EMT Chapters 17, 22

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

Which of the following is considered an organic brain syndrome? Select one: A. Alzheimer dementia B. Schizophrenia C. Depression D. Anxiety conditions

A. Alzheimer dementia

When a psychiatric emergency arises, a patient is most likely to exhibit which of the following behaviors? Select one: A. Any behaviors that are a violent threat to the patient, EMTs, or others B. Disruptions to activities of daily living C. Visual or auditory hallucinations D. Any behaviors unacceptable to the patient, family, or community

A. Any behaviors that are a violent threat to the patient, EMTs, or others

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

A. Ask the patient if she has developed a suicidal plan.

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

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

Which of the following conditions would MOST likely affect the entire brain? Select one: A. Respiratory failure or cardiopulmonary arrest B. Ruptured cerebral artery in the occipital lobe C. Blocked cerebral artery in the frontal lobe D. Reduced blood supply to the left hemisphere

A. Respiratory failure or cardiopulmonary arrest

When caring for a patient with documented hypoglycemia, you should be MOST alert for: Select one: A. a seizure. B. respiratory distress. C. an acute stroke. D. a febrile convulsion.

A. a seizure.

When assessing for arm drift of a patient with a suspected stroke, you should: Select one: A. ask the patient to close his or her eyes during the assessment. B. expect to see one arm slowly drift down to the patient's side. C. observe movement of the arms for approximately 2 minutes. D. ask the patient to hold his or her arms up with the palms down.

A. ask the patient to close his or her eyes during the assessment.

You are caring for a 68-year-old man with sudden onset of left-sided paralysis and slurred speech. His airway is patent, his respirations are 14 breaths/min with adequate depth, and his oxygen saturation is 98%. Treatment for this patient should include: Select one: A. recovery position and transport. B. oral glucose gel and transport. C. high-flow oxygen and transport. D. ventilatory assistance and transport.

A. recovery position and transport.

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? Select one: A. The broken window B. His large body size C. His clenched fists D. His shouting of obscenities

B. His large body size

Which of the following terms applies to a state of delusion in which the patient is out of touch with reality? Select one: A. Agitated delirium B. Psychosis C. Schizophrenia D. Suicidal

B. Psychosis

A general impression of the patient is formed by an EMT: Select one: A. speaking privately with the patient. B. at a distance when the patient is first seen. C. when the patient is in the ambulance. D. speaking with family members or bystanders first.

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

Everyone exhibits some signs and symptoms of mental illness at some point in life ____________. Select one: A. and needs medication administered to control them B. but that does not mean a person is mentally ill C. because mental illness affects everyone D. and should be physically restrained for their own safety and the safety of the EMT

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

A 40-year-old male intentionally cut his wrist out of anger after losing his job. Law enforcement has secured the scene prior to your arrival. As you enter the residence and visualize the patient, you can see that he has a towel around his wrist and a moderate amount of blood has soaked through it. You should: Select one: A. tell the patient that you want to help. B. calmly identify yourself to the patient. C. approach the patient with caution. D. quickly tend to the bleeding wound.

B. calmly identify yourself to the patient.

Interruption of cerebral blood flow may result from all of the following, EXCEPT: Select one: A. an embolism. B. cerebral vasodilation. C. a thrombus. D. an acute arterial rupture.

B. cerebral vasodilation.

A patient who is possibly experiencing a stroke is NOT eligible for thrombolytic (fibrinolytic) therapy if he or she: Select one: A. has had a prior heart attack. B. has bleeding within the brain. C. has a GCS score that is less than 8. D. is older than 60 years of age.

B. has bleeding within the brain.

The MOST significant risk factor for a hemorrhagic stroke is: Select one: A. diabetes mellitus. B. hypertension. C. heavy exertion. D. severe stress.

B. hypertension.

A patient with an altered mental status is: Select one: A. typically alert but is confused as to preceding events. B. not thinking clearly or is incapable of being aroused. C. usually able to be aroused with a painful stimulus. D. completely unresponsive to all forms of stimuli.

B. not thinking clearly or is incapable of being aroused.

A patient whose speech is slurred and difficult to understand is experiencing: Select one: A. paraplegia. B. dysphagia. C. dysarthria. D. aphasia.

C. dysarthria.

You respond to a residence for a child who is having a seizure. Upon arrival at the scene, you enter the residence and find the mother holding her child, a 2-year-old male. The child is conscious and crying. According to the mother, the child had been running a high fever and then experienced a seizure that lasted approximately 3 minutes. You should: Select one: A. call medical control and request permission to give the child aspirin. B. transport the child to the hospital and reassure the mother en route. C. advise the mother to take her child to the doctor the following day. D. cover the child with wet towels and give oxygen via nasal cannula.

B. transport the child to the hospital and reassure the mother en route.

From a mental health standpoint, an abnormal or disturbing pattern of behavior is a matter of concern if it lasts for at least: Select one: A. 3 weeks. B. 1 week. C. 1 month. D. 2 weeks.

C. 1 month.

Your patient opens his eyes, moans, and pulls away from you when you pinch his trapezius muscle. You should assign a Glasgow Coma Scale (GCS) score of: Select one: A. 7. B. 9. C. 8. D. 6.

C. 8.

Which of the following is an example of a psychiatric emergency? Select one: A. A person who is depressed and no longer caring for himself B. A person going on a week-long "bender" after losing a job C. A person violently attacking family members D. A person who is experiencing a panic attack

C. A person violently attacking family members

Which of the following MOST accurately describes a simple partial seizure? Select one: A. A generalized seizure without incontinence B. A seizure that causes the patient to stare blankly C. A seizure that begins in one extremity D. A seizure that is not preceded by an aura

C. A seizure that begins in one extremity

You are attending to a 32-year-old male patient. The patient's wife tells you that he returned from Afghanistan last year. While he initially seemed fine, lately he has become withdrawn and distanced himself from his family and friends. He does not talk about it, but she knows that he has been having terrible nightmares that wake him up. The most appropriate question to ask regarding his experience in Afghanistan is: Select one: A. Can you tell me about your experience? B. Have you ever been diagnosed with PTSD? C. Were you shot at or under fire? D. Were you in combat?

C. Were you shot at or under fire?

Signs of excited delirium include: Select one: A. subdued behavior, crying, and suicidal thoughts. B. slurred speech, bradycardia, and a high fever. C. diaphoresis, tachycardia, and hallucinations. D. pallor, hypotension, and constricted pupils.

C. diaphoresis, tachycardia, and hallucinations.

You are attending to a 27-year-old patient with a history of depression. The patient's family tells you that she has been openly talking about harming herself and suicide, and they got scared when she tried to overdose on some medications. The patient did not take the pills and is alert and oriented. Despite all of your best efforts to convince her, the patient refuses to go to hospital for treatment. Based on this information, you should: Select one: A. call for the police to attend the scene and, once they arrive, release responsibility for patient transport to them B. ensure that the patient is competent and completes the required documentation, and leave her in the care of her family. C. stay with the patient while you arrange for other transport options as a potentially life-threatening emergency exists. D. restrain the patient and transport her to the hospital as she represents a threat to her safety.

C. stay with the patient while you arrange for other transport options as a potentially life-threatening emergency exists.

When you are obtaining medical history from the family of a suspected stroke patient, it is MOST important to determine: Select one: A. if the patient has been hospitalized before. B. if there is a family history of a stroke. C. when the patient last appeared normal. D. the patient's overall medication compliance.

C. when the patient last appeared normal.

The left cerebral hemisphere controls: Select one: A. heart rate and pupil reaction. B. the right side of the face. C. breathing and blood pressure. D. the right side of the body.

D. the right side of the body.

A behavioral crisis interferes with which of the following? Select one: A. Activities of daily living B. Behavior that is acceptable to the community C. Dressing, eating, or bathing D. All of these answers are correct.

D. All of these answers are correct.

Which of the following is a good guideline for physical examination of any patient? Select one: A. Always work toe-to-head. B. Complete the physical exam first, then check the ABCs. C. Examine extremities first. D. Avoid touching without permission.

D. Avoid touching without permission.

Which of the following MOST accurately describes what the patient will experience during the postictal state that follows a seizure? Select one: A. A gradually decreasing level of consciousness B. A rapidly improving level of consciousness C. Hyperventilation and hypersalivation D. Confusion and fatigue

D. Confusion and fatigue

What is the most common misconception surrounding mental illness? Select one: A. Many mental illnesses stem from drug or alcohol abuse. B. Everyone has some form of mental illness. C. All persons with mental disorders are physically violent and dangerous. D. Feeling "bad" or "depressed" means that you must be "sick."

D. Feeling "bad" or "depressed" means that you must be "sick."

A 30-year-old male experienced a generalized (tonic-clonic) seizure, which stopped before you arrived at the scene. The patient is conscious, is answering your questions appropriately, and refuses EMS transport. Which of the following would be the MOST compelling reason to disagree with his refusal of transport? Select one: A. His Glasgow Coma Scale (GCS) score is 15 B. His wife states that this was his "usual" seizure C. He has experienced seizures since he was 20 D. He is currently not prescribed any medications

D. He is currently not prescribed any medications

Which of the following conditions would be the LEAST likely to mimic the signs and symptoms of a stroke? Select one: A. Intracranial bleeding B. A postictal state C. Hypoglycemia D. Hypovolemia

D. Hypovolemia

Which of the following symptoms would lead the EMT to believe that a patient's headache is caused by sinus congestion? Select one: A. The headache began suddenly B. There is associated neck stiffness C. There is numbness in the extremities D. The pain is worse when bending over

D. The pain is worse when bending over

The three major parts of the brain are the: Select one: A. midbrain, cerebellum, and spinal cord. B. brain stem, midbrain, and spinal cord. C. cerebellum, medulla, and occiput. D. cerebrum, cerebellum, and brain stem.

D. cerebrum, cerebellum, and brain stem.

During the primary assessment of a semiconscious 70-year-old female, you should: Select one: A. insert a nasopharyngeal airway and assist ventilations. B. ask family members if the patient has a history of stroke. C. immediately determine the patient's blood glucose level. D. ensure a patent airway and support ventilation as needed.

D. ensure a patent airway and support ventilation as needed.

A 38-year-old male with a history of schizophrenia is reported by neighbors to be screaming and throwing things in his house. You are familiar with the patient and have cared for him in the past for unrelated problems. Law enforcement officers escort you into the residence when you arrive. The patient tells you that he sees vampires and is attempting to ward them off by screaming and throwing things at them. He has several large lacerations to his forearms that are actively bleeding. The MOST appropriate way to manage this situation is to: Select one: A. try to gain the patient's trust by telling him that you see the vampires too. B. approach the patient and calm him by placing your hand on his shoulder. C. request that the police officers arrest him and take him to the hospital. D. restrain the patient with appropriate force in order to treat his injuries.

D. restrain the patient with appropriate force in order to treat his injuries.

When caring for a patient experiencing excited delirium, the EMT should remember that: Select one: A. most patients will have low blood pressure and hyperglycemia. B. lights and siren are effective in redirecting the patient's behavior. C. excited delirium is worsened by nervous system depressant drugs. D. sudden death can occur if the patient's violence is not controlled.

D. sudden death can occur if the patient's violence is not controlled.