Chapter 2 The Well-being of the EMT
3) All of the following are ways that an EMT can increase both physical and mental well-being, except: A) drinking caffeine instead of alcohol. B) following a regular walking regimen. C) spending more time relaxing with friends and family. D) eating more carbohydrates. Answer:
A
32) Which of the following is a physiologic effect of the "Stress Triad" as described by the physician Hans Selye? A) Bleeding gastric ulcers B) Hypertrophy of the lymph nodes C) Atrophy of the adrenal glands D) Amnesia for stressful events Answer:
A
43) Since EMS personnel are often exposed to both acute and chronic stressors, ________ management may be helpful to cope with on-the-job experiences. A) critical incident stress B) crisis intervention C) stress prevention D) chronic stress Answer:
A
45) While transporting a patient to the hospital who has a history of terminal brain cancer, the patient says, "I know I'm going to die, but first I want to see my grandson graduate from high school." What stage of death and dying describes this patient's current condition? A) Bargaining B) Denial C) Anger D) Depression Answer:
A
49) You observe a coworker telling a terminal cancer patient and her family, "Everything will be okay." Making false reassurances is considered: A) naive and uncompassionate. B) caring and supportive. C) professional and discreet. D) ambiguous and uncertain. Answer:
A
50) Which of the following behaviors would demonstrate that an EMT understands reactions to death and dying? A) Being tolerant of angry reactions by patients and family members B) Giving a dying patient hope that a cure can be found before the patient dies C) Providing spiritual guidance to patients who express anger at God D) Being firm with grieving family members and telling them they need to accept what has happened Answer:
A
51) Which three "Rs" are essential for the EMT to practice when reacting to danger? A) Retreat, radio, reevaluate B) Remember, respect, respond C) Ricochet, recover, re-entry D) Realize, react, reassess Answer:
A
52) What is the EMT's highest priority at the scene of a hazardous materials incident? A) Personal safety B) Identification of hazardous materials C) Patient care D) Safety of bystanders Answer:
A
55) You are first on the scene of a vehicle collision where a vehicle has gone off a bridge and is partially submerged. You are told that a person is still trapped in the vehicle. Your partner starts to take off his shoes and prepares to go in to save the victim. You stop your partner and tell him it is too dangerous. He tells you he is prepared to die to save a life. What is the best response to him? A) He is not only putting his life at risk, but also placing the lives of the professional rescuers unnecessarily at risk. B) His family will not receive any benefits if he is not trained in rescue and dies while attempting a rescue. C) The patient's family may sue him if he is not successful in rescuing him. D) He will force additional fire units to come to his aid unnecessarily and waste taxpayer money. Answer:
A
61) What is a simple step EMTs can perform to help prevent the spread of flu in the prehospital environment? A) Place a surgical mask on suspected flu patients. B) Transport all patients with coughs to negative pressure rooms. C) Notify the CDC and local health department of flu cases. D) Encourage patients to get their H1N1 antivirals early in the flu season. Answer:
A
11) Which of the following pathogens can live in dried blood for days and should be a major concern for EMS providers even while cleaning contaminated equipment? A) Tuberculosis B) Hepatitis B C) Hepatitis A D) AIDS Answer:
B
12) Healthcare employers are required by law to provide a hepatitis B ________ available to employees free of charge. A) prophylaxis B) vaccine C) cure D) immunity Answer:
B
15) Which one of these groups is at greatest risk of contracting and transmitting tuberculosis? A) Current and former smokers B) Immunosuppressed patients C) Uranium mine workers D) Healthcare practitioners Answer:
B
19) You respond to a laceration call. When you arrive on-scene, you walk into the house and find a person suffering from a severe wrist laceration from a broken window. Without thinking, you immediately grab the wrist and apply direct pressure to the wound. You then realize that, in your hurry to save a life, you forgot to put on your gloves. You look down to see your hand is covered in blood. When practical, you immediately wash your hands thoroughly. What is your next best action? A) Report the exposure incident because it is the law and you could be fined a large sum of money for failing to report the exposure. B) Report the exposure so you can protect yourself from any accidental infection. C) Report the exposure. Failure to report the exposure may result in you not receiving financial compensation for a potential line-of-duty injury. D) If your hands had no open wounds, it is not required to report the exposure as there is no risk of infection, and you could get in trouble at work for failure to follow policy. Answer:
B
23) The tuberculin skin test (TST), formerly known as the purified protein derivative (PPD) test, is used to: A) determine if a person has infected others with TB. B) detect a person's exposure to tuberculosis. C) inoculate healthcare workers against TB infections. D) prevent tuberculosis from spreading following an exposure. Answer:
B
39) Which of the following behaviors would be considered a common sign of stress rather than an acute psychological problem? A) Failure to use PPE appropriately on a regular basis B) Irritability with friends, family, coworkers, or patients C) Flashbacks, nightmares, and feelings of detachment D) Increased speeding and reckless driving Answer:
B
41) What is a positive, healthy way to help deal with stress? A) Caffeine to "get up and go" B) Regular physical exercise C) Adding workload to a busy regular schedule D) Drinking alcohol to "unwind" Answer:
B
44) Critical Incident Stress Debriefings (CISDs): A) are always recommended. B) are now less common than they once were. C) must be held from 2 to 4 hours following an incident to be effective. D) have been replaced with "defusings." Answer:
B
53) What reference provides important information regarding hazardous materials, emergency care, and procedures in case of accidental fire or release; supplies definitions of placard colors and identification numbers; and should be standard issue on-board all ambulances and rescue units? A) Accidental Exposure and Contamination Guide B) Emergency Response Guidebook C) Emergency Preparedness and Response Plan D) Safety Data Sheets Answer:
B
54) You are dispatched to the staging area of a terrorist-related chemical exposure. The incident commander asks you to stand by while hazmat personnel bring patients to the cold zone. As an EMT on-board an ambulance, what statement BEST describes your role? A) Triage patients to be decontaminated. B) Transport decontaminated patients. C) Coordinate hazmat response. D) Transport patients to be decontaminated. Answer:
B
60) Which of the following pathogens is transmitted through contact with open wounds or sores? A) Pertussis B) Staphylococcus C) Rubella D) Meningitis Answer:
B
62) Which of the following provides the greatest personal safety for an EMT working at a motor vehicle collision? A) Nonslip footwear B) Reflective outer clothing C) Portable radio D) Flashlight Answer:
B
7) Due to the high risk of an unstable work environment, EMTs responding to a motor vehicle crash may consider using ________ in addition to standard PPE. A) N-95 masks B) heavy-duty gloves C) face shields D) Level B hazmat suits Answer:
B
8) You are called to an assault on a homeless male. Dried blood from the trauma is visible around the patient's mouth and nose. During assessment, you note the patient has a productive cough. The patient says, "Don't worry, I'm not contagious. I've had this cough for a year." Describe the best approach regarding respiratory isolation. A) Isolate the patient with a nonrebreather mask. B) Mask yourself and the patient. C) Mask yourself only. D) Use gloves for PPE, as that's all that's needed. Answer:
B
9) Which of the following is true regarding proper hand cleaning? A) Soap and water should be used following any patient contact if the EMT does not wear gloves. B) If the EMT's hands are visibly dirty, an alcohol-based hand cleaner is not sufficient. C) In cases where soap and water and alcohol-based hand cleaners are not immediately available, bleach wipes should be used. D) Following patient contact, the EMT should soak his hands in warm soapy water for at least 30 seconds and then shake them vigorously. Answer:
B
10) What mode of transmission most accurately describes the route of spreading hepatitis A? A) Respiratory droplet B) Unprotected sex C) Fecal-oral D) Bloodborne Answer:
C
14) Which of the following statements about HIV/AIDS is true? A) HIV positive needlesticks have a 30 percent infection rate. B) The HIV virus lives longer outside the body than hepatitis B. C) HIV positive needlesticks have less than a 0.05 percent infection rate. D) Drugs are not available that slow HIV from progressing into AIDS. Answer:
C
2) What is a common term used to describe the items needed for Standard Precautions or body substance isolation precautions? A) Harm-reduction strategy B) Exposure-control plan C) Personal protective equipment D) Infection-control plan Answer:
C
24) Which of the following terms is best defined as "a state of physical and/or psychological arousal to a stimulus?" A) Homeostasis B) Distress C) Stress D) Eustress Answer:
C
25) Which of the following is the form of stress that can cause immediate and long-term problems with an EMT's health and well-being? A) Megastress B) Hyperstress C) Distress D) Eustress Answer:
C
29) An EMT is confronted by an armed gunman who is threatening to kill the EMT and his partner. An elevation in the EMT's heart rate and blood pressure occurs in which stage of the body's response to stress? A) Resistance stage B) Exhaustion stage C) Alarm reaction stage D) Response stage Answer:
C
31) According to Dr. Hans Selye, the third stage of the "Stress Triad" is known as the ________ stage. A) resistance B) cumulative C) exhaustion D) alarm Answer:
C
40) For the last few days, your regular EMT partner has been having trouble sleeping, has been on edge, and has trouble concentrating on his job during EMS calls. Luckily, your call volume has been low with no serious calls since the infant cardiac arrest you both worked last month. You ask him if anything is bothering him and he states he is fine in every way. He states that he has been going to the bars lately to relax and invites you to come along for some drinks after work. Choose the best answer for this situation. A) Your partner is suffering from acute stress reaction and you should recommend to him that he seek professional counseling. B) Your partner is suffering from post-traumatic stress disorder and you should go to the bar with him to provide moral support and talk with him. C) Your partner is suffering from a delayed stress reaction and you should recommend that he seek professional counseling. D) Your partner is suffering from a cumulative stress reaction. This is a natural response and he should be fine in a few days. Answer:
C
42) An EMT involved in an especially difficult call, such as one in which a coworker was killed, should be urged to: A) discuss the experience freely with coworkers. B) begin a course of psychiatric medications. C) seek help from a trained mental health professional. D) conceal the problem because care may not be covered financially. Answer:
C
46) When responding to the scene of a patient who was discovered to be unresponsive, not breathing, and without a pulse, family members state that the patient has been suffering from cancer for several years. One of his sons is cursing at you and your partner, saying that you are not moving fast enough. Which stage of grief is the patient's son experiencing in response to his father's death? A) Denial B) Depression C) Anger D) Acceptance Answer:
C
5) An EMT should consider wearing protective eyewear when caring for which of these patients? A) A patient with a difficult-to-visualize scalp laceration B) A trauma patient who is covered in dirt, rocks, and other foreign debris C) A patient who is actively coughing D) A patient who was sprayed with mace by police during arrest Answer:
C
56) You are dispatched to a female with altered mental status. Once inside the home, you find a female who appears to have been beaten unconscious. A man, who smells of alcohol, says that she is his wife and that he does not know what happened: "I just found her this way!" The husband is behaving suspiciously, appears paranoid, and is pacing erratically around the room. What would be the safest course of action? A) Continue to question the man and begin treating the patient. B) Evacuate the patient and begin treatment. C) Leave the house and call for law enforcement. D) Have your partner call for help while you stay with the patient. Answer:
C
58) You are dispatched to a "man down" with no further information. As your unit arrives on-scene, you see a crowd of bystanders looking at a man lying in an alleyway. The bystanders begin screaming to you, "Help him, he's been shot! He's bleeding real bad!" What would be the best course of action? A) Move bystanders aside since the patient will die without treatment. B) Tell law enforcement investigators to meet your unit at the ER. C) Dispatch law enforcement and wait until the scene is secure. D) Load and go, because you're already on-scene. Answer:
C
59) You are approaching the scene of a motor vehicle crash. Which of the following would be the first way to safeguard your well-being as an EMT? A) Take personal protective equipment (PPE) precautions. B) Request additional resources. C) Ensure scene safety. D) Utilize DOT-approved reflective safety clothing. Answer:
C
6) During which of these situations would the EMT be least likely to experience a body substance exposure? A) Bandaging a laceration B) Childbirth C) Splinting a sprained ankle D) Glucometry Answer:
C
1) Which of the following descriptions BEST defines the term pathogen? A) An immunity developed after an exposure B) A study of the origins of infection and disease C) A medication with a harmful effect D) An organism that causes infection and disease Answer:
D
13) Which of the following is an accurate statement regarding tuberculosis (TB)? A) The incubation period of TB is from 1 to 7 days. B) TB is not spread through surface contamination. C) The TB pathogen only affects lung tissue. D) A tuberculin skin test can detect TB exposure. Answer:
D
16) You are treating a patient who has a productive cough and who reports weight loss, loss of appetite, weakness, night sweats, and fever. Which of the following diseases is most likely the cause of these signs and symptoms? A) Hepatitis B B) Pneumonia C) AIDS D) Tuberculosis Answer:
D
17) The CDC recommends using an alcohol-based hand sanitizer in all except which of the following situation(s)? A) The patient has a bloodborne communicable disease. B) The patient has a respiratory illness. C) The provider is not vaccinated against hepatitis B. D) The provider's hands come into contact with fecal matter. Answer:
D
18) What is the name of the federal act that mandates a procedure by which emergency healthcare providers can find out if they have been exposed to potentially life-threatening diseases while on the job? A) Communicable Disease Notification Act B) EMS Personnel Health Protection Act of 1991 C) Occupational Exposure to Bloodborne Pathogens Act D) Ryan White CARE Act Answer:
D
20) What are the minimum Standard Precautions an EMT should take when transporting a patient infected with Middle East Respiratory Syndrome (MERS)? A) Gloves, N-95 mask, and goggles B) Gloves C) Gloves and N-95 mask D) Gloves, N-95 mask, goggles, and gown Answer:
D
21) When covering a patient's mouth and nose with a mask of any kind, which of the following is the primary risk? A) Causing or exasperating respiratory illnesses B) Interfering with patient communication C) Upsetting the patient because of the social stigma D) Obstructing the ability to visualize and protect the airway Answer:
D
22) When the potential exists for exposure to exhaled air of a person with suspected or confirmed TB, a(n) ________ mask should be worn by the EMT. A) surgical B) B-50 C) nonrebreather D) N-95 Answer:
D
26) What action does an organ undergo to best describe the term hypertrophy? A) Absence B) Wasting C) Changing D) Enlargement Answer:
D
27) Which of the following parts of the nervous system is responsible for the "fight or flight" response experienced in response to a stressor? A) Parasympathetic nervous system B) Central nervous system C) Peripheral nervous system D) Sympathetic nervous system Answer:
D
28) Which hormone helps the body control stress, regulate metabolism, and influence an immune response? A) Immunoglobulin B) Serotonin C) Epinephrine D) Cortisol Answer:
D
30) The "Stress Triad," or the body's response to a stressful stimulation, is known as general ________ syndrome. A) incident B) resistance C) reaction D) adaptation Answer:
D
33) The term burnout is also known as a(n) ________ stress reaction. A) delayed B) post-traumatic C) acute D) cumulative Answer:
D
34) Post-traumatic stress disorder may be described as a(n): A) acute stress reaction. B) cumulative stress reaction. C) severe stress reaction. D) delayed stress reaction. Answer:
D
35) What are some signs and symptoms that a coworker may be experiencing delayed stress reaction (PTSD)? A) Suspicion of friends, family, coworkers, or patients B) Excessive sleeping, loss of appetite, and distractibility C) Headaches, stomach ailments, and a chronic cough D) Flashbacks, nightmares, and feelings of detachment Answer:
D
36) A(n) ________ is a situation that may lead to an acute stress reaction. A) routine call B) abuse of alcohol C) ongoing night shift D) injury of a coworker Answer:
D
37) One's "cognitive ability" refers to his or her ability to do which of the following? A) Control his or her emotions B) Use fine motor skills C) Adapt to stress D) Think and solve problems Answer:
D
38) Which of the following terms refers to a positive form of stress that helps people work when under pressure and respond effectively? A) Prostress B) Distress C) Unstress D) Eustress Answer:
D
4) What would be the primary reason for an EMT to change gloves between contact with different patients? A) To protect the EMT from becoming infected B) To minimize the amount of time the EMT's hands are spent in gloves C) To ensure soiled gloves are changed as soon as possible D) To prevent spreading infection to the next patient Answer:
D
47) A family member who keeps pleading with a deceased loved one to "wake up" is experiencing which reaction to death and dying? A) Anger B) Rejection C) Projection D) Denial Answer:
D
48) You have just worked a cardiac arrest call on a 48-year-old father of three. Despite your best efforts, the patient died in the emergency department. As you are getting your ambulance in service, the patient's wife rushes out of the emergency department. She finds you and begins screaming at you that her husband's death is your fault. She blames you for not getting on the scene fast enough, taking too long at the house, and not shocking her husband back to life like she has seen on television. What response should you have to her anger? A) Recognize that she is in the denial stage of grief and interrupt her hysterical behavior pattern by getting her attention and helping her calm down. B) Reassure her that you did everything you could and that everything will be okay. C) Correct her misconceptions and remind her that television shows are fiction, so she will not sue you in the future. D) Listen empathetically to all of her complaints and let her know she can contact you for any additional assistance. Answer:
D
57) You are on the scene of an "unknown medical" call. The patient is a 26-year-old, 250-pound male patient who suddenly becomes violently angry. Everything you say to the patient only makes him angrier. Offended by your questions, he screams that he is going to "cut your tongue out" and hurries into the kitchen. What should you do? A) Radio for police and then calmly walk out of the house, being sure to take all of your medical equipment. B) Tackle the patient before he can get a kitchen knife to stab you. C) Radio for police and relay to dispatch important scene information until they arrive. D) Leave immediately to a safe area and then call for police assistance. Answer:
D
