CH 27: Behavioral and Psychiatric Emergencies and Suicide

Question 1

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?

Answer 1

scene size-up

Question 2

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?

Answer 2

Make certain the patient gets between you and the door. The patient should always feel he has an escape route.

Question 3

Which of the following patients would be considered to be at the greatest risk for​ suicide?

Answer 3

​22-year-old man who has lost his job and is getting divorced

Question 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:

Answer 4

excited delirium.

Question 5

When restraining a​ patient, which of the following is not a​ consideration?

Answer 5

​Patient’s informed consent

Question 6

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?

Answer 6

Head injury

Question 7

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?

Answer 7

Repeat part of what the patient is saying to show that you are listening to him.

Question 8

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?

Answer 8

Stay a safe distance away.

Question 9

Which of the following statements regarding behavioral emergencies is false​?

Answer 9

It is unusual to find a person with schizophrenia outside a mental health facility.

Question 10

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?

Answer 10

Quietly and carefully evaluate the situation and keep your emotions under control. Be as unhurried as you can.

Question 11

Which of the following is acceptable when managing the patient with a behavioral or psychiatric​ emergency?

Answer 11

Make supportive statements such​ as, “That must have been very hard for​ you.”

Question 12

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?

Answer 12

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

Question 13

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?

Answer 13

Have a female EMT attend to the patient.

Question 14

Which of the following communication strategies should be used when dealing with a patient with a behavioral​ emergency?

Answer 14

Acknowledge the​ patient’s feelings.

Question 15

When providing emergency care to an aggressive or hostile​ patient, what is the highest​ priority?

Answer 15

Performing a scene​ size-up

Question 16

When dealing with a psychiatric​ emergency, which one of the following would generally be inappropriate behavior on your​ part?

Answer 16

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.

Question 17

Which of the following factors suggest that a patient is at risk for​ suicide?

Answer 17

udden improvement in depression
B.
Recent emotional trauma
C.
Alcohol and drug abuse

Question 18

Which of the following actions is the most appropriate for the EMT to take when managing a patient with a behavioral​ emergency?

Answer 18

Remain calm and reassure the patient.

Question 19

Which of the following statements concerning forcible restraint of patients is true​?

Answer 19

This is normally considered to be within the jurisdiction of law enforcement.

Question 20

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?

Answer 20

An underlying physical illness

Question 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?

Answer 21

There is not enough information to answer this question.

Question 22

Which of the following statements concerning behavioral emergencies is true​?

Answer 22

It may be difficult to determine what behavior is abnormal for a given person in a given situation.

Question 23

Why is it important to gather a detailed medical history when dealing with a psychiatric​ emergency?

Answer 23

It will alert you to past issues as well as medication.

Question 24

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:

Answer 24

excited or agitated delirium.

Question 25

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?

Answer 25

stress reaction

Question 26

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?

Answer 26

Transport the patient against his will with the assistance of law enforcement.

Question 27

Which of the following situations generally allows the EMT to transport a patient with a behavioral emergency against his or her​ wishes?

Answer 27

The patient is a threat to himself or others.

Question 28

All of the following are general rules for dealing with a psychiatric patient except​:

Answer 28

do not be​ judgmental; instead, show​ pity, because he needs to know that you understand him.

Question 29

Which of the following may cause a patient to exhibit abnormal​ behavior?

Answer 29

hypoxia

Question 30

Which combination of the following is most appropriate when assessing an emotionally disturbed​ patient?

Answer 30

Establish eye and verbal contact and listen to the patient without without being judgmental.

Question 31

When a person acts in a manner that is unacceptable to himself or those around​ him, this would be considered which of the​ following?

Answer 31

Behavioral emergency

Question 32

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?

Answer 32

Contact medical direction for further advice.

Question 33

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?

Answer 33

Never make eye contact with the​ patient, as it will just increase his nervousness.

Question 34

When managing a patient who may hurt himself or​ others, you should do all of the following except​:

Answer 34

make sure only you and the patient are in the room.

Question 35

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​?

Answer 35

After the impulse is​ transmitted, the neurotransmitter goes through a process called​ reuptake, in which the neurotransmitter is returned to the postsynaptic neuron.

Question 36

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?

Answer 36

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.

Question 37

Which of the following statements concerning people who have made prior suicide attempts is true​?

Answer 37

They are at an increased risk for a subsequent successful suicide.

Question 38

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?

Answer 38

Take the razor blade away from her by force.

Question 39

Which of the following is not an acceptable method or adjunct in restraining a​ patient?

Answer 39

​Hog-tying the patient

Question 40

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?

Answer 40

Attempt to determine whether there is a possible physical cause for the​ patient's behavior.

Question 41

Which of the following medical conditions could be the underlying cause of an apparent behavioral​ emergency?

Answer 41

A. Stroke B. Hypoglycemia C. Mental illness

Question 42

Which of the following does not indicate that a patient may be about to become​ violent?

Answer 42

Crying

Question 43

Concerning attempted​ suicide, which of the following statements is true​?

Answer 43

All suicide attempts must be taken seriously.

Question 44

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​?

Answer 44

Consider patients who are exhibiting crisis or unusual behavior to be having an altered mental status from a nonpsychiatric 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.

Question 45

When responding to an attempted​ suicide, which of the following is the​ EMT's primary​ concern?

Answer 45

personal safety

Question 46

Which of the following must be treated by the EMT if present in a patient with an apparent behavioral​ emergency?

Answer 46

hypoglycemia

Question 47

Which of the following traumatic conditions could account for signs and symptoms of a behavioral​ emergency?

Answer 47

Hemorrhage