39. Geriatrics
If an elderly patient's condition is unstable, what is the maximum time that should elapse between reassessments? A. 10 minutes B. 20 minutes C. 5 minutes D. 15 minutes
5 minutes
Which age-related respiratory changes should you anticipate in a 72-year-old patient? A. Greater sensitivity of the respiratory drive to hypoxia B. Calcium deposits where the ribs join the sternum, causing the rib cage to be less pliable C. Decreased reliance on the diaphragm as the major muscle of respiration D. Increased tidal volume at rest
Calcium deposits where the ribs join the sternum, causing the rib cage to be less pliable
With age, degenerative processes affect the ability of the heart to pump blood. Calcium is deposited in areas of deterioration, fibrous tissue begins to replace muscle tissue, and the heart walls become thicker. What is the medical term for that condition? A. Cardiac hypertrophy B. Myocardial infarction C. Atherosclerosis D. Cardiomyopathy
Cardiac hypertrophy
Which of these descriptions illustrates an expected age-related change in signs and symptoms associated with illnesses in the elderly? A. A full, bounding pulse resulting from shock B. Bradypnea is an early sign of hypoxia C. Increased likelihood of fever, even with minor infections D. Complaints of weakness, fatigue, and nausea, rather than of classic chest pain with myocardial infarction
Complaints of weakness, fatigue, and nausea, rather than of classic chest pain with myocardial infarction
Which choice is an age-related change that affects the nervous system and senses? A. Increased myelination of nerve fibers B. Difficulty perceiving the position of the body or its parts C. A decrease in the amount of cerebral spinal fluid in the skull D. The necessity of holding items very close to the eyes in order to see
Difficulty perceiving the position of the body or its parts
Which choice is a general guideline for managing elderly patients? A. Remove a patient's dentures to achieve an effective bag-valve-mask device seal. B. Assume the patient has impaired hearing and speak in a louder-than-normal voice with all elderly patients. C. Even a minor fall can result in spinal injury or long bone fracture. D. Application of supplemental oxygen is a frequent cause of respiratory depression in the elderly.
Even a minor fall can result in spinal injury or long bone fracture.
Which choice occurs in the elderly as a result of age-related changes in physiology? A. Increased incidence of pneumonia B. Increased sensitivity to pain, resulting in frequent complaints of pain without physiological basis C. The skin becomes tough and thick D. Fever occurs more frequently, even with minor illnesses
Increased incidence of pneumonia
Which choice occurs in the elderly as a result of age-related changes in physiology? A. Increased incidence of pneumonia B. The skin becomes tough and thick C. Fever occurs more frequently, even with minor illnesses D. Increased sensitivity to pain, resulting in frequent complaints of pain without physiological basis
Increased incidence of pneumonia
Which condition occurs as a result of loss of minerals in bone tissue? A. Osteoporosis B. Osteoarthritis C. Skeletal hypertrophy D. Kyphosis
Osteoporosis
Which of these actions should be taken when immobilizing the spine of an elderly patient? A. Flex the patient's hips and knees for comfort, and to flatten out the lumbar curve. B. Place padding under all voids, including between the head, neck, and shoulders, and the backboard. C. Use one hand to apply pressure to the forehead to place the patient in a completely supine position. D. Use a tall cervical collar to maintain the neck in extension.
Place padding under all voids, including between the head, neck, and shoulders, and the backboard.
_____ is more common in the elderly because of the diminished ability of the respiratory system to fight off infections. A. Pneumonia B. COPD C. Pneumothorax D. Pulmonary edema
Pneumonia
Which condition is characterized as a blockage in an artery of the lungs, often a blood clot that can cause a sudden onset of shortness of breath and nonradiating chest discomfort? A. Pulmonary edema B. Chronic obstructive pulmonary disease C. Pulmonary embolism D. Pneumonia
Pulmonary embolism
A 70-year-old man complains of a headache that he calls a migraine. The headache began about four hours ago and has gotten worse. He has also started to feel nauseated and has "foggy" thinking. Upon questioning, you determine that the patient has NEVER had a history of migraines. He tells you, "No, this is the first one, but it's a doozy!" For which of these conditions should you immediately have an increased index of suspicion? A. Stroke B. Atypical seizure C. New onset of migraine headache D. Brain tumor
Stroke
Which of the following is a general guideline for adapting your approach to assessment to meet the needs of an elderly patient? A. Assume that all geriatric patients have sight and hearing impairment. B. Many elderly patients cannot hear low frequency speech. C. Talk to the patient about the emergency, not about the patient with others. D. The elderly patient will usually have one specific chief complaint.
Talk to the patient about the emergency, not about the patient with others.
Which of these statements about accommodations should you anticipate is CORRECT in assessing and caring for an elderly patient? A. The elderly patient's diminished gag reflex makes him vulnerable to aspiration. B. Fever in the geriatric patient will most always result in very warm skin. C. The acute onset of an irregular pulse is a normal occurrence in this age group. D. The patient's skin condition is a good indicator of dehydration.
The elderly patient's diminished gag reflex makes him vulnerable to aspiration.
Which of the following statements regarding a silent heart attack is CORRECT? A. A silent heart attack results in chest pain only, without other related symptoms. B. The only symptoms to a silent heart attack may be weakness and fatigue. C. A silent heart attack is one in which the patient suddenly collapses in cardiac arrest. D. The term silent heart attack arises from the patient's reluctance to seek help.
The only symptoms to a silent heart attack may be weakness and fatigue.
Which of these guidelines should you keep in mind when assessing elderly patients? A. They can be easily fatigued by the exam. B. It is always necessary to speak up when questioning an elderly patient. C. Unlike younger patients, the elderly prefer not to have explanations of medical procedures. D. Capillary refill time greater than two seconds is a reliable indicator of poor perfusion.
They can be easily fatigued by the exam.
Which of these changes occurs in the cardiovascular system as a result of the aging process? A. An increase of electrical conducting cells B. Increased thickness of capillary walls C. A decrease in resting heart rate D. Widespread arteriosclerosis
Widespread arteriosclerosis
Cardiac hypertrophy is A. an increase in blood flow to the heart. B. a thickening of the heart walls. C. stretching of the cardiac muscle fibers. D. weakening of the right ventricle.
a thickening of the heart walls.
Kyphosis is caused by A. arthritis in the vertebrae. B. improper posture. C. narrowing of the vertebrae. D. the break down of cartilage.
narrowing of the vertebrae.
A loss of minerals in bone tissue as a person ages is known as A. kyphosis. B. osteomyolitis. C. osteoporosis. D. osteoarthritis.
osteoporosis.
A temporary loss of consciousness is also known as A. syncope. B. Alzheimer's disease. C. cerebrovascular accident. D. trans-ischemic attack.
syncope.
What is the meaning of the term chronic illness? A. An illness that is due to lifestyle factors B. An illness that is present at birth C. Long-term illness, progressing gradually D. Severe illness with a sudden onset
Long-term illness, progressing gradually