Chapter 22 Psychiatric Emergencies

Question 1

What is the most common misconception surrounding mental illness?

Answer 1

Feeling “bad” or “depressed” means that you must be “sick”

Question 2

Why might EMTs encounter a larger proportion of violent patients than the population at large?

Answer 2

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

Question 3

Everyone exhibits some signs and symptoms of mental illness at some point in life but _____.

Answer 3

That does not mean a person is mentally ill

Question 4

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

Answer 4

B) A person violently attacking family members

Question 5

The two basic categories of diagnosis that a physician will use for behavioral crises or psychiatric emergencies are _____.

Answer 5

Physical and psychological

Question 6

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

Answer 6

B) Alzheimer dementia

Question 7

What is a good guideline for physical examination of any patient?

Answer 7

Avoid touching without permission

Question 8

A general impression of the patient is formed by an EMT:

Answer 8

At a distance when the patient is first seen

Question 9

What term applies to a state of delusion in which the patient is out of touch with reality?

Answer 9

Psychosis

Question 10

A 40-year-old man 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. You should first:

Answer 10

Calmly identify yourself to the patient

Question 11

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?

Answer 11

Ask the patient if she has developed a suicidal plan

Question 12

What are some signs of excited delirium?

Answer 12

Diaphoresis
Tachycardia
Hallucinations

Question 13

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:

Answer 13

Restrain the patient with appropriate force in order to treat his injuries

Question 14

You receive a call for a domestic dispute. When you arrive at the scene, you fine 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?

Answer 14

His large body size

Question 15

When caring fora patient experiencing excited delirium, the EMT should remember that:

Answer 15

Sudden death can occur if the patient’s violence is not controlled

Question 16

From a mental health standpoint, an abnormal or disturbing pattern of behavior is a matter of concern if it lasts more than:

Answer 16

1 month

Question 17

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:

Answer 17

Were you shot at or under fire?

Question 18

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 the hospital for treatment. Based on this information, you should:

Answer 18

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

Question 19

Which of the following is a normal reaction to a crisis situation?
A) Monday morning blues that last until Friday
B) Feeling “blue” after the breakup of a long-term relationship
C) Feeling depressed week after week with no discernible cause
D) Thoughts of suicide

Answer 19

B) Feeling “blue” after the breakup of a long-term relationship

Question 20

Patients may show agitation of violence or become a threat to themselves or others when the experience a(n) _____ emergency.

Answer 20

Psychiatric

Question 21

When documenting abnormal behavior, it is important to:

Answer 21

Document everything that happened on the call

Question 22

Dean, a man in 50s, is acting irrationally. His wife states that he thinks he is the dictator of a small country, and he is wearing nothing but a baseball cap and a belt with a small handgun attached to it. What is your best course of action?

Answer 22

Call for police backup

Question 23

People with _____ may experience symptoms including delusions, hallucinations, a lack of interest in pleasure, and erratic speech.

Answer 23

Schizophrenia

Question 24

_____ is a behavior that is characterized by restlessness and irregular physical activity.

Answer 24

Agitation

Question 25

A condition of impairment in cognitive function that can present with disorientation, hallucinations, or delusions is called:

Answer 25

Delirium

Question 26

What is an illness with psychological or behavioral symptoms that may result in impaired functioning?

Answer 26

A psychiatric disorder

Question 27

What is a functional disorder?

Answer 27

A psychological disorder that impairs bodily function when the body seems to be structurally normal

Question 28

What is a behavioral crisis?

Answer 28

Any reaction to events that interferes with activities of daily living or is unacceptable to the patient or others