EMT Ch 27 Chapter Test

It can sometimes be difficult to determine whether someone who is showing unusual behavior is having a psychological emergency or is showing an altered mental status due to a physical issue. Which of the following statements are true​? 1. Consider patients who are exhibiting crisis or unusual behavior to be having an altered mental status from a nonpsychiatric cause until proven otherwise. 2. Many medical and traumatic conditions are likely to alter a​ patient's behavior. 3. Lack of oxygen may cause restlessness and​ confusion, cyanosis​ (blue or gray​ skin), and altered mental status. 4. Stroke or inadequate blood to the brain may cause confusion or dizziness and what appears to be erratic behavior.

1, 2,​ 3, 4

Which of the following communication strategies should be used when dealing with a patient with a behavioral​ emergency?

Acknowledge the​ patient's feelings.

Neurotransmitters are chemicals within the body that transmit the message from the distal end of one neuron​ (presynaptic neuron) to the proximal end of the next neuron​ (postsynaptic neuron). While it sounds like a complicated​ process, it takes only milliseconds. Which one of the following sentences is false​?

After the impulse is​ transmitted, the neurotransmitter goes through a process called​ reuptake, in which the neurotransmitter is returned to the postsynaptic neuron.

Concerning attempted​ suicide, which of the following statements is true​?

All suicide attempts must be taken seriously.

According to​ coworkers, your​ 25-year-old female patient suddenly began acting aggressively and being verbally abusive. She tells you she is​ "starving" and you notice that she is pale and diaphoretic. Which of the following would be an appropriate general​ impression?

An underlying physical illness

Your patient is a​ 22-year-old male who has ingested a large amount of alcohol and is vomiting. He is conscious but uncooperative. He allows you to examine him but refuses transport to the hospital. You have sought assistance from law enforcement on scene. Which of the following is the best​ action?

Contact medical direction for further advice.

Which of the following does not indicate that a patient may be about to become​ violent?

Crying

Your patient is a​ 15-year-old female who has been diagnosed with a personality disorder. She has no history of violent behavior. The staff at her residential care facility wants her to be transported for evaluation of a possible urinary tract infection. Which of the following is the best way to handle this​ situation?

Have a female EMT attend to the patient.

You are confronted with a patient experiencing personality changes ranging from irritability to irrational​ behavior, altered mental​ status, amnesia or​ confusion, irregular​ respirations, elevated blood​ pressure, and decreasing pulse. It appears to be a psychiatric emergency. What else could cause this​ behavior?

Head injury

Which of the following traumatic conditions could account for signs and symptoms of a behavioral​ emergency?

Hemorrhage

Which of the following must be treated by the EMT if present in a patient with an apparent behavioral​ emergency?

Hypoglycemia

Which of the following may cause a patient to exhibit abnormal​ behavior?

Hypoxia

Which of the following statements regarding behavioral emergencies is false​?

It is unusual to find a person with schizophrenia outside a mental health facility.

Which of the following statements concerning behavioral emergencies is true​?

It may be difficult to determine what behavior is abnormal for a given person in a given situation.

Why is it important to gather a detailed medical history when dealing with a psychiatric​ emergency?

It will alert you to past issues as well as medication.

You are dispatched to a suicide attempt. You arrive to find a​ 16-year-old who is extremely agitated and pacing up and down in the living room of his house.​ Apparently, he threatened to go​ out, get a​ gun, and shoot himself. His parents called it in as an attempted suicide. The scene is safe and there are apparently no weapons accessible to the patient. Which of the following would not be appropriate in caring for this​ patient?

Make certain the patient gets between you and the door. The patient should always feel he has an escape route.

Which of the following is acceptable when managing the patient with a behavioral or psychiatric​ emergency?

Make supportive statements such​ as, "That must have been very hard for​ you."

There are general rules for dealing with psychiatric emergencies. Which of the following is not one of those rules and would not be considered​ appropriate?

Never make eye contact with the​ patient, as it will just increase his nervousness.

When providing emergency care to an aggressive or hostile​ patient, what is the highest​ priority?

Performing a scene​ size-up

When responding to an attempted​ suicide, which of the following is the​ EMT's primary​ concern?

Personal safety

It is important​ that, as an EMS​ provider, you avoid creating a situation where positional asphyxia could occur. Which of the following is positional​ asphyxia?

Positional asphyxia is inadequate breathing or respiratory arrest caused by a body position that restricts breathing.

You are dispatched to a local​ fast-food restaurant for a​ "nature unknown" call. You arrive​ on-scene and find a​ 47-year-old male in front of the counter repeatedly singing​ "Happy Birthday" to himself. Police are​ on-scene and the scene is safe. Which of the following would be considered appropriate​ care?

Quietly and carefully evaluate the situation and keep your emotions under control. Be as unhurried as you can.

Which of the following actions is the most appropriate for the EMT to take when managing a patient with a behavioral​ emergency?

Remain calm and reassure the patient.

You are on the scene of a possible overdose. You find a​ 30-year-old man pacing around his living room. There is evidence of illicit drug use and the apartment is in disarray. The patient seems agitated and nervous. Attempts at calming the patient should include which of the​ following?

Repeat part of what the patient is saying to show that you are listening to him.

You are dispatched to a psychiatric emergency for a​ 68-year-old male. Dispatch provides no other information​ and, when questioned by​ you, they do not have any more information. Although all steps are important for dealing with this​ situation, which step is the most​ important?

Scene​ size-up

Your patient is a​ 37-year-old male sitting on the kitchen floor. His wife is attempting to talk with​ him, but he does not look at her or answer. He is fidgeting and has apparently thrown some dishes against the wall. What should be your first​ consideration?

Stay a safe distance away.

When a patient or bystander at the scene of an emergency displays​ fear, anger, or​ grief, this is best described as which of the​ following?

Stress reaction

You are called to the scene of an attempted suicide. You arrive to find a​ 25-year-old man sitting on the sofa who apparently cut his wrists. Family members have bandaged​ them, and there does not appear to be any bleeding risk at this time. The scene is secure. Which action would not be appropriate in treating this​ patient?

Take charge of the​ situation; let the patient know that what he has done is wrong and tell him he is coming with you whether he likes it or not.

You are on the scene where a​ 23-year-old female has attempted suicide by cutting her forearms with a razor. She is sitting in the front yard and has lost a large amount of blood. She is conscious and holding a small razor​ blade, and she tells you to get away from her. Which of the following should not be​ done?

Take the razor blade away from her by force.

Which of the following situations generally allows the EMT to transport a patient with a behavioral emergency against his or her​ wishes?

The patient is a threat to himself or others.

You respond to the scene of a private residence for a patient who is known to have​ insulin-dependent diabetes. The patient is combative and cursing as you approach. Should this patient be​ restrained?

There is not enough information to answer this question.

Which of the following statements concerning people who have made prior suicide attempts is true​?

They are at an increased risk for a subsequent successful suicide.

Which of the following statements concerning forcible restraint of patients is true​?

This is normally considered to be within the jurisdiction of law enforcement.

All of the following are general rules for dealing with a psychiatric patient except​:

do not be​ judgmental; instead, show​ pity, because he needs to know that you understand him.

Your patient is exhibiting bizarre and aggressive​ behavior; he starts shouting and becomes violent. He has extra strength and appears insensitive to pain. Drug paraphernalia is visible​ on-scene. This behavior is known​ as:

excited delirium.

EMTs may come across a situation where a patient begins to act extremely agitated or psychotic. Uncontrolled psychiatric illness and sometimes drug intoxication may be present. The patient may suddenly cease​ struggling, and often within minutes the patient develops inadequate or absent respirations and subsequently dies. It is important for the EMT to be alert for this sequence of events in a patient who exhibits this behavior and monitor the patient constantly throughout the call. This condition is​ called:

excited or agitated delirium.

When managing a patient who may hurt himself or​ others, you should do all of the following except​:

make sure only you and the patient are in the room.

Which of the following patients would be considered to be at the greatest risk for​ suicide?

​22-year-old man who has lost his job and is getting divorced

Which of the following is not an acceptable method or adjunct in restraining a​ patient?

​Hog-tying the patient

When restraining a​ patient, which of the following is not a​ consideration?

​Patient's informed consent

Which of the following factors suggest that a patient is at risk for​ suicide?

all (Alcohol and drug abuse, Recent emotional trauma, Sudden improvement in depression)

Which of the following medical conditions could be the underlying cause of an apparent behavioral​ emergency?

all (Hypoglycemia, Mental illness, Stroke)

Once you have established with reasonable certainty that your patient is suffering from a behavioral​ emergency, which of the following is the best course of​ action?

Attempt to determine whether there is a possible physical cause for the​ patient's behavior.

When dealing with a psychiatric​ emergency, which one of the following would generally be inappropriate behavior on your​ part?

Be as hurried as you can. It is extremely important to resolve the call and get the patient to the hospital as soon as possible.

When a person acts in a manner that is unacceptable to himself or those around​ him, this would be considered which of the​ following?

Behavioral emergency

Which combination of the following is most appropriate when assessing an emotionally disturbed​ patient?

Establish eye and verbal contact and listen to the patient without without being judgmental.

Your patient is a​ 24-year-old male who is severely depressed. He tells you that he​ can't "handle the​ pressure" anymore and that he wants to die. He is refusing transport. Which of the following is the most appropriate decision regarding this​ patient's care?

Transport the patient against his will with the assistance of law enforcement.