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's 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.

Accepted Answer

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.

Accepted Answer

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.

Accepted Answer

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.

Accepted Answer

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.

Accepted Answer

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.

Accepted Answer

D. renal insufficiency.

Question 7

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

Accepted Answer

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.

Accepted Answer

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.

Accepted Answer

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.

Accepted Answer

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

Accepted Answer

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.

Accepted Answer

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.

Accepted Answer

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.

Accepted Answer

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.

Accepted Answer

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.

Accepted Answer

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.

Accepted Answer

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.

Accepted Answer

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.

Accepted Answer

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.

Accepted Answer

C. hyperosmolar hyperglycemic nonketotic syndrome.

Question 21

A 73-year-old female experienced a syncopal episode while watching TV. She is now conscious, but is diaphoretic, tachycardic, and hypotensive. Your assessment reveals abdominal tenderness and a pulsating mass to the left of her umbilicus. You should suspect: an aortic aneurysm. acute appendicitis. a strangulated bowel. myocardial infarction.

Accepted Answer

an aortic aneurysm.

Question 22

Which of the following statements regarding the aging process is correct? A. Because he or she is younger and healthier, a 35-year-old person ages slower than a 75-year-old person. B. Human growth and development peaks in the late 40s or early 50s, at which point the aging process sets in. C. The older a person gets, the slower the decline in the function of vital organs, such as the kidneys and liver. D. The process of aging is gradual, and the rate at which a person loses functions does not increase with age.

Accepted Answer

D. The process of aging is gradual, and the rate at which a person loses functions does not increase with age.

Question 23

You are dispatched to a skilled nursing care facility for an 80-year-old female with abnormal behavior. The patient is clearly confused and asks you if you are her husband. You should: determine the patient's baseline mental status. inquire about a history of Alzheimer's disease. obtain a complete list of the patient's medications. ask an attendant for the patient's medical records.

Accepted Answer

determine the patient's baseline mental status.

Question 24

Which of the following statements regarding suicide in the older patient is correct? Older patients tend to use more lethal means than younger patients. Older females have a higher rate of suicide than any other group. Depression and hopeless feelings are often not predisposing factors. Most suicidal patients readily seek care and do not deny the problem.

Accepted Answer

Older patients tend to use more lethal means than younger patients.

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Chapter 36 - Geriatric Emergencies Flashcards

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