Ch. 45 Flashcards
You have been asked to deliver a talk about EMS and the geriatric population. Which one of the following points would you emphasize in your presentation?
A) Many of the elderly have a combination of different diseases in various stages.
B) Assessment can be difficult since most persons older than 70 suffer from dementia.
C) Dementia is an inevitable part of the aging process.
D) Geriatrics actually comprises a small number of EMS calls and transports.
A) Many of the elderly have a combination of different diseases in various stages.
Page Ref: 993
An elderly man mistakenly presses the gas pedal instead of the brake, causing him to crash into a convenience store. This scenario is commonly related to:
A) dementia.
B) confabulation.
C) Alzheimer’s disease.
D) proprioception.
D) proprioception.
Page Ref: 996
The cumulative effects of vascular disease and inflammatory processes can lead to:
A) Alzheimer’s disease.
B) dementia.
C) proprioception.
D) delirium.
B) dementia.
Page Ref: 996
Degeneration of the vertebrae and intervertebral disc caused by ________, can affect the neck and back, limiting mobility and increasing the risk for spine injury.
A) arthritis
B) pathological fractures
C) osteoporosis
D) spondylosis
D) spondylosis
Page Ref: 1006
You respond for an elderly female who has apparently taken the wrong medication. She tells you that she thought she took an aspirin for her headache, but instead she is feeling real tired. You check her medication and see that the aspirin looks like her sleeping pills. Which of the following likely led to the problem?
A) Presbyopia
B) Presbycusis
C) Menopause
D) Proprioception
A) Presbyopia
Page Ref: 994
Decreased clearance of drugs that are metabolized by the liver may contribute to:
A) constipation and bowel obstruction.
B) signs and symptoms of drug overdose.
C) increased risk of infection.
D) impaired proprioception.
B) signs and symptoms of drug overdose.
Page Ref: 1006
You respond for a 66-year-old man complaining of severe pain on the back of his neck and right shoulder. You examine the area and see fluid-filled blisters in a horizontal line across his shoulder. You should suspect:
A) kyphosis.
B) spondylosis.
C) shingles.
D) chicken pox.
C) shingles.
Page Ref: 1005
Which of the following can increase the potential for organ injury in blunt trauma in the elderly?
A) Decreased bone density
B) Decreased sensitivity to pain
C) Decreased circulation to the organs
D) Decreased amount of adipose tissue
D) Decreased amount of adipose tissue
Page Ref: 1007
You are called for a motor vehicle collision involving two elderly women. You are concerned because you know that elderly patients are often prescribed blood thinner for cardiac problems. This can be a problem because?
A) Impaired blood clotting can exacerbate blood loss.
B) It means they most likely have cardiac problems.
C) It increases their risk for pulmonary embolism.
D) It leads to diminished liver and kidney function.
A) Impaired blood clotting can exacerbate blood loss.
Page Ref: 1007
Which of the following patients would be the MOST likely to be abused?
A) A 68-year-old man with asthma
B) A 62-year-old woman with decreased enjoyment of food
C) An 82-year-old woman with Alzheimer’s disease
D) A 74-year-old man with hypertension
C) An 82-year-old woman with Alzheimer’s disease
Page Ref: 997
All of the following are risk factors for elder abuse EXCEPT:
A) The caregiver has other responsibilities besides caring for the elder patient.
B) The patient is wheelchair bound and incontinent.
C) The elderly patient is destitute and must depend on family for housing.
D) The patient is 68 years old and plays golf every day.
D) The patient is 68 years old and plays golf every day.
Page Ref: 997
Which of the following would be appropriate to care for an elderly patient?
A) Cut away excess clothing when trying to examine the chest.
B) Recheck breath sounds after the patient has taken a few breaths.
C) Apply more pressure to open the airway if the neck is stiff.
D) Pad the cervical collar with extra padding to keep it snug.
B) Recheck breath sounds after the patient has taken a few breaths.
Page Ref: 1001
You have been called for a 91-year-old woman who fell. Since your assessment reveals bruises to her body in various stages of healing and inconsistencies in information related to the fall from her family, you are suspicious of geriatric abuse. Your BEST action would be to:
A) notify the Office of Elder Affairs prior to leaving the scene.
B) quietly transport and inform the emergency department physician.
C) confront the family members regarding your suspicions.
D) have the EMS supervisor contact the patient’s primary care physician.
B) quietly transport and inform the emergency department physician.
Page Ref: 997-998
To BEST communicate with a geriatric patient who has diminished hearing, the AEMT should do which one of the following?
A) Increase both the pitch and volume of your voice.
B) Ask the family members about the patient’s history.
C) Try to communicate using sign language.
D) Be sure the patient has his hearing aid in place.
D) Be sure the patient has his hearing aid in place.
Page Ref: 998
Your patient states that he “passed out” and fell down. He regained consciousness a few moments later but had shortness of breath and sharp chest pain. Which of the following in the patient’s history is of greatest concern?
A) He had hip surgery two years ago.
B) The patient states his left calf is tender and painful.
C) The patient took nitroglycerin and now has a headache.
D) The patient injured his wrist when he fell.
B) The patient states his left calf is tender and painful.
Page Ref: 1003
You are called for an elderly man with what appears to be pleuritic chest pain. Further assessment shows he has pain in the lower leg with increased calf pain when he flexes his toes upwards. You should suspect:
A) acute pulmonary edema.
B) referred pain from appendicitis.
C) pulmonary embolism.
D) aortic aneurysm.
C) pulmonary embolism.
Page Ref: 1003
Which one of the following BEST describes the term “silent heart attack”?
A) The pain did not radiate into the arms, neck, or back.
B) The patient had a single episode of chest pain followed by cardiac arrest.
C) The chest pain was so intense the patient could not speak.
D) The patient had little to no chest pain or discomfort.
D) The patient had little to no chest pain or discomfort.
Page Ref: 1003
A patient with kyphosis has fallen and is complaining of numbness in both arms. Regarding immobilization, you should:
A) place pillows in voids between the patient and stretcher.
B) disregard immobilization and transport using lights and sirens.
C) apply a cervical collar and transport in a semi-Fowler’s position.
D) transport fully immobilized and in a prone position.
A) place pillows in voids between the patient and stretcher.
Page Ref: 998, 1001
Which of the following statements regarding the elderly is TRUE?
A) A decrease in estrogen leads to increased cardiovascular disease in postmenopausal women.
B) Cardiac output remains constant, but hypercholesterolemia and hypertension increase.
C) There is a marked increase in obesity, which is associated with the onset of type 1 diabetes.
D) Osteoporosis can occur in both genders, but is especially common in men.
A) A decrease in estrogen leads to increased cardiovascular disease in postmenopausal women.
Page Ref: 994
Which of the following conditions will NOT put the elderly patient at risk for drug toxicity?
A) Loss of total fluid volume
B) Decreased fat stores
C) Polypharmacy
D) Increased plasma proteins
D) Increased plasma proteins
Page Ref: 1000
A common condition appearing as cloudiness of the lens of the eye that affects the elderly and causes an impairment of vision is/are:
A) chemical conjunctivitis.
B) astigmatism.
C) cataracts.
D) blindness.
C) cataracts.
Page Ref: 1001
You are interviewing an elderly patient about his eyesight. He tells you that he has good peripheral vision but diminished central vision. You should suspect:
A) glaucoma.
B) macular degeneration.
C) proprioception.
D) confabulation.
B) macular degeneration.
Page Ref: 996
It is important to remember that emergencies experienced by elderly patients may NOT present with the normal signs and symptoms experienced by younger populations because:
A) poor skin turgor diminishes pain sensations.
B) hyperreflexia is present in the elderly.
C) the brain is unable to interpret signals.
D) sensations may be seriously diminished.
D) sensations may be seriously diminished.
Page Ref: 1001
All of the following can lead to urinary retention EXCEPT:
A) urinary incontinence.
B) medications.
C) neurological problems.
D) enlarged prostate.
A) urinary incontinence.
Page Ref: 1004
An elderly patient presenting with pneumonia may experience no fever but frequently will complain of:
A) nausea and vomiting.
B) profuse sweating.
C) pain referred to the abdomen.
D) pulmonary edema.
C) pain referred to the abdomen.
Page Ref: 1003
Which of the following statements regarding myocardial infarction in the elderly is TRUE?
A) They are more likely to present with classic symptoms.
B) They usually complain of more severe symptoms.
C) They are less likely to have cardiac enzyme elevation.
D) They are less likely than younger patients to present with classic symptoms.
D) They are less likely than younger patients to present with classic symptoms.
Page Ref: 1003
Which of the following statements about pneumonia in the elderly patient is FALSE?
A) It may have a bacterial or viral cause.
B) Pain may be referred to the shoulders.
C) It may present without any fever.
D) It may be community acquired or nosocomial.
B) Pain may be referred to the shoulders.
Page Ref: 1003
You are called for an elderly man with an apparent broken hip. The patient tells you that he has osteoporosis and type 2 diabetes. He denies falling and cannot remember any trauma. You should suspect:
A) decreased range of motion.
B) osteoarthritis.
C) a pathological fracture.
D) an associated spinal injury.
C) a pathological fracture.
Page Ref: 1005
Pain that worsens with movement of the chest wall during inspiration is called ________ pain.
A) acute
B) somatic
C) visceral
D) pleuritic
D) pleuritic
Page Ref: 1003
Which of the following statements regarding treatment of an elderly patient is TRUE?
A) Remove dentures to achieve a good seal between a ventilation mask and the face.
B) Most external bleeding must be controlled by medications.
C) Changes in spinal alignment can made airway management challenging.
D) Use caution when administering fluids except when the patient is hypovolemic.
C) Changes in spinal alignment can made airway management challenging.
Page Ref: 1002
All of the following can lead to malnourishment in the elderly population EXCEPT:
A) diminished salivation and gastric secretions.
B) a disruption of the sleep-wake cycle.
C) decreased senses of taste and smell.
D) decreased financial resources.
B) a disruption of the sleep-wake cycle.
Page Ref: 995
Patients with dementia often have reduced levels of melatonin, which can lead to:
A) impairment of the sleep-wake cycle.
B) decrease in calcium in the bones.
C) an increase in the inflammatory process.
D) decreased absorption of medications.
A) impairment of the sleep-wake cycle.
Page Ref: 996
The dysrhythmia commonly encountered as a result of the aging process is:
A) atrial fibrillation.
B) sinus bradycardia.
C) ventricular tachycardia.
D) idioventricular.
A) atrial fibrillation.
Page Ref: 998
All of the following are common causes of seizures in the elderly EXCEPT:
A) epilepsy.
B) stroke.
C) brain injury.
D) syncope.
D) syncope.
Page Ref: 1004
Alzheimer’s is the MOST recognizable form of ________ in the elderly.
A) delirium
B) dementia
C) dysarthria
D) bipolar disorder
B) dementia
Page Ref: 1004
Pressure sores associated with decreased mobility in the elderly are known as:
A) confabulation.
B) kyphosis.
C) spondylosis.
D) decubitus ulcers.
D) decubitus ulcers.
Page Ref: 994
Signs and symptoms of ________ include postural rigidity, tremors, and loss of facial expression.
A) Alzheimer’s disease
B) Parkinson’s disease
C) Ménière’s disease
D) Starling’s disease
B) Parkinson’s disease
Page Ref: 1004
There is a high prevalence of urinary tract infection in patients with:
A) diabetes.
B) urinary incontinence.
C) diarrhea.
D) Foley catheters.
D) Foley catheters.
Page Ref: 1004
