Chapter 28 Psychiatric Emergencies Flashcards Preview

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Flashcards in Chapter 28 Psychiatric Emergencies Deck (80)
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1. Almost all disoriented behavior:
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.

Ans: B
Page: 1369
Type: General Knowledge


2. A psychiatric emergency:
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.

Ans: C
Page: 1369
Type: General Knowledge


3. A psychotic episode MOST often leads to violence because of:
A) exaggerated fear or paranoia.
B) overreaction of the paramedic.
C) the influence of an illicit drug.
D) the patient's family's reaction.

Ans: A
Page: 1369
Type: General Knowledge


4. Many EMS personnel may experience a lack of confidence in their ability to deal with emotional disturbances for all of the following reasons, EXCEPT:
A) the uncontrollable fear of personal injury.
B) the fact that they are action-oriented people.
C) they like to see tangible results of their actions.
D) their training only addresses such issues topically.

Ans: A
Page: 1369-1370
Type: General Knowledge


5. Organic brain syndrome is a term used to describe a condition in which a person's abnormal behavior is:
A) irreversible and cannot be linked to a physical abnormality or the influence of illicit substances.
B) caused by premature brain cell deterioration that is progressive and cannot be reversed.
C) directly related to an endocrine disturbance that results in the underproduction of key hormones.
D) caused by a physical illness or the influence of a substance that interferes with normal cerebral function.

Ans: D
Page: 1371
Type: General Knowledge


6. In contrast to dementia, delirium:
A) generally results from conditions such as Alzheimer disease.
B) is characterized by acute global impairment of cognitive function.
C) is an irreversible process caused by premature cerebral deterioration.
D) is a chronic process that causes deficits in memory and abstract thinking.

Ans: B
Page: 1383
Type: General Knowledge


7. Abnormal behavior that stems from a psychosocial etiology would MOST likely occur in a patient who:
A) is under severe stress caused by work.
B) resorts to alcohol to mitigate daily stress.
C) experienced emotional trauma as a child.
D) recently experienced the death of a loved one.

Ans: C
Page: 1371
Type: General Knowledge


8. Which of the following conditions would be the LEAST likely to produce psychotic symptoms?
A) Hyperglycemia
B) Closed head injury
C) Low cardiac output
D) Temporal lobe seizures

Ans: A
Page: 1371
Type: General Knowledge


9. Metabolic causes of abnormal behavior include:
A) diabetic ketoacidosis.
B) vitamin deficiencies.
C) thyroid hyperfunction.
D) amphetamine toxicity.

Ans: A
Page: 1371
Type: General Knowledge


10. A patient who is confused:
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.

Ans: D
Page: 1373
Type: General Knowledge


11. Disorders of thinking include all of the following, EXCEPT:
A) phobias.
B) anxiety.
C) delusions.
D) obsessions.

Ans: B
Page: 1373
Type: General Knowledge


12. A person who is neologistic:
A) repeats what he or she hears.
B) talks with grossly slurred speech.
C) invents words.
D) has accelerated or pressured speech.

Ans: C
Page: 1373
Type: General Knowledge


13. A confused, bedridden resident in a skilled nursing facility who tells you that he or she cooks dinner for the other residents each night:
A) is confabulating.
B) is experiencing delirium.
C) has a disorder of affect.
D) is experiencing echolalia.

Ans: A
Page: 1373
Type: General Knowledge


14. When extreme anxiety occurs in conjunction with restlessness, a patient:
A) becomes agitated.
B) is not distractible.
C) often becomes suicidal.
D) presents with a flat affect.

Ans: A
Page: 1373, 1387
Type: General Knowledge


15. Accelerated thinking in which the mind skips very rapidly from one thought to the next is called:
A) confabulation.
B) circumstantial thinking.
C) perseveration.
D) flight of ideas.

Ans: D
Page: 1373
Type: General Knowledge


16. Repetitive actions that are carried out to relieve the anxiety of obsessive thoughts are called:
A) perseverations.
B) compulsions.
C) stereotyped movements.
D) confabulations.

Ans: B
Page: 1373
Type: General Knowledge


17. A man who smiles pleasantly when he tells you of the recent death of his wife:
A) is thinking circumstantially.
B) has a disorder of perception.
C) has an inappropriate affect.
D) has delusions of persecution.

Ans: C
Page: 1373
Type: General Knowledge


18. When painful memories are repressed, __________ is impaired.
A) recall
B) retention
C) recognition
D) registration

Ans: A
Page: 1373
Type: General Knowledge


19. Which of the following statements regarding a person's intelligence is MOST correct?
A) All individuals possess the same basic level of intelligence.
B) A person with mental retardation has a disorder of intelligence.
C) Patients with Down syndrome typically lack basic intelligence.
D) Intelligence is generally a reflection of a person's past education.

Ans: B
Page: 1373-1373
Type: General Knowledge


20. When assessing a patient with a behavioral emergency, the MOST important assessment tool you have is:
A) your mind.
B) a penlight.
C) a glucometer.
D) cardiac monitoring.

Ans: A
Page: 1373-1373
Type: General Knowledge


21. At a minimum, you should be able to assess an emotionally disturbed patient's:
A) ability to recall.
B) blood pressure.
C) blood sugar level.
D) general appearance.

Ans: D
Page: 1374
Type: General Knowledge


22. When evaluating a patient with a behavioral emergency, virtually all of the diagnostic information you obtain must come from:
A) the medical history.
B) the patient's family members.
C) your conversation with the patient.
D) the patient's general mood and affect.

Ans: C
Page: 1376
Type: General Knowledge


23. If a patient with a behavioral emergency misperceives reality, you should:
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.

Ans: B
Page: 1377
Type: General Knowledge


24. When asking an emotionally disturbed patient a series of questions, you should:
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.

Ans: D
Page: 1377
Type: General Knowledge


25. Detecting disorders of perception is often difficult because:
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.

Ans: A
Page: 1376
Type: General Knowledge


26. Most psychotropic medications exert their therapeutic effects by:
A) inhibiting endocrine function.
B) suppressing cerebellar function.
C) targeting the autonomic nervous system.
D) enhancing the effects of the thyroid gland.

Ans: C
Page: 1391
Type: General Knowledge


27. Which of the following assessment findings is MOST suggestive of an organic cause of abnormal behavior?
A) Multiple tattoos
B) Unusual breath odor
C) Skin that is cool and dry
D) Auditory hallucinations

Ans: B
Page: 1376
Type: General Knowledge


28. Which of the following is NOT a general guideline to follow when caring for a patient with a psychiatric problem?
A) Be indirect when possible.
B) Provide honest reassurance.
C) Remain confident in your abilities.
D) Maintain a nonjudgmental attitude

Ans: A
Page: 1377-1378
Type: General Knowledge


29. 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?
A) Asking direct questions
B) Encouraging the patient to talk
C) Remaining calm and confident
D) Developing a definite plan

Ans: D
Page: 1378
Type: General Knowledge


30. Disorganization and disorientation:
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.

Ans: C
Page: 1382
Type: General Knowledge