Infection Control, PPE, and Exposures Practice Questions

25 multiple-choice questions on Infection control, PPE, and exposures for paramedic and EMT students, from Chapter 27 (Infectious Diseases). Read each question, pick your answer, then tap Show answer to check it and read the explanation.

25 practice questions

1. During care of a patient with suspected Ebola, a trained observer watches each provider remove PPE. The main reason is to:

   1. A. Catch self-contamination during doffing
   2. B. Time how long each provider takes to undress
   3. C. Count the used PPE items for restocking later
   4. D. Document the patient's vital signs for the chart
   Show answer

   Answer: A. Catch self-contamination during doffing

   Removing PPE is when most self-contamination happens. A trained observer reads a checklist step by step and watches for breaches so they can be corrected immediately. It is not for timing, supply counts, or charting.

2. While transporting a patient with suspected active TB, the patient wears a surgical mask and you wear an N95. What else helps?

   1. A. Close all vents and recirculate the cabin air
   2. B. Run the exhaust fan for air exchange
   3. C. Turn the heater up full
   4. D. Remove your N95 once the patient has a mask on
   Show answer

   Answer: B. Run the exhaust fan for air exchange

   Increasing air exchange dilutes airborne particles. Use the patient compartment's exhaust fan (and keep the partition closed) per agency policy. Recirculating air keeps particles in the compartment, heat does nothing to them, and the N95 stays on.

3. When cleaning the patient compartment after a call, the usual order is to work:

   1. A. From the floor upward toward the ceiling
   2. B. In any order, as long as every spot is wiped
   3. C. From the dirtiest spots out to the clean
   4. D. From cleaner areas toward dirtier ones
   Show answer

   Answer: D. From cleaner areas toward dirtier ones

   Cleaning from top to bottom and from cleaner to dirtier areas avoids spreading contamination onto surfaces you have already cleaned. Change wipes as they become soiled. Starting at the floor or the dirtiest spot drags germs onto clean surfaces.

4. You spray a disinfectant on the stretcher and wipe it dry after 10 seconds. The label lists a 2-minute contact time. The problem is that:

   1. A. The wipe has made the surface sterile
   2. B. The chemical will damage the vinyl
   3. C. The surface may not be disinfected
   4. D. Wiping it dry speeds up its action
   Show answer

   Answer: C. The surface may not be disinfected

   Each disinfectant needs to stay wet on the surface for its labeled contact (dwell) time to kill the listed organisms. Wiping it off early leaves germs alive. Disinfection is not sterilization, and wiping dry does not speed it up.

5. A small amount of blood spills on the ambulance floor. The correct cleanup is to:

   1. A. Absorb it, then use a disinfectant
   2. B. Mop it up with plain soap and warm water
   3. C. Wipe it with a dry towel
   4. D. Let it dry first, then sweep up the flakes
   Show answer

   Answer: A. Absorb it, then use a disinfectant

   Wearing gloves, absorb the blood with disposable towels, discard them as biohazard waste, then clean and disinfect the area with an EPA-registered disinfectant or diluted bleach. Plain soap does not disinfect, and dried blood can still carry hepatitis B.

6. The correct order for removing PPE is generally:

   1. A. Mask, gown, goggles, gloves
   2. B. Gloves, goggles, gown, mask
   3. C. Goggles, mask, gloves, gown
   4. D. Gown, mask, gloves, goggles
   Show answer

   Answer: B. Gloves, goggles, gown, mask

   Remove the most contaminated items first. Remove the mask or respirator last, then perform hand hygiene.

7. Your glove tears while you are starting an IV. You should:

   1. A. Tape over the tear
   2. B. Pull a new glove over the torn one and go on
   3. C. Finish the IV first, then change the gloves
   4. D. Remove it, clean hands, glove again
   Show answer

   Answer: D. Remove it, clean hands, glove again

   A torn glove no longer protects you. Remove it as soon as it is safe, perform hand hygiene, check for any skin exposure, and put on a new glove. Patching it or layering a glove over it leaves contaminated skin underneath.

8. Under OSHA rules, an EMS provider who uses N95 respirators must be fit tested:

   1. A. Once when first hired
   2. B. Every 5 years of service
   3. C. At least once a year
   4. D. After each TB exposure
   Show answer

   Answer: C. At least once a year

   OSHA requires fit testing before first use, at least annually after that, and again if facial changes such as weight change or dental work might affect the seal. A one-time test is not enough.

9. Before searching the pockets of an unresponsive patient with track marks, you should:

   1. A. Ask bystanders about needles and look first
   2. B. Reach in bare-handed
   3. C. Squeeze the pockets firmly to feel for any items
   4. D. Put on two pairs of gloves and then dig right in
   Show answer

   Answer: A. Ask bystanders about needles and look first

   Pockets may hold uncapped needles. Ask companions what is there, look and use a light, and pat only from the outside carefully, or cut the pocket away. Gloves, even doubled, do not stop needles.

10. A crew member has vomiting and diarrhea from norovirus. Per CDC guidance, she should return to work:

    1. A. As soon as the vomiting has slowed
    2. B. 48 hours after symptoms resolve
    3. C. The day after her first symptom
    4. D. Once she feels well enough to drive
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    Answer: B. 48 hours after symptoms resolve

    Health care workers with norovirus should stay home until at least 48 hours after their symptoms end, because shedding remains high and the infectious dose is tiny. Working while sick spreads it to patients and coworkers.

11. Before transporting a patient with suspected measles, you should notify the receiving hospital so that it can:

    1. A. Begin his MMR vaccine series on arrival
    2. B. Arrange a standard contact isolation bed
    3. C. Give antibiotics for his rash
    4. D. Prepare an airborne isolation room
    Show answer

    Answer: D. Prepare an airborne isolation room

    Early notification lets the hospital route the patient directly into an airborne infection isolation room and keep him out of a crowded waiting room. Vaccination does not treat active measles, contact isolation is not enough, and antibiotics do not treat a virus.

12. Alcohol-based hand rubs used in EMS should contain at least:

    1. A. 10% alcohol
    2. B. 60% alcohol
    3. C. 30% alcohol
    4. D. 45% alcohol
    Show answer

    Answer: B. 60% alcohol

    CDC recommends hand rubs with at least 60% alcohol (ethanol or isopropanol). Lower concentrations are much less effective at killing germs.

13. A paramedic has fever, cough, and body aches during flu season. Under CDC guidance, she may return to patient care once she has been:

    1. A. Fever-free 24 hours without drugs
    2. B. Taking an antiviral for one dose
    3. C. Coughing less for half a day
    4. D. Fever-free while on acetaminophen
    Show answer

    Answer: A. Fever-free 24 hours without drugs

    Health care workers with a febrile respiratory illness should stay home until at least 24 hours after the fever ends without fever-reducing medicine. Acetaminophen can hide a fever that is still present, and one antiviral dose does not end shedding.

14. Which item from a call belongs in a red biohazard bag rather than the regular trash?

    1. A. A glucose strip with a drop of blood
    2. B. Clean packaging from an IV kit
    3. C. Gloves with no visible blood
    4. D. Gauze soaked and dripping with blood
    Show answer

    Answer: D. Gauze soaked and dripping with blood

    Regulated medical waste includes items saturated or dripping with blood that could release it if compressed. Items with only a trace of blood, clean packaging, and unsoiled gloves usually go in regular trash per local rules. Lancets and needles go in a sharps container.

15. A patient has profuse diarrhea of unknown cause. Besides standard precautions, you should use:

    1. A. Airborne precautions with a fitted N95
    2. B. Droplet precautions with a surgical mask
    3. C. Contact precautions (gown and gloves)
    4. D. No added precautions until a test is back
    Show answer

    Answer: C. Contact precautions (gown and gloves)

    Diarrhea of unknown cause may be C. difficile, norovirus, or another organism spread by contact, so use gloves and a gown and wash hands with soap and water afterward. It is not spread by the airborne route.

16. Blood on intact skin should be:

    1. A. Treated as a major exposure
    2. B. Scrubbed with full-strength bleach
    3. C. Washed off with soap and water
    4. D. Left in place until the end of the call
    Show answer

    Answer: C. Washed off with soap and water

    Intact skin is an effective barrier. Wash promptly.

17. After transporting a patient with C. difficile, the ambulance should be cleaned with:

    1. A. Alcohol wipes
    2. B. A damp cloth
    3. C. A quaternary spray left for 10 seconds
    4. D. A sporicidal disinfectant
    Show answer

    Answer: D. A sporicidal disinfectant

    Bleach-based or other sporicidal agents kill spores.

18. Why do many agencies prohibit artificial nails for providers who touch patients?

    1. A. They harbor bacteria under the nail
    2. B. They tear gloves during every call
    3. C. They interfere with radio use
    4. D. They slow down blood pressure checks
    Show answer

    Answer: A. They harbor bacteria under the nail

    Artificial and long nails trap gram-negative bacteria and fungi even after hand hygiene and have been linked to outbreaks. Keep natural nails short. The other options are not the reason.

19. During a long transfer of an intubated patient, raising the head of the bed 30 to 45 degrees mainly helps prevent:

    1. A. Pressure injuries on the patient's heels
    2. B. Aspiration and ventilator pneumonia
    3. C. Blood clots forming in the leg veins
    4. D. Accidental extubation when the unit hits bumps
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    Answer: B. Aspiration and ventilator pneumonia

    Keeping the head up reduces reflux of stomach contents and pooled secretions into the lungs, a key step to prevent ventilator-associated pneumonia. It does not prevent clots, heel injuries, or extubation.

20. To lower the risk of infection in a patient with a urinary catheter during transport, keep the drainage bag:

    1. A. Resting on top of the patient's abdomen
    2. B. Below the bladder, off the floor
    3. C. Clamped shut for the entire trip
    4. D. Hung on the IV pole above the patient's head
    Show answer

    Answer: B. Below the bladder, off the floor

    Gravity drainage keeps urine flowing away from the bladder. A bag above the bladder lets urine flow back, and clamping causes retention; both raise the risk of infection. Keep the bag off the floor to avoid contamination.

21. A TB skin test or blood test is used to detect:

    1. A. Exposure to TB
    2. B. Active pneumonia
    3. C. Hepatitis C
    4. D. HIV infection
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    Answer: A. Exposure to TB

    A positive test indicates infection but not necessarily active disease.

22. Isolation precautions for a patient with an open, draining MRSA wound are:

    1. A. Airborne precautions
    2. B. Droplet precautions
    3. C. No precautions needed
    4. D. Contact precautions
    Show answer

    Answer: D. Contact precautions

    Use gloves and a gown, and cover the wound.

23. During aerosol-generating procedures, such as intubation, you should wear:

    1. A. Gloves and a gown
    2. B. A surgical mask
    3. C. An N95 and eye protection
    4. D. A face shield without a mask
    Show answer

    Answer: C. An N95 and eye protection

    Procedures such as intubation, suctioning, and CPAP spread infectious aerosols.

24. A patient's blood sprays into a paramedic's open mouth. After rinsing, the next step is to:

    1. A. Wait for symptoms before telling anyone
    2. B. Finish the shift, then report it
    3. C. Report it and get evaluated right away
    4. D. Wait for the source's test results
    Show answer

    Answer: C. Report it and get evaluated right away

    Rinse the mouth with water, then report the exposure immediately so the source can be tested and PEP considered within hours if needed. Waiting for symptoms, the end of the shift, or the source's results wastes the hours when PEP works best.

25. Dispatch screening asks callers with fever about recent international travel. This mainly helps crews:

    1. A. Decide whether to transport
    2. B. Use the right PPE before contact
    3. C. Pick an antibiotic before arrival
    4. D. Know which vaccine to give on scene
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    Answer: B. Use the right PPE before contact

    Asking about travel and symptoms before arrival lets crews identify a possible highly infectious disease, such as Ebola or MERS, and put on the right PPE before they are exposed. The patient is still assessed and transported, and the hospital is notified early. Screening does not choose an antibiotic or a vaccine; its purpose is protection before contact.