behavioralflashcards.txt


You are called to the home of 28-year-old male who called 911 complaining of "a severe panic attack." When you arrive, he informs you that he has a history of panic attacks, and he is currently experiencing chest pain and a feeling of doom. The most appropriate action is to:


Assess the patient for signs of myocardial infarction and transport him to an emergency department


Your crew is called to the home of a 28-year-old male to check on his welfare after his neighbors called 911. They have not seen the patient for several days despite the fact that his car is in the driveway. When you arrive, a neighbor informs you that the patient has been very depressed since the loss of his fianc?e in an automobile crash that occurred while the patient was driving. You find the patient sitting in a chair in his bedroom. He informs you that he hasn't slept well in weeks because of nightmares. He expresses remorse and responsibility over the loss of his fianc?e, saying that it should have been he who died. He is most likely suffering from:


Posttraumatic syndrome


When the decision has been made to restrain a patient, you should exert:


Reasonable force


The mania phase of bipolar disorder is characterized by:


Excessive elation


Medication designed to treat schizophrenia includes antipsychotic drugs and agents that block the action of the brain chemical:


Dopamine


Another term for multiple personality disorder is:


Dissociative identity disorder


Your crew is called to the home of a 67-year-old male. The patient's wife tells you that her husband has progressively lost awareness of his surroundings and cannot recall recent events such as breakfast. These findings are indicative that this patient may be suffering from:


Dementia


You notice that your partner washes her hands five times after every patient contact. She realizes that washing them once thoroughly is sufficient, but says she feels the need to wash them again and again. This is an example of:


Obsessive-compulsive disorder


A behavioral emergency is best defined as a:


Change in mood or behavior that cannot be tolerated by the involved person or others


Your crew is called to the home of a 44-year-old male who is threatening suicide. Local law enforcement personnel are already on scene when you arrive, and you find the patient sitting on the hood of his car in the garage. During your interview of this patient, you should:


Try to ascertain whether the patient has a specific plan for the way he intends to commit suicide


Delirium and dementia are classified as:


Cognitive disorders


A dual diagnosis means a patient has a mental illness and a:


Substance-abuse disorder


Your crew is called to the home of a 44-year-old male who is threatening suicide. Local law enforcement personnel are already on scene when you arrive, and you find the patient sitting on the hood of his car in the garage. The patient informs you that he intends to put a garden hose in his car's exhaust, place the other end of the hose inside the vehicle, and sit in the vehicle with the windows up until he is dead. His detailed plan:


Increases the risk that he actually intends to commit suicide


A factitious disorder in which the patient makes habitual pleas for treatment and hospitalization for a symptomatic but imaginary acute illness is:


Munchausen syndrome


911 is called for a man who is sitting in his office after returning from a physical examination in which he was pronounced "in good health." Suddenly he experiences a feeling of terror. His heart pounds, he feels as though he cannot breathe, and he cannot focus on what is being said to him. This experience can be assessed as a possible


Panic attack


A patient is having a series of diagnostic tests. He insists there is nothing wrong with him except a chest cold that he can't "shake off." His wife says he smokes and coughs a lot, has lost 15 pounds, and is easily fatigued. What defense mechanism is he using?


Denial


Flashbacks are characteristic of


PTSD


A patient who is a veteran of the Gulf War has intrusive thoughts of missiles screaming toward her and exploding. She reexperiences feelings of terror. These recurrent events are part of


PTSD


You note that an elderly patient has fluctuating levels of awareness. She seems anxious. She tells you that she saw her granddaughter standing at the foot of the bed during the night. Later, you see her moving her hands as though picking things out of the air. You should suspect:


Delirium


Medication use can lead to confusion in older adults because


Metabolism slows as people age


Individuals with an acute onset of delusions or hallucinations who are agitated and hyperactive may be experiencing


Delirium


Depression in the elderly is


Common


Whixh of the following types of perceptual alteration is most commonly displayed by patients with schizophrenia?


Auditory hallucinations


A withdrawn patient exhibits peculiar gestures and facial contortions, but does not otherwise respond verbally. These symptoms are consistent with the schizophrenia subtype called


Catatonic


The patient is hostile, angry, and suspicious. He thinks that his family is trying to poison him. He is classified as being


Paranoid


Unlike dementia, delirium:


Is an abrupt disorientation of time and place


Statistically, which of the following is true regarding suicide?


Men commit suicide more often than women


Before physically restraining a violently combative patient, it is a good idea to:


Give the patient one last opportunity to comply willingly


Depression is characterized by an impairment of normal function and:


Is episodic, usually lasting longer than 1 month, with periods of remission


Before beginning a suicidal patient's interview, you should:


Assess for life-threatening injuries


Your crew is called to the home of a 28-year-old male to check on his welfare after his neighbors called 911. They have not seen the patient for several days despite the fact that his car is in the driveway. When you arrive, a neighbor informs you that the patient has been very depressed since the loss of his fianc?e in an automobile crash that occurred while the patient was driving. You find the patient sitting in a chair in his bedroom. He informs you that he hasn't slept well in weeks because of nightmares. He expresses remorse and responsibility over the loss of his fianc?e, saying that it should have been he who died. He is most likely suffering from:


Posttraumatic syndrome


Your crew is called to the home of a 34-year-old female for a nonspecific abdominal complaint. She informs you that she has had many abdominal surgeries that have not resolved her complaints. Which of the following disorders is a condition in which an individual has complaints (lasting several years) of various physical problems for which no physical cause can be found?


Somatization disorder


Which of the following is true regarding schizophrenic patients' ability to function in society?


If they are compliant with their medications, schizophrenics may function quite well


Two paramedics were considered for promotion. The promotion was announced via a memo on the station bulletin board. The paramedic who was not promoted told another friend, "I knew I'd never get the job. The medical director hates me." If he actually believes this of the medical director (who in reality knows little of him) he is demonstrating


Projection


A patient tells you that he experiences palpitations, difficulty breathing, and a sense of overwhelming dread whenever he goes out of his home. He has been unable to go to his office for over a month. You recognizes this problem as


Agoraphobia


A paramedic who recently unsuccessfully worked a cardiac arrest patient is being interviewed by the medical director. He blames the loss on his partner, saying, "she is not competent in giving CPR." The paramedic may be using this defense mechanism:


Rationalization


An elderly female patient, age 72, lives alone. Her daughter visits weekly. The patient takes digoxin, hydrochlorothiazide, and an antihypertensive drug. She also has a prescription for diazepam (Valium) to be used for moderate to severe anxiety. When the daughter visited today she found her mother confused. Her speech was thick and slurred and she had an unsteady gait. You have assessed the patient as having several cognitive problems, including memory and attention deficits, and fluctuating levels of orientation. You confirms that the patient's symptoms developed over a 2-day period. The patient's symptoms are most characteristic of


Delirium


Severe, prolonged depression affects a person's risk for suicide by _________ the risk.


Increasing


A patient with schizophrenia believes that he is a Presidential aide. He has expressed fear that hostile forces are looking for him. He carries a sheaf of papers and writes notes in "code." The patient can be assessed as demonstrating


Grandiose and paranoid delusions


A patient displays disorganized, difficult to understand speech, behavioral disorganization, and a silly, inappropriate affect. The paramedic assesses that this patient's behavior most closely conforms to the characteristic behavior of


Disorganized schizophrenia


A schizophrenic patient approaches you and says, "The voices are bothering me. They're yelling and telling me I'm bad. Can't you hear them?" The most helpful reply for you to make would be


"I can't hear the voices, but I can see that you're upset."


While you are gathering a medical history, your patient reports that she takes Zoloft, leading you to ask whether the patient has a history of:


Depression


You are called to treat a 23-year-old woman who reports sudden paralysis of her arm. She states she has no feeling in or ability to move her arm. Last week this same patient was treated for sudden blindness. The patient was recently the victim of a violent crime. You suspect:


Conversion disorder


Your crew is called to the workplace of a 43-year-old female who is despondent. Her coworkers inform you that she is normally a very "bizarre" person and has acted out inappropriately in the past. They further inform you that the patient has been muttering to herself all morning and shouting at inanimate objects (walls, coffee maker, toilets, etc.). The patient explains her current dilemma. In doing so, she exhibits an abnormal thought process, inappropriate judgment, and delusions. She further informs you that she is hearing voices. These findings are all hallmark symptoms of:


Schizophrenia


Your crew is called to the workplace of a 43-year-old female who is despondent. Her coworkers inform you that she is normally a very "bizarre" person and has acted out inappropriately in the past. They further inform you that the patient has been muttering to herself all morning and shouting at inanimate objects (walls, coffee maker, toilets, etc.). After responding to a few of your questions, the patient becomes verbally abusive. To mitigate the situation, your proper response should be to:


Not respond to the anger, but continue with a calm tone and demeanor


One particular manifestation of depression is the inability to derive pleasure from events or experiences that ordinarily are pleasurable. This is referred to as:


Anhedonia


Typical causes of behavioral emergencies include:


Biological, psychosocial, and sociocultural causes


What is the minimum number of capable individuals necessary to restrain a physically violent patient?


Four


The DSM-IV is a(n):


Classification system for psychiatric disorders


Two paramedics were considered for promotion. The promotion was announced via a memo on the station bulletin board. The paramedic who was not promoted told a friend, "Oh, well, I really didn't want the job anyway." This is an example of


DenialCompensationRationalization


An elderly man presents with symptoms of delirium. The family states that he has not seemed ill and has not changed anything about his usual lifestyle. The most important data to obtain would be


A list of medications he takes


A depressed patient tells you during transport, "The night is blackest before the dawn. Things will be better soon." You wonders if the patient is alluding to making a suicide attempt. You should


Ask the patient if he or she is having suicidal thoughts


A homeless individual is found by police trying to break down a door of a storefront mental health clinic. His explanation was, "The sign said 'mental health' and I need some." The police think that his symptoms of mental illness have recently worsened. Which of the following should the paramedic make it a priority to learn about?


Medication adherence


The paramedic observes a patient in a restaurant sitting alone. He covers his ears and loudly commands, "You leave me alone. Stop calling me humpty dumpty." It is assumed that the patient is


Experiencing auditory hallucinations


Your crew is called to a local high school for a 14-year-old female who has passed out in the restroom. Her teacher secretly informs you that the patient is known to follow eating binges with purging using the assistance of laxatives. She is very frail. These are classic findings associated with:


Bulimia nervosa


What is a common misconception about schizophrenia?


Schizophrenia is often confused with multiple personality disorder


You are called to the home of a 27-year-old male who refuses to come out of his bathroom. Through the door, he explains that he saw a large spider on the wall of his bedroom and is deathly afraid of spiders. He ran in the bathroom, stuffed a towel under the door, and got in the bathtub. The patient most likely:


Is aware that his fear is unreasonable


You are called to the home of a 27-year-old male who refuses to come out of his bathroom. Through the door, he explains that he saw a large spider on the wall of his bedroom and is deathly afraid of spiders. He ran in the bathroom, stuffed a towel under the door, and got in the bathtub. When coaxing the patient out of the bathroom, your actions should include:


Explaining exactly what your intentions are, step by step


A paramedic student has to perform a scenario in front of the class. As the time draws near, he begins to feel lightheaded, his heart begins to race, he feels short of breath, and he is afraid of losing control. The student is experiencing a(n)


Panic attack


The patient is unable to leave the house without turning off all electrical appliances at least 3 times. She must check every electrical socket and reassure herself that everything is unplugged before she leaves. Otherwise she experiences intense discomfort. The patient's behavior is suggestive of


OCD


911 is called for a man who is sitting in his office after returning from a physical examination in which he was pronounced "in good health." Suddenly he experiences a feeling of terror. His heart pounds, he feels as though he cannot breathe, and he cannot focus on what is being said to him. This experience can be assessed as a possible


Panic attack


The nurse on night shift during a transfer tells you that a patient with dementia "gets flakier in the evening." meaning that the patient becomes more agitated and anxious and minimally responds. You can assume that this behavior represents:


Sundowning


A patient has fluctuating levels of consciousness, disturbed orientation, and perceptual alterations. An important facet of care enroute to the hospital will be


Careful observation and supervision


You are transporting an elderly woman is to a hospital from an assisted care facility with a diagnosis of delirium secondary to a urinary tract infection. The family is very concerned with whether she will return to her old self. The best information that you can provide is:


Your mother's mental symptoms will probably get better as we treat her infection


The patient lives his life rapidly bouncing from feelings of deep sadness to great joy. The patient's diagnosis is most likely


Bipolar disorder


The paramedic should focus assessment for a patient with schizophrenia primarily on gathering data about


Perceptual alterations


The kind of disorder diagnosed when a person's anxiety is broad, long lasting, and excessive is called


Generalized anxiety disorder


Which piece of subjective data obtained during your psychiatric assessment of a patient may indicate the possibility of posttraumatic stress disorder?


"I keep having nightmare involving the rape."


A prolonged emotional state that influences one's personality and life functioning is for greater than one month is called


Mood


Expressing one's own feelings about another person's problem is known as:


Sympathy


An open-ended question:


Is asked in a narrative form and encourages the patient to talk


A paramedic dealing with a patient who is acting out should:


Restate the cause of anger


Placing a message in an understandable format (either written or verbal) is called:


Encoding


In the mnemonic memory device SAMPLE, the M stands for _____


Medications


One component of a patient's past medical history would include:


Surgeries


Using the results of questions to think about associated problems and body system changes related to the patient's complaint is known as:


Clinical reasoning


The SOAP acronym is used as a memory aid for:


Organizing written and verbal reports


The "echo" procedure for communications:


Means to repeat directions received from the dispatcher or orders received from a physician


In a call-prioritization-prearrival instructions system, the emergency medical dispatcher:


Determines what type of assistance is needed for an emergency call


Refusal or failure to fulfill obligations to a person is called:


Neglect


Male victims of battering:


Account for about 5% of reported incidents of domestic violence


Which of the following is a true statement?


Rape is a crime of violence, motivated by the desire for power


Elder abuse is most commonly inflicted by:


Adult children of the victims


Sensorineural deafness:


May occur later in life because of prolonged exposure to loud noises


The most common form of emotional/mental impairment is:


Mild impairment: IQ of 50 to 70


Patients with severe hearing loss may also have associated:


Voice production


You are transferring a patient to convalescent care following a stroke. The patient is aphasic. You should also expect that the patient will exhibit:


Difficulty in comprehending speech


Duchenne's muscular dystrophy affects only:


Males


Dispatch informs you that you are responding to a medical call involving a patient with Down syndrome. You know that Down syndrome results from:


Chromosomal abnormality


You are evaluating an 80-year-old man who presents with cyanosis, wheezing, and diminished breath sounds. He has JVD and low pulse oximetry readings. He has smoked cigarettes for 60 years and has recently had an upper respiratory tract infection. You suspect he may have:


COPD


The most common type of diabetes in elderly patients who are overweight is:


Type 2 non-insulin-dependent


An elderly patient will succumb more quickly to shock resulting from trauma because of:


Less cardiac reserve


An 86-year-old is being transported for sudden onset of a rapid, irregular rhythm. Which rhythm is most likely?


Atrial fibrillation


The most common complaint of patients over 70 years of age experiencing an MI is:


Dyspnea


Communication that facilitates improved patient care, prevents escalation of potentially violent situations, and reduces the risk of litigation is known as:


Therapeutic communication


A patient's "private space" is:


Culturally defined


A paramedic who is skilled and thorough in interviewing patients will always:


View each patient as a unique individual with his or her own set of needs and concerns


Asking a patient with abdominal pain about his or her last bowel movement helps the paramedic to determine the patient's:


Current health status


What does the letter Q represent in the mnemonic memory device OPQRST?


Quality


The chief complaint is best derived from:


The patient, either verbally or nonverbally


In a call-prioritization-prearrival instructions system, the emergency medical dispatcher:


Determines what type of assistance is needed for an emergency call


A device that retransmits a signal at a higher power on another frequency to increase coverage is called a(n):


Repeater


If any form of abuse or neglect is suspected by the paramedic team, it must:


Document findings factually and provide details about the injuries in written documentation


The most common type of injury seen in child abuse is:


Soft tissue injury


Domestic violence against women:


Is the leading cause of injury to women between the ages of 15 and 44


The most common type of child abuse is:


Neglect


Patients with severe hearing loss may also have associated:


Voice production


You are treating an unresponsive cancer patient with a ventilatory rate of 4 and pinpoint pupils. How should you treat this patient?


Administer 0.4 mg naloxone SIVP


Which of the following types of deafness may be curable?


Conductive deafness


You are dispatched to the home of an 86-year-old male in the final stages of terminal lung cancer. His daughter called because of the patient's increasing distress over the past 3 days. He is alert and answers questions slowly but appropriately, although with much discomfort. He is prescribed oral narcotics to deal with the pain, and a Prehospital Medical Care Directive is properly filled out, indicating the patient's desire for no resuscitative measures when he dies. His daughter would like him transported to the hospital. The patient is alert and oriented and is refusing care and transport. You should:


Refer the patient to a hospice center and inform the daughter that the patient is legally allowed to refuse treatment and transportation


Which of the following complications is associated with Duchenne's muscular dystrophy?


Chronic lung infections and congestive heart failure typically lead to death during the teenage years


A 79-year-old patient presents with orthopnea, a dry hacking cough, nocturia, and ascites. You suspect the patient is experiencing:


Heart failure


Mortality rates due to acute myocardial infarction (AMI) after the age of 70:


Doubles


Changes in the cardiovascular system are normally associated with:


Atherosclerotic coronary artery disease


Physiological factors that contribute to a geriatric patient?s developing hypothermia include:


Decreased ability to sense changes in ambient temperatures


Shifting focus is a technique employed by:


Paramedics to ask about a sensitive problem in an indirect way


As a rule, a receiver is more likely to understand a message if it is:


Clear, organized, and include verbal and nonverbal communication


You are on the scene of a motor vehicle crash and you are told that the occupants of one of the cars are Native Americans. While talking to the patients, you notice that they will not look you directly in the eye. You recognize this as:


A cultural difference expressed by these patients


What is an example of an open-ended question about pain?


?What is the pain like??


The question ?What makes your pain better?? is aimed at addressing which part of the OPQRST assessment?


P


The governmental agency responsible for regulating communications as well as for establishing and enforcing communications rules and guidelines is the:


Federal Communications Commission


Which of the following is a role of an emergency medical dispatcher?


Receive and process calls for EMS assistance


Infliction of anguish, pain, or distress through verbal or nonverbal acts is:


Emotional abuse


Male victims of battering:


Account for about 5% of reported incidents of domestic violence


The most common type of child abuse is:


Neglect


Cystic fibrosis is a disease that affects primarily the:


Lungs


You are transferring a patient to convalescent care following a stroke. The patient is aphasic. You should also expect that the patient will exhibit:


Difficulty in comprehending speech


You are preparing to transport a clinically obese patient to the emergency department for severe substernal chest pain. The patient weighs more than 500 pounds and is on the third floor of an apartment complex with no elevator. Currently, there are only you and your partner in the apartment. The patient states that he can walk and doesn?t want you to call for extra lift assistance. You should:


Request as much additional help as is necessary to move the patient


Spina bifida patients have an increased likelihood for allergy to:


Latex


The most common reason elderly patients are at risk for adverse drug reactions is because of:


Age-related alterations in body composition and drug distribution


Although all body systems are affected by the aging process, its effects on specific organ systems are particularly relevant to older adults; these systems are:


The respiratory, cardiovascular, renal, nervous, and musculoskeletal


In elderly patients, thoracic aneurysm:


Is commonly caused by atherosclerotic disease


The most common dysrhythmia experienced by older adults is:


Atrial fibrillation


A paramedic dealing with a patient who is acting out should:


Restate the cause of anger


A patient smiles when a paramedic tells her that she will be receiving medication to ease her pain. The patient?s smile is nonverbal:


Feedback


A communication technique in which the paramedic must help the patient identify irrational thoughts or behavior, particularly if the patient is "acting out," is called:


Distraction


What is an example of "false reassurance"?


"Everything is going to be okay."


A reported diagnosis of psychiatric illness would most accurately be documented by the paramedic as part of the patient's:


Significant past medical history


Which of the following techniques aids EMS providers in efficient communications?


Using clear English when communicating


You are dispatched to a sexual assault. The victim exhibits petechiae of the face and conjunctiva. This would be indicative of:


Choking of the victim


A major factor in the likelihood of child abuse is:


Living in a home where spouse or partner abuse occurs


The form of child abuse most commonly attributed to female perpetrators is:


Neglect


You are dispatched to the home of a 42-year-old male who complains of diarrhea for the past 3 days. He has been unable to eat for the past 24 hours and would like to go to the emergency department. He is visually impaired by complete blindness and has a leader/work dog to assist him. The patient informs you that he needs to have his dog with him. You should:


Allow the dog to accompany the patient in the ambulance and to the hospital


Cerebral palsy (CP) is often diagnosed during a child's first year of life after a history of unusual muscle tone and/or poor feeding habits. What is the most common cause of this disease?


The most common cause of CP is abnormal cerebral development (cerebral dysgenesis)


Stuttering is an example of which type of speech disorder?


Fluency


Duchenne's muscular dystrophy affects only:


Males


You are called to a local elementary school for a special-needs 9-year-old male with an unknown medical problem. The school nurse informs you that the patient suffered some neurological impairment as the result of a head injury when involved in a motor vehicle collision (approximately 2 years ago). The patient's 12-year-old sister is present and tells you that the patient has been vomiting all morning. While treating this patient, you observe that he overreacts to minor stimuli such as a penlight. He alternates between being profoundly agitated and periods of sleepiness and lethargy. To assess this patient's mental status, you should:


Ask the patient's sister about his normal mental status


Talking with a geriatric patient can be enhanced by:


Speaking slowly, distinctly, and respectfully


You are called to the home of a 75-year-old male. Neighbors tell you that the patient has been confused, hostile, anorexic, and depressed and has been falling frequently. You suspect that the patient may be abusing:


Alcohol


Most suicide attempts by older adults include:


Firearms


Decreases in renal function, combined with other physiological changes, make older people more susceptible than young adults to:


Drug toxicities


A patient who does not want to provide the paramedic with any personal information because he or she is afraid of rejection or ridicule is using the technique of:


Resistance


Which of the following techniques enhances radio communications?


Confirm that the receiving party has received the message


You are en route to the hospital with a 53-year-old victim of a shooting. After relaying patient information and, with medical direction, developing a treatment plan for this patient, the patient's condition suddenly deteriorates. After stabilizing the patient, your next course of action should be to:


Advise medical direction of the change in the patient's condition


You are called to a group home for a 50-year-old woman who has a debilitating mental illness. Her caregivers say that she has been complaining of chest pain and difficulty breathing. When evaluating this patient, you should:


Treat the patient?s chest pain and dyspnea according to standard protocol


A woman loses 3 inches in height as she ages. This is:


A normal age-related phenomenon


The lowest blood pressure that can be defined as hypertension is:


140/90 mm Hg


Bacterial pneumonia in elderly patients presents with:


Few or no signs and symptoms common to the clinical picture seen in younger patients


The desertion of an elder at a hospital is a form of:


Abuse


As an individual approaches the age of 65:


Lean body mass decreases and fat tissue increases