Chapter 29 Flashcards
Which of the following questions would be the most appropriate initial question to ask when broaching the subject of suicide with a depressed patient?
“Have you ever thought that life wasn’t worth living?”
Which of the following drugs is an MAOI?
Parnate
A state of delusion in which a person is out of touch with reality is called:
psychosis.
An example of an impulse control disorder is:
pathologic gambling.
When asking an emotionally disturbed patient a series of questions, you should:
use words such as “how” and “what” whenever possible.
A patient is very demanding and is trying to dictate the care that you provide to him. This is characteristic of which type of personality?
Histrionic
At a minimum, you should be able to assess an emotionally disturbed patient’s:
general appearance.
Signs and symptoms of depression that last for at least 2 years:
are highly suggestive of dysthymic disorder.
If a psychotic person’s level of consciousness is fluctuating, you should:
suspect an organic brain syndrome.
You are dispatched to a residence for a patient who has overdosed. You immediately recognize the address as that of a patient with a known psychiatric condition. Law enforcement is at the scene and has ensured its safety. When you arrive and enter the residence, you find the patient, a man in his mid-20s, sitting on the floor. He is conscious and appears anxious. Which of the following questions should you ask the patient first?
“What medication did you take?”
Accelerated thinking in which the mind skips very rapidly from one thought to the next is called:
flight of ideas.
A 50-year-old woman called 9-1-1 after she was suddenly awakened in the middle of the night with the feeling that she was being smothered. Your assessment reveals that she is clearly anxious, is trembling, and complains of chest pain and numbness and tingling to her face and hands. Her blood pressure is 168/96 mm Hg, pulse rate is 160 beats/min, and respirations are 30 breaths/min. Her medications include Xanax, Lipitor, and Vasotec. The most appropriate treatment for this patient includes:
coaching her to slow her breathing, monitoring her oxygen saturation and end-tidal carbon dioxide levels, assessing her cardiac rhythm, establishing vascular access, considering a benzodiazepine, and transporting.
Abnormal behavior that stems from a psychosocial etiology would most likely occur in a patient who:
experienced emotional trauma as a child.
Which of the following scenarios is indicative of posttraumatic stress disorder?
A paramedic whose son was struck and killed by a car becomes acutely anxious upon arriving at the scene of a motor-vehicle-versus-pedestrian incident.
Which of the following statements regarding schizophrenia is correct?
The typical onset of schizophrenia occurs during early adulthood.
Which of the following statements about panic disorder is correct?
Panic disorder is characterized by sudden, unexpected fear and dread.
The most important aspect in the care of a patient who is at risk for suicide is:
never leaving the patient alone.
A hallmark sign of mania is:
an elated affect.
Which of the following medications would most likely cause prolongation of the QT interval?
Inapsine
A psychiatric emergency:
exists when a person’s abnormal behavior threatens the safety and well-being of him- or herself or others.
Unlike a person with bulimia nervosa, a person with anorexia nervosa:
experiences weight loss that may cause poor health or even death.
Psychomotor abnormalities associated with depression include:
agitation and pacing.
Metabolic causes of abnormal behavior include:
diabetic ketoacidosis.
Which of the following is a disorder of thought content?
Delusions
An agitated person with an antisocial personality:
will not think twice about hurting you.
You are dispatched to a skilled nursing care facility for a 74-year-old male resident who is ill. During your assessment, you note that the patient has his head cocked to the side and is unable to move it. The charge nurse tells you that the patient was placed on Seroquel 2 days ago. Based on this patient’s clinical presentation and medication history, you should:
administer 25 to 50 mg of diphenhydramine.
You receive a call to an apartment complex for a patient with an unknown behavioral problem. The scene has been secured by law enforcement prior to your arrival. The patient, a 39-year-old man, appears very anxious and worried. He tells you that he has obsessive-compulsive disorder and stopped taking his prescribed medication a week ago because he did not like its side effects. He tells you that he has had fleeting thoughts of suicide, but denies homicidal thoughts. You should:
safely transport him to the hospital and monitor his behavior en route.
When caring for a patient experiencing a psychotic episode, you should:
first assess the situation for danger.
A patient is speaking rapidly, skipping from one irrelevant topic to another. This is an example of:
tangential thinking.
An acute dystonic reaction is characterized by:
muscle spasms of the neck, face, and back within a few days of starting treatment with an antipsychotic drug.
A confused, bedridden resident in a skilled nursing facility who tells you that they cook dinner for the other residents each night:
confabulating
A psychotic person may have thought insertions, which are defined as:
the belief that thoughts are being thrust into their mind by another person.
Manic patients may report that their thoughts are racing and they may rapidly skip from one topic to another. This is called:
tangential thinking.
In hypochondriasis, patients have significant anxiety or fear that they:
may have a serious disease.
Which of the following assessment findings is suggestive of an organic cause of abnormal behavior?
Unusual breath odor
Which of the following is a general guideline to follow when caring for a patient with a psychiatric problem?
Maintain a nonjudgmental attitude.
A man who smiles pleasantly when he tells you of the recent death of his wife:
has an inappropriate affect.
Which of the following disease states can produce psychotic symptoms?
Low cardiac output
You are transporting a 22-year-old woman whose violent behavior required physical restraint. A law enforcement officer is in the back of the ambulance with you. The patient tells you that she is sorry for her behavior and did not mean to take it out on you and your partner. You should:
continue to talk to the patient and monitor her peripheral circulation.
The best way to ensure that no one is harmed during an EMS call is to:
assess the potential for violence on every EMS call.
Which of the following is a common sign or symptom of a panic attack?
Nausea and abdominal discomfort
Which of the following words would likely de-escalate the symptoms of a panic attack to a more manageable level?
Safe
A 41-year-old woman attempted to kill herself by cutting her wrists. Law enforcement personnel are at the scene. You have controlled the bleeding with direct pressure and a pressure bandage. The patient’s vital signs are stable and she is conscious and alert; however, she refuses to go to the hospital. Despite pleas from her family to go to the hospital, she still refuses. You should:
remain with the patient, contact medical control, and request law enforcement intervention.
In anxiety disorders, the dominant moods are:
fear and apprehension.
While assessing a patient, you note that she is making repetitive hand gestures as though she is trying to grasp at something. This is an example of which type of movement?
Stereotyped
People who are overly concerned with their physical health and appearance most likely have a:
somatoform disorder.
When a person has a personality disorder:
another psychiatric illness typically is present.
Which of the following steps of caring for a patient with a psychiatric emergency would most likely give the patient the feeling that something is being done to help?
Developing a specific plan
Which of the following is an identified risk factor for suicide?
A sudden improvement in depression
Law enforcement personnel request your assistance in caring for a violent patient. When you arrive at the scene, the patient, a 48-year-old man, is yelling obscenities and is threatening to kill anyone who comes near him. Despite your attempts to calm him verbally, he continues his threatening behavior. It is most important for you to:
ensure that you have a route for rapid egress and visually scan the patient for potential weapons.
