When Decontaminating the Back of Your Ambulance

IÕm Chapter 2 Multiple Choice 1. A. B. C. D. 2. A. B. C. D. 3. 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? direct contact indirect contact airborne transmission vector-borne transmission Vector-borne transmission of an infectious organism occurs via: animals or insects. smoke or dust. direct contact. inanimate objects. A. B. C. D. The simplest yet most effective method of preventing the spread of an infectious disease is to: undergo an annual physical examination. ensure that your immunizations are up-to-date. wash your hands in between patient contacts. undergo human immunodeficiency virus (HIV) testing at least twice a year. 4. A. B. C. D. If you use a waterless handwashing substitute in the field, it is important to: wash your hands with soap and water at the hospital. immediately dry your hands with a paper towel. wait at least 5 minutes before touching another patient. avoid donning another pair of gloves for at least 10 minutes. 5. A. B. C. D. 6. A. B. C. D. 7. A. B. C. D. 8. A. B. C. D. 9. A. B. C. D. Gloves, a mask, eye protection, and a face shield should be used: any time you touch non-intact skin. during routine cleaning of the ambulance. while handling needles or other sharps. when performing endotracheal intubation. 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. 2 3 4 5 Prescription glasses do not provide adequate eye protection because they: have large rounded lenses. are not secured with a strap. offer little or no side protection. do not have shatterproof lenses. 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. remain at least 3 feet away from the patient and apply a surgical mask on him. apply a sterile surgical mask on yourself and a HEPA respirator on the patient. apply a nasal cannula on the patient and a sterile surgical mask on yourself. While assisting an advanced life support (ALS) ambulance crew, you are accidentally stuck with an IV needle. You should: immerse your wound in an alcohol-based solution. report the incident to your supervisor after the call. get immunized against hepatitis as soon as possible. discontinue patient care and seek medical attention. 10. The spread of HIV and hepatitis in the health care setting can usually be traced to: A. careless handling of sharps. B. a lack of proper immunizations. C. excessive blood splashing or splattering. D. a noncompliance with standard precautions. 11. According to Occupational Safety and Health Administration (OSHA) regulations, an employer must: A. guarantee a 100% risk-free environment prior to employment. B. offer a workplace environment that reduces the risk for exposure. C. provide gloves and other personal protective equipment (PPE) to full-time paid employees only. D. screen all prospective employees for bloodborne pathogens. 12. Determination of exposure is an important component of an infection control plan because it: A. determines the time of day that most exposures are likely to occur. B. determines which type of communicable disease might be present in the workplace. C. defines who is most likely to transmit communicable diseases in the workplace. D. defines who is at risk for contact with blood and body fluids and which tasks pose a risk of exposure. 13. The hepatitis B vaccine program, a component of the infection control plan, addresses all of the following issues, EXCEPT: A. family history of hepatitis. B. postvaccine antibody titers. C. vaccine safety and efficacy. D. record keeping and tracking. 14. 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. identify who to notify after an exposure and where treatment should be provided. C. consist of a list of tasks that pose a risk for contact with blood or other body fluids. D. address issues such as medical waste collection, storage, and ambulance disinfection. 15. 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. clean the ambulance at your station in a designated area that is well ventilated. C. wait until the end of your shift and then disinfect the entire patient compartment. D. thoroughly wash the back of the ambulance at a local car wash or similar facility. 16. 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. clean all surfaces and patient contact areas with a mixture of alcohol and water. D. spray the contaminated areas and then immediately wipe them dry with a towel. 17. A. B. C. D. Which of the following is the MOST significant factor in determining if a person will become ill from certain germs? age race gender immunity 18. Which of the following statements regarding the hepatitis B vaccine is correct? A. Vaccination against hepatitis B provides partial immunity for life. B. OSHA requires that your employer offer you the vaccine free of charge. C. The hepatitis B vaccine provides protection against the disease for 2 years. D. Vaccination with the hepatitis B vaccine confers immunity against hepatitis A. 19. According to the CDC, recommended immunizations and tests include a: A. smallpox vaccine every 5 years. B. TB skin test every 6 months. C. two-shot hepatitis A vaccination series. D. tetanus-diphtheria booster every 10 years. 20. Vaccination against the hepatitis A virus is unnecessary if you: A. are older than 35 years of age. B. have a weak immune system. C. have been infected in the past. D. received a hepatitis B vaccination. 21. If a person is partially immune to a particular disease, he or she: A. is not protected from a new infection if exposed to another individual. B. must be revaccinated at least every 18 months to avoid infection. C. may develop illness from germs that lie dormant from the initial infection. D. will not experience future illness, even if his or her immune system is stressed. 22. Which of the following infectious diseases confers no protection from reinfection after exposure? A. mumps B. rubella C. syphilis D. chickenpox 23. Which of the following statements regarding HIV is correct? A. It is far more contagious than hepatitis B. B. It is easily transmittable in the EMS field. C. HIV is transmitted exclusively via blood. D. There is no vaccine against HIV infection. 24. A positive TB skin test indicates that: A. you have never been exposed to TB. B. you have been exposed to the disease. C. you are actively infected with the disease. D. the disease is dormant and may become active. 25. If you are exposed to a patientÕs blood or other bodily fluid, your first action should be to: A. report the incident to the infection control officer. B. abandon patient care and seek medical attention. C. transfer care of your patient to another EMS provider. D. vigorously clean the area with soap and water. 26. The BEST way to reduce your risk of contracting a work-related disease following exposure is to: A. vigorously wash the affected area with an antimicrobial solution. B. be evaluated by a physician within 72 hours following the exposure. C. get vaccinated against the disease you think you were exposed to. D. activate your departmentÕs infection control plan as soon as possible. 27. The general adaptation syndrome is characterized by which of the following phases? A. alarm response, reaction and resistance, and recovery B. delayed reaction, alarm response, and physical recovery C. reaction and resistance, euphoria, and physical exhaustion D. immediate reaction, psychological exhaustion, and recovery 28. Physiologic manifestations of stress include: A. flushed skin, decreased muscle control, and vomiting. B. slow heart rate, low blood pressure, and severe headaches. C. perspiration, increased blood glucose levels, and dilated pupils. D. increased blood pressure, decreased blood glucose levels, and chest pain. 29. What type of stress reaction occurs when an EMT is exposed to many insignificant stressors over a period of several months or years? A. acute stress reaction B. cumulative stress reaction C. posttraumatic stress reaction D. critical incident stress reaction 30. Which of the following scenarios MOST accurately depicts a posttraumatic stress disorder (PTSD) reaction? A. An EMT with many years of field experience becomes irritable with her coworkers and experiences headaches and insomnia. B. A newly certified EMT becomes extremely nauseated and diaphoretic at the scene of an incident involving grotesque injuries. C. An EMT is emotionally exhausted and depressed after a school bus crash involving critical injuries and the death of several children. D. 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. 31. 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 personnel are preparing to reenter the scene. C. when patients are actively being assessed or treated. D. before leaving the scene after the incident is resolved. 32. 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. providing large amounts of caffeine to the rescue workers. B. requesting a CISM team to provide on-scene peer support. C. conducting a critical incident stress debriefing the next day. D. allowing each worker to sleep in 15- to 30-minute increments. 33. A critical incident stress debriefing should be conducted no longer than ________ hours following the incident. A. 6 B. 12 C. 24 D. 72 34. As an EMT, it is important to remember that the signs and symptoms of cumulative stress: A. may not be obvious or present all the time. B. usually manifest suddenly and without warning. C. cannot be identified and can cause health problems. D. are most effectively treated with medications. 35. Which of the following signs would indicate that your partner is experiencing significant stress? A. increased interest in daily activities B. isolation from the rest of the crew C. hyperactivity during an EMS call D. acute increase in his or her appetite 36. Which of the following is the MOST effective strategy for managing stress? A. Frequently reflect on troublesome calls. B. Avoid friends and interests outside of EMS. C. Request overtime to increase your income. D. Focus on delivering high-quality patient care. 37. 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. 38. Quid pro quo, a type of sexual harassment, occurs when the harasser: A. requests sexual favors in exchange for something else. B. touches another person without his or her consent. C. stares at certain parts of another personÕs anatomy. D. makes rude remarks about a personÕs body parts. 39. 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 each other for their safety. C. must work together every third day. D. may have to bunk in the same room. 40. While on duty, your partner asks you out on a date and touches you in an inappropriate location without your consent. You should: A. tell your partner to quit kidding around and focus on his or her job. B. warn your partner that you will report him or her if it happens again. C. notify law enforcement personnel and have your partner arrested. D. tell your partner to stop and report the incident to your supervisor. 41. The MOST serious consequence of drug or alcohol abuse among EMS personnel is: A. punitive action and the loss of a job. B. low morale and frequently missed shifts. C. tension among coworkers and supervisors. D. substandard or inappropriate patient care. 42. 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. Remain quiet and simply request another partner. B. Report the incident to your EMS medical director. C. Discreetly report your suspicions to your supervisor. D. Tell your partner that he must seek professional help. 43. 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 patientÕs behavior consistent with? A. denial B. anger C. bargaining D. depression 44. Which of the following statements is MOST consistent with the bargaining phase of the grieving process? A. ÒIt is because of our lousy health care system that I developed this brain tumor.Ó B. ÒI will be compliant with all my medications if I can just see my grandson graduate.Ó C. ÒI understand that my death is inevitable and I am ready to die when the time comes.Ó D. ÒThe doctors must be wrong in their diagnosis because I have always been healthy.Ó 45. The final stage of death and dying is MOST commonly displayed as: A. anger. B. denial. C. depression. D. acceptance. 46. Which of the following statements regarding the different stages of the grieving process is correct? A. The grieving process typically begins with severe depression. B. It is rare that people will jump back and forth between stages. C. The stages of the grieving process may occur simultaneously. D. Bargaining is the most unpleasant stage of the grieving process. 47. Which of the following statements would NOT be appropriate to say to the family of a dying patient? A. ÒThings will get better in time.Ó B. ÒIt is okay to be angry and sad.Ó C. ÒThis must be painful for you.Ó D. ÒTell me how you are feeling.Ó 48. 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 partnerÕs attempt to diminish their grief. B. a show of respect for the person who has died. C. coaching them through the grieving process. D. your partnerÕs caring and supportive attitude. 49. 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. depart the scene and allow her to die with dignity. B. start cardiopulmonary resuscitation (CPR) if she experiences cardiopulmonary arrest. C. provide no interventions and transport to the hospital. D. make her comfortable and provide emotional support. 50. Common questions asked by patients with a serious illness or injury include all of the following, EXCEPT: A. ÒAm I going to die?Ó B. ÒWhat hospital am I going to?Ó C. ÒWhat are you doing to me?Ó D. ÒWill I be permanently disabled?Ó 51. 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. reassure her that after proper treatment in the hospital, she will regain her speech in time. B. acknowledge that she is scared and tell her that you are going to take good care of her. C. maintain eye contact at all times and tell her that there is no need for her to be scared. D. tell her that you understand why she is scared and that everything will likely be okay. 52. 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. tell the family member that it is not your fault. C. subdue the family member until the police arrive. D. ignore the family member and assess the patient. 53. Patients who become dependent upon EMS personnel or other health care providers often feel: A. relieved. B. superior. C. hopeful. D. shamed. 54. When a patient is dying, he or she may experience regression. This is MOST accurately defined as: A. anger projected toward the EMT or other providers. B. fear of being completely dependent upon other people. C. behavior consistent with an earlier developmental stage. D. a decreased ability to exercise age-appropriate judgment. 55. 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. tell him that he is having a heart attack and that he needs to go to the hospital. C. explain the seriousness of the situation to him, but avoid causing undue alarm. D. proceed to treat him because the stress of the situation has impaired his thinking. 56. 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 childÕs 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 childÕs 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. 57. When caring for the parents of a child who has died of leukemia, the EMT should: A. immediately refer them to a counselor. B. tell them that their feelings are understood. C. refrain from using words such as ÒdiedÓ or Òdead.Ó D. acknowledge the death of their child in private. 58. Common factors that influence how a patient reacts to the stress of an illness or injury include all of the following, EXCEPT: A. distrust of the EMT. B. mental disorders. C. history of chronic disease. D. fear of medical personnel. 59. 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. demonstrate courtesy and speak with a professional tone of voice. B. discourage her from expressing fears until a counselor is available. C. explain to her that Òeverything will be all rightÓ in order to calm her down. D. restrain her if she is extremely emotional and will not calm down. 60. 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. immediately tell her of his death so that she may grieve. C. let clergy or hospital staff relay the bad news if possible. D. avoid answering her questions and focus on her injuries. 61. What should you do before attempting to access a patient trapped in a vehicle? A. Check for other patients. B. Ensure the vehicle is stable. C. Request another ambulance. D. Contact medical control. 62. The MOST important consideration at the scene of a hazardous material incident is: A. identifying the material. B. calling the hazardous materials team. C. evacuating the bystanders. D. ensuring your personal safety. 63. 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 that live near the crash site. D. don PPE and quickly triage all patients. 64. 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. proceed with normal extrication procedures. B. remove the lines with a nonconductive object. C. advise the patients to carefully get out of the car. D. mark off a danger zone around the downed lines. 65. 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. sit down, bend your knees, and hold your crossed arms close to your body. C. quickly cover the patient with a blanket and then lie down flat on the ground. D. immediately lie down on your side and draw your knees into your abdomen. 66. Hazards that are associated with a structural fire include all of the following, EXCEPT: A. smoke and toxic gases. B. carbon dioxide deficiency. C. high ambient temperatures. D. the risk of building collapse. 67. 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. fills the lungs with secretions. C. causes the body to expel too much carbon dioxide. D. destroys the number of circulating red blood cells. 68. 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. request permission from the fire chief to enter the structure. B. don a self-contained breathing apparatus (SCBA) and rescue the woman. C. stay where you are until fire fighters remove her from the house. D. immediately notify the incident commander or safety officer. 69. 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. assist with vehicle stabilization. C. report to the incident commander. D. put on high-visibility safety vests. 70. 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. avoid outer clothing with zippers. C. wear at least three layers of clothing. D. wear socks made of heavy-duty cotton. 71. When treating a patient who is trapped in a vehicle and covered with broken glass, it is BEST to wear: A. latex gloves with thick leather gloves underneath. B. puncture-proof leather gloves over your latex gloves. C. fire fighter gloves only, to preserve manual dexterity. D. thick fire fighter gloves over two pairs of latex gloves. 72. You arrive at the scene of a domestic violence situation. As you approach the doorway of the apartment, you hear screaming and the statement ÒHe has a gun!Ó Your MOST appropriate action should be to: A. continue into the apartment using extreme caution. B. proceed into the apartment and apprehend the gunman. C. get in your ambulance and leave the scene immediately. D. seek a safe place and request law enforcement assistance. 73. Which of the following statements regarding a patient with a behavioral crisis is correct? A. Depression accounts for a very small percentage of violent attacks. B. A quiet patient is not as likely to attack you as one who is screaming. C. A past history of violence is an unreliable indicator of future violence. D. People who say that they are Òhearing voicesÓ are usually bluffing you. 74. Which of the following factors is NOT taken into consideration when assessing a personÕs potential for violence? A. poor impulse control B. tattoos, such as those with gang identification C. substance abuse D. large physical size