WFR Behavioral and Psychological Emergencies

Question 1

A hiker who was uninjured in a rockfall is pale, sweating, has a fast pulse, and briefly faints after seeing an injured partner. Their vital signs return to normal within minutes while lying down. What is the most likely cause?

Accepted Answer

Acute stress reaction (psychogenic/vasovagal response)

Answer

An acute stress reaction, also called a sympathetic or vasovagal response, can cause pallor, sweating, a racing pulse, and fainting. Unlike true shock, it resolves quickly once the patient lies down and is reassured. Because this patient was not injured, this is the most likely explanation.

Question 2

During a wilderness trip, a participant says they have been thinking about ending their life. What should the WFR do first?

Accepted Answer

Ask directly whether they have a plan and the means, and keep them under constant supervision

Answer

Asking directly about a plan and the means to carry it out is how you assess suicide risk, and asking does not increase that risk. The patient should never be left alone, any means should be removed, and evacuation and professional help should be arranged. You cannot promise confidentiality when someone's life is at risk.

Question 3

A patient becomes suddenly combative and confused on a trip. Before treating this as a purely psychiatric problem, what should the WFR do?

Accepted Answer

Rule out medical causes such as hypoxia, hypoglycemia, head injury, and hypothermia or hyperthermia

Answer

A sudden change in mental status is often caused by a medical problem: low oxygen, low blood sugar, brain injury, temperature extremes, or toxins. Assume a medical cause until you have ruled those out.

Question 4

Which of the following is a core principle of psychological first aid after a traumatic event in the backcountry?

Accepted Answer

Provide safety, calm, connection, and practical help

Answer

Psychological first aid focuses on safety, calming, connection, practical help, and helping people feel capable again. Forcing a detailed debriefing is no longer recommended.

Question 5

A patient is breathing rapidly and reports tingling in their hands and around their mouth during an anxiety episode. There is no injury, and their SpO2 is normal. What is the best management?

Accepted Answer

Coach slow, controlled breathing, reassure them, and rule out other causes

Answer

Coached slow breathing and reassurance are the standard treatment for anxiety-related hyperventilation, once medical causes have been considered. Paper-bag rebreathing is discouraged because it can cause hypoxia and can hide serious conditions.

WFR - Wilderness First Responder Practice Test

WFR - Wilderness First Responder Practice Test

WFR Behavioral and Psychological Emergencies