EMT Chapter 2

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:

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

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:

retreat and notify law enforcement personnel.

A critical incident stress debriefing should be conducted no longer than ________ hours following the incident.

72

A positive TB skin test indicates that:

you have been exposed to the disease..

According to Occupational Safety and Health Administration (OSHA) regulations, an employer must:

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

According to the CDC, recommended immunizations and tests include a:

tetanus-diphtheria booster every 10 years.

As an EMT, it is important to remember that the signs and symptoms of cumulative stress:

may not be obvious or present all the time.

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:

mark off a danger zone around the downed lines.

Carbon monoxide blocks the ability of the blood to oxygenate the body because it:

binds with the hemoglobin in the red blood cells.

Common factors that influence how a patient reacts to the stress of an illness or injury include all of the following, EXCEPT:

distrust of the EMT.

Common questions asked by patients with a serious illness or injury include all of the following, EXCEPT:

"What hospital am I going to?"

Critical incident stress management (CISM) can occur at an ongoing scene in all of the following circumstances, EXCEPT:

when patients are actively being assessed or treated..

Determination of exposure is an important component of an infection control plan because it:

defines who is at risk for contact with blood and body fluids and which tasks pose a risk of exposure..

Gloves, a mask, eye protection, and a face shield should be used:

when performing endotracheal intubation..

Hazards that are associated with a structural fire include all of the following, EXCEPT:

carbon dioxide deficiency.

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.

. 3

If a person is partially immune to a particular disease, he or she:

may develop illness from germs that lie dormant from the initial infection.

If it is not possible to adequately clean your ambulance at the hospital following a call, you should:

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

If you are exposed to a patient’s blood or other bodily fluid, your first action should be to:

transfer care of your patient to another EMS provider.

If you use a waterless handwashing substitute in the field, it is important to:

wash your hands with soap and water at the hospital.

It is especially important for EMS personnel to develop nonadversarial relationships with their coworkers because they

depend on each other for their safety.

Patients who become dependent upon EMS personnel or other health care providers often feel:

shamed

Physiologic manifestations of stress include:

perspiration, increased blood glucose levels, and dilated pupils.

Prescription glasses do not provide adequate eye protection because they:

offer little or no side protection.

Quid pro quo, a type of sexual harassment, occurs when the harasser:

requests sexual favors in exchange for something else.

The BEST way to reduce your risk of contracting a work-related disease following exposure is to:

activate your department’s infection control plan as soon as possible..

The compliance monitoring component of an infection control plan should:

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

The final stage of death and dying is MOST commonly displayed as:

acceptance..

The general adaptation syndrome is characterized by which of the following phases?

alarm response, reaction and resistance, and recovery

The hepatitis B vaccine program, a component of the infection control plan, addresses all of the following issues, EXCEPT:

family history of hepatitis..

The MOST effective way to preserve your own body heat when functioning in cold, wet weather is to:

wear at least three layers of clothing..

The MOST important consideration at the scene of a hazardous material incident is:

ensuring your personal safety..

The MOST serious consequence of drug or alcohol abuse among EMS personnel is:

substandard or inappropriate patient care.

The simplest yet most effective method of preventing the spread of an infectious disease is to:

wash your hands in between patient contacts.

The spread of HIV and hepatitis in the health care setting can usually be traced to:

careless handling of sharps..

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:

put on high-visibility safety vests..

Vaccination against the hepatitis A virus is unnecessary if you:

have been infected in the past.

Vector-borne transmission of an infectious organism occurs via:

animals or insects.

What should you do before attempting to access a patient trapped in a vehicle?

Ensure the vehicle is stable.

What type of stress reaction occurs when an EMT is exposed to many insignificant stressors over a period of several months or years?

cumulative stress reaction.

When a patient is dying, he or she may experience regression. This is MOST accurately defined as:

behavior consistent with an earlier developmental stage.

When caring for the parents of a child who has died of leukemia, the EMT should:

acknowledge the death of their child in private.

When considering his or her personal life, it is important for the EMT to realize that:

family or friends may not understand the stress associated with EMS.

When decontaminating the back of your ambulance after a call, you should:

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

When treating a patient who is trapped in a vehicle and covered with broken glass, it is BEST to wear:

puncture-proof leather gloves over your latex gloves.

Which of the following factors is NOT taken into consideration when assessing a person’s potential for violence?

large physical size

Which of the following infectious diseases confers no protection from reinfection after exposure?

syphilis

Which of the following is the MOST effective strategy for managing stress?

Focus on delivering high-quality patient care..

Which of the following is the MOST significant factor in determining if a person will become ill from certain germs?

immunity

Which of the following scenarios MOST accurately depicts a posttraumatic stress disorder (PTSD) reaction?

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.

Which of the following signs would indicate that your partner is experiencing significant stress?

isolation from the rest of the crew.

Which of the following statements is MOST consistent with the bargaining phase of the grieving process?

"I will be compliant with all my medications if I can just see my grandson graduate.".

Which of the following statements regarding a patient with a behavioral crisis is correct?

A quiet patient is not as likely to attack you as one who is screaming..

Which of the following statements regarding HIV is correct?

There is no vaccine against HIV infection.

Which of the following statements regarding the different stages of the grieving process is correct?

The stages of the grieving process may occur simultaneously.

Which of the following statements regarding the hepatitis B vaccine is correct?

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

Which of the following statements would NOT be appropriate to say to the family of a dying patient?

"Things will get better in time."

While assisting an advanced life support (ALS) ambulance crew, you are accidentally stuck with an IV needle. You should:

report the incident to your supervisor after the call.

While on duty, your partner asks you out on a date and touches you in an inappropriate location without your consent. You should:

tell your partner to stop and report the incident to your supervisor.

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?

indirect contact

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:

your partner’s attempt to diminish their grief..

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:

immediately notify the incident commander or safety officer.

You and your partner respond to the residence of a 66-year-old male with shortness of breath. As you are assessing the patient, his wife tells you that he was recently diagnosed with lung cancer. The patient is verbally abusive and tells you that failure of the health care system caused his disease. What stage of the grieving process is this patient’s behavior consistent with?

anger

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:

explain the seriousness of the situation to him, but avoid causing undue alarm.

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:

crouch down in a position so that only your feet are touching the ground.

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:

demonstrate courtesy and speak with a professional tone of voice.

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:

let clergy or hospital staff relay the bad news if possible.

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:

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

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:

make her comfortable and provide emotional support.

You are transporting a 40-year-old male with respiratory distress. The patient tells you that he recently had a positive tuberculosis (TB) skin test and is currently being evaluated for possible TB. You should:

apply a nonrebreathing mask on the patient and a high-efficiency particulate air (HEPA) respirator on yourself..

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:

acknowledge that she is scared and tell her that you are going to take good care of her.

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:

seek a safe place and request law enforcement assistance..

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:

requesting a CISM team to provide on-scene peer support

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?

Discreetly report your suspicions to your supervisor.