Question 1

Which of the following is the best method of communicating with an emotionally disturbed patient?

Accepted Answer

It's important to show the patient that you are concerned with their welfare and want to help them. This can help build trust and establish a therapeutic relationship. Ignoring irrelevant statements or agreeing with everything the patient says can escalate the situation or undermine the patient's trust in you. While empathy is important, simply telling the patient you understand how they feel without taking any action to support them may not be effective.

Question 2

Your patient is a 34-year-old female, eight weeks postpartum. She is alert and oriented but crying and extremely depressed. She states she "just can't go on like this." Her husband called EMS because she is distraught and cannot care for herself or the baby. Which of the following statements about this situation is TRUE?

Accepted Answer

The patient is exhibiting symptoms of postpartum depression and needs medical treatment. It is important to take suicidal ideation seriously and provide appropriate intervention. It is not appropriate to advise the patient not to have additional children without a thorough evaluation and treatment for her current symptoms. Postpartum depression is a risk factor for suicide and requires medical attention.

Question 3

Which of the following is NOT associated with anorexia nervosa?

Accepted Answer

Intentionally inducing vomiting after eating is not associated with anorexia nervosa, but it is a symptom of bulimia nervosa.

Question 4

Which of the following helps assess a patient's potential for violence?

Accepted Answer

Body language is one of the best indicators of a patient's potential for violence, as it can reveal signs of aggression or agitation. Gender, ethnicity, and age are not reliable predictors of violence.

Question 5

Which of the following is most relevant to your decisions about how to handle a potentially violent patient?

Accepted Answer

The patient's current behavior is the most relevant factor in determining how to handle a potentially violent patient. The patient's past behavior and medication use may provide additional information, but the current behavior should always be the primary consideration. The family's reassurances may not be reliable and should not be the sole basis for decision-making.

Question 6

Your patient is a 34-year-old male who is threatening to kill himself. Which of the following does NOT indicate an increased risk for suicide?

Accepted Answer

Being married does not necessarily indicate a decreased risk for suicide. The other options (ingesting alcohol, family history of suicide, and previous suicide attempt) are all known risk factors for suicide.

Question 7

Which of the following statements about patient restraint is FALSE?

Accepted Answer

Patients should not be transported in a prone position due to the risk of respiratory distress or asphyxiation. Instead, they should be transported in a supine or lateral position.

Question 8

Your patient is a 50-year-old male who has been detained by mall security officers. The patient is distraught, stating that he needs to "get away from the terrorists." The security officers state the patient was found climbing into a trash dumpster behind the mall and became distressed when they took him away from it. Your physical exam is unremarkable except for noting neglect of hygiene and nutrition. His skin is warm and dry. HR = 98, BP = 114/78, RR = 12, SaO₂ = 99%, blood glucose = 80 mg/dL. You offer him transport to the ED, which he accepts. Which of the following is most appropriate during transport of this patient?

Accepted Answer

Given the patient's presentation with no immediate life threats, signs of neglect, and possible mental health concerns but no indication of a need for advanced life support interventions or restraints at this time, making the patient comfortable during transport is the most appropriate action.

Question 9

Which of the following statements about consent is accurate?

Accepted Answer

Competent individuals who are alert and oriented have the right to refuse transportation or medical treatment, and cannot be transported against their will unless they pose a danger to themselves or others.

Question 10

Which of the following is NOT a common pathophysiological cause of behavioral emergencies?

Accepted Answer

The environment is not a common pathophysiological cause of behavioral emergencies, but it can contribute to triggering them. The other options (underlying psychiatric illness, psychosocial stressors, and use of recreational drugs and alcohol) are commonly identified as causative factors of behavioral emergencies.

Question 11

Which of the following statements about patient restraint is TRUE?

Accepted Answer

Four-point restraints are often used to safely secure a patient who poses a risk to themselves or others, ensuring that all limbs are restrained to prevent injury.

Question 12

Your patient is a 32-year-old female who is depressed and tearful after a fight with her ex-husband. Which of the following would NOT increase the risk of or indicate an increased risk of the patient committing suicide?

Accepted Answer

Direct questioning about suicidal intentions by healthcare professionals is a critical step in assessing risk and does not increase the risk of suicide. It allows for open communication about the patient's feelings and intentions, providing an opportunity for intervention and support.

Question 13

Which of the following is most likely to effectively gain the cooperation of a psychologically disturbed patient for physical examinations?

Accepted Answer

Asking for the patient's permission can help establish trust and respect, leading to greater cooperation during physical examinations. It also respects the patient's autonomy and can reduce feelings of powerlessness or coercion. Option A might create resistance, while option B might make the patient feel uncomfortable or violated. Option D is too directive and does not allow for collaboration or informed consent.

Question 14

Which of the following best describes the position or bearing of the body?

Accepted Answer

Posture refers to the position of the body in relation to gravity, such as standing upright or hunched over. Stature refers to a person's physical height or build, facies refers to the appearance of the face, and affect refers to a person's emotional expression.

Question 15

Which of the following is described as the visible indication of mood?

Accepted Answer

"Affect" is the visible indication of mood, such as facial expressions or tone of voice. "Mental status" refers to a person's overall cognitive and emotional functioning. "Behavior" refers to observable actions. "Level of consciousness" refers to a person's alertness and awareness of their surroundings.

Question 16

Your patient is a 27-year-old female who is distraught and crying after having her children taken by child protective services. Her sister called EMS because the patient threatened to cut her wrists. On your arrival you find that she has not attempted to harm herself and has no weapons within reach. However, she does not wish to speak with you. Which of the following actions is most likely to be effective when communicating with this patient?

Accepted Answer

Sitting down so that you are at eye level with the patient is most likely to be effective when communicating with this patient. This action shows that you are willing to listen and that you care. Maintaining a distance of 3 to 5 feet from the patient may be perceived as standoffish or uncaring. Telling the patient that you cannot help her unless she talks to you or that you want to help her, but you can't unless she calms down may come across as dismissive of her emotions and may escalate the situation.

Question 17

Which of the following best describes perceived loss of physical functioning without medical or traumatic cause?

Accepted Answer

Conversion disorder is characterized by physical symptoms that cannot be explained by a medical or traumatic cause. Symptoms may include the perceived loss of physical functioning, such as paralysis or blindness, without any underlying physical explanation. Somatization disorder involves multiple physical complaints and concerns, while catatonia is a neuropsychiatric condition characterized by abnormal movements or behaviors. Body dysmorphic disorder involves a preoccupation with perceived flaws or defects in one's appearance.

Question 18

Your patient is a 32-year-old male who has been successfully treated for depression with a selective serotonin reuptake inhibitor. The patient's wife is concerned, because over the past few days her husband has not slept and has been spending most of his time trading stocks online and making extravagant purchases. He has been talking about taking a trip to Spain to run with the bulls in Pamplona. She states that he is talking incessantly and seems "wired." The patient had a similar episode about a month ago that came on suddenly but resolved when the patient "crashed" and slept for several days. Which of the following is most consistent with this situation?

Accepted Answer

The patient's symptoms are consistent with a manic episode, which is a hallmark feature of bipolar disorder. The previous episode that resolved when the patient slept for several days is also consistent with a manic episode. The symptoms of excessive spending, talking incessantly, decreased need for sleep, and grandiosity are all commonly seen in a manic episode. The other answer choices (A, B, C) are less likely given the patient's history and presentation.

Question 19

Which of the following best describes a feeling of alarm at the expectation of danger?

Accepted Answer

Fear is the emotion that arises when one anticipates or is aware of potential danger or harm, and it is often accompanied by physical sensations such as increased heart rate, sweating, and breathing difficulties. Rage, phobia, and stress are all different emotions that may be experienced in response to various stimuli or situations, but they do not specifically relate to the expectation of danger.

Question 20

A 19-year-old female states that she is addicted to Vicodin because it makes her feel good, and she cannot stop taking the pills. She states that she craves them all the time, and when she runs out she does not feel sick but becomes preoccupied with how she can get more. Assessment reveals no abnormalities, and vital signs are within acceptable limits. This patient's condition is most consistent with:

Accepted Answer

The patient's description of craving and preoccupation with obtaining the drug even when not feeling physically ill suggests psychological dependence, which is characterized by a strong desire or compulsion to use a drug despite the absence of physical symptoms. Physical dependence refers to the development of withdrawal symptoms when a drug is discontinued, while habituation refers to a decreased response to a drug due to repeated exposure. Tolerance refers to a need for higher doses of a drug to achieve the same effect, but it is not mentioned in the patient's case.

Quiz 11: Psychiatric and Behavioral Disorders