Prehospital Emergency Care Chapter #25, Prehospital Emergency Care Chapter #26, Prehospital Emergency Care, Chapter #41

Prehospital Emergency Care Chapter #25, Prehospital Emergency Care Chapter #26, Prehospital Emergency Care, Chapter #41 1) Which patient would the EMT classify as having a psychiatric (behavioral) emergency? A) A 44-year-old female with bipolar disorder who has a fever of 102.5°F B) A 56-year-old male with schizophrenia who has stopped taking his medications C) A 29-year-old male with diabetes who is suddenly confused D) A 36-year-old male with no known history who is hearing voices - ANSWER-D) A 36-year-old male with no known history who is hearing voices .1) You have been asked to present information on water safety and drowning to a community civic group. In regard to prevention, which point would you emphasize? A) The vast majority of children who drown do so in public swimming pools B) A significant number of drownings are preventable due to the involvement of alcohol C) Individuals with seizure disorders are safe in the water if they wear personal flotation devices D) Most authorities agree that children younger than 3 years should be taught to swim - ANSWER-B) A significant number of drownings are preventable due to the involvement of alcohol .1) You have been dispatched to a Veterans Administration (VA) clinic for a male patient with a behavioral emergency. On scene, the VA physician tells you that the patient is a returning veteran with newly diagnosed post-traumatic stress disorder (PTSD). Based on this information, you would surmise: A) the veteran was involved in active combat while in the service B) the veteran may have been in the military but not necessarily involved in combat C) the veteran most likely had a prior history of mental health issues D) the veteran has sustained physical injury to his brain - ANSWER-B) the veteran may have been in the military but not necessarily involved in combat .10) In a patient with post-traumatic stress disorder (PTSD), the EMT would recognize that a patient is reliving an event when he states: A) "I do not like the smell of diesel fuel because of the airplane crash." B) "I feel so guilty that there was nothing I could do to save them." C) "I notice that my heart rate will sometimes increase for no reason." D) "I cannot sleep well because of nightmares that I am back in the desert." - ANSWER-D) "I cannot sleep well because of nightmares that I am back in the desert." .10) You have been dispatched to a pool party for a 19-year-old male with shoulder pain. He states that he dove off the diving board and hit the bottom of the pool with his right shoulder and back. Although there is alcohol at the party, he denies drinking. The patient is alert and oriented and has obvious redness and abrasions to his right shoulder, neck, and back. He complains of neck pain and tingling in his right arm, but denies any other discomfort to any other part of the body. Your next action would be to: A) Measure and apply a cervical collar B) Establish manual spine motion restriction C) Provide supplemental oxygen D) Perform the secondary assessment - ANSWER-B) Establish manual spine motion restriction .10) You have been dispatched to transfer a patient with schizophrenia from a hospital emergency department to a behavioral health unit at another hospital. While en route, your partner states that he cannot remember what schizophrenia is. You should tell him that schizophrenia is a psychiatric disorder commonly characterized by: A) Multiple personalities B) The need to be around others C) Delusions and hallucinations D) Feelings of worthlessness - ANSWER-C) Delusions and hallucinations .11) Given the research related to suicide, which patient should the EMT recognize as the highest risk for a suicidal action? A) A 22-year-old male who has just broken up with his girlfriend of six months B) An 18-year-old male who was just arrested for possession of marijuana C) A 72-year-old widow who was just informed of a diagnosis of Alzheimer's disease D) A 34-year-old male who has been in and out of prison and was just convicted of receiving stolen property - ANSWER-C) A 72-year-old widow who was just informed of a diagnosis of Alzheimer's disease .11) The EMT shows she understands the concept of the mammalian diving reflex by stating: A) "It is a protective mechanism that occurs when the spinal column is compressed, such as would occur in a diving accident." B) "It occurs in warm water and serves to increase blood flow to the vital organs." C) "It may provide a benefit to the submerged patient by diverting oxygen-rich blood to the brain and heart." D) "It occurs in cold water and increases the activity of the vital organs, thereby protecting them." - ANSWER-C) "It may provide a benefit to the submerged patient by diverting oxygen-rich blood to the brain and heart." .11) The EMT would recognize which response when a combat veteran patient states, "I still see them burning but cannot do anything about it"? A) Reliving B) Response C) Avoiding D) Anxiety - ANSWER-A) Reliving .12) A combat veteran patient with a history of severe PTSD states that he has a headache that feels worse than any other he has ever had. The patient is alert and oriented, with no threats to the airway, breathing, or circulation. His vital signs are pulse, 78 beats/min; respirations, 16 breaths/min; blood pressure, 168/100 mmHg; and SpO2, 95% on room air. What would your next action be? A) Recognize the component of anguish B) Perform a neurologic assessment C) Treat the patient for PTSD and transport D) Administer low-concentration oxygen - ANSWER-B) Perform a neurologic assessment .12) After taking a patient to the hospital for an unsuccessful suicide attempt, your partner states that this is the fifth suicide call he has had this month. Four of them have been women who were unsuccessful; the fifth was a man who shot himself in the head and was dead on the scene. How should you respond to your partner? A) "That is odd since more men than women attempt suicide, and men are generally more unsuccessful than woman." B) "That seems to make sense, given that more women than men attempt suicide, but men are generally more successful." C) "That is unusual given that women are generally more successful and tend to use more lethal means such as guns." D) "Studies have shown that there is no difference in the frequency in which men and women attempt or commit suicide." - ANSWER-B) "That seems to make sense, given that more women than men attempt suicide, but men are generally more successful." .12) The head of the water rescue team has just informed you that the divers have retrieved a young woman who fell through ice on a pond while walking her dog. The estimated submersion time is 22 minutes. Another EMT asks you if it will be necessary to start resuscitation, given the length of submersion. What is your most appropriate reply? A) "Let's assess her first. If she does not have a pulse, then we will contact medical direction for orders to not resuscitate." B) "Our resuscitation will consist of CPR only. The AED is contraindicated if the patient is hypothermic." C) "Probably not. Given the amount of time she was submerged in the water, there is most likely little that can be done." D) "Absolutely! Given that she has been in cold water, she may still have a chance of survival." - ANSWER-D) "Absolutely! Given that she has been in cold water, she may still have a chance of survival." .13) The wife of a military veteran with PTSD states that her husband developed type 2 diabetes 10 years after returning from combat. There is no history of this disease in either side of the family, and the patient is not overweight and does not have any other risk factors for the disease. Consequently, the wife believes the diabetes results from her husband's experience in the military. How would you best respond to her assertion? A) "The diabetes is most likely a result of undiagnosed traumatic brain injury, not the PTSD." B) "It is not uncommon for combat veterans to unexpectedly develop such conditions like this." C) "I think we have to suspect that he sustained an injury to his pancreas at some point." D) "Although it can happen, era veterans-rather than not combat veterans-more typically develop diabetes." - ANSWER-B) "It is not uncommon for combat veterans to unexpectedly develop such conditions like this." .13) Which patient has the best chance for an optimal outcome after drowning? A) A 34-year-old female who was submerged for 9 minutes in 39°F water B) A 47-year-old male who was submerged for 8 minutes in a heated swimming pool C) A 22-year-old female who was submerged for 10 minutes in a whirlpool with 90°F water D) A 17-year-old female who was submerged for 10 to 12 minutes in warm salt water - ANSWER-A) A 34-year-old female who was submerged for 9 minutes in 39°F water .13) You are at the scene where a male patient threatened to take pills to end his life. In talking with the patient, he informs you that he just got a new job that requires more of his time and his wife has been giving him a hard time about it. Tonight, he had enough and just made the comment because he was mad at her. He says that although he is still upset, he does not plan to do anything "drastic." Before taking further action, which fact about the patient should raise the EMT's suspicion that he is indeed at a higher risk for suicide? A) New job with increased stress B) Scar on the patient's neck C) New diagnosis of high blood pressure D) Unsuccessful attempt three years ago - ANSWER-D) Unsuccessful attempt three years ago .14) The EMT recognizes that alcohol or drug dependence often occurs in individuals with post-traumatic stress disorder (PTSD) because: A) The alcohol or drug is used to blunt the sympathetic nervous system and emotional mental anguish B) The medications that treat PTSD make the individual more prone to alcohol and drug abuse C) The alcohol or drug dependence reflects an individual weakness, since not everyone with PTSD will have substance abuse issues D) The alcohol or drug serves a therapeutic purpose by "slowing down" the brain and allowing mental processing of past experiences - ANSWER-A) The alcohol or drug is used to blunt the sympathetic nervous system and emotional mental anguish .14) When working the scene of a water rescue, anytime that the EMT is within 10 feet of the water's edge, it is essential that she don which equipment for personal safety? A) Rope secured to the waist B) Examination gloves C) Personal flotation devices D) SCUBA equipment - ANSWER-C) Personal flotation devices .14) You are preparing a 24-year-old male for transport to the hospital after he stated that he wanted to kill himself. The patient's father pulls you aside and tells you that his son repeatedly has been in the hospital for suicidal statements but is then released and comes home and the whole cycle repeats itself. He is worried that one day his son will actually commit suicide and wonders if there is anything he can do to decrease the chance of this happening. In regard to the most common means by which people commit suicide, you should respond by saying: A) "Lock up all of the household cleaning products, since these are commonly ingested poisons during suicide attempts." B) "The chance of your son committing suicide is low since he has never actually attempted it." C) "I would suggest gathering up all guns and weapons and removing them from the house." D) "It would be best to get rid of all the beer, wine, and alcoh - ANSWER-C) "I would suggest gathering up all guns and weapons and removing them from the house." .15) When approaching a combat veteran who is highly agitated, the EMT must remember that: A) Combat veterans are more dangerous than civilians because of their training B) Identification of the event that led to the PTSD is essential C) Combat veterans are more likely to assault caregivers and medical providers D) Reassurance with a firm, calm voice may be necessary and should be attempted first - ANSWER-D) Reassurance with a firm, calm voice may be necessary and should be attempted first .15) You are by the side of a young male patient who hit his head after diving from a hillside into a shallow lake. The patient is unresponsive and has a large hematoma to his forehead with abrasions all over his face. A paramedic asks you to apply painful stimuli to his arms and legs. You recognize that the paramedic wants you to assess for which type of injury or condition? A) Alcohol intoxication B) True unresponsiveness C) Extremity fractures D) Spinal injury - ANSWER-D) Spinal injury .15) You arrive on scene to find that the police have subdued a violent man with a history of psychiatric problems. The police state they will put the patient on the stretcher. Which action should cause the EMT to take immediate and corrective action? A) The patient is placed and restrained in a prone position on the stretcher B) The patient is placed supine with straps over the chest, waist, and thighs C) Police state that the restraints will not be removed until arrival at the hospital D) Police move very quickly to get the patient onto the stretcher - ANSWER-A) The patient is placed and restrained in a prone position on the stretcher