EMT Geriatrics and Special Populations Practice Questions
A 73 y/o female experienced a syncopal episode while watching TV. She is now conscious, but is diaphoretic, tachypneic, and hypotensive. Your assessment reveals abdominal tenderness and a pulsating mass to the left of her umbilicus. You should suspect: A) AAA B) acute appendicitis C) a strangulated bowel D) MI
A) AAA
Causes of delirium in the older patient include all of the following EXCEPT: A) AD B) hypoglycemia C) acute hypovolemia D) decreased cerebral perfusion
A) AD
You are assessing a 70 y/o female who complains of intense thirst, frequent urination, and dizziness. She has a history of T2DM, heart disease, rheumatoid arthritis, and gout. Her BGL reads "high". She is conscious, but confused. Her BP is 92/52, pulse is 130 bpm and weak, and respirations are 22/min and shallow. The patient's clinical presentation is MOST consistent with: A) HHNS B) hyperglycemia with moderate dehydration C) DKA D) acute renal failure with associated hyperglycemia
A) HHNS
Under what circumstances is an LVAD used? A) as a bridge to heart transplantation while a donor heart is being located B) to permanently replace the function of one or both of the ventricles C) to ensure that the ventricles contract at an adequate and consistent rate D) to reduce ventricular pumping force in patients with aortic aneurysms
A) as a bridge to heart transplantation while a donor heart is being located
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) attempt to resuscitate the patient B) try to locate the documentation C) allow the patient to die in peace D) contact medical control for advice
A) attempt to resuscitate the patient
When documenting a case of suspected elder abuse, it is MOST important for the EMT to: A) avoid documenting any unsupported opinions B) document his or her perceptions of the event C) theorize as to why the patient was abused D) list the names of the suspected abusers
A) avoid documenting any unsupported opinions
Syncope in an 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 MI D) rarely life-threatening but should be evaluated by a physician
A) caused by an interruption of blood flow to the brain
Vagal nerve stimulators may be an alternative treatment to medication for patients with: A) chronic seizure disorders B) inherently slow HR C) certain psychiatric conditions D) chronic muscle pain and fatigue
A) chronic seizure disorders
A surgical procedure that creates an opening between the intestine and the surface of the body that allows for elimination of waste products is called a(n): A) colostomy B) intestinal shunt C) gastrostomy D) gastric stoma
A) colostomy
Which of the following statements regarding interaction with the caregiver or a child or adult with special healthcare needs is correct? A) communication with the patient's caregiver or family members is important because they are the most familiar with the patient's condition B) in most cases, it is more appropriate for the EMT to contact medical control prior to speaking with the patient's primary caregiver C) before performing an assessment of the patient's ABCs, the EMT should ask the caregiver about the patient's medical condition D) in general, the EMT should only speak with a certified home healthcare provider because they are the expert on the patient's illness
A) communication with the patient's caregiver or family members is important because they are the most familiar with the patient's condition
With age, the spine stiffens as a result of shrinkage of the intervertebral disk spaces, and the vertebrae become brittle. This increases the risk of: A) compression fractures B) kyphosis C) distracting injuries D) spinal cord tearing
A) compression fractures
Which of the following regarding cerebral palsy is correct? A) conditions such as brain injury at birth, postpartum infections, and fetal hypoxia can cause cerebral palsy B) most cases of cerebral palsy develop within the first 10 years of life and are typically caused by meningitis C) approximately 25% of patients with cerebral palsy possess some varying degrees of developmental delays D) a key clinical feature of cerebral palsy is paralysis of the respiratory muscles, which confines the patient to a ventilator
A) conditions such as brain injury at birth, postpartum infections, and fetal hypoxia can cause cerebral palsy
You are dispatched to a skilled nursing facility for an 80 y/o female with abnormal behavior. The patient is clearly confused and asks if you are her husband. You should: A) determine the patient's baseline mental status B) inquire about a history of AD C) obtain a complete list of the patient's medications D) ask an attendant for the patient's medical records
A) determine the patient's baseline mental status
To minimize distractions and confusion when assessing an older patient, you should: A) have only one EMT speak to the patient at a time B) perform a physical exam and then talk to the patient C) elevate your voice and speak directly to the patient D) dismiss the family members from the room or area
A) have only one EMT speak to the patient at a time
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
A) help EMS personnel remember what is different about elderly patients
An AAA: A) is often the result of HTN and atherosclerosis B) can sometimes be palpated as a mass in the groin C) causes dull pain that often radiates to the shoulders D) is usually not repairable, even if discovered early
A) is often the result of HTN and atherosclerosis
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
A) is usually considered irreversible
The stooped posture of some older people, which gives them a humpback appearance, is called: A) kyphosis B) scoliosis C) miosis D) arthritis
A) kyphosis
Motor nerve neuropathy is characterized by: A) loss of balance, muscle weakness, and spasms B) loss of bladder control and sensitivity to touch C) numbness, tingling, and severe muscle pain D) constipation, low blood pressure, and bradycardia
A) loss of balance, muscle weakness, and spasms
Talking about an elderly patient in front of them to other members of the family: A) may cause the patient to think that they have no say in making decisions B) often causes the patient to become paranoid and untrusting of your help C) is usually beneficial because the patient's cognitive skills are typically impaired D) will anger the patient and result in their refusal to accept care or transport
A) may cause the patient to think that they have no say in making decisions
Which of the following statements regarding autism is correct? A) most cases of autism are diagnosed by 3 years of age B) the majority of patients with autism do not speak at all C) impairment of motor activity is a classic sign of autism D) autism affects females four times greater than males
A) most cases of autism are diagnosed by 3 years of age
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) older patients tend to use more lethal means than younger patients
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) comminuted fracture D) compression fracture
A) pathologic fracture
EMTs are dispatched for a patient in cardiac arrest. When they arrive, they find that the patient is pulseless and apneic, and is waring an external defibrillator vest. In this situation, the EMTs should: A) perform CPR and leave the vest in place B) quickly remove the vest and perform CPR C) apply the AED pads over the vest's pads D) wait 5 mins prior to using the AED
A) perform CPR and leave the vest in place
When immobilizing a patient with a kyphotic spine to a long backboard, the EMT would MOST likely have to: A) place blankets behind the patient's head B) force the head into a neutral alignment C) use a scoop stretcher instead of a log roll D) secure the patient's head before the torso
A) place blankets behind the patient's head
General techniques for communicating with hearing-impaired patients include: A) positioning yourself approximately 18 inches directly in front of the patient B) removing any hearing aids and using pen and paper to ask questions C) exaggerating your lip movements to ensure the patient understands D) speaking directly into the patient's ear with an increased pitch
A) positioning yourself approximately 18 inches directly in front of the patient
When an elderly patient presents you with multiple OTC medications that they are 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) contact each of the physicians whose names are on the medications D) look up all of the medications before providing care to the patient
A) recall that the patient is at risk for negative medication interactions
In contrast to an AICD, an internal cardiac pacemaker: A) regulates the patient's HR if it falls below a preset value B) delivers a shock to the heart if the rate becomes exceedingly fast C) is implanted under the skin in the left upper abdominal quadrant D) will only activate if it detects rhythms such as V-fib
A) regulates the patient's HR if it falls below a preset value
A ventricular atrium shunt drains excess fluid from the ventricles of the brain into the: A) right atrium B) left ventricle C) left atrium D) right ventricle
A) right atrium
Because a tracheostomy tube bypasses the nose and mouth: A) secretions can build up in and around the tube B) bleeding or air leakage may occur around the tube C) severe swelling of the trachea and bronchi can occur D) the risk of a local infection is significantly high
A) secretions can build up in and around the tube
You are dispatched to a residence for an 80 y/o 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 AD
A) she became dizzy or fainted before falling
A tube from the brain to the abdomen that drains excessive CSF is called a: A) shunt B) CS tube C) G-tube D) cerebral bypass
A) shunt
When caring for a patient who is visually impaired, it is important to: A) tell them what is happening, identify noises, and describe the situation and surroundings B) leave items such as canes and walkers at the residence if the patient will be carried on a gurney C) allow a service dog to remain with the patient at all times, even if the patient is critically ill D) stand to the side of the patient when speaking if their peripheral vision is impaired
A) tell them what is happening, identify noises, and describe the situation and surroundings
In contrast to younger patients, older patients are more prone to a decrease in blood pressure upon standing because: A) the body is less able to adapt the BP to rapid postural changes B) any change in position causes BP to be shunted to the brain C) the aging process results in an overall increase in blood volume D) their RBCs are destroyed at a faster than normal rate
A) the body is less able to adapt the BP to rapid postural changes
A 77 y/o female presents with an acute onset of AMS. Her son is present and advises that she has a history of HTN, A-fib, T2DM, and glaucoma. He further advises that she takes numerous medications and 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) dementia typically presents as an acute onset of deterioration of cognitive function C) because of her age and medical history, you should suspect Alzheimer's disease D) her mental status is likely the result of hypoglycemia and you should give her sugar
A) the patient is experiencing delirious behavior, which suggests a new health problem
Which of the following represents the "E" in the GEMS diamond? A) the patient's residence is cold due to a malfunctioning heater B) a patient is assisted with their ADLs C) the patient's medications have not been filled in 2 months D) elderly patients present atypically and deserve your respect
A) the patient's residence is cold due to a malfunctioning heater
Which of the following statements regarding the aging process is correct? A) the process of aging is gradual, and the rate at which a person loses functions does not increase with age B) because they are younger and healthier, a 35 y/o person ages slower than a 75 y/o person C) human growth and development peaks in the late 40s or 50s, at which point the aging process sets in D) the older a person gets, the slower the decline in function of vital organs
A) the process of aging is gradual, and the rate at which a person loses functions does not increase with age
When caring for patients with cerebral palsy, it is important to remember that: A) their limbs are often underdeveloped and are prone to injury B) hearing aids are usually ineffective for patients with hearing loss C) they are unable to walk and are totally dependent on others D) most patients have the ability to walk, but have an unsteady gait
A) their limbs are often underdeveloped and are prone to injury
Many older victims of physical abuse may make false statements or lie about the origin of their injuries because: A) they fear retaliation from the abuser B) they do not want to be bothersome C) most elderly patients have dementia D) they are protective of the absuer
A) they fear retaliation from the abuser
Which of the following statements is NOT true regarding patients with autism? A) they will talk with normal tone and speech patterns B) they have difficulty making eye contact C) they fail to use or understand nonverbal communication D) they may have extreme difficulty with complex tasks that require many steps
A) they will talk with normal tone and speech patterns
When explaining the need for a particular procedure to an elderly patient, you should: A) use plain language and simple terms B) be complex so the patient fully understands C) use the appropriate medical terminology D) realize that they will not understand you
A) use plain language and simple terms
The tip of a central venous catheter rests in the: A) vena cava B) left atrium C) right ventricle D) pulmonary vein
A) vena cava
You receive a call for a sick person. When you arrive, you find the patient, a 75 y/o male, lying unresponsive in 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 911. His PMHx is significant for hypothyroidism, DVT, 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 SDH C) acute ischemic stroke D) DKA
B) a SDH
EMTs are dispatched for a fall. The patient, a 16 y/o female with Down syndrome, is experiencing difficulty walking and says that her fingers "feel like needles". The EMTs should suspect: A) an ICH B) a c-spine injury C) a seizure D) hydrocephalus
B) a c-spine injury
Characteristic anatomic features of Down syndrome include: A) a proportionately small tongue B) a round head with a flat occiput C) bulging eyes and a large face D) long hands with wide fingers
B) a round head with a flat occiput
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 ADLs
B) accuse a caregiver of physical abuse
Common causes of depression in the elderly include all of the following EXCEPT: A) chronic medical conditions B) acute onset of dementia C) prescription medication use D) alcohol abuse and dependence
B) acute onset of dementia
EMTs are dispatched for a patent whose central venous catheter is malfunctioning. When they arrive and assess the patient, they find bleeding from the tubing attached to the line. The EMTs should: A) carefully remove the catheter and transport B) apply direct pressure to the tubing and transport C) request an ALS ambulance to clamp the tubing D) gently manipulate the catheter to reduce the bleeding
B) apply direct pressure to the tubing and transport
Cerebral palsy is characterized by poorly controlled _________ movement. A) extremity B) body C) eye D) neck
B) body
Cerebral palsy is a condition that results from damage or injury to the: A) spinal cord B) brain C) peripheral nervous system D) voluntary muscles
B) brain
According to the "E" in the DOPE mnemonic, which of the following actions should you perform to troubleshoot inadequate ventilation in a patient with a tracheostomy tube? A) attempt to pass a suction catheter into the tube B) check the mechanical ventilator for malfunction C) listen for breath sounds to assess for PTX D) look for blood or other secretions in the tube
B) check the mechanical ventilator for malfunction
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
B) chronically increased afterload
The slow onset of progressive disorientation, shortened attention span, and loss of cognitive function is known as: A) paranoia B) dementia C) delusion D) delirium
B) dementia
When assessing a geriatric patient who has possibly experienced an acute ischemic stroke, it is MOST important to: A) ascertain if there is a history of atrial fibrillation B) determine the onset of the patient's symptoms C) determine if the patient has risk factors for a stroke D) administer 324 mg ASA as soon as possible
B) determine the onset of the patient's symptoms
Which of the following is the MOST common mechanism of injury in older patients? A) suicide B) falls C) abuse D) burns
B) falls
For which of the following conditions would you MOST likely encounter a VP shunt? A) epidural hematoma B) hydrocephalus C) cerebral palsy D) SDH
B) hydrocephalus
Because hearing-impaired patients typically have more difficulty hearing high-frequency sounds, it is important for you to: A) speak in a monotone voice B) lower the pitch of your voice C) increase the pitch of your voice D) try basic sign language first
B) lower the pitch of your voice
In contrast to conductive hearing loss, sensorineural hearing loss is caused by: A) barotrauma B) nerve damage C) earwax accumulation D) eardrum perforation
B) nerve damage
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 caregiver B) observe for conditions that may make the residence unsafe C) talk to the patient after performing the primary assessment D) begin the assessment after gathering any medication bottles
B) observe for conditions that may make the residence unsafe
Poor maintenance of home, poor personal care, and dietary neglect are all possible indicators of ______ elder abuse. A) emotional B) physical C) financial D) psychological
B) physical
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) polypharmacy
The purpose of a VP shunt is to: A) monitor pressure within the skull in patients with a head injury B) prevent excess CSF from accumulating in the brain C) divert excess CSF to the ventricles of the brain D) remove fluid from the abdomen in patients with right-sided heart failure
B) prevent excess CSF from accumulating in the brain
Which of the following does NOT contribute to or cause obesity? A) high caloric intake B) rapid metabolism C) low metabolic rate D) genetic predisposition
B) rapid metabolism
Blood levels of medications may rise in the elderly, sometimes to toxic levels. This is MOST likely due to: A) splenic dysfunction B) renal insufficiency C) intentional overdose D) pancreatic failure
B) renal insufficiency
When enlisting the help of an interpreter who signs, it is important for you to ask the interpreter to: A) document the answers to the questions that the patient has responded to B) report exactly what the patient signs and not to add any commentary C) avoid any kind of lip movement while they are signing with the patient D) voice what they are signing while communicating with the patient
B) report exactly what the patient signs and not to add any commentary
Common associated conditions in patients with spina bifida include all of the following EXCEPT: A) hydrocephalus B) spastic limb movement C) extreme latex allergy D) loss of bladder control
B) spastic limb movement
In contrast to a living will, a DNR order becomes valid when: A) the patient has a terminal illness B) the patient develops cardiac arrest C) the patient is in a healthcare setting D) it is signed by three or more physicians
B) the patient develops cardiac arrest
Common causes of syncope in older patients include all of the following: A) venous pooling B) vasoconstriction C) acute hypotension D) blood volume loss
B) vasoconstriction
When caring for a patient with a previous head injury, you should: A) never consider restraining the patient B) watch the patient for signs of anxiety C) speak in a loud, commanding tone D) expect the patient to be able to walk
B) watch the patient for signs of anxiety
A person is said to be obese when they are ________ over their ideal weight. A) 20% or more B) 10% or more C) 30% or more D) 40% or more
C) 30% or more
Osteoporosis is 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
C) a decrease in bone mass and density
During the natural aging process, the number of functional cilia in the respiratory system decreases, resulting in: A) an increased risk of COPD B) baseline respiratory distress C) a decreased ability to cough D) air-trapping within the alveoli
C) a decreased ability to cough
An 84 y/o male fell a week ago and has been bedridden since then. Today, he presents with AMS. His skin is pale and cold, and his respirations are rapid and shallow. The EMT should suspect: A) acute hyperglycemia B) hypovolemic shock C) a systemic infection D) a SDH
C) a systemic infection
Down syndrome is a genetic defect that occurs as the result of: A) a separation of chromosome 21 B) a sperm that contains 24 chromosomes C) a triplication of chromosome 21 D) an extra pair of chromosomes
C) a triplication of chromosome 21
A 70 y/o male complains of a sudden onset of dyspnea. He has dried blood on his lips and is very anxious. His left leg is red, swollen, and painful. The EMT should: A) suspect severe pneumonia B) position the patient supine C) administer high-flow oxygen D) apply a cold pack to his leg
C) administer high-flow oxygen
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) physician directive B) statute of care C) advance directive D) power of attorney
C) advance directive
According to the Emergency Medical Treatment and Active Labor Act (EMTALA): A) a patient maintains the legal right to recant their consent to emergency treatment, even after signing into the emergency department B) a healthcare facility has the right to refuse assessment and treatment to a patient, but only if their condition is not deemed critical C) all healthcare facilities must provide a medical assessment and required treatment, regardless of the patient's ability to pay D) all healthcare facilities are legally obligated to provide assessment and care only if the patient is critically injured or ill
C) all healthcare facilities must provide a medical assessment and required treatment, regardless of the patient's ability to pay
When interacting with an intellectually disabled patient, then best approach is to: A) speak primarily with the patient's family to establish the degree of disability B) position yourself slightly above the patient's level to reduce their anxiety C) ask your team members to wait until you can establish a rapport with the patient D) approach the patient as a team to reassure them that you are there to help
C) ask your team members to wait until you can establish a rapport with the patient
Because of the complexity of the older patient and the vagueness of their complaint, you should: A) limit your exam to the area of pain or injury B) perform a rapid assessment on all geriatric patients you treat C) attempt to differentiate between chronic and acute problems D) rely exclusively on family members for the medical history
C) attempt to differentiate between chronic and acute problems
If suctioning of the tracheostomy tube is necessary, the EMT should: A) attach a BVM to the tracheostomy tube and hyperventilate the patient for 2 mins B) instill 20 mL of saline into the tracheostomy tube and suction for no longer than 20 seconds C) attempt to use the patient's suction device first, because it is probably already sized correctly D) insert the suction catheter to a depth of no more than 15 cm and set the suction unit to 140 mmHg
C) attempt to use the patient's suction device first, because it is probably already sized correctly
You are assessing a 440 lb man who complains of SOB and lower back pain. The patient is conscious and alert, his BP is 148/98, and his HR is 120 bpm. Your MOST immediate action should be to: A) notify the receiving facility and advise them of the patient's weight and status B) perform a secondary assessment, focusing on his respiratory system and back C) avoid placing him in a supine position if possible, and administer oxygen D) ask a member of your team to locate the best route to move him to the ambulance
C) avoid placing him in a supine position if possible, and administer oxygen
When assessing or providing care to a patient with an intellectual disability, you should: A) move swiftly and deliberately to quickly accomplish the task B) frequently reassure him or her that everything will be okay C) be observant for signs of fear or reluctance from the patient D) explain procedures while in the process of performing them
C) be observant for signs of fear or reluctance from the patient
If a patient's mechanical ventilator malfunctions, you should remove the patient from the ventilator and: A) place the patient on a NRB B) contact medical control C) begin ventilations with a BVM D) place the patient on a NC
C) begin ventilations with a BVM
When assessing a 78 y/o female who complains of SOB, the EMT should: A) place the patient supine to see if the problem worsens B) conclude that the patient is experiencing an MI C) determine the position in which the patient normally sleeps D) give oxygen only if the patient has labored breathing
C) determine the position in which the patient normally sleeps
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: A) suction her airway, apply a c-collar, administer high-flow oxygen via NRB, and perform a rapid assessment B) open her airway with the head tilt-chin lift, insert an OPA or NPA, and assess her BGL to rule out hypoglycemia C) direct your partner to manually stabilize her head while you quickly visualize her chest for signs of breathing D) begin assisting ventilations with a BVM while your partner auscultates her lung sounds to ensure adequate positive-pressure ventilations
C) direct your partner to manually stabilize her head while you quickly visualize her chest for signs of breathing
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
C) frequently asking the patient if he or she understands
EMS personnel would MOST likely be called to the residence of a patient receiving home health care when the home care provider: A) needs simple assistance in providing patient care B) must confirm that a specific intervention is required C) has recognized a change in the patient's health status D) has a question that is specific to the patient's condition
C) has recognized a change in the patient's health status
Patients with autism: A) use and understand nonverbal means of communicating messages B) prefer to maintain eye contact with whomever is talking with them C) have extreme difficulty with complex tasks that require many steps D) often speak with speech patterns that alternate in tone and speed
C) have extreme difficulty with complex tasks that require many steps
Which of the following regarding hearing aids is correct? A) over time, hearing aids can restore normal hearing B) in-the-canal hearing aids fit in the outer part of the ear C) hearing aids cannot restore hearing to normal levels D) a whistling sound indicates correct hearing aid placement
C) hearing aids cannot restore hearing to normal levels
The leading cause of death in the geriatric patient is: A) HTN B) arthritis C) heart disease D) AMS
C) heart disease
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
C) human resource agencies fail to investigate
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
C) outdated medications
Which of the following statements regarding gastrostomy tubes is correct? A) gastrostomy tubes are placed directly into the small intestine B) most gastrostomy tubes are temporary and are not sutured in place C) patients with a gastrostomy tube may still be at risk for aspiration D) gastrostomy tubes are used for patients who cannot digest food
C) patients with a gastrostomy tube may still be at risk for aspiration
Sedentary behavior while healing from a hip fracture would MOST likely predispose the older patient to: A) ischemic stroke B) osteoporosis C) pneumonia D) heart failure
C) pneumonia
When caring for an elderly patient who is hearing impaired, you should: A) remember that most hearing-impaired patients can read lips B) request that they communicate with you by writing on paper C) recall that elderly patients often have difficulty hearing high-frequency sounds D) speak directly into his or her ear with an elevated tone
C) recall that elderly patients often have difficulty hearing high-frequency sounds
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
C) recall that it will take a less severe mechanism of injury to cause significant injuries
General care for a patient with a tracheostomy tube includes all of the following EXCEPT: A) suctioning the tube as needed to clear a thick mucous plug B) maintaining the patient in a position of comfort when possible C) removing the tube if the area around it appears to be infected D) ensuring adequate oxygenation and ventilation at all times
C) removing the tube if the area around it appears to be infected
Down syndrome patients are at an increased risk for medical complications. Which of the following is NOT one of those potential complications? A) endocrine complications B) GI complications C) respiratory complications D) CV complications
C) respiratory complications
Which of the following conditions would MOST likely be encountered in a patient with cerebral palsy? A) brain tumors B) T2DM C) seizure disorder D) paralysis
C) seizure disorder
The EMT should suspect left-sided heart failure in the geriatric patient who presents with: A) fever and cough that produces green sputum B) JVD and peripheral edema C) tachypnea and paroxysmal nocturnal dyspnea D) swelling of the lower extremities and weakness
C) tachypnea and paroxysmal nocturnal dyspnea
A 69 y/o female was involved in an MVC. She is semiconscious with a BP of 80/50 and HR of 74 bpm that is weak. Her daughter, who was uninjured in the crash, tells you that her mother has a history of HTN 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) failure of the PSNS B) intrathoracic bleeding and cardiac compression C) the effects of her antihypertensive medication D) deterioration of the cardiac conduction system
C) the effects of her antihypertensive medication
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
C) the injury may have been preceded by a medical condition
When transporting a stable older patient to the hospital, the MOST effective way to reduce their anxiety is to: A) allow at least two family members to accompany the patient B) avoid the use of a long backboard, even if trauma is suspected C) transport them to a hospital that they are familiar with D) perform frequent detailed assessments to gain the patient's trust
C) transport them to a hospital that they are familiar with
A 70 y/o male complains of SOB. During your assessment, you note that he has bilateral hearing aids. When you ask him questions related to your chief complaint, he does not answer you. You can hear a whistling sound coming from his hearing aids. You should: A) remove both of his hearing aids and use pencil and paper to communicate B) recognize that the batteries in his hearing aids are probably depleted C) try repositioning the hearing aid or remove it and turn down the volume D) remove his hearing aids, turn up the volume, and replace them in his ears
C) try repositioning the hearing aid or remove it and turn down the volume
Which of the following would be the MOST practical method of communicating with a hearing-impaired patient until his or her hearing aids can be located? A) contacting dispatch and requesting a sign language interpreter B) using a high-pitched voice while speaking directly into the ear C) using a piece of paper and writing utensil to ask questions D) attempting to use body language to determine the problem
C) using a piece of paper and writing utensil to ask questions
Which of the following patients is at highest risk for a PE? A) 78 y/o female who takes blood thinners B) 66 y/o active female with history of HTN C) 59 y/o male who is recovering from pneumonia D) 71 y/o male with recent surgery to a lower extremity
D) 71 y/o male with recent surgery to a lower extremity
Spina bifida is defined as: A) chronic pressure on the brain caused by excess CSF B) a birth defect in which the child is born without spinal vertebrae C) congenital inflammation of the spinal cord, usually in the neck D) a birth defect caused by incomplete closure of the spinal column
D) a birth defect caused by incomplete closure of the spinal column
By placing one hand on your head and the other hand over your abdomen, you are asking a hearing-impaired patient if they: A) are hurt B) are nauseated C) need help D) are sick
D) are sick
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) do not have deformities to the skull C) have a history of AD D) are taking blood-thinners
D) are taking blood-thinners
A 13 y/o child is on a home ventilator. The parents called because the mechanical ventilator is malfunctioning and the child has increasing respiratory distress. You should: A) attempt to troubleshoot the mechanical ventilator problem B) place a call to the home health agency treating this patient C) reset the ventilator by unplugging it for 30-60 seconds D) disconnect the ventilator and apply a tracheostomy collar
D) disconnect the ventilator and apply a tracheostomy collar
When caring for a morbidly obese patient, you should: A) leave them in a supine position B) ask the patient if they know what led to their obesity problem C) call for ALS backup because obese patients are at high risk for MI D) establish their chief complaint and then communicate your plan to help
D) establish their chief complaint and then communicate your plan to help
A service dog is easily identified by its: A) size B) breed C) color D) harness
D) harness
The reduction in brain weight and volume increases an older person's risk for: A) dementia B) delirium C) stroke D) head trauma
D) head trauma
You respond to a residence for a 9 y/o female with Down syndrome who is sick. When you arrive at the scene and assess the patient, you determine that she is unresponsive and has gurgling respirations. You should: A) insert an OPA and begin assisting ventilations with a BVM B) open her airway with the jaw-thrust maneuver and assess the rate and depth of her breathing C) immediately apply high-flow oxygen via NRB and then assess pulse rate D) open her airway with a manual maneuver, suction her oropharynx, and insert a simple airway adjunct
D) open her airway with a manual maneuver, suction her oropharynx, and insert a simple airway adjunct
Which of the following statements regarding patients with intellectual disabilities is correct? A) most patients with intellectual disabilities have normal cognitive function, but abnormal physical features B) speaking with the patient's family is the least effective way to determine how much the patient understands C) an intellectual disability differs from mental retardation in that it is the result of a congenital abnormality D) patients with intellectual disabilities are susceptible to the same disease processes as other patients
D) patients with intellectual disabilities are susceptible to the same disease processes as other patients
Autism is defined as a: A) psychiatric condition related to an imbalance of serotonin in the brain B) mental disability caused by insufficient cognitive development of the brain C) congenital condition caused by factors such as malnutrition or birth complications D) pervasive developmental disorder characterized by impairments of social interaction
D) pervasive developmental disorder characterized by impairments of social interaction
A productive cough, fever, and chills in an 80 y/o patient with a compromised immune system should make you MOST suspicious for: A) heart failure B) bronchitis C) emphysema D) pneumonia
D) pneumonia
An important aspect in the assessment of a patient who experienced a previous brain injury includes: A) presuming that they have cognitive impairment until proven otherwise B) contacting the patient's physician to determine the extent of the brain injury C) recalling that most patients with a brain injury have other organ dysfunction D) speaking with the patient and family to establish what is considered normal for the patient
D) speaking with the patient and family to establish what is considered normal for the patient
Airway management can be challenging in patients with Down syndrome because their: A) occiput is round, which causes flexion of the neck B) mandible is large, which inhibits a mask-to-face seal C) tongue is relatively small and falls back in the throat D) teeth are misaligned and they have a large tongue
D) teeth are misaligned and they have a large tongue
A "silent" heart attack occurs when: A) sweating is the only presentation B) a sudden dysrhythmia causes death C) the patient minimizes the chest pain D) the usual chest pain is not present
D) the usual chest pain is not present
An elderly patient may understate or minimize the symptoms of their illness because: A) of decreased perception of pain B) of conditions such as dementia C) the nervous system has deteriorated D) they fear hospitalization
D) they fear hospitalization
You receive a call to a residence for an apneic 2-month-old male. when you arrive at the scene, the infant's mother tells you that her son was born prematurely and his apnea monitor has alarmed 4 times in the past 30 mins. Your assessment reveals that he is conscious and active. His skin is pink and dry, and he is breathing at an adequate rate and with adequate tidal depth. His SpO2 reads 98% on RA. You should: A) request an ALS ambulance to transport the infant to the hospital B) advise the mother to observe her son and call 911 again if necessary C) administer high-flow oxygen and observe for a drop in SpO2 D) transport the infant to the hospital and bring the apnea monitor with you
D) transport the infant to the hospital and bring the apnea monitor with you
Which of the following is NOT true regarding the care of a patient with cerebral palsy? A) be prepared to care for a seizure if one occurs B) limbs are often underdeveloped and prone to injury C) do not assume these patients are mentally disabled D) walkers or wheelchairs should not be taken in the ambulance
D) walkers or wheelchairs should not be taken in the ambulance
