Ch. 23: Behavioral and Psychiatric Emergencies and Suicide

Your partner is conducting a detailed examination of a 19-year-old female patient who is experiencing depression and an abnormal distrust of others (paranoia). Your partner is assessing the patient's abdomen by exposing it, inspecting it, and palpating it carefully. Do you consider this approach necessary? Why or why not? A. No, even if the patient also had complaints of abdominal pain, this level of assessment is unnecessary. B. Yes, it is important that a thorough abdominal assessment be conducted on all patients. C. No, while a physical exam is appropriate for all patients; it should only be performed once trust and rapport has been established. D. Yes, physical findings can disclose problems that a history cannot, so this approach is necessary - C. No, while a physical exam is appropriate for all patients; it should only be performed once trust and rapport has been established. You arrive at the scene of a 25-year-old male patient who is reportedly suffering from an acute episode of paranoia schizophrenia. On arrival, you should FIRST: A. ask everyone to stand back as you approach the patient cautiously. B. agree with what the patient says, even though it may sound outrageous to you. C. engage the patient in conversation in an attempt to ground him in reality. D. conduct a scene size-up and ensure the safety of the scene. - D. conduct a scene size-up and ensure the safety of the scene. Inadequate breathing due to body position is called: A. obstructive asphyxia. B. restraint apnea. C. positional asphyxia. D. fixed apnea. - C. positional asphyxia. An older adult patient is exhibiting unusual behavior by asking the same questions over and over. What should you FIRST consider as a possible cause for this behavior? A. The patient may be developing a bipolar illness. B. The patient may be experiencing amnesia from a recent head trauma. C. The patient has Alzheimer's disease. D. It is not unusual for the elderly to ask the same questions, so there is no reason for concern. - B. The patient may be experiencing amnesia from a recent head trauma. You have been summoned to evaluate a 29-year-old female patient who admits to being depressed and in despair. She recently divorced her husband of ten years and then learned that she has breast cancer. She states in a quiet voice, "There's nothing to live for." What should you do? A. Give the woman your phone number, and instruct her to call you if she feels greater depression. B. Contact the woman's family, and have them take care of her until her depression subsides. C. Do not leave the patient alone, and arrange for psychiatric evaluation immediately. D. Since there is no apparent medical problem, you are under no obligation to continue caring for this patient. - C. Do not leave the patient alone, and arrange for psychiatric evaluation immediately. You have been summoned to assist a search-and-rescue team in the care of a 50-year-old backcountry hiker. He was stranded overnight in freezing temperatures and is reportedly hallucinating and lethargic. What should you suspect is MOST likely to be the cause of his unusual behavior?