Chapter 26: EMT: Behavioral Emergencies Post study Questions

Which of these situations is of greatest concern when trying to decide if a patient is mentally​ competent? A. An emotionally distraught patient who is refusing care B. A traumatized patient who is crying C. An incident where you have to contact law enforcement D. A patient with a behavioral emergency due to hypoglycemia

An emotionally distraught patient who is refusing care The best way to protect yourself against false accusations by a patient is to carefully and completely document everything that happens during the​ encounter, including detailed aspects of the​ patient's abnormal behavior. In most​ jurisdictions, anything that is documented during the call is considered legally admissible evidence. Anything that is not documented is considered hearsay.

Once you decide to restrain a​ patient, the intervention should be carried​ out: A. after informing the patient. B. slowly. C. without police assistance D. as quickly as possible.

As quickly as possible Once you have made the decision to​ restrain, act quickly. A key to effective restraint is taking the patient by​ surprise; delay or indecision could allow the patient to gain control. Carrying out the procedure as quickly as possible not only will take the patient by​ surprise, which may work to your​ advantage, but also will eventually result in the​ de-escalation of the scene so that you can begin treating the patient.

When transporting a patient who you believe to be having a behavioral emergency as the result of a medical​ emergency, what is your FIRST​ concern? A. Assessing the​ airway, breathing, and circulation B. Collecting a thorough history C. Performing a detailed secondary exam D. Transporting to the nearest ED

Assessing the​ airway, breathing, and circulation Your first treatment priority for any emergent patient is to ensure that the​ airway, breathing, and circulation are all intact and protected. All other concerns are secondary.

Which statement is TRUE about suicide and suicide​ attempts? A. At least 75 percent of suicide victims give clear warning that they intend to kill themselves. B. The most common method of suicide is by poisoning through ingestion. C. Suicide is the leading cause of death among​ college-age students. D. The majority of suicide attempts are made to get attention and should not be taken seriously.

At least 75 percent of suicide victims give clear warning that they intend to kill themselves. At least half of all people who succeed at suicide have attempted it​ previously, and 75 percent give clear warning that they intend to kill themselves.

Why is it important to report all suicide attempts to the physician in the​ ED? A. At least half of those who succeed have prior​ attempts, so all attempts should be followed up. B. The patient might hurt others in the ED. C. Suicide is a reportable crime. D. The doctor will not give the patient medicine to take home.

At least half of those who succeed have prior​ attempts, so all attempts should be followed up. In all suicide attempts it is essential that you report the attempt to the physician in the ED so the patient will be given the appropriate mental health​ follow-up. At least half of those who are successful at suicide had prior attempts.

You are called to an auto parts store for an​ "agitated person who appears to be​ confused." When you​ arrive, the patient is standing in front of the store yelling at two teenagers who appear to be antagonizing him. What should your FIRST goal​ be? A. Restrain the patient. B. Retreat to the ambulance. C. Remove the antagonizer. D. Ask the antagonizers to assist you in restraining the patient.

Remove the antagonizer If the patient has attracted a​ crowd, do what you can to disperse it. You need to deal with the patient on a​ one-to-one basis. If the scene is especially​ hectic, remove the patient from it or remove distressing stimuli from the scene before trying to calm the patient.

Techniques that make dealing with behaviorally disturbed patients easier for you and more helpful for the patient​ include: A. using phrases such​ as, "Everything will be​ fine," or​ "You do not have anything to worry​ about," to help gain the​ patient's confidence. B. always telling the​ truth; never lying to the patient. C. speaking in an​ authoritative, stern voice to show you are in charge. D. playing along with visual or auditory disturbances.

always telling the​ truth; never lying to the patient. Although patients with a behavioral emergency may act​ unusually, that does not mean they do not recognize when someone is lyinglong dash—or has changed the story. As​ such, never lie to behavioral​ (or any) patients as it will only anger them more. OK

What would be an appropriate response to visual or auditory disturbances that the behavioral emergency patient might​ describe? A. You should reassure the patient that the disturbances are temporary. B. You should ignore the patient. C. You should​ "play along" with the patient. D. You should tell the patient the disturbances are not really there.

You should reassure the patient that the disturbances are temporary. Do not​ "play along" with visual or auditory disturbances. If the patient seems frightened by these​ disturbances, reassure the patient that these are temporary and​ that, with a combination of medication and other​ therapies, these symptoms can be stabilized or even completely removed.

A psychiatric disorder that causes patients to swing to opposite sides of the mood spectrum is​ called: A. schizophrenic disorder. B. paranoid disorder. C. depressive disorder. D. bipolar disorder.

bipolar disorder Bipolar disorder is often described as changes in mood from​ "very high​ highs" to​ "very low​ lows." The high phase is considered either mania or hypomania and the low phase is that of depression. Schizophrenia is a chronic mental illness in which a patient does not return to a premorbid level of functioning. Patients with this illness suffer debilitating distortions of speech and​ thought, bizarre​ delusions, hallucinations, social​ withdrawal, catatonic​ behavior, and lack of emotional expressiveness. Anxiety is a state of painful uneasiness about impending problems. Paranoia is a highly exaggerated or unwarranted mistrust or suspiciousness of others. Paranoid patients often interpret​ others' motives as​ malevolent, believing that these people may exploit or harm​ them, even if there is no evidence to support these beliefs. Depression is one of the most common psychiatric conditions. It is characterized by deep feelings of​ sadness, worthlessness, and​ discouragement, feelings that often do not seem connected to the actual circumstances of the​ patient's life.

Your treatment for a patient who is exhibiting signs of agitated delirium should​ include: A. asking law enforcement to handcuff the patient. B. ensuring that restraints are properly tightened. C. releasing the patient if he shows symptoms. D. calling for advanced life support backup.

calling for advanced life support In agitated​ delirium, the patient may suffer a sudden cardiac arrest.​ Often, the patient fights against the​ restraints, suddenly appears to​ relax, and then becomes apneic and pulseless. One potential contributing factor in deaths associated with agitated delirium is allowing the patient to fight against being restrained. Without​ restraint, the patient is typically violent and a potential danger to​ you, your​ partner, bystanders, and himself. To reduce the chance of sudden​ death, consider early contact with advanced life support for the use of a drug as a chemical restraint. OK

When you are faced with a patient who was involved in a suicide​ attempt, your first efforts should be​ to: A. establish why the patient is depressed. B. retreat to your unit. C. notify law enforcement. D. care for the​ patient's medical problems.

care for the​ patient's medical problems. If a patient has attempted​ suicide, caring for trauma or medical problem rather than behavioral problem will be your priority. Proceed with assessment and care based on the mechanism of the suicide attempt.

Which restraint system is an example of humane​ restraints? A. Handcuffs B. Zip ties C. Cravats D. Wire cord

cravats pg743

Which disorder is a factor in approximately 50 percent of all​ suicides? A. Delirium B. Depression C. Anxiety D. Paranoia

depression Depression is one of the most common psychiatric conditions. It is characterized by deep feelings of​ sadness, worthlessness, and​ discouragement, feelings that often do not seem connected to the actual circumstances of the​ patient's life. Depression is a factor in approximately 50 percent of all suicides and may cause other psychological disorders as well. Anxiety is a state of painful uneasiness about impending problems. Delirium is an acutely disturbed state of mind that occurs in​ fever, intoxication, and other disorders and is characterized by​ restlessness, illusions, and incoherence of thought and speech. Paranoia is a highly exaggerated or unwarranted mistrust or suspiciousness of others. Paranoid patients often interpret​ others' motives as​ malevolent, believing that these people may exploit or harm​ them, even if there is no evidence to support these beliefs.

One of the MOST common psychiatric conditions is characterized by deep feelings of​ sadness, worthlessness, and discouragement. This condition is known​ as: A. schizophrenia. B. bipolar disorder. C. depression. D. phobia.

depression Depression is one of the most common psychiatric conditions. It is characterized by deep feelings of​ sadness, worthlessness, and​ discouragement, feelings that often do not seem connected to the actual circumstances of the​ patient's life. Depression is a factor in approximately 50 percent of all suicides and may cause other psychological disorders as well.

You are transporting a conscious and seemingly stable​ 19-year-old female bulimia nervosa patient. In addition to psychological​ support, which of the following treatments will she also likely​ need? A. Management for rickets B. Medication for nausea and vomiting C. Supplements for vitamin deficiencies D. Fluid for dehydration

fluid for dyhydration Fluid for dehydration will likely be required. Determine the​ patient's chief​ complaint, then perform a physical examination that focuses on the areas in which the patient has a complaint. Starvation and attempts to purge can have drastic​ consequences, such as​ anemia, dehydration, vitamin​ deficiencies, hypoglycemia, and cardiovascular problems. The ALS backup or ED may have to treat the clinical state of dehydration and hypoglycemia from malnutrition.

By carefully and completely documenting everything that happens during an encounter with an emotionally disturbed​ patient, you​ can: A. help protect yourself against false accusations. B. retain a copy of the trip for your own records. C. explain what you think the patient was perceiving. D. stop the patient from filing a complaint.

help protect yourself against false accusations. The best way to protect yourself against false accusations by a patient is to carefully and completely document everything that happens during the​ encounter, including detailed aspects of the​ patient's abnormal behavior. In most​ jurisdictions, anything that is documented during the call is considered legally admissible evidence. Anything that is not documented is considered hearsay.

In any case in which you might need to use reasonable force or transport without​ consent, the best way to protect yourself legally is​ to: A. call for ALS backup. B. involve your chain of command. C. refuse to transport the patient. D. have the patient sign a refusal form.

involve your chain of command. The best way to protect yourself legally is to involve your chain of command. Before you restrain any patient for any​ reason, seek medical direction. If medical direction advises​ restraint, you can use that later as justification for your​ actions, should they be questioned.

Studies show that 60 to 75 percent of all behavioral emergency patients will become assaultive or violent. An early sign to watch for​ is: A. quietly sitting or crying. B. refusing to talk or interact with you. C. constant talking or rambling. D. nervous pacing.

nervous pacing Early signs that a person may have lost control and may become violent​ include: nervous​ pacing, shouting,​ threatening, cursing, throwing​ objects, clenched​ teeth, and clenched fists.

Which statement is TRUE about the causes of behavioral​ emergencies? A. Purely psychological conditions are precipitated by substance abuse. B. Behavioral emergencies most frequently involve a purely psychological condition. C. Behavioral emergencies most frequently involve biological conditions or substance abuse. D. Purely psychological conditions are precipitated by biological conditions.

Behavioral emergencies most frequently involve biological conditions or substance abuse. Behavioral emergencies frequently involve biological conditions. Do not assume a patient with an altered mental status or unusual behavior is suffering from a purely psychological condition or disease until you have completely ruled out medical conditions and substance abuse.

A disease process in which the​ patient's mood changes from elated to depressed is​ called: A. bipolar disorder. B. social anxiety disorder. C. depression. D. psychosis.

Bipolar disorder Bipolar disorder is often described as changes in mood from​ "very high​ highs" to​ "very low​ lows." The high phase is considered to be either mania or​ hypomania, and the low phase is depression. Depression is one of the most common psychiatric conditions. It is characterized by deep feelings of​ sadness, worthlessness, and​ discouragement, feelings that often do not seem connected to the actual circumstances of the​ patient's life. Psychosis is a mental state in which the patient is out of touch with reality. The patient is truly living within his own world and often mistakes his reality for that which is actually occurring. Social anxiety​ disorder, also known as social​ phobia, is an anxiety disorder characterized by an intense fear in one or more social situations causing considerable distress and impaired ability to function in at least some parts of daily life.

Your treatment for a patient who is exhibiting signs of agitated delirium should​ include: A. asking law enforcement to handcuff the patient. B. ensuring that restraints are properly tightened. C. releasing the patient if he shows symptoms. D. calling for advanced life support backup.

Calling for advanced life support backup In agitated​ delirium, the patient may suffer a sudden cardiac arrest.​ Often, the patient fights against the​ restraints, suddenly appears to​ relax, and then becomes apneic and pulseless. One potential contributing factor in deaths associated with agitated delirium is allowing the patient to fight against being restrained. Without​ restraint, the patient is typically violent and a potential danger to​ you, your​ partner, bystanders, and himself. To reduce the chance of sudden​ death, consider early contact with advanced life support for the use of a drug as a chemical restraint. OK

Which of the following is NOT a possible physical cause of a behavioral​ change? A. Excess cold B. Seizure disorder C. ​Mind-altering substances D. A history of chest trauma

Chest trauma As obvious as it​ seems, you need to be sure that you are dealing with a behavioral emergency and not a physical one. Behavioral change may occur for a number of​ reasons, such as low blood​ sugar, hypoxia, inadequate blood flow to the​ brain, head​ trauma, mind-altering​ substances, psychogenic​ substances, excess cold or​ heat, infections of the​ brain, seizure​ disorder, toxic ingestion or​ overdose, or drug or alcohol withdrawal. A history of chest trauma would not be a cause of behavioral change.

You are transporting a patient​ who, after a history and primary​ exam, you believe to be suffering from hypochondriasis. What should your NEXT action​ be? A. Discuss the possibility with your patient B. Withhold treatment C. Continue to treat the symptoms until medical conditions have been ruled out D. Explain the disease to your patient

Continue to treat the symptoms until medical conditions have been ruled out Somatoform disorders are often difficult to identify and diagnose. They can mimic and be confused with various bona fide physical conditions. Never attribute physical symptoms to a behavioral disorder until medical conditions have been ruled out.

What is the biggest risk factor for committing​ suicide? A. Anger B. Bipolar disorder C. Anxiety D. Depression

Depression Depression is the most commonly found behavioral emergency in the patient who has attempted or committed suicide. Depression is a factor in approximately 50 percent of all suicides and may cause other psychological disorders as well.

What is the biggest risk factor for committing​ suicide? A. Anger B. Anxiety C. Bipolar disorder D. Depression

Depression Depression is the most commonly found behavioral emergency in the patient who has attempted or committed suicide. Depression is a factor in approximately 50 percent of all suicides and may cause other psychological disorders as wel

Which statement is correct regarding scene​ size-up and initial assessment of a patient with a behavioral​ emergency? A. Suicide scenes are generally safe to enter if law enforcement is not there yet. B. Never stand between a patient and an open​ door, blocking an escape if the patient wants it. C. If a patient has a​ weapon, back out of the scene and wait for law enforcement. D. If a patient has attempted​ suicide, your priority is to care for the​ patient's behavioral problem before treating the trauma or medical problem.

If a patient has a​ weapon, back out of the scene and wait for law enforcement. The EMT has no duty to act if the scene is not secure.​ Furthermore, EMTs should never place themselves or their partners at risk. If the patient displays a​ weapon, never ignore or disregard it.​ Instead, in a calm and​ non-confrontational way, tell the patient that you want to help but cannot do so until the weapon is released. Ask the patient to give you the weapon. If the patient does​ not, back out of the scene and call or wait for police response. Remember that any weapon can be used against the EMT.

Which statement about people with personality disorders is MOST​ accurate? A. In many​ cases, people suffer from multiple disorders. B. People with personality disorders are actually​ "normal"; they just simply choose to act out against society. C. Personality disorders typically develop out of interpersonal rejection that occurs during young adulthood. D. People with personality disorders rely heavily on their normally superior ability to adapt.

In many​ cases, people suffer from multiple disorders. Diagnosing a personality disorder requires evaluating the​ individual's long-term functioning and behavior. In many​ cases, the individual suffers from multiple disorders that are described across three broad​ types, known as​ "clusters."

Which statement is TRUE about suicides and suicide​ attempts? A. Men are four times more likely to die from suicide than are women. B. Approximately 80 percent of people who succeed in committing suicide were attempting it for the first time. C. Depression seems to have little influence on suicide attempts. D. Most people who formulate a detailed plan for suicide do not carry it through.

Men are four times more likely to die from suicide than are women. What has been learned about attempted suicide is that the men are more successful in the attempt than females as men typically use more lethal means.

EMTs should always consider that all of the findings are potential causes of abnormal behavior​ EXCEPT: A. tachycardia. B. inadequate blood flow to the brain. C. head trauma. D. low blood sugar.

Tachycardia Tachycardia in and of itself is not a cause of abnormal behavior. A person who is anxious may develop tachycardia.

Depression is one of the most common psychiatric conditions. Which statement is TRUE about​ depression? A. Depression causes the patient to have highly exaggerated or unwarranted mistrust. B. Depression causes the patient to have mood swings from deliriously happy to feeling worthless. C. Depression is a factor in about 50 percent of all suicides. D. Depression causes irrational fears of specific​ things, places, or situations.

Depression is a factor in about 50 percent of all suicides. Depression is one of the most common psychiatric conditions. It is characterized by deep feelings of​ sadness, worthlessness, and​ discouragement, feelings that often do not seem connected to the actual circumstances of the​ patient's life. Depression is a factor in approximately 50 percent of all suicides and may cause other psychological disorders as well.

What is the BEST way to protect yourself from false accusations made by patients with behavioral​ emergencies? A. Direct B. Record C. Remember D. Document

Document The best way to protect yourself against false accusations by a patient is to carefully and completely document everything that happens during the​ encounter, including detailed aspects of the​ patient's abnormal behavior.

Which statement is NOT an example of the basic principles of behavioral​ emergencies? A. All people have limitations. B. All people have more ability to cope with crisis than they might think. C. Emotional injury is not as real as a physical injury. D. All people have a right to their feelings.

Emotional injury is not as real as a physical injury. Basic principles include all people have​ limitations, all people have a right to their​ feelings, all people have more ability to cope with crisis than they might​ think, all people feel some emotional disturbance when involved in a disaster or when​ injured, emotional injury is just as real as physical​ injury, and people who have been through a crisis do not just​ "get better."

You have just talked an attempted suicide patient off the ledge of a building. After getting him in the back of the ambulance for transport to the​ hospital, what should be the priority of​ treatment? A. Empathizing with his mental state while treating any physical problems B. Repeatedly asking him why he did it so he realizes how inappropriate his action was C. Telling him to never try it again as he could harm others D. Scolding him for trying a suicide attempt

Empathizing with his mental state while treating any physical problems When performing an assessment on a patient who has attempted or threatened​ suicide, keep these additional guidelines in​ mind: Injuries or medical conditions related to the suicide attempt are your primary concern. Listen​ carefully, accepting all the​ patient's complaints and feelings. Do not underestimate what the patient may be​ feeling, and do not dismiss what you consider to be minor. Be specific in your actions. Do something tangible for the​ patient, such as arranging for a member of the clergy to meet the patient at the hospital. Never show disgust or horror when you care for the patient. Watch your body​ language; the patient is analyzing​ you, too. Do not try to deny that the suicide attempt​ occurred; your denial may be perceived as condemnation of the​ patient's feelings.

Sociocultural causes of behavioral disorders are related to which​ events? A. Events that change the​ patient's relationships or support systems B. Events that are related to the​ patient's personality style and dynamics of unresolved conflict C. Events that are related to the​ patient's treatment by the parents D. Events that are strictly biological

Events that change the​ patient's relationships or support systems Sociocultural problems are usually attributable to events that change the​ patient's social space or otherwise have an impact on socialization. Events that result in a detrimental change in the​ patient's relationships or support systems may be sufficient cause to precipitate a behavioral disorder.

As you approach a person who is in the middle of a behavioral​ emergency, what should you do​ FIRST? A. Notify law enforcement. B. Perform a quick primary exam. C. Introduce yourself and let the person know that you are there to help. D. Position yourself above the eye level of the patient if possible.

Introduce yourself and let the person know that you are there to help. As you approach the​ patient, introduce yourself and state that you want to​ help, since this might not be intuitively clear to a person with distorted perceptions. At this​ point, law enforcement should have been notified if​ required; do not position yourself above the​ patient's eye level without weighing the situation. This action may be seen as threatening to a​ patient's distorted view. Perform the balance of your primary assessment only once the patient is comfortable having you in their​ "space." OK

If a patient threatens to hurt himself or others and you can demonstrate reason to believe that the​ patient's threats are​ real, you can transport that patient without his consent.​ However, you​ should: A. chemically restrain the patient. B. fully immobilize the patient. C. involve law enforcement. D. ensure that the patient cannot escape the restraints.

Involve law enforcement You must be able to show that your belief that the patient poses a reasonable threat. This can be documented by providing direct quotes from the patient. In such​ cases, make every effort to have law enforcement personnel participate in the transport. They can provide important corroboration for your actions.

Why should a patient never be restrained in the prone​ position? A. Patients are harder to place on the stretcher that way. B. The police will not allow that to be done. C. It takes more rescuers to restrain a patient that way. D. It can be the cause of positional asphyxia and lead to cardiac arrest.

It can be the cause of positional asphyxia and lead to cardiac arrest. When a patient is placed in a prone​ position, the weight of the body places upward pressure on the abdomen and forces the abdominal organs to be displaced toward the diaphragm. The added compression prevents a normal downward movement of the​ diaphragm, leading to the inability of the patient to take in adequate breaths. This results in a decreased tidal volume and inadequate breathing. The inadequate breathing results in hypoxia and​ acidosis, which may cause further agitation and cardiac arrest. When the patient is in a prone​ position, it is impossible to adequately assess the airway and the ventilatory status. You cannot assess for chest rise and adequate tidal volume with the patient in a prone position.

A basic principle for EMS providers regarding abnormal behavior is​ that: A. all patients with a behavioral problem can become violent. B. medical conditions are ruled out first. C. all patients with abnormal behavior must be seen in the hospital. D. all patients with behavioral disorders are likely to commit suicide.

Medical conditions are ruled out first Before deciding that a patient has abnormal behavior due to a mental health​ problem, the EMT must first consider the medical causes of abnormal​ behavior, some of which can be treated in the field​ (for example,​ hypoxia, hypothermia,​ hypoglycemia, and so​ forth).

You are assessing a patient with a behavioral disorder who appears to be slightly agitated. What can you do to help calm the​ patient's anxiety and avoid​ escalation? A. Retreat to the ambulance and depart the scene. B. Have police handcuff the patient. C. Keep a proper distance. D. Rush the patient and restrain him.

Keeping the proper distance Personal space is an area of about a​ 3-foot radius around a​ person; entering this space can cause additional anxiety and may further agitate the patient. Maintain a comfortable distance between yourself and the patient. Many patients are threatened by physical contact. Unwanted touching could set off a violent response. After you have established some rapport with the​ patient, you might then ask whether it is okay to touch or to get a little​ closer, which can be comforting to some patients. OK

What is a common medical cause for behavioral changes in a​ patient? A. Slow heart rate B. Rapid capillary refill C. Low blood sugar D. High blood sugar

Low blood sugar One common reason behavior may change includes low blood sugar in a​ diabetic, which can cause​ delirium, confusion, and even hallucinations. Elevated blood sugar or bradycardia would not result in behavioral changes beyond possibly​ anxiety, and capillary refill rates are not a cause but rather a sign.

When you are approaching a​ patient, if you determine there is a potential for​ violence, what should you​ do? A. Recruit bystanders to assist you. B. Let your partner try talking to him. C. Attempt to restrain him. D. Maintain a safe distance and call police.

Maintain a safe distance and call police Your safety is of utmost importance. If you determine that there is a potential for​ violence, you should retreat to a safe distance and call for law enforcement. Be alert at all times to the possibility that the patient may become violent and do harm to​ you, others at the​ scene, or himself. Always allow yourself an exit in case the patient becomes violent. Never allow a patient to come between you and an exit.

You have been called to the local jail for a patient who has made several superficial lacerations on the wrists. The patient has been disarmed but is still threatening to commit suicide. What should you​ do? A. Tell the patient that the​ self-inflicted wounds are not consistent with those of a person​ "actually trying to commit​ suicide." B. Arrange for a member of the clergy to meet the patient at the hospital. C. Make the injuries or medical conditions related to the attempted suicide your primary concern. D. Deny the​ patient's complaints and feelings.

Make the injuries or medical conditions related to the attempted suicide your primary concern. The purpose of EMS is to treat physical findings​ appropriately, and to empathize with emotional findings the best we can. Our task is not to judge why the patient attempted suicide or judge the parameters of his life that has led to that decision.

What should be your FIRST phase of assessment on a patient with a behavioral​ emergency, after completing the scene​ size-up? A. Vitals B. History and SAMPLE C. Primary survey D. Behavioral assessment test

Primary survey Even if the patient has a behavioral​ emergency, the EMT should start with the primary assessment to help rule out any actual or potential loss of vital body function​ (ABCs). Assess the​ patient's mental status by asking specific questions that will help you to measure the​ patient's level of responsiveness and orientation. Watch the​ patient's appearance, level of​ activity, and speech patterns.​ Specifically, try to determine whether the patient is oriented to​ time, person, and place. Pay particular attention to the​ patient's airway and breathing. Following the​ ABC's, proceed with the other aspects of your exam.

Which causes of behavioral disorders are related to a​ patient's personality​ style, dynamics of unresolved​ conflict, or crisis management​ methods? A. Drug abuse B. Biological C. Sociocultural D. Psychosocial

Psychosocial Psychosocial conditions are related to a​ patient's personality​ style, dynamics of unresolved​ conflict, or crisis management methods. These disorders are not attributable to substance abuse or medical conditions. Biological psychiatric disorders result from disease​ processes, such as infections and​ tumors, or from structural changes in the​ brain, such as those brought on by the abuse of alcohol or drugs.

If​ you, as an​ EMT, are involved in a situation where you must restrain a​ patient, make sure that you​ use: A. chemical restraints. B. approved handcuffs. C. swift action. D. reasonable force.

Reasonable force If it proves necessary to restrain a patient or to transport a patient without​ consent, make sure you use reasonable force when doing so. This is defined as the minimum amount of force required to keep the patient from injuring self or others. If the patient presents with signs of agitated​ delirium, call for ALS in case chemical restraint is required.

You arrive at the scene of a potential psychiatric emergency at the grocery store. A sales clerk tells you that a female in her 30s is talking to the frozen​ food, and whenever anyone​ approaches, she starts flailing her fists. The​ police, who were dispatched at the same​ time, have not arrived yet. What should you do​ NEXT? A. Attempt to engage in a dialogue with the patient. B. Overpower the patient and restrain her on the stretcher. C. Retreat to a safe​ location, encouraging bystanders to do so​ also, and await assistance. D. Distract the patient while your partner engages her from behind.

Retreat to a safe location, encouraging bystanders to do so also and await assistance Your primary responsibility is to​ yourself, your​ partner, and in this​ instance, bystanders. Retreating to the ambulance or to a safe location and awaiting arrival of the police helps to ensure your safety.

You arrive at the scene of a potential psychiatric emergency at the local library. The​ patient, a female in her​ 40s, appears to be​ hallucinating, yelling for​ "them" to leave her​ alone, and throwing books at patrons and bookshelves. The​ police, who were dispatched at the same​ time, have not arrived yet. What should you do​ NEXT? A. Attempt to engage in a dialogue with the patient. B. Retreat to a safe​ location, encouraging bystanders to do so​ also, and await assistance. C. Overpower the patient and restrain her on the stretcher. D. Distract the patient while your partner engages her from behind.

Retreat to a safe​ location, encouraging bystanders to do so​ also, and await assistance. Your primary responsibility is to​ yourself, your​ partner, and in this​ instance, bystanders. Retreating to the​ ambulance, or to a safe​ location, and awaiting arrival of the police helps ensure your safety.

Patients with what disease suffer debilitating distortions of speech and​ thought, and have bizarre delusions about their​ world? A. Schizophrenia B. Depression C. Psychosis D. Bipolar disorder

Schizophrenia Schizophrenia is a chronic mental illness in which patients do not return to their premorbid level of functioning. Patients with this illness suffer debilitating distortions of speech and​ thought, bizarre​ delusions, hallucinations, social​ withdrawal, catatonic​ behavior, and lack of emotional expressiveness. There are different types of schizophrenia with various diagnostic​ criteria, including onset and symptomatology. Bipolar disorder is often described as changes in mood from​ "very high​ highs" to​ "very low​ lows." The high phase is considered to be either mania or​ hypomania, and the low phase is depression. Depression is one of the most common psychiatric conditions. It is characterized by deep feelings of​ sadness, worthlessness, and​ discouragement, feelings that often do not seem connected to the actual circumstances of the​ patient's life. Psychosis is a mental state in which the patient is out of touch with reality.

Emotionally disturbed patients commonly refuse treatment. Which of the following statements is true if your patient refuses​ care? A. Once the EMT decides to transport a patient against her​ will, there is no need for law enforcement to participate. B. Any adult over 18 years of age may refuse treatment. C. The EMT has the authority to transport any patient against her will. D. The EMT must complete a refusal of care​ form, then have the patient sign it and law enforcement witness it.

The EMT must complete a refusal of care​ form, then have the patient sign it and law enforcement witness it. Emotionally disturbed​ patients, especially those who are intoxicated or who have taken a drug​ overdose, commonly refuse treatment. A disturbed person who is alert and​ oriented, unless considered mentally​ incompetent, must still legally provide consent before you can treat him. Under these​ situations, the​ patient, not concerned family​ members, must consent to the care. In the situation​ described, the EMS provider should complete a refusal form and have the patient and other witnesses sign it. OK

Which of the following statements BEST defines the term​ "reasonable force"? A. The force required to restrain a cooperative patient B. Any force necessary to subdue a patient C. Only that force that is necessary to handcuff a patient D. The minimum force needed to keep the patient from hurting someone

The minimum force needed to keep the patient from hurting someone If it proves necessary to restrain a patient or to transport a patient without​ consent, make sure you use reasonable force when doing so. This is defined as the minimum amount of force required to keep the patient from injuring self or others.

Restraining a patient should be avoided​ unless: A. your partner feels it is the best thing. B. the patient is bigger than you. C. the patient insists on being restrained. D. the patient is a danger to you or herself.

The patient is a danger to you or herself Restraining a patient should be avoided unless the patient is a danger to you or herself. In situations such as​ these, where the EMT must actively restrain a​ patient, the EMT can do so based on the principle of implied consent. This is the belief that if the patient was mentally​ competent, she would want to be treated if​ needed, but more importantly would not be trying to hurt herself or others.

Why might a situation where a patient has committed suicide be a potentially unsafe scene for EMS​ providers? A. Family members may grieve too loudly when they find out. B. The patient may not be​ dead, and when EMS​ arrives, the patient may try lashing out at them. C. The EMS provider may feel sorry for the patient and attempt the same. D. The suicide mechanism itself may create an unsafe scene.

The suicide mechanism itself may create an unsafe scene. If you are dispatched to the scene of a suicide or potential​ suicide, be alert so that you do not fall victim to a mechanism that the patient planned to use to end his own life. Running an automobile in a closed​ garage, blowing out a pilot light and turning on all the burners on a gas​ stove, and using electrical devices in water are common suicide methods that can pose risks for EMTs. An EMS provider may be injured or killed by the same mechanism.

To help determine whether your​ patient's behavioral change is due to a physical problem rather than a psychological​ problem, you should consider which​ clues? A. The patient has auditory hallucinations. B. The patient is​ alert, being oriented to​ person, place, and time. C. The patient has a​ gradual, rather than a​ sudden, onset. D. The​ patient's pupils are​ constricted, dilated, or unequal.

The​ patient's pupils are​ constricted, dilated, or unequal. Clues that the problem may be physical rather than psychological include pupils which are​ dilated, constricted, or unequal or that respond differently to light.​ Orientation, speed of onset and hallucinations may be the result of physical or psychological causes.

Unwarranted mistrust or suspiciousness of others is​ called: A. anxiety. B. schizophrenia. C. paranoia. D. psychosis.

paranoia Paranoia is a highly exaggerated or unwarranted mistrust or suspiciousness of others. Paranoid patients often interpret​ others' motives as​ malevolent, believing that these people may exploit or harm​ them, even if there is no evidence to support these beliefs. Anxiety is a state of painful uneasiness about impending problems. Psychosis is a mental state in which the patient is out of touch with reality. The patient is truly living within his own world and often mistakes his reality for that which is actually occurring. Schizophrenia is a chronic mental illness in which a patient does not return to his or her premorbid level of functioning. Patients with this illness suffer debilitating distortions of speech and​ thought, bizarre​ delusions, hallucinations, social​ withdrawal, catatonic​ behavior, and lack of emotional expressiveness.

Basic principles to keep in mind when you encounter a patient with a behavioral emergency​ include: A. some people who have been through a crisis suddenly get better. B. only psychologically unstable people feel emotional disturbance when injured. C. emotional injury is not truly​ "real" as is a physical injury. D. people have more ability to cope with crisis than they might think.

people have more ability to cope with crisis than they might think. People have more ability to cope with crisis than they might think. How individuals handle a crisis depends on their previous​ problem-solving experience, the way they view the​ problem, and the amount and kind of support or resources available to them.

Your unit was dispatched to a patient having a behavioral emergency. Police who are already present assure you the scene is safe. You begin assessment to care for this patient who has a long history of mental illness. The patient is NOT very cooperative and repeatedly curses at you. You​ should: A. find a weakness and belittle the patient until the cursing stops. B. lie to the patient and tell her she will be arrested at the hospital. C. call the police for assistance to restrain the patient. D. remain kind and​ calm, knowing that the comments are not personal.

remain kind and​ calm, knowing that the comments are not personal. Frustrated people often make comments that they would not normally say under different circumstances. Be​ kind, calm, and supportive and do not take the comments personally.

A patient who is suffering debilitating distortions of speech and​ thought, bizarre​ delusions, and hallucinations is suffering​ from: A. anxiety. B. bipolar disorder. C. schizophrenia. D. paranoia.

schizophrenia Schizophrenia is a chronic mental illness in which a patient does not return to a premorbid level of functioning. Patients with this illness suffer debilitating distortions of speech and​ thought, bizarre​ delusions, hallucinations, social​ withdrawal, catatonic​ behavior, and lack of emotional expressiveness. Anxiety is a state of painful uneasiness about impending problems. Delirium is an acutely disturbed state of mind that occurs in​ fever, intoxication, and other disorders and is characterized by​ restlessness, illusions, and incoherence of thought and speech. Paranoia is a highly exaggerated or unwarranted mistrust or suspiciousness of others. Paranoid patients often interpret​ others' motives as​ malevolent, believing that these people may exploit or harm​ them, even if there is no evidence to support these beliefs. Bipolar disorder is often described as changes in mood from​ "very high​ highs" to​ "very low​ lows." The high phase is considered to be either mania or​ hypomania, and the low phase is depression.

An important measure in transporting an emotionally disturbed patient is​ to: A. use medical responders that are of the same gender as the patient. B. complete an incident report. C. fully restrain the patient. D. refuse to render care.

use medical responders that are of the same gender as the patient. It is common for emotionally disturbed patients to accuse medical responders of sexual misconduct. To protect against these kinds of​ charges, consider involving other medical responders who can testify that there was no misconduct. Whenever​ possible, use medical responders who are of the same gender as the patient. Involve​ third-party witnesses, and carefully document your physical assessment.