involving grotesque injuries.
Your partner, a veteran EMT who you have worked with regularly for the past 4 years, seems unusually agitated during a call involving an elderly patient. Upon arrival back at your station, you note the obvious smell of alcohol on his breath. What should you do?
A. Discreetly report your suspicions to your supervisor. B. Tell your partner that he must seek professional help. C. Report the incident to your EMS medical director. D. Remain quiet and simply request another partner.
Which of the following is the MOST effective strategy for managing stress?
A. Frequently reflect on troublesome calls. B. Focus on delivering high-quality patient care. C. Avoid friends and interests outside of EMS. D. Request overtime to increase your income.
Which of the following statements regarding HIV is correct?
A. HIV is transmitted exclusively via blood. B. It is easily transmittable in the EMS field. C. It is far more contagious than hepatitis B. D. There is no vaccine against HIV infection.
The spread of HIV and hepatitis in the health care setting can usually be traced to:
A. a lack of proper immunizations. B. a noncompliance with standard precautions. C. careless handling of sharps. D. excessive blood splashing or splattering.
You are transporting an elderly woman who has possibly experienced a stroke. She is obviously scared but is unable to talk and cannot move the entire right side of her body. In addition to providing the medical care that she needs, you should:
A. acknowledge that she is scared and tell her that you are going to take good care of her. B. reassure her that after proper treatment in the hospital, she will regain her speech in time. C. tell her that you understand why she is scared and that everything will likely be okay. D. maintain eye contact at all times and tell her that there is no need for her to be scared.
At the scene of an automobile crash, a utility pole has been broken, and power lines are lying across the car. The patients inside the car are conscious. You should:
A. advise the patients to carefully get out of the car. B. remove the lines with a nonconductive object. C. proceed with normal extrication procedures. D. mark off a danger zone around the downed lines.
A 15-year-old boy was killed when he was struck by a car while riding his bicycle. He has numerous disfiguring injuries and has been placed in the back of the ambulance to shield him from curious bystanders. When the child's parents arrive at the scene, they demand to see him. You should:
A. advise them that their son had severely disfiguring injuries and ask them if there is anyone they would like you to contact first. B. discreetly escort them to the back of the ambulance and allow them to see their child by themselves while you wait outside. C. let them know that because of the circumstances of their child's death, they will not be permitted to see him at this time. D. express your sincere condolences over their loss and have them escorted away from the scene by a law enforcement officer.
Vector-borne transmission of an infectious organism occurs via:
A. animals or insects. B. smoke or dust. C. inanimate objects. D. direct contact.
Prescription glasses do not provide adequate eye protection because they:
A. are not secured with a strap. B. offer little or no side protection. C. have large rounded lenses. D. do not have shatterproof lenses.
If you use a waterless handwashing substitute in the field, it is important to:
A. avoid donning another pair of gloves for at least 10 minutes. B. immediately dry your hands with a paper towel. C. wash your hands with soap and water at the hospital. D. wait at least 5 minutes before touching another patient.
Critical incident stress management (CISM) can occur at an ongoing scene in all of the following circumstances, EXCEPT:
A. before personnel are preparing to reenter the scene. B. when patients are actively being assessed or treated. C. before leaving the scene after the incident is resolved. D. when personnel are assessed during periods of rest.
When a patient is dying, he or she may experience regression. This is MOST accurately defined as:
A. behavior consistent with an earlier developmental stage. B. fear of being completely dependent upon other people. C. anger projected toward the EMT or other providers. D. a decreased ability to exercise age-appropriate judgment.
Carbon monoxide blocks the ability of the blood to oxygenate the body because it:
A. binds with the hemoglobin in the red blood cells. B. destroys the number of circulating red blood cells. C. fills the lungs with secretions. D. causes the body to expel too much carbon dioxide.
You are assessing a woman who was thrown from her horse. She is located in a large field and you can see that a thunderstorm is rapidly approaching. Suddenly, you feel your skin begin to tingle and the hair on your arms stands on end. The ambulance is located about 30 yards away. You should:
A. crouch down in a position so that only your feet are touching the ground. B. immediately lie down on your side and draw your knees into your abdomen. C. quickly cover the patient with a blanket and then lie down flat on the ground. D. sit down, bend your knees, and hold your crossed arms close to your body.
The final stage of death and dying is MOST commonly displayed as:
A. denial. B. acceptance. C. anger. D. depression.
The compliance monitoring component of an infection control plan should:
A. ensure that employees understand what they should do and why it is important. B. consist of a list of tasks that pose a risk for contact with blood or other body fluids. C. address issues such as medical waste collection, storage, and ambulance disinfection. D. identify who to notify after an exposure and where treatment should be provided.
You are caring for a 35-year-old female with pregnancy-related complications. She is clearly experiencing significant stress and is crying uncontrollably. Your MOST appropriate action would be to:
A. explain to her that "everything will be all right" in order to calm her down. B. restrain her if she is extremely emotional and will not calm down. C. demonstrate courtesy and speak with a professional tone of voice. D. discourage her from expressing fears until a counselor is available.
Which of the following is the MOST significant factor in determining if a person will become ill from certain germs?
A. gender B. age C. immunity D. race
The BEST way to reduce your risk of contracting a work-related disease following exposure is to:
A. get vaccinated against the disease you think you were exposed to. B. vigorously wash the affected area with an antimicrobial solution. C. be evaluated by a physician within 72 hours following the exposure. D. activate your department's infection control plan as soon as possible.
Vaccination against the hepatitis A virus is unnecessary if you:
A. have been infected in the past. B. received a hepatitis B vaccination. C. are older than 35 years of age. D. have a weak immune system.
When considering his or her personal life, it is important for the EMT to realize that:
A. he or she should not discuss stressful issues with family members. B. shift work is the least stressful type of an EMS-related work schedule. C. family or friends may not understand the stress associated with EMS. D. it is more difficult to effectively relax at home than it is while on duty.
Which of the following signs would indicate that your partner is experiencing significant stress?
A. hyperactivity during an EMS call B. acute increase in his or her appetite C. increased interest in daily activities D. isolation from the rest of the crew
While assisting an advanced life support (ALS) ambulance crew, you are accidentally stuck with an IV needle. You should:
A. immerse your wound in an alcohol-based solution. B. report the incident to your supervisor after the call. C. get immunized against hepatitis as soon as possible. D. discontinue patient care and seek medical attention.
Physiologic manifestations of stress include:
A. increased blood pressure, decreased blood glucose levels, and chest pain. B. perspiration, increased blood glucose levels, and dilated pupils. C. flushed skin, decreased muscle control, and vomiting. D. slow heart rate, low blood pressure, and severe headaches.
While providing care to a patient, blood got onto the ambulance stretcher. Because the stretcher was not properly cleaned afterward, a virus was transmitted to another emergency medical technician (EMT) several days later. What route of transmission does this scenario describe?
A. indirect contact B. vector-borne transmission C. direct contact D. airborne transmission
You are summoned to a convalescent center for an 88-year-old female with an altered mental status. A staff nurse advises you that the patient has terminal cancer and her physician stated that she would probably die within the next few hours; a valid do not resuscitate (DNR) order is presented to you. When caring for this patient, you should:
A. make her comfortable and provide emotional support. B. provide no interventions and transport to the hospital. C. depart the scene and allow her to die with dignity. D. start cardiopulmonary resuscitation (CPR) if she experiences cardiopulmonary arrest.
If a person is partially immune to a particular disease, he or she:
A. must be revaccinated at least every 18 months to avoid infection. B. will not experience future illness, even if his or her immune system is stressed. C. is not protected from a new infection if exposed to another individual. D. may develop illness from germs that lie dormant from the initial infection.
Which of the following factors is NOT taken into consideration when assessing a person's potential for violence?
A. poor impulse control B. large physical size C. substance abuse D. tattoos, such as those with gang identification
According to Occupational Safety and Health Administration (OSHA) regulations, an employer must:
A. provide gloves and other personal protective equipment (PPE) to full-time paid employees only. B. offer a workplace environment that reduces the risk for exposure. C. guarantee a 100% risk-free environment prior to employment. D. screen all prospective employees for bloodborne pathogens.
When treating a patient who is trapped in a vehicle and covered with broken glass, it is BEST to wear:
A. puncture-proof leather gloves over your latex gloves. B. fire fighter gloves only, to preserve manual dexterity. C. thick fire fighter gloves over two pairs of latex gloves. D. latex gloves with thick leather gloves underneath.
Upon arriving at the scene of a motor vehicle crash, you note that two small cars collided head-on; the occupants are still in their vehicles. The fire department is in the process of stabilizing the vehicles and law enforcement personnel are directing traffic. After parking the ambulance at a safe distance, you and your partner should:
A. quickly begin the triage process. B. report to the incident commander. C. assist with vehicle stabilization. D. put on high-visibility safety vests.
You are assessing a middle-aged man with chest pain that you suspect is caused by a cardiac problem. The patient tells you that he does not want to go to the hospital and insists that you leave him alone. You should:
A. reassure him that he will not receive a bill for the EMS call if he cannot pay. B. explain the seriousness of the situation to him, but avoid causing undue alarm. C. proceed to treat him because the stress of the situation has impaired his thinking. D. tell him that he is having a heart attack and that he needs to go to the hospital.
When caring for the parents of a child who has died of leukemia, the EMT should:
A. refrain from using words such as "died" or "dead." B. tell them that their feelings are understood. C. acknowledge the death of their child in private. D. immediately refer them to a counselor.
You have been working at the scene of a major building collapse for 8 hours. Many injured people are still being removed, and everyone is becoming frustrated and losing focus. This situation is MOST effectively managed by:
A. requesting a CISM team to provide on-scene peer support. B. providing large amounts of caffeine to the rescue workers. C. allowing each worker to sleep in 15- to 30-minute increments. D. conducting a critical incident stress debriefing the next day.
You arrive at the scene of a domestic violence situation. As you approach the doorway of the apartment, you hear screaming and the statement "He has a gun!" Your MOST appropriate action should be to:
A. seek a safe place and request law enforcement assistance. B. get in your ambulance and leave the scene immediately. C. proceed into the apartment and apprehend the gunman. D. continue into the apartment using extreme caution.
When decontaminating the back of your ambulance after a call, you should:
A. spray the contaminated areas and then immediately wipe them dry with a towel. B. use a bleach and water solution at a 1:2 dilution ratio to thoroughly wipe all surfaces. C. allow surfaces to air dry unless otherwise indicated in the product directions. D. clean all surfaces and patient contact areas with a mixture of alcohol and water.
You and your partner are EMTs and have been dispatched to standby at the scene of a residential fire. While standing next to the ambulance observing the fire fighters, you see a woman frantically moving around in her burning house. You should:
A. stay where you are until fire fighters remove her from the house. B. request permission from the fire chief to enter the structure. C. don a self-contained breathing apparatus (SCBA) and rescue the woman. D. immediately notify the incident commander or safety officer.
A 75-year-old male with a terminal illness has died at home. As you and your partner enter the residence, a family member becomes verbally abusive, pushes you, and states that you took too long to get there. You should:
A. subdue the family member until the police arrive. B. retreat and notify law enforcement personnel. C. tell the family member that it is not your fault. D. ignore the family member and assess the patient.
You are caring for a 40-year-old female who was involved in a motor vehicle crash. Her husband, who was driving the vehicle, was killed. When the patient asks you if her husband is all right, you should:
A. tell her that he is being resuscitated by other EMTs. B. avoid answering her questions and focus on her injuries. C. let clergy or hospital staff relay the bad news if possible. D. immediately tell her of his death so that she may grieve.
According to the CDC, recommended immunizations and tests include a:
A. two-shot hepatitis A vaccination series. B. tetanus-diphtheria booster every 10 years. C. smallpox vaccine every 5 years. D. TB skin test every 6 months.
If you are exposed to a patient's blood or other bodily fluid, your first action should be to:
A. vigorously clean the area with soap and water. B. report the incident to the infection control officer. C. transfer care of your patient to another EMS provider. D. abandon patient care and seek medical attention.
The MOST effective way to preserve your own body heat when functioning in cold, wet weather is to:
A. wear a heavy, thick jacket or coat. B. wear at least three layers of clothing. C. wear socks made of heavy-duty cotton. D. avoid outer clothing with zippers.
Gloves, a mask, eye protection, and a face shield should be used:
A. while handling needles or other sharps. B. when performing endotracheal intubation. C. during routine cleaning of the ambulance. D. any time you touch non-intact skin.
A positive TB skin test indicates that:
A. you have never been exposed to TB. B. you are actively infected with the disease. C. the disease is dormant and may become active. D. you have been exposed to the disease.
While trying to make a family member feel better after a loved one has died, your partner uses trite statements. The family members may view this as:
A. your partner's attempt to diminish their grief. B. coaching them through the grieving process. C. a show of respect for the person who has died. D. your partner's caring and supportive attitude.