Prehospital Emergency Care., 11th Edition Test Bank

Prehospital Emergency Care, 11e (Mistovich et al.) Chapter 2 Workforce Safety and Wellness of the EMT 1) A distraught husband awoke to find his 26-year-old wife not breathing and cold to the touch. Since your assessment indicates that the woman has been dead for some time, you contact medical direction for authorization to withhold emergency care. The medical director agrees and the coroner is notified. At this time, your immediate responsibility is: A) Establishing the time of death B) Preparing for the next call C) Determining the cause of death D) Providing supportive care to the husband Answer: D Diff: 2 Page Ref: 22 Objective: 2-3 2) You are doing CPR on a male patient who is unresponsive, not breathing, and pulseless. Emergency Medical Responders (EMRs) were on scene first and applied the AED, which did not deliver a shock to the patient. The patient’s wife is crying and asks how her husband is doing. Your response would be: A) “I have to be honest, he is probably dead, but we are going to take him to the hospital so the doctor can examine him and make sure.” B) “Why don’t we wait until we get to the hospital to talk about your husband’s condition?” C) “Right now he is not breathing and his heart is not beating, but we are doing everything we possibly can for him.” D) “I am not a doctor, but his current condition is very grave and he will likely die, based on my previous experiences.” Answer: C Diff: 2 Page Ref: 22 Objective: 2-3 3) The EMT practice of protecting oneself from disease transmission through exposure to blood and other body fluids is referred to as: A) Standard Precautions B) Exposure control C) Personal protective equipment D) Body Fluid Precautions Answer: A Diff: 1 Page Ref: 28 Objective: 2-1 1 Copyright © 2018 Pearson Education, Inc. 4) An EMT is correct when he describes a communicable disease as: A) Any of a number of diseases that are deadly once contracted B) A disease that can be spread from one person to another C) Any disease that is caused and spread by a viral agent D) A disease for which no immunization exists Answer: B Diff: 1 Page Ref: 27 Objective: 2-9 5) What is the single best technique that the EMT can use to prevent the spread of infection? A) Disinfecting equipment B) Wearing gloves C) Washing hands D) Getting immunizations Answer: C Diff: 2 Page Ref: 28 Objective: 2-9 6) The EMT is correctly performing routine handwashing when she: A) Uses an alcohol-based hand sanitizer without water B) Rinses with hot water after using a disinfectant soap C) Lathers and scrubs with plain soap for 20 seconds D) Dries hands thoroughly for 30 seconds with a reusable towel Answer: C Diff: 2 Page Ref: 29 Objective: 2-9 7) A patient with human immunodeficiency virus (HIV) infection is complaining of chest pain. In this situation, which personal protective equipment, at a minimum, is required to be donned prior to contact with the patient? A) Gloves and eyewear B) Gloves and gown C) Gloves, gown, and N-95 respirator D) Gloves, gown, goggles, and mask Answer: A Diff: 2 Page Ref: 33-34 Objective: 2-12 2 Copyright © 2018 Pearson Education, Inc. 8) The hospital staff has just returned the long spine board that you used to immobilize a patient from a minor motor vehicle collision. There is no blood on the board, but your service policy states that all equipment is to be disinfected anytime that it is used. To properly disinfect the long spine board, which type of product should you use? A) Soap and water B) Sterilizing solution C) Germicidal solution D) Superheated steam Answer: C Diff: 2 Page Ref: 31-32 Objective: 2-9 9) Which immunization should the EMT receive annually? A) Purified protein derivative B) Measles, mumps, and rubella vaccine C) Hepatitis B vaccine D) Influenza vaccine Answer: D Diff: 2 Page Ref: 32 Objective: 2-13 10) You have been told that you must get your purified protein derivative (PPD) test for tuberculosis (TB). As a knowledgeable EMT, you recognize that the PPD test will: A) Provide continued immunity to tuberculosis B) Need to be repeated annually C) Reveal whether you need a TB immunization D) Determine the effectiveness of treatment for TB Answer: B Diff: 2 Page Ref: 32 Objective: 2-9 11) Which statement made by an EMT demonstrates that he has an accurate understanding of hepatitis C? A) “It is important to get the hepatitis C vaccine to decrease my chance of contracting the disease if exposed to the virus.” B) “Wearing gloves and washing hands are the best means by which to prevent the transmission of hepatitis C to health care workers.” C) “Since hepatitis C is primarily transmitted in the spring and summer, more precautions are needed during that time.” D) “Respiratory droplets are the primary means by which hepatitis C is transmitted, making a mask necessary when caring for patients with this disease.” Answer: B Diff: 3 Page Ref: 33 Objective: 2-11 3 Copyright © 2018 Pearson Education, Inc. 12) While you are assessing a patient with abdominal pain, the patient informs you that he is a chronic carrier of hepatitis B. His skin is not jaundiced, nor does he have a fever. As an EMT, you realize: A) The patient has the disease but is not infectious B) The hepatitis B vaccine will not protect you if you are exposed to the virus C) The patient’s blood and body fluids are infectious D) A mask must be placed over the patient’s mouth Answer: C Diff: 3 Page Ref: 32 Objective: 2-13 13) You are treating a patient with active tuberculosis. What will afford you the best protection from the disease while you care for the patient? A) Surgical mask with a face shield B) Purified protein derivative injection C) Gloves, gown, and goggles D) High-efficiency particulate aspirator mask Answer: D Diff: 2 Page Ref: 33 Objective: 2-12 14) A patient informs you that he was recently diagnosed with the human immunodeficiency virus (HIV) infection, but has yet to develop AIDS. Given this information, which statement is true? A) Until the patient develops AIDS, he is not infectious B) Family members should not share the patient’s hand towels or utensils C) The hepatitis B and C vaccines provide the EMT with limited protection from transmission of HIV D) Gloves and eye protection will be enough protection under most conditions unless body fluids are present Answer: D Diff: 2 Page Ref: 33-34 Objective: 2-12 15) Preincident stress education, one-on-one support, and disaster support services are all part of: A) A comprehensive CISM program B) A balanced work environment C) Burnout prevention programs D) Stress reduction techniques Answer: A Diff: 2 Page Ref: 26 Objective: 2-8 4 Copyright © 2018 Pearson Education, Inc. 16) You are dispatched to a motor vehicle collision on a remote country road. It is night, and your scene size-up reveals a heavily damaged car that rolled several times. The driver has been ejected and is lying prone in the middle of the road. In this situation, which type of protective clothing is it most essential that you don prior to making patient contact? A) Rubber-soled boots B) Reflective vest C) Protective helmet D) Leather gloves Answer: B Diff: 2 Page Ref: 37 Objective: 2-14 17) As EMTs leave a house where the patient refused care, a panicked boy approaches them and states that some men just shot his friend in a house two doors up the street. The EMTs’ immediate action should be to: A) Instruct the boy to carry the patient from the house to the yard B) Gather basic equipment and go to the home to care for the patient C) Notify dispatch and proceed to the home to care for the patient D) Contact the police and move the ambulance from the immediate area Answer: D Diff: 2 Page Ref: 39 Objective: 2-14 18) You are transporting a 58-year-old female with terminal breast cancer. While in the ambulance, she becomes tearful yet agitated, and repeatedly asks, “Why me?” As a knowledgeable EMT, you recognize that she is in which stage of grieving? A) Anger B) Denial C) Bargaining D) Depression Answer: A Diff: 2 Page Ref: 21 Objective: 2-2 19) A reaction to death or dying where the patient asserts “Not me!” is recognized as which stage of grieving? A) Anger B) Denial C) Bargaining D) Depression Answer: B Diff: 2 Page Ref: 21 Objective: 2-2 5 Copyright © 2018 Pearson Education, Inc. 20) What statement would you expect to hear from a patient who has accepted the fact that he is terminally ill and will die sooner than later? A) “It is just not fair.” B) “It’s okay. I am not afraid.” C) “I have no energy to even think anymore.” D) “I cannot go on like this any longer.” Answer: B Diff: 2 Page Ref: 21 Objective: 2-3 21) Organisms that cause diseases are called: A) Pathogens B) Toxins C) Antigens D) Antibodies Answer: A Diff: 1 Page Ref: 27 Objective: 2-1 22) A reference tool that should be placed in every emergency vehicle for use when responding to a possible “hazmat” incident is: A) The Emergency Response Guidebook B) The Physician’s Desk Reference C) The Merck Manual D) A list of chemicals processed by local industries Answer: A Diff: 1 Page Ref: 36 Objective: 2-14 23) To ensure your own safety and the safety of your crew, you should: A) Request police assistance on all calls B) Search each and every patient for weapons C) Evaluate every scene for danger before entering D) Ensure the availability of a paramedic for most medical calls Answer: C Diff: 1 Page Ref: 26 Objective: 2-14 6 Copyright © 2018 Pearson Education, Inc. 24) You have worked with the same partner for several years and know him well. Over the past three months, the two of you have had four horrific pediatric calls with death as the outcome of each. Which observation would make you the most suspicious that your partner is experiencing a possible stress reaction that might encumber his ability to work as an EMT? A) Excessive and uncharacteristic irritability B) Request to be scheduled for night shifts C) Interest in going back to school to study accounting D) Statement that he intends to drop to part-time status Answer: A Diff: 2 Page Ref: 23 Objective: 2-5 25) Changes in your lifestyle that may help you manage stress include: A) Eating a high-protein and fatty diet B) Concentrating on your job 24 hours a day C) Self-medication with over-the-counter medicines D) Practicing relaxation techniques such as meditation Answer: D Diff: 1 Page Ref: 24 Objective: 2-7 26) You have just been instructed to stop emergency care on an unresponsive and pulseless 61year-old man found by his wife in the bathroom. When you tell his wife that there is nothing more that can be done, she erupts in an episode of rage and starts screaming that there must be something else that can be done and you are not doing your job well enough. In this situation, which action is best? A) Resume resuscitation for another 5 minutes B) Be tolerant of the angry reaction C) Leave the scene immediately D) Contact medical direction for advice Answer: B Diff: 2 Page Ref: 22 Objective: 2-2 27) After a particularly disturbing call the previous day, your partner is unusually angry and having a difficult time concentrating on his work. Which type of stress reaction would you suspect? A) Acute stress reaction B) Posttraumatic stress reaction C) Physical stress reaction D) Cumulative stress reaction Answer: A Diff: 2 Page Ref: 23 Objective: 2-4 7 Copyright © 2018 Pearson Education, Inc. 28) A coworker is suffering from posttraumatic stress. Which statement made by you would be the most appropriate and beneficial to the coworker? A) “It would be best to take a few weeks off from work.” B) “Maybe you can get the medical director to write a prescription for some medication.” C) “I think that it would be best if you saw a mental health professional.” D) “How about taking a Benadryl before bed to promote restful sleep?” Answer: C Diff: 2 Page Ref: 23 Objective: 2-4 29) A prospective student is interested in becoming an EMT, but is unsure how it will affect his family. He says that his wife is very worried about the danger associated with EMS and has never had to deal with him being gone for 24 hours at a time. What is the most appropriate response? A) “The long hours actually make things easier since there is less time to argue.” B) “I have found that the family becomes used to it and things are okay after about six months.” C) “It may help to bring your wife here so she can see what we do and the safety precautions we take.” D) “I would just tell her that everything will be okay and avoid talking about work when you are home.” Answer: C Diff: 1 Page Ref: 25 Objective: 2-6 30) You and your partner were among several rescuers on a call involving a house fire in which a 4-year-old girl died. That night, your partner states that he did not sleep well and is extremely bothered by the little girl’s death. The next day he calls you and states that he is so upset that he is now having chest pain. What is the most appropriate response? A) “Why don’t you request a week off of work to get things sorted out?” B) “Maybe you should get an appointment with a behavioral health professional.” C) “Perhaps we need to have a critical incident stress debriefing so we can all talk.” D) “You really need to get yourself to the emergency department to get checked out.” Answer: D Diff: 2 Page Ref: 26 Objective: 2-5 31) You would be concerned about cumulative stress when an EMS provider informs you that she: A) Is physically tired and would like one week of unpaid leave to recuperate B) Drinks a small amount of alcohol every night to help her sleep C) Is taking prescribed antidepressants to treat mild depression D) Is bothered by a call she had yesterday and does not feel like talking Answer: B Diff: 3 Page Ref: 23-24 Objective: 2-4 8 Copyright © 2018 Pearson Education, Inc. 32) A shooting at a public mall leaves three people dead and nine injured, several critically. As operations wind down, many rescuers are physically and emotionally upset. Which event may be most appropriate at this specific time? A) A critical incident stress debriefing session (CISD) B) A discussion on how to reduce cumulative stress C) A gathering that allows the rescuers to vent their emotions D) Providing information about mental health programs Answer: C Diff: 2 Page Ref: 26 Objective: 2-8 33) A tornado ripped through a small town, killing 5 people and seriously injuring 21, including several young children. At a defusing session, which action is most appropriate? A) Allow the rescuers to vent their emotions B) Evaluate and critique the rescue effort C) Provide information on stress reduction techniques D) Have a mental health professional available to talk with the rescuers Answer: A Diff: 2 Page Ref: 26 Objective: 2-8 34) If you have questions regarding the steps to take when exposed to an infectious disease, your best resource would be: A) The U.S. Department of Health and Human Services B) Your service’s written exposure control plan C) Your service’s medical director D) Your primary care physician or ED physician Answer: B Diff: 1 Page Ref: 27 Objective: 2-13 35) You have just transferred care of a patient to an emergency department nurse. There is no blood, fluid, or dirt on your gloves. After taking them off, your best action would be to: A) Use an alcohol-based hand sanitizer B) Disinfect the stretcher and equipment C) Wash your hands with soap and water D) Complete the prehospital care report Answer: C Diff: 1 Page Ref: 28-29 Objective: 2-11 9 Copyright © 2018 Pearson Education, Inc. 36) A 38-year-old male is complaining of generalized weakness and fatigue. Assessment findings include abdominal pain, fever, and yellowing of the eyes. Given these signs and symptoms, you would be suspicious of: A) Hepatitis B) Tuberculosis C) AIDS D) West Nile virus Answer: A Diff: 1 Page Ref: 33 Objective: 2-10 37) You are accidentally stuck with a needle used to administer a medication to a patient with a known history of hepatitis B. You have already completed your hepatitis B vaccine series. In this case, which statement is true? A) You have complete protection from hepatitis B and no further action is needed B) You have two weeks from the time of exposure to start medical care for a potential infection C) You will have to get another series of three vaccines to give you protection in the future D) You need to report the needle stick to your supervisor as soon as possible Answer: D Diff: 2 Page Ref: 33 Objective: 2-13 38) A patient with a history of hepatitis C has called 911 because he has a headache. Given the complaint and medical history, which personal protective equipment, at a minimum, is most appropriate? A) Goggles B) Gloves C) Gloves and gown D) No protection is needed. Answer: B Diff: 1 Page Ref: 33 Objective: 2-11 39) The primary personal threat to a person with AIDS is: A) Infection B) Organ damage C) Heart failure D) Weight loss Answer: A Diff: 1 Page Ref: 34 Objective: 2-10 10 Copyright © 2018 Pearson Education, Inc. 40) In the field setting, the best way to avoid becoming infected with human immunodeficiency virus (HIV) is: A) Avoid unnecessarily touching patients with confirmed HIV infection B) Always ask patients if they have HIV infection or AIDS C) Always wear gloves, goggles, and a gown for all patient contacts D) Use the appropriate protective personal equipment Answer: D Diff: 1 Page Ref: 34 Objective: 2-13 41) You are by the side of a patient whom you suspect has severe acute respiratory syndrome (SARS). What is an effective way to prevent transmission of the disease from the patient to you? A) Use eye protection or a face shield B) Use an alcohol-based hand sanitizer frequently during transport C) Place a surgical mask on the patient D) Sterilize all equipment used in the care of the patient Answer: C Diff: 1 Page Ref: 34 Objective: 2-11 42) You have been called to transport a patient from one medical facility to another. The patient is infected with vancomycin-resistant enterococci (VRE), but does not have any open wounds and is medically stable. Given this information, which action is most appropriate? A) Place a surgical mask on the patient B) Place a surgical mask on the patient and yourself C) Use an N-95 respirator or HEPA mask D) Use the appropriate personal protective equipment and handwashing Answer: D Diff: 2 Page Ref: 35 Objective: 2-13 43) Which organism is classified as multi-drug resistant? A) Methicillin/oxacillin-resistant Staphylococcus aureus B) Hepatitis B virus C) Human immunodeficiency virus D) Zika virus Answer: A Diff: 1 Page Ref: 35 Objective: 2-10 11 Copyright © 2018 Pearson Education, Inc. 44) Which rationale best explains the reason for wearing a high-visibility safety vest at the scene of a motor vehicle collision? A) Wearing the vest makes you easily identifiable as an EMT B) The use of the vest can increase your visibility to passing drivers at the scene of an accident C) Federal law requires that you wear the vest or the EMS system can be fined D) The vest increases your visibility to bystanders and protects you from blood and body fluids Answer: B Diff: 2 Page Ref: 37 Objective: 2-14 45) What action taken by an EMT illustrates an effort toward maintaining well-being in the field of EMS? A) Taking a body-building class B) Avoiding all alcohol and fatty foods C) Creating a healthy balance between work and family life D) Establishing a relationship with a mental health professional Answer: C Diff: 1 Page Ref: 41 Objective: 2-15 46) After 20 minutes of performing CPR on a 65-year-old female with end-stage multiple sclerosis, your medical director orders you to stop resuscitation and inform the family that the patient has died. The family members are upset and crying. You notice the patient’s daughter holding her hand. Your immediate response would be: A) “It’s okay to hold her hand, but you should really use gloves like we do.” B) “It’s important not to touch her since she may be infectious from her disease.” C) “I know that you are upset, but it is best not to touch her since she just passed.” D) “It’s okay to hold her hand.” Answer: D Diff: 3 Page Ref: 22 Objective: 2-3 47) A young girl with end-stage cancer is unresponsive, not breathing, and pulseless. Her mother and father are by her side, both crying as you start resuscitation. Which statement indicates the most appropriate thing you could say to the parents as you begin? A) “I think that it would be best for you both to leave the room so we can care for your daughter.” B) “If you feel comfortable, it’s okay to stay and watch how we care for your daughter.” C) “It is important not to cry since she may still be able to hear you and needs you to be strong for her.” D) “I can show you how to do chest compressions so that you can take part in caring for your daughter.” Answer: B Diff: 3 Page Ref: 22 Objective: 2-3 12 Copyright © 2018 Pearson Education, Inc. 48) A patient with terminal lung cancer has called EMS for shortness of breath. At the request of your paramedic partner, you are obtaining the patient’s blood pressure. While inflating and then deflating the blood pressure cuff, the patient angrily shouts, “That thing is too tight! What are you trying to do–send me to the funeral home early?” Your best reply would be: A) “I have to get your blood pressure. The paramedic needs it.” B) “Why are you so mad at me? I am just trying to help you.” C) “I know that this is tight and uncomfortable, but I am almost done now.” D) “Do not yell at me. There is no need for yelling and I do not appreciate it.” Answer: C Diff: 3 Page Ref: 22 Objective: 2-3 49) As an EMT, you would recognize what situation as having the greatest potential for causing emotional stress? A) Lifting and moving an obese patient from a second-floor bedroom B) Being required to show up for a shift 15 minutes prior to its start C) Caring for a child whose parents have appeared to have neglected him D) Responding to many EMS calls during the course of a shift Answer: C Diff: 2 Page Ref: 23 Objective: 2-5 50) Regarding “burnout” and the emergency medical services, what statement is most accurate? A) Employers are required to have a written plan addressing EMT burnout B) Burnout can diminish an EMT’s ability to provide competent care C) Research indicates that burnout affects all EMS personnel within a five-year period D) Burnout often tends to resolve on its own over time Answer: B Diff: 2 Page Ref: 23 Objective: 2-4 51) Your supervisor has assigned you the task of designing a program that provides for stress management and health promotion within the department. Which program would accomplish this task in the best way? A) Complementary passes to a local fitness center B) Mandatory monthly meetings for all EMS personnel with a mental health counselor C) Doughnuts and coffee every morning for all EMS personnel D) A weekly night out for beer, wings, and other snacks at a local eatery Answer: A Diff: 3 Page Ref: 24 Objective: 2-7 13 Copyright © 2018 Pearson Education, Inc. 52) An EMT has an understanding of the different types of pathogens when she states: A) “Bacteria tend to be larger than viruses and can be seen without a microscope.” B) “Protozoa are considered parasitic worms and can live within the human body.” C) “Fungal infections typically attack the immune systems of healthy persons.” D) “Viruses are resistant to antibiotics because they live within the body’s cells.” Answer: D Diff: 1 Page Ref: 27 Objective: 2-10 53) You are at a long-term care facility at the bedside of an 89-year-old female with an infected area on her back. The staff members state that they are fearful that the patient has a MRSA infection, so they have requested transport to the emergency department for further evaluation. To decrease your chance of acquiring MRSA, what should you, as an EMT, do? A) Wash your hands following patient contact B) Place a mask on the patient C) Wash the infected area with an alcohol sanitizer prior to transporting the patient D) Avoid unnecessarily touching the patient Answer: A Diff: 2 Page Ref: 28 Objective: 2-11 54) You are attempting to increase your cardiovascular endurance in an effort to better perform your job as an EMT. Which action would be most appropriate in working toward this goal? A) Increasing sleep to 8 to 10 hours per day B) Weight lifting with attention to the upper body C) Walking on a treadmill 3 to 4 times per week D) Doing stretching exercises every 4 hours while awake Answer: C Diff: 2 Page Ref: 40 Objective: 2-15 55) A coworker is constantly tired and asks you for advice on how to better sleep after a busy night shift. Which response would best address this situation? A) “A small amount of alcohol can be relaxing and effective in helping you to sleep.” B) “Try to make your bedroom dark and keep the temperature cool.” C) “Research has shown that exercising prior to bed helps you fall asleep faster.” D) “Try eating a meal before going to bed, since digestion makes you drowsy.” Answer: B Diff: 3 Page Ref: 40-41 Objective: 2-15 14 Copyright © 2018 Pearson Education, Inc. 56) Your friend and coworker got married a little more than a year ago, and then shortly thereafter she became an EMT and started working with you. On your shifts, she complains that her new husband doesn’t like the fact she is an EMT, saying that the job is “too risky.” Which bit of advice could you provide to your partner to help her calm the nerves of her new husband? A) Explain to her husband that EMS is “just a job” and is not any risker than other occupations B) Let the husband know about all the training EMTs have to complete and which types of safety precautions they take on each call C) Tell your partner that you personally would like to talk to her husband to let him know that you have been in EMS for years without any incident or injury D) Do not tell the husband about the types of calls or situations encountered in EMS so that he starts to believe it’s becoming safer Answer: B Diff: 2 Page Ref: 25 Objective: 2-6 15 Copyright © 2018 Pearson Education, Inc.