Chapter 35: Geriatric Emergencies

B. the usual chest pain is not present.

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

D. head trauma.

A 10% to 20% reduction in brain weight and volume would MOST likely increase an older person's risk for: A. stroke. B. delirium. C. dementia. D. head trauma.

C. the effects of her antihypertensive medication

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? A. deterioration of the cardiac conduction system B. intrathoracic bleeding and cardiac compression C. the effects of her antihypertensive medication D. failure of the parasympathetic nervous system

B. Stroke ​Headache, especially without a prior history of​ headache, in an elderly person should make you suspect stroke.

A 70-year-old man complains of a headache that he calls a migraine. The headache began about four hours ago and has gotten worse. He has also started to feel nauseated and has​ "foggy" thinking. Upon​ questioning, you determine that the patient has NEVER had a history of migraines. He tells​ you, "No, this is the first​ one, but​ it's a​ doozy!" For which of these conditions should you immediately have an increased index of​ suspicion? A. A brain tumour B. Stroke C. New onset of migraine headache D. Atypical seizure

A. an aortic aneurysm.

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: A. an aortic aneurysm. B. acute appendicitis. C. a strangulated bowel. D. myocardial infarction.

B. the patient is experiencing delirious behaviour, 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: A. because of her age and medical history, you should suspect Alzheimer disease. B. the patient is experiencing delirious behaviour, which suggests a new health problem. C. her mental status is likely the result of hypoglycemia and you should give her sugar. D. dementia typically presents as an acute onset of deterioration of cognitive function.

D. osteoporosis.

A loss of minerals in bone tissue as a person ages is known as A. osteoarthritis. B. kyphosis. C. osteomyelitis. D. osteoporosis.

D. pneumonia.

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

D. 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): A. statute of care. B. power of attorney. C. physician directive. D. advance directive.

A. syncope.

A temporary loss of consciousness is also known as A. syncope. B. cerebrovascular accident. C. Alzheimer's disease. D. trans-ischemic attack.

C. is often the result of hypertension and atherosclerosis.

An abdominal aortic aneurysm: A. is usually not repairable, even if discovered early. B. causes dull pain that often radiates to the shoulders. C. is often the result of hypertension and atherosclerosis. D. can sometimes be palpated as a mass in the groin area.

D. he or she fears hospitalisation.

An elderly patient may understate or minimize the symptoms of his or her illness because: A. the nervous system has deteriorated. B. of decreased perception of pain. C. of conditions such as dementia. D. he or she fears hospitalisation.

B. dizziness or fainting upon standing.

An older patient with significant dehydration would MOST likely present with: A. an increase in blood pressure upon standing. B. dizziness or fainting upon standing. C. weakness to one side of the body. D. a drop in heart rate upon standing.

A. 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): A. pathologic fracture. B. idiopathic fracture. C. compression fracture. D. comminuted fracture.

B. chronically increased afterload

As a person ages, the heart may enlarge as a result of: A. widespread vascular dilation B. chronically increased afterload C. an overall decrease in blood volume D. decreased blood return to the heart

A. In their own or a family​ member's home

Because of significant advancements in​ medicine, which choice BEST describes the trend for the living arrangements of increasing numbers of people with serious chronic​ illnesses? A. In their own or a family​ member's home B. Group homes C. Hospice D. Skilled nursing centres

C. attempt to differentiate between chronic and acute problems.

Because of the complexity of the older patient and the vagueness of his or her complaint, you should: A. limit your physical examination to the area of pain or injury. B. rely exclusively on family members for the medical history. C. attempt to differentiate between chronic and acute problems. D. perform a rapid assessment on all geriatric patients you treat.

B. renal insufficiency.

Blood levels of medications may rise in the elderly, sometimes to toxic levels. This is MOST likely due to: A. pancreatic failure. B. renal insufficiency. C. intentional overdose. D. splenic dysfunction.

B. a thickening of the heart walls.

Cardiac hypertrophy is A. an increase in blood flow to the heart. B. a thickening of the heart walls. C. weakening of the right ventricle. D. stretching of the cardiac muscle fibres.

B. Alzheimer disease.

Causes of delirium in the older patient include all of the following, EXCEPT: A. acute hypovolemia. B. Alzheimer disease. C. low blood sugar level. D. decreased cerebral perfusion

B. cataracts.

Clouding of the lenses of the eyes is called: A. retinitis. B. cataracts. C. glaucoma. D. conjunctivitis.

C. an acute onset of dementia.

Common causes of depression in the elderly include all of the following, EXCEPT: A. chronic medical conditions. B. prescription medication use. C. an acute onset of dementia. D. alcohol abuse and dependence.

B. vasoconstriction.

Common causes of syncope in older patients include all of the following, EXCEPT: A. venous pooling. B. vasoconstriction. C. acute hypotension. D. blood volume loss.

A. a decreased ability to cough.

During the natural process of ageing, the number of functional cilia in the respiratory system decreases, resulting in: A. a decreased ability to cough. B. baseline respiratory distress. C. an increased risk of COPD. D. air-trapping within the alveoli.

Environmental assessment Assessment of the environment can help give clues to the patient's condition and the cause of the emergency. Is the home too hot or too cold? Is the home well kept and secure? Are there hazardous conditions? Preventive care is also very important for a geriatric patient, who may not carefully study the environment or may not realize where risks exist.

E in GEMS stands for:

C. outdated medications.

Findings during the social assessment of an older patient include all of the following, EXCEPT: A. interaction with others. B. daily activity assistance. C. outdated medications. D. delays in obtaining meals

A. osteoporosis and low-energy trauma.

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

Geriatric patients When responding to an emergency involving an older patient, you should consider that older patients are different from younger patients and may present atypically. Be familiar with the normal changes of ageing and treat older patients with compassion and respect.

G in GEMS stands for:

Geriatric patients// Environmental assessment// Medical assessment// Social assessment

GEMS stands for

C. frequently asking the patient if he or she understands.

Good general communication techniques with the elderly include: A. using medical terms to ensure patient understanding. B. explaining procedures while you are performing them. C. frequently asking the patient if he or she understands. D. having at least two EMTs talk to the patient at a time.

A. 5 minutes As with any unstable​ patient, assess an unstable geriatric patient every five​ minutes, or​ sooner, if necessary.

If an elderly​ patient's condition is​ unstable, what is the maximum time that should elapse between​ reassessments? A. 5 minutes B. 10 minutes C. 20 minutes D. 15 minutes

B. Move to where the patient can see your face.

If a​ hearing-impaired patient is having difficulty understanding you while you are seated behind the patient in the​ ambulance, which of these actions is​ recommended? A. Call the receiving facility to arrange for a sign language interpreter. B. Move to where the patient can see your face. C. Move directly to the physical assessment. D. Shout.

A. Decreased coronary artery perfusion

In arteriosclerosis, overproduction of abnormal collagen and decreased quantities of elastin lead to what? A. Decreased coronary artery perfusion B. Increased coronary artery perfusion C. Narrowing pulse pressure D. Hypotension

B. the patient develops cardiac arrest.

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

A. is usually considered irreversible.

In contrast to delirium, dementia: A. is usually considered irreversible. B. is the result of an acute condition. C. is reversible with certain treatment. D. often develops over a period of days.

C. the baroreceptors have become less sensitive to blood pressure.

In contrast to younger patients, older patients are more prone to a decrease in blood pressure 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. the baroreceptors have become less sensitive to blood pressure. D. any change in position causes blood to be shunted to the brain.

Medical assessment Older patients tend to have a variety of medical problems and may be taking numerous prescription, OTC, and herbal medications. Obtaining a thorough medical history is very important in older patients.

M in GEMS stands for:

D. they fear retribution from the abuser.

Many older victims of physical abuse may make false statements or lie about the origin of their injuries because: A. they are protective of the abuser. B. they do not want to be bothersome. C. most elderly patients have dementia. D. they fear retribution from the abuser.

C. loss of balance, muscle weakness, and spasms.

Motor nerve neuropathy is characterised by: A. numbness, tingling, and severe muscle pain. B. loss of bladder control and sensitivity to touch. C. loss of balance, muscle weakness, and spasms. D. constipation, low blood pressure, and bradycardia.

C. Fluid in the alveoli

On auscultation of a patient's lungs, you hear crackles. These lung sounds are caused by air passing through what? A. Constricted airways B. Thick secretions in the airways C. Fluid in the alveoli D. Inflamed airways

C. a decrease in bone mass and density.

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

B. are taking blood-thinning medications.

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

A. physical

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

Social assessment Older people may have a smaller social network because of the death of a spouse, family members, and friends. Older people may need assistance with activities of daily living (ADLs), such as dressing and eating.

S in GEMS stands for:

A. pneumonia.

Sedentary behavior while healing from a hip fracture would MOST likely predispose the older patient to: A. pneumonia. B. osteoporosis. C. heart failure. D. ischemic stroke.

A. caused by an interruption of blood flow to the brain.

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

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

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. tachypnea and paroxysmal nocturnal dyspnea.

The EMT should suspect left-sided heart failure in the geriatric patient who presents with: A. fever and a cough that produces green sputum. B. tachypnea and paroxysmal nocturnal dyspnea. C. jugular venous distention and peripheral edema. D. swelling of the lower extremities and weakness.

D. collagen.

The chief component of connective tissues and bones that deteriorates as people age is called: A. fibrin. B. elastin. C. sebum. D. collagen.

D. heart disease.

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

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

The purpose of the GEMS diamond is to: A. help EMS personnel remember what is different about elderly patients. B. provide the EMT with a standard format for assessing elderly patients. C. replace the typical ABC approach to patient care when caring for the elderly. D. provide clues about an elderly patient's problem by observing his or her home.

D. dementia.

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

A. kyphosis.

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

B. polypharmacy.

The use of multiple prescription drugs by a single patient, causing the potential for negative effects such as overdosing or drug interaction, is called: A. potentiation. B. polypharmacy. C. drug tolerance. D. drug dependency.

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

To minimize distractions and confusion when assessing an older patient, you should: A. dismiss the family members from the room or area. B. have only one EMT speak to the patient at a time. C. elevate your voice and speak directly to the patient. D. perform a physical exam and then talk to the patient.

C. direct your partner to manually stabilise her head while you quickly visualise 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 neighbour 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: A. suction her airway, apply a cervical collar, administer high-flow oxygen via a nonrebreathing mask, and perform a rapid assessment. B. open her airway with the head tilt-chin lift manoeuvre, insert an oral or nasal airway, and assess her blood glucose level to rule out hypoglycemia. C. direct your partner to manually stabilise her head while you quickly visualise her chest for signs of breathing. D. begin assisting her ventilations with a bag-mask device while your partner auscultates her lung sounds to ensure adequate positive-pressure ventilation.

B. 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: A. immediately seek out a family member or other caregiver. B. observe for conditions that may make the residence unsafe. C. begin his or her assessment after gathering any medication bottles. D. talk to the patient after performing his or her primary assessment.

D. Long-term illness, progressing gradually

What is the meaning of the term chronic​ illness? A. An illness that is present at birth B. Severe illness with a sudden onset C. An illness that is due to lifestyle factors D. Long-term illness, progressing gradually

A. recall that the patient is at risk for negative medication interactions.

When an elderly patient presents you with multiple over-the-counter medications that he or she is taking, it is MOST important to: A. recall that the patient is at risk for negative medication interactions. B. ask the patient to explain what each of the medications is used for. C. look up all of the medications before providing care to the patient. D. contact each of the physicians whose names are on the medications.

C. ask her how many pillows she uses when she sleeps.

When assessing a 78-year-old female who complains of shortness of breath, the EMT should: A. give oxygen only if the patient has labored breathing. B. conclude that the patient is experiencing a heart attack. C. ask her how many pillows she uses when she sleeps. D. place the patient supine to see if the problem worsens.

A. 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: A. determine the onset of the patient's symptoms. B. ascertain about a history of atrial fibrillation. C. administer 324 mg of aspirin as soon as possible. D. determine if the patient has risk factors for a stroke.

B. accuse a caregiver of physical abuse.

When assessing an older patient who has multiple bruises in various stages of healing, the EMT should do all of the following, EXCEPT: A. factually document all findings. B. accuse a caregiver of physical abuse. C. ask the patient how the bruises occurred. D. review the patient's activities of daily living.

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

When caring for a geriatric patient with a traumatic injury, it is important to consider that: A. geriatric patients usually present with little to no pain. B. decreased bone density often results in incomplete fractures. C. the injury may have been preceded by a medical condition. D. geriatric patients typically present with classic signs of shock.

D. recall that elderly patients often have difficulty hearing high-frequency sounds.

When caring for an elderly patient who is hearing impaired, you should: A. request that he or she communicates with you by writing on paper B. remember that most hearing-impaired patients can read lips. C. speak directly into his or her ear with an elevated tone. D. recall that elderly patients often have difficulty hearing high-frequency sounds.

D. recall that elderly patients have difficulty hearing high-frequency sounds.

When caring for an elderly patient who is hearing-impaired, you should: A. speak directly into his or her ear with an elevated tone. B. remember that most hearing-impaired patients can read lips. C. request that he or she communicates with you by writing on paper. D. recall that elderly patients have difficulty hearing high-frequency sounds.

D. avoid documenting any unsupported opinions.

When documenting a case of suspected elder abuse, it is MOST important for the EMT to: A. theorize as to why the patient was abused. B. document his or her perceptions of the event. C. list the names of all of the suspected abusers. D. avoid documenting any unsupported opinions.

A. use plain language and simple terms.

When explaining the need for a particular procedure to an elderly patient, you should: A. use plain language and simple terms. B. use the appropriate medical terminology. C. be complex so the patient fully understands. D. realise that he or she will not understand you.

B. attempt to resuscitate the patient.

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: A. try to locate the documentation. B. attempt to resuscitate the patient. C. allow the patient to die in peace. D. contact medical control for advice.

B. place blankets behind the patient's head.

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

C. recall that it will take a less severe mechanism of injury to cause significant injuries.

When performing your secondary assessment on an older patient who has been injured, it is important to: A. routinely perform a focused exam to minimize time at the scene. B. perform an in-depth physical exam prior to initiating any treatment. C. recall that it will take a less severe mechanism of injury to cause significant injuries. D. focus your assessment just on the area(s) of pain or obvious injury.

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

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

B. Inability to understand the spoken word

Which choice BEST describes a language​ disorder? A. Stuttering speech B. Inability to understand the spoken word C. Hoarseness or unusual voice pitch D. Inability to form or pronounce words

C. Even a minor fall can result in spinal injury or long bone fracture.

Which choice is a general guideline for managing elderly​ patients? A. Assume the patient has impaired hearing and speak in a​ louder-than-normal voice with all elderly patients. B. Application of supplemental oxygen is a frequent cause of respiratory depression in the elderly. C. Even a minor fall can result in spinal injury or long bone fracture. D. Remove a​ patient's dentures to achieve an effective​ bag-valve-mask device seal.

B. Increased incidence of pneumonia

Which choice occurs in the elderly as a result of​ age-related changes in​ physiology? A. Fever occurs more​ frequently, even with minor illnesses B. Increased incidence of pneumonia C. The skin becomes tough and thick D. Increased sensitivity to​ pain, resulting in frequent complaints of pain without physiological basis

B. Listen carefully to the answers the patient provides.

Which interview technique should you use when addressing a geriatric patient? A. Speak loudly and slowly. B. Listen carefully to the answers the patient provides. C. Refer to the patient by his first name. D. Have both you and your partner ask questions.

D. White males older than 85 years

Which of the following groups are most likely to commit suicide? A. Teenage girls (of any ethnicity) B. African American women older than 65 years C. College-educated males aged 45-65 years D. White males older than 85 years

C. Human resource agencies fail to investigate.

Which of the following is NOT a reason why the exact extent and prevalence of elder abuse is unknown? A. It has been largely hidden from society. B. The definitions of abuse and neglect vary. C. Human resource agencies fail to investigate. D. Victims of elder abuse are hesitant to report it.

B. Talk to the patient about the​ emergency, not about the patient with others.

Which of the following is a general guideline for adapting your approach to assessment to meet the needs of an elderly​ patient? A. Assume that all geriatric patients have sight and hearing impairment. B. Talk to the patient about the​ emergency, not about the patient with others. C. The elderly patient will usually have one specific chief complaint. D. Many elderly patients cannot hear low frequency speech.

A. Age

Which of the following is a nonpreventable factor in stroke? A. Age B. Atrial fibrillation C. Hypertension D. Obesity

A. falls

Which of the following is the MOST common mechanism of injury in older patients? A. falls B. burns C. abuse D. suicide

B. Memory remains intact.

Which of the following is true regarding delirium? A. It has a slow onset of progressive disorientation. B. Memory remains intact. C. It is a result of an irreversible metabolic disorder. D. It is rare in older hospitalised patients.

B. The patient's residence is cold due to a malfunctioning heater.

Which of the following observations or statements represents the "E" in the GEMS diamond? A. Elderly patients present atypically and deserve your respect. B. The patient's residence is cold due to a malfunctioning heater. C. A patient is assisted with his or her activities of daily living. D. The patient's medications have not been filled in 2 months.

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

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

C. "How many pillows do you sleep on?" The need to sleep on several pillows suggests early congestive heart failure.

Which of the following questions should you ask if you suspect a patient may have congestive heart failure? A. "How many hours of sleep do you get each night?" B. "In what position do you normally sleep?" C. "How many pillows do you sleep on?" D. "Do you take any medication to help you sleep at night?"

A. A decreased level of consciousness is not a normal part of the ageing process.

Which of the following statements regarding a decreased level of consciousness in the elderly patient is correct? A. A decreased level of consciousness is not a normal part of the ageing process. B. Most elderly patients have some deterioration in their level of consciousness. C. A decreased level of consciousness is most often the result of chronic dementia. D. The AVPU scale is an ineffective tool when assessing an elderly patient's level of consciousness.

D. The only symptoms to a silent heart attack may be weakness and fatigue. Elderly patients may experience a myocardial infarction without recognizing it as such because it is not accompanied by classic chest pain.

Which of the following statements regarding a silent heart attack is​ CORRECT? A. A silent heart attack results in chest pain​ only, without other related symptoms. B. A silent heart attack is one in which the patient suddenly collapses in cardiac arrest. C. The term silent heart attack arises from the​ patient's reluctance to seek help. D. The only symptoms to a silent heart attack may be weakness and fatigue.

D. Older patients have difficulty understanding when they are stressed.

Which of the following statements regarding communications with the elderly is correct? A. The majority of elderly patients are hearing or visually impaired. B. Attempt to calm the elderly patient by using his or her first name. C. Explain the justification for a procedure after it has been completed. D. Older patients have difficulty understanding when they are stressed.

A. Older patients tend to use more lethal means than younger patients.

Which of the following statements regarding suicide in the older patient is correct? A. Older patients tend to use more lethal means than younger patients. B. Older females have a higher rate of suicide than any other group. C. Depression and hopeless feelings are often not predisposing factors. D. Most suicidal patients readily seek care and do not deny the problem.

A. Ageing is a linear process; the rate at which a person loses functions does not increase with age.

Which of the following statements regarding the aging process is correct? A. Ageing is a linear process; the rate at which a person loses functions does not increase with age. B. Because he or she is younger and healthier, a 35-year-old person ages slower than a 75-year-old person. C. Human growth and development peaks in the late 40s or early 50s, at which point the aging process sets in. D. The older a person gets, the slower the decline in the function of vital organs, such as the kidneys and liver.

A. Activities of daily living The "S" in the GEMS diamond stands for "social assessment." Activities of daily living would fall under this category.

Which of the following would be part of the "S" component of the GEMS diamond? A. Activities of daily living B. Hazardous living conditions C. Normal changes of ageing D. Polypharmacy

C. Place padding under all​ voids, including between the​ head, neck, and​ shoulders, and the backboard. Do not force the​ patient's spine into position. Kyphosis can create a void between the​ head, neck, and​ shoulders, and the​ backboard, which needs to be filled with padding.

Which of these actions should be taken when immobilizing the spine of an elderly​ patient? A. Use a tall cervical collar to maintain the neck in extension. B. Use one hand to apply pressure to the forehead to place the patient in a completely supine position. C. Place padding under all​ voids, including between the​ head, neck, and​ shoulders, and the backboard. D. Flex the​ patient's hips and knees for​ comfort, and to flatten out the lumbar curve.

D. Widespread arteriosclerosis

Which of these changes occurs in the cardiovascular system as a result of the ageing​ process? A. An increased thickness of capillary walls B. An increase of electrical conducting cells C. A decrease in resting heart rate D. Widespread arteriosclerosis

B. Complaints of​ weakness, fatigue, and​ nausea, rather than of classic chest pain with myocardial infarction --- Silent heart attack.

Which of these descriptions illustrates an expected​ age-related change in signs and symptoms associated with illnesses in the​ elderly? A. A​ full, bounding pulse resulting from shock B. Complaints of​ weakness, fatigue, and​ nausea, rather than of classic chest pain with myocardial infarction C. Bradypnea is an early sign of hypoxia D. Increased likelihood of​ fever, even with minor infections

A. The elderly​ patient's diminished gag reflex makes him vulnerable to aspiration.

Which of these statements about accommodations should you anticipate is CORRECT in assessing and caring for an elderly​ patient? A. The elderly​ patient's diminished gag reflex makes him vulnerable to aspiration. B. The acute onset of an irregular pulse is a normal occurrence in this age group. C. The​ patient's skin condition is a good indicator of dehydration. D. Fever in the geriatric patient will most always result in very warm skin.

B. Calcium deposits where the ribs join the​ sternum, causing the rib cage to be less pliable Calcification of the thoracic cage decreases the pliability of the chest wall.

Which​ age-related respiratory changes should you anticipate in a​ 72-year-old patient? A. Decreased reliance on the diaphragm as the major muscle of respiration B. Calcium deposits where the ribs join the​ sternum, causing the rib cage to be less pliable C. Increased tidal volume at rest D. Greater sensitivity of the respiratory drive to hypoxia

D. compression fractures.

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: A. severe kyphosis. B. distracting injuries. C. spinal cord tearing. D. compression fractures.

C. 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: A. diabetic ketoacidosis. B. hyperglycemia with moderate dehydration. C. hyperosmolar hyperglycemic nonketotic coma (HHNC). D. acute renal failure with associated hyperglycaemia.

D. Paroxysmal nocturnal dyspnea Paroxysmal nocturnal dyspnea is a condition that is characterised by a sudden attack of respiratory distress that wakes the person at night when the patient is in a reclining position. The respiratory distress is caused by fluid accumulation in the lungs.

You are assessing an 80-year-old patient who explains that he was awakened by a sudden feeling of suffocation and respiratory distress. What are his symptoms a characteristic of? A. Orthopnea B. Exertional dyspnea C. Intermittent sleep apnea D. Paroxysmal nocturnal dyspnea

A. she became dizzy or fainted before falling.

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: A. she became dizzy or fainted before falling. B. she attempted to catch herself before falling. C. a family member regularly checks up on her. D. she takes medications for Alzheimer disease.

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

A. Abdominal aortic aneurysm

You are working on a geriatric patient who reports severe abdominal pain radiating through her back and flank. She also reports discomfort in her right leg and your assessment reveals a diminished pulse in the extremity. What should you suspect? A. Abdominal aortic aneurysm B. Peptic ulcer disease C. Pulmonary embolism D. Venous stasis

B. a subdural hematoma.

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. acute hyperglycemia. B. a subdural hematoma. C. acute ischemic stroke. D. diabetic ketoacidosis.

C. Glaucoma

_____ is an abnormal increase in intraocular pressure. A. Diabetic retinopathy B. Strabismus C. Glaucoma D. Cataracts

B. Pneumonia

_____ is more common in the elderly because of the diminished ability of the respiratory system to fight off infections. A. Pneumothorax B. Pneumonia C. Pulmonary edema D. COPD

B. Cataracts

​_____ are a condition in which the lens of the eye becomes cloudy. A. Diplopia B. Cataracts C. Glaucoma D. Diabetic retinopathy