10 free Paramedic practice questions: Responder Wellness and Resilience

Hepatitis A vaccination: The hepatitis A vaccine protects against a disease that is not usually spread through the blood and body fluid contact you have on calls.

Rabies vaccination: Rabies vaccine is for people at risk of animal bites. Animal bites are not the routine exposure behind the federal rule for EMS providers.

Yellow fever vaccination: Yellow fever vaccine protects against a disease spread by mosquitoes. Mosquito bites have no connection to the bloodborne exposure paramedics face on calls.

To provide mandatory psychological counseling to any paramedic involved in a traumatic call: Professional counseling is the right next step when peer support is not enough, and CISM makes that referral. Support through CISM is offered rather than compelled. Making debriefing mandatory has not been shown to prevent post-traumatic stress.

To investigate whether the paramedic made errors during the call that contributed to a bad outcome: Looking at what went wrong on a call is the job of quality improvement. Chart and case review looks at protocol adherence and clinical decision-making on one specific run. QI has to be improvement-focused, not disciplinary. CISM is about how the crew is coping after the call, not about what the crew did.

To determine whether the paramedic is fit to safely return to full duty: A fitness-for-duty check decides whether one responder can safely go back to full duty. CISM does not make that decision. CISM gives support and early intervention to responders after the event, and responders choose whether to take part.

Acute stress reaction: An acute stress reaction happens during the stressful call itself. You feel nervous and sharply focused while the call is running. This paramedic handled each call well while the call was happening, so the reaction is not coming during calls.

Delayed stress reaction: Delayed stress shows up after one specific event. You get through the crisis and then feel nervous, excited energy once things calm down. There is no single event in this question. The paramedic's problems built slowly over 4 months instead of following one call.

Posttraumatic stress disorder: would fit a responder who keeps reliving one distressing call and overreacts to reminders of that call. The question says there was no single overwhelming call. The paramedic also does not relive or think back on any particular call. Without the event and without the reliving, posttraumatic stress disorder does not fit.

Attending the next critical incident stress management debriefing: A debriefing helps many providers. Critical incident stress management does not work for everyone, and some providers do not want to talk about a traumatic call with peers. This partner has already said peer discussion would not help. The debriefing window of 24 to 72 hours also closed weeks ago.

Talking through the call with the crew at the end of the shift: Talking with the crew is peer support, and peer support is a real option when someone turns down the program. This partner said talking with peers would not help. Talking at the end of a shift is the same peer discussion in a less formal setting.

Taking several shifts off until the feelings pass: Rest and a rotated schedule help with general stress. This partner's behavior is still clearly changed weeks after the call. Time off does nothing about the behavior change while the pattern keeps going.

Spinal motion restriction and patient refusal: Spinal motion restriction is on the list, so half of this pair is right. Patient refusal is a medical and legal risk, and it is not a named high risk activity. Both items in the pair have to be on the list.

Handoff of care and radio communication: Handoff and communication are both on the list. Neither one depends on how a crew lifts or how a crew drives. A lifting and driving program would not target them.

Medication administration and airway management: Medication and airway are on the list too. Both are clinical steps in patient care, and neither is a movement hazard. A lifting program does not touch them.

Saliva from a patient who is drooling: Drooling looks like an obvious exposure. Saliva is a secretion, so saliva is on the list. A drooling patient is a reason to add a mask and eye protection.

Tears from a patient who is crying: Tears look like the most harmless fluid in the group. Clear and watery is not what decides it. Tears are a secretion, and every secretion is covered. Tears get the same handling as any other fluid that comes off a patient.

Nasal drainage from a patient with a cold: Nasal drainage from a cold seems more like a nuisance than a hazard on a routine transport. Respiratory secretions are still secretions. The list covers them, even when the source looks minor.

At no cost, once the first documented exposure has occurred: Services do respond after an exposure has happened. The vaccine is prevention. A series started after the needlestick has already missed the exposure it was meant to cover.

At no cost, but only after a titer shows no existing immunity: A titer first would avoid vaccinating someone who is already immune. The rule is to offer the series on assignment, not to hold the series back until testing is done.

At the employee's own cost, at any point during employment: Paying for your own vaccination sounds like a personal health choice. For employees with occupational exposure risk, the employer has to offer the series at no cost.

The strain shifts onto the shoulders and leaves the spine alone: Your shoulders do work harder as the load moves out. The strain is added to the spine, not moved off it. Your spine is the pivot point the load is levering against.

The load feels lighter, so the legs stop sharing the work: A load that drifts out can feel different in your hands. The legs do not stop working. The change is that the back now takes torque the legs were carrying.

The grip is what fails first, and the spine is not affected: Grip does fail under a load held far out, and a slipping grip is a real way patients get dropped. The spine is loaded at the same time, not spared. Calling the spine unaffected misses the back injury this rule is meant to prevent.

Back rounded slightly, reaching under 15 to 20 inches in front: A reach under 15 to 20 inches in front of the body is correct. The rounded back is the problem. Rounding the back gives up the locked, neutral position that makes the reach safe.

Back locked, reaching over the bed with the knees straight: Reaching over the bed is often the only way to get to the patient. Reaching with straight knees takes your legs out of the movement, and your back takes the whole load.

Back locked, reaching as far as the arms will comfortably go: A locked back is the right start. The reach also has to stay within 15 to 20 inches. Reaching as far as your arms will go turns even a locked back into a long lever.

The apparatus parks downstream and the crew works from the traffic side: Parking downstream keeps the apparatus out of the way of arriving units. Approaching traffic then reaches the crew first. Working from the traffic side puts people in the lane that is still moving.

The apparatus parks alongside the ambulance and the crew works between: Parking side by side makes a corridor between the two vehicles that looks protected. Neither vehicle is upstream blocking traffic. The corridor stays open to approaching traffic at one end.

The ambulance alone blocks the lane and the crew works from either side: The ambulance does block a lane, and the ambulance has warning lights. When a larger apparatus is available, the larger apparatus is the barrier. Working from either side leaves the crew members on the traffic side exposed.