CH 2

Question 1

At the scene of an incident involving multiple patients, an obviously depressed bystander needs:
prompt removal from the scene by law enforcement personnel.
to be brought back to reality and removed from the scene.
an assessment to determine why he or she is depressed.
immediate psychological support and possible transport.

Answer 1

to be brought back to reality and removed from the scene.

Question 2

It is important for you to remember that an angry or resentful patient:
usually thinks that you are incompetent and uncaring.
can only be calmed by a family member or friend.
is extremely difficult to effectively care for.
could be acting in such a manner due to fear of the situation.

Answer 2

could be acting in such a manner due to fear of the situation.

Question 3

When managing stress, it is important to:
consume moderate amounts of alcohol.
avoid taking sleeping aids after a stressful event.
increase your caffeine intake to increase your alertness.
avoid vigorous exercise because it raises your heart rate.

Answer 3

avoid taking sleeping aids after a stressful event.

Question 4

You are transporting a 60-year-old man with pancreatic cancer to the local cancer therapy center for his radiation treatment. The man is clearly depressed. Which of the following questions or statements would be appropriate in this situation?
“I know how you feel and am sorry about your condition.”
“I will take care of you and everything will be all right.”
“Do you feel the need to talk about dying?”
“If there’s anything worrying you, I’d be glad to listen.”

Answer 4

“If there’s anything worrying you, I’d be glad to listen.”

Question 5

Which of the following is an early warning sign of stress?
Heart palpitations
Dry, irritated skin
Increased energy
Improved sleeping

Answer 5

Heart palpitations

Question 6

Which of the following statements regarding distress is correct?
A paramedic who becomes distressed at the sight of a mutilating injury should consider a different line of work.
Paramedics most commonly become distressed because of what other people believe about them.
Distress is a learned reaction, based on the way the paramedic perceives and interprets a given situation.
The same situations or events that cause distress in one paramedic usually cause distress in another paramedic.

Answer 6

Distress is a learned reaction, based on the way the paramedic perceives and interprets a given situation.

Question 7

In general, paramedics who do not experience burnout are those who:
regularly see a psychiatrist or psychologist.
consider the patient’s needs before their own.
have learned to value and respect themselves.
have been paramedics for fewer than 10 years.

Answer 7

have learned to value and respect themselves.

Question 8

To prepare for or handle stress, you should:
stop taking any prescribed anxiolytic medications so you can stay focused.
avoid using alcohol during the 36-hour period before the start of your shift.
increase your caffeine intake to facilitate the fight-or-flight mechanism.
exercise vigorously and regularly during the 12 hours preceding your shift.

Answer 8

exercise vigorously and regularly during the 12 hours preceding your shift.

Question 9

A return to an earlier age level of behavior or emotional adjustment during a crisis situation is called:
redirection.
projection.
digression.
regression.

Answer 9

regression

Question 10

A woman having a possible heart attack redirects her anger away from her condition and toward the paramedic. This is called:
regression.
digression.
projection.
displacement.

Answer 10

displacement.

Question 11

Which of the following is a realistic and healthy belief that any paramedic should possess?
“As a paramedic, I must never make mistakes while caring for patients.”
“My safety depends on being able to anticipate every possible danger.”
“If a patient that I am caring for dies, it is solely my responsibility.”
“If there’s something I don’t know, people will not think less of me.”

Answer 11

“If there’s something I don’t know, people will not think less of me.”

Question 12

According to the Social Readjustment Rating Scale, which of the following stressors has the highest life-change unit value?
Gain of a new family member
Spouse begins or stops working
Change to a different line of work
Foreclosure of mortgage or loan

Answer 12

Gain of a new family member

Question 13

According to the USDA dietary guidelines, the keys to controlling body weight include:
consuming more calories and eating fewer vegetables.
eating fewer calories while increasing physical activity.
drinking less water per day and exercising regularly.
exercising more and increasing your caloric intake.

Answer 13

eating fewer calories while increasing physical activity.

Question 14

Which of the following is a common sign of PTSD?
Recurring mental flashbacks of the incident
Seeking participation in new hobbies and activities
Becoming more social with friends and family
Feelings of guilt that you performed inadequately

Answer 14

Recurring mental flashbacks of the incident

Question 15

You should know your target heart rate and:
attempt to achieve it every time you exercise.
avoid reaching it because it may injure the heart.
surpass it by 50% every time you exercise.
achieve at least half of it when you exercise.

Answer 15

attempt to achieve it every time you exercise.

Question 16

Which of the following is a physiologic response of the fight-or-flight response?
Decreased flow of blood to the skeletal muscles
Shunting of blood toward the gastrointestinal tract
Decreased sympathetic tone and pupil constriction
Mobilization of glucose and an increased heart rate

Answer 16

Mobilization of glucose and an increased heart rate

Question 17

You and your partner are caring for an 82-year-old woman who is obviously confused at the situation. How should you interact with the patient?
Sympathize with the woman and tell her that everything will be all right.
Carefully explain what you are doing and frequently talk to the patient.
Ask a family member talk to the patient.
Limit your dialogue with the patient to avoid agitating her.

Answer 17

Carefully explain what you are doing and frequently talk to the patient.

Question 18

What is the recommended exercise routine for most adults?
At least 1 hour a day of mild to moderate physical activity
No more than 2 hours of vigorous exercise every other day
At least 30 minutes a day of moderate to vigorous exercise
At least 20 minutes a day of moderate to vigorous exercise

Answer 18

At least 30 minutes a day of moderate to vigorous exercise

Question 19

Which of the following should be done first when you are beginning to experience symptoms of burnout?
See a psychologist and try to identify the underlying cause.
Request to work at a busier station to keep your mind occupied.
Take at least 3 weeks off from work and go on a vacation.
Re-examine your beliefs and your ways of responding to stress.

Answer 19

Re-examine your beliefs and your ways of responding to stress.

Question 20

A critical incident is defined as:
a delayed stress reaction to an incident that is similar to what has been experienced in the past.
an incident that overwhelms the ability of an EMS worker or system to cope with the experience, either at the scene or later.
a situation that completely incapacitates a person’s ability to cope with the acute stress reaction at the scene.
any incident that completely overwhelms a paramedic’s ability to manage the short-term stress caused by the incident.

Answer 20

an incident that overwhelms the ability of an EMS worker or system to cope with the experience, either at the scene or later.

Question 21

Whole grains are healthier than processed grains because they have more:
vitamin A.
calcium.
protein.
potassium.

Answer 21

protein.

Question 22

If a patient with a possible heart attack asks you if he or she is going to die, you should:
acknowledge the seriousness of the situation without taking away all hope.
advise him or her that only a licensed physician can answer this question.
be honest and forthcoming by stating that the situation does not look good.
avoid answering the question and redirect the patient’s thought process.

Answer 22

acknowledge the seriousness of the situation without taking away all hope.

Question 23

General guidelines for preventing burnout include:
avoiding stress-relieving techniques while you are on duty.
engaging in social activities with people not involved in EMS.
taking a mild sedative to help get adequate sleep each night.
discussing your shift with your spouse or other family members.

Answer 23

engaging in social activities with people not involved in EMS.

Question 24

You and your team are attempting to resuscitate a 50-year-old man in cardiac arrest when his wife returns home. She immediately goes into a blind panic and begins screaming and crying. You should:
ask a police officer to take her outside and explain the current situation to her.
separate her from the area and place her under the supervision of a calmer person.
continue your resuscitative efforts and then tend to the woman when it is feasible.
tactfully advise the woman that her screaming and crying are hampering your efforts.

Answer 24

separate her from the area and place her under the supervision of a calmer person.

Question 25

Which of the following is a symptom of impending burnout? Requesting additional shifts Increased energy Engaging more in social activities Decreased ability to concentrate

Answer 25

Decreased ability to concentrate

Question 26

If you are approached by a coworker who has noticed a negative change in your behavior, you should: keep an open mind regarding what the coworker has noticed. request to speak to a psychologist as soon as possible. thank your coworker, but let him or her know you are okay. ask your supervisor to be moved to a different station.

Answer 26

keep an open mind regarding what the coworker has noticed.

Question 27

Which of the following habits will increase your exposure to injury from lifting your maximum weight? Removing all unnecessary equipment from the cot before loading it Ensuring that the patient is aware that he or she is about to be lifted Routinely lowering the ambulance stretcher all the way to the ground Utilizing a second person to help lift the foot end of the cot if needed

Answer 27

Routinely lowering the ambulance stretcher all the way to the ground

Question 28

When attempting to control your own anxiety through controlled breathing, you should: wait until the call is over before attempting this form of anxiety relief. take in several shallow breaths followed by prolonged exhalation. breathe rapidly for 5 seconds and then hold your breath for 5 seconds. take deep breaths in through the nose and out through the mouth.

Answer 28

take deep breaths in through the nose and out through the mouth.

Question 29

Prolonged or excessive stress has been proven to be a strong contributor to: hypotension. depression. bipolar disorder. schizophrenia

Answer 29

depression.

Question 30

Progressive relaxation is a technique of anxiety relief that: utilizes sedative medications to facilitate anxiety relief. can easily be used even if you are on an emergency call. involves tightening and relaxing specific muscle groups. allows you to relax without being noticed by others.

Answer 30

involves tightening and relaxing specific muscle groups.

Question 31

If a 30-year-old man has a resting heart rate of 60 beats/min and a maximum heart rate of 190 beats/min, what is his target heart rate? 143 beats/min 147 beats/min 151 beats/min 139 beats/min

Answer 31

151 beats/min

Question 32

When a patient minimizes his or her symptoms by stating, “I'm fine,” the paramedic should: realize that he or she is subconsciously in a state of regression. explain that the situation is indeed urgent and requires evaluation. recognize that his or her condition is not life threatening. find a reliable informant among the patient's family or friends.

Answer 32

find a reliable informant among the patient's family or friends.

Question 33

What type of person is particularly vulnerable to anxiety when he or she experiences an illness or injury? One whose self-esteem depends on being active, independent, and aggressive One who can evaluate the competence level of the paramedic taking care of him or her One who takes medications for conditions such as high blood pressure and hyperactivity One who understands that his or her situation is hopeless but who is easily able to accept it

Answer 33

One whose self-esteem depends on being active, independent, and aggressive

Question 34

Upon arriving at the scene of a motor vehicle collision: traffic is usually the only hazard with which to be concerned. parking the ambulance on the road may cause a fire. the ambulance should be parked at least 200 feet away. you should look for hazards as you approach the vehicle.

Answer 34

you should look for hazards as you approach the vehicle.

Question 35

EMS providers who work 24-hour shifts are prone to poor nutritional habits on the job because: their water intake often is increased. they are faced with greater stress. their meals are interrupted frequently. they have a higher call volume.

Answer 35

their meals are interrupted frequently.

Question 36

Any time you need to move a patient who cannot or should not walk, it is important to: give the patient an assistive device. request a speciality unit. ask for extra help. ask the patient why they cannot walk.

Answer 36

ask for extra help.

Question 37

When you enter a situation in which everyone is under stress, it is important to remember that: an authoritative tone of voice will quickly defuse the situation. all human beings respond to stress in almost identical ways. most people respond to stress with isolated bouts of violence. there is no guarantee that people are going to behave appropriately.

Answer 37

there is no guarantee that people are going to behave appropriately.

Question 38

Burnout is defined as: a person's emotional reaction to a stressful event. the exhaustion of physical or emotional strength. an acute reaction to an overwhelming situation. cynicism after being a paramedic for many years.

Answer 38

the exhaustion of physical or emotional strength.

Question 39

A patient with different cultural beliefs will not maintain eye contact with you. He is very pleasant, but looks down at the ground when answering your questions. What does this indicate? He cannot express his feelings accurately. He is not forthcoming to your questions. He is showing respect for your authority. He fears your presence and is intimidated.

Answer 39

He is showing respect for your authority.

Question 40

Many prepared or processed foods include which of the following as a preservative? Potassium Sugar Sodium Caffeine

Answer 40

Sodium

Question 41

Which of the following is a component of the American Heart Association's Simple 7 list? Become vegetarian. Decrease portions. Take a multivitamin. Control cholesterol.

Answer 41

Control cholesterol.

Question 42

Which of the following is a common trigger of distress? Planning a lengthy vacation Reduced responsibility at work The loss of a loved one Preparing for retirement

Answer 42

The loss of a loved one

Question 43

Chronic stress: has been shown to lower one's risk for cancer. places the body in a continuous, unrelieved state of alert. commonly results from a single acute stress reaction. is preferentially treated with a benzodiazepine medication.

Answer 43

places the body in a continuous, unrelieved state of alert.

Question 44

Regardless of a paramedic's circadian rhythms, he or she should: eat at different times of the day. not overlook the need for rest. vary his or her sleep schedule. only consume minimal caffeine.

Answer 44

not overlook the need for rest.

Question 45

As a part of your personal health assessment, you should: have your cholesterol checked every 3 or 4 months. see your personal physician at least every 6 months. have a routine colonoscopy beginning at age 25 years. consider hereditary factors that can impact your health.

Answer 45

consider hereditary factors that can impact your health.

Question 46

People who overreact at the scene of an emergency, such as an incident with multiple casualties, will likely: be in a numbed, dazed state. be overly quiet. experience bodily dysfunction. be compulsively talkative.

Answer 46

be compulsively talkative.

Question 47

When the parent of an ill or injured child is angry and demanding, and implies that you are not competent to handle the situation, your response should be to: reassure the parent that you are working under the physician's guidance in the best interests of the child. advise the parent that you have many hours of training and experience and can handle the situation competently. ask the parent if he or she would like to transport the child to the hospital in his or her personal vehicle. show the parent your paramedic credential to reassure him or her that you are qualified to provide emergency care.

Answer 47

reassure the parent that you are working under the physician's guidance in the best interests of the child.

Question 48

The statement “If I can just live long enough to see my son's wedding, I can die in peace” is indicative of which stage of the grieving process? Denial Bargaining Depression Anger

Answer 48

Bargaining

Question 49

What is the best way to control your flight-or-flight response during stressful situations? Prepare for stressful situations before they occur. Avoid stressful situations. Use breathing exercises. Immerse yourself in stressful situations.

Answer 49

Prepare for stressful situations before they occur.

Question 50

How can a paramedic improve his or her ability to effectively manage stress? Identify the stress triggers and take action to minimize their effects. Recognize what causes the stress and eliminate it from his or her life. Avoid caffeine and get a minimum of 12 hours of sleep every day. Seek psychiatric assistance and request a mild sedative drug.

Answer 50

Identify the stress triggers and take action to minimize their effects.