Behavioral and Psychiatric Emergencies and Suicide
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: A) chemical delirium. B) excited delirium. C) sensory excitement. D) delusions.
B) excited delirium.
Which of the following is the most accurate definition of anemia? A) An inherited disease in which a genetic defect in the hemoglobin results in abnormal structure of the red blood cells B) The loss of the kidneys' ability to filter the blood and remove toxins and excess fluid from the body C) The process by which toxins and excess fluid are removed from the body by a medical system independent of the kidneys D) A lack of a normal number of red blood cells in the circulation
D) A lack of a normal number of red blood cells in the circulation
Your patient is a 6-year-old child who has fallen down while running on a sidewalk. She has abrasions on both knees and the palms of both hands, which are oozing blood. This is an example of bleeding from which of the following types of vessels? A) Veins B) Arteries C) Venules D) Capillaries
D) Capillaries
Excited delirium
extreme agitation and delirium
If you do not have a commercial tourniquet available, what common supply found on the ambulance can be used as a substitute? A) Air splint B) Triangle bandage C) Cold pack D) Rope tie-down
B) Triangle bandage
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? A) Alcoholic intoxication B) An underlying physical illness C) Sudden onset of schizophrenia D) Alcohol withdrawal
B) An underlying physical illness
Platelets are actually fragments of larger cells that are crucial to the formation of clots. Clumping (called aggregation) of platelets is the body's most rapid response to stop bleeding from an injured site. However, in some situations the clumping of platelets is not desirable, such as when a plaque in a coronary artery ruptures. In this situation, the rapid clumping of platelets can cause a clot that then completely blocks the coronary artery and results in a heart attack (myocardial infarction). One of the most effective and widely available drugs to prevent the aggregation of platelets is: A) aspirin. B) plasma. C) hemoglobin. D) acetaminophen.
A) aspirin.
Which of the following is a characteristic of arterial bleeding? A) Steady flow B) Dark red color C) Spurting under pressure D) Both B and C
C) Spurting under pressure
Psychosis
Loss of contact with reality, paranoia and hallucinations.
Two chronic medical conditions that dialysis patients frequently have in addition to kidney failure are ________ and ________. A) blood clots; COPD B) high cholesterol; cerebral aneurysms C) heart failure; stroke D) hypertension; diabetes
D) hypertension; diabetes
Which of the following traumatic conditions could account for signs and symptoms of a behavioral emergency? A) Fractured lumbar vertebra B) Partial thickness burn C) Fractured tibia D) Hemorrhage
D) Hemorrhage
You encounter a patient who has been having diffuse abdominal pain for one week. The patient has a pulse rate of 86, a blood pressure of 140/90, and a respiratory rate of 20. However, the patient appears pale and complains of generalized weakness and shortness of breath during everyday activities. You suspect the patient is experiencing: A) anxiety disorder. B) chronic anemia. C) sickle cell anemia. D) acute anemia.
B) chronic anemia.
Your patient is a 33-year-old man who has a gunshot wound to his right leg and has active, steady, dark red bleeding. He is awake, pale, and diaphoretic. He has a strong radial pulse of 112 per minute, a respiratory rate of 24 breaths per minute, and a blood pressure of 122/82 mmHg. He has no other injuries or complaints. Which of the following is the best sequence of steps in the management of this patient? A) High-concentration oxygen, elevation of the extremity, and application of ice B) Cervical spine immobilization, high-concentration oxygen, direct pressure, and pressure point compression C) High-concentration oxygen, tourniquet, PASG, and elevation of the extremity D) Direct pressure, high-concentration oxygen, and splinting the leg
D) Direct pressure, high-concentration oxygen, and splinting the leg
The correct terminology used for patients whose kidneys are damaged to the point where they require dialysis to survive is:
end-stage renal disease.
Which of the following is a hallmark of irreversible shock? A) Cell damage and death in the vital organs B) Altered mental status C) Delayed capillary refill time D) Pale, cool skin
A) Cell damage and death in the vital organs
You are on the scene of a possible overdose. You find a 30-year-old man pacing around 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.
B) Repeat part of what the patient is saying to show that you are listening to him.
How many times per week do the majority of American hemodialysis patients receive treatment? A) Five B) Three C) Seven D) One
B) Three
Your patient is a 12-year-old boy who ran his arm through a glass window and has an 8-inch laceration on his anterior forearm. You have applied a pressure dressing and bandage, but these have become saturated due to continued bleeding. Which of the following should you do now? A) Remove the pressure dressing and bandage, apply an ice pack to the wound, and bandage it in place with an elastic bandage. B) Elevate the arm and prepare to apply a tourniquet or consider administering a hemostatic agent. C) Apply additional dressing material, bandage it in place, and apply pressure to the brachial artery. D) Remove the pressure dressing and bandage, apply direct pressure with your gloved hand, and elevate the arm.
B) Elevate the arm and prepare to apply a tourniquet or consider administering a hemostatic agent.
Shock
Shock is the circulatory system's failure to provide sufficient blood and oxygen to all the body's tissues.
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 whether 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.
C) Attempt to determine whether there is a possible physical cause for the patient's behavior.
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.
D) After the impulse is transmitted, the neurotransmitter goes through a process called reuptake, in which the neurotransmitter is returned to the postsynaptic neuron.
There are two main types of dialysis, hemodialysis and peritoneal dialysis. The main difference between them is: A) hemodialysis is usually done at a special facility and peritoneal dialysis is usually done at home. B) hemodialysis is usually done at home and peritoneal dialysis is usually done at a special facility. C) hemodialysis filters the blood and peritoneal dialysis filters the urine. D) hemodialysis filters the urine and peritoneal dialysis filters the blood.
A) hemodialysis is usually done at a special facility and peritoneal dialysis is usually done at home.
Which of the following statements about neurogenic shock is true? A) Neurogenic shock is sometimes caused by spinal injuries. B) Neurogenic shock is the result of the blood vessels decreasing in size. C) Neurogenic shock is caused by the blood vessels overfilling with blood, causing leaking into the nerves. D) Neurogenic shock is the most common type of shock.
A) Neurogenic shock is sometimes caused by spinal injuries.
Hemostatic Agent
A hemostatic agent is a medical device or dressing used to control bleeding from blood vessels in the body.
Which of the following statements about treating a patient who appears to be in shock is false? A) Spend time on scene to correct the causes of the shock so it does not worsen. B) The patient should be promptly put on high-concentration oxygen. C) Airway management is a top priority. D) Prompt transportation is a very high priority.
A) Spend time on scene to correct the causes of the shock so it does not worsen.