Chapter 22 Psychiatric Emergencies

During a psychiatric emergency, the EMT should be able to ____________.
predict whether the patient will become violent

Which of the following might help the EMT differentiate between “normal” depression and mental illness?
The amount of time that the patient remains feeling “blue”

Patients with mental health disorders are often ____________.
misunderstood

A person’s response to their environment is defined as ____________.
behavior

A chronic feeling of sadness or despair is defined as:
depression.

A disorder in which the abnormal operation of an organ cannot be traced to an obvious change in the structure or physiology of the organ system is called ____________.
a functional disorder

Which of the following is an example of a psychiatric disorder?
Depression

Which of the following considerations is the most important for the EMT during the scene size-up step of managing a psychiatric emergency?
Do you need to call for law enforcement as additional resources?

When investigating the chief complaint of a psychiatric emergency, the EMT should attempt to determine which of the following?
Are psychogenic circumstances or illnesses involved?

Are hallucinogens or other drugs or alcohol a factor?

Is the patient’s central nervous system functioning properly?

All of these answers are correct.******

When responding to a psychiatric emergency, it is recommended that the EMT obtain vital signs ____________.
only when doing so will not exacerbate the patient’s distress

Any attempt to physically restrain a patient should involve ____________.
law enforcement

The term “behavioral crisis” is MOST accurately defined as:
any reaction that interferes with activities of daily living or is deemed unacceptable by others.

When assessing a patient who is displaying bizarre behavior, the EMT should:
consider that an acute medical illness may be causing the patient’s behavior.

A 78-year-old female presents with an acute change in her behavior. The patient’s son tells you that his mother has type 2 diabetes and was diagnosed with Alzheimer disease 6 months ago. The patient’s speech is slurred and she is not alert to her surroundings. You should:
inquire about the possibility of head trauma.

Common causes of acute psychotic behavior include all of the following, EXCEPT:
Alzheimer disease.

It is MOST important for the EMT to remember that suicidal patients may:
be homicidal as well.

Law enforcement personnel request your assistance for a 30-year-old man whom they pulled over for erratic driving. The patient became acutely violent while he was being questioned, which required one of the officers to subdue him with a Taser. When you arrive and assess the patient, you find that he is very agitated and is experiencing apparent hallucinations. His skin is flushed and diaphoretic. You should:
limit physical contact with the patient as much as possible and avoid interrupting him if he is attempting to communicate with you.

In which position should you restrain a physically uncooperative patient?
Lateral decubitus

You are attending to a 24-year-old male patient who is delusional. His family tells you that his hallucinations started as a teenager and have gotten progressively worse over time. The patient is difficult to communicate with because his speech is erratic and he appears to have his own rules of logic. Based on this information, the patient is most likely suffering from:
schizophrenia.

The mental health care system in the United States functions on several levels. For patients with clinical depression, care is most often provided by:
a psychologist.

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:
restrain the patient with appropriate force in order to treat his injuries.

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:
calmly identify yourself to the patient.

A behavioral crisis interferes with which of the following?Select one:
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.
D. All of these answers are correct.

A general impression of the patient is formed by an EMT:
at a distance when the patient is first seen.

Everyone exhibits some signs and symptoms of mental illness at some point in life ____________.
but that does not mean a person is mentally ill

From a mental health standpoint, an abnormal or disturbing pattern of behavior is a matter of concern if it lasts for at least:
1 month.

Signs of excited delirium include:
diaphoresis, tachycardia, and hallucinations.

The two basic categories of diagnosis that a physician will use for behavioral crises or psychiatric emergencies are ____________.
physical and psychological

What is the most common misconception surrounding mental illness?
Feeling “bad” or “depressed” means that you must be “sick.”

When a psychiatric emergency arises, a patient is most likely to exhibit which of the following behaviors?
Any behaviors that are a violent threat to the patient, EMTs, or others

When caring for a patient experiencing excited delirium, the EMT should remember that:
sudden death can occur if the patient’s violence is not controlled.

Which of the following is a good guideline for physical examination of any patient?
Avoid touching without permission.

Which of the following is an example of a psychiatric emergency?
A person violently attacking family members

Which of the following is considered an organic brain syndrome?
Alzheimer dementia

Which of the following terms applies to a state of delusion in which the patient is out of touch with reality?
Psychosis

Why might EMTs encounter a larger proportion of violent patients than the population at large?
EMTs respond to patients who, by definition, are having an emergency.

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?
Ask the patient if she has developed a suicidal plan.

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:
stay with the patient while you arrange for other transport options as a potentially life-threatening emergency exists.

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:
Were you shot at or under fire?

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?
His large body size

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