Chapter 18 Practice Test

B

A geriatric patient is commonly defined as a person who:
A. has decreased mobility.
B. is older than 65 years.
C. receives social security benefits.
D. cannot take care of himself or herself.

A

Which of the following statements regarding the aging process is correct?
A. The natural process of aging results in a gradual decline in the functioning of all body systems.
B. Heredity and lifestyle choices have no influence on the speed with which body functions decline.
C. Most older patients have lost their full mental capacity by the time they reach 70 years of age.
D. Deterioration of body functions is a rapid process that begins as soon as a person reaches 50 years of age.

C

You will achieve a greater rapport with older patients if you:
A. show respect for their family.
B. conduct a brief physical exam
C. treat each person as an individual.
D. acknowledge that they are older.

D

You respond to the residence of an 80-year-old woman who fell. When you enter the patient's home, you find her sitting on the couch. She is wearing several layers of clothing and complains of pain to her left arm, shoulder, and hip. Responding EMTs are en route to the scene. After ensuring a patent airway and adequate breathing and circulation, you should:
A. contact a family member and obtain consent to assess her and provide further treatment.
B. obtain her medical history by speaking with an elevated tone of voice directly into her ear.
C. leave her clothing in place to prevent hypothermia and keep her still until the EMTs arrive.
D. carefully remove enough clothing so that you can conduct a complete full-body assessment.

B

An older person who is hearing-impaired:
A. usually experiences a loss of hearing of high and low frequencies.
B. may be able to hear a low-pitched voice but not a high-pitched voice.
C. usually is able to understand you if you elevate the tone of your voice.
D. usually can read lips easily and can communicate effectively with you

D

Effective ways of communicating with a hearing-impaired person include all of the following, except:
A. writing down your questions on paper.
B. identifying yourself and speaking slowly.
C. facing the person and maintaining eye contact.
D. getting close to the person's ear and shouting.

B

You are caring for a 76-year-old man who complains of breathing difficulty. During your assessment, you note that he has hearing aids in both ears. You should:
A. speak loudly into his ear with a high tone of voice.
B. ensure that he can hear you by speaking slowly and clearly.
C. remove his hearing aids and secure them in a place of safety.
D. ask him if he hurts by placing your fist in the palm of your hand.

B

When communicating with a hearing-impaired person using sign language, placing the tips of your index fingers together means:
A. sick.
B. hurt.
C. help.
D. pain.

B

The sign language expression for "help" is communicated by:
A. holding the palms of both of your hands tightly together.
B. placing your clenched fist in the palm of your open hand.
C. holding your hand out with the thumb away from the fingers.
D. touching your head with one hand and your stomach with the other.

C

The presence of a white cane in an older person's residence indicates that he or she most likely has:
A. an artificial leg.
B. a balance disorder.
C. visual impairment.
D. a history of a stroke.

B

Upon entering the residence of an older woman who complains of nausea and weakness, you see a pair of eyeglasses on an adjacent end table and a small dog sitting calmly near the patient. As you approach the patient, you should:
A. remove the dog and begin your assessment.
B. introduce yourself and ask her if she can see.
C. conclude that she is blind and keep her calm.
D. place her glasses on her to improve her vision.

D

If you must move a visually impaired patient, it is most important to:
A. move him or her as quickly as possible.
B. ask the patient to remain calm and quiet.
C. carry him or her with at least two rescuers.
D. tell him or her what is happening and why.

A

You are helping EMTs load an older man into the ambulance when the patient tells you that he cannot see and that he left his eyeglasses in his living room. The patient is stable and is being transported for a minor fall. You should:

A. ask the EMTs to wait until you can retrieve the patient's glasses.
B. reassure the patient that you will bring his glasses to the hospital.
C. accompany the patient to the hospital and reassure him en route.
D. advise the patient that he will not need his glasses in the hospital.

A

All of the following are techniques used when communicating with older patients, except:
A. speaking slowly and loudly.
B. showing the patient respect.
C. looking directly at the patient.
D. using clear, simple language.

A

A person with osteoporosis has:
A. a loss of bone strength resulting from a lack of calcium.
B. bones that are of increased density and strength.
C. muscle weakness secondary to poor dietary habits.
D. decreased pain sensitivity because of nerve deterioration

C

After fracturing a bone, it is common for geriatric patients to:
A. attempt to drive themselves to the emergency department.
B. experience severe pain because of hypersensitive nerve fibers.
C. experience little pain and not realize the seriousness of their injury.
D. refuse emergency medical care because they are senile and paranoid.

B

When performing your primary assessment of an older patient who fell at home, it is most important to:
A. educate the patient about safety precautions in the home.
B. consider that a medical condition may have caused the fall.
C. locate a member of the patient's family as soon as possible.
D. suspect abuse if the patient has experienced a major fracture.

C

A patient with a hip fracture typically presents with:
A. shortening of the injured leg with the toes pointed inward.
B. lengthening of the injured leg with the foot rotated inward.
C. shortening of the injured leg with the toes pointed outward.
D. lengthening of the injured leg with the foot rotated outward.

D

Which of the following medical conditions cause the most number of deaths in the older population?
A. Respiratory diseases and diabetes
B. Parkinson's disease and diabetes
C. Cancer and cardiovascular diseases
D. Cardiovascular diseases and respiratory diseases

D

When assessing geriatric patients, it is important to remember that:
A. they are much more likely to experience severe chest pain during a heart attack.
B. they usually do not understand you and cannot provide a reliable medical history.
C. most of their signs and symptoms are related to undiagnosed cancer or diabetes.
D. they may not experience classic signs and symptoms of many medical conditions.

A

Because many older patients have a weakened immune system, they are especially susceptible to:
A. pneumonia.
B. emphysema.
C. heart failure.
D. high blood pressure.

B

Patients with cancer usually request EMS:
A. because of the fact that they have cancer.
B. when complications from cancer cause an acute condition.
C. because they need transportation for chemotherapy.
D. at the request of a family member who is emotionally upset.

C

You arrive at an assisted living center where a cancer patient has experienced an altered mental status. Responding paramedics are approximately 6 minutes away. While caring for this patient, it is most appropriate to:
A. determine whether or not his cancer has spread.
B. reassure the patient that everything will be all right.
C. provide supportive care and prepare him for transport.
D. presume that he has a living will or advance directive.

C

All of the following are common causes of altered mental status in older patients, except:
A. hypothermia.
B. low blood glucose level.
C. intentional drug overdose.
D. lack of oxygen to the brain.

B

What would most likely happen if two doctors who are seeing the same patient for different conditions do not communicate effectively with each other?
A. The patient would be much more likely to take higher doses of one or more medications intentionally.
B. Medications prescribed by one doctor may interfere with the action of medications prescribed by the other doctor.
C. The patient would become very discouraged and would most likely stop taking all of his or her prescription medications.
D. The patient would take the medications prescribed by the doctor that he or she knows and trusts more.

D

If you are called to a residence to assist a chronically ill patient whose problem is likely the result of malfunctioning home healthcare equipment, you should:
A. immediately contact the equipment manufacturer and ask how to repair the equipment.
B. turn the malfunctioning equipment off and wait for paramedics to arrive and fix the problem.
C. be able to determine how to repair it because you should be thoroughly familiar with the equipment.
D. enlist the help of people who regularly take care of the patient and are familiar with the equipment.

B

Which of the following statements regarding depression in geriatric patients is correct?
A. Depression occurs in only a small portion of the geriatric population and tends to affect men more commonly than women.
B. Depression is the most common psychiatric condition experienced by older patients and occurs more frequently in women than in men.
C. Depression is most common in geriatric patients who take few medications and who live with immediate family members or close friends.
D. Depression is the third most common psychiatric condition among geriatric patients and most often develops after the age of 75 years.

A

Suicide in the older population:
A. occurs most frequently in men and results in more deaths per attempt because they choose more lethal means than do younger patients.
B. is the leading cause of death in patients older than 65 years and occurs with much greater frequency in women with a chronic disease.
C. occurs infrequently because most older patients are incapacitated and cannot acquire the means with which to end their own lives.
D. is more common in women than in men and usually is the result of intentional overdose of medications used to treat multiple medical conditions.

A

A 71-year-old severely depressed man tells you that he is contemplating killing himself because his wife of 50 years recently passed away. It is most important for you to:
A. provide emotional support and arrange for prompt transport.
B. ignore his emotional complaints because you cannot help him.
C. realize that depression following the death of a loved one is normal.
D. conduct a thorough assessment to detect life-threatening conditions.

C

Dementia is most accurately defined as:
A. an acute deterioration in mental function caused by a stroke.
B. a hereditary condition that is most common after the age of 70 years.
C. a progressive and usually irreversible decline in mental functions.
D. a normal process in which the patient slowly loses mental function.

D

The most common cause of dementia in older patients is:
A. a massive stroke.
B. progressive senility.
C. Parkinson's disease.
D. Alzheimer disease.

A

Hospice programs are designed to:
A. provide pain relief and other supportive care to patients experiencing a terminal condition.
B. rehabilitate older patients who are temporarily incapacitated by minor illnesses or injuries.
C. ensure that terminally ill patients receive adequate pain relief by administering medications through an IV line.
D. provide around-the-clock care to terminally ill patients who remain in the hospital for a long time.

B

An advance directive is most accurately defined as a:
A. legal document that allows healthcare providers to determine whether or not resuscitative efforts should be initiated on a patient.
B. document that provides instructions to medical caregivers regarding the care the patient wants if he or she is unable to communicate.
C. court order that clearly defines what care a physician deems appropriate for a patient who is expected to die within the next 6 months.
D. document signed by the patient and his or her family that outlines the care to be provided when the patient becomes incapacitated.

B

Elder abuse is hard to detect because:
A. the patient's injuries are often attributed to falls and other age-related mechanisms of injury.
B. those at highest risk are also isolated from public view if they are confined to their homes or an assisted care facility.
C. the abuser usually inflicts injuries to areas of the patient's body where healthcare providers are least likely to look.
D. emergency care providers often perform an incomplete physical examination of the patient and tend to overlook the injuries.

A

An older person who has a malnourished appearance has most likely experienced:
A. neglect.
B. sexual abuse.
C. physical abuse.
D. emotional abuse.

C

The most effective way to minimize the incidence of elder abuse is to:
A. physically remove the patient from the abusive environment.
B. ask the suspected abuser if the injury was intentionally inflicted.
C. promptly report its signs and symptoms to the proper authorities.
D. arrange for the suspected abuser to get psychological assistance.