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:
A. request that the police officers arrest him and take him to the hospital.
B. approach the patient and calm him by placing your hand on his shoulder.
C. restrain the patient with appropriate force in order to treat his injuries. Correct
D. try to gain the patient's trust by telling him that you see the vampires too.
A 40-year-old male 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 it. You should:
A. approach the patient with caution.
B. calmly identify yourself to the patient. Correct
C. tell the patient that you want to help.
D. quickly tend to the bleeding wound.
A behavioral crisis interferes with which of the following?
A. Activities of daily living
B. Behavior that is acceptable to the community
C. Dressing, eating, or bathing
D. All of these answers are correct. Correct
A general impression of the patient is formed by an EMT:
A. at a distance when the patient is first seen. Correct
B. when the patient is in the ambulance.
C. speaking privately with the patient.
D. speaking with family members or bystanders first
Everyone exhibits some signs and symptoms of mental illness at some point in life ____________.
A. but that does not mean a person is mentally ill Correct
B. and needs medication administered to control them
C. because mental illness affects everyone
D. and should be physically restrained for their own safety and the safety of the EMT
From a mental health standpoint, an abnormal or disturbing pattern of behavior is a matter of concern if it lasts for at least:
A. 1 week.
B. 1 month. Correct
C. 2 weeks.
D. 3 weeks.
Signs of excited delirium include:
A. subdued behavior, crying, and suicidal thoughts.
B. diaphoresis, tachycardia, and hallucinations. Correct
C. slurred speech, bradycardia, and a high fever.
D. pallor, hypotension, and constricted pupils.
The two basic categories of diagnosis that a physician will use for behavioral crises or psychiatric emergencies are ____________.
A. organic brain syndrome and altered mental status
B. functional and nonfunctional
C. physical and psychological Correct
D. All of these answers are correct.
What is the most common misconception surrounding mental illness?
A. Feeling "bad" or "depressed" means that you must be "sick." Correct
B. Many mental illnesses stem from drug or alcohol abuse.
C. Everyone has some form of mental illness.
D. All persons with mental disorders are physically violent and dangerous.
When a psychiatric emergency arises, a patient is most likely to exhibit which of the following behaviors?
A. Visual or auditory hallucinations
B. Any behaviors that are a violent threat to the patient, EMTs, or others Correct
C. Any behaviors unacceptable to the patient, family, or community
D. Disruptions to activities of daily living
When caring for a patient experiencing excited delirium, the EMT should remember that:
A. most patients will have low blood pressure and hyperglycemia.
B. sudden death can occur if the patient's violence is not controlled. Correct
C. excited delirium is worsened by nervous system depressant drugs.
D. lights and siren are effective in redirecting the patient's behavior.
Which of the following is a good guideline for physical examination of any patient?
A. Examine extremities first.
B. Avoid touching without permission. Correct
C. Complete the physical exam first, then check the ABCs.
D. Always work toe-to-head.
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 who is depressed and no longer caring for himself
C. A person who is experiencing a panic attack
D. A person violently attacking family members Correct
Which of the following is considered an organic brain syndrome?
A. Schizophrenia
B. Depression
C. Anxiety conditions
D. Alzheimer dementia Correct
Which of the following terms applies to a state of delusion in which the patient is out of touch with reality?
A. Psychosis Correct
B. Suicidal
C. Schizophrenia
D. Agitated delirium
Why might EMTs encounter a larger proportion of violent patients than the population at large?
A. EMTs respond to patients who, by definition, are having an emergency. Correct
B. EMTs respond with law enforcement.
C. It is a common misperception; EMTs do NOT encounter a larger proportion of violent patients than the population at large.
D. EMTs have to restrain patients.
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?
A. Encourage the patient to remain quiet during transport.
B. Have law enforcement place her in protective custody.
C. Leave the scene and have a neighbor check in on her.
D. Ask the patient if she has developed a suicidal plan. Correct
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 hospital for treatment. Based on this information, you should:
A. stay with the patient while you arrange for other transport options as a potentially life-threatening emergency exists. Correct
B. ensure that the patient is competent and completes the required documentation, and leave her in the care of her family.
C. restrain the patient and transport her to the hospital as she represents a threat to her safety.
D. call for the police to attend the scene and, once they arrive, release responsibility for patient transport to them
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:
A. Have you ever been diagnosed with PTSD?
B. Were you shot at or under fire? Correct
C. Were you in combat?
D. Can you tell me about your experience?
You receive a call for a domestic dispute. When you arrive at the scene, you find 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?
A. His shouting of obscenities
B. His large body size Correct
C. His clenched fists
D. The broken window
