Chapter 39 (Geriatrics)

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

A)

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 This is the correct answer.B. Group homes C. Hospice D. Skilled nursing centers

A)

Of the​ following, who is the FIRST person you should rely on when obtaining the history of a patient with cognitive​ impairment? A. The patient This is the correct answer.B. The​ patient's physician C. A family member D. The​ patient's caregiver

A)

What will be the effect of the Institute of​ Medicine's report, The Future of EMS​ Care: EMS at the Crossroads on EMS in the next​ decade? A. States should adopt a common scope of practice for prehospital personnel. This is the correct answer.B. State certification will be a prerequisite for national credentials. C. Interstate reciprocity will come to an end. D. All training programs will need to be accredited by their respective state.

A)

Which of the following governmental departments was responsible for developing EMS standards and assisting states to upgrade the quality of their prehospital emergency​ care? A. U.S. Department of Transportation This is the correct answer.B. National EMS Council C. National Highway Traffic Safety Council D. National Registry of EMTs

A)

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. This is the correct answer.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.

A)

You should suspect respiratory difficulty in a patient with damage to the spinal cord at or above which​ level? A. C3 to C5 This is the correct answer.B. L4 to L5 C. T10 to T12 D. T1 to T2

A)

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

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

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

B)

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. This is the correct answer.C. Move directly to the physical assessment. D. Shout.

B)

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

B)

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 This is the correct answer.C. The skin becomes tough and thick D. Increased sensitivity to​ pain, resulting in frequent complaints of pain without physiological basis

B)

Which choice should you keep in mind when interacting with a patient who has a developmental​ disability? A. Despite difficulty​ speaking, learning and intelligence generally are not affected. B. Patients with developmental disability generally retain the ability to derive meaning from body language and tone of voice. This is the correct answer.C. Communicate with the patient through his caregivers. D. Explanations of what you are doing will confuse the patient.

B)

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. This is the correct answer.C. The elderly patient will usually have one specific chief complaint. D. Many elderly patients cannot hear low frequency speech.

B)

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 This is the correct answer.C. Bradypnea is an early sign of hypoxia D. Increased likelihood of​ fever, even with minor infections

B)

Which of these devices may be required by a patient as a result of high spinal cord​ paralysis? A. An implanted​ cardioverter-defibrillator B. A mechanical ventilator This is the correct answer.C. Dialysis D. An implanted port

B)

Which one of the following statements about EMS in the United States is​ true? A. The Federal Department of Health and Human Services establishes curricula for all levels of EMS education. B. Each state has governmental control of its own EMS​ system, independent of the federal government. This is the correct answer.C. The EMS system is controlled and governed by the National Highway Transport and Safety Administration​ (NHTSA). D. The federal government oversees all aspects of EMS in the United States.

B)

_____ 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)

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

B)

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 This is the correct answer.C. Increased tidal volume at rest D. Greater sensitivity of the respiratory drive to hypoxia

B) Calcification of the thoracic cage decreases the pliability of the chest wall.

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. Brain tumor B. Stroke This is the correct answer.C. New onset of migraine headache D. Atypical seizure

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

Of these​ problems, which is second only to smoking as a cause of preventable​ death? A. Diabetes B. Trauma C. Obesity This is the correct answer.D. Heart disease

C)

The highest level of certification for a nationally recognized prehospital care provider​ is: A. emergency medical technician. B. EMS supervisor. C. paramedic. This is the correct answer.D. advanced emergency medical technician.

C)

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. This is the correct answer.D. Remove a​ patient's dentures to achieve an effective​ bag-valve-mask device seal.

C)

Which of the following actions should you take if you suspect you patient is a victim of child​ abuse? A. Contact medical direction to report your suspicions and request direction about contacting law enforcement. B. Tell the caregiver that you are obligated by law to contact law enforcement and that he needs to stay on the scene until law enforcement arrives. C. Report your findings to law enforcement or the appropriate social services​ agency, as well as to the receiving hospital personnel. This is the correct answer.D. Request a social services​ follow-up visit for after the child is discharged from the hospital.

C)

​_____ is an abnormal increase in intraocular pressure. A. Diabetic retinopathy B. Strabismus C. Glaucoma This is the correct answer.D. Cataracts

C)

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. This is the correct answer.D. Flex the​ patient's hips and knees for​ comfort, and to flatten out the lumbar curve.

C) 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.

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

D)

As a general​ rule, what action should you take when you encounter medical technology you are NOT familiar with when caring for a​ patient? A. Turn off the equipment in preparation for transport. B. Take the equipment with the patient. C. Disable any alarms on the equipment in preparation for transport. D. Ask the patient and caregivers about the device.

D)

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

D)

When responding to a report of a patient with difficulty​ breathing, you find a man in his 60s in a hospital bed in his home. There is a​ small, round tube that exits from a​ patient's neck, through which he is breathing. Which of these devices does the patient MOST likely​ have? A. Airway catheter B. Dual lumen catheter C. Endotracheal tube D. Tracheostomy tube

D)

Which of the following is the LEAST likely reason why impoverished patients are at an increased risk of medical​ conditions? A. Poor nutrition and environmental extremes increase the likelihood of illness. B. The poor often must choose between receiving health care and buying food. C. Lack of access to preventative health services. D. The poor often choose to spend money on alcohol and drugs instead of medical care.

D)

Which of the following statements BEST describes morbid​ obesity? A. Being unable to bear your own body weight. B. Weighing over 300 lb. C. Weighing 25 percent more than a​ person's ideal weight. D. Weighing 100 lb. more than a​ person's ideal weight.

D)

Which of the following statements accurately describes the hospital emergency​ department? A. It is the only destination to which EMS can transport patients with a medical emergency. B. It provides lifesaving care instructions to callers accessing the 911 system. C. It requires patients to make an​ appointment, unless they arrive by ambulance. D. It is designed to evaluate and treat patients prior to other needed medical care​ (if needed).

D)

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

D)

Which of these conditions is NOT common amongst hospice​ patients? A. AIDS B. Cancer C. Cystic fibrosis D. ​Crohn's disease

D)

Which of these injuries is LEAST suspicious for being inflicted by child​ abuse? A. ​Small, round burns from cigarettes B. Bite marks C. Injuries in various stages of healing D. Scraped knees

D)

Which one of the following statements about EMS in the United States is​ true? A. The Federal Department of Health and Human Services establishes curricula for all levels of EMS education. B. The federal government oversees all aspects of EMS in the United States. C. The EMS system is controlled and governed by the National Highway Transport and Safety Administration​ (NHTSA). D. Each state has governmental control of its own EMS​ system, independent of the federal government.

D)

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) Elderly patients may experience a myocardial infarction without recognizing it as such because it is not accompanied by classic chest pain.

Which choice is LEAST likely as a health care implication of poverty and​ homelessness? A. The homeless and impoverished do not have access to prescription medications to control chronic health conditions. B. There is a higher rate of physical abuse against the homeless and impoverished. C. Homeless patients can receive the same quality of health care by utilizing the emergency department for their health needs. This is the correct answer.D. The homeless often experience delays in diagnosis of chronic medical problems.

c)