Geriatric Emergencies Chapter 33 (set)
Which of the following patients is at highest risk for a pulmonary embolism?
71-year-old male with recent surgery to a lower extremity
Which of the following statements regarding a decreased level of consciousness in the elderly patient is correct?
A decreased level of consciousness is not a normal part of the aging process.
Which of the following statements regarding the aging process is correct?
Aging is a linear process; the rate at which a person loses functions does not increase with age.
35. Causes of delirium in the older patient include all of the following, EXCEPT:
Alzheimer disease.
Which of the following is NOT a reason why the exact extent and prevalence of elder abuse is unknown?
Human resource agencies fail to investigate.
Which of the following statements regarding communications with the elderly is correct?
Older patients have difficulty understanding when they are stressed.
Which of the following statements regarding suicide in the older patient is correct?
Older patients tend to use more lethal means than younger patients.
Which of the following observations or statements represents the "E" in the GEMS diamond?
The patient's residence is cold due to a malfunctioning heater.
Osteoporosis is MOST accurately defined as:
a decrease in bone mass and density.
During the natural process of aging, the number of functional cilia in the respiratory system decreases, resulting in:
a decreased ability to cough.
You receive a call for a sick person. When you arrive, you find the patient, a 75-year-old male, lying unresponsive in his bed. His respirations are slow and irregular and his pulse is slow and weak. His daughter tells you that he fell the day before, but refused to allow her to call 9-1-1. His past medical history is significant for hypothyroidism, deep vein thrombosis, heavy alcohol use, and liver cirrhosis. His medications include blood thinners and vitamins. You should be MOST suspicious that this patient is experiencing:
a subdural hematoma.
When assessing an older patient who has multiple bruises in various stages of healing, the EMT should do all of the following, EXCEPT:
accuse a caregiver of physical abuse.
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):
advance directive
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):
advance directive.
Common causes of depression in the elderly include all of the following, EXCEPT:
an acute onset of dementia.
A 73-year-old female experienced a syncopal episode while watching TV. She is now conscious, but is diaphoretic, tachycardic, and hypotensive. Your assessment reveals abdominal tenderness and a pulsating mass to the left of her umbilicus. You should be MOST suspicious for:
an aortic aneurysm.
Patients who have experienced even minor-appearing head injuries should be suspected of having a brain injury, especially if they:
are taking blood-thinning medications.
When assessing a 78-year-old female who complains of shortness of breath, the EMT should:
ask her how many pillows she uses when she sleeps.
Because of the complexity of the older patient and the vagueness of his or her complaint, you should:
attempt to differentiate between chronic and acute problems.
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:
attempt to resuscitate the patient
When documenting a case of suspected elder abuse, it is MOST important for the EMT to:
avoid documenting any unsupported opinions.
Clouding of the lenses of the eyes is called:
cataracts.
Syncope in the older patient is:
caused by an interruption of blood flow to the brain.
The chief component of connective tissues and bones that deteriorates as people age is called:
collagen
With age, the spine stiffens as a result of shrinkage of the intervertebral disc spaces, and the vertebrae become brittle. This increases the risk of:
compression fractures.
The slow onset of progressive disorientation, shortened attention span, and loss of cognitive function is known as:
dementia
The slow onset of progressive disorientation, shortened attention span, and loss of cognitive function is known as:
dementia.
When assessing a geriatric patient who has possibly experienced an acute ischemic stroke, it is MOST important to:
determine the onset of the patient's symptoms.
When assessing a geriatric patient who has possibly experienced an acute ischemic stroke, it is MOST important to:
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. As your partner administers oxygen to the patient, you should:
determine the patient's baseline mental status.
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. As your partner administers oxygen to the patient, you should:
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:
direct your partner to manually stabilize her head while you quickly visualize her chest for signs of breathing.
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:
direct your partner to manually stabilize her head while you quickly visualize her chest for signs of breathing.
An older patient with significant dehydration would MOST likely present with:
dizziness or fainting upon standing.
Which of the following is the MOST common mechanism of injury in older patients?
falls
General communication techniques with the elderly include:
frequently asking the patient if he or she understands.
To minimize distractions and confusion when assessing an older patient, you should:
have only one EMT speak to the patient at a time.
An elderly patient may understate or minimize the symptoms of his or her illness because:
he or she fears hospitalization.
A 10% to 20% reduction in brain weight and volume would MOST likely increase an older person's risk for:
head trauma
The leading cause of death in the geriatric patient is:
heart disease.
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 level is 450 mg/dL. 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:
hyperosmolar hyperglycemic nonketotic coma (HHNC).
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 level is 450 mg/dL. 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:
hyperosmolar hyperglycemic nonketotic coma (HHNC).
An abdominal aortic aneurysm:
is often the result of hypertension and atherosclerosis.
In contrast to delirium, dementia:
is usually considered irreversible.
The stooped posture of some older people, which gives them a humpback appearance, is called:
kyphosis.
Motor nerve neuropathy is characterized by:
loss of balance, muscle weakness, and spasms.
Talking about an elderly patient in front of him or her to other members of the family:
may cause the patient to think that he or she has no say in making decisions.
The purpose of the GEMS diamond is to:
observe for conditions that may make the residence unsafe.
Upon entering the residence of a geriatric patient with a medical or trauma complaint, the EMT should:
observe for conditions that may make the residence unsafe.
Fractures of the pelvis in older patients often occur as the result of a combination of:
osteoporosis and low-energy trauma.
Findings during the social assessment of an older patient include all of the following, EXCEPT:
outdated medications.
An older woman with osteoporosis presents with pain and deformity to her left hip after she shifted her weight onto her other foot. She has MOST likely experienced a(n):
pathologic fracture.
An older woman with osteoporosis presents with pain and deformity to her left hip after she shifted her weight onto her other foot. She has MOST likely experienced a(n):
pathologic fracture.
Poor maintenance of home, poor personal care, and dietary neglect are all possible indicators of ____________ elder abuse.
physical
Poor maintenance of home, poor personal care, and dietary neglect are all possible indicators of ____________ elder abuse.
physical
When immobilizing a patient with a kyphotic spine to a long backboard, the EMT would MOST likely have to:
place blankets behind the patient's head.
Sedentary behavior while healing from a hip fracture would MOST likely predispose the older patient to:
pnemonia
A productive cough, fever, and chills in an 80-year-old patient with a compromised immune system should make you MOST suspicious for:
pneumonia
Sedentary behavior while healing from a hip fracture would MOST likely predispose the older patient to:
pneumonia
A productive cough, fever, and chills in an 80-year-old patient with a compromised immune system should make you MOST suspicious for:
pneumonia.
The use of multiple prescription drugs by a single patient, causing the potential for negative effects such as overdosing or drug interaction, is called:
polypharmacy
When caring for an elderly patient who is hearing-impaired, you should:
recall that elderly patients have difficulty hearing high-frequency sounds.
When performing your secondary assessment on an older patient who has been injured, it is important to:
recall that it will take a less severe mechanism of injury to cause significant injuries.
When an elderly patient presents you with multiple over-the-counter medications that he or she is taking, it is MOST important to:
recall that the patient is at risk for negative medication interactions.
Blood levels of medications may rise in the elderly, sometimes to toxic levels. This is MOST likely due to:
renal insufficiency.
You are dispatched to a residence for an 80-year-old female who fell. When you arrive, you find the patient conscious, lying in a recumbent position on the floor in her living room. In addition to providing the appropriate treatment, you should ask the patient if:
she became dizzy or fainted before falling.
The EMT should suspect left-sided heart failure in the geriatric patient who presents with:
tachypnea and paroxysmal nocturnal dyspnea.
In contrast to younger patients, older patients are more prone to a decrease in blood pressure upon standing because:
the baroreceptors have become less sensitive to blood pressure.
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. Considering the fact that this patient is probably in shock, what is the MOST likely explanation for the absence of tachycardia?
the effects of her antihypertensive medication
When caring for a geriatric patient with a traumatic injury, it is important to consider that:
the injury may have been preceded by a medical condition.
In contrast to a living will, a "do not resuscitate" (DNR) order becomes valid when:
the patient develops cardiac arrest.
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:
the patient is experiencing delirious behavior, which suggests a new health problem.
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:
the patient is experiencing delirious behavior, which suggests a new health problem.
A "silent" heart attack occurs when:
the usual chest pain is not present.
Many older victims of physical abuse may make false statements or lie about the origin of their injuries because:
they fear retribution from the abuser.
When transporting a stable older patient to the hospital, the MOST effective way to reduce his or her anxiety is to:
transport him or her to a hospital that he or she is familiar with.
When explaining the need for a particular procedure to an elderly patient, you should:
use plain language and simple terms.
Common causes of syncope in older patients include all of the following, EXCEPT:
vasoconstriction.
