H-1) Which of the following is most indicative of a behavioral emergency?A. A terminally ill cancer patient begins giving away her prized possessions.B. A patient at the scene of a terrorist attack wails with grief at the loss of a spouse.C. A patient with no apparent awareness of his surroundings speaks in gibberish. D. A patient in severe respiratory distress begins grunting and collapses to her knees.
C. A patient with no apparent awareness of his surroundings speaks in gibberish The patient with no apparent awareness of his surrounding and who is speaking in gibberish most likely has an altered mental status, because his behavior is at odds with his circumstances. The other patients are responding in normal ways to difficult or life-threatening situations.
H-2) Which of the following is a common medical cause for behavioral changes in a patient?A. Rapid capillary refillB. High blood sugarC. Low blood sugar D. Slow heart rate
C. Low blood sugar(Page 748) Diabetes is a very common disease process that EMTs encounter. When a diabetic patient's blood sugar level gets too low and the patient becomes hypoglycemic, the patient starts to have mental and physical changes that may be confused with psychological problems. Err on the side of caution, and look for physiological causes first.
H-3) When you are dealing with someone who presents with a behavioral emergency, remember that:A. you must consider physiological causes.B. the cause is likely psychological.C. transport to the hospital is rarely indicated. D. the patient will likely need to be restrained.
A. you must consider physiological causes.(Page 749) You must consider physical (non-psychiatric) causes for abnormal behavior, because these causes could be life-threatening to the patient, as in the case of hypoglycemia.
H-4) A 38-year-old female patient presents with restlessness, confusion, and an altered mental status. Which finding below indicates a physiological cause of her bizarre behavior?A. HypertensionB. StrokeC. Hypercholesterolemia (high blood cholesterol) D. Hypoxia
D. Hypoxia (Page 749) Hypoxia can cause restlessness, confusion, and an altered mental status.
H-5) You respond with the police to a domestic violence call where the wife has sustained superficial injuries. The police inform you that the husband is in custody and may be having a reaction to a drug such as PCP (phencyclidine). He is speaking rapidly and appears nervous. The police ask you to check him out before they take him away. What should be your greatest safety concern regarding this patient?A. Use of some drugs can lead to unpredictable behavior and may result in sudden violence.B. His condition may involve a chemical contamination that poses a safety threat to all near him.C. His excited state may result in a heart attack or similar medical problem. D. He will likely attempt to evade arrest by running away, posing a threat to others.
A. Use of some drugs can lead to unpredictable behavior and may result in sudden violence. Your greatest concern is the unpredictability of a patient who is in this condition.
H-6) Which patient is showing the least likely sign of aggressive or hostile behavior?A. A patient keeps getting too close to you.B. A patient keeps slapping away your attempts at a physical examination.C. A patient is moving and speaking suddenly and unpredictably. D. A patient expresses remorse for his unhealthy habits.
D. A patient expresses remorse for his unhealthy habits. Remorse doesn't demonstrate a potential for aggressive or hostile behavior nearly as much as panicky or threatening behavior, and slapping away attempts at physical examination actually is hostile behavior.
H-7) When a patient is acting irrationally and uncooperatively, which of the following is the most effective approach toward gaining the patient's trust and cooperation?A. Making sure other people are around as you interact with the patientB. Being general and nondescript in your expectations of the patientC. Displaying a calm, confident demeanor D. Telling the patient what the patient wants to hear, even though it may not be the truth
C. Displaying a calm, confident demeanor Showing the patient that you are relaxed and confident helps to reassure the patient that the patient's problems are not unmanageable and that you are the person to help the patient.
H-8) Rushing the assessment of a patient who is in an agitated state from a situational stress reaction:A. encourages the patient to give you pertinent information more quickly.B. makes the situation seem more out of control to the patient.C. contributes to the patient's perception of your authority. D. puts the current emergency into better perspective for the patient.
B. makes the situation seem more out of control to the patient. Rushing the assessment for a patient overwhelmed by stress will likely magnify the patient's feeling that events are out of control. Don't rush, and show a firm control over your actions and the situation.
H-9) You have arrived at the scene of a patient with a psychiatric condition that has led to a behavioral emergency. The scene has been declared safe, and you have explained to the patient why you are there. What should be your next step?A. Obtain a history from the patient.B. Obtain the patient's vital signs.C. Conduct a primary assessment of the patient. D. Prepare for transport, with the plan of completing your assessment en route to the hospital.
C. Conduct a primary assessment of the patient After determining scene safety, the next priority is to conduct a primary assessment. Obtaining a history and obtaining vital signs from the patient are parts of the secondary assessment process. Primary assessments must be accomplished on all patients before transporting.
H-10) In your assessment of a 50-year-old female with confusion, irrational behavior, and agitation, you discover that the patient has a history of high blood pressure, diabetes, previous heart attacks, arthritis, and gallstones. Part of your continued assessment for this patient should be:A. summoning paramedics, as this patient is most likely having a heart attack.B. trending the patient's blood pressure by obtaining at least three readings.C. a thorough examination of the abdomen, to reveal the presence of gallstones. D. obtaining the patient's blood glucose level.
D. obtaining the patient's blood glucose level. Hypoglycemia is a likely cause of this patient's mental status, so you should obtain her blood glucose level, if protocol permits
H-11) Which of the following is recommended when interacting with a behavioral patient?A. Acknowledging the patient's feelingsB. Showing pityC. Agreeing with whatever the patient says D. Speaking quickly
A. Acknowledging the patient's feelings(Page 751)It is good to acknowledge the patient's feelings. The other choices are not appropriate. Show COMPASSION, NOT pity (Bullet Point 5) Speak slowly and clearly (Bullet Point 1)
H-12) 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. Performing a detailed secondary examinationB. Assessment of the airway, breathing, and circulationC. Transporting the patient to the nearest ED D. Collecting a thorough history
B. Assessment of 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, and to treat any life-threatening problems. All other concerns are secondary.
H-13) When you are responding to a call involving a behavioral emergency, you should ensure throughout the call that you:A. develop a definitive diagnosis of the patient's condition.B. remain alert for personal and scene safety problems.C. carefully avoid touching or coming too near the patient. D. gather evidence ruling out a psychiatric cause.
B. remain alert for personal and scene safety problems. Throughout each call involving a behavioral emergency, be alert for personal and scene safety problems.
H-14) What is it important to do in response to a patient's exhibiting signs of depression?A. Counsel the patient that depression is an insufficient coping mechanism.B. Take the patient's depression seriously and don't dismiss it.C. Refer the patient immediately to a mental health team. D. Tell the patient that everyone has bad days but things always work out.
B. Take the patient's depression seriously and don't dismiss it. Take seriously a patient's feelings and expressions of despair or suicidal thoughts without dismissing or judging the patient's behavior.
H-15) When you are called to care for a patient who may be about to attempt suicide, your first concern should be:A. for your own safety.B. to restrain the patient.C. to establish your authority over the patient. D. to call law enforcement.
A. for your own safety Whenever you are called to care for a patient who has attempted or may be about to attempt suicide, your first concern must be your own safety. Not all patients will wish to harm you, but the mechanism used to attempt suicide will be capable of causing death. It could intentionally or accidentally be turned on you.
H-16) You should leave a patient who is suicidal alone:A. when law enforcement arrives on the scene.B. if you feel that the patient is likely to commit suicide.C. only if you are at risk of physical harm. D. if the patient is verbally abusive and irrational.
C. only if you are at risk of physical harm.
H-17) For a psychiatric patient:A. reassessment should be confined to trending vital signs.B. take the patient's history only from family members, not the patient.C. you may not be able to complete a detailed examination. D. you will never perform a physical exam.
C. you may not be able to complete a detailed examination. A physical exam may be difficult with a psychiatric patient. Because of this, you may not be able to begin or complete the physical exam.
H-18) Restraining a patient:A. is always indicated for any patient in a behavioral emergency.B. involves careful planning and adequate assistance.C. is a decision you'll likely make in the moment. D. should be as forceful as possible to ensure success.
B. involves careful planning and adequate assistance. Restraining a patient involves having a well-delineated plan of action before attempting the restraint and having adequate assistance
H-19) Once you decide to restrain a patient, how quickly should the intervention be carried out?A. Only after the patient agrees to restraintsB. As quickly as possibleC. Without police assistance D. Slowly
B. As quickly as possible 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.
H-20) Why is it dangerous to restrain a patient in the prone position?A. It takes more rescuers to restrain a patient that way.B. It can be the cause of positional asphyxia and lead to cardiac arrest.C. Patients are harder to place on the stretcher that way. D. The police will not allow that to be done.
B. It can be the cause of positional asphyxia and lead to cardiac arrest Never restrain a patient in the prone position, as the patient may seem to calm down but may actually be going into respiratory or cardiac arrest as a result of positional asphyxia.
H-21) You are transporting a stable patient with a behavioral problem. You should:A. put a same-sex provider in the back with the patient, if possible.B. restrain the patient for transport.C. request that law enforcement ride in with you. D. leave the patient unattended in the back.
A. put a same-sex provider in the back with the patient, if possible Emotionally disturbed patients sometimes accuse EMS personnel of sexual misconduct. If possible, EMTs of the same sex as the patient should attend to the emergency care of a disturbed patient.
H-22) Which of the following is true of excited delirium?A. The patient is usually hypersensitive to pain.B. The patient often has a history of dementia.C. It is often associated with alcohol withdrawal. D. It is often associated with cocaine or amphetamine use.
D. It is often associated with cocaine or amphetamine use Excited delirium entails bizarre and/or aggressive behavior, shouting, paranoia, panic, violence toward others, insensitivity to pain, unexpected physical strength, and/or hyperthermia, usually associated with cocaine or amphetamine use
H-23) Inadequate breathing or respiratory arrest caused by a body position that restricts breathing is:A. circumstantial hypoxia.B. restraint dyspnea.C. positional asphyxia. D. receptive aphasia.
C. positional asphyxia Positional asphyxia is inadequate breathing or respiratory arrest caused by a body position that restricts breathing
H-24) You are at the scene of a middle-aged man who attempted to take his own life by cutting both of his wrists deeply. He is distraught over the death last week of his wife of 30 years. He is conscious and refuses any care or transport, and he warns you and your partner to stay away from him. He is unarmed but bleeding freely. Which of the following is the best course of action?A. Wait until the patient bleeds sufficiently to cause unconsciousness, and then treat him.B. Request law enforcement assistance and contact medical direction for advice.C. Immediately restrain the patient against his will and treat him accordingly. D. Follow the patient's commands and leave the scene immediately.
B. Request law enforcement assistance and contact medical direction for advice It will always be beneficial to have the police present if the patient must be restrained as a matter of safety. You may also be required to contact medical direction about the psychiatric patient who refuses care
PT-1) Early signs of potential impending violence include:A. refusing to talk or interact with you.B. anxiety and panicky behavior.C. long, rambling conversations. D. quietly sitting and crying.
B. anxiety and panicky behavior.
PT-2) If a patient's erratic, confused behavior suddenly subsides into calm and rationality, the least likely cause of the erratic, confused behavior was:A. hypoxia.B. hypoglycemia.C. head trauma. D. mind-altering substances.
PT-3) You are restraining a patient who continues to spit at you. What should you do?A. Restrain the patient in the prone positionB. Put a surgical mask on the patientC. Consider tightening the restraints so that they are painful D. Refuse to transport the patient
B. Put a surgical mask on the patient
PT-4) Regarding caring for a patient who is experiencing a situational stress reaction, which of the following statements is true or appropriate?A. The patient can be snapped out of the reaction by a stern, loud command.B. Tell the patient immediately that whatever is causing stress isn't important.C. Engaging in a quiet and careful review of the patient's situation is best. D. Taking a zero-tolerance attitude toward anything the patient does that you find unacceptable is essential.
C. Engaging in a quiet and careful review of the patient's situation is best
PT-5) What adjective best describes the attitude you should take toward a patient experiencing a situational stress reaction?A. LoftyB. FawningC. Dominant D. Attentive
PT-6) Physical contact and eye contact with a patient in a psychiatric emergency should be:A. avoided no matter what.B. direct and frequent.C. natural and necessary for the situation. D. prolonged and constant.
C. natural and necessary for the situation(Page 751)Bullet 3 - Make eye contact with patientBullet 8 - Do not enter a patient's personal space. Stay at least 3 feet from your patient.So, the question is actually not a great question, because you can do BOTH - maintain eye contact, WITHOUT entering the patient's personal space. You do NOT want to make either of these "prolonged and constant" as this makes EVERYONE uncomfortable.You additionally, do not want to avoid eye contact, regardless of how long it takes to get the trust of your patient and be able to make physical contact. The direct and constant, is not something you do on ANY patient, much less a patient with a patient in a psychiatric emergency.
PT-7) Bizarre, aggressive behavior is exhibited by patients with:A. anxiety.B. depression.C. excited delirium. D. phobia.
PT-8) A patient who threatens to harm himself or his wife because he is sure she is plotting against him with her sister; although both she and her sister deny it; is:A. in a behavioral emergency if he is lying.B. certainly lying but not in a behavioral emergency.C. in a behavioral emergency. D. possibly telling the truth, and behaving normally, if so.
C. in a behavioral emergency
PT-9) The manner in which someone acts is known as:A. schizophrenia.B. behavior.C. bipolar disorder. D. phobia.
PT-10) Which example best demonstrates providing reassurance to a patient who appears to be suicidal?A. You listen carefully to the patient's concerns and indicate that hospital treatment is best.B. You relate your own struggles with dark thoughts.C. You ask the patient if he feels his emotional pain is somehow unique. D. You validate the patient's emotions by agreeing that life is often overwhelming.
A. You listen carefully to the patient's concerns and indicate that hospital treatment is best.
PT-11) Which of the following actions or risk factors is the least indicative of a potential suicide attempt?A. Previous suicide attemptsB. Having a detailed plan for suicideC. Calling 911 for help D. Recent improvements from deep depression
PT-12) Which of the following should you do when interacting with a behavioral patient?A. Avoid discussing what is troubling the patientB. Lie to the patient if it assists with your assessmentC. Limit the interaction to no more than 15 minutes D. Encourage the patient to discuss what is troubling the patient
D. Encourage the patient to discuss what is troubling the patient(Page 753) Do this, but DO NOT dwell on stressors or situations that escalate the current behavior
PT-13) What is least likely to be a sign of a psychiatric emergency?A. A patient appears to be panicked and anxious.B. A patient cries out in pain.C. A patient appears to be unable to use appropriate words to express himself. D. A patient is engaged in obsessive, repetitive movements of his hands and arms.
B. A patient cries out in pain
PT-14) Which of the following is defined as a situation in which a patient's behavior becomes so bizarre, threatening, or dangerous that it alarms the patient or others and requires intervention?A. Abnormal behaviorB. OverdoseC. Psychosis D. Behavioral emergency
PT-15) You are caring for a 27-year-old male who is screaming and throwing dishes in the kitchen. The family called EMS because they are concerned about his behavior. They inform you that his father just died that day. What can you reasonably conclude?A. That the patient's behavior is normal in the circumstances and deserves support and monitoringB. That the patient's behavior should simply be accepted and ignored until it stopsC. That the patient's behavior is unacceptable and intolerable, even if the reason is understandable D. That the patient is in a behavioral emergency brought on by grief
A. That the patient's behavior is normal in the circumstances and deserves support and monitoring(Page 747) Behavioral Emergencies are looked at in the context of "within a given situation." In this situation, the patient found out about his father dying that day. Part of a situation such as this include screaming, crying, throwing things, or other outbursts. So, in this context, the patients, behavior would not be unusual, but would deserve support and monitoring of the patient.
PT-16) As you physically examine a patient who might be in a behavioral emergency, you should:A. be alert for any relevant medical and traumatic conditions.B. make the examination as rapid and abbreviated as possible.C. stop at the first sign that appears to point to a psychiatric cause for the patient's behavior. D. expect to find clear evidence of mental illness.
A. be alert for any relevant medical and traumatic conditions
PT-17) Which patient is least likely to be in danger of committing suicide?A. A patient who tells you he feels hopeless about the worldB. A patient who has just been fired after 20 years of serviceC. A patient who is drunk and seems violent D. A patient in respiratory distress who is displaying anxiety
D. A patient in respiratory distress who is displaying anxiety This would be a medical situation versus the other ones which are in the lines of a behavioral/suicide threat situation
PT-18) You are caring for a 19-year-old male patient who has multiple superficial lacerations over each wrist, in different stages of healing. When you ask him what the marks are from, he states that he sustained them when he was trying to climb over a chain link fence. You suspect multiple attempts at suicide. What should you do?A. Report your suspicions to the staff at the receiving hospitalB. Inform the patient that he needs to be honest about any suicide attemptsC. State that transport must be delayed until an exact cause for injuries may be determined D. Accept the patient's explanation, and simply remind him to be more careful
A. Report your suspicions to the staff at the receiving hospital
PT-19) What is a physical, non-psychiatric cause for strange behavior?A. Obsessive-compulsive disorderB. Posttraumatic stress disorderC. Schizophrenia D. Hypoxia
PT-20) What is the most likely reason medical control would direct you to forcibly restrain a patient?A. The patient has verbally threatened EMS workers.B. The patient is clinically depressed.C. The patient is a danger to self. D. The patient has a life-threatening condition.
C. The patient is a danger to self
PT-21) A patient who told his friend that he planned to commit suicide is refusing ambulance transportation but is agreeable to going to the hospital via a friend's private vehicle. What action should you take at this point?A. Allow the friend to transport the patient via private vehicle.B. Have your partner accompany the patient in the friend's car.C. Have the patient sign a refusal of care and transportation form. D. Contact medical direction for assistance.
D. Contact medical direction for assistance
PT-22) If a patient becomes violent, your first action should be to:A. restrain the patient.B. try to calm the patient.C. call for additional resources. D. retreat from the scene, if possible.
D. retreat from the scene, if possible
CT-1) When managing a patient who may hurt himself or others, you should do all of the following except:A. keep bystanders a safe distance away.B. watch for sudden changes in the patient's behavior.C. make sure only you and the patient are in the room. D. retreat if the patient becomes threatening.
C. make sure only you and the patient are in the room You want to avoid isolating yourself
CT-2) Which of the following medical conditions could be the underlying cause of an apparent behavioral emergency?A. StrokeB. Mental illnessC. Hypoglycemia D. All of the above
CT-3) Which of the following factors suggest that a patient is at risk for suicide?A. Sudden improvement in depressionB. Alcohol and drug abuseC. Recent emotional trauma D. All of the above
CT-4) 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:A. sensory excitement.B. excited delirium.C. chemical delirium. D. delusions.
CT-5) Which of the following statements concerning forcible restraint of patients is true?A. This is normally considered to be within the jurisdiction of law enforcement.B. This is necessary only with mentally ill individuals.C. It is easily accomplished by two EMTs with a good plan. D. It causes irreparable emotional harm to most patients.
A. This is normally considered to be within the jurisdiction of law enforcement.
CT-6) 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?A. Ask the wife to step into the other room so you can speak with the patient alone.B. Quickly check the patient's carotid pulse.C. Stay a safe distance away. D. Ask the wife to step outside with you so you can get information from her.
C. Stay a safe distance away
CT-7) Which of the following does not indicate that a patient may be about to become violent?A. Rapid speech and movementB. Tense body posture or clenched fistsC. Crying D. Rapid pulse and breathing
CT-8) Which of the following is appropriate when assessing an emotionally disturbed patient?A. Establish eye and verbal contact.B. Both A and BC. Use assertive body language to show you are in control. D. Listen to the patient without being judgmental.
B. Both A and B (There IS no B!!!)
CT-9) Which of the following statements concerning people who have made prior suicide attempts is true?A. They should be allowed to sign a release if their injuries are not serious.B. They are usually just making a cry for help but do not want to die.C. They are at an increased risk for a subsequent successful suicide. D. They do not require psychological counseling like a person who is depressed.
C. They are at an increased risk for a subsequent successful suicide.
CT-10) Which of the following situations generally allows the EMT to transport a patient with a behavioral emergency against his or her wishes?A. The patient is a threat to himself or others.B. The patient's personal physician gives you permission.C. A family member gives consent and is willing to accompany the patient. D. The patient's insurance company agrees to pay, even though the patient has not given consent.
A. The patient is a threat to himself or others.
CT-11) Which of the following actions is the most appropriate for the EMT to take when managing a patient with a behavioral emergency?A. Remain calm and reassure the patient.B. Quickly perform a head-to-toe exam and transport without delay.C. Establish control of the situation by a show of force. D. Find out if the patient's insurance covers psychiatric treatment.
A. Remain calm and reassure the patient
CT-12) Which of the following statements concerning behavioral emergencies is true?A. Emotional outbursts are considered behavioral emergencies.B. A person with a behavioral emergency is mentally ill.C. The person with a behavioral emergency requires prolonged institutionalization. D. It may be difficult to determine what behavior is abnormal for a given person in a given situation.
D. It may be difficult to determine what behavior is abnormal for a given person in a given situation
CT-13) 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 non-psychiatric 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.A. 1, 2, 3B. 1, 2C. 1, 2, 3, 4 D. 1, 3, 4
CT-14) 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?A. Alcoholic intoxicationB. Alcohol withdrawalC. An underlying physical illness D. Sudden onset of schizophrenia
C. An underlying physical illness
CT-15) 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?A. Refuse to transport the patient without a police escort.B. Have a female EMT attend to the patient.C. Transport the patient, but do not speak to her or perform an assessment. D. Ask that the patient be given a tranquilizer injection prior to transport.
B. Have a female EMT attend to the patient
CT-16) 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?A. Use Standard Precautions.B. Call law enforcement for assistance.C. Keep bystanders away from the patient. D. Take the razor blade away from her by force.
D. Take the razor blade away from her by force
CT-17) Which of the following may cause a patient to exhibit abnormal behavior?A. GastroenteritisB. Allergic reactionC. Snakebites D. Hypoxia
CT-18) When responding to an attempted suicide, which of the following is the EMT's primary concern?A. Managing the patient's airwayB. Determining whether the patient suffers from clinical depressionC. Contacting law enforcement because suicide is illegal D. Personal safety
CT-19) When a person acts in a manner that is unacceptable to himself or those around him, this would be considered which of the following?A. Behavioral emergencyB. Mental illnessC. Psychosomatic reaction D. Psychotic episode
CT-20) 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?A. Secondary assessmentB. Primary assessmentC. Vital signs and SAMPLE history D. Scene size-up
CT-21) 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?A. Yes, he likely has a medical condition that requires treatment.B. No, this patient is not likely experiencing a behavioral emergency.C. There is not enough information to answer this question. D. Yes, he is combative and all combative patients can be restrained.
C. There is not enough information to answer this question.
CT-22) 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?A. Repeat part of what the patient is saying to show that you are listening to him.B. Stand still with your arms crossed to instill a sense of control and authority.C. Sit close to him with your arm around his shoulders to show that you are truly concerned. D. Speak quickly to give the patient all of the important information without delay.
A. Repeat part of what the patient is saying to show that you are listening to him.(Page 751)Bullet 6 - Use positive body language. Avoid crossing your arms or looking uninterestedBullet 8 - Do not enter patient's personal space. Stay at least 3' from the patient (Making the patient feel closed in can cause an emotional outburst) Bullet 2 - Speak slowly and clearly. Use a calm and reassuring tone
CT-23) 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?A. Contact the receiving hospital and report on current mental status and other essential information.B. 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.C. Watch for sudden changes in the patient's behavior and physical condition. D. As soon as possible, perform a history and physical exam and provide emergency care on the wrist, if necessary.
B. 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.
CT-24) Which of the following is acceptable when managing the patient with a behavioral or psychiatric emergency?A. Allow family members to confront the patient about his behavior.B. Make supportive statements such as, "That must have been very hard for you."C. Sit as close to the patient as you can to reassure him that you will not abandon him. D. Go along with the patient's hallucinations or false beliefs.
B. Make supportive statements such as, "That must have been very hard for you."
CT-25) 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?A. Head injuryB. StrokeC. Low blood sugar D. Lack of oxygen
CT-26) Which of the following is not an acceptable method or adjunct in restraining a patient?A. Placing a surgical mask over the patient's face to prevent spittingB. Restraining the patient face-upC. Hog-tying the patient D. Securing all four limbs with leather restraints
C. Hog-tying the patient
CT-27) 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?A. NeurosisB. Post-traumatic stress disorderC. Stress reaction D. Catharsis
CT-28) 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?A. Positional asphyxia is the position the person is seated in when you approach him.B. Positional asphyxia is inadequate breathing or respiratory arrest caused by a body position that restricts breathing.C. Positional asphyxia is a birth defect that causes psychiatric issues and is initiated because of the way the fetus was positioned in the uterus. D. Positional asphyxia is the name for the position someone assumes after she has been hit with a taser.
B. Positional asphyxia is inadequate breathing or respiratory arrest caused by a body position that restricts breathing.
CT-29) 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?A. Contact the patient's family to find out what their wishes are.B. Leave the scene and allow law enforcement to handle the situation.C. Respect the patient's wishes; he is alert, oriented, and capable of giving consent. D. Transport the patient against his will with the assistance of law enforcement.
D. Transport the patient against his will with the assistance of law enforcement.
CT-30) Concerning attempted suicide, which of the following statements is true?A. There is always an indication that a suicide attempt is imminent.B. All suicide attempts must be taken seriously.C. Attempted suicide is a matter for law enforcement, not EMS. D. Truly suicidal patients nearly always leave a note.
B. All suicide attempts must be taken seriously
CT-31) When providing emergency care to an aggressive or hostile patient, what is the highest priority?A. Performing a scene size-upB. Calming the patient downC. Finding out if the patient is oriented to person, time, and place D. Checking the patient for possible physical causes of the behavior
A. Performing a scene size-up
CT-32) Which of the following traumatic conditions could account for signs and symptoms of a behavioral emergency?A. HemorrhageB. Fractured tibiaC. Partial thickness burn D. Fractured lumbar vertebra
CT-33) Which of the following patients would be considered to be at the greatest risk for suicide?A. 22-year-old man who has lost his job and is getting divorcedB. 30-year-old married man who has just learned that his employer is transferring him to a different stateC. 44-year-old woman who has just recovered from a serious illness D. 35-year-old female who has a child with a serious illness
A. 22-year-old man who has lost his job and is getting divorced
CT-34) Which of the following statements regarding behavioral emergencies is false?A. Patients experiencing a behavioral emergency are not always dangerous to themselves or others.B. It is unusual to find a person with schizophrenia outside a mental health facility.C. Apparent behavioral emergencies may be due to an underlying medical cause. D. Cultural differences may cause a patient's behavior to initially appear abnormal to the EMT.
B. It is unusual to find a person with schizophrenia outside a mental health facility.
CT-35) 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?A. Do not take any action that may be considered threatening by the patient; doing so may bring about hostile behavior directed against you or others.B. Always be on the watch for weapons.C. Make certain the patient gets between you and the door. The patient should always feel he has an escape route. D. Do not isolate yourself from your partner or other sources of help.
C. Make certain the patient gets between you and the door. The patient should always feel he has an escape route.
CT-36) Why is it important to gather a detailed medical history when dealing with a psychiatric emergency?A. It will help you to determine whether you need to restrain the patient.B. It will help you to determine whether the police are needed.C. It is not. You want to get the call resolved as quickly as possible and this will just delay it. D. It will alert you to past issues as well as medication.
D. It will alert you to past issues as well as medication.
CT-37) Which of the following must be treated by the EMT if present in a patient with an apparent behavioral emergency?A. HypoglycemiaB. Severe clinical depressionC. Suicidal ideology D. Acute alcohol intoxication
CT-38) All of the following are general rules for dealing with a psychiatric patient except:A. listen to the patient, showing you are listening by repeating part of what the patient says back to him.B. do not be judgmental; instead, show pity, because he needs to know that you understand him.C. speak slowly and clearly, and use a calm and reassuring tone. D. make eye contact with the patient.
B. do not be judgmental; instead, show pity, because he needs to know that you understand him.(Page 751) Bullet 5 - Show COMPASSION - NOT PITY
CT-39) 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?A. This is the mechanism by which the impulse is moved along the nervous system.B. Neurotransmitters are released from a neuron, then travel across the synapse to the next neuron.C. After the impulse is transmitted, the neurotransmitter goes through a process called reuptake, in which the neurotransmitter is returned to the postsynaptic neuron. D. The receptors on the postsynaptic neuron receive the neurotransmitter.
C. After the impulse is transmitted, the neurotransmitter goes through a process called reuptake, in which the neurotransmitter is returned to the postsynaptic neuron.
CT-40) 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?A. Contact medical direction for further advice.B. Stay with the patient until he has stopped vomiting.C. Find a relative or neighbor to come over and stay with the patient. D. Obtain a witnessed refusal.
A. Contact medical direction for further advice
CT-41) 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?A. Identify yourself and your role.B. Never make eye contact with the patient, as it will just increase his nervousness.C. Speak slowly and clearly, using a calm and reassuring tone. D. Listen to the patient. You can show you are listening by repeating part of what the patient says back to him.
B. Never make eye contact with the patient, as it will just increase his nervousness.
CT-42) 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:A. psychotic delirium.B. excited or agitated delirium.C. bipolar disorder. D. excited psychosis.
B. excited or agitated delirium
CT-43) 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?A. Have your partner join you in approaching the patient and explain to him that he has to stop singing or you will have him arrested.B. Quietly and carefully evaluate the situation and keep your emotions under control. Be as unhurried as you can.C. Quickly approach the patient and take charge. Tell him he has to come with you to be evaluated. D. Have the police take charge, restrain the patient, and have him brought into your ambulance.
B. Quietly and carefully evaluate the situation and keep your emotions under control. Be as unhurried as you can.
CT-44) Which of the following communication strategies should be used when dealing with a patient with a behavioral emergency?A. Play along with any visual or auditory hallucinations the patient is experiencing.B. Acknowledge the patient's feelings.C. Interrupt the patient if he appears to be going off on a tangent about something not concerning the immediate situation. D. Stay 2 to 3 inches from the patient at all times to make him feel secure.
B. Acknowledge the patient's feelings
CT-45) When dealing with a psychiatric emergency, which one of the following would generally be inappropriate behavior on your part?A. Let the patient know that you are listening to what he is saying, and explain things to the patient honestly.B. 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.C. Act in a calm manner, giving the patient time to gain control of his emotions. D. Stay alert for sudden changes in behavior.
B. 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
CT-46) When restraining a patient, which of the following is not a consideration?A. How to position the patientB. Number of people available to carry out the required actionsC. Patient's size and strength D. Patient's informed consent
D. Patient's informed consent
CT-47) 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?A. There is no need to assess for medical conditions if the patient does not have a history of past medical problems.B. Attempt to determine whether there is a possible physical cause for the patient's behavior.C. Begin intense individual counseling with the patient. D. Establish the best way to restrain the patient before he has the opportunity to become violent.
B. Attempt to determine whether there is a possible physical cause for the patient's behavior |