Paramedic Care: Principles & Practice, 4th edition

Bledsoe/ Porter/ Cherry

Volume 1 Introduction to Paramedicine

Chapter 4 Workforce Safety and Wellness

1) The stage of the stress response in which the pituitary gland releases a flood of
adrenocorticotropic hormones is:
A) Exhaustion
B) Resistance
C) Withdrawal
D) Alarm

2) Which of the following statements about Kübler-Ross’s five stages of grief is most accurate?
A) These stages refer only to patients actually dying.
B) Dying patients experience these stages in their own unique ways.
C) While people have unique experiences along the way, they do experience all five stages.
D) These stages refer to dying people and their loved ones but not to the feelings of health care
providers.

3) Which of the following best describes those in an ambulance that should use seat belts?
A) All persons on board (care providers, patients, and family)
B) Only the patient because the requirements of medical care take priority
C) Only those riding in the back
D) Only those seated in the front

4) Of the following, which is NOT generally used on-scene to minimize hazards?

A) Helmets
B) Body armor
C) Reflective tape
D) Managing stress

5) One of the principles of proper lifting is to:

A) Hold your breath while lifting
B) Position the load close to your body
C) Pull rather than push when possible
D) Bend at the waist to use the strong muscles of the back

6) Which of the Kübler-Ross five stages of grief would be suspected if a cancer patient said to
you, “This frustrates me so much. I never saw it coming, and now my family will have to go on
without me”?
A) Bargaining
B) Hopelessness
C) Anger
D) Denial

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7) Which of the following is an important factor in reducing the risk of infectious disease?
A) Stress management
B) Adequate rest
C) Good nutrition
D) All of the above

8) To minimize the stress of shift work, on their days off paramedics should sleep:
A) At the times they sleep on workdays
B) After a heavy meal or strenuous exercise
C) At least 12 hours to catch up on lost sleep
D) At night regardless of when they sleep on workdays

9) Which of the following is NOT one of the core elements of physical fitness?
A) Muscular strength
B) Speed
C) Cardiovascular endurance
D) Flexibility

10) When coping mechanisms can no longer buffer job stressors, the likely result is:
A) Withdrawal
B) Burnout
C) Eustress
D) Fugue state

11) Which of the following causes the greatest number of job-related deaths among EMS
personnel?
A) Motor vehicle collisions
B) Violence
C) Suicide
D) Communicable diseases

12) What is the minimum number of times you should exercise weekly to build cardiovascular
endurance?
A) 2
B) 5
C) 3
D) 10

13) Good nutrition habits include:

A) Drinking 2–3 cups of coffee a day
B) Eating 1–2 servings of grains or breads daily
C) Drinking soft drinks
D) Bringing low-calorie snacks to work

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14) You are on a scene at which you have requested and received orders for field termination of
resuscitative measures. Which of the following terms should you use when informing the family
of the patient’s status?
A) Gone
B) Expired
C) Dead
D) Passed

15) At which of the following times should you wash your hands?
A) Before meals
B) When your hands are visibly soiled
C) After every patient contact and/or decontamination procedure
D) All of the above

16) The minimum recommended PPE for prehospital providers is all of the following, EXCEPT:
A) Reusable equipment
B) HEPA respirator
C) Protective gloves
D) Protective eyewear

17) When operating an emergency vehicle, the paramedic should show due regard for the safety
of:
A) The patient
B) The EMS crew members
C) The general public
D) All of the above

18) Which of the following is NOT a recommended vaccination for EMS providers?
A) Tuberculosis
B) Hepatitis B
C) Measles/mumps/rubella
D) Influenza

19) The most important standard precaution the EMS provider can employ as an infection-
control practice is to:
A) Avoid direct patient contact
B) Sterilize all contaminated equipment
C) Utilize frequent hand washing
D) Receive all recommended vaccinations

20) A type of exercise in which muscles are worked through their full ranges of motion to
develop muscular strength is called:
A) Iatrogenic
B) Isotonic
C) Isolateral
D) Isometric

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21) A patient with suspected or known ________ makes it necessary for the care provider to don
a HEPA or an N-95 respirator.
A) Pneumonia
B) HIV
C) Viral meningitis
D) Tuberculosis

22) In addition to gloves, what personal protective equipment should you wear when assisting
with childbirth?
A) Protective eyewear and gown
B) Mask, gown, and protective eyewear
C) Mask
D) Protective eyewear and N-95 respirator

23) What can be done to minimize the possibility of developing cancer?

A) Eating broccoli and high-fiber foods
B) Wearing sunblock
C) Risk-assessment screening
D) All of the above

24) Which of the following procedures would you use for dealing with a backboard
contaminated with blood?
A) Sterilization
B) Cleaning
C) Disinfection
D) Disposal

25) Your EMS partner has been through some hard times lately. He broke up with his wife a few
months ago, and his father died last month. After not smoking for years, he’s taken it up again
and now chain-smokes. He’s sometimes rude to patients, and when you try to talk with him
about this, he cuts you off. Your partner is using stress-management techniques best described
as:
A) Normal
B) Defensive
C) Detrimental
D) Neutral

26) Which of the following increases the risk of motor vehicle collision?
A) Poor weather conditions
B) Multiple vehicle responses
C) The use of an ambulance escort
D) All of the above

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27) You are responding to a call for a “person slumped behind the wheel of car” on a “quiet side
street at 1 A.M. How should you approach this car?
A) Pull up in front of the car, turn on all lights and the siren, and move quickly toward the
vehicle.
B) Pull up in front of the car, turn on all lights, and stay in the ambulance to determine scene
safety.
C) Pull up behind the car, use spotlights to “blind” the occupant, and approach cautiously until
you perceive that there is no hostile intent.
D) Park behind the car at a safe distance, remain in the ambulance, and wait for law enforcement
to arrive and ensure scene safety.

28) When you are in a stressful situation and find yourself thinking, “I can’t do this,” one
effective strategy is to:
A) Withdraw
B) Deny
C) Project
D) Reframe

29) Which of the following normally occurs as part of the “fight-or-flight” response?
A) Pupils dilate
B) Heart rate decreases
C) Blood pressure decreases
D) Digestion speeds up

30) One way to prevent a potentially hostile situation is to:

A) Assert your authority
B) Move into bystanders’ personal space
C) Communicate effectively
D) Maintain a closed stance

31) Your ambulance arrives at a scene where a car has run into a ditch alongside a two-lane
country highway. You should park the ambulance:
A) In front of the car on the same side of the street
B) Behind the car on the same side of the street
C) Behind the car on the opposite side of the street
D) In front of the car on the opposite side of the street

32) The stress-management technique of controlled breathing works by:

A) Reducing adrenaline levels
B) Increasing blood pressure
C) Increasing ACTH levels
D) Speeding digestion

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33) Which of the following can increase the risk of back injury?
A) Smoking
B) Weak abdominal muscles
C) Poor nutrition
D) All of the above

34) You are providing end-of-life care to a patient in the last stages of a terminal illness. She
appears to be at peace and speaks animatedly about her upcoming funeral. She is in which stage
of loss?
A) Acceptance
B) Denial
C) Bargaining
D) Depression

35) Which of the following is a benefit of good nutritional habits?

A) Proper body weight
B) Reduced risk of cardiovascular disease
C) Reduced cancer risk
D) All of the above

36) Eating habits that contribute to good nutrition include which of the following?
A) Consuming no more than 10 percent of calories from carbohydrates
B) Eating a variety of foods from the major food groups daily
C) Eating primarily high-protein foods
D) Consuming 8 to 10 glasses of fruit juice per day

37) Which of the following practices, when done regularly, can help reduce back injuries during
lifting?
A) Gaining body weight to “anchor” the lift
B) Keeping the palms up when possible while lifting the cot
C) Using traditional sit-ups to strengthen lower back muscles during exercise routines
D) Twisting during lifting to reduce the number of steps to move a patient from the floor to the
cot

38) Which of the following standard precautions should paramedics use with every patient?
A) Disposable gloves
B) Surgical gown and mask
C) Mask and protective eyewear
D) HEPA mask

39) Shift work, down time between calls, and inadequate pay are all examples of ________
stressors.
A) Emotional
B) Administrative
C) Environmental
D) Physical

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40) Standard precautions are utilized on the assumption that:
A) The blood and body fluids of all patients are potentially infectious
B) Hemorrhage is likely in most patients who call EMS
C) Paramedics are mainly threatened by airborne pathogens
D) Patients who look healthy are not contagious

41) You just sustained an accidental needle stick with a contaminated intravenous needle. You
should immediately:
A) Request a tetanus shot
B) Contact your supervisor
C) Wash the affected area with soap and water
D) Ask the patient about lifestyle risk factors for AIDS

42) Which of the following is part of good hand-washing technique?

A) Use the hottest water that can be tolerated.
B) Use only antibacterial bar soap, avoiding liquid soaps when possible.
C) Thoroughly lather your hands with soap, front and back, for at least 15 seconds.
D) Use an ethanol-based, waterless hand sanitizer instead of soap when possible.

43) Which of the following is NOT a common warning sign of cancer?

A) Change in mole size or appearance
B) Weight gain
C) Unexplained chronic fatigue
D) Abnormal lumps

44) Which of the following is a physiological benefit of achieving and maintaining physical
fitness?
A) Increased resting blood pressure
B) Increased metabolic rate
C) Decreased oxygen-carrying capacity
D) Increased resting heart rate

45) Which of the following is a bloodborne disease?

A) Hepatitis B
B) Rubella
C) Tuberculosis
D) Influenza

46) The long spine board on which you transported a patient directly contacted the patient’s
unbroken skin. How would you clean the board?
A) Wash it with soap and water.
B) Discard it.
C) Sterilize it with an EPA-approved solution.
D) Disinfect it with a solution of 1 part bleach to 10 parts of water.

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47) Any occurrence in which blood or body fluids contact nonintact skin or mucous membranes
is considered a(n):
A) Contamination
B) Exposure
C) Incident
D) Infection

48) As part of a healthy diet to control weight, you should:

A) Eat low-calorie snacks
B) Cut back on fluids
C) Eat one “fast food” meal a day
D) Reduce by half the serving size on a food label

49) A supervisor senses that an EMS crew that has just conducted a very dramatic, but
unsuccessful, rescue of a drowned child may be experiencing very intense emotions about the
incident. Which of the following is an appropriate supervisory action?
A) Do nothing unless the providers become obviously distressed.
B) Refer all crew members to psychiatric help at the end of the shift.
C) Minimize any effects by keeping a low-key attitude about the incident.
D) Initiate a “resiliency based care” program to care for the mental health of the crew.

50) When physically preparing yourself to work safely as a paramedic, you should:
A) Exercise your cardiovascular system at least three times a week
B) Read as much as you can about physical fitness
C) Perform as many traditional sit-ups as you can to promote abdominal strength
D) Do as little as possible to preserve your strength for emergency duty

51) When evaluating a patient with tuberculosis, paramedics should protect themselves by:
A) Placing a HEPA respirator on the patient
B) Wearing surgical masks
C) Wearing HEPA respirators
D) Placing nonrebreather masks on their patients

52) Which of the following is NOT a benefit of physical fitness?

A) Increased irritability
B) Improved self-image
C) Enhanced quality of life
D) Maintenance of motor skills

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