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1.

When assessing a patient with a behavioral crisis, the EMT-B must be


concerned with:
A: gathering all the patient's belongings and taking them to the
hospital.
B: letting the patient express himself to you in his own words.

C: setting your personal feelings aside and providing needed care.

D: whether or not the patient will cause harm to you or your partner.

2. When you are dealing with an emotionally disturbed patient, the best
legal situation is to:
A: always transport the patient with restraints.

B: try to obtain the patient's consent to medical treatment.

C: have law enforcement restrain the patient with police-type


handcuffs.
D: allow the patient to refuse treatment when the patient presents a
threat to self or others.

3. As you are assessing a deeply unconscious patient suspected of


being acutely intoxicated with alcohol, you note that the patient has a
.22 caliber handgun tucked in his boot. The police department is not
on the scene yet. How should this matter be handled?
A: Continue your assessment because the patient is unconscious.

B: Remove the gun and give it to a family member, then continue


assessing.
C: Secure the gun and turn it over to the emergency department
physician.
D: Ensure that the weapon is turned over to law enforcement upon
their arrival.

4. You respond to the scene where a patient states, "the Russians are
after me." The patient is conscious and alert to his surroundings, and
his vital signs are stable. The patient states that he does not need to
go to the hospital because he is not sick. The MOST appropriate
action for the EMT-B in this case should be to:
A: restrain the patient and transport, because he is clearly
delusional.
B: request the assistance of law enforcement personnel.

C: obtain permission from medical control to transport.

D: have the patient committed to a psychiatric facility.


5. After you restrain a patient, which of the following information does
NOT need to be documented?
A: The reason for the restraint

B: The technique that was used

C: The patient's abnormal behavior

D: A listing of the patient's personal belongings

6. General safety guidelines to follow when managing a patient with a


behavioral emergency include all of the following, EXCEPT:
A: having a definite plan of action.

B: being honest and reassuring.

C: rapidly transporting the patient.

D: avoiding a fight with the patient.

7. When it becomes necessary to restrain a patient, which of the


following factors is NOT typically a consideration during the restraining
process?
A: The patient's gender

B: The patient's age

C: The medical history of the patient

D: The mental status of the patient

8. You are called to a residence to care for a man who is having a


psychiatric crisis. When you arrive, a police officer at the scene tells
you that the man is conscious, but is acting bizarre. You enter the
house and see the man sitting on his couch. He is conscious but not
aware of his surroundings. He states that he takes medications, but
cannot remember why. His skin is pale and clammy and he has
noticeable tremors to his hands. The EMT-B should manage this
patient as though he were:
A: a schizophrenic.

B: severely depressed.

C: hypoglycemic.

D: suicidal.
9. When trying to manage a disruptive patient, you should:
A: turn your back on the patient to show that you are not a threat.

B: attempt to disarm the patient yourself if the patient has a gun or


knife.
C: leave the patient alone for a few minutes to think about the
situation.
D: keep your eyes on the patient at all times and be alert for
aggressive behavior.

10. Which of the following signs would be LEAST indicative of a patient


who has a high potential for violence?
A: The patient appears tense and "edgy."

B: The patient is loud and shouting obscenities.

C: The patient is standing toward you with clenched fists.

D: The patient is 6' 9" tall and weighs 200 lb.

11. Which of the following patients would be considered to be at


HIGHEST risk for suicide?
A: A 45-year-old man who recently found out his cancer is in full
remission.
B: A 33-year-old man who regularly consumes alcohol and
purchased a gun.
C: A 24-year-old woman who is successfully being treated for
depression.
D: A 29-year-old man who was recently promoted with a large pay
increase.

12. The first step in the management of a patient who is exhibiting


disruptive behavior is to:
A: call the police.

B: assess the situation.

C: give supplemental oxygen.

D: notify the emergency department.

13. When physically restraining a patient, it would be appropriate for the


EMT-B to:
A: remove the restraints if the patient appears to be calming down.
B: use additional force if the restrained patient begins to yell at you.

C: continually talk to the patient as he or she is being restrained.

D: check circulation in all extremities only if the patient is prone.

14. A man has worked in a high-stress job for 22 years. Progressively


over his 22-year career, he has learned that there is no way to remove
the stress from the job, but only to make changes in his life that will
help him cope with the physical signsof anxiety. This scenario is
typical of:
A: adjustment.

B: adjournment.

C: accommodation.

D: active participation.

Answers:
NO ANS REASON

Reason: There are many things that the EMT-B must be concerned with
when assessing a patient with a behavioral crisis, including all of the items
1. D
listed in the question.Your primary concern, however, should be your and
your partner's personal safety. (ECTSI 8, pp. 480 - 481)

Reason: When dealing with emotionally disturbed patients, the best legal
situation is to try to obtain the patient's consent to medical treatment. This
may be difficult, since these patients often resist treatment to try to threaten
2. B
you. If the patient presents a threat to self or others, you can legally care for,
and even restrain, the patient against his or her will. (ECTSI 8, pp. 484 -
485)

Reason: If a patient is armed or has potentially harmful objects in his or her


possession, have these removed by law enforcement personnel before you
3. D provide care. Because the patient in this scenario is unconscious and the
police have not arrived, you must ensure that the weapon is turned over to
them as soon as they arrive. (ECTSI 8, p. 480)

Reason: It can be difficult to determine if a psychiatric patient is mentally


competent to refuse EMS care. You must determine whether or not a life-
4. B
threatening emergency exists. If you are not sure, you should request the
assistance of law enforcement personnel. (ECTSI 8, p. 484)

Reason: To protect yourself from false accusations, you need to promptly


5. D document the patient's abnormal behavior, the reason for the restraint, and
the technique that was used. (ECTSI 8, p. 486)
Reason: When managing a patient with a behavioral emergency, the EMT-
B must be prepared to spend extra time with the patient. It may take longer
6. C
to assess and listen to the patient and prepare him or her for transport.
(ECTSI 8, p. 480)

Reason: When restraining a patient becomes necessary, the factors that


must be considered include the degree of force needed to keep the patient
7. C from harming him or herself or others; the patient's age, gender, size,
strength, and mental status; and the type of abnormal behavior that the
patient is exhibiting. (ECTSI 8, pp. 486 - 487)

Reason: There are causes other than psychiatric problems that can result in
bizarre behavior, including hypoglycemia, hypoxia, sudden physical illness,
and diseases of the brain. This patient, because of his pallor and tremors,
8. C should be managed as though he his hypoglycemic. In the best interest of
the patient, the EMT-B should consider physical causes. This particular
patient would most likely improve with a tube of oral glucose. (ECTSI 8, pp.
479 - 480)

Reason: When trying to manage a disruptive patient, you should keep your
9. D eyes on the patient at all times and be alert for aggressive behavior. (ECTSI
8, p. 486)

Reason: In assessing a patient for the potential for violence, the EMT-B
should note if the patient has any past history of violence; if the patient is
tense, rigid, or sitting on the edge of his or her seat; whether or not the
10. D patient is in possession of a weapon; if there is any vocal activity, including
being loud and shouting obscenities; and if there is any physical activity,
such as clenching of the fists or glaring eyes. There is no correlation
between physical size and the potential for violence. (ECTSI 8, p. 486)

Reason: Patients who are at high risk of suicide include, but are not limited
to those with a chronic, debilitating illness or recently diagnosed with a
serious illness; those with a severe mental illness, such as depression (the
11. B patient in choice"C" is successfully being treated); those who have had a
financial setback or recent loss of a job; those who consume alcohol
regularly; and those who recently have acquired items that can cause death,
such as a gun. (ECTSI 8, p. 483)

Reason: The first step in the management of a patient exhibiting disruptive


12. B
behavior is to assess the situation. (ECTSI 8, pp. 480 - 481)

Reason: When physically restraining a violent patient, the EMT-B or his or


her partner should continue to talk to the patient throughout the process.
The patient must be treated with dignity and respect, regardless of the
13. C situation. Once restraints are placed, they should not be removed, even if
the patient appears to be calm.Circulation in all extremities should be
monitored, regardless of the position in which the patient is restrained.
(ECTSI 8, p. 486)

Reason: Over the years, people learn to adapt to a variety of situations in


14. A daily life, including stresses and strains. This is called adjustment. (ECTSI 8,
p. 479)

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