TEST BANK PREHOSPITAL EMERGENCY CARE JOSEPH J. MISTOVICH, KEITH J. KARREN, BRENT HAFEN

TEST BANK PREHOSPITAL EMERGENCY CARE JOSEPH J. MISTOVICH, KEITH J. KARREN, BRENT HAFENEmergency Care Systems, Research, and Public Health .................................................................................................... 2 Chapter 2 Workforce Safety and Wellness of the EMT .....................................................................................................................13 Chapter 3 Medical, Legal, and Ethical Issues .................................................................................................................................... 25 Chapter 4 Documentation ................................................................................................................................................................. 42 Chapter 5 Communication ................................................................................................................................................................. 52 Chapter 6 Lifting and Moving Patients ............................................................................................................................................. 64 Chapter 7 Anatomy, Physiology, and Medical Terminology ............................................................................................................ 73 Chapter 8 Pathophysiology ............................................................................................................................................................... 94 Chapter 9 Life Span Development .................................................................................................................................................... 111 Chapter 10 Airway Management, Artificial Ventilation, and Oxygenation .................................................................................... 119 Chapter 11 Vital Signs, Monitoring Devices, and History Taking .................................................................................................... 146 Chapter 12 Scene Size-Up ................................................................................................................................................................. 174 Chapter 13 Patient Assessment ....................................................................................................................................................... 180 Chapter 14 General Pharmacology and Medication Administration ............................................................................................. 207 Chapter 15 Shock and Resuscitation ............................................................................................................................................... 216 Chapter 16 Respiratory Emergencies .............................................................................................................................................. 238 Chapter 17 Cardiovascular Emergencies ......................................................................................................................................... 260 Chapter 18 Altered Mental Status, Stroke, and Headache ............................................................................................................ 284 Chapter 19 Seizures and Syncope ................................................................................................................................................... 301 Chapter 20 Acute Diabetic Emergencies ........................................................................................................................................ 314 Chapter 21 Allergic and Anaphylactic Reactions ............................................................................................................................. 328 Chapter 22 Toxicologic Emergencies .............................................................................................................................................. 341 Chapter 23 Abdominal, Hematologic, Gynecologic, Genitourinary, and Renal Emergencies ........................................................ 369 Chapter 24 Environmental Emergencies ........................................................................................................................................ 395 Chapter 25 Submersion Incidents: Drowning and Diving Emergencies ........................................................................................ 417 Chapter 26 Psychiatric Emergencies ............................................................................................................................................... 427 Chapter 27 Trauma Overview: The Trauma Patient and the Trauma System ............................................................................... 439 Chapter 28 Bleeding and Soft Tissue Trauma ................................................................................................................................ 449 Chapter 29 Burns .............................................................................................................................................................................. 467 Chapter 30 Musculoskeletal Trauma and Nontraumatic Fractures ............................................................................................... 479 Chapter 31 Head Trauma .................................................................................................................................................................. 491 Chapter 32 Spinal Trauma and Spine Motion Restriction .............................................................................................................. 504 Chapter 33 Eye, Face, and Neck Trauma ......................................................................................................................................... 520 1 | P a g eChapter 34 Chest Trauma ................................................................................................................................................................ 530 Chapter 35 Abdominal and Genitourinary Trauma ......................................................................................................................... 540 Chapter 36 Multisystem Trauma and Trauma in Special Patient Populations .............................................................................. 549 Chapter 37 Obstetrics and Care of the Newborn ...........................................................................................................................560 Chapter 38 Pediatrics ....................................................................................................................................................................... 582 Chapter 39 Geriatrics ...................................................................................................................................................................... 608 Chapter 40 Patients with Special Challenges ................................................................................................................................. 622 Chapter 41 The Combat Veteran .....................................................................................................................................................638 Chapter 42 Ambulance Operations and Air Medical Response .................................................................................................... 644 Chapter 43 Gaining Access and Patient Extrication ....................................................................................................................... 652 Chapter 44 Hazardous Materials ..................................................................................................................................................... 657 Chapter 45 Multiple-Casualty Incidents and Incident Management ............................................................................................ 664 Chapter 46 EMS Response to Terrorism Involving Weapons of Mass Destruction ..................................................................... 673 Chapter 1 Emergency Care Systems, Research, and Public Health 1) What is a primary purpose of the modern-day EMS system? A) Provide a means of transport to and from the hospital B) Ensure that all members of society have equal access to hospitals C) Decrease the incidence of death and disability related to injury and illness D) Provide emergency health care services to medically underserved areas Answer: C Diff: 2 Page Ref: 7 Objective: 1-2 2) Most authorities agree that the modern-day EMS system evolved after the release of which document? A) The Emergency Medical Services Act of 1973 B) The white paper "Accidental Death and Disability: The Neglected Disease of Modern Society" in 1966 C) The American Heart Association's Guidelines for Cardiac Resuscitation D) Emergency Medical Services: Agenda for the Future, in 1996 Answer: B Diff: 1 Page Ref: 3 Objective: 1-2 3) An Emergency Medical Responder comes to you and states that he would like to work for your emergency ambulance service on a full-time basis. Knowing the National EMS Scope of Practice Model, you inform him of which element? A) He will be able to take care of only patients with non-life-threatening complaints B) He will first need approval from your ambulance service's medical director 2 | P a g eC) He will be able to work only with an Advanced EMT or paramedic D) He will first have to become an Emergency Medical Technician Answer: D Diff: 1 Page Ref: 6-7 Objective: 1-1 4) As defined by the National EMS Scope of Practice Model, the four levels of EMS practitioners include: A) Ambulance drivers B) EMS medical director C) Paramedics D) Emergency medical dispatchers Answer: C Diff: 1 Page Ref: 6-7 Objective: 1-3 5) An Emergency Medical Responder (EMR) approaches you and states that he is interested in becoming an EMT. Specifically, he asks what he will be able to do as an EMT that he cannot presently do as an EMR. You respond by saying he will be able to: A) Administer some medications B) Assist in emergency childbirth C) Use an automated external defibrillator D) Obtain vital signs Answer: A Diff: 1 Page Ref: 6-7 Objective: 1-5 6) You have been dispatched for a 61-year-old female in cardiac arrest. Emergency Medical Responders (EMRs) are on scene. In your community, all EMS practitioners are trained according to the National EMS Scope of Practice Model. Given this, which type of care do you expect the EMRs to be providing? A) Emergency medication administration B) Automated external defibrillation C) Intravenous therapy D) Reading an electrocardiogram Answer: B Diff: 2 Page Ref: 6 Objective: 1-5 7) An EMT with your service states that she desires to become a paramedic because she wants to provide advanced care. Under the National EMS Scope of Practice Model, which one of these types of care will she be able to provide as a paramedic that she cannot provide as an EMT? A) Automated blood pressure monitoring B) Assistance with emergency childbirth C) Interfacility transports D) IV therapy Answer: D Diff: 1 Page Ref: 7 3 | P a g eObjective: 1-5 8) Which statement made by an EMT requires immediate intervention by a superior or the service supervisor? A) "I always wear my seat belt whenever I am in the patient compartment of the ambulance, unless I have to remove it to care for a patient." B) "I drive as fast as I can to get to the scene of an emergency, especially if a child is sick or injured according to dispatch information." C) "When I am driving with lights and sirens, I instruct my partner that he will need to handle all radio communications." D) "I put exam gloves on for every patient I contact, even if he or she does not have a known or suspected infectious disease." Answer: B Diff: 1 Page Ref: 9 Objective: 1-7 9) Which statement shows that the EMT has a good understanding of her role and responsibilities related to being an EMT? A) "The patient's needs come before anyone else's needs." B) "At the scene of an emergency, my responsibility is to get to the patient no matter what." C) "My safety comes first, and then the patient's safety." D) "As an EMT, I recognize that the public's safety comes before the safety of me or my partner." Answer: C Diff: 2 Page Ref: 8-9 Objective: 1-7 10) An ambulance with two EMTs arrives in front of a house for an unknown medical emergency. On scene, bystanders report that a female patient was beaten by her husband in the driveway and then dragged back into the house. They state that the patient appeared unconscious and was bleeding from the head. Which action would the EMTs perform next? A) Do not enter the scene until it has been controlled by law enforcement B) Quietly enter the home and quickly move the patient to the ambulance C) Remove the husband from the house, then provide emergency care to the wife D) Enter the home to protect the patient while waiting for the police to arrive Answer: A Diff: 2 Page Ref: 9 Objective: 1-7 11) Why is EMS in a unique position to contribute significantly to mobile integrated health care? A) EMS providers are familiar with and capable of functioning in the out-of-hospital environment B) Ambulances are easily identified C) The community trusts uniformed health care providers D) EMS providers are familiar with the many routes of medication administration Answer: A Diff: 1 Page Ref: 17 Objective: 1-15 4 | P a g e12) You have arrived on the scene of a motor vehicle collision. A car has gone off the road and into a utility pole. The pole is broken and wires are hanging just above the car. You do not see any sparking or arcing of the wires. The driver of the car is slumped over the steering wheel and not moving. Several bystanders around the car are yelling for you to help. Which steps represent the correct order of your response? A) Clear the bystanders, allow the fire department to secure the wires, access the patient, extricate the patient, transport B) Access the patient, clear the bystanders, allow the fire department to secure the wires, extricate the patient, transport C) Clear the bystanders, access the patient, extricate the patient, transport, allow the fire department to secure the wires D) Access the patient, allow the fire department to secure the wires, clear the bystanders, extricate the patient, transport Answer: A Diff: 2 Page Ref: 8-9 Objective: 1-7 13) Once a scene is free of safety hazards, the EMT must recognize and focus on the needs of the: A) Rescuers B) Patient C) Family D) Bystanders Answer: B Diff: 1 Page Ref: 9 Objective: 1-7 14) You have been asked to sit on your service's quality improvement (QI) committee. As a knowledgeable EMT, you recognize that in this role you will be involved in projects that are primarily designed to: A) Communicate with insurance companies for increased reimbursement B) Recruit and educate EMTs about the Emergency Medical Services profession C) Develop ways in which the delivery of emergency care can be improved D) Identify and reeducate EMTs who routinely do not provide proper care Answer: C Diff: 2 Page Ref: 13 Objective: 1-10 15) What would be a logical project to be undertaken and developed by a quality improvement (QI) committee? A) Termination of EMTs who are chronically late to work B) A program by which pay raises are based on performance and attitude C) Community fundraiser to raise money for new EMS equipment D) Monthly continuing education programs in which seldom-used skills are practiced Answer: D Diff: 2 Page Ref: 14 Objective: 1-10 5 | P a g e16) You are interviewing for the position of EMT with a busy urban service. This morning you are to meet with the service's medical director. You have been told that she likes it when applicants ask questions about her role as the medical director. Related to her responsibilities as medical director, which question is most appropriate? A) "How do you determine the wages that the EMTs are paid?" B) "How do you determine the number and location of ambulances within the system?" C) "How often are the emergency care protocols updated?" D) "Do you assign the daily chores that must be completed around the stations?" Answer: C Diff: 2 Page Ref: 12 Objective: 1-9 17) To be a medical director of an ambulance service, which requirement must the interested individual satisfy? A) Licensed physician B) Emergency physician with surgical experience C) Physician who was a paramedic D) Physician with a college degree in EMS Answer: A Diff: 1 Page Ref: 12 Objective: 1-9 18) As an EMT, which requirement must be met so that you can provide routine and emergency medical care to the sick and injured, as an extension of the medical director's authority? A) Prior medical experience B) A service medical director C) A knowledgeable partner D) A safe driving record Answer: B Diff: 1 Page Ref: 12 Objective: 1-9 19) It has been some time since you were involved in the care of a pediatric patient. You decide to review the assessment and treatment basics that your medical director requires. To review this information, which resource should you consult first? A) Emergency Medical Responders B) Reputable websites C) Emergency department nurses D) Service protocols Answer: D Diff: 1 Page Ref: 13 Objective: 1-9 20) Before the EMT contacts medical direction for authorization to assist a patient with shortness of breath in using her metered-dose inhaler, protocols state that the EMT must first attempt to provide relief by administering oxygen if the pulse oximeter reading is less than 94%. You recognize that the administration of oxygen is best described as a(n): A) Standing order 6 | P a g eB) On-line medical direction C) Direct permission D) Quality improvement Answer: A Diff: 2 Page Ref: 13 Objective: 1-9 21) If a patient with chest pain takes a daily aspirin, your medical director wants the EMT to contact an emergency department physician first before administering additional aspirin. The act of contacting the emergency department physician by phone or radio for permission to administer additional aspirin is an example of: A) Quality improvement B) On-line medical direction C) Off-line medical direction D) Indirect medical control Answer: B Diff: 2 Page Ref: 13 Objective: 1-1 22) At the scene of a minor motor vehicle collision, you are attending to a female patient who complains of head and neck pain. A crowd has gathered to watch the action. What will the observing public most likely remember about the role EMS portrayed? A) The number of emergency vehicles that showed up B) The color of the ambulances C) If the EMTs were all wearing the same color uniforms D) EMTs who were yelling and cursing loudly at the fire department to hurry up and get the patient out of the car Answer: D Diff: 2 Page Ref: 11 Objective: 1-8 23) You work in a community that has an "enhanced" 911 system. Given this, which is true about such a system? A) The physical location of the landline used to make the 911 call is displayed to the call taker B) The EMS system uses EMTs, Advanced EMTs, and paramedics C) The fire department responds simultaneously with EMS D) The total response time for EMS will rarely exceed 9 minutes Answer: A Diff: 1 Page Ref: 5 Objective: 1-4 24) Which patient would most benefit from calling an enhanced 911 system from the home phone? A) Patient with chest pain B) Patient with sudden onset of confusion C) Patient requiring advanced medical care D) Patient who cannot reach the phone Answer: B 7 | P a g eDiff: 2 Page Ref: 5 Objective: 1-4 25) A 14-year-old boy has fallen through a plate glass window and is bleeding heavily from a laceration to his arm. His panicked mother has called 911 for help. Since the 911 operators are also emergency medical dispatchers, what sort of assistance will they be able to provide? A) Simultaneous notification of the hospital B) Whether the EMS response is covered by medical insurance C) Instructions on how to control bleeding D) The names of the EMTs who are responding Answer: C Diff: 2 Page Ref: 5 Objective: 1-3 26) Which be an EMS public health initiative? A) Educating the public on the benefit of wearing seat belts B) Volunteering time to help raise money for a sick child and his family C) Providing volunteer emergency ambulance service 24 hours a day, 7 days a week D) Purchasing new equipment to better help those persons who experience a medical emergency Answer: A Diff: 2 Page Ref: 16 Objective: 1-14 27) Your service's medical director would like to explore the idea of EMTs using special transport ventilators when caring for patients who require assistance with their breathing. When using an evidence-based medicine approach, what should you do first? A) Go to a local hospital to see which kind of ventilators it uses B) Contact vendors that sell ventilators and ask for price quotations C) Select specific EMTs to conduct a field trial of particular ventilators D) Search the medical literature for research related to this topic Answer: D Diff: 2 Page Ref: 14 Objective: 1-13 28) You are by the side of a confused patient who has diabetes and a low blood sugar level. You know that the patient needs orally administered sugar, so following your service's guidelines, you call the physician on duty at the hospital emergency department and request permission to administer it. This request is an example of: A) Standing orders B) On-line medical direction C) Medical cooperation D) Off-line medical direction Answer: B Diff: 1 Page Ref: 12 Objective: 1-1 29) Which statement about emergency medical services in the United States is true? A) The EMS system is controlled and governed by the National Highway Transport and Safety 8 | P a g eAdministration (NHTSA) B) The federal government oversees all aspects of EMS in the United States C) Each state has governmental control of its own EMS system, independent of the federal government D) The U.S. Department of Health and Human Services establishes curricula for all levels of EMS education Answer: C Diff: 2 Page Ref: 4 Objective: 1-3 30) The county dispatch center where you work employs emergency medical dispatchers (EMDs) as call takers. Using EMDs as opposed to a person who is just a "call taker" enables the dispatch center to: A) Process all emergency calls, including those asking for police, fire, and EMS assistance B) Provide medical instructions to the caller prior to the arrival of EMS personnel C) Use computer technology when dispatching the closest ambulance D) Properly utilize an enhanced 911 call-taking system Answer: B Diff: 2 Page Ref: 5 Objective: 1-3 31) A 40-year-old man has been seriously injured in a car crash. He is unresponsive and has what you believe to be a collapsed lung. Additionally, his left leg is severely deformed with heavy bleeding and his vital signs are unstable. A passenger in the car informs you that the patient has diabetes and significant heart problems. Given this information, what is the best destination for this patient, assuming all of the facilities are the same distance away? A) Cardiac center B) Spine injury center C) Trauma center D) Stroke center Answer: C Diff: 2 Page Ref: 7 Objective: 1-6 32) You have arrived at the scene of a medical emergency and find a woman lying on the floor of a grocery store. As you approach her, you know that your first priority as an EMT is: A) Personal safety B) Patient care C) Public safety D) Patient advocacy Answer: A Diff: 1 Page Ref: 8 Objective: 1-11 33) A female jogger has collapsed on a trail at a public park. A crowd of curious onlookers have collected and are watching as the EMT examines the patient for any life-threatening conditions. After determining that there are none and the patient is stable, the EMT acts as a patient advocate by: 9 | P a g eA) Informing the crowd that the patient appears to be okay B) Transporting the patient to the hospital using lights and sirens C) Continuing care despite the crowd's presence D) Asking curious onlookers to leave the scene Answer: D Diff: 2 Page Ref: 10 Objective: 1-7 34) At a public 911 center meeting, a concerned woman asks whether voice over Internet Protocol (VoIP) can be used to access the community emergency operations center. You would inform her that: A) Internet providers are encouraged to provide 911 access, but are not required by law, so the dispatch center may have to get an address from the caller B) Internet providers are required to provide their own 911 call-taker service to subscribers C) Internet providers must provide a callback number and physical location of the phone from which the 911 call was placed D) Internet providers are required to employ EMDs who can provide medical instructions prior to arrival of EMS Answer: C Diff: 2 Page Ref: 6 Objective: 1-4 35) What would the EMT recognize as an advantage of the 911 universal number? A) It is able to track the locations of all emergency vehicles in an EMS system B) It is a common number through which to request EMS, law enforcement, and fire services C) It is less expensive to operate than a 7- or 10-digit telephone number D) It is the most easily remembered 3-digit combination of numbers Answer: B Diff: 1 Page Ref: 5 Objective: 1-4 36) Which statement accurately describes the hospital emergency department? A) It is a health care destination staffed by physicians, nurses, and others designed to evaluate and stabilize patients, preparing them for further care B) It requires patients to make an appointment to be seen by a physician, unless they arrive by ambulance C) It is the only health care destination to which EMS can transport patients with a medical emergency D) It provides lifesaving care instructions to callers accessing the 911 system Answer: A Diff: 1 Page Ref: 7 Objective: 1-6 37) As a supervisor with an emergency ambulance service, which situation regarding a potential employee would you recognize as falling under the Americans with Disabilities Act (ADA), and as case in which you would make reasonable accommodations? A) An EMT who has requested help with a drug and alcohol problem B) Applicant who cannot pass the EMT certification exam because he is dyslexic 10 | P a g eC) A blind patient who wants to become an EMT, but has not taken a class yet D) A dispatcher with a prosthetic leg who requires parking next to the building entrance Answer: D Diff: 3 Page Ref: 8 Objective: 1-7 38) How would the Americans with Disabilities Act (ADA) be satisfied for a pregnant emergency medical dispatcher (EMD) who suffers from paralysis of both legs and requires the use of a wheelchair? A) Wheelchair accessibility to and from dispatch B) Hourly pay rate 10 percent above that of the other EMDs C) Scheduled shifts during daylight hours only D) Transport by your service to and from work Answer: A Diff: 2 Page Ref: 8 Objective: 1-7 39) A young man wishes to become an EMT and asks you what he will need to do to become certified. You would reply that he must first: A) Volunteer with an ambulance service to gain experience B) Complete a course that meets the requirements of the U.S. Department of Transportation C) Demonstrate that he has prior medical experience D) Attend classes at a local community college Answer: B Diff: 2 Page Ref: 4 Objective: 1-3 40) The functions of a state EMS agency include: A) Determination of the number of EMRs, EMTs, AEMTs, and paramedics allowed in the state B) Review of patient care reports (PCRs) to ensure proper care C) Planning and coordination of the statewide EMS system D) Encouraging fair wages for the different levels of EMS providers Answer: C Diff: 2 Page Ref: 4 Objective: 1-3 41) What actions place the patient at greatest risk for a medical mistake? A) Driving to an emergency department at night B) Backing the ambulance into the ambulance bay at the hospital C) Responding to a call in an "unsafe" neighborhood D) Transferring care from one EMT to another Answer: D Diff: 2 Page Ref: 14 Objective: 1-11 42) Which statement best summarizes the underlying benefit of using evidence-based medicine? A) Formulates emergency care guidelines that have been reviewed by the legal community B) Improves patient care while simultaneously reducing the costs associated with EMS 11 | P a g eC) Provides for legal representation in the quality improvement process D) Allows the use of research and evidence in determining which care is effective Answer: D Diff: 2 Page Ref: 14 Objective: 1-13 43) Which item of protective gear is appropriate to wear at an automobile collision? A) Gown B) A HEPA mask C) Reflective clothing D) SCBA gear Answer: C Diff: 1 Page Ref: 9 Objective: 1-12 44) At a bare minimum, which type of personal protective equipment should be worn by EMS providers at any emergency scene involving a shooting? A) Face mask B) Gloves C) Gown D) Goggles Answer: B Diff: 1 Page Ref: 9 Objective: 1-12 45) Which of these tasks has not been identified as one that could be provided by a mobile integrated health care system? A) Manage patients who are at a high risk for hospital readmission B) Assist in the ongoing home management of chronic conditions C) Provide preventive services and check up on patients after discharge D) Conduct health screening and provide minor outpatient surgical services Answer: D Diff: 2 Page Ref: 17 Objective: 1-15 46) In the public health continuum, what is the first responsibility that public health officials must satisfy to improve the health of a community? A) Identify problems that affect the health of the population in question B) Design a plan for remediating the disturbances that cause a population's health to decline C) Integrate their work with EMS services to provide outpatient home care services designed to improve health D) Meet with city administrators to determine which type of public health budget will be provided so cost-effective plans can be established Answer: A Diff: 2 Page Ref: 16 Objective: 1-14 47) Which attribute of a person would not likely work out well in the EMS profession? 12 | P a g eA) Inability or no desire to "take charge" B) Being able to make good decisions with minimal information C) Being able to adapt to a situation when things become chaotic D) Willingness to hold what is learned about patients, good and bad, in confidence Answer: A Diff: 2 Page Ref: 11 Objective: 1-8 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 4) An EMT is correct when he describes a communicable disease as: A) Any of a number of diseases that are deadly once contracted 13 | P a g eB) 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 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 14 | P a g e9) 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 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 15 | P a g eC) 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 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 16 | P a g e18) 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 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 17 | P a g eDiff: 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 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 61- year-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 18 | P a g esuspect? 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 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 19 | P a g eD) 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 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 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: 20 | P a g eA) 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 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 21 | P a g e41) 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 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 22 | P a g eDiff: 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 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 23 | P a g eDiff: 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