EMT Chapter 36 - Geriatric Emergencies Quiz

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:

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

B. her mental status is likely the result of hypoglycemia and you should give her sugar.

C. because of her age and medical history, you should suspect Alzheimer disease.

D. dementia typically presents as an acute onset of deterioration of cognitive function.

A.

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):

A. statute of care.

B. power of attorney.

C. physician directive.

D. advance directive.

D.

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:

A. hypovolemic shock.

B. a systemic infection.

C. a subdural hematoma.

D. acute hyperglycemia.

B.

An abdominal aortic aneurysm:

A. can sometimes be palpated as a mass in the groin area.

B. causes dull pain that often radiates to the shoulders.

C. is often the result of hypertension and atherosclerosis.

D. is usually not repairable, even if discovered early.

C.

Because of the complexity of the older patient and the vagueness of his or her complaint, you should:

A. attempt to differentiate between chronic and acute problems.

B. perform a rapid assessment on all geriatric patients you treat.

C. limit your physical examination to the area of pain or injury.

D. rely exclusively on family members for the medical history.

A.

Blood levels of medications may rise in the elderly, sometimes to toxic levels. This is MOST likely due to:

A. pancreatic failure.

B. intentional overdose.

C. splenic dysfunction.

D. renal insufficiency.

D.

Clouding of the lenses of the eyes is called:

A. conjunctivitis.

B. glaucoma.

C. retinitis.

D. cataracts.

D.

Common causes of depression in the elderly include all of the following, EXCEPT:

A. alcohol abuse and dependence.

B. an acute onset of dementia.

C. chronic medical conditions.

D. prescription medication use.

B.

During the natural process of aging, the number of functional cilia in the respiratory system decreases, resulting in:

A. an increased risk of COPD.

B. a decreased ability to cough.

C. baseline respiratory distress.

D. air-trapping within the alveoli.

B.

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

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

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

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

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

D.

Poor maintenance of home, poor personal care, and dietary neglect are all possible indicators of ____________ elder abuse.

A. physical

B. financial

C. emotional

D. psychological

A.

Sedentary behavior while healing from a hip fracture would MOST likely predispose the older patient to:

A. ischemic stroke.

B. heart failure.

C. osteoporosis.

D. pneumonia.

D.

Talking about an elderly patient in front of him or her to other members of the family:

A. often causes the patient to become paranoid and untrusting of your help.

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

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.

B.

The EMT should suspect left-sided heart failure in the geriatric patient who presents with:

A. tachypnea and paroxysmal nocturnal dyspnea.

B. fever and a cough that produces green sputum.

C. jugular venous distention and peripheral edema.

D. swelling of the lower extremities and weakness.

A.

The leading cause of death in the geriatric patient is:

A. heart disease.

B. hypertension.

C. altered mental status.

D. arthritis.

A.

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

A. miosis.

B. arthritis.

C. scoliosis.

D. kyphosis.

D.

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

A. elevate your voice and speak directly to the patient.

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

C. dismiss the family members from the room or area.

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

B.

When immobilizing a patient with a kyphotic spine to a long backboard, the EMT would MOST likely have to:

A. secure the patient's head before the torso.

B. use a scoop stretcher instead of a log roll.

C. place blankets behind the patient's head.

D. force the head into a neutral alignment.

C.

Which of the following observations or statements represents the "E" in the GEMS diamond?

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.

D.

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:

A. hyperglycemia with moderate dehydration.

B. acute renal failure with associated hyperglycemia.

C. diabetic ketoacidosis.

D. hyperosmolar hyperglycemic nonketotic syndrome.

D.