Chapter 2- Workforce Safety and Wellness

Chapter 2 Multiple Choice 1. 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. direct contact B. indirect contact C. airborne transmission D. vector-borne transmission Answer: B Question Type: General Knowledge Page: 34 2. Vector-borne transmission of an infectious organism occurs via: A. animals or insects. B. smoke or dust. C. direct contact. D. inanimate objects. Answer: A Question Type: General Knowledge Page: 34 3. The simplest yet most effective method of preventing the spread of an infectious disease is to: A. undergo an annual physical examination. B. ensure that your immunizations are up-to-date. C. wash your hands in between patient contacts. D. undergo human immunodeficiency virus (HIV) testing at least twice a year. Answer: C Question Type: General Knowledge Page: 35 4. If you use a waterless handwashing substitute in the field, it is important to: A. wash your hands with soap and water at the hospital. B. immediately dry your hands with a paper towel. C. wait at least 5 minutes before touching another patient. D. avoid donning another pair of gloves for at least 10 minutes. Answer: A Question Type: General Knowledge Page: 35 5. Gloves, a mask, eye protection, and a face shield should be used: A. any time you touch non-intact skin. B. during routine cleaning of the ambulance. C. while handling needles or other sharps. D. when performing endotracheal intubation. Answer: D Question Type: General Knowledge Page: 36 6. 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. 3 C. 4 D. 5 Answer: B Question Type: General Knowledge Page: 36 7. Prescription glasses do not provide adequate eye protection because they: A. have large rounded lenses. B. are not secured with a strap. C. offer little or no side protection. D. do not have shatterproof lenses. Answer: C Question Type: General Knowledge Page: 39 8. 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: A. apply a nonrebreathing mask on the patient and a high-efficiency particulate air (HEPA) respirator on yourself. B. remain at least 3 feet away from the patient and apply a surgical mask on him. C. apply a sterile surgical mask on yourself and a HEPA respirator on the patient. D. apply a nasal cannula on the patient and a sterile surgical mask on yourself. Answer: A Question Type: Critical Thinking Page: 39 9. 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. Answer: B Question Type: Critical Thinking Page: 40 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. Answer: A Question Type: General Knowledge Page: 40 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. Answer: B Question Type: General Knowledge Page: 40 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. Answer: D Question Type: General Knowledge Page: 41 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. Answer: A Question Type: General Knowledge Page: 41 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. Answer: A Question Type: General Knowledge Page: 41 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. Answer: B Question Type: General Knowledge Page: 42 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. Answer: A Question Type: General Knowledge Page: 42 17.Which of the following is the MOST significant factor in determining if a person will become ill from certain germs? A. age B. race C. gender D. immunity Answer: D Question Type: General Knowledge Page: 43 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. Answer: B Question Type: General Knowledge Page: 44 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. Answer: D Question Type: General Knowledge Page: 44 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. Answer: C Question Type: General Knowledge Page: 44 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. Answer: C Question Type: General Knowledge Page: 44 22. Which of the following infectious diseases confers no protection from reinfection after exposure? A. mumps B. rubella C. syphilis D. chickenpox Answer: C Question Type: General Knowledge Page: 44 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. Answer: D Question Type: General Knowledge Page: 44 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. Answer: B Question Type: General Knowledge Page: 45 25. If you are exposed to a patient’s 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. Answer: C Question Type: General Knowledge Page: 45 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 department’s infection control plan as soon as possible. Answer: D Question Type: General Knowledge Page: 45 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 Answer: A Question Type: General Knowledge Page: 45 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. Answer: C Question Type: General Knowledge Page: 45 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 Answer: B Question Type: General Knowledge Page: 46 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. Answer: D Question Type: General Knowledge Page: 46 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. Answer: C Question Type: General Knowledge Page: 46–47 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. Answer: B Question Type: Critical Thinking Page: 46–47 33. A critical incident stress debriefing should be conducted no longer than ________ hours following the incident. A. 6 B. 12 C. 24 D. 72 Answer: D Question Type: General Knowledge Page: 47 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. Answer: A Question Type: General Knowledge Page: 47 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 Answer: B Question Type: General Knowledge Page: 47 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. Answer: D Question Type: General Knowledge Page: 48 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. Answer: C Question Type: General Knowledge Page: 51 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 person’s anatomy. D. makes rude remarks about a person’s body parts. Answer: A Question Type: General Knowledge Page: 53 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. Answer: B Question Type: General Knowledge Page: 53 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. Answer: D Question Type: Critical Thinking Page: 53 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. Answer: D Question Type: General Knowledge Page: 53–54 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. Answer: C Question Type: Critical Thinking Page: 54 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 patient’s behavior consistent with? A. denial B. anger C. bargaining D. depression Answer: B Question Type: Critical Thinking Page: 55 44. Which of the following statements is MOST consistent with the bargaining phase of the grieving process? A.