Chapter 11

You are called by law enforcement to the residence of a​ 22-year-old adult male who overdosed on PCP. On your​ arrival, you determine that the scene has been​ secured, and you find the patient lying prone in the front yard in handcuffs. His is being physically restrained by two police officers. The patient is violently fighting back to get​ lose, and you note that he is​ tachypenic, ; his skin is​ hot, and he is perspiring heavily. An officer tells you it several people to subdue and restrain​ him, at which time he became even more violent. What should the paramedic consider​ performing?

administer midazolam

Which of the following disorders can result from​ AIDS, Parkinson's, or drug​ abuse?

dementia

The feeling of being different - that their body has taken a different form or that they have become someone else is the characteristic of which of the​ following?

depersonalization

Suicide is 500 times more common among people also suffering from which of the​ following?

depression

What mental disorder is normally mistaken for dementia in the elderly​ patient?

depression

Which of the following is most indicative of​ schizophrenia?

disorganized​ speech, distortions of​ reality, and flat affect

You are treating a​ 19-year-old female patient who has been TASERed by police. After removing the​ darts, how should they be​ secured?

disposed of in the sharps container

The overuse of​ mood-altering drugs can result in which of the following​ conditions?

drug abuse

Which of the following causes of behavioral disorders are related to a​ patient's personality​ style, dynamics of unresolved​ conflict, or crisis management​ methods?

psychosocial

Which of the following conditions is related to a​ patient's personality or crisis management​ methods?

psychosocial

You are transporting a behavioral patient with a history of parental neglect. This person is likely suffering from which of the following forms of behavioral​ conditions?

psychosocial

You are transferring a schizophrenic patient from the local hospital to a specialty hospital for continuing treatment. Despite your​ encouragement, he begins to exhibit aggressive behavior while en route to the specialty hospital. Your next action should be to do which of the​ following?

restrain the patient

What is the general rule of thumb when a patient is physically restrained in the​ field?

restraints remain in place until the patient is evaluated in the hospital

Which behavioral disorder is distinguished by a significant change in behavior and a loss of contact with reality that is manifested by hallucinations or​ delusions?

schizophrenia

What is the disorder that is characterized by physical symptoms that have no apparent physiologic​ cause?

somatoform

Your patient complains of acute onset​ blindness, deafness and loss of touch sensation. This would suggest which of the following psychiatric​ disorders?

somatoform disorder

Which of the following is a psychiatric disorder in which the patient is commonly dependent on​ mood-altering drugs?

substance abuse

Which of the following are the best indicators of an abnormal assessment finding that may indicate substance​ abuse?

track marks and smell of alcohol

Your crew has been called to a potential suicide. He is found in the bathroom holding a razor blade to his​ wrist, but​ hasn't cut yet. He states​ "I don't want to hurt​ anyone; I just want to end the​ pain." You ask him to put down the razor so you can talk to him. He puts the razor down and consents to your questioning and evaluation. What should be the next​ action?

you should limit the number of people around the patient and ask​ open-ended questions

You are treating a 17​ year-old female for a syncopal episode. The school nurse informs you that the patient is known to follow eating binges with purging with the assistance of laxatives. The patient is very frail with a blood pressure of​ 88/50 mmHg and glucose of 38​ mg/dL. Which of the following are proper treatment considerations for this​ patient?

​50% dextrose, IV fluids administered to maintain perfusion

Which of the following is an indicator of potential danger with a person experiencing a behavioral​ emergency?

​patient's posture

What is one of the best methods for gathering more information during your mental status examination during a behavioral​ emergency?

Ask the patient​ clear, open-ended questions.

Which of the following psychiatric disorders have organic causes such as brain injury or diseases like​ infections, neoplasm, or drug​ abuse?

Cognitive disorders

What is the reversible state of maniacal excitement characterized by restless​ behavior, confused​ speech, hallucinations, disorientation and widespread disorganized​ thought?

Delirium

Which of the following acronyms provides a screening mnemonic for major​ depression?

INSADCAGES

Which of the following is most indicative of mood​ disorders?

Significant weight loss and feelings of worthlessness

A patient suffering from excited delirium will always present with which sign or​ symptom?

abnormal pain tolerance

Which of the following is a​ well-known cause of excited delirium​ syndrome?

cocaine

The schizophrenic patient you are transporting is preoccupied with feelings of persecution and is delusional. Which type of schizophrenia is he​ exhibiting?

paranoid

What is typically considered the radius of a​ patient's personal​ space?

3 feet

What is the proper sequence for removing a TASER​ dart?

Have TASER turned​ off, cut the dart​ wire, pull dart​ out, and cover wound with dressing

Which of the following guidelines is recommended for questioning patients who have behavior​ problems?

Place yourself at the​ patient's level and listen to what the patient says.

Why should the use of chemical restraint by paramedics be considered whenever a physically restrained patient struggles​ excessively?

The patient may be suffering from excited delirium syndrome.

Which of the following statements is true regarding the causes of behavioral​ emergencies?

They most frequently involve biological conditions or substance abuse.

You are transporting an elderly female patient who displays symptoms of early dementia to the local hospital for routine testing. The patient expresses concern that you are in a rush and she​ can't locate her glasses. How should you​ respond?

We have plenty of​ time, Mrs. Jones.​ I'll help you look for them.

If depression lasts longer than two months or is accompanied by suicide ideation or marked functional​ impairment, it is classified​ as:

a major depressive episode

You are called to the scene of a domestic dispute for a​ 46-year-old adult male that was TASERed by law​ enforcement; they are still at the scene. On your​ arrival, approximately 15 minutes​ later, you determine that the scene has been secured and that there is adequate police presence. You move toward the​ patient, who is prone with one TASER lead in his lower back and the other on the ground next to him. He is handcuffed and being further restrained by two police​ officers, one on his shoulders and one on his legs. The patient is violently fighting the restraint and has a respiratory rate of​ 32; his skin is hot and he is perspiring heavily. An officer tells you he has been that way since a couple of minutes after being TASERed. What would you do​ next?

administer midazolam

What component of the MSE is evaluated when the​ patient's immediate expression of emotion is​ observed?

affect

What is the psychological term for an observable expression of​ emotion?

affect

Removal of the TASER darts by emergency personnel should be​ considered:

after ensuring that the patient is stable and has no other acute medical condition

When dealing with either geriatric or pediatric patients in behavioral​ crisis, it is better​ to:

allow a family member to remain with them whenever possible

Which situation would best describe a potentially dangerous​ scene?

arguing family members

Which of the following will help you gain the trust of an emotionally distraught​ child?

be truthful with the child

Which of the following is not one of the diagnostic criteria used when determining if a patient has a depressive​ episode?

bereavement

Which of the following terms describes psychiatric disorders which 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?

biological

Which of the following best describe the factors that alter the behavior of an ill or injured​ person?

brain​ trauma, hypoxia and hypoglycemia

When treating an elderly person with a behavioral disorder who is in​ crisis, how can you compensate for the​ patient's impaired sight and​ hearing?

by using reassuring physical contact

Which of the following mental disorders appears to be a factor in sudden death associated with restraint​ situations?

excited delirium syndrome

When conducting the MSE on a​ patient, which of the following can you observe upon initial contact on​ scene?

general appearance

Which of the following is not a risk factor for a patient considering​ suicide?

heterosexuality

What appears to be the main reason why excited delirium emerges within a​ patient?

increased brain dopamine levels

A​ patient's ability or​ non-ability to recognize that she or he has a behavioral problem is what MSE component that should be​ evaluated?

insight

Lesions in certain cortical areas of the brain may affect the normal pitch and cadence of speech and destroy subtleties of full comprehension such as appreciation of​ irony, sarcasm, and humor. This can be evaluated with what component of the​ MSE?

intelligence

The electric shock delivered to the body by a​ TASER:

is considerably less than needed to affect the heart

When approaching a​ patient, if you determine the potential for​ violence, you should do which of the​ following?

maintain a safe distance and call police

Which of the following is characterized by the need for increased amounts of a​ mood-altering drug to obtain the desired​ effect?

physical dependence

Which of the following patients is at the highest risk of committing​ suicide?

one in possession of a gun

Bipolar disorder is characterized by which of the​ following?

one or more manic episodes

Questions such​ as, "Where are we right​ now? What city are we​ in? What is​ today's date? What time is it right now​ (to the nearest​ hour)?" evaluate what aspect of the​ MSE?

orientation