What are some signs and symptoms that a coworker may be experiencing delayed stress reaction?

CHAPTER 2

1. While transporting a patient to the hospital who has a history of terminal brain cancer, the patient says, "I know I'm going to die, but first I want to see my grandson graduate from high school." What stage of death and dying describes this patient's current condition? - Bargaining

2. You are on the scene of an "unknown medical" call. The patient is a 26-year-old, 250- pound male patient who suddenly becomes violently angry. Everything you say to the patient only makes him angrier. Offended by your questions, he screams that he is going to "cut your tongue out" and hurries into the kitchen. What should you do? - Leave immediately to a safe area and then call for police assistance.

3. When the potential exists for exposure to exhaled air of a person with suspected or confirmed TB, a(n) ________ mask should be worn by the EMT. - N-

4. What is a simple step EMTs can perform to help prevent the spread of flu in the prehospital environment? - Place a surgical mask on suspected flu patients.

5. You are first on the scene of a vehicle collision where a vehicle has gone off a bridge and is partially submerged. You are told that a person is still trapped in the vehicle. Your partner starts to take off his shoes and prepares to go in to save the victim. You stop your partner and tell him it is too dangerous. He tells you he is prepared to die to save a life. What is the best response to him? - He is not only putting his life at risk, but also placing the lives of the professional rescuers unnecessarily at risk.

6. Which of the following pathogens can live in dried blood for days and should be a major concern for EMS providers even while cleaning contaminated equipment? - Hepatitis B

7. For the last few days, your regular EMT partner has been having trouble sleeping, has been on edge, and has trouble concentrating on his job during EMS calls. Luckily, your call volume has been low with no serious calls since the infant cardiac arrest you both worked last month. You ask him if anything is bothering him and he states he is fine in every way. He states that he has been going to the bars lately to relax and invites you to come along for some drinks after work. Choose the best answer for this situation. - Your partner is suffering from a delayed stress reaction and you should recommend that he seek professional counseling.

8. Which of the following pathogens is transmitted through contact with open wounds or sores? - Staphylococcus

9. The term burnout is also known as a(n) ________ stress reaction. - cumulative

10. An EMT should consider wearing protective eyewear when caring for which of these patients? - A patient who is actively coughing

11. During which of these situations would the EMT be least likely to experience a body substance exposure? - Splinting a sprained ankle

12. Which of the following behaviors would be considered a common sign of stress rather than an acute psychological problem? - Irritability with friends, family, coworkers, or patients

13. When responding to the scene of a patient who was discovered to be unresponsive, not breathing, and without a pulse, family members state that the patient has been suffering from cancer for several years. One of his sons is cursing at you and your partner, saying that you are not moving fast enough. Which stage of grief is the patient's son experiencing in response to his father's death? - Anger

14. Which three "Rs" are essential for the EMT to practice when reacting to danger? - Retreat, radio, reevaluate

15. Healthcare employers are required by law to provide a hepatitis B ________ available to employees free of charge. - vaccine

16. All of the following are ways that an EMT can increase both physical and mental well- being, except: - drinking moderate amounts of caffeine and alcohol.

17. According to Dr. Hans Selye, the third stage of the "Stress Triad" is known as the ________ stage. - exhaustion

18. Which of the following is an accurate statement regarding tuberculosis (TB)? - A tuberculin skin test can detect TB exposure.

19. You are called to an assault on a homeless male. Dried blood from the trauma is visible around the patient's mouth and nose. During assessment, you note the patient has a productive cough. The patient says, "Don't worry, I'm not contagious. I've had this cough for a year." Describe the best approach regarding respiratory isolation. - ask yourself and the patient.

20. An EMT involved in an especially difficult call, such as one in which a coworker was killed, should be urged to: - seek help from a trained mental health professional.

21. Since EMS personnel are often exposed to both acute and chronic stressors, ________ management may be helpful to cope with on-the-job experiences. - critical incident stress

22. What is the name of the federal act that mandates a procedure by which emergency healthcare providers can find out if they have been exposed to potentially life-threatening diseases while on the job? - Ryan White CARE Act

23. Due to the high risk of an unstable work environment, EMTs responding to a motor vehicle crash may consider using ________ in addition to standard PPE. - heavy-duty gloves

24. Which of the following parts of the nervous system is responsible for the "fight or flight" response experienced in response to a stressor? - Sympathetic nervous system

25. Which of the following is the form of stress that can cause immediate and long-term problems with an EMT's health and well-being? - Eustress

26. Which of the following terms is best defined as "a state of physical and/or psychological arousal to a stimulus?" - Stress

45. What are some signs and symptoms that a coworker may be experiencing delayed stress reaction (PTSD)? - Flashbacks, nightmares, and feelings of detachment

46. What action does an organ undergo to best describe the term hypertrophy? - Enlargement

47. You are treating a patient who has a productive cough and who reports weight loss, loss of appetite, weakness, night sweats, and fever. Which of the following diseases is most likely the cause of these signs and symptoms? - Tuberculosis

48. Which of the following statements about HIV/AIDS is true? - HIV positive needlesticks have less than a 0 percent infection rate.

49. You respond to a laceration call. When you arrive on-scene, you walk into the house and find a person suffering from a severe wrist laceration from a broken window. Without thinking, you immediately grab the wrist and apply direct pressure to the wound. You then realize that, in your hurry to save a life, you forgot to put on your gloves. You look down to see your hand is covered in blood. When practical, your next action should be - Wash your hands and report the exposure.

50. You are dispatched to a "man down" with no further information. As your unit arrives on-scene, you see a crowd of bystanders looking at a man lying in an alleyway. The bystanders begin screaming to you, "Help him, he's been shot! He's bleeding real bad!" What would be the best course of action? - Dispatch law enforcement and wait until the scene is secure.

51. You are approaching the scene of a motor vehicle crash. Which of the following would be the first way to safeguard your well-being as an EMT? - Ensure scene safety.

52. The tuberculin skin test (TST), formerly known as the purified protein derivative (PPD) test, is used to: - detect a person's exposure to tuberculosis.

53. Which of the following is a physiologic effect of the "Stress Triad" as described by the physician Hans Selye? - Bleeding gastric ulcers

54. Which of the following is true regarding proper hand cleaning? - If the EMT's hands are visibly dirty, an alcohol-based hand cleaner is not sufficient.

55. A(n) ________ is a situation that may lead to an acute stress reaction. - injury of a coworker

56. What reference provides important information regarding hazardous materials, emergency care, and procedures in case of accidental fire or release; supplies definitions of placard colors and identification numbers; and should be standard issue on-board all ambulances and rescue units? - Emergency Response Guidebook

57. An EMT is confronted by an armed gunman who is threatening to kill the EMT and his partner. An elevation in the EMT's heart rate and blood pressure occurs in which stage of the body's response to stress? - Alarm reaction stage

58. The "Stress Triad," or the body's response to a stressful stimulation, is known as general ________ syndrome. - adaptation

59. What mode of transmission most accurately describes the route of spreading hepatitis A? - Fecal-oral

60. You are dispatched to the staging area of a terrorist-related chemical exposure. The incident commander asks you to stand by while hazmat personnel bring patients to the cold zone. As an EMT on-board an ambulance, what statement BEST describes your role? - Transport decontaminated patients.

61. What is the EMT's highest priority at the scene of a hazardous materials incident? - Personal safety

62. You are dispatched to a female with altered mental status. Once inside the home, you find a female who appears to have been beaten unconscious. A man, who smells of alcohol, says that she is his wife and that he does not know what happened: "I just found her this way!" The husband is behaving suspiciously, appears paranoid, and is pacing erratically around the room. What would be the safest course of action? - Leave the house and call for law enforcement.

CHAPTER 3

1. To minimize the risk of litigation, the EMT should always:
   • provide competent care that meets current standards.
2. Which of the following general statements regarding consent is MOST correct?
   • A patient can consent to transport but can legally refuse to be treated.
3. What type of consent is involved when a 39-year-old mentally competent female with a severe headache asks you to take her to the hospital?
   • expressed
4. Which of the following scenarios MOST accurately depicts informed consent?
   • An EMT advises a patient of the risks of receiving treatment.
5. Which of the following types of consent allows treatment of a patient who is unconscious or mentally incapacitated?
   • implied
6. You are dispatched to an office building for a 49-year-old male with chest pain. When you arrive at the scene, you find the patient to be conscious and alert, but in obvious pain. He tells you that he did not call 9-1-1; a coworker did. He further states that he does not want to be treated or transported to the hospital. You should:
   • ensure that he is aware of the risks of refusing medical care.
7. You suspect that a pregnant 16-year-old girl has a broken leg after she was hit by a car. You explain that you plan to splint her leg, and she agrees to treatment. What type of consent is her agreement considered?
   • expressed
8. In many states, a minor may be treated as an adult for the purpose of consenting to or refusing medical treatment if the minor:
   • is self-supporting and lives by him- or herself.
9. You arrive at the scene of a motor vehicle versus pedestrian accident. The patient, a 13- year-old male, is unconscious and has multiple injuries. As you are treating the child, a law enforcement officer advises you that the child's parents will be at the scene in approximately 15 minutes. What should you do?
   • Transport the child immediately and have the parents meet you at the hospital. 10 are dispatched to a middle school for a 16-year-old female experiencing an asthma attack. She is conscious and alert, but in severe respiratory distress. The school nurse informs you that she has tried several times to contact the patient's parents but has not been successful. You should:
   • provide treatment up to your level of training and transport the child at once. 11 are treating a man with a closed head injury following an assault by a burglar. The patient, who has slurred speech, becomes verbally abusive and tells you to leave him alone. You should:
   • proceed with treatment and utilize law enforcement if necessary. 12 patient regains consciousness en route from his office to the emergency department. The patient tells you that he feels fine and does not want to go to the hospital. Under these circumstances, you should:
   • assess whether or not the patient's mental condition is impaired. 13 after loading your patient, a 50-year-old man with abdominal pain, into the ambulance, he tells you that he changed his mind and does not want to go to the hospital. He is conscious and alert and has no signs of mental incapacitation. You are suspicious that the man has a significant underlying condition and feel strongly that he should go to the hospital. Which of the following statements regarding this situation is correct?
   • A mentally competent adult can withdraw his or her consent to treat at any time. 14 suspect that a 6-year-old girl has broken her leg after falling from a swing at a playground. Shortly after you arrive, the child's mother appears and refuses to allow you

35 of the following components are needed to prove negligence? - duty to act, breach of duty, injury/damages, and causation 36 caring for a 65-year-old male with respiratory distress, you place him in a comfortable position but do not apply oxygen. The patient's condition continues to deteriorate and he develops cardiac arrest and dies at the hospital. This scenario is an example of: - negligence. 37. Which of the following scenarios MOST accurately depicts abandonment? - A paramedic transfers patient care to an EMT. 38 transporting a stable patient with chest pain to the hospital, you come across a major motor vehicle crash involving several critically injured patients. Your MOST appropriate action should be to: - continue transporting your patient and notify the dispatcher of the crash. 39 EMT would MOST likely be held liable for abandonment if he or she: - did not make provisions for continued care of an injured patient. 40. Acting in such a way as to make another person fear immediate bodily harm is called: - assault. 41 of the following statements regarding the Good Samaritan law is correct? - It will not protect the EMT in cases of gross negligence. 42. 42. If an action or procedure that was performed on a patient is not recorded on the written report: - it was not performed in the eyes of the law. 43. In the eyes of the court, an incomplete or untidy patient care form indicates: - that inadequate patient care was administered. 44. Which of the following situations requires you to notify the appropriate authorities? - attempted suicide 45 and your partner are the first to arrive at a potential crime scene with a critically injured patient involved. The scene is safe. Your first priority is to: - provide immediate patient care. 46 the chain of evidence at the scene of a crime should include: - not cutting through holes in clothing that were caused by weapons. 47 are dispatched to an apartment complex for a shooting. Law enforcement personnel are present and have the suspect in custody. You find the patient lying in a narrow space between the couch and coffee table of his small apartment. He is semiconscious and has a large gunshot wound to his chest. You should: - quickly move the coffee table so you can access and treat the patient. 48 EMTs witnessed a call in which a coworker gave adequate medical care but ignored the patient's emotional needs. The coworker was deliberately rude solely because the patient was thought to be infected with the human immunodeficiency virus (HIV). The EMTs ignored the coworker's treatment of this patient and took no steps to prevent this behavior from happening again. This lack of action on the part of the two EMTs is considered: - legal but unethical. 49 transporting a woman with diabetes, you inadvertently give her oral glucose even though her blood glucose level was high. You reassess the patient and note that her condition did not change; she remained stable. You should: - contact medical control and notify him or her of the error. 50 you and your partner arrive at the residence of a man in cardiac arrest, you immediately recognize the patient as the drunk driver who killed your brother several years earlier. A backup ambulance is en route to the scene. You should: - begin two-rescuer CPR and apply the automated external defibrillator (AED) as soon as possible.

CHAPTER 4

1. Ethnocentrism is defined as:
   • considering your own cultural values as more important when interacting with people of a different culture.
2. You are dispatched to the residence of an Asian family for a child with a high fever. When you assess the child, you note that he has numerous red marks on his back. The child's parents explain that these marks represent coining—a traditional Asian healing

practice in which hot coins are rubbed on the back. You should:

• document this on your patient care report and advise the emergency department staff of what the child's parents told you.

1. You are assessing a 75-year-old woman with mild shortness of breath. As you are asking her questions regarding her chief complaint and medical history, you progressively move closer and closer to her. In doing this, it is important to remember that:

• as you physically get closer to the patient, a greater and greater sense of trust must be established.

1. A 60-year-old man complains of chest pain. He is conscious and alert and denies shortness of breath. Which of the following questions would be the MOST appropriate to ask him?

• "Do you have any heart problems or take any medications?"

1. You are interviewing a 52-year-old man who complains of chest discomfort. The patient is a retired paramedic and is very anxious because he thinks he is having a heart attack. Which of the following statements would be appropriate to say?

• "It is possible that you are experiencing a heart attack. I am going to give you four baby aspirin to chew and swallow."

1. Calming and reassuring an anxious patient can be facilitated by:

• maintaining eye contact with the patient whenever possible.

1. During your assessment of a 20-year-old man with a severe headache and nausea, you ask him when his headache began, but he does not answer your question immediately. You should:

• allow him time to think about the question and respond to it.

1. In what manner should you act and speak with a patient?

• calm and confident

1. When communicating with an older patient, it is important to remember that:

• most older people think clearly and are capable of answering questions. 10 4-year-old boy had an apparent seizure. He is conscious and calm and is sitting on his mother's lap. His father is sitting in a nearby chair. The child's mother suddenly begins crying uncontrollably, which causes the child to start crying. You should:
• consider asking the father to hold the child so you can assess him while your partner tries to calm the mother. 11 of the following statements regarding communication with a child is MOST correct?
• Standing over a child often increases his or her level of anxiety. 12 with hearing-impaired patients can be facilitated by doing all of the following, EXCEPT:
• elevating the tone of your voice and exaggerating word pronunciation.

1. When communicating with a visually impaired patient, you should:

• determine the degree of the patient's impairment. 14 and your partner are dispatched to a residence for an "ill person." When you arrive, you find that the patient, a 44-year-old man, does not speak English. There are no relatives or bystanders present who can act as an interpreter. You should:
• use short, simple questions and point to specific parts of your body to try to determine the source of the patient's complaint. 15 you are wheeling your patient through the emergency department doors, you receive another call for a major motor vehicle crash. You should:
• respond only after giving a verbal patient report to a nurse or physician. 16 official transfer of patient care does not occur until the EMT:
• gives an oral report to the emergency room physician or nurse.

1. When you begin an oral report, you should state the patient's age, sex, and:

• chief complaint.

1. Typical components of an oral patient report include all of the following, EXCEPT: -the set of baseline vital signs taken at the scene.
2. The patient care report (PCR) ensures:

• continuity of care. 20 EMS system uses a computerized PCR in which you fill in the information electronically and then send it to the emergency department via a secure Internet server. The PCR has a comprehensive series of drop-down boxes, which are used to identify your assessment findings and specify the treatment that you provided; it also has a section for your narrative. When completing your PCR after a call, you should:

40 are transporting a 54-year-old male in cardiac arrest. An EMR is driving the ambulance as you and your partner attempt to resuscitate the patient. What is the MOST logical way of notifying the hospital? - Have the driver contact dispatch and relay the patient information to the hospital. 41 guidelines for effective radio communications include all of the following, EXCEPT: - using 10 codes to ensure radio traffic confidentiality. 42 communicating information over the radio, you should: - use the words "affirmative" and "negative" instead of "yes" or "no." 43. When providing a patient report via radio, you should protect the patient's privacy by: - not disclosing his or her name. 44 included in a radio report to the receiving hospital should include all of the following, EXCEPT: - a preliminary diagnosis of the patient's problem. 45. You could be sued for ___________ if your radio report to the hospital describes the patient in a manner that injures his or her reputation. - slander 46 obtaining patient care orders from a physician via a two-way radio, it is MOST important to remember that: - his or her instructions are based on the information you provide. 47. After receiving online orders from medical control to perform a patient care intervention, you should: - repeat the order to medical control word for word. 48 control gives you an order that seems inappropriate for the patient's condition. After confirming that you heard the physician correctly, you should: - advise the physician that the order is unclear and ask for clarification. 49 of the following statements regarding standing orders is MOST correct? - Standing orders should be followed when physician contact is not possible. 50 and your partner are attempting to resuscitate a middle-aged female in cardiac arrest. Because of the remote location you are in, you are unable to contact medical control. What should you do? - Follow locally established protocols or standing orders.

CHAPTER 5

• CHAPTER
• CHAPTER

What signs or symptoms associated with acute stress reactions require immediate intervention?

Which of the following terms refers to a positive form of stress that helps people work under pressure and respond effectively?

Which of the following is a physiologic effect of the stress triad?

What is a simple step EMTs can perform to help prevent the spread of flu?