Chapter 35 Quiz

Question 1

A 77-year-old female presents with an acute onset of altered mental status. Her son is present and advises that she has a history of hypertension, atrial fibrillation, type 2 diabetes, and glaucoma. He further advises that she takes numerous medications and that she is normally alert. When you assess this patient, it is important to note that:
Select one:
A. her mental status is likely the result of hypoglycemia and you should give her sugar.
B. because of her age and medical history, you should suspect Alzheimer disease.
C. dementia typically presents as an acute onset of deterioration of cognitive function.
D. the patient is experiencing delirious behavior, which suggests a new health problem.

Answer 1

D. the patient is experiencing delirious behavior, which suggests a new health problem.

Question 2

A specific legal document that directs relatives and caregivers regarding the medical treatment that may be given to patients who cannot speak for themselves is called a(n):
Select one:
A. physician directive.
B. advance directive.
C. statute of care.
D. power of attorney.

Answer 2

B. advance directive.

Question 3

An 84-year-old male fell a week ago and has been bedridden since then. Today, he presents with an altered mental status. His skin is pale and cold and his respirations are rapid and shallow. The EMT should suspect:
Select one:
A. hypovolemic shock.
B. a subdural hematoma.
C. acute hyperglycemia.
D. a systemic infection.

Answer 3

D. a systemic infection.

Question 4

An abdominal aortic aneurysm:
Select one:
A. is often the result of hypertension and atherosclerosis.
B. is usually not repairable, even if discovered early.
C. causes dull pain that often radiates to the shoulders.
D. can sometimes be palpated as a mass in the groin area.

Answer 4

A. is often the result of hypertension and atherosclerosis.

Question 5

Because of the complexity of the older patient and the vagueness of his or her complaint, you should:
Select one:
A. rely exclusively on family members for the medical history.
B. limit your physical examination to the area of pain or injury.
C. attempt to differentiate between chronic and acute problems.
D. perform a rapid assessment on all geriatric patients you treat.

Answer 5

C. attempt to differentiate between chronic and acute problems.

Question 6

Blood levels of medications may rise in the elderly, sometimes to toxic levels. This is MOST likely due to:
Select one:
A. pancreatic failure.
B. splenic dysfunction.
C. intentional overdose.
D. renal insufficiency.

Answer 6

D. renal insufficiency.

Question 7

Clouding of the lenses of the eyes is called:
Select one:
A. conjunctivitis.
B. retinitis.
C. glaucoma.
D. cataracts.

Answer 7

D. cataracts.

Question 8

Common causes of depression in the elderly include all of the following, EXCEPT:
Select one:
A. chronic medical conditions.
B. an acute onset of dementia.
C. alcohol abuse and dependence.
D. prescription medication use.

Answer 8

B. an acute onset of dementia.

Question 9

During the natural process of aging, the number of functional cilia in the respiratory system decreases, resulting in:
Select one:
A. an increased risk of COPD.
B. air-trapping within the alveoli.
C. a decreased ability to cough.
D. baseline respiratory distress.

Answer 9

C. a decreased ability to cough.

Question 10

In contrast to younger patients, older patients are more prone to a decrease in blood pressure (BP) upon standing because:
Select one:
A. the aging process results in an overall increase in blood volume.
B. any change in position causes blood to be shunted to the brain.
C. their red blood cells are destroyed at a faster than normal rate.
D. the body is less able to adapt the BP to rapid postural changes.

Answer 10

D. the body is less able to adapt the BP to rapid postural changes.

Question 11

Poor maintenance of home, poor personal care, and dietary neglect are all possible indicators of \_\_\_\_\_\_\_\_\_\_\_\_ elder abuse.
Select one:
A. physical
B. psychological
C. financial
D. emotional

Answer 11

A. physical

Question 12

Sedentary behavior while healing from a hip fracture would MOST likely predispose the older patient to:
Select one:
A. heart failure.
B. osteoporosis.
C. ischemic stroke.
D. pneumonia.

Answer 12

D. pneumonia.

Question 13

Talking about an elderly patient in front of him or her to other members of the family:
Select one:
A. may cause the patient to think that he or she has no say in making decisions.
B. often causes the patient to become paranoid and untrusting of your help.
C. will anger the patient and result in his or her refusal to accept care or transport.
D. is usually beneficial because the patient’s cognitive skills are typically impaired.

Answer 13

A. may cause the patient to think that he or she has no say in making decisions.

Question 14

The EMT should suspect left-sided heart failure in the geriatric patient who presents with:
Select one:
A. swelling of the lower extremities and weakness.
B. fever and a cough that produces green sputum.
C. jugular venous distention and peripheral edema.
D. tachypnea and paroxysmal nocturnal dyspnea.

Answer 14

D. tachypnea and paroxysmal nocturnal dyspnea.

Question 15

The leading cause of death in the geriatric patient is:
Select one:
A. altered mental status.
B. hypertension.
C. heart disease.
D. arthritis.

Answer 15

C. heart disease.

Question 16

The stooped posture of some older people, which gives them a humpback appearance, is called:
Select one:
A. arthritis.
B. scoliosis.
C. kyphosis.
D. miosis.

Answer 16

C. kyphosis.

Question 17

To minimize distractions and confusion when assessing an older patient, you should:
Select one:
A. perform a physical exam and then talk to the patient.
B. dismiss the family members from the room or area.
C. have only one EMT speak to the patient at a time.
D. elevate your voice and speak directly to the patient.

Answer 17

C. have only one EMT speak to the patient at a time.

Question 18

When immobilizing a patient with a kyphotic spine to a long backboard, the EMT would MOST likely have to:
Select one:
A. force the head into a neutral alignment.
B. place blankets behind the patient’s head.
C. use a scoop stretcher instead of a log roll.
D. secure the patient’s head before the torso.

Answer 18

B. place blankets behind the patient’s head.

Question 19

Which of the following observations or statements represents the “E” in the GEMS diamond?
Select one:
A. Elderly patients present atypically and deserve your respect.
B. A patient is assisted with his or her activities of daily living.
C. The patient’s medications have not been filled in 2 months.
D. The patient’s residence is cold due to a malfunctioning heater.

Answer 19

D. The patient’s residence is cold due to a malfunctioning heater.

Question 20

You are assessing a 70-year-old female who complains of intense thirst, frequent urination, and dizziness. She has a history of type 2 diabetes, heart disease, rheumatoid arthritis, and gout. Her blood glucose reads “high.” She is conscious, but confused. Her blood pressure is 92/52 mm Hg, her pulse rate is 130 beats/min and weak, and her respirations are 22 breaths/min and shallow. This patient’s clinical presentation is MOST consistent with:
Select one:
A. acute renal failure with associated hyperglycemia.
B. hyperglycemia with moderate dehydration.
C. hyperosmolar hyperglycemic nonketotic syndrome.
D. diabetic ketoacidosis.

Answer 20

C. hyperosmolar hyperglycemic nonketotic syndrome.