Question 1

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.

Accepted Answer

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.

Question 2

``` H-2) Which of the following is a common medical cause for behavioral changes in a​ patient? A. Rapid capillary refill B. High blood sugar C. Low blood sugar D. Slow heart rate ```

Accepted Answer

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.

Question 3

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.

Accepted Answer

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.

Question 4

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. Hypertension B. Stroke C. Hypercholesterolemia​ (high blood​ cholesterol) D. Hypoxia

Accepted Answer

D. Hypoxia (Page 749) Hypoxia can cause​ restlessness, confusion, and an altered mental status.

Question 5

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.

Accepted Answer

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.

Question 6

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.

Accepted Answer

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.

Question 7

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 patient B. Being general and nondescript in your expectations of the patient C. Displaying a​ calm, confident demeanor D. Telling the patient what the patient wants to​ hear, even though it may not be the truth

Accepted Answer

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.

Question 8

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.

Accepted Answer

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.

Question 9

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.

Accepted Answer

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.

Question 10

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.

Accepted Answer

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

Question 11

H-11) Which of the following is recommended when interacting with a behavioral​ patient? A. Acknowledging the​ patient's feelings B. Showing pity C. Agreeing with whatever the patient says D. Speaking quickly

Accepted Answer

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)

Question 12

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 examination B. Assessment of the​ airway, breathing, and circulation C. Transporting the patient to the nearest ED D. Collecting a thorough history

Accepted Answer

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.

Question 13

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.

Accepted Answer

B. remain alert for personal and scene safety problems. Throughout each call involving a behavioral​ emergency, be alert for personal and scene safety problems.

Question 14

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.

Accepted Answer

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.

Question 15

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.

Accepted Answer

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.

Question 16

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.

Accepted Answer

C. only if you are at risk of physical harm.

Question 17

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.

Accepted Answer

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.

Question 18

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.

Accepted Answer

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

Question 19

H-19) Once you decide to restrain a​ patient, how quickly should the intervention be carried​ out? A. Only after the patient agrees to restraints B. As quickly as possible C. Without police assistance D. Slowly

Accepted Answer

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.

Question 20

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.

Accepted Answer

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.

Question 21

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.

Accepted Answer

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.

Question 22

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.

Accepted Answer

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

Question 23

``` 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. ```

Accepted Answer

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

Question 24

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.

Accepted Answer

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

Question 25

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.

Accepted Answer

B. anxiety and panicky behavior.

Question 26

``` 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. ```

Accepted Answer

C. head trauma

Question 27

PT-3) You are restraining a patient who continues to spit at you. What should you​ do? A. Restrain the patient in the prone position B. Put a surgical mask on the patient C. Consider tightening the restraints so that they are painful D. Refuse to transport the patient

Accepted Answer

B. Put a surgical mask on the patient

Question 28

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.

Accepted Answer

C. Engaging in a quiet and careful review of the​ patient's situation is best

Question 29

``` PT-5) What adjective best describes the attitude you should take toward a patient experiencing a situational stress​ reaction? A. Lofty B. Fawning C. Dominant D. Attentive ```

Accepted Answer

D. Attentive

Question 30

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.

Accepted Answer

C. natural and necessary for the situation (Page 751) Bullet 3 - Make eye contact with patient Bullet 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.

Question 31

``` PT-7) ​Bizarre, aggressive behavior is exhibited by patients​ with: A. anxiety. B. depression. C. excited delirium. D. phobia. ```

Accepted Answer

C. excited delirium

Question 32

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.

Accepted Answer

C. in a behavioral emergency

Question 33

``` PT-9) The manner in which someone acts is known​ as: A. schizophrenia. B. behavior. C. bipolar disorder. D. phobia. ```

Accepted Answer

B. behavior.

Question 34

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.

Accepted Answer

A. You listen carefully to the​ patient's concerns and indicate that hospital treatment is best.

Question 35

PT-11) Which of the following actions or risk factors is the least indicative of a potential suicide​ attempt? A. Previous suicide attempts B. Having a detailed plan for suicide C. Calling 911 for help D. Recent improvements from deep depression

Accepted Answer

C. Calling 911 for help

Question 36

PT-12) Which of the following should you do when interacting with a behavioral​ patient? A. Avoid discussing what is troubling the patient B. Lie to the patient if it assists with your assessment C. Limit the interaction to no more than 15 minutes D. Encourage the patient to discuss what is troubling the patient

Accepted Answer

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

Question 37

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.

Accepted Answer

B. A patient cries out in pain

Question 38

``` 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 behavior B. Overdose C. Psychosis D. Behavioral emergency ```

Accepted Answer

D. Behavioral emergency

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CH 27 Behavioral and Psychiatric Emergencies and Suicide Flashcards

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