Quiz 18

Question 1

To minimize distractions and confusion when assessing an older patient, you should:

1 dismiss the family members from the room or area.

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

3 elevate your voice and speak directly to the patient.

4 perform a physical exam and then talk to the patient.

Answer 1

2

Question 2

The leading cause of death in the geriatric patient is:

1 hypertension.

2 altered mental status.

3 arthritis.

4 heart disease.

Answer 2

4

Question 3

When caring for a geriatric patient with a traumatic injury, it is important to consider that:

1 geriatric patients usually present with little to no pain.

2 decreased bone density often results in incomplete fractures.

3 the injury may have been preceded by a medical condition.

4 geriatric patients typically present with classic signs of shock.

Answer 3

3

Question 4

When transporting a stable older patient to the hospital, the most effective way to reduce his or her anxiety is to:

1 allow at least two family members to accompany the patient.

2 transport him or her to a hospital that he or she is familiar with.

3 avoid the use of a long backboard, even if trauma is suspected.

4 perform frequent detailed assessments to gain the patient’s trust.

Answer 4

2

Question 5

The purpose of the GEMS diamond is to:

1 help EMS personnel remember what is different about elderly patients.

2 provide the EMT with a standard format for assessing elderly patients.

3 replace the typical ABC approach to patient care when caring for the elderly.

4 provide clues about an elderly patient’s problem by observing his or her home.

Answer 5

1

Question 6

Which of the following statements regarding the aging process is correct?

1 Aging is a linear process despite the variations in physical or mental condition.

2 Because he or she is younger and healthier, a 35-year-old person ages slower than a 75-year-old person.

3 Human growth and development peaks in the late 40s or early 50s, at which point the aging process sets in.

4 The older a person gets, the slower the decline in the function of vital organs, such as the kidneys and liver.

Answer 6

1

Question 7

Which of the following patients is at highest risk for a pulmonary embolism?

1 59-year-old male who is actively recovering from pneumonia

2 66-year-old active female with a history of hypertension

3 71-year-old male with recent surgery to a lower extremity

4 78-year-old female who takes blood thinning medications

Answer 7

3

Question 8

In contrast to younger patients, older patients are more prone to a decrease in blood pressure upon standing because:

1 their red blood cells are destroyed at a faster than normal rate.

2 the aging process results in an overall increase in blood volume.

3 the baroreceptors have become less sensitive to blood pressure.

4 any change in position causes blood to be shunted to the brain.

Answer 8

3

Question 9

When assessing a geriatric patient who has possibly experienced an acute ischemic stroke, it is MOST important to:

1 determine the onset of the patient’s symptoms.

2 ascertain about a history of atrial fibrillation.

3 administer 324 mg of aspirin as soon as possible.

4 determine if the patient has risk factors for a stroke.

Answer 9

1

Question 10

The slow onset of progressive disorientation, shortened attention span, and loss of cognitive function is known as:

1 delirium.

2 delusion.

3 paranoia.

4 dementia.

Answer 10

4

Question 11

Which of the following is not a common causes of syncope in older patients:

1 venous pooling.

2 vasoconstriction.

3 acute hypotension.

4 blood volume loss.

Answer 11

2

Question 12

The stooped posture of some older people, which gives them a humpback appearance, is called:

1 kyphosis.

2 arthritis.

3 scoliosis.

4 miosis.

Answer 12

1

Question 13

Which of the following is not a common causes of depression in the elderly:

1 chronic medical conditions.

2 prescription medication use.

3 an acute onset of dementia.

4 alcohol abuse and dependence.

Answer 13

3

Question 14

Upon arriving at the residence of an elderly female who apparently fainted, you find the patient lying supine on her living room floor. She is not moving and her eyes are closed. A neighbor tells you that she found the patient this way, but did not move her. When you gently tap the patient, she does not respond. You should:

1 suction her airway, apply a cervical collar, administer high-flow oxygen via a nonrebreathing mask, and perform a rapid assessment.

2 open her airway with the head tilt–chin lift maneuver, insert an oral or nasal airway, and assess her blood glucose level to rule out hypoglycemia.

3 direct your partner to manually stabilize her head while you quickly visualize her chest for signs of breathing.

4 begin assisting her ventilations with a bag-mask device while your partner auscultates her lung sounds to ensure adequate positive-pressure ventilation.

Answer 14

3

Question 15

Fractures of the pelvis in older patients often occur as the result of a combination of:

1 osteoporosis and low-energy trauma.

2 increased bone density and car crashes.

3 arthritic joints and high-energy trauma.

4 acetabular separation and severe falls.

Answer 15

1

Question 16

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):

1 statute of care.

2 power of attorney.

3 physician directive.

4 advance directive.

Answer 16

4

Question 17

When assessing an older patient who has multiple bruises in various stages of healing, which action should the EMT avoid:

1 factually document all findings.

2 accuse a caregiver of physical abuse.

3 ask the patient how the bruises occurred.

4 review the patient’s activities of daily living.

Answer 17

2

Question 18

When documenting a case of suspected elder abuse, it is most important for the EMT to:

1 theorize as to why the patient was
abused.

2 document his or her perceptions of the event.

3 list the names of all of the suspected abusers.

4 avoid documenting any unsupported opinions.

Answer 18

4

Question 19

Which of the following statements regarding autism is correct?

1 Autism affects females four times greater than males.

2 The majority of patients with autism do not speak at all.

3 Most cases of autism are diagnosed by 3 years of age.

4 Impairment of motor activity is a classic sign of autism.

Answer 19

3

Question 20

Down syndrome is a genetic defect that occurs as the result of:

1 an extra pair of chromosomes.

2 a separation of chromosome 21.

3 a triplication of chromosome 21.

4 a sperm that contains 24 chromosomes.

Answer 20

3

Question 21

Characteristic anatomic features of Down syndrome include:

1 a proportionately small tongue.

2 a round head with a flat occiput.

3 bulging eyes and a large face.

4 long hands with wide fingers.

Answer 21

2

Question 22

Two thirds of children born with Down syndrome have:

1 diabetes mellitus.

2 intracranial bleeding.

3 unilateral paralysis.

4 congenital heart disease.

Answer 22

4

Question 23

Airway management can be challenging in patients with Down syndrome because their:

1 teeth are misaligned and they have a large tongue.

2 occiput is round, which causes flexion of the neck.

3 tongue is relatively small and falls back in the throat.

4 mandible is large, which inhibits a mask-to-face seal.

Answer 23

1

Question 24

A service dog is easily identified by its:

1 size.

2 breed.

3 color.

4 harness.

Answer 24

4

Question 25

When caring for a patient who is visually impaired, it is important to:

1 allow a service dog to remain with the patient at all times, even if the patient is critically ill.

2 stand to the side of the patient when speaking if his or her peripheral vision is impaired.

3 leave items such as canes and walkers at the residence if the patient will be carried on a gurney.

4 tell him or her what is happening, identify noises, and describe the situation and surroundings.

Answer 25

4

Question 26

By placing one hand on top of your head and the other hand over your abdomen, you are asking a hearing-impaired patient if he or she:

1 is hurt.

2 is sick.

3 needs help.

4 is nauseated.

Answer 26

2

Question 27

A significant number of patients with cerebral palsy also have:

1 paralysis.

2 brain tumors.

3 type 2 diabetes.

4 a seizure disorder.

Answer 27

4

Question 28

When caring for patients with cerebral palsy, it is important to remember that:

1 they are unable to walk and are totally dependent upon you.

2 their limbs are often underdeveloped and are prone to injury.

3 hearing aids are usually ineffective for patients with hearing loss.

4 most patients have the ability to walk, but have an unsteady gait.

Answer 28

2

Question 29

Spina bifida is MOST accurately defined as:

2 congenital inflammation of the spinal cord, usually in the neck.

1 a birth defect caused by incomplete closure of the spinal column.

4 a birth defect in which the child is born without spinal vertebrae.

3 chronic pressure on the brain caused by excess cerebrospinal fluid

Answer 29

2

Question 30

Which of the following is not a commonly associated conditions in patients with spina bifida:

1 hydrocephalus.

2 spastic limb movement.

3 extreme latex allergy.

4 loss of bladder control.

Answer 30

2

Question 31

A tube from the brain to the abdomen that drains excessive cerebrospinal fluid is called a:

1 shunt.

2 G-tube.

3 CS tube.

4 cerebral bypass.

Answer 31

1

Question 32

If suctioning of the tracheostomy tube is necessary, the EMT should:

1 attach a bag-mask device to the tracheostomy tube and hyperventilate the patient for 2 minutes.

2 instill 20 mL of saline into the tracheostomy tube and suction for no longer than 20 seconds.

3 attempt to use the patient’s suction device first because it is probably already sized correctly.

4 insert the suction catheter to a depth of no more than 15-cm and set the suction unit to 140 mm Hg.

Answer 32

3

Question 33

A 13-year-old child is on a home ventilator. The parents called because the ventilator is malfunctioning and the child has increasing respiratory distress. You should:

1 attempt to troubleshoot the ventilator problem.

2 disconnect the ventilator and use a bag-mask device.

3 place a call to the home health agency treating this patient.

4 reset the ventilator by unplugging it for 30 to 60 seconds.

Answer 33

2

Question 34

You receive a call to a residence for an apneic 2-month-old male. When you arrive at the scene, the infant’s mother tells you that her son was born prematurely and that his apnea monitor has alarmed 4 times in the past 30 minutes. Your assessment of the infant reveals that he is conscious and active. His skin is pink and dry, and he is breathing at an adequate rate and with adequate tidal depth. His oxygen saturation reads 98% on room air. You should:

1 request an ALS ambulance to transport the infant to the hospital.

2 advise the mother to observe her son and call 9-1-1 again if necessary.

3 administer high-flow oxygen and observe for a drop in oxygen saturation.

4 transport the infant to the hospital and bring the apnea monitor with you.

Answer 34

4

Question 35

In contrast to an automated implanted cardioverter/defibrillator, an internal cardiac pacemaker:

1 regulates the patient’s heart rate if it falls below a preset value.

2 delivers a shock to the heart if the rate becomes exceedingly fast.

3 is implanted under the skin in the left upper abdominal quadrant.

4 will only activate if it detects rhythms such as ventricular fibrillation.

Answer 35

1