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Prehospital Emergency Care Practice Test: Handling Psychiatric Emergencies
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Emergency medical services (EMS) providers should follow these steps for pre-hospital treatment of psychiatric disorders: Stabilize the crisis, Avoid coercion, Treat in the least restrictive setting, Form a therapeutic alliance, and Formulate an appropriate disposition and aftercare plan.  Here are some de-escalation techniques for psychiatric emergencies: Maintain a calm, reassuring, and compassionate tone of voice Ask the person's name and use the name they give you Do not touch the patient unless required and permission is given Physically lower yourself to eye level with the... Show more
Prehospital Emergency Care Practice Test: Handling Psychiatric Emergencies
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25 Questions

1. You have been called for a female patient with a history of bipolar disease who is severely depressed and stated suicidal intentions. Which type of affect would you expect this patient to display?
2. A patient experiencing command hallucinations would most likely tell you:
3. An alert and oriented 18-year-old female patient has threatened to hurt herself, but is refusing transport to the hospital. She is calm and states that she knows her rights and taking her would constitute false imprisonment. Her family is present and wants her to go to the hospital for help, as she has attempted suicide in the past. Given the situation and the patient's threat, what is your best course of action?
4. You are at a community crisis center with a male patient who is depressed. What is the most important question you must ask first in the care of this patient?
5. You are called by a husband who states that his wife is bipolar and in need of help at the hospital. Which presentation would make the most sense related to this disorder?
6. You have been called to the post office to assist police with a disorderly male. On scene, you find a middle-aged male patient who states that he needs to be protected because the CIA is out to get him for something he did not do. As a knowledgeable EMT, you should recognize the patient's behavior as:
7. You are responding to a home for injuries resulting from a domestic altercation. In preparation for patient contact, what would you tell your partner?
8. After restraining a violent patient on the stretcher, which action is it essential that the EMT perform as soon as reasonably possible?
9. Given the research related to suicide, which patient should the EMT recognize as the highest risk for a suicidal action?
10. Which patient would the EMT classify as having a psychiatric (behavioral) emergency?
11. 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:
12. Your partner is assessing a patient who has a history of antisocial disorder and just got into a heated verbal exchange with his neighbor. He threatened to kill his neighbor, and 911 was called. As you observe the patient, what is the strongest indication that the patient may be ready to have a violent outburst?
13. A patient states that she cannot leave the house to go to the hospital 'because I am scared I will do something idiotic and lose it and then everyone will look at me and laugh.' She states she rarely leaves the house and the last time she did, she began to hyperventilate. This caused her to return home immediately. Based on this information, the EMT should recognize the patient as having:
14. You are assessing a patient with schizophrenia. Friends called 911 because he was experiencing hallucinations this morning. He is prescribed Thorazine and risperidone for his illness. Which question is most pertinent to the current situation and should be asked first?
15. A woman has called you to help her middle-aged friend, who has stopped eating and talking and has frequent crying spells. Your history reveals that the woman lost her husband a few months ago, and has been withdrawn and despondent ever since. Throughout the assessment, the alert and oriented woman continually states that she wants to be left alone. When you bring the stretcher into the room, the woman states, 'I do not want to go to the hospital. Let me sign whatever I need to sign.' What is your best response to this situation?
16. You are transporting a restrained 23-year-old female patient with a past history of sexual abuse and multiple behavioral problems. She is very upset with being restrained as well as with being transported to the hospital. She informs you that she will take you to court for your actions. Consequently, you are concerned about false accusations. What is your best protection should she follow through with legal action?
17. After taking a young, depressed female to the hospital, your partner says, 'I am tired of running all of these psych patient calls. There are real patients with real emergencies and pain out there. It is just a waste of our time!' Given his thoughts, what is your best response?
18. When at the scene where a patient has attempted suicide, what is the most immediate priority?
19. 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?
20. A group of EMTs is preparing to restrain a large and violent patient. Which instruction from the team leader is most appropriate?
21. The EMT would recognize a patient as having a phobia when the patient makes which statement?
22. You are at a scene where a patient was calm and compliant until a few seconds ago. Now he is brandishing a knife and threatening to kill you and your partner if you do not immediately leave. The man is intoxicated and police have been notified but have not yet arrived. What is your best course of action?
23. You have been called for a young male patient who has been acting withdrawn. As a precaution, dispatch also alerted police, who are now on scene with you. The patient appears depressed and when you ask him if he is thinking about hurting himself, he answers, 'Yes.' The next question asked by the EMT should be:
24. A 48-year-old female patient with a history of depression has called for help because she feels suicidal. During transport, the patient refuses to talk to you despite repeated attempts to obtain her past medical history and learn about the events leading up to her call for help. Which statement is most appropriate at this time?
25. You have been called to an assisted living facility for a 43-year-old male patient who has a history of anxiety and schizophrenia and who, according to staff, is more confused today. The staff also states that the patient has refused to take his medications for the past three days. Your assessment reveals him to have no primary assessment life threats, but his speech is slurred and he does not make sense when he talks. As you review the paperwork provided to you by staff, you note that the patient has a history of thyroid problems, diabetes, and hypertension. His pulse is 124 beats/min, respirations 16 breaths/min, and blood pressure 154/70 mmHg. At this point, which action is most important?

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