Question 1

Which of the following statements regarding behavioral emergencies is NOT true?

Accepted Answer

It is not unusual to find a person with schizophrenia outside a mental health facility. Many people with schizophrenia can live relatively normal lives with appropriate treatment and support.

Question 2

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

Accepted Answer

Ensuring only you and the patient are in the room is not advisable when managing a potentially violent patient. It's important to have support available for safety reasons. Keeping bystanders away, watching for sudden behavior changes, and retreating if threatened are all appropriate safety measures.

Question 3

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

Accepted Answer

Hypoxia, or lack of oxygen to the brain, can cause abnormal behavior such as confusion, agitation, and even hallucinations. Allergic reactions, gastroenteritis, and snakebites may cause physical symptoms but may not necessarily cause abnormal behavior.

Question 4

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

Accepted Answer

The most appropriate action for the EMT to take when managing a patient with a behavioral emergency is to remain calm and reassure the patient. Establishing control of the situation by force can escalate the situation, and performing a head-to-toe exam and transport without delay may not be possible or safe until the patient is calmed down. Checking the patient's insurance coverage is not a priority during the acute phase of a behavioral emergency.

Question 5

It is often difficult to distinguish a true medical emergency from a psychiatric emergency.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 also likely cause this behavior?

Accepted Answer

The symptoms described could indicate a head injury, which can cause personality changes, altered mental status, confusion, and irregular respirations. It is important to rule out any potential medical causes before assuming it is solely a psychiatric emergency.

Question 6

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

Accepted Answer

Acknowledging the patient's feelings can help de-escalate the situation and show empathy towards the patient. A and B are not recommended as they can make the patient feel uncomfortable and may escalate the situation. Option C is inappropriate as it implies that the patient has no control over his behavior which can be perceived as insensitive.

Question 7

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

Accepted Answer

All of the conditions listed (mental illness, stroke, and hypoglycemia) can cause symptoms that mimic a behavioral emergency. For example, a person with a stroke may suddenly become confused, agitated, or combative. Similarly, a person with low blood sugar levels due to hypoglycemia may experience disorientation or even loss of consciousness, which can lead to behaviors that appear erratic or alarming. Additionally, individuals with certain mental illnesses may exhibit challenging behaviors that require intervention. Therefore, it is important to consider medical conditions as a potential underlying cause of behavioral emergencies and to seek appropriate medical assessment and treatment as needed.

Question 8

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:

Accepted Answer

The behavior described is consistent with a state of excited delirium, which is often associated with drug use and can include symptoms such as aggression, increased strength, and insensitivity to pain.

Question 9

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

Accepted Answer

Hurrying in a psychiatric emergency can increase the patient's anxiety level and potentially escalate the situation. It is important to approach the situation calmly and with patience.

Question 10

Which of the following statements concerning behavioral emergencies is true?

Accepted Answer

Behavioral emergencies are situations where an individual's behavior is so abnormal that it causes alarm or poses a danger to themselves or others. The difficulty in determining what constitutes abnormal behavior for a specific individual in a specific context is true because behavior can be influenced by a wide range of factors, including cultural norms, personal experiences, and the situation at hand. Not all emotional outbursts are considered behavioral emergencies, not all individuals experiencing a behavioral emergency require prolonged institutionalization, and not all are mentally ill, making D the correct choice.

Question 11

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?

Accepted Answer

The patient's sudden change in behavior, along with her physical symptoms of pallor and diaphoresis, suggest an underlying physical illness may be present. Further evaluation and medical intervention may be required. The other options (alcoholic intoxication, sudden onset of schizophrenia, and alcohol withdrawal) may also cause behavioral changes but do not necessarily explain the physical symptoms.

Question 12

Which of the following findings would be helpful in differentiating between a closed head injury and a behavioral emergency?

Accepted Answer

Unequal pupils can be a sign of a closed head injury, while the other options are common findings in both closed head injuries and behavioral emergencies.

Question 13

It can sometimes be difficult to determine whether someone who is showing unusual behavior is having a psychological emergency or is showing an altered level of consciousness due to a physical issue.Which of the following statements are true?
1)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.

Accepted Answer

All statements are true. It's important to consider nonpsychiatric causes for altered mental status, as many medical and traumatic conditions can alter behavior. Lack of oxygen and inadequate blood flow to the brain are specific examples of physical issues that can cause symptoms similar to those seen in psychiatric emergencies.

Question 14

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

Accepted Answer

Acting in an unacceptable manner can indicate a behavioral emergency, which may involve a person who is a danger to themselves or others, or who has lost touch with reality. It may not necessarily indicate a mental illness or psychosomatic reaction, and may not always involve a psychotic episode.

Question 15

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

Accepted Answer

Making supportive statements validates the patient's feelings and shows that you are listening and empathetic towards their situation.

Answer: B 
 Sitting close to the patient can help establish trust and a rapport with the patient, but also allows for immediate intervention if necessary.

Answer: C 
 It is not recommended to allow family members to confront the patient, as this can escalate the situation and make it more difficult to manage.

Answer: D 
 Going along with the patient's hallucinations or false beliefs can further exacerbate the situation and may not be helpful in treating the underlying issue. It is important to be honest with the patient and offer alternative explanations or options for care.

Question 16

EMTs may come across a situation where a patient begins to act extremely agitated or psychotic.Elevated temperature and sometimes alcohol or drug intoxication may be present.The patient will soon 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:

Accepted Answer

The described condition is excited or agitated delirium, which can be characterized by extreme agitation, psychosis, and potentially lethal physiological changes. It is important for EMTs to recognize the signs and monitor the patient closely. The other options, psychotic delirium, excited psychosis, and bipolar disorder, do not fully match the described condition.

Question 17

There are general rules when dealing with psychiatric emergencies.Which of the following is NOT one of those rules and would be considered inappropriate?

Accepted Answer

Making eye contact is important in establishing a connection with the patient and showing that you are present and attentive. Avoiding eye contact can make the patient feel ignored or insignificant.

Question 18

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

Accepted Answer

Internal hemorrhage can lead to signs and symptoms of a behavioral emergency due to hypoperfusion and the potential for altered mental status. Other options, while serious, are less likely to directly cause behavioral emergencies.

Question 19

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?

Accepted Answer

Fear, anger or grief displayed by a patient or bystander at the scene of an emergency best describes a stress reaction. This is a common and normal reaction to a traumatic event and is a part of the body's natural response to stress. Neurosis refers to a type of mental disorder characterized by anxiety and obsessive behavior. Post-traumatic stress disorder (PTSD) is a condition that develops in some people who have experienced a shocking, scary, or dangerous event, and is characterized by intrusive memories and avoidance behaviors. Catharsis refers to the emotional release or discharge that occurs when repressed emotions are brought to consciousness and expressed.

Question 20

Which one of the following statements is NOT true?

Accepted Answer

It is not true that it is very unusual for an EMT to be called for a psychiatric emergency. EMTs are often called to respond to psychiatric emergencies, such as suicide attempts or acute psychosis.

Quiz 23: Behavioral and Psychiatric Emergencies and Suicide