Ch. 45 Questions AEMT

Which of the following statements regarding the elderly is​ TRUE? A. Cardiac output remains​ constant, but hypercholesterolemia and hypertension increase. B. A decrease in estrogen leads to increased cardiovascular disease in postmenopausal women. C. Osteoporosis can occur in both​ genders, but is especially common in men. D. There is a marked increase in obesity which is associated with the onset of type 1 diabetes.

A decrease in estrogen leads to increased cardiovascular disease in postmenopausal women.

Which of the following is NOT a risk factor for elder​ abuse? A. Female B. Immobility C. Age 70 D. Dementia

Age 70

Which of the following statements regarding treatment of an elderly patient is​ TRUE? A. Most external bleeding must be controlled by medications. B. Use caution when administering fluids except when the patient is hypovolemic. C. Changes in spinal alignment can made airway management challenging. D. Remove dentures to achieve a good seal between a ventilation mask and the face.

Changes in spinal alignment can made airway management challenging.

Which of the following BEST describes​ cataracts? A. Detachment of the retina B. Increased pressure in the anterior chamber of the eye C. Clouding of the lens of the eye D. Degeneration of the macula densa

Clouding of the lens of the eye

You are transporting a​ 69-year-old male who is dehydrated. You have started an IV and are administering a fluid bolus. The patient suddenly becomes short of breath and begins coughing. You hear coarse crackles bilaterally when you auscultate lung sounds. What should you immediately​ do? A. Discontinue the IV. B. Administer a beta2​ agonist, such as albuterol. C. Decrease the IV fluid. D. Place the patient on a CPAP device.

Decrease the IV fluid.

Which of the following can increase the potential for organ injury in blunt trauma in the​ elderly? A. Decreased amount of adipose tissue. B. Decreased circulation to the organs. C. Decreased sensitivity to pain. D. Decreased bone density.

Decreased amount of adipose tissue.

Which of the following is the​ global, irreversible, progressive loss of cognitive​ function? A. Psychosis B. Epilepsy C. Dementia D. Delirium

Demetia

Which of the following is a factor associated with a person who abuses an elderly​ person? A. Adequate income B. Retired volunteers C. Females aged 35 to 50 years D. Financial and work difficulties

Financial and work difficulties

There is a high prevalence of urinary tract infection in patients​ with: A. Foley catheters. B. diarrhea. C. diabetes. D. urinary incontinence.

Foley catheters.

What is the difference between your treatment of an elderly patient you suspect of acute coronary syndrome without chest pain and your treatment of an elderly patient you suspect of ACS who has chest​ pain? A. For the patient with chest​ pain, start an IV. B. For the patient with chest​ pain, maintain an SpO2 of 95 percent or higher. C. For the patient without chest​ pain, administer oxygen if the SpO2 is less than 95 percent. D. For the patient without chest​ pain, contact medical direction for further orders concerning administration of nitroglycerin or aspirin.

For the patient without chest​ pain, contact medical direction for further orders concerning administration of nitroglycerin or aspirin.

Which of the following is NOT a normal physiologic change of the cardiovascular system in the​ elderly? A. Increased systemic vascular resistance B. Hypertension C. Dysrhythmias D. Hypotension

Hypotension

What is the consequence of changes in chest wall compliance in the elderly​ patient? A. Increased lung capacity B. Airway obstruction C. Enhanced diffusion D. Impaired ventilation

Impaired ventilation

You have been called to transport an​ 89-year-old female from a nursing home. The nursing staff states that the patient has become lethargic and slow to respond. Your assessment reveals that she is​ febrile, and when you move her to your​ stretcher, you find a deep ulcer over the ischial tuberosity. Which of the following BEST summarizes the appropriate response to this​ situation? A. An ulcer in this area is a result of​ abuse, and law enforcement should be contacted immediately. B. A decubitus ulcer is extremely uncommon in the elderly and is a clear sign of physical abuse. C. Decubitus ulcers are so common in the elderly that you would not expect the staff to report it.​ However, the patient is probably septic and needs to be treated and transported. D. It is concerning that the staff did not report the​ ulcer; the patient may be septic and needs an IV and supportive treatment in the prehospital setting.

It is concerning that the staff did not report the​ ulcer; the patient may be septic and needs an IV and supportive treatment in the prehospital setting.

Which of the following statements regarding physical assessment findings in elderly patients is​ FALSE? A. They may have difficulty staying warm. B. Pain perception increases in the elderly population. C. Crackles may be normal. D. They may exhibit a limited range of motion.

Pain perception increases in the elderly population.

You respond for an elderly female who has apparently taken the wrong medication. She tells you that she thought she took an aspirin for her​ headache, but instead she is feeling real tired. You check her medication and see that the aspirin looks like her sleeping pills. Which of the following likely lead to the​ problem? A. Presbycusis B. Presbyopia C. Proprioception D. Menopause

Presbyopia

Pressure sores associated with decreased mobility in the elderly are known​ as: A. kyphosis. B. spondylosis. C. decubitus ulcers. D. confabulation.

decubitus ulcers.

A sudden onset of altered mental​ status, often with changes in​ behavior, due to an underlying medical cause is known​ as: A. epilepsy. B. delirium. C. dementia. D. psychosis.

delirium.

Cognitive impairment of sudden onset and limited duration BEST​ defines: A. dementia. B. transient ischemic attack. C. ​Alzheimer's disease. D. delirium.

delirium.

Alzheimer's is the MOST recognizable form of​ ________ in the elderly. A. delirium B. dysarrthia C. bipolar disorder D. dementia

dementia

During your assessment of an elderly​ patient, if you have any doubt about the​ patient's mental​ status, then in the secondary​ assessment: A. perform a​ Mini-Mental State Exam. B. look for evidence of substance abuse. C. determine the​ patient's baseline condition. D. reassess the​ patient's ABCs.

perform a​ Mini-Mental State Exam.

A patient with kyphosis has fallen and is complaining of numbness in both arms. Regarding​ immobilization, you​ should: A. apply a cervical collar and transport in a​ semi-Fowler's position. B. place pillows in voids between the patient and stretcher. C. transport fully immobilized and in a prone position. D. disregard immobilization and transport using lights and sirens.

place pillows in voids between the patient and stretcher.

Pain that worsens with movement of the chest wall during inspiration is called​ ________ pain. A. pleuritic B. visceral C. somatic D. acute

pleuritic

The use of multiple medications is known​ as: A. noncompliance. B. polypharmacy. C. substance abuse. D. forgetfulness.

polypharmacy

You have been called for a​ 91-year-old woman who fell. Since your assessment reveals bruises to her body in various stages of healing and inconsistencies in information related to the fall from her​ family, you are suspicious of geriatric abuse. Your BEST action would be​ to: A. confront the family members regarding your suspicions. B. quietly transport and inform the emergency department physician. C. notify the Office of Elder Affairs prior to leaving the scene. D. have the EMS supervisor contact the​ patient's primary care physician.

quietly transport and inform the emergency department physician.

All of these statements concerning trauma in the elderly are correct​ EXCEPT: A. what appears to be a normal blood pressure may actually be low for an elderly person with preexisting hypertension. B. an early sign of hypoperfusion is altered mental status. C. the thicker skin of the elderly provides protection against burns. D. the ribs provide less​ protection, making thoracic organ injury more likely.

the thicker skin of the elderly provides protection against burns.

All of the following can lead to urinary retention​ EXCEPT: A. medications. B. neurological problems. C. enlarged prostate. D. urinary incontinence.

urinary incontinence.

When assessing a​ 70-year-old female​ patient, the best way to speak to the patient is​ to: A. use the​ patient's first name. B. use Ms. or Mrs. with her last name. C. direct questions to the​ patient's caregiver. D. immediately ask​ follow-up questions if the patient is slow to respond to the first question you ask.

use Ms. or Mrs. with her last name.

You are called for a motor vehicle collision involving two elderly women. You are concerned because you know that elderly patients are often prescribed blood thinner for cardiac problems. This can be a problem​ because? A. It increases their risk for pulmonary embolism. B. It leads to diminished liver and kidney function. C. It means they most likely have cardiac problems. D. .Impaired blood clotting can exacerbate blood loss.

.Impaired blood clotting can exacerbate blood loss.

An​ 88-year-old woman complains of generalized abdominal pain with a gradual onset and increasing intensity over the past nine hours. She is nauseated and vomited after she tried to drink some tea this morning. She has not had any oral intake since dinner last evening nearly 24 hours ago. She is awake but prefers to lie very still on her side with her legs drawn up. She is confused about the day and month but knows what year it is and recognizes her family members. Her skin is​ pale, warm,​ dry, and has poor turgor. The patient gives a history of heart failure and atrial​ fibrillation, for which she takes an ACE inhibitor and platelet aggregation inhibitor. She also recently had pneumonia and suffered a compression fracture of two thoracic vertebrae from forceful coughing. You hear slight crackles in the lower lung fields bilaterally on your initial auscultation of the lungs. Vital signs are heart​ rate, 112 beats per minute and​ irregular; blood​ pressure, 104/84​ mmHg; respiratory​ rate, 24 breaths per minute with decreased tidal​ volume; and​ SpO2, 93 percent on room air. Which of the following is the BEST treatment plan for this​ patient? A. Sit the patient up in high​ Fowler's position, apply oxygen by nonrebreather​ mask, begin​ transport, and start an IV with a saline lock. B. Sit the patient up in high​ Fowler's position, apply oxygen by nasal​ cannula, begin​ transport, start two​ large-bore IVs, and infuse two​ 500-mL boluses of normal saline. C. Administer oxygen by nasal​ cannula, allow the patient to assume a position of comfort on the​ stretcher, start an IV of normal​ saline, and infuse fluids at a rate of 150​ mL/hr. D. Allow the patient to assume a position of​ comfort, administer oxygen by nonrebreather​ mask, begin​ transport, and start an IV with a saline lock.

Administer oxygen by nasal​ cannula, allow the patient to assume a position of comfort on the​ stretcher, start an IV of normal​ saline, and infuse fluids at a rate of 150​ mL/hr.

A​ 69-year-old man complains of a sudden onset of shortness of breath and weakness accompanied by pain in his chest while he was shopping. He describes the pain as a​ dull, heavy​ sensation, rated 5 on a scale of 1 to 10. He has a history of heart disease and had a heart attack 10 years ago. He also has high blood pressure and type 2 diabetes. He is pale and​ sweaty, and prefers to sit straight up. His lung sounds are clear and equal. He is​ obese, but his abdomen is soft and there are no areas of tenderness to palpation. Vital signs are heart​ rate, 64 beats per minute and​ regular; blood​ pressure, 142/92​ mmHg; respiratory​ rate, 20 breaths per​ minute; and​ SpO2, 96 percent on room air. The patient has no known drug allergies and takes no medications other than his​ antihypertensive, although he cannot remember the name of it right now. Which treatment plan is BEST for this​ patient? A. Begin​ transport, perform a detailed​ head-to-toe assessment, give​ 325-mg aspirin chewed and​ swallowed, start an IV of normal saline at a​ keep-open rate, and give​ 0.4-mg nitroglycerin sublingually. B. Administer​ 325-mg aspirin chewed and​ swallowed, start an IV of normal saline at a​ keep-open rate, give​ 0.4-mg nitroglycerin sublingually while preparing for​ transport, and transport without further delay. C. Administer​ high-flow oxygen by nonrebreather​ mask, begin​ transport, administer​ 0.4-mg nitroglycerin sublingually and​ 162-mg aspirin chewed and​ swallowed, and start an IV with a saline lock. D. Administer oxygen by nasal​ cannula, begin​ transport, start an IV of normal saline at a​ keep-open rate, and administer​ 325-mg aspirin chewed and swallowed.

Administer​ 325-mg aspirin chewed and​ swallowed, start an IV of normal saline at a​ keep-open rate, give​ 0.4-mg nitroglycerin sublingually while preparing for​ transport, and transport without further delay.

When managing the airway of an elderly patient who is not​ breathing, what is NOT a consideration that must be made in regard to delivering proper​ ventilations? A. An irregular pulse is a common finding in elderly patients. B. Padding may be needed under the head due to kyphosis of the spine. C. Patients may have diminished gag reflexes. D. Elderly patients may have a loss of dentition or poorly fitting dentures.

An irregular pulse is a common finding in elderly patients.

Which of the following patients would be the MOST likely to be​ abused? A. A​ 62-year-old woman with decreased enjoyment of food B. An​ 82-year-old woman with​ Alzheimer's disease C. A​ 68-year-old man with asthma D. A​ 74-year-old man with hypertension

An​ 82-year-old woman with​ Alzheimer's disease

To BEST communicate with a geriatric patient who has diminished​ hearing, the AEMT should do which one of the​ following? A. Ask the family members about the​ patient's history. B. Be sure the patient has his hearing aid in place. C. Increase both the pitch and volume of your voice. D. Try to communicate using sign language.

Be sure the patient has his hearing aid in place.

A​ 78-year-old patient is complaining of​ "not feeling​ well." The​ patient's daughter is present. How should you obtain information about the​ patient's medical​ condition? A. Ask to speak directly to the​ patient's physician. B. Only speak to the​ patient's daughter. C. Encourage the patient to answer but incorporate the daughter if the patient is having difficulty. D. Speak directly to the patient unless the patient is slow to respond.

Encourage the patient to answer but incorporate the daughter if the patient is having difficulty.

Which of the following is a risk factor in elderly patients for environmental emergencies such as hyperthermia and hypothermia that involves​ trauma? A. Impaired thermoregulatory function B. Cognitive impairment C. Housing with inadequate climate control D. Extensive burns

Extensive burns

Which of the following is a characteristic of the elderly that is associated with a higher risk of suffering​ abuse? A. Having multiple stressors B. Being wealthy C. Living alone D. Having numerous medical problems

Having numerous medical problems

A patient has recently started a new medicine for hypertension that works by decreasing cardiac output. He also has a history of two myocardial​ infarctions, renal disease and hepatic disease. Two weeks​ later, he is very weak and is found to be borderline hypotensive and bradycardic. He is very thin and​ frail, but does have significant peripheral edema and mild inspiratory crackles. What pathophysiologic change to a geriatric patients is least likely contributing to this untoward blood pressure​ response? A. Increased total fluid volume B. Use of multiple medications C. Impaired renal and hepatic function D. Decreased fat stores

Increased total fluid volume

Which of the following is a factor that can increase​ drug-treatment compliance in the​ elderly? A. Making medications available without childproof packaging B. Minimizing the information provided about the drug C. Increasing the​ out-of-pocket costs to the elderly D. Prescribing​ long-term drug therapy

Making medications available without childproof packaging

You have been asked to deliver a talk about EMS and the geriatric population. Which one of the following points would you emphasize in your​ presentation? A. Many of the elderly have a combination of different diseases in various stages. B. Dementia is an inevitable part of the aging process. C. Assessment can be difficult since most persons older than 70 suffer from dementia. D. Geriatrics actually comprises a small number of EMS calls and transports.

Many of the elderly have a combination of different diseases in various stages.

On which of the following should you rely MOST heavily in determining the potential for shock in an elderly trauma​ patient? A. Heart rate B. Capillary refill C. Mechanism of injury D. Blood pressure

Mechanism of injury

Regarding the​ age-related physiologic changes of the​ elderly, which of the following listed below is​ FALSE? A. Fractures of the spine can occur from forceful coughing. B. Pain perception decreases. C. Menopause occurs in women in their late 50s. D. Urine production decreases.

Menopause occurs in women in their late 50s.

Which of the following statements about pneumonia in the elderly patient is​ FALSE? A. It may present without any fever. B. It may have a bacterial or viral cause. C. Pain may be referred to the shoulders. D. It may be community acquired or nosocomial.

Pain may be referred to the shoulders.

During the scene​ size-up for an emergency involving an older​ adult, which of the following would you NOT​ do? A. Assess the​ patient's degree of mobility. B. If the patient has a hearing aid but is not wearing​ it, offer to retrieve it for him. C. Remove poorly fitting dentures if they interfere with airway management. D. Notice any indications of chronic​ illness, such as the presence of oxygen tanks or​ tubing, nebulizers, a hospital​ bed, or other medical equipment.

Remove poorly fitting dentures if they interfere with airway management.

You are treating a​ 76-year-old female who is experiencing signs and symptoms of pneumonia. Despite several attempts to talk the patient into being transported to the​ hospital, she is still refusing transport. Which of the following is the LEAST likely reason she is refusing​ transport? A. She does not want to create an increasing financial burden upon herself. B. She is concerned for her spouse. C. She is suffering from acute dementia. D. She is afraid she will not be allowed to return home and live independently.

She is suffering from acute dementia.

When caring for an​ 84-year-old male at a​ residence, your partner is gathering information from the​ patient's adult daughter. Which of the following actions by the daughter would alert you to potential elder​ abuse? A. The daughter refuses to let you speak to the patient alone. B. The daughter appears very fatigued and overwhelmed. C. The daughter states that the​ patient's health has been quickly declining. D. The daughter hastily gives your partner information.

The daughter refuses to let you speak to the patient alone.

Which one of the following BEST describes the term​ "silent heart​ attack"? A. The patient had a single episode of chest pain followed by cardiac arrest. B. The chest pain was so intense the patient could not speak. C. The pain did not radiate into the​ arms, neck, or back. D. The patient had little to no chest pain or discomfort.

The patient had little to no chest pain or discomfort.

Which of the following is a characteristic of neglect of the elderly​ patient? A. The patient is bedridden with signs of multiple bruises in different stages of healing. B. The patient seems depressed. C. The patient is not being turned to help prevent decubitus ulcers from occurring. D. The patient is being restrained unnecessarily when the caretaker leaves the room.

The patient is not being turned to help prevent decubitus ulcers from occurring.

Your patient states that he​ "passed out" and fell down. He regained consciousness a few moments​ later, but had shortness of breath and sharp chest pain. Which of the following in the​ patient's history is of greatest​ concern? A. He had hip surgery two years ago. B. The patient states his left calf is tender and painful. C. The patient injured his wrist when he fell. D. The patient took nitroglycerin and now has a headache.

The patient states his left calf is tender and painful.

Which of the following statements regarding myocardial infarction in the elderly is​ TRUE? A. They are less likely than younger patients to present with classic symptoms. B. They usually complain of more severe symptoms. C. They are more likely to present with classic symptoms. D. They are less likely to have cardiac enzyme elevation.

They are less likely than younger patients to present with classic symptoms.

Which of the following statements regarding elderly patients is​ FALSE? A. They present with signs and symptoms of disease that should be attributed to their age unless proven otherwise. B. They may have problems with communication such as hearing impairment or poor dentition. C. They often have vague or multiple complaints that can make it difficult to identify the reason they need medical care. D. They may attribute symptoms to​ "old age" that actually indicate acute problems requiring treatment.

They present with signs and symptoms of disease that should be attributed to their age unless proven otherwise.

If it is not clear to you that the patient is oriented to​ person, place, and​ time, which assessment tool would be a more sensitive indication of the​ patient's mental​ status? A. The OPQRST mnemonic B. The AVPU mnemonic C. The Glasgow Coma Scale D. The​ Mini-Mental State Exam

The​ Mini-Mental State Exam

You are assessing the pupils of a​ 65-year-old male. When you shine the pin light into his​ eye, you note a gray clouding over the lens. You would document this assessment finding​ as: A. a chalazion. B. glaucoma. C. a cataract. D. conjunctivitis.

a cataract.

You are called for an elderly man with an apparent broken hip. The patient tells you that he has osteoporosis and type 2 diabetes. He denies falling and cannot remember any trauma. You should​ suspect: A. a pathological fracture. B. an associated spinal injury. C. decreased range of motion. D.

a pathological fracture.

The dysrhythmia commonly encountered as a result of the aging process​ is: A. idioventricular. B. sinus bradycardia. C. ventricular tachycardia. D. atrial fibrillation.

atrial fibrillation.

Each of the following patients is a high priority for treatment and transport​ EXCEPT: A. a​ 78-year-old male patient who presents with respiratory difficulty and requires an advanced airway adjunct. B. a​ 76-year-old female patient with a decreased level of responsiveness who presents with signs of dehydration and malnutrition. C. a​ 72-year-old female patient who is quiet and slow to respond to questions. D. a​ 74-year-old male patient who complains of chest pain.

a​ 72-year-old female patient who is quiet and slow to respond to questions.

A common condition appearing as cloudiness of the lens of the eye that affects the elderly and causes an impairment of vision​ is/are: A. cataracts. B. chemical conjunctivitis. C. astigmatism. D. blindness.

cataracts.

The cumulative effects of vascular disease and inflammatory processes can lead​ to: A. ​Alzheimer's disease. B. dementia. C. delirium. D. proprioception.

dementia.

An elderly patient with a flat or sad affect who gives​ slow, halting responses to questions should be suspected​ of: A. dementia. B. depression. C. hypoxia. D. infection.

depression.

A​ 75-year-old patient complains of​ severe, unilateral back pain at the level of T6. Inspection shows a vesicular rash along the T6 dermatome to the right of the midline. This is MOST consistent​ with: A. herpes zoster. B. eczema. C. pruritis. D. decubitus ulcer.

herpes zoster.

A​ shortened, externally-rotated lower extremity in an elderly patient is MOST associated​ with: A. hip fracture. B. anterior hip dislocation. C. fracture of the ischial tuberosity. D. posterior hip dislocation.

hip fracture.

Elderly patients with extensive burns are at increased risk​ for: A. hypoglycemia. B. hyperthermia. C. hypothermia. D. hyperglycemia.

hypothermia.

Patients with dementia often have reduced levels of melatonin which can lead​ to: A. decrease in calcium in the bones. B. impairment of the​ sleep-wake cycle. C. decreased absorption of medications. D. an increase in the inflammatory process.

impairment of the​ sleep-wake cycle.

You are interviewing an elderly patient about his eyesight. He tells you that he has good peripheral vision but diminished central vision. You should​ suspect: A. macular degeneration. B. confabulation. C. glaucoma. D. proprioception.

macular degeneration.

The MOST common mechanisms of trauma in the elderly​ are: A. falls and burns. B. motor vehicle collisions and abuse C. motor vehicle collisions and falls D. burns and abuse

motor vehicle collisions and falls

Which of the following is a contributing factor for the development of type 2 diabetes as a person​ ages? A. Obesity B. Presbyopia C. Immunocompromise D. Organ failure

obesity

An elderly man mistakenly presses the gas pedal instead of the brake causing him to crash into a convenience store. This scenario is commonly related​ to: A. ​Alzheimer's disease. B. proprioception. C. confabulation. D. dementia

proprioception.

The ability to sense the​ location, orientation, and movement of the body and its parts without visual input is known​ as: A. palliation. B. pronation. C. perception. D. proprioception.

proprioception.

You are called for an elderly man with what appears to be pleuritic chest pain. Further assessment shows he has pain in the lower leg with increased calf pain when he flexes his toes upwards. You should​ suspect: A. acute pulmonary edema. B. pulmonary embolism. C. aortic aneurysm. D. referred pain from appendicitis.

pulmonary embolism.

It is important to remember that emergencies experienced by elderly patients may NOT present with the normal signs and symptoms experienced by younger populations​ because: A. hyperreflexia is present in the elderly. B. sensations may be seriously diminished. C. the brain is unable to interpret signals. D. poor skin turgor diminishes pain sensations.

sensations may be seriously diminished.

You respond for a​ 66-year-old man complaining of severe pain on the back of his neck and right shoulder. You examine the area and see fluid filled blisters in a horizontal line across his shoulder. You should​ suspect: A. spondylosis. B. chicken pox. C. shingles. D. kyphosis.

shingles.

Decreased clearance of drugs that are metabolized by the liver may contribute​ to: A. increased risk of infection. B. impaired proprioception. C. constipation and bowel obstruction. D. signs and symptoms of drug overdose.

signs and symptoms of drug overdose.

Degeneration of the vertebrae and intervertebral disc caused by​ ________, can affect the neck and​ back, limiting mobility and increasing the risk for spine injury. A. arthritis B. osteoporosis C. pathological fractures D. spondylosis

spondylosis

Each of the following is a change in the respiratory system experienced by the elderly​ EXCEPT: A. swallowing is impaired. B. general decline causes a diminished level of gas exchange. C. the tendency for infection is increased. D. cough power is diminished

swallowing is impaired.

All of the following are common causes of seizures in the elderly​ EXCEPT: A. stroke. B. epilepsy. C. syncope. D. brain injury.

syncope

Which neurologic disorder is a common form of dementia in which there is a progressive loss of function including memory​ loss, confusion, and alterations in emotions and​ behavior? A. Status epilepticus B. Epilepsy C. ​Parkinson's disease D. ​Alzheimer's disease

​Alzheimer's disease

Signs and symptoms of​ ________ include postural​ rigidity, tremors, and loss of facial expression. A. ​Alzheimer's disease B. Meniere disease C. ​Starling's disease D. ​Parkinson's disease

​Parkinson's disease