Exposure Response and Protections Practice Questions

30 multiple-choice questions on Exposure response and protections for paramedic and EMT students, from Chapter 2 (Workforce Safety and Wellness). Read each question, pick your answer, then tap Show answer to check it and read the explanation.

30 practice questions

1. The first action after a needlestick injury is to:

   1. A. Report to a supervisor
   2. B. Wash the site with soap and water
   3. C. Complete the patient care report
   4. D. Contact the health department
   Show answer

   Answer: B. Wash the site with soap and water

   Flush mucous membrane splashes with water; wash skin exposures.

2. After washing, the exposed provider should:

   1. A. Return to service and report at shift end
   2. B. Ask the patient about their history
   3. C. Wait to see if symptoms develop
   4. D. Report, document, and get evaluated
   Show answer

   Answer: D. Report, document, and get evaluated

   Some post-exposure treatments are far more effective when started quickly. Report promptly.

3. Postexposure prophylaxis for HIV is most effective when:

   1. A. Delayed until testing returns
   2. B. Started within hours
   3. C. Started within days to weeks
   4. D. Given only for confirmed exposures
   Show answer

   Answer: B. Started within hours

   That is why immediate reporting matters. Start it as soon as possible.

4. The designated infection control officer is responsible for:

   1. A. Writing patient care protocols
   2. B. Coordinating exposure follow-up
   3. C. Cleaning and restocking the ambulance
   4. D. Purchasing PPE and equipment
   Show answer

   Answer: B. Coordinating exposure follow-up

   This role is required under federal law for EMS agencies. The role also covers notification and education.

5. The Ryan White law provisions relevant to EMS:

   1. A. Allow notification of responder exposures
   2. B. Limit workers' compensation claims
   3. C. Prohibit treating infected patients
   4. D. Require testing of all patients
   Show answer

   Answer: A. Allow notification of responder exposures

   Notification runs through the designated officer. It covers certain infectious diseases.

6. OSHA's bloodborne pathogens standard requires employers to provide:

   1. A. PPE, HBV vaccine, and training
   2. B. Legal counsel after exposures
   3. C. Paid leave for every exposure
   4. D. Annual HIV testing for each employee
   Show answer

   Answer: A. PPE, HBV vaccine, and training

   These protections are legal requirements, not courtesies. An exposure control plan is also required, all at no cost to employees. The standard requires PPE, hepatitis B vaccine, training, and post-exposure evaluation, but not routine HIV screening, legal counsel, or paid leave.

7. An exposure should be documented with:

   1. A. A verbal report to your supervisor only
   2. B. Route, PPE used, and actions taken
   3. C. The patient's name only
   4. D. No details, to protect privacy
   Show answer

   Answer: B. Route, PPE used, and actions taken

   Documentation supports workers' compensation and follow-up care. Include the date, time, and available source patient information.

8. A provider with an open wound on the hand should:

   1. A. Cover it occlusively and wear gloves
   2. B. Double glove and skip the dressing
   3. C. Avoid all patient care until healed
   4. D. Work with no special precautions
   Show answer

   Answer: A. Cover it occlusively and wear gloves

   Broken skin is an entry point for pathogens.

9. An exposure is defined as:

   1. A. Blood on intact skin of the forearm
   2. B. Blood on nonintact skin or mucosa
   3. C. Any patient contact, gloved or not
   4. D. Being in the same room as the patient
   Show answer

   Answer: B. Blood on nonintact skin or mucosa

   Route determines risk. Punctures also count, as does other potentially infectious material.

10. The highest risk route for bloodborne transmission is:

    1. A. Deep hollow-bore needlestick
    2. B. Blood on intact skin
    3. C. Blood splash to the skin
    4. D. Airborne blood droplets
    Show answer

    Answer: A. Deep hollow-bore needlestick

    Depth and device type both matter. A blood-filled needle is the highest risk.

11. Immediately after a splash to the eyes, the provider should:

    1. A. Rub the eyes to clear them
    2. B. Wait and report at shift end
    3. C. Apply antibiotic ointment
    4. D. Flush with water or saline
    Show answer

    Answer: D. Flush with water or saline

    Use an eyewash station if available. Flush for an extended period.

12. After a needlestick, the wound should be:

    1. A. Squeezed to express blood
    2. B. Washed with soap and water
    3. C. Soaked in diluted bleach
    4. D. Covered without washing
    Show answer

    Answer: B. Washed with soap and water

    Harsh agents are not recommended.

13. Exposure reporting should occur:

    1. A. Within a week
    2. B. At the end of the shift
    3. C. Only if symptoms develop
    4. D. Immediately
    Show answer

    Answer: D. Immediately

    Hours matter for HIV prophylaxis. Prophylaxis decisions are time-sensitive.

14. The source patient's infectious status:

    1. A. Cannot be determined by law
    2. B. May be tested under state law
    3. C. Is always known at the time
    4. D. Is irrelevant to follow-up
    Show answer

    Answer: B. May be tested under state law

    Rules for consent vary by state.

15. Postexposure prophylaxis for HIV typically involves:

    1. A. A single dose of an antiviral
    2. B. A vaccine given within 72 hours
    3. C. A multidrug course lasting weeks
    4. D. No treatment, only monitoring
    Show answer

    Answer: C. A multidrug course lasting weeks

    Side effects are common but manageable. Start it as soon as possible.

16. For hepatitis B, an unvaccinated exposed provider may receive:

    1. A. No treatment is available
    2. B. HBIG and the vaccine series
    3. C. Antiviral medication only
    4. D. A course of antibiotics
    Show answer

    Answer: B. HBIG and the vaccine series

    Vaccinated providers with documented immunity usually need nothing.

17. For hepatitis C exposure, current management involves:

    1. A. Hepatitis C vaccination
    2. B. Immediate antiviral prophylaxis
    3. C. Baseline and follow-up testing
    4. D. Hepatitis C immune globulin
    Show answer

    Answer: C. Baseline and follow-up testing

    Effective treatment exists if infection develops. Treat early if infection occurs.

18. Follow-up testing after a bloodborne exposure is important because:

    1. A. It matters mainly for HIV exposures
    2. B. It prevents infection from occurring
    3. C. It is optional for most exposures
    4. D. Infection may not appear immediately
    Show answer

    Answer: D. Infection may not appear immediately

    Missed follow-up complicates compensation. Documentation supports any future claim. Hepatitis B and C follow-up matter just as much.

19. Two days after you transported a coughing patient, the hospital confirms active pulmonary tuberculosis. You were not wearing an N95. Who should notify you and coordinate your follow-up?

    1. A. The patient's own primary care physician or clinic
    2. B. Your agency's designated infection control officer
    3. C. The state EMS licensing office's complaint line
    4. D. The ED charge nurse who received the patient
    Show answer

    Answer: B. Your agency's designated infection control officer

    Under the Ryan White Part G notification provisions, the hospital notifies the agency's designated officer about exposures to listed diseases such as active TB, and that officer contacts the provider and arranges testing and follow-up. The patient's physician and the licensing office are not part of exposure follow-up. ED staff send the result to the designated officer rather than tracking down each crew member.

20. Under federal law, a hospital must notify EMS when:

    1. A. A transported patient later dies in the ED
    2. B. Any transported patient is admitted
    3. C. A patient has a listed infection
    4. D. A patient tests positive for drugs
    Show answer

    Answer: C. A patient has a listed infection

    Notification runs through the designated officer. The diagnosis may come after transport. Drug test results are not an infectious exposure and are not part of this notification.

21. A new EMT asks who pays for her hepatitis B vaccine series. Under OSHA's Bloodborne Pathogens Standard, the vaccine must be:

    1. A. Paid for by her, then reimbursed if she is exposed
    2. B. Given only after she has a documented exposure
    3. C. Offered by the employer at no cost to her
    4. D. Required as a condition of employment, at her expense
    Show answer

    Answer: C. Offered by the employer at no cost to her

    OSHA 29 CFR 1910.1030 requires employers to offer the hepatitis B vaccine series at no cost to employees with occupational exposure risk, within 10 working days of assignment. Employees may decline by signing a declination form and can accept the vaccine later. Making her pay, waiting until after an exposure, or charging her as a condition of hire all violate the standard.

22. An exposure control plan must be:

    1. A. Written once and filed away
    2. B. Kept confidential from staff
    3. C. Optional for small agencies
    4. D. Reviewed and updated annually
    Show answer

    Answer: D. Reviewed and updated annually

    It must reflect current practices and devices. It must be accessible to employees.

23. Engineering controls that reduce sharps injuries include:

    1. A. Safety needles and sharps bins
    2. B. Written sharps policies
    3. C. Annual training sessions
    4. D. Double gloving for procedures
    Show answer

    Answer: A. Safety needles and sharps bins

    Devices outperform reminders. Sharps containers must be accessible.

24. Work practice controls include:

    1. A. Ventilation of the patient compartment
    2. B. Safety-engineered device design
    3. C. Choosing the right PPE
    4. D. No recapping, safe sharps passing
    Show answer

    Answer: D. No recapping, safe sharps passing

    They change how tasks are performed. Hand hygiene procedures are another.

25. A provider who is pregnant and exposed to an infectious disease should:

    1. A. Mention it at her next prenatal visit
    2. B. Report it once symptoms develop
    3. C. Rely on her past vaccines and continue
    4. D. Report it promptly
    Show answer

    Answer: D. Report it promptly

    Rubella, varicella, and CMV are examples. Some infections carry fetal risk requiring specific management. Some exposures need treatment within days, so waiting for a visit or for symptoms loses time, and past vaccines do not cover every infection, such as CMV.

26. Records of exposure incidents must be:

    1. A. Kept only by the exposed employee
    2. B. Filed in the provider's personnel file
    3. C. Discarded after one year of storage
    4. D. Kept confidentially per regulation
    Show answer

    Answer: D. Kept confidentially per regulation

    Retention periods are lengthy. Exposure medical records must be kept confidential and apart from the general personnel file.

27. A provider concerned about privacy after an exposure should know that:

    1. A. HIV results are private, others are not
    2. B. Results go into the personnel file
    3. C. The whole crew is notified
    4. D. The records are confidential
    Show answer

    Answer: D. The records are confidential

    Confidentiality protections apply. Confidentiality covers every exposure result, and medical records are kept separate from personnel files.

28. Which factor most influences the risk of infection after an exposure?

    1. A. Pathogen, route, and volume
    2. B. Whether the patient appeared ill
    3. C. Provider years of experience
    4. D. The type of glove that was worn
    Show answer

    Answer: A. Pathogen, route, and volume

    Risk differs greatly among pathogens. The source patient's status also matters. Many infectious patients look well, and glove type matters far less than the pathogen, route, and volume.

29. A provider who develops symptoms weeks after a documented exposure should:

    1. A. Seek care and cite the exposure
    2. B. Treat it as a cold unless fever is high
    3. C. Wait until the next scheduled blood test
    4. D. Assume it is unrelated to work
    Show answer

    Answer: A. Seek care and cite the exposure

    This is where documentation pays off. Self-diagnosis or waiting for the next scheduled test delays care and weakens the link to the exposure.

30. The purpose of baseline testing after an exposure is to:

    1. A. Determine which drugs to prescribe
    2. B. Prove infection occurred at work
    3. C. Document status at exposure time
    4. D. Satisfy the hospital's paperwork
    Show answer

    Answer: C. Document status at exposure time

    Without it, causation is disputed. Later seroconversion can then be attributed correctly.