Option B i.e The sound becomes louder as the ambulance approaches her,
Option E i.e The sound becomes less loud as the ambulance moves away from her, are the two changes in the the loudness of the Siren which Tina would hear.
The above changes are due to the Doppler Effect. According to Doppler Effect, effective wavelength is shortened when an approaching source moves closer during the period of sound wave and thus gives a higher pitch. Likewise the pitch of a receding sound source will be lowered.