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20) There are general rules when dealing with psychiatric emergencies. Which of the following
is NOT one of those rules and would be considered inappropriate?
A) Identify yourself and your role.
B) Speak slowly and clearly, using a calm and reassuring tone.
C) Never make eye contact with the patient, as it will just increase his nervousness.
D) Listen to the patient. You can show you are listening by repeating part of what the patient says
back to him.
Objective: 23.4
21) You are on the scene of a possible overdose. You find a 30-year-old man pacing about his
living room. There is evidence of illicit drug use and the apartment is in disarray. The patient
seems agitated and nervous. Attempts at calming the patient should include which of the
following?
A) Speak quickly to give the patient all of the important information without delay.
B) Repeat part of what the patient is saying to show that you are listening to him.
C) Stand still with your arms crossed to instill a sense of control and authority.
D) Sit close to him with your arm around his shoulders to show that you are truly concerned.
Objective: 23.4
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22) Which of the following is appropriate when assessing an emotionally disturbed patient?
A) Establish eye and verbal contact.
B) Avoid arguing with the patient.
C) Make it clear that you are in control of the situation, not the patient.
D) Both A and B
Objective: 23.5
23) Neurotransmitters are chemicals within the body that transmit the message from the distal
end of one neuron (presynaptic neuron) to the proximal end of the next neuron (postsynaptic
neuron). While it sounds like a complicated process, it takes only milliseconds. Which one of the
following sentences is false?
A) Neurotransmitters are released from a neuron, then travel across the synapse to the next
neuron.
B) The receptors on the postsynaptic neuron receive the neurotransmitter.
C) This is the mechanism by which the impulse is moved along the nervous system.
D) After the impulse is transmitted, the neurotransmitter goes through a process called reuptake,
in which the neurotransmitter is returned to the postsynaptic neuron.
Objective: 23.5
12
24) When providing emergency care to an aggressive or hostile patient, what is the highest
priority?
A) Checking the patient for possible physical causes of the behavior
B) Finding out if the patient is oriented to person, time, and place
C) Calming the patient down
D) Performing a scene size-up
Objective: 23.5
25) As an EMT, it is important that you be able to do all of the following except:
A) control your own emotions when dealing with patients who say upsetting things to you.
B) provide counseling and advice to patients with personal problems.
C) ensure your safety and that of others at the scene.
D) deal with a wide variety of emotions and behaviors.
Objective: 23.5
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26) Which of the following should NOT be included in documentation of an incident involving a
patient with a behavioral or psychiatric emergency?
A) Description of the patient's behavior
B) Whether or not you think the patient is mentally ill
C) Your observations of the patient's surroundings at the scene
D) Your actions
Objective: 23.5
27) You are dispatched to a psychiatric emergency for a 68-year-old male. Dispatch provides no
other information and, when questioned by you, they do not have any more information.
Although all steps are important in dealing with this situation, which step is the MOST
important?
A) Scene size-up
B) Primary assessment
C) Vital signs and SAMPLE history
D) Secondary assessment
Objective: 23.5
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28) Once you have established with reasonable certainty that your patient is suffering from a
behavioral emergency, which of the following is the best course of action?
A) Establish the best way to restrain the patient before he has the opportunity to become violent.
B) Begin intense individual counseling with the patient.
C) Attempt to determine if there is a possible physical cause for the patient's behavior.
D) There is no need to assess for medical conditions if the patient does not have a history of past
medical problems.
Objective: 23.6
29) Which of the following must be treated by the EMT if present in a patient with an apparent
behavioral emergency?
A) Acute alcohol intoxication
B) Hypoglycemia
C) Suicidal ideology
D) Severe clinical depression
Objective: 23.6
15
30) Your patient is a 15-year-old female who has n diagnosed with a personality disorder. She
has no history of violent behavior. The staff at her residential care facility wants her to be
transported for evaluation of a possible urinary tract infection. Which of the following is the
BEST way to handle this situation?
A) Have a female EMT attend to the patient.
B) Transport the patient, but do not speak to her or perform an assessment.
C) Refuse to transport the patient without a police escort.
D) Ask that the patient be given a tranquilizer injection prior to transport.
Objective: 23.6
31) Which of the following is the BEST defense for an EMT when facing allegations of
misconduct from a mentally ill patient?
A) Hiring a background investigator to discredit the accuser
B) Having a clean employment record and lack of a criminal background
C) Providing accurate and complete documentation, supported by a third-party witness
D) Making sure you and your partner get your stories straight before talking to anyone
Objective: 23.6
16
32) You are dispatched to a local fast-food restaurant for a "nature unknown" call. You arrive on-
scene and find a 47-year-old male in front of the counter repeatedly singing "Happy Birthday" to
himself. Police are on-scene and the scene is safe. Which of the following would be considered
appropriate care?
A) Quickly approach the patient and take charge. Tell him he has to come with you to be
evaluated.
B) Quietly and carefully evaluate the situation and keep your emotions under control. Be as
unhurried as you can.
C) Have the police take charge, restrain the patient, and have him brought into your ambulance.
D) Have your partner join you in approaching the patient and explain to him that he has to stop
singing or you will have him arrested.
Objective: 23.6
33) All of the following are general rules in dealing with a psychiatric patient except:
A) speak slowly and clearly, and use a calm and reassuring tone.
B) make eye contact with the patient.
C) listen to the patient, showing you are listening by repeating part of what the patient says back
to him.
D) do not be judgmental; instead, show pity, as he needs to know that you understand him.
Objective: 23.6
17
34) Concerning attempted suicide, which of the following statements is true?
A) Truly suicidal patients nearly always leave a note.
B) All suicide attempts must be taken seriously, even if the method seems insincere.
C) There is always an indication that a suicide attempt is imminent.
D) Attempted suicide is a matter for law enforcement, not EMS.
Objective: 23.7
35) Which of the following factors suggest that a patient is at risk for suicide?
A) Recent emotional trauma
B) Sudden improvement in depression
C) Alcohol and drug abuse
D) All of the above
Objective: 23.7
18
36) Which of the following patients would be considered to be at the greatest risk for suicide?
A) 22-year-old man who has lost his job and is getting divorced
B) 35-year-old female who has a child with a serious illness
C) Married, 30-year-old man who has just learned that his employer is transferring him to a
different state
D) 44-year-old woman who has just recovered from a serious illness
Objective: 23.7
37) Why is it important to gather a detailed medical history when dealing with a psychiatric
emergency?
A) It is not. You want to get the call resolved as quickly as possible and this will just delay it.
B) It will alert you to past issues as well as medication.
C) It will help you to determine if the police are needed.
D) It will help you to determine if you need to restrain the patient.
Objective: 23.8
19
38) Management of the suicidal patient includes all of the following except:
A) a physical examination.
B) psychoanalysis of the patient by the EMT.
C) a SAMPLE history.
D) communication.
Objective: 23.8
39) When responding to an attempted suicide, which of the following is the EMT's primary
concern?
A) Personal safety
B) Determining whether the patient suffers from clinical depression
C) Contacting law enforcement since suicide is illegal
D) Managing the patient's airway
Objective: 23.8
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