Psychiatric Emergencies Ch. 21

Which of the following findings does NOT indicate the potential for violence?

A. Large physical body size

B. Agitated or depressed

C. Uncoordinated movements

D. Withdrawn or detached

A. Large physical body size

When assessing a patient with bizarre behavior, it is important to ensure your own safety and then:

A. talk the patient down to convince him or her to be transported.

B. ensure that the patient is in between you and an escape route.

C. have law enforcement place the patient in protective custody.

D. consider that a medical illness may be an underlying etiology.

D. consider that a medical illness may be an underlying etiology

A 31-year-old man has signs and symptoms of excited delirium. When assessing his orientation, memory, and ability to concentrate, you should:

A. ask him if he knows the date and time and when he last visited his physician.

B. ask him simple questions, such as “When did you first notice these feelings?”

C. allow him up to 30 seconds to answer a question before asking another one.

D. inquire about his medical history, including any medications that he is taking.

B. ask him simple questions, such as “When did you first notice these feelings?”

When interviewing a patient with an emotional crisis, you repeat the patient’s words back to him or her, and encourage him or her to expand on these thoughts. This is an example of:

A. active listening.

B. definitive listening.

C. reflective listening.

D. appeasing the patient.

C. reflective listening

Common physical signs and symptoms of agitated delirium include:

A. constricted pupils, drowsiness, and cool skin.

B. hypertension, tachycardia, and diaphoresis.

C. chest pain, shortness of breath, and bradycardia.

D. confusion, hypotension, and pallor.

B. hypertension, tachycardia, and diaphoresis

The level of force used to restrain a violent patient is dependent upon all of the following factors, EXCEPT the:

A. patient’s size, gender, strength, and mental status.

B. type of abnormal behavior the patient is exhibiting.

C. type and dosage of medications he or she is taking.

D. force needed to protect the patient from self-injury.

C. type and dosage of medications he or she is taking

Which of the following is LEAST suggestive of a person’s intent to commit suicide?

A. Giving away personal possessions

B. Developing or changing a will

C. Procurement of a knife or gun

D. Taking time away from a job

D. Taking time away from a job

When caring for a patient with a behavioral emergency, it is important for you to:

A. spend minimal time at the scene and transport the patient quickly.

B. let the patient tell you what happened in his or her own words.

C. clearly identify yourself as being in charge and set ground rules.

D. qualify the patient’s hallucinations in order to gain his or her trust.

B. let the patient tell you what happened in his or her own words

A behavioral crisis occurs when:

A. an individual reacts violently when faced with danger.

B. a person experiences stress without other people’s knowledge.

C. a reaction to an event interferes with daily living activities.

D. an individual suppresses feelings of anger, guilt, or depression.

C. a reaction to an event interferes with daily living activities

A violent patient should never be restrained in a prone position because:

A. the patient would likely aspirate if he or she vomited.

B. suctioning of the airway is not possible in this position.

C. the patient will not be able to see what is happening.

D. you cannot effectively monitor the patient’s airway.

D. you cannot effectively monitor the patient’s airway

Which of the following statements regarding schizophrenia is correct?

A. Early-onset schizophrenia may be associated with brain damage.

B. Although it is a complex disorder, schizophrenia is easy to treat.

Which of the following conditions would be the LEAST likely cause of mental incapacitation?

A. Hypoxia and hypercarbia

B. CNS depressant drugs

C. Chronic hyperthyroidism

D. Acute hypoglycemia

C. Chronic hyperthyroidism

Which of the following would provide you with the LEAST amount of information about the emotional state of a 20-year-old male who will not respond to any of your questions?

A. Respirations

B. Hair length

C. Facial expression

D. Pulse rate

B. Hair length

As an AEMT, you may legally restrain a patient if he or she:

A. is under the influence of a CNS depressant drug.

B. is acutely intoxicated and verbally abusive to you.

C. refuses to allow you to begin treatment or transport.

D. presents harm to you, your partner, or bystanders.

D. presents harm to you, your partner, or bystanders

Which of the following is the MOST reliable sign of a potentially violent patient?

A. History of violence

B. Physical activity

C. The patient’s posture

D. Vocal activity

B. Physical activity

A minimum of _____ personnel should be used to restrain a 17-year-old, 120-pound, violent patient.

A. 1

B. 2

C. 4

D. 3

C. 4

When performing your assessment of a 40-year-old male who is agitated and is displaying bizarre behavior, you should:

A. put your hand on the patient’s arm or shoulder.

B. limit the number of personnel around the patient.

C. ask a police officer to assess the patient first.

D. have at least four personnel around the patient.

B. limit the number of personnel around the patient

Alzheimer disease is an example of a/an:

A. psychological behavioral disorder.

B. organic psychiatric disorder.

C. functional behavioral disorder.

D. psychosocial psychiatric disorder.

B. organic psychiatric disorder

When caring for a patient with a behavioral crisis, you should ensure your own safety and then:

A. identify any life-threatening conditions.

B. frisk the patient for dangerous weapons.

C. determine if the patient is seeing a psychiatrist.

D. apply oxygen with a nonrebreathing mask.

A. identify any life-threatening conditions

An individual who poses a threat to the safety of his or her family, friends, or the AEMT is experiencing a/an:

A. behavioral emergency.

B. emotional crisis.

C. psychiatric emergency.

D. psychological crisis.

C. psychiatric emergency

Which of the following situations is NOT an example of a patient with a mental illness?

A. A 55-year-old male who experiences a panic attack after being diagnosed with cancer

B. A 41-year-old male with sadness and despair with no appreciable underlying cause

C. A 38-year-old female with depression and anxiety for at least one month’s duration

D. A 29-year-old female whose violent actions are no longer tolerated by society

A. A 55-year-old male who experiences a panic attack after being diagnosed with cancer

When restraining a violent patient, it is important to:

A. utilize at least 3 people to effectively restrain the patient.

B. ensure that you have taken standard precautions first.

C. use significant force to effectively subdue the patient.

D. avoid talking to the patient during the restraining process.

B. ensure that you have taken standard precautions first

Which of the following would be the MOST important parameter(s) to assess in a patient with a behavioral emergency?

A. Pupillary response

B. Blood glucose level

C. Baseline vital signs

D. Glasgow Coma Score

B. Blood glucose level

During your assessment of a 43-year-old male with suicidal thoughts, he becomes agitated and appears uncomfortable. You should:

A. continue talking to him while your partner requests police backup.

B. immediately assess his blood glucose level to rule out hypoglycemia.

C. immediately restrain him to prevent him from injuring himself.

D. call for a paramedic unit so they can administer a sedative to him.

A. continue talking to him while your partner requests police backup

Which of the following conditions or situations would result in a psychiatric emergency of an organic etiology?

A. Death of a loved one

B. Schizophrenia

C. Hypoglycemia

D. Childhood trauma

C. Hypoglycemia

You arrive at the residence of a young female who is experiencing an apparent psychotic episode. Law enforcement is on scene and has ensured that it is safe. You find the patient sitting in a chair, rocking back and forth. You should:

A. remain calm as you gently place your hand on her shoulder.

B. clearly identify yourself and your partner and tell her you are there to help.

C. reassure her that everything will be okay and ask her if she can walk.

D. kneel down in front of the patient and ask her what is troubling her.

B. clearly identify yourself and your partner and tell her you are there to help

While assessing a patient with an apparent behavioral crisis, he tells you that he sees a pink elephant in the corner of the room. This is an example of a(n):

A. visual hallucination.

B. visual delusion.

C. auditory hallucination.

D. auditory delusion.

A. visual hallucination

You are dispatched to a residence for an elderly female with “mental status changes.” During your assessment of the patient, you should first:

A. ask the husband if she has Alzheimer disease.

B. perform serial Cincinnati Stroke Scale assessments.

C. determine the patient’s baseline mental status.

D. rule out hypoglycemia by administering glucose.

C. determine the patient’s baseline mental status

You are dispatched to an apartment complex for a young male experiencing an “emotional problem.” Law enforcement is at the scene when you arrive. You should:

A. request a paramedic unit to chemically sedate the patient.

B. confer with a police officer before making patient contact.

C. have the police restrain the patient before you assess him.

D. enter the scene and ask a police officer about the nature of the problem.

B. confer with a police officer before making patient contact

Behavior is MOST accurately defined as:

A. how a person reacts during a violent situation.

B. the internal feelings and emotions of a person.

C. how a person responds to his or her environment.

D. a feeling of internal psychological stability.

C. how a person responds to his or her environment

Violent or dangerous individuals who do not require medical care should be:

A. given a sedative medication.

B. transported for psychiatric care.

C. subdued with soft restraints.

D. taken into police custody.

D. taken into police custody

To minimize the risk of legal implications when managing an emotionally disturbed 33-year-old male, you should:

A. gain his confidence so that he consents to care.

B. allow him to refuse transport if he appears alert.

C. transport him to a specialized psychiatric facility.

D. restrain him to prevent him from injuring himself.

A. gain his confidence so that he consents to care

Which of the following conditions would be LEAST likely to cause an alteration in behavior?

A. Brain injury

B. Hypertension

C. Hypoxemia

D. Hypoglycemia

B. Hypertension

Which of the following emotionally disturbed patients could legally refuse EMS treatment and transport?

A. A 77-year-old male who is severely depressed over the death of his wife

B. A 55-year-old confused male with auditory and visual hallucinations

C. A 60-year-old female with a history of schizophrenia and bizarre behavior

D. A 43-year-old female who is mumbling incomprehensible words

A. A 77-year-old male who is severely depressed over the death of his wife

The length and severity of an acute psychotic episode caused by a mind-altering substance depends on the:

A. duration of the substance being metabolized within the body.

B. patient’s vital signs at the time the substance was introduced.

C. AEMT’s ability to effectively communicate with the patient.

D. patient’s gender, age, and socioeconomic background.

A. duration of the substance being metabolized within the body

The two goals to achieve when assessing a patient with a behavioral emergency are to:

A. notify law enforcement and transport the patient promptly.

B. provide emotional support and diagnose the problem.

C. reassure the family and contact the patient’s psychiatrist.

D. identify life-threats and reduce the stress of the situation.

D. identify life-threats and reduce the stress of the situation

General safety guidelines to follow when caring for a patient with a behavioral emergency include all of the following, EXCEPT:

A. maintaining a safe distance from the patient.

B. being honest and assuring and avoid judging.

C. having a predefined definitive plan of action.

D. spending as little time as possible at the scene.

D. spending as little time as possible at the scene

While assessing a 32-year-old male with an acute behavioral crisis, he asks to go to into the kitchen to get something to eat. You should:

A. tell him that he will get something to eat at the hospital.

B. not allow him to leave the area without a police escort.

C. leave the scene immediately and notify law enforcement.

“Normal” behavior is basically classified as what:

A. the patient perceives.

B. is agreed upon by psychiatrists.

C. is acceptable by society.

D. your protocols dictate.

C. is acceptable by society

The single most significant factor that contributes to suicide is:

A. marital discord.

B. financial setback.

C. significant depression.

C. significant depression

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