37 and 38

A person is said to be obese when he or she is ________ over his or her ideal weight. A) 40% to 50% B) 5% to 10% C) 10% to 15% D) 20% to 30%

20% to 30%

Which of the following patients would require the MOST structured and comprehensive dependent living facility? A) A 69-year-old male with Alzheimer disease B) A 76-year-old male with cardiovascular disease C) A 65-year-old female with controlled diabetes D) A 72-year-old female who is hearing impaired

A 69-year-old male with Alzheimer disease

Which of the following conditions would NOT cause acute delirious behavior? A) Alzheimer disease B) Severe hypovolemia C) Cerebral hypoxia D) Blood glucose of 30 mg/dL

Alzheimer disease

Under what circumstances is a left ventricular assist device used? A) To ensure that the ventricles contract at an adequate and consistent rate B) To reduce ventricular pumping force in patients with aortic aneurysms C) To permanently replace the function of one or both of the ventricles D) As a bridge to heart transplantation while a donor heart is being located

As a bridge to heart transplantation while a donor heart is being located

Which of the following statements regarding interaction with the caregiver of a child or adult with special health care needs is correct? A) In general, the AEMT should only speak with a certified home health care provider because he or she is the expert on the patient's illness. B) Communication with the home care provider or patient's caregiver is important because they are the most familiar with the patient's condition. C) In most cases, it is more appropriate for the AEMT to contact medical control prior to speaking with the patient's primary caregiver. D) Before performing an assessment of the patient's ABCs, the AEMT should ask the caregiver about the patient's medical condition.

Communication with the home care provider or patient's caregiver is important because they are the most familiar with the patient's condition.

Which of the following statements regarding cerebral palsy is correct? A) A key clinical feature of cerebral palsy is paralysis of the respiratory muscles, which confines the patient to a ventilator. B) Conditions such as brain injury at birth, postpartum infections, and fetal hypoxia can cause cerebral palsy. C) Approximately 25% of patients with cerebral palsy possess some varying degrees of developmental delay. D) Most cases of cerebral palsy develop within the first 10 years of life and are typically caused by meningitis.

Conditions such as brain injury at birth, postpartum infections, and fetal hypoxia can cause cerebral palsy.

Which of the following physiologic responses would MOST likely occur when an elderly patient experiences hypovolemic shock? A) Arterial hypertension caused by sustained vasoconstriction B) Profound vasoconstriction and peripheral blood shunting C) Decreased ability to increase heart rate and contractility D) Significant tachycardia and weakened cardiac contraction

Decreased ability to increase heart rate and contractility

Which of the following statements regarding delirium and dementia is correct? A) Delirium is caused by a progressive disease. B) Alzheimer disease is a form of delirium. C) Delirium is an acute change in mentation. D) Dementia is caused by an acute condition.

Delirium is an acute change in mentation.

______________ is/are the leading cause of trauma, death, and disability in older patients. A) Motor-vehicle crashes B) Abuse C) Self-inflicted injuries D) Falls

Falls

Which of the following is an example of a developmental disability? A) Alzheimer's disease B) Fetal alcohol syndrome C) Parkinson disease D) Uncontrolled hypertension

Fetal alcohol syndrome

Which of the following conditions would NOT cause weakness and dizziness in the elderly patient? A) Hypotension B) Inner ear infections C) Dysrhythmias D) Glaucoma

Glaucoma

Which of the following statements 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.

Hearing aids cannot restore hearing to normal levels.

For which of the following conditions would you MOST likely encounter a ventriculoperitoneal shunt? A) Hydrocephalus B) Cerebral palsy C) Subdural hematoma D) Heart failure

Hydrocephalus

Which of the following conditions would MOST likely make spinal immobilization of an elderly patient especially challenging? A) Osteoporosis B) Arthritis C) Myalgia D) Kyphosis

Kyphosis

Which of the following conditions is characterized by a reduction in the center of vision and is especially common in older diabetics? A) Cataracts B) Glaucoma C) Macular degeneration D) Diabetic neuropathy

Macular degeneration

Which of the following statements regarding autism is correct? A) Impairment of motor activity is a classic sign of autism. B) The majority of patients with autism do not speak at all. C) Most cases of autism are diagnosed by 3 years of age. D) Autism affects females four times greater than males.

Most cases of autism are diagnosed by 3 years of age.

Which of the following conditions would MOST likely cause a patient to slur words, speak very slowly, or speak in a monotone? A) Advanced age B) Parkinson disease C) Visual impairment D) Cerebral palsy

Parkinson disease

Which of the following statements regarding gastrostomy (gastric) tubes is correct? A) Gastrostomy tubes are placed directly into the small intestine. B) Patients with a gastrostomy tube may still be at risk for aspiration. C) Gastrostomy tubes are used for patients who cannot digest food. D) Most gastrostomy tubes are temporary and are not sutured in place.

Patients with a gastrostomy tube may still be at risk for aspiration.

Which of the following is an example of physical abuse? A) Poor personal care B) Benign neglect C) Verbal defamation D) Sensory stimulation deprivation

Poor personal care

Which of the following is an example of physical abuse? A) Sensory stimulation deprivation B) Poor personal care C) Benign neglect D) Verbal defamation

Poor personal care

Which of the following is NOT an expected physiologic response to the natural process of aging? A) Progressive and steady decrease in the blood pressure B) Decreased ability to maintain core body temperature C) Decreased motor nerve function and reaction time D) Weight gain due to a decrease in the metabolic rate

Progressive and steady decrease in the blood pressure

Which of the following does NOT usually contribute to or cause obesity? A) Low metabolic rate B) High caloric intake C) Genetic predisposition D) Rapid metabolism

Rapid metabolism

Which of the following does NOT usually contribute to or cause obesity? A) Low metabolic rate B) Rapid metabolism C) Genetic predisposition D) High caloric intake

Rapid metabolism

Which of the following is a significant risk factor that affects mortality in elderly patients? A) Slightly impaired mobility B) Age older than 65 years C) Urinary or fecal continence D) Recent death of a spouse

Recent death of a spouse

Which of the following statements regarding the elderly patient's nervous system is correct? A) Reduction in brain size increases the risk of significant head trauma. B) Parkinson's disease affects the cells in the sensory area of the brain. C) Alzheimer disease is the most common form of acute delirium. D) Short-term memory impairment is not simply the result of aging.

Reduction in brain size increases the risk of significant head trauma.

When interviewing a 70-year-old male with a headache, you ask him when the headache began. What should you do if he does not answer your question immediately? A) Remain patient and give him time to comprehend and answer your question. B) Immediately repeat the question but slightly increase the volume of your voice. C) Ask another pertinent question and requestion him later about the onset of the headache. D) Conclude that the patient does not understand you and transport him at once.

Remain patient and give him time to comprehend and answer your question.

Which of the following senses declines at the slowest rate? A) Taste B) Hearing C) Smell D) Vision

Smell

Which of the following findings would be MOST suggestive that an elderly patient who fell has been lying on the ground for a long period of time? A) The call is received in the morning and cold uneaten dinner is found on the table. B) The patient is incontinent and there are two messages on the answering machine. C) The patient is clearly confused and does not remember what time he or she fell. D) A neighbor requested EMS because the patient would not answer the telephone.

The call is received in the morning and cold uneaten dinner is found on the table.

Which of the following statements regarding vision in the older patient is correct? A) The pupils require more time to adjust to changes in light. B) The majority of older people have cataracts or glaucoma. C) Excess tear production is a normal part of the aging process. D) The pupils of an older person are normally asymmetrical.

The pupils require more time to adjust to changes in light.

A 69-year-old female presents with chest pressure and nausea. As you begin your assessment, the patient's husband hands you a valid "do not resuscitate" (DNR) document and tells you that his wife has terminal cancer. How should you manage this situation? A) Administer oxygen and pain relief only during transport to the hospital. B) Treat the patient as though she is experiencing a myocardial infarction. C) Adhere to the DNR order and not transport the patient to the hospital. D) Transport the patient and be prepared to defibrillate her if it is needed.

Treat the patient as though she is experiencing a myocardial infarction.

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) Using a high-pitched voice while speaking directly into the ear B) Using a piece of paper and writing utensil to ask questions C) Contacting dispatch and requesting a sign language interpreter D) Attempting to use body language to determine the problem

Using a piece of paper and writing utensil to ask questions

Which of the following is a reason why the prevalence of elder abuse is not fully known? A) Protective services organizations are overloaded. B) There is no official method for reporting abuse. C) Victims are often hesitant to report the crime. D) AEMTs are not required to report suspected abuse.

Victims are often hesitant to report the crime.

Which of the following is a reason why the prevalence of elder abuse is not fully known? A) There is no official method for reporting abuse. B) Protective services organizations are overloaded. C) AEMTs are not required to report suspected abuse. D) Victims are often hesitant to report the crime.

Victims are often hesitant to report the crime.

Which of the following findings would fall into the "E" category of the GEMS diamond? A) An elderly patient experiences a pathologic hip fracture due to osteoporosis. B) You slip on a throw rug upon entering the home of an elderly patient who fell. C) Your patient has a history of diabetes mellitus and degenerative joint disease. D) An elderly widowed female has no one whom she can call or with whom she can communicate.

You slip on a throw rug upon entering the home of an elderly patient who fell.

Assessment findings related to the "S" in the GEMS diamond include all of the following, EXCEPT: A) a 79-year-old male whose caretaker delays his prescribed medication. B) a 78-year-old female who falls after experiencing acute hypoglycemia. C) a 70-year-old male who is unable to feed himself in a nursing home. D) a 68-year-old female who does not have access to a telephone.

a 68-year-old female who does not have access to a telephone.

Spina bifida is MOST accurately defined as: A) congenital inflammation of the spinal cord, usually in the neck. B) chronic pressure on the brain caused by excess cerebrospinal fluid. C) a birth defect caused by incomplete closure of the spinal column. D) a birth defect in which the child is born without spinal vertebrae.

a birth defect caused by incomplete closure of the spinal column.

Characteristic anatomic features of Down syndrome include: A) long hands with wide fingers. B) bulging eyes and a large face. C) a round head with a flat occiput. D) a proportionately small tongu

a round head with a flat occiput.

A significant number of patients with cerebral palsy also have: A) brain tumors. B) a seizure disorder. C) paralysis. D) type 2 diabetes.

a seizure disorder.

A significant number of patients with cerebral palsy also have: A) brain tumors. B) type 2 diabetes. C) a seizure disorder. D) paralysis.

a seizure disorder.

Down syndrome is a genetic defect that occurs as the result of: A) a separation of chromosome 21. B) a triplication of chromosome 21. C) an extra pair of chromosomes. D) a sperm that contains 24 chromosomes.

a triplication of chromosome 21.

According to the Emergency Medical Treatment and Active Labor Act (EMTALA): A) all health care facilities are legally obligated to provide assessment and care only if the patient is critically ill or injured. B) a health care facility has the right to refuse assessment and treatment to a patient, but only if his or her condition is not deemed critical. C) a patient maintains the legal right to recant his or her consent to emergency treatment, even after signing in to the emergency department. D) all health care facilities must provide a medical assessment and required treatment, regardless of the patient's ability to pay.

all health care facilities must provide a medical assessment and required treatment, regardless of the patient's ability to pay.

Signs of a blocked ventriculoperitoneal or ventriculoatrial shunt include: A) tachycardia and severe vomiting without nausea. B) low-pitched cry (in infants) and low body temperature. C) altered mental status and projectile vomiting. D) sunken fontanelles (in infants) and neck stiffness.

altered mental status and projectile vomiting.

You are transporting an 80-year-old male who is hearing impaired. When speaking to the patient, you should: A) visually inspect both internal ears for the presence of cerumen. B) recall that changes in the inner ear distort low-frequency sounds. C) elevate your tone of voice and talk directly into the patient's ear. D) always attempt to position yourself on the patient's "good" side.

always attempt to position yourself on the patient's "good" side.

Because delirium and dementia can present in a similar manner, an important part of the assessment process of an elderly patient with an altered mental status is to: A) assume that dementia is the underlying cause. B) obtain a list of the patient's current medications. C) ascertain the patient's baseline mental status. D) give 50% dextrose to rule out hypoglycemia.

ascertain the patient's baseline mental status.

When interacting with a developmentally disabled patient, the best approach is to: A) approach the patient as a team to reassure him or her that you are there to help. B) ask your team members to wait until you can establish a rapport with the patient. C) speak primarily with the patient's family to establish the degree of disability. D) position yourself slightly above the patient's level to reduce his or her anxiety.

ask your team members to wait until you can establish a rapport with the patient.

When interacting with a developmentally disabled patient, the best approach is to: A) ask your team members to wait until you can establish a rapport with the patient. B) speak primarily with the patient's family to establish the degree of disability. C) position yourself slightly above the patient's level to reduce his or her anxiety. D) approach the patient as a team to reassure him or her that you are there to help.

ask your team members to wait until you can establish a rapport with the patient.

When assessing a 74-year-old male with an altered mental status, you should: A) recall that altered mentation is normal with aging. B) determine if he has ever had an ischemic stroke. C) attempt to determine his baseline mental status. D) be highly suspicious that he is hypoglycemic.

attempt to determine his baseline mental status.

You are assessing a 440-lb man who complains of shortness of breath and lower back pain. The patient is conscious and alert, his blood pressure is 148/98 mm Hg, and his heart rate is 120 beats/min. Your MOST immediate action should be to: A) ask a member of your team to locate the best route to move him to the ambulance. B) avoid placing him in a supine position if possible and administer oxygen. C) perform a secondary assessment, focusing on his respiratory system and back. D) notify the receiving facility and advise them of the patient's weight and status.

avoid placing him in a supine position if possible and administer oxygen.

You are assessing a 440-lb man who complains of shortness of breath and lower back pain. The patient is conscious and alert, his blood pressure is 148/98 mm Hg, and his heart rate is 120 beats/min. Your MOST immediate action should be to: A) ask a member of your team to locate the best route to move him to the ambulance. B) notify the receiving facility and advise them of the patient's weight and status. C) avoid placing him in a supine position if possible and administer oxygen. D) perform a secondary assessment, focusing on his respiratory system and back.

avoid placing him in a supine position if possible and administer oxygen.

When assessing or providing care to a patient with a developmental disability, you should: A) explain procedures while in the process of performing them. B) be observant for signs of fear or reluctance from the patient. C) move swiftly and deliberately to quickly accomplish the task. D) frequently reassure him or her that everything will be okay.

be observant for signs of fear or reluctance from the patient.

Cerebral palsy is characterized by poorly controlled ________ movement. A) extremity B) eye C) body D) neck

body

Cerebral palsy is characterized by poorly controlled ________ movement. A) neck B) extremity C) eye D) body

body

Because the gastrointestinal tract slows with aging, the elderly patient is prone to frequent: A) vomiting and diarrhea. B) gastrointestinal bleeding. C) bowel obstructions. D) anorexic episodes.

bowel obstructions.

Cerebral palsy is a condition that results from damage or injury to the: A) spinal cord. B) brain. C) voluntary muscles. D) peripheral nervous system.

brain.

The skin of an elderly person is more susceptible to injury from even minor trauma because of a decrease in: A) collagen. B) elastin. C) synovial fluid. D) sebum.

collagen.

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/an: A) colostomy. B) gastric stoma. C) intestinal shunt. D) gastrostomy.

colostomy.

Two thirds of children born with Down syndrome have: A) diabetes mellitus. B) intracranial bleeding. C) congenital heart disease. D) unilateral paralysis.

congenital heart disease.

Two thirds of children born with Down syndrome have: A) intracranial bleeding. B) unilateral paralysis. C) diabetes mellitus. D) congenital heart disease.

congenital heart disease.

A 77-year-old female fell and experienced a possible hip fracture. She complains of pain to the left hip area. Your assessment reveals that she is conscious and alert with stable vital signs; there is no deformity or gross bleeding to the injured area. You should: A) completely expose her and carefully assess for other injuries. B) consider an underlying medical cause that resulted in her fall. C) tell her that her home is unsafe and that she should make the necessary improvements. D) conclude that she fell because of decreased skeletal stability.

consider an underlying medical cause that resulted in her fall.

A 77-year-old female fell and experienced a possible hip fracture. She complains of pain to the left hip area. Your assessment reveals that she is conscious and alert with stable vital signs; there is no deformity or gross bleeding to the injured area. You should: A) consider an underlying medical cause that resulted in her fall. B) tell her that her home is unsafe and that she should make the necessary improvements. C) conclude that she fell because of decreased skeletal stability. D) completely expose her and carefully assess for other injuries.

consider an underlying medical cause that resulted in her fall.

Although the alveoli become enlarged, elderly people have difficulty expelling used air from the lungs because of: A) decreased alveolar tension secondary to increased surfactant. B) sustained vasoconstriction of the alveolar-capillary vessels. C) decreased alveolar elasticity secondary to decreased surfactant. D) frequent consolidation of infectious material in the alveoli.

decreased alveolar elasticity secondary to decreased surfactant.

Although the alveoli become enlarged, elderly people have difficulty expelling used air from the lungs because of: A) sustained vasoconstriction of the alveolar-capillary vessels. B) decreased alveolar tension secondary to increased surfactant. C) frequent consolidation of infectious material in the alveoli. D) decreased alveolar elasticity secondary to decreased surfactant.

decreased alveolar elasticity secondary to decreased surfactant.

A loss of sensory nerve ending fibers and slowing of the peripheral nervous system predisposes the elderly patient to: A) decreased reflexes when touching a hot or cold object. B) decreased ability to catch himself or herself during a fall. C) inability to differentiate between good and spoiled food. D) hypertension that is unresponsive to medications.

decreased reflexes when touching a hot or cold object.

While attempting to ventilate a patient with a tracheostomy, you meet resistance when squeezing the bag-mask device. The patient's oxygen saturation has fallen to 84%. You should: A) remove the inner cannula of the tracheostomy tube, instill 3 to 5 mL of saline down the tube, and suction the tracheostomy tube for up to 30 seconds. B) deflate the cuff on the tracheostomy tube, cover the patient's mouth and nose with a mask, and reattempt to ventilate with the bag-mask device. C) carefully remove the tracheostomy tube, control any bleeding that may be present, and ventilate through a mask directly into the stoma. D) cover the tracheostomy tube with a nonrebreathing mask attached to high-flow oxygen and request a paramedic unit to remove the tube.

deflate the cuff on the tracheostomy tube, cover the patient's mouth and nose with a mask, and reattempt to ventilate with the bag-mask device.

Alzheimer and Parkinson's disease are examples of ____________ causes of an altered mental status. A) congenital B) degenerative C) systemic D) metabolic

degenerative

When assessing an 82-year-old female who takes multiple medications, you should: A) assume that she has inadvertently overdosed. B) determine overall medication compliance. C) ask her if she took her medications today. D) ascertain the names of all of her physicians.

determine overall medication compliance.

A 13-year-old child is on a home ventilator. The parents called because the ventilator is malfunctioning and the child has increasing respiratory distress. You should: A) place a call to the home health agency treating this patient. B) reset the ventilator by unplugging it for 30 to 60 seconds. C) disconnect the ventilator and use a bag-mask device. D) attempt to troubleshoot the ventilator problem.

disconnect the ventilator and use a bag-mask device.

When caring for a morbidly obese patient, you should: A) call for ALS backup because obese patients are at high risk for heart attack. B) leave him or her in a supine position, as this often facilitates breathing. C) ask the patient if he or she knows what led to his or her obesity problem. D) establish his or her chief complaint and then communicate your plan to help.

establish his or her chief complaint and then communicate your plan to help.

Upon entering the residence of an elderly patient who has fallen, you should ensure personal safety and then: A) carefully inspect each room in the residence. B) evaluate the patient's living environment. C) proceed immediately to the patient's side. D) look for the presence of medication bottles.

evaluate the patient's living environment

You respond to a skilled nursing facility for an 81-year-old female with abdominal pain. As you begin your assessment, the patient tells you that she is waiting for her husband to visit her and adamantly refuses going to the hospital. She is conscious and alert to person, place, and time. You should: A) transport her since she is clearly unable to live an independent life. B) obtain a court order that allows you to transport her against her will. C) wait for her husband to arrive and then transport her to the hospital. D) explain the potential complications and then obtain a signed refusal.

explain the potential complications and then obtain a signed refusal.

Victims of elder abuse often do not report the crime because they: A) do not perceive it as being an issue. B) are threatened by the abuser. C) fear that they won't be believed. D) fear retribution and further abuse.

fear retribution and further abuse

You are assessing a 76-year-old widowed female who complains of shortness of breath and malaise. Upon advising her of the need for EMS treatment and transport, she tells you that she does not want to go to the hospital. Her refusal is MOST likely the result of: A) an inability to pay for the hospital expenses. B) paranoia that her home will be burglarized. C) fear that she will be placed in a nursing home. D) stubbornness that is typical in elderly patients.

fear that she will be placed in a nursing home.

Elder abuse occurs MOST commonly in: A) females older than 75 years of age. B) males between 65 and 70 years of age. C) females between 65 and 70 years of age. D) males older than 75 years of age.

females older than 75 years of age.

When assessing an 80-year-old male with acute shortness of breath, it is MOST important to remember that: A) lung cancer is the most common cause of death in the elderly. B) motor nerves have deteriorated and reaction time has decreased. C) elderly patients experience a steady decrease in blood pressure. D) gas exchange in the lungs and at the cellular level is decreased.

gas exchange in the lungs and at the cellular level is decreased.

The "G" in the GEMS diamond recognizes the patient as a geriatric patient and serves as a reminder for the AEMT to: A) gather all pertinent information regarding the elderly patient's family history. B) gear his or her thought process to the potential problems of an aging patient. C) assess the environment in which the ill or injured elderly patient is found. D) consider that changes in mentation are a natural part of the aging process.

gear his or her thought process to the potential problems of an aging patient.

If a caregiver is not present, and you need to clean the inner cannula of a tracheostomy tube, it is MOST appropriate to use: A) half hydrogen peroxide and half water. B) a betadine solution mixed with water. C) sterile saline or clean tap water. D) isopropyl alcohol and clean water.

half hydrogen peroxide and half water.

If a caregiver is not present, and you need to clean the inner cannula of a tracheostomy tube, it is MOST appropriate to use: A) isopropyl alcohol and clean water. B) half hydrogen peroxide and half water. C) a betadine solution mixed with water. D) sterile saline or clean tap water.

half hydrogen peroxide and half water.

A service dog is easily identified by its: A) size. B) breed. C) color. D) harness.

harness.

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) has recognized a change in the patient's health status. C) must confirm that a specific intervention is required. D) has a question that is specific to the patient's condition.

has recognized a change in the patient's health status.

Patients with autism: A) prefer to maintain eye contact with whomever is talking with them. B) use and understand nonverbal means of communicating messages. C) have extreme difficulty with complex tasks that require many steps. D) often speak with speech patterns that alternate in tone and speed.

have extreme difficulty with complex tasks that require many steps.

Most people who are hearing impaired: A) are able to hear if you simply raise the tone of your voice. B) experience great difficulty hearing high-pitched sounds. C) have conductive hearing loss due to ear wax impaction. D) have learned to read body language, such as hand gestures.

have learned to read body language, such as hand gestures.

By placing one hand on top of your head and the other hand over your abdomen, you are asking a hearing-impaired patient if he or she: A) needs help. B) is sick. C) is hurt. D) is nauseated.

is sick.

Because hearing-impaired patients typically have more difficulty hearing high-frequency sounds, it is important for you to: A) increase the volume of your voice. B) try basic sign language first. C) lower the pitch of your voice. D) speak in a monotone voice.

lower the pitch of your voice.

Although an injury may be considered isolated and not alarming in young adults, older adults: A) often develop a compensatory bradycardia in response to the injury. B) usually experience more profound tachycardia than younger adults. C) often dramatize the problem and demand that you transport them. D) may not be able to effectively compensate for even minor injuries.

may not be able to effectively compensate for even minor injuries.

Elderly patients who become isolated from outside social events are susceptible to all of the following, EXCEPT: A) medication compliance. B) drug or alcohol abuse. C) self-inflicted injuries. D) clinical depression.

medication compliance.

A 71-year-old male presents with sudden diaphoresis, malaise, and near-syncope. You should be MOST suspicious for: A) severe dehydration. B) an acute infection. C) myocardial infarction. D) acute ischemic stroke.

myocardial infarction.

In contrast to conductive hearing loss, sensorineural hearing loss is caused by: A) eardrum perforation. B) earwax accumulation. C) barotrauma. D) nerve damage.

nerve damage.

You respond to a residence for a 9-year-old 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) open her airway with a manual maneuver, suction her oropharynx, and insert a simple airway adjunct. 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 a nonrebreathing mask and then assess her pulse rate. D) insert an oropharyngeal airway and begin assisting her ventilations with a bag-mask device.

open her airway with a manual maneuver, suction her oropharynx, and insert a simple airway adjunct.

You respond to a residence for a 9-year-old 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) open her airway with the jaw-thrust maneuver and assess the rate and depth of her breathing. B) immediately apply high-flow oxygen via a nonrebreathing mask and then assess her pulse rate. C) open her airway with a manual maneuver, suction her oropharynx, and insert a simple airway adjunct. D) insert an oropharyngeal airway and begin assisting her ventilations with a bag-mask device.

open her airway with a manual maneuver, suction her oropharynx, and insert a simple airway adjunct.

Determining the chief complaint of an elderly patient can be difficult because: A) most elderly patients are hearing impaired and cannot hear your questions. B) normal alterations in mental status impede effective patient communication. C) elderly patients fear going to the hospital and will not disclose their complaint. D) patients may have multiple problems but usually reveal the lesser complaint.

patients may have multiple problems but usually reveal the lesser complaint.

Autism is MOST accurately defined as a: A) psychiatric condition related to an imbalance of serotonin in the brain. B) congenital condition caused by factors such as malnutrition or birth complications. C) pervasive developmental disorder characterized by impairment of social interaction. D) mental disability caused by insufficient cognitive development of the brain.

pervasive developmental disorder characterized by impairment of social interaction.

You are assessing a 76-year-old female who complains of chest pressure and shortness of breath. During your assessment, the patient tells you that her daughter has not refilled her prescribed medications in over a week. This is an example of: A) benign neglect. B) psychological abuse. C) financial abuse. D) physical abuse.

physical abuse.

If you are unable to ventilate a patient through his or her tracheostomy, you should: A) cover the tracheostomy stoma with a nonrebreathing mask and request a paramedic unit at once. B) use the head tilt-chin lift maneuver to open the airway and ventilate the patient with a bag-mask device. C) pass a suction catheter no more than 3 inches into the tracheostomy stoma and suction for 15 seconds. D) plug the tracheostomy stoma and ventilate in the traditional manner with a bag-mask device.

plug the tracheostomy stoma and ventilate in the traditional manner with a bag-mask device.

If you are unable to ventilate a patient through his or her tracheostomy, you should: A) use the head tilt-chin lift maneuver to open the airway and ventilate the patient with a bag-mask device. B) cover the tracheostomy stoma with a nonrebreathing mask and request a paramedic unit at once. C) plug the tracheostomy stoma and ventilate in the traditional manner with a bag-mask device. D) pass a suction catheter no more than 3 inches into the tracheostomy stoma and suction for 15 seconds.

plug the tracheostomy stoma and ventilate in the traditional manner with a bag-mask device.

General techniques for communicating with hearing-impaired patients include: A) speaking directly into the patient's ear with an increased voice pitch. B) exaggerating your lip movements to ensure the patient understands. C) positioning yourself approximately 18″ directly in front of the patient. D) removing any hearing aids and using pen and paper to ask questions.

positioning yourself approximately 18″ directly in front of the patient.

The purpose of a ventriculoperitoneal shunt is to: A) remove fluid from the abdomen of patients with right heart failure. B) divert excess cerebrospinal fluid to the ventricles of the brain. C) monitor pressure within the skull in patients with a head injury. D) prevent excess cerebrospinal fluid from accumulating in the brain.

prevent excess cerebrospinal fluid from accumulating in the brain.

If the AEMT is called to a scene in which death of a terminally ill patient is imminent, it is important for him or her to: A) speak to all family members as a group in order to diffuse intense emotions. B) realize that his or her actions will have a lasting effect on the family. C) provide supportive care only, even in the absence of a valid DNR order. D) determine if a specific funeral home has been selected and offer to call them.

realize that his or her actions will have a lasting effect on the family.

In contrast to an automated implanted cardioverter/defibrillator, an internal cardiac pacemaker: A) delivers a shock to the heart if the rate becomes exceedingly fast. B) will only activate if it detects rhythms such as ventricular fibrillation. C) is implanted under the skin in the left upper abdominal quadrant. D) regulates the patient's heart rate if it falls below a preset value.

regulates the patient's heart rate if it falls below a preset value.

When caring for an 81-year-old female with bilateral visual impairment, it is important to: A) remain in direct contact with the patient at all times. B) not touch the patient unless it is absolutely necessary. C) position yourself on the patient's "good" side. D) speak to the patient with an increased tone of voice.

remain in direct contact with the patient at all times.

General care for a patient with a tracheostomy tube includes all of the following, EXCEPT: A) removing the tube if the area around it appears to be infected. B) ensuring adequate oxygenation and ventilation at all times. C) suctioning the tube as needed to clear a thick mucous plug. D) maintaining the patient in a position of comfort when possible.

removing the tube if the area around it appears to be infected.

Certain medications must be given in reduced doses to elderly patients because: A) many organs are no longer responsive to certain drugs. B) renal function decline may result in toxic drug levels. C) the liver increases its ability to detoxify certain drugs. D) the body may rapidly absorb and process the medication.

renal function decline may result in toxic drug levels.

Complications that may be associated with central venous catheters include all of the following, EXCEPT: A) bleeding around the line. B) a local infection. C) rupture of a central vein. D) clotting of the line.

rupture of a central vein.

Complications that may be associated with central venous catheters include all of the following, EXCEPT: A) rupture of a central vein. B) clotting of the line. C) a local infection. D) bleeding around the line.

rupture of a central vein.

A tube from the brain to the abdomen that drains excessive cerebrospinal fluid is called a: A) CS tube. B) cerebral bypass. C) G-tube. D) shunt.

shunt.

Polypharmacy is defined as the: A) use of two drugs to treat the same condition. B) simultaneous use of multiple medications. C) prescription of medications by two physicians. D) intentional use of five or more medications.

simultaneous use of multiple medications.

Common associated conditions in patients with spina bifida include all of the following, EXCEPT: A) loss of bladder control. B) extreme latex allergy. C) hydrocephalus. D) spastic limb movement.

spastic limb movement.

Common associated conditions in patients with spina bifida include all of the following, EXCEPT: A) loss of bladder control. B) hydrocephalus. C) spastic limb movement. D) extreme latex allergy.

spastic limb movement.

An important aspect in the assessment of a patient who experienced a previous brain injury involves: A) speaking with the patient and family to establish what is considered normal for the patient. B) recalling that most patients with a brain injury have other organ dysfunction. C) contacting the patient's physician to determine the extent of the brain injury. D) presuming that he or she has cognitive impairment until proven otherwise.

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) tongue is relatively small and falls back in the throat. B) teeth are misaligned and they have a large tongue. C) occiput is round, which causes flexion of the neck. D) mandible is large, which inhibits a mask-to-face seal.

teeth are misaligned and they have a large tongue.

When caring for a patient who is visually impaired, it is important to: A) allow a service dog to remain with the patient at all times, even if the patient is critically ill. B) leave items such as canes and walkers at the residence if the patient will be carried on a gurney. C) tell him or her what is happening, identify noises, and describe the situation and surroundings. D) stand to the side of the patient when speaking if his or her peripheral vision is impaired.

tell him or her what is happening, identify noises, and describe the situation and surroundings.

When caring for a patient who is visually impaired, it is important to: A) stand to the side of the patient when speaking if his or her peripheral vision is impaired. B) tell him or her what is happening, identify noises, and describe the situation and surroundings. C) leave items such as canes and walkers at the residence if the patient will be carried on a gurney. D) allow a service dog to remain with the patient at all times, even if the patient is critically ill.

tell him or her what is happening, identify noises, and describe the situation and surroundings.

Syncope in an elderly person is the result of a/an: A) temporary interruption of cerebral blood flow. B) obstruction of a large cerebral artery. C) a "silent" or atypical acute myocardial infarction. D) sudden but transient cardiac dysrhythmia.

temporary interruption of cerebral blood flow.

Compression fractures of the spine occur more frequently in elderly patients because: A) the intervertebral discs atrophy and the vertebrae become brittle. B) the kyphotic spine causes distraction of the intervertebral discs. C) the sacral and coccygeal spines are much weaker in the elderly. D) most elderly people land feet first following a significant fall.

the intervertebral discs atrophy and the vertebrae become brittle.

Compression fractures of the spine occur more frequently in elderly patients because: A) the sacral and coccygeal spines are much weaker in the elderly. B) the kyphotic spine causes distraction of the intervertebral discs. C) most elderly people land feet first following a significant fall. D) the intervertebral discs atrophy and the vertebrae become brittle.

the intervertebral discs atrophy and the vertebrae become brittle.

When caring for patients with cerebral palsy, it is important to remember that: A) hearing aids are usually ineffective for patients with hearing loss. B) their limbs are often underdeveloped and are prone to injury. C) most patients have the ability to walk, but have an unsteady gait. D) they are unable to walk and are totally dependent upon you.

their limbs are often underdeveloped and are prone to injury.

Elderly patients are at higher risk for food poisoning because: A) of a decreased ability of the gastrointestinal system to process food. B) many elderly patients are on a fixed income and cannot afford food. C) they must rely on a friend or caregiver to prepare all of their meals. D) they may unknowingly eat contaminated food due to sensory decline.

they may unknowingly eat contaminated food due to sensory decline.

When speaking to an elderly patient regarding his or her chest pain, you should ask the patient: A) if the pain is crushing. B) to describe the pain. C) if the pain is sharp. D) if the pain is radiating.

to describe the pain.

By the time a person reaches the age of 65 years: A) he or she will likely develop a disease. B) total body water has decreased by 30%. C) the myocardial walls have become thin. D) pulmonary function has decreased by 20%.

total body water has decreased by 30%.

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 that his apnea monitor has alarmed 4 times in the past 30 minutes. Your assessment of the infant reveals that he is conscious and active. His skin is pink and dry, and he is breathing at an adequate rate and with adequate depth. His oxygen saturation reads 98% on room air. You should: A) advise the mother to observe her son and call 9-1-1 again if necessary. B) administer high-flow oxygen and observe for a drop in oxygen saturation. C) transport the infant to the hospital and bring the apnea monitor with you. D) request an ALS ambulance to transport the infant to the hospital.

transport the infant to the hospital and bring the apnea monitor with you.

A 70-year-old male complains of shortness of breath. During your assessment, you note that he has bilateral hearing aids. When you ask him questions related to his chief complaint, he does not answer you. You can hear a whistling sound coming from his hearing aids. You should: A) try repositioning the hearing aid or remove it and turn down the volume. B) remove his hearing aids, turn up the volume, and replace them in his ears. C) remove both of his hearing aids and use pencil and paper to communicate. D) recognize that the batteries in his hearing aids are probably depleted.

try repositioning the hearing aid or remove it and turn down the volume.

The AEMT should consult medical control when caring for a terminally ill patient who: A) wishes to receive only supportive care and transport. B) is being cared for by anyone other than a hospice nurse. C) uses a self-administered pain medication device. D) has died and has a valid DNR order.

uses a self-administered pain medication device.

The tip of a central venous catheter rests in the: A) left atrium. B) pulmonary vein. C) right ventricle. D) vena cava.

vena cava.

The tip of a central venous catheter rests in the: A) right ventricle. B) vena cava. C) pulmonary vein. D) left atrium.

vena cava.