Chapter 2: WORKFORCE SAFETY AND WELLNESS

Common questions asked by patients with a serious illness or injury include all of the following, EXCEPT: a. "Am I going to die?" b. "What are you doing to me?" c. "Which hospital am I going to?" d. "Will I be permanently disabled?"

c. "Which hospital am I going to?"

Which of the following infectious diseases confers no protection from reinfection after exposure? a. Chickenpox b. Rubella c. Mumps d. Syphilis

d. Syphilis

The final stage of death and dying MOST commonly takes the form of: a. denial. b. depression. c. anger. d. acceptance.

d. acceptance.

Hazards that are associated with a structural fire include all of the following, EXCEPT: a. risk of building collapse. b. smoke and toxic gases. c. high ambient temperatures. d. carbon dioxide deficiency.

d. carbon dioxide deficiency.

The spread of HIV and hepatitis in the health care setting can usually be traced to: a. noncompliance with standard precautions. b. excessive blood splashing or splattering. c. lack of proper immunizations. d. careless handling of sharps.

d. careless handling of sharps.

As an EMT, it is important to remember that the signs and symptoms of cumulative stress: a. are most effectively treated with medications. b. cannot be identified and can cause health problems. c. usually manifest suddenly and without warning. d. may not be obvious or present all the time.

d. may not be obvious or present all the time.

Which of the following statements would NOT be appropriate to say to the family of a dying patient? a. "Tell me how you are feeling." b. "It is okay to be angry and sad." c. "Things will get better in time." d. "This must be painful for you."

c. "Things will get better in time."

Which of the following is an effective stress management strategy? a. Developing a social network outside of EMS b. Modestly increasing caffeine consumption c. Frequently reflecting on troublesome calls d. Requesting overtime to occupy your mind

a. Developing a social network outside of EMS

You are transporting a veteran whose legs were amputated in the war. When calling your radio report to the emergency department, which of the following words would be the MOST appropriate to use when describing the patient? a. Disabled b. Crippled c. Handicapped d. Deformed

a. Disabled

When decontaminating the back of your ambulance after a call, you should: a. allow surfaces to air dry unless otherwise indicated in the product directions. b. use a bleach and water solution at a 1:2 dilution ratio to thoroughly wipe all surfaces. c. spray the contaminated areas and then immediately wipe them dry with a towel. d. clean all surfaces and patient contact areas with a mixture of alcohol and water.

a. allow surfaces to air dry unless otherwise indicated in the product directions.

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. a decreased ability to exercise age-appropriate judgment. d. anger projected toward the EMT or other providers.

a. behavior consistent with an earlier developmental stage.

Carbon monoxide blocks the ability of the blood to oxygenate the body because it: a. binds with the hemoglobin in red blood cells. b. fills the alveoli in the lungs with thick secretions. c. causes the body to expel too much carbon dioxide. d. destroys the number of circulating red blood cells.

a. binds with the hemoglobin in red blood cells.

You are dispatched to the scene of a crash involving a large tanker truck. While you are en route, dispatch advises you that there are multiple patients and that the fire department is en route as well. As you approach the scene, you should: a. maintain a safe distance and try to read the placard with binoculars. b. cordon off the area and quickly remove all of the injured patients. c. immediately begin evacuating residents who live near the crash site. d. don personal protective equipment and quickly triage all patients.

a. maintain a safe distance and try to read the placard with binoculars.

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. mark off a danger zone around the downed lines. b. remove the lines with a nonconductive object. c. advise the patients to carefully get out of the car. d. proceed with normal extrication procedures.

a. mark off a danger zone around the downed lines.

regulations, an employer must: a. offer a workplace environment that reduces the risk of exposure. b. guarantee a 100% risk-free environment prior to employment. c. provide gloves and other personal protective equipment to full-time paid employees only. d. screen all prospective employees for blood-borne pathogens.

a. offer a workplace environment that reduces the risk of exposure.

After assessing a patient's blood glucose level, you accidentally stick yourself with the contaminated lancet. You should: a. report the incident to your supervisor after the call. b. immerse your wound in an alcohol-based solution. c. get immunized against hepatitis as soon as possible. d. discontinue patient care and seek medical attention.

a. report the incident to your supervisor after the call.

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. retreat and notify law enforcement personnel. b. ignore the family member and assess the patient. c. subdue the family member until the police arrive. d. tell the family member that it is not your fault.

a. retreat and notify law enforcement personnel.

If you are exposed to a patient's blood or other bodily fluid, your first action should be to: a. transfer care of the patient to another EMS provider. b. vigorously clean the area with soap and water. c. report the incident to the infection control officer. d. abandon patient care and seek medical attention.

a. transfer care of the patient to another EMS provider.

Your partner, a veteran EMT with whom you have worked 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? Select one: a. Tell your partner that he must seek professional help. b. Discreetly report your suspicions to your supervisor. c. Report the incident to your EMS medical director. d. Remain quiet and simply request another partner.

b. Discreetly report your suspicions to your supervisor.

Which of the following statements regarding the hepatitis B vaccine is correct? a. Vaccination with the hepatitis B vaccine confers immunity against hepatitis A. b. OSHA requires that your employer offer you the vaccine free of charge. c. Vaccination against hepatitis B provides partial immunity for life. d. The hepatitis B vaccine provides protection against the disease for 2 years.

b. OSHA requires that your employer offer you the vaccine free of charge.

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. restrain her if she is extremely emotional and will not calm down. b. demonstrate courtesy and speak with a professional tone of voice. c. discourage her from expressing fears until a counselor is available. d. tell her that "everything will be all right" to calm her down.

b. demonstrate courtesy and speak with a professional tone of voice.

It is especially important for EMS personnel to develop nonadversarial relationships with their coworkers because they: a. are highly prone to stress and burnout. b. depend on one another for their safety. c. must work together every third day. d. may have to bunk in the same room.

b. depend on one another for their safety.

The compliance monitoring component of an infection control plan should: a. consist of a list of tasks that pose a risk for contact with blood or other body fluids. b. ensure that employees understand what they should do and why it is important. 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.

b. ensure that employees understand what they should do and why it is important.

The MOST effective way to preserve your own body heat when functioning in cold, wet weather is to: a. wear socks made of heavy-duty cotton. b. wear at least three layers of clothing. c. wear a heavy, thick jacket or coat. d. avoid outer clothing with zippers.

b. wear at least three layers of clothing.

While trying to make a family member feel better after a loved one has died, your partner states, "I know how you are feeling." The family members may view this as: a. your partner's caring and supportive attitude. b. your partner's attempt to diminish their grief. c. coaching them through the grieving process. d. a show of respect for the person who has died.

b. your partner's attempt to diminish their grief.

General adaptation syndrome is characterized by which of the following phases? a. Delayed reaction, alarm response, and physical recovery b. Immediate reaction, psychological exhaustion, and recovery c. Alarm response, reaction and resistance, and recovery d. Reaction and resistance, euphoria, and physical exhaustion

c. Alarm response, reaction and resistance, and recovery

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. tell her that you understand why she is scared and that everything will likely be okay. b. maintain eye contact at all times and tell her that there is no need for her to be scared. c. acknowledge that she is scared and tell her that you will take good care of her. d. reassure her that after proper treatment in the hospital, she will regain her speech in time.

c. acknowledge that she is scared and tell her that you will take good care of her.

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. let them know that because of the circumstances of their child's death, they will not be permitted to see him at this time. b. discreetly escort them to the back of the ambulance and allow them to see their child by themselves while you wait outside. c. advise them that their son had severely disfiguring injuries and ask them if there is anyone they would like you to contact first. d. express your sincere condolences over their loss and have them escorted away from the scene by a law enforcement officer.

c. advise them that their son had severely disfiguring injuries and ask them if there is anyone they would like you to contact first.

If it is not possible to adequately clean your ambulance at the hospital following a call, you should: a. quickly wipe down all high-contact surfaces with an antibacterial solution. b. wait until the end of your shift and then disinfect the entire patient compartment. c. clean the ambulance at your station in a designated area that is well ventilated. d. thoroughly wash the back of the ambulance at a local car wash or similar facility.

c. clean the ambulance at your station in a designated area that is well ventilated.

The MOST important consideration at the scene of a hazardous materials incident is: a. evacuating the bystanders. b. identifying the hazardous material. c. ensuring your personal safety. d. calling the hazardous materials team.

c. ensuring your personal safety.

The hepatitis B vaccine program, a component of the infection control plan, addresses all of the following issues, EXCEPT: a. postvaccine antibody titers. b. record keeping and tracking. c. family history of hepatitis. d. vaccine safety and efficacy.

c. family history of hepatitis.

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. assist with vehicle stabilization. b. report to the incident commander. c. put on high-visibility safety vests. d. quickly begin the triage process.

c. put on high-visibility safety vests.

According to the Centers for Disease Control and Prevention (CDC), recommended immunizations and tests include a: a. TB skin test every 6 months. b. two-shot hepatitis A vaccination series. c. tetanus/diphtheria/pertussis booster every 10 years. d. smallpox vaccine every 5 years.

c. tetanus/diphtheria/pertussis booster every 10 years.

Physiologic manifestations of stress include: a. flushed skin, decreased muscle control, and vomiting. b. increased blood pressure, decreased blood glucose levels, and chest pain. c. slow heart rate, low blood pressure, and severe headaches. d. perspiration, increased blood glucose levels, and dilated pupils.

d. perspiration, increased blood glucose levels, and dilated pupils.

When treating a patient who is trapped in a vehicle and covered with broken glass, it is BEST to wear: a. thick firefighter gloves over two pairs of latex gloves. b. firefighter gloves only, to preserve manual dexterity. c. latex gloves with thick leather gloves underneath. d. puncture-proof leather gloves over your latex gloves.

d. puncture-proof leather gloves over your latex gloves.

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. get in your ambulance and leave the scene immediately. b. continue into the apartment and apprehend the gunman. c. continue into the apartment using extreme caution. d. seek a safe place and request law enforcement assistance.

d. seek a safe place and request law enforcement assistance.

The MOST serious consequence of drug or alcohol abuse among EMS personnel is: a. low morale and frequently missed shifts. b. tension among coworkers and supervisors. c. punitive action and the loss of a job. d. substandard or inappropriate patient care.

d. substandard or inappropriate patient care.

The simplest, yet most effective method of preventing the spread of an infectious disease is to: a. undergo an annual physical examination. b. undergo annual testing for tuberculosis and hepatitis. c. ensure that your immunizations are up-to-date. d. wash your hands in between patient contacts.

d. wash your hands in between patient contacts.

Critical incident stress management (CISM) can occur at an ongoing scene in all of the following circumstances, EXCEPT: a. when personnel are assessed during periods of rest. b. before leaving the scene after the incident is resolved. c. before personnel are preparing to reenter the scene. d. when patients are actively being assessed or treated.

d. when patients are actively being assessed or treated.

A positive TB skin test indicates that: a. the TB disease is currently dormant but may later become active. b. you have never been exposed to TB. c. you are actively infected with TB. d. you have been exposed to TB.

d. you have been exposed to TB.