Ch 36

Which of the following patients is at highest risk for a pulmonary embolism? 71-year-old male with recent surgery to a lower extremity 66-year-old active female with a history of hypertension 59-year-old male who is recovering from pneumonia 78-year-old female who takes blood-thinning medications

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

When immobilizing a patient with a kyphotic spine to a long backboard, the EMT would most likely have to: use a scoop stretcher instead of a log roll. place blankets behind the patient's head. secure the patient's head before the torso. force the head into a neutral alignment.

place blankets behind the patient's head.

A productive cough, fever, and chills in an 80-year-old patient with a compromised immune system should make you most suspicious for: bronchitis. emphysema. pneumonia. heart failure.

pneumonia.

Which of the following is the most common mechanism of injury in older patients? Suicide Abuse Falls Burns

Falls

A 75-year-old woman complains of shortness of breath. Which of the following findings should alert the EMT to the possibility of a pulmonary embolism? History of deep venous thrombosis The patient is prescribed an inhaler The patient's abdomen is swollen Frequent urinary tract infections

History of deep venous thrombosis

A 69-year-old female was involved in a motor vehicle crash. She is semiconscious with a blood pressure of 80/50 mm Hg and a heart rate of 74 beats/min that is weak. Her daughter, who was uninjured in the crash, tells you that her mother has a history of hypertension and takes beta-blockers. Because this patient is probably in shock, what is the most likely explanation for the absence of tachycardia? The effects of her antihypertensive medication Intrathoracic bleeding and cardiac compression Deterioration of the cardiac conduction system Failure of the parasympathetic nervous system

The effects of her antihypertensive medication

Osteoporosis is defined as: an abnormality near the growth plate. increased flexibility of bone mass. a decrease in bone mass and density. decreased bone marrow production.

a decrease in bone mass and density.

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): statute of care. power of attorney. physician directive. advance directive.

advance directive.

The leading cause of death in the geriatric patient is: hypertension. arthritis. heart disease. altered mental status.

heart disease.

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

an aortic aneurysm.

Patients who have experienced even minor-appearing head injuries should be suspected of having a brain injury, especially if they: have a history of Alzheimer disease. do not have deformities to the skull. are taking blood-thinning medications. have minor abrasions to the head area.

are taking blood-thinning medications.

When faced with a situation in which an older patient with a terminal illness is in cardiac arrest, but written documentation regarding the patient's wishes cannot be located, the EMT should: contact medical control for advice. try to locate the documentation. attempt to resuscitate the patient. allow the patient to die in peace.

attempt to resuscitate the patient.

Syncope in the older patient is: most commonly caused by a silent myocardial infarction. generally of no concern unless the patient was injured. rarely life threatening but should be evaluated by a physician. caused by an interruption of blood flow to the brain.

caused by an interruption of blood flow to the brain.

The slow onset of progressive disorientation, shortened attention span, and loss of cognitive function is known as: delusion. delirium. dementia. paranoia.

dementia.

When assessing a geriatric patient who has possibly experienced an acute ischemic stroke, it is most important to: ascertain about a history of atrial fibrillation. administer 324 mg of aspirin as soon as possible. determine the onset of the patient's symptoms. determine if the patient has risk factors for a stroke.

determine the onset of the patient's symptoms.

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: obtain a complete list of the patient's medications. inquire about a history of Alzheimer disease. ask an attendant for the patient's medical records. determine the patient's baseline mental status.

determine the patient's baseline mental status.

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: 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. begin assisting her ventilations with a bag-valve mask while your partner auscultates her lung sounds to ensure adequate positive-pressure ventilation. direct your partner to manually stabilize her head while you quickly visualize her chest for signs of breathing. suction her airway, apply a cervical collar, administer high-flow oxygen via a nonrebreathing mask, and perform a rapid assessment.

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

EMTs are dispatched to a residence for an 80-year-old woman who is ill. The patient's daughter states that her mother almost fainted after going to the bathroom and that her pulse was very slow. The patient's pulse rate is 80 beats/min and irregular, and she is conscious and alert. The EMTs should suspect that the patient: took too much of her medication. has a gastrointestinal hemorrhage. has an abdominal aortic aneurysm. experienced a vasovagal response.

experienced a vasovagal response.

The stooped posture of some older people, which gives them a humpback appearance, is called: arthritis. scoliosis. kyphosis. miosis.

kyphosis.

Fractures of the pelvis in older patients often occur as the result of a combination of: increased bone density and car crashes. osteoporosis and low-energy trauma. acetabular separation and severe falls. arthritic joints and high-energy trauma.

osteoporosis and low-energy trauma.

In contrast to a living will, a "do not resuscitate" (DNR) order becomes valid when: the patient develops cardiac arrest. it is signed by three or more physicians. the patient has a terminal illness. the patient is in a healthcare setting.

the patient develops cardiac arrest.

A "silent" heart attack occurs when: the usual chest pain is not present. sweating is the only presentation. a sudden dysrhythmia causes death. the patient minimizes the chest pain.

the usual chest pain is not present.

When transporting a stable older patient to the hospital, the most effective way to reduce his or her anxiety is to: avoid the use of a long backboard, even if trauma is suspected. perform frequent detailed assessments to gain the patient's trust. allow at least two family members to accompany the patient. transport him or her to a hospital that he or she is familiar with.

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