Chapter 20 Quiz JBL

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You receive a call for a domestic dispute. When you arrive at the scene, you find a young male standing on the front porch of his house. You notice that an adjacent window is broken. The patient has a large body, is clenching his fists, and is yelling obscenities at you. Which of the following findings is LEAST predictive of this patient’s potential for violence?

A. his clenched fists
B. the broken window
C. his shouting of obscenities
D. his large body

D. his large body

Law enforcement personnelrequest your assistance for a 30-year-old man who they pulled over for erratic driving. The patient became acutely violent while he was being questioned, which required one of the officers to subdue him with a Taser. When you arrive and assess the patient, you find that he is very agitated and is experiencing apparent hallucinations. His skin is flushed and diaphoretic. You should:

A. quickly rule out any life-threatening conditions and then perform a detailed secondary assessment as he is being restrained.
B. suspect that he is acutely hypoglycemic, consider giving him one tube of oral glucose, and transport with lights and siren.
C. limit physical contact with the patient as much as possible and avoid interrupting him if he is attempting to communicate with you.
D. recognize that he is experiencing a complex psychiatric crisis, quickly load him into the ambulance, and immediately transport.

C. limit physical contact with the patient as much as possible and avoid interrupting him if he is attempting to communicate with you.

You are assessing a 45-year-old female who is severely depressed. She states that it seems as though her entire world is crashing down around her. She further states that she has had frequent thoughts of suicide, but is not sure if she can actually go through with it. How should you manage this situation?

A. Ask the patient if she has developed a plan for suicide.
B. Leave the scene and have a neighbor check in on her.
C. Have law enforcement place her in protective custody.
D. Encourage the patient to remain quiet during transport.

A. Ask the patient if she has developed a plan for suicide.

Which of the following terms applies to a state of delusion in which the patient is out of touch with reality?

A. agitated delirium
B. schizophrenia
C. suicidal
D. psychosis

D. psychosis

Common causes of acute psychotic behavior include all of the following, EXCEPT:

A. intense stress.
B. schizophrenia.
C. Alzheimer disease.
D. mind-altering substance use.

C. Alzheimer disease.

Assessing the blood pressure and oxygen saturation of a patient with a behavioral crisis should be performed:

A. within the first few minutes after making patient contact.
B. at least every 5 minutes in order to detect signs of shock.
C. only if you will be transporting the patient to the hospital.
D. if doing so will not worsen the patient’s emotional distress.

D. if doing so will not worsen the patient’s emotional distress.

Which of the following statements regarding the physical examination of a patient with a behavioral problem is correct?

A. It is only appropriate to perform a physical examination on a patient with a behavioral problem if he or she is unconscious or is being physically restrained.
B. A physical examination for a behavioral problem may be difficult to perform but may provide clues to the patient’s state of mind and thought processes.
C. The physical examination of a patient with a behavioral problem often yields crucial information and should always be performed, even if the patient is violent.
D. Performing a physical examination on a patient with a behavioral problem will likely cause the patient to become violent and should be avoided in the field.

B. A physical examination for a behavioral problem may be difficult to perform but may provide clues to the patient’s state of mind and thought processes.

A general impression of the patient is formed by an EMT:

A. when the patient is in the ambulance.
B. at a distance when the patient is first seen.
C. speaking with family members or bystanders first.
D. speaking privately with the patient

B. at a distance when the patient is first seen.

Which of the following is a good guideline for physical examination of any patient?

A. Always work toe-to-head.
B. Examine extremities first.
C. Avoid touching without permission.
D. Complete the physical exam first, then check the ABCs.

C. Avoid touching without permission.

A 66-year-old man presents with bizarre behavior. His daughter states that he did not seem to recognize her and was very rude to her. The patient is conscious and has a patent airway and adequate breathing. You should:

A. conclude that the patient has Alzheimer disease.
B. ask the daughter how her father normally behaves.
C. carefully restrain the patient and immediately transport.
D. advise the patient that his behavior is unacceptable.

B. ask the daughter how her father normally behaves.

When assessing a patient with a behavioral crisis, you should:

A. be direct and clearly state your intentions.
B. frisk the patient for the presence of weapons.
C. spend as little time with the patient as possible.
D. ask the police to handcuff the patient for safety.

A. be direct and clearly state your intentions.

General guidelines for treating a patient with a behavioral emergency include:

A. firmly identifying yourself as an EMS provider.
B. placing the patient between yourself and an exit.
C. allowing the patient to be alone if he or she wishes.
D. being prepared to spend extra time with the patient.

D. being prepared to spend extra time with the patient.

The first step in assessing a patient with a behavioral emergency is to:

A. obtain vital signs.
B. restrain the patient.
C. ensure your safety.
D. obtain proper consent.

C. ensure your safety.

Which of the following is considered an organic brain syndrome?

A. schizophrenia
B. Alzheimer disease
C. anxiety conditions
D. depression

B. Alzheimer disease

Which of the following conditions or factors would be the LEAST likely to result in a change in behavior?

A. low blood glucose levels
B. antihypertensive medications
C. exposure to excess heat or cold
D. inadequate blood flow to the brain

B. antihypertensive medications

The two basic categories of diagnosis that a physician will use for behavioral crises or psychiatric emergencies are ____________.

A. organic brain syndrome and altered mental status.
B. functional and nonfunctional.
C. physical and psychological.
D. all of these answers are correct

C. physical and psychological.

Organic brain syndrome is MOST accurately defined as:

A. bizarre behavior secondary to a chemical imbalance or disturbance in the brain.
B. a dysfunction of the brain caused by abnormal physical or physiologic function.
C. a disorder that cannot be traced to the abnormal structure or function of an organ.
D. a change in behavior or mental status secondary to inadequate cerebral blood flow.

B. a dysfunction of the brain caused by abnormal physical or physiologic function.

When a psychiatric emergency arises, a patient is most likely to exhibit which of the following behaviors?

A. disruptions to activities of daily living
B. any behaviors unacceptable to the patient, family, or community
C. any behaviors that are a violent threat to the patient, EMTs, or others
D. visual or auditory hallucinations

B. any behaviors unacceptable to the patient, family, or community

In contrast to a behavioral crisis, a psychiatric emergency occurs when a person:

A. demonstrates agitation or violence or becomes a threat to himself or herself, or to others.
B. experiences feelings of sadness and despair for longer than a month.
C. exhibits impaired functioning due to a chemical or genetic disturbance.
D. experiences a sudden attack of panic secondary to a stressful situation.

A. demonstrates agitation or violence or becomes a threat to himself or herself, or to others.

Which of the following is an example of a psychiatric emergency?

A. a person going on a week-long “bender” after losing a job
B. a person violently attacking family members
C. a person who is depressed and no longer caring for himself
D. a person who is experiencing a panic attack

B. a person violently attacking family members

A behavioral crisis interferes with which of the following?

A. activities of daily living
B. behavior that is acceptable to the community
C. behavior that regularly interferes with dressing, eating, or bathing
D. all of these answers are correct

D. all of these answers are correct

The term “behavioral crisis” is MOST accurately defined as:

A. a sudden, violent outburst of an otherwise mentally stable person toward a family member.
B. any reaction that interferes with activities of daily living or is deemed unacceptable by others.
C. a situation in which a patient demonstrates bizarre behavior and becomes a risk to other people.
D. a period of severe depression that lasts longer than 2 weeks and cannot be controlled with medications.

B. any reaction that interferes with activities of daily living or is deemed unacceptable by others.

Everyone exhibits some signs and symptoms of mental illness at some point in life ____________.

A. because mental illness affects everyone
B. and needs medication administered to control them
C. and should be physically restrained for their own safety and the safety of the EMT
D. but that does not mean a person is mentally ill

D. but that does not mean a person is mentally ill

Why might EMTs encounter a larger proportion of violent patients than the population at large?

A. EMTs have to restrain patients.
B. EMTs respond with law enforcement.
C. EMTs respond to patients who, by definition, are having an emergency.
D. It is a common misperception; EMTs do NOT encounter a larger proportion of violent patients than the population at large.

C. EMTs respond to patients who, by definition, are having an emergency.

What is the most common misconception surrounding mental illness?

A. Feeling “bad” or “depressed” means that you must be “sick.”
B. All persons with mental disorders are physically violent and dangerous.
C. Many mental illnesses stem from drug or alcohol abuse.
D. Everyone has some form of mental illness.

A. Feeling “bad” or “depressed” means that you must be “sick.”

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