Chapter 26
An Application for Emergency Admission allows a patient to be assessed by removing his rights for: A. 48 hours. B. 72 hours. C. 12 hours. D. 24 hours.
72 hours
Which of these situations is of greatest concern when trying to decide if a patient has the mental capacity to understand and make rational decisions? A. A patient with a behavioral emergency due to hypoglycemia B. A traumatized patient who is crying C. An incident where you have to contact law enforcement D. An emotionally distraught patient who is refusing care
an emotionally distraught patient who is refusing care
In the mnemonic MEND A MIND, the A stands for: A. anxiety. B. assessment. C. allergic reaction. D. arterial.
arterial
Once you decide to restrain a patient, the intervention should be carried out: A. slowly. B. after informing the patient. C. as quickly as possible. D. without police assistance.
as quickly as possible
Which statement is TRUE about suicide and suicide attempts? A. The majority of suicide attempts are made to get attention and should not be taken seriously. B. Suicide is the leading cause of death among college-age students. C. The most common method of suicide is by poisoning through ingestion. D. At least 75 percent of suicide victims give clear warning that they intend to kill themselves.
at least 75 percent of suicide victims 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 made prior attempts, so all attempts should be followed up. B. Suicide is a reportable crime. C. The doctor will not give the patient medicine to take home. D. The patient might hurt others in the ED.
at least half of those who succeed have made prior attempts, so all attempts shjould be followed up
Law enforcement should be requested in which of the following situations? A. An 18-year-old man refusing treatment for a fractured arm B. A 24-year-old woman suffering from anxiety C. A 50-year-old man refusing treatment for chest pain D. A 65-year-old woman living in an insect-infested home
a 65 year old woman living in an insect infested home
Which of the following is UNLIKELY to be a physical cause of a behavioral change? A. Excess cold B. Seizure disorder C. A history of chest trauma D. Mind-altering substances
a history of chest trauma
Which patient would require law enforcement to intervene? A. A patient experiencing a panic attack B. A patient with chest pain who refuses transport C. A patient who has not slept for 2 weeks D. A patient suffering from depression
a patient who has not slept for 2 weeks
During the assessment of a patient who you suspect has a behavioral disorder, you should pay particular attention to each of the following, EXCEPT: A. body language. B. general appearance. C. speech. D. age of the patient.
age of the patient
Techniques that make dealing with behaviorally disturbed patients easier for you and more helpful for the patient include: A. speaking in an authoritative, stern voice to show you are in charge. B. always telling the truth and never lying to the patient. C. playing along with visual or auditory disturbances. D. using phrases such as, "Everything will be fine," or "You do not have anything to worry about," to help gain the patient's confidence.
always telling the truth and never lying to the patient
A disease process in which the patient's mood changes from elated to depressed is called: A. social anxiety disorder. B. bipolar disorder. C. depression. D. psychosis.
bipolar disorder
A psychiatric disorder that causes patients to swing to opposite sides of the mood spectrum is called: A. paranoid disorder. B. bipolar disorder. C. depressive disorder. D. schizophrenic disorder.
bipolar disorder
You are called by law enforcement to the residence of a 22-year-old adult man who overdosed on PCP. On arrival, you determine that the scene has been secured, and you find the patient lying prone in the front yard in handcuffs. He is being physically restrained by two police officers. The patient is violently fighting back to get loose, and you note that he is tachypneic, his skin is hot, and he is perspiring heavily. An officer tells you that it took several people to subdue and restrain the patient, at which time he became even more violent. What should you do? A. Attempt to verbally de-escalate the patient's agitation. B. Restrain the patient prone on your stretcher and apply additional soft restraints. C. Call for an ALS unit to administer medication to calm the patient. D. Ask the police to transport.
call for an ALS unit to administer medication to calm the patient
Your treatment for a patient who is exhibiting signs of agitated delirium should include: A. calling for advanced life support backup. B. asking law enforcement to handcuff the patient. C. releasing the patient if he shows symptoms. D. ensuring that restraints are properly tightened.
calling for ALS backup
When you are faced with a patient who was involved in a suicide attempt, your first efforts should be to: A. care for the patient's medical problems. B. establish why the patient is depressed. C. notify law enforcement. D. retreat to your unit.
care for the patient's medical problems
A patient who has a blank stare as if displaying an inability to move is described as: A. comatose. B. delirious. C. agitated. D. catatonic.
catatonic
Your partner is assessing a patient who has a history of antisocial disorder and just got into a heated verbal exchange with his neighbor. He threatened to kill his neighbor, and 911 was called. As you observe the patient, what is the strongest indication that the patient may be ready to have a violent outburst? A. Avoiding eye contact B. Refusal to answer questions C. Increased sighing D. Clenching of both fists
clenching both fists
An alert and oriented 18-year-old female patient has threatened to hurt herself, but is refusing transport to the hospital. She is calm and states that she knows her rights and taking her would constitute false imprisonment. Her family is present and wants her to go to the hospital for help, as she has attempted suicide in the past. Given the situation and the patient's threat, what is your best course of action? A. Physically restrain the patient for transport B. Transport the patient on her father's consent C. Have the patient sign a refusal-of-care form that is witnessed by family D. Contact law enforcement for assistance
contact law enforcement for assistance
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. depression. C. bipolar disorder. D. phobia.
depression
A person with an alcohol-like odor on the breath may be suffering from a(n): A. opiate overdose. B. diabetic emergency. C. stroke. D. seizure.
diabetic emergency
When questioning a patient with suicidal ideation, you should be: A. direct. B. indirect. C. vague. D. crafty.
direct
You have been called for a young male patient who has been acting withdrawn. As a precaution, dispatch also alerted police, who are now on scene with you. The patient appears depressed and when you ask him if he is thinking about hurting himself, he answers, "Yes." The next question asked by the EMT should be: A. "Are there guns in the house?" B. "Do you take medications?" C. "Do you want to go to the hospital?" D. "Do you have a plan?"
do you have a plan
What is the BEST way to protect yourself from false accusations made by patients with behavioral emergencies? A. Document B. Direct C. Record D. Remember
document
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. Repeatedly asking him why he did it so he realizes how inappropriate his action was B. Scolding him for trying a suicide attempt C. Empathizing with his mental state while treating any physical problems D. Telling him to never try it again, as he could harm others
empathizing with his mental state while treating any physical problems
You are called to an attempted suicide by hanging. On arrival, you see that law enforcement has arrived and the scene is safe. Your first act of care for the patient should be to: A. perform a primary examination. B. establish manual inline stabilization. C. check for a pulse. D. notify the ED.
establish manual inline stabilization
A male patient with a history of behavioral problems continually smacks his lips, sticks his tongue out, and turns his head to the left. His arm also jerks upward regularly. Which statement, made by a caregiver, would an EMT recognize as most important and relating to this presentation? A. "He can be very delusional at times." B. "He refused to take his morning medications." C. "Lately, he will only eat potato chips for breakfast." D. "He has been on psych medications for many years."
he has been on psych meds for many years
By carefully and completely documenting everything that happens during an encounter with an emotionally disturbed patient, you can: A. explain what you think the patient was perceiving. B. help protect yourself against false accusations. C. stop the patient from filing a complaint. D. retain a copy of the trip for your own records.
help protect yourself against false accusations
What should you include on your PCR regarding the restraint of an angry patient? A. What the patient's family said to the patient prior to the restraining process B. How many EMS providers were used in the procedures C. How far away from the hospital you were D. How long the police were on scene prior to executing the procedure
how many EMS providers were used in the procedures
The EMT would recognize a patient as having a phobia when the patient makes which statement? A. "I am unemployed and think that I will lose my home." B. "I found a snake in my house and am having dreams of finding others." Your answer is not correct.C. "I was just diagnosed with cancer and think that it is terminal." D. "I cannot eat meat because they put dangerous bacteria in it that can hurt me."
i cannot eat meat because they put dangerous bacteria in it that can hurt me
You are preparing a 24-year-old male for transport to the hospital after he stated that he wanted to kill himself. The patient's father pulls you aside and tells you that his son repeatedly has been in the hospital for suicidal statements but is then released and comes home and the whole cycle repeats itself. He is worried that one day his son will actually commit suicide and wonders if there is anything he can do to decrease the chance of this happening. In regard to the most common means by which people commit suicide, you should respond by saying: A. "The chance of your son committing suicide is low since he has never actually attempted it." B. "Lock up all of the household cleaning products, since these are commonly ingested poisons during suicide attempts." C. "It would be best to get rid of all the beer, wine, and alcohol in the house." D. "I would suggest gathering up all guns and weapons and removing them from the house."
i would suggest gathering up all guns and weapons and removing them from the hoseu
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. fully immobilize the patient. B. ensure that the patient cannot escape the restraints. C. involve law enforcement. D. chemically restrain the patient.
involve law enforcement
Why should a patient never be restrained in the prone position? A. It can be the cause of positional asphyxia and lead to cardiac arrest. B. The police will not allow that to be done. C. Patients are harder to place on the stretcher that way. D. It takes more rescuers to restrain a patient that way.
it can be the cause of positional asphyxia and lead to cardiac arrest
A 48-year-old female patient with a history of depression has called for help because she feels suicidal. During transport, the patient refuses to talk to you despite repeated attempts to obtain her past medical history and learn about the events leading up to her call for help. Which statement is most appropriate at this time? A. "Talking often helps people feel better. If you talk to me, I am sure that it will help." B. "I really must have information related to your medical history; therefore, you must talk to me." C. "I know that people with depression seem to get better very quickly by taking medications. Have you thought about taking some?" D. "It's okay if you do not want to talk, I will be right here if you change your mind."
its okay if you dont want to talk, i will be right here if you change your mind
Who has the capability to force a patient to be transported when his life is in danger? A. EMS supervisor B. EMS personnel C. Psychiatrist D. Law enforcement
law enforcement
Which statement is TRUE about suicides and suicide attempts? A. Depression seems to have little influence on suicide attempts. B. Most people who formulate a detailed plan for suicide do not carry it through. C. Men are four times more likely to die from suicide than are women. D. Approximately 80 percent of people who succeed in committing suicide were attempting it for the first time.
men are four times more likely to die from suicide than are women
After completing the scene size-up, what should be your FIRST phase of assessment on a patient with a behavioral emergency? A. Behavioral assessment test B. Primary survey C. Vitals D. History and SAMPLE
primary survey
The question, "Can you see things that other people can't see," would be asked to identify: A. mania. B. psychosis. C. suicidal ideation. D. homicidal ideation.
psychosis
If you are restraining a patient and he continues to spit at you, what should you do? A. Restrain the patient in the prone position. B. Refuse to transport the patient. C. Put a surgical mask on the patient. D. Consider tightening the patient's restraints so they are painful.
put a surgical mask on the patient
Which of the following is a sign of a patient suffering from psychomotor agitation? A. Slow movements B. Bradycardia C. Rapid speech D. Blank stare
rapid speech
If you, as an EMT, are involved in a situation where you must restrain a patient, make sure that you use: A. swift action. B. chemical restraints. C. reasonable force. D. approved handcuffs.
reasonable force
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. remain kind and calm, knowing that the comments are not personal. B. find a weakness and belittle the patient until the cursing stops. C. call the police for assistance to restrain the patient. D. lie to the patient and tell her she will be arrested at the hospital.
remain kind and calm, knowing that the comments are not personal
Which of the following statements BEST defines the term "reasonable force"? A. The minimum force needed to keep the patient from hurting someone B. Only that force that is necessary to handcuff a patient C. The force required to restrain a cooperative patient D. Any force necessary to subdue a patient
the minimum force needed to keep the patient from hurting someone
What is the danger involved in managing a patient with agitated or excited delirium? A. The patient has a very high body temperature. B. The patient is so strong he can fight off multiple rescuers. C. The patient can go into shock right in front of you. D. The patient could suddenly go from fighting to cardiac arrest.
the pateitn could suddenly go from fighting to cardiac arrest
Restraining a patient should be avoided unless: A. the patient is bigger than you. B. your partner feels it is the best thing. 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
Why might a situation where a patient has committed suicide be a potentially unsafe scene for EMS providers? A. The suicide mechanism itself may create an unsafe scene. B. Family members may grieve too loudly when they find out. C. The EMS provider may feel sorry for the patient and attempt the same. D. The patient may not be dead, and when EMS arrives, the patient may try lashing out at them.
the suicide mechanism itself may create an unsafe scene
You are called by a husband who states that his wife is bipolar and in need of help at the hospital. Which presentation would make the most sense related to this disorder? A. Paranoia B. Thoughts of persecution C. Distortion of speech and thought D. Depressed and not wanting to talk
Depressed and not wanting to talk
You are caring for an attempted suicide patient who has shot himself in the chest. What would be the priority of treatment? A. Asking him how he feels B. Immobilizing the spine to a backboard C. Initiating an IV line D. Occluding the open wound
occluding the open wound
A highly exaggerated suspiciousness of others is known as: A. paranoia. B. schizophrenia. C. agitated delirium. D. psychosis.
paranoia
Unwarranted mistrust or suspiciousness of others is called: A. anxiety. B. psychosis. C. paranoia. D. schizophrenia.
paranoia
Basic principles to keep in mind when you encounter a patient with a behavioral emergency include: A. only psychologically unstable people feel emotional disturbance when injured. B. some people who have been through a crisis suddenly get better. C. people have more ability to cope with crisis than they might think. D. emotional injury is not truly "real" as is a physical injury.
people have more ability to cope with crisis than they might think
You have been called to an extended care facility for a 48-year-old male patient with a history of schizophrenia. On scene, you find the patient to be highly agitated and clutching his left hand while complaining that there are bugs in it. After performing the primary assessment and finding no life threats, you should: A. Ask the patient to describe the bugs B. Reassure the patient that he is safe, and then transport to the hospital C. Determine whether the patient is compliant with his medications D. Physically assess his left hand for any abnormalities
physically assess his left hand for any abnormaliites
You are talking with an individual who is having a behavioral emergency, when the patient begins pacing and clenching his fists. What should you do next? A. Stand over the patient. B. Tell the patient to calm down. C. Retreat to a safe location and wait for the police. D. Threaten to call law enforcement.
retreat to a safe location and wait for the police
You arrive at the scene of a potential psychiatric emergency at the grocery store. A sales clerk tells you that a woman 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. Distract the patient while your partner engages her from behind. B. Attempt to engage in a dialogue with the patient. C. Retreat to a safe location, encouraging bystanders to do so also, and await assistance. D. Overpower the patient and restrain her on the stretcher.
retreat to a safe location, encourage bystanders to do so also, await assistance
You arrive at the scene of a potential psychiatric emergency at the local library. The patient, a woman 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. Overpower the patient and restrain her on the stretcher. B. Retreat to a safe location, encouraging bystanders to do so also, and await assistance. C. Attempt to engage in a dialogue with the patient. 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
A patient who is suffering debilitating distortions of speech and thought, bizarre delusions, and hallucinations is suffering from: A. paranoia. B. schizophrenia. C. bipolar disorder. D. anxiety.
schizophrenia
Patients with what disease suffer debilitating distortions of speech and thought, and have bizarre delusions about their world? A. Bipolar disorder B. Psychosis C. Schizophrenia D. Depression
schizophrenia
EMTs should always consider that all of the following findings are potential causes of abnormal behavior EXCEPT: A. tachycardia. B. inadequate blood flow to the brain. C. low blood sugar. D. head trauma.
tachycardia
You are caring for a 19-year-old female patient whom you notice has multiple superficial lacerations over each wrist, some in different stages of healing. When you ask her what caused the marks, she states she sustained them when she was trying to jump over a chain link fence. What should you consider when evaluating her story? A. The marks are probably from parental abuse. B. The marks are in fact from jumping over a fence. C. The marks could be from attempts at suicide. D. The marks are from something else, as she has no reason to jump over a fence.
the marks could be from attempts at suicide
You are at the scene where a male patient threatened to take pills to end his life. In talking with the patient, he informs you that he just got a new job that requires more of his time and his wife has been giving him a hard time about it. Tonight, he had enough and just made the comment because he was mad at her. He says that although he is still upset, he does not plan to do anything "drastic." Before taking further action, which fact about the patient should raise the EMT's suspicion that he is indeed at a higher risk for suicide? A. New job with increased stress B. New diagnosis of high blood pressure C. Scar on the patient's neck D. Unsuccessful attempt three years ago
unsuccessful attempt 3 years ago
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
What would be an appropriate response to visual or auditory disturbances that the behavioral emergency patient might describe? A. You should ignore the patient. B. You should reassure the patient that the disturbances are temporary. 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