homework week 15

Question 1

Accelerated thinking in which the mind skips very rapidly from one thought to the next is called:
Select one:
a. confabulation.
b. circumstantial thinking.
c. perseveration.
d. flight of ideas.

Answer 1

d. flight of ideas.

Question 2

A confused, bedridden resident in a skilled nursing facility who tells you that he or she cooks dinner for the other residents each night:
Select one:
a. is confabulating. 
b. is experiencing delirium.
c. has a disorder of affect.
d. is experiencing echolalia.

Answer 2

a. is confabulating.

Question 3

Repetitive actions that are carried out to relieve the anxiety of obsessive thoughts are called:
Select one:
a. perseverations.
b. compulsions.
c. stereotyped movements.
d. confabulations.

Answer 3

b. compulsions.

Question 4

When extreme anxiety occurs in conjunction with restlessness, a patient:
Select one:
a. becomes agitated. 
b. is not distractible.
c. often becomes suicidal.
d. presents with a flat affect.

Answer 4

a. becomes agitated.

Question 5

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?
Select one:
a. Asking direct questions
b. Encouraging the patient to talk
c. Remaining calm and confident
d. Developing a specific plan

Answer 5

d. Developing a specific plan

Question 6

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 \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ movements.
Select one:
a. obsessive
b. compulsive
c. circumstantial
d. stereotyped

Answer 6

d. stereotyped

Question 7

Which of the following is NOT a general guideline to follow when caring for a patient with a psychiatric problem?
Select one:
a. Be indirect when possible. 
b. Provide honest reassurance.
c. Remain confident in your abilities.
d. Maintain a nonjudgmental attitude.

Answer 7

a. Be indirect when possible.

Question 8

A person who is neologistic:
Select one:
a. repeats what he or she hears.
b. talks with grossly slurred speech.
c. invents words that have no meaning. 
d. has accelerated or pressured speech.

Answer 8

c. invents words that have no meaning.

Question 9

A patient who is confused:
Select one:
a. cannot recall the events that preceded his or her illness.
b. should be given 50% dextrose to rule out hypoglycemia.
c. can usually be redirected by providing emotional support.
d. has an impaired understanding of his or her surroundings.

Answer 9

d. has an impaired understanding of his or her surroundings.

Question 10

Disorders of thought content include all of the following, EXCEPT:
Select one:
a. phobias.
b. anxiety.
c. delusions. 
d. obsessions.

Answer 10

b. anxiety.

Question 11

A man who smiles pleasantly when he tells you of the recent death of his wife:
Select one:
a. is thinking circumstantially.
b. has a disorder of perception.
c. has an inappropriate affect. 
d. has delusions of persecution.

Answer 11

c. has an inappropriate affect.

Question 12

A psychiatric emergency:
Select one:
a. generally occurs following the use of an illicit drug or excessive consumption of alcohol.
b. is caused by a chemical imbalance in the brain but does not interfere with activities of daily living.
c. exists when a person’s abnormal behavior threatens the safety and well-being of himself or herself or others.
d. is generally the result of a short-term emotional crisis that is treated effectively with behavior modification.

Answer 12

c. exists when a person’s abnormal behavior threatens the safety and well-being of himself or herself or others.

Question 13

Which of the following assessment findings is MOST suggestive of an organic cause of abnormal behavior?
Select one:
a. Multiple tattoos
b. Unusual breath odor
c. Skin that is cool and dry
d. Auditory hallucinations

Answer 13

b. Unusual breath odor

Question 14

When evaluating a patient with a behavioral emergency, virtually all of the diagnostic information you obtain must come from:
Select one:
a. the medical history.
b. the patient’s family members.
c. your conversation with the patient.
d. the patient’s general mood and affect.

Answer 14

c. your conversation with the patient.

Question 15

Detecting disorders of perception is often difficult because:
Select one:
a. patients are often hesitant to answer direct questions regarding hallucinations or illusions.
b. patients experiencing a behavioral emergency are generally agitated and uncooperative.
c. the paramedic’s line of questioning is often too difficult or impossible for the patient to understand.
d. it is often difficult for the paramedic to determine the patient’s baseline level of mentation.

Answer 15

a. patients are often hesitant to answer direct questions regarding hallucinations or illusions.

Question 16

When asking an emotionally disturbed patient a series of questions, you should:
Select one:
a. keep your questions as indirect as you possibly can.
b. simplify the process by asking closed-ended questions.
c. try to ask questions that can be answered with a yes or no.
d. use words such as “how” and “what” whenever possible.

Answer 16

d. use words such as “how” and “what” whenever possible.

Question 17

If a patient with a behavioral emergency misperceives reality, you should:
Select one:
a. disagree and correct the patient’s perception.
b. avoid arguing about the patient’s misperception.
c. conclude that he or she is suffering from schizophrenia.
d. agree with the patient to facilitate his or her cooperation.

Answer 17

b. avoid arguing about the patient’s misperception.

Question 18

In anxiety disorders, the dominant moods are:
Select one:
a. anger and agitation.
b. confusion and apathy.
c. euphoria and elation.
d. fear and apprehension.

Answer 18

d. fear and apprehension.

Question 19

While assessing a patient, you ask the patient’s wife, “Ma’am, has your husband ever been hospitalized?” The patient then states, “Ma’am, has you husband ever been hospitalized?” This is an example of:
Select one:
a. echolalia. 
b. confabulation.
c. a neologism.
d. circumstantial thinking.

Answer 19

a. echolalia.

Question 20

At a minimum, you should be able to assess an emotionally disturbed patient's:
Select one:
a. ability to recall.
b. blood pressure.
c. blood sugar level.
d. general appearance.

Answer 20

d. general appearance.

Question 21

Almost all disoriented behavior:
Select one:
a. has an underlying physical etiology that may be life threatening.
b. represents a person’s effort to adapt to internal or external stress.
c. can be identified and treated definitively in the prehospital setting.
d. is the result of an acute behavioral crisis that requires intervention.

Answer 21

b. represents a person’s effort to adapt to internal or external stress.

Question 22

Which of the following drugs would MOST likely be the safest to use for a patient with aggressive and dangerous behavior secondary to methamphetamine use?
Select one:
a. Ativan 
b. Haldol
c. Droperidol
d. Ziprasidone

Answer 22

a. Ativan

Question 23

A psychotic episode MOST often leads to violence because of:
Select one:
a. exaggerated fear or paranoia. 
b. overreaction of the paramedic.
c. the influence of an illicit drug.
d. the patient's family's reaction.

Answer 23

a. exaggerated fear or paranoia.

Question 24

The outward expression of a person’s inner feelings is called:
Select one:
a. mood.
b. affect. 
c. thought.
d. behavior.

Answer 24

b. affect.

Question 25

Disorganization and disorientation:
Select one:
a. are clinical presentations that are most common in younger patients.
b. reinforce the fact that the patient’s problem is psychiatric in nature.
c. are ways that certain psychiatric conditions may present themselves.
d. are presentations that represent a relatively small number of EMS calls.

Answer 25

c. are ways that certain psychiatric conditions may present themselves.