Medical and Trauma Emergencies

Question 1

Which of the following cardiac dysrhythmias is associated with the highest risk of stroke?

Select one:

a. AV heart block
b. Sinus tachycardia
c. Junctional rhythm
d. Atrial fibrillation

Answer 1

d. Atrial fibrillation

Question 2

Which of the following conditions would MOST likely impair pulmonary function by limiting lung volume and maximal inspiratory pressure?

Select one:

a. Asthma
b. Kyphosis
c. Spondylosis
d. Osteoporosis

Answer 2

b. Kyphosis

Question 3

Hypertensive emergencies in the geriatric population:

Select one:

a. require a controlled decline in blood pressure that often cannot be achieved in the prehospital setting.
b. can cause a ruptured cerebral or aortic aneurysm and should be treated in the field with antihypertensives.
c. are relatively uncommon owing to increased elasticity of the blood vessels, which facilitates vasodilation.
d. are typically treated in the prehospital setting with beta-blocker medications or a slow nitroglycerin infusion.

Answer 3

a. require a controlled decline in blood pressure that often cannot be achieved in the prehospital setting.

Question 4

Which of the following is the MOST common respiratory infection that causes death in the elderly population?

Select one:

a. Pneumocystis carinii
b. Respiratory syncytial virus
c. Pneumococcus bacteria
d. Mycobacterium tuberculosis

Answer 4

c. Pneumococcus bacteria

Question 5

The risk of a pulmonary embolus increases with age because of:

Select one:

a. increased immobility.
b. chronic use of aspirin.
c. frequent lung infections.
d. drug-induced bradycardia.

Answer 5

a. increased immobility.

Question 6

The MOST common risk factor for the development of type 2 diabetes in people over 65 years of age is:

Select one:

a. poor dietary habits and a sedentary lifestyle. Incorrect
b. frequent infections that do not heal properly.
c. hypertension of longer than 5 years’ duration.
d. the presence of more than one chronic disease.

Answer 6

d. the presence of more than one chronic disease.

Question 7

Which of the following disease processes would MOST likely present with signs and symptoms that mimic those seen with normal aging?

Select one:

a. Type 2 diabetes
b. Hypothyroidism
c. Thyrotoxicosis
d. Hyperglycemia

Answer 7

b. Hypothyroidism

Question 8

The relatively high use of nonsteroidal anti-inflammatory drugs by older patients predisposes them to:

Select one:

a. constipation.
b. cholelithiasis.
c. mesenteric ischemia.
d. peptic ulcer disease.

Answer 8

d. peptic ulcer disease.

Question 9

Kyphosis is characterized by:

Select one:

a. cartilage degeneration.
b. vertebral disc compression.
c. a hunchback appearance.
d. lateral curvature of the spine.

Answer 9

c. a hunchback appearance.

Question 10

Type I osteoporosis tends to progress more rapidly in:

Select one:

a. postmenopausal women.
b. the lower extremity bones.
c. males over 60 years of age.
d. patients with excess calcium.

Answer 10

a. postmenopausal women.

Question 11

Delirium is MOST accurately defined as:

Select one:

a. an acute alteration in mentation that indicates an underlying condition.
b. any alteration in cognitive function that may or may not be reversible.
c. a pattern of disorganized thinking that progresses over several weeks.
d. an altered mental status that is caused by structural damage to the brain.

Answer 11

a. an acute alteration in mentation that indicates an underlying condition.

Question 12

In contrast to delirium, dementia is:

Select one:

a. often caused by conditions such as poisonings and infection.
b. an acute state of confusion that may last for up to 1 week.
c. often reversible if the underlying cause is identified rapidly.
d. a progressive disease that produces irreversible brain failure

Answer 12

d. a progressive disease that produces irreversible brain failure

Question 13

Resting tremor of an extremity and bradykinesia are associated with:

Select one:

a. vascular dementia.
b. focal motor seizures.
c. Parkinson disease.
d. Alzheimer disease.

Answer 13

c. Parkinson disease.

Question 14

Untreated depression in people over 65 years of age:

Select one:

a. causes homicidal behavior in as much as 50% of this age group.
b. is often recognized by the patient, who subsequently asks for help.
c. is associated with a higher suicide rate than in any other age group.
d. usually goes unrecognized because it is often mistaken for delirium.

Answer 14

c. is associated with a higher suicide rate than in any other age group.

Question 15

Which of the following conditions would MOST likely mimic depression?

Select one:

a. Delirium
b. Dementia
c. Hyperglycemia
d. Hypoglycemia

Answer 15

b. Dementia

Question 16

Which of the following is NOT a predisposing risk factor for trauma in the elderly?

Select one:

a. Slower reflexes
b. Decreased body water
c. Equilibrium disorders
d. Overall decrease in agility

Answer 16

b. Decreased body water

Question 17

An elderly person is more likely to sustain serious injury following trauma due to:

Select one:

a. brittle, demineralized bone.
b. ineffective vasoconstriction.
c. chronic renal hypertrophy.
d. decreased respiratory function.

Answer 17

a. brittle, demineralized bone.

Question 18

Which of the following is an extrinsic cause of falls in the elderly?

Select one:

a. Postural hypotension
b. Dizziness or syncope
c. A pathologic fracture
d. An uneven sidewalk

Answer 18

d. An uneven sidewalk

Question 19

After falls, _______________ is/are the second leading cause of accidental death among elderly people.

Select one:

a. thermal burns
b. drug interactions
c. submersion injury
d. motor vehicle crashes

Answer 19

d. motor vehicle crashes

Question 20

Elderly people are more susceptible to intracranial bleeding because of:

Select one:

a. a marked increase in brain size.
b. depletion of cerebrospinal fluid.
c. enlargement of the subdural space.
d. constriction of the cerebral vessels.

Answer 20

c. enlargement of the subdural space.

Question 21

Cervical spondylosis is a degenerative change in the cervical spine that causes:

Select one:

a. destruction of the intervertebral discs and vertebral fractures.
b. narrowing of the spinal canal and pressure on the spinal cord.
c. lateral curvature of the cervical spine with cord impingement.
d. fracture of the odontoid process of the second cervical vertebra.

Answer 21

b. narrowing of the spinal canal and pressure on the spinal cord.

Question 22

Fall-related fractures in the elderly occur MOST often to the _______, usually in patients with underlying _______.

Select one:

a. hip, osteoporosis
b. humerus, arthritis
c. elbow, osteoporosis
d. pelvis, osteoarthritis

Answer 22

a. hip, osteoporosis

Question 23

Which of the following risk factors is associated with the HIGHEST rate of mortality following a burn injury in an elderly person?

Select one:

a. Age over 55 years
b. Musculoskeletal injury
c. Preexisting medical condition
d. Proportional increase in adipose tissue

Answer 23

c. Preexisting medical condition

Question 24

Considering the physiologic changes that occur with age, which of the following interventions would pose the GREATEST potential for further harm when caring for an elderly patient with a severe burn that is complicated by a spinal injury?

Select one:

a. Intubation
b. Fluid replacement
c. Thermal management
d. Spinal immobilization

Answer 24

b. Fluid replacement

Question 25

A 90-year-old nursing home resident presents with confusion and a cough after several days of complaining of being weak. She is bedridden, has numerous medical conditions, and takes a variety of medications. Your assessment reveals that her temperature is 99.0°F, her skin is cool and dry, her blood pressure is 118/66 mm Hg, and her heart rate is 68 beats/min and regular. She is not experiencing obvious respiratory distress, and her oxygen saturation is 93% on room air. This patient is MOST likely experiencing:

Select one:

a. pneumonia.
b. heart failure.
c. hypoglycemia.
d. a pulmonary embolism.

Answer 25

a. pneumonia.