Exam #1 Geriatrics Questions With Complete Solutions

1. Sedentary behavior while healing from a hip fracture would MOST likely predispose the older patient to: - ANSWER pneumonia. 2. The EMT should suspect left-sided heart failure in the geriatric patient who presents with: - ANSWER tachypnea and paroxysmal nocturnal dyspnea. 3. Common causes of depression in the elderly include all of the following, EXCEPT: - ANSWER an acute onset of dementia. 4. Geriatric patients present as a special problem for caregivers because: - ANSWER the classic presentation of disease is often altered. 5. Talking about an elderly patient in front of him or her to other members of the family: - ANSWER may cause the patient to think that he or she has no say in making decisions. 6. When an elderly patient presents you with multiple over the-counter medications that he or she is taking, it is MOST important to: - ANSWER recall that the patient is at risk for negative medication interactions. 7. A 69-year-old female was involved in a motor vehicle crash. She is semiconscious with a blood pressure of 80/50 mm Hg and a heart rate of 74 beats/min that is weak. Her daughter, who was uninjured in the crash, tells you that her mother has a history of hypertension 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? - ANSWER The effects of her antihypertensive medication 8. 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): - ANSWER pathologic fracture. 9. Using the patient's ___ shows respect and helps the patient to focus on your questions. - ANSWER name 10. 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): - ANSWER advance directive. 11. The leading cause of death in the geriatric patient is: - ANSWER heart disease. 12. Which of the following patients is at highest risk for a pulmonary embolism? - ANSWER 71-year-old male with recent surgery to a lower extremity 13. A drop in blood pressure with a change in position is referred to as: - ANSWER orthostatic hypotension. 14. When immobilizing a patient with a kyphotic spine to a long backboard, the EMT would MOST likely have to: - ANSWER place blankets behind the patient's head. 15. When explaining the need for a particular procedure to an elderly patient, you should: - ANSWER use plain language and simple terms. 16. Which of the following is generally NOT acceptable when interviewing an older patient? - ANSWER Do not initiate eye contact, because many geriatric patients might find this disrespectful. 17. The slow onset of progressive disorientation, shortened attention span, and loss of cognitive function is known as: - ANSWER dementia. 18. 19. Clouding of the lens of the eye - ANSWER Cataract Abnormal blood-filled dilation of a blood vessel - ANSWER Aneurysm 20. Difficulty breathing - ANSWER Dyspnea 21. Sudden change in mental status, consciousness, or cognitive processes - ANSWER Delirium 22. Slow onset of progressive disorientation - ANSWER Dementia 23. 24. Forward curling of the spine - ANSWER Kyphosis The stooped posture of some older people, which gives them a humpback appearance, is called: - ANSWER kyphosis. 25. Common causes of syncope in older patients include all of the following, EXCEPT: - ANSWER vasoconstriction. 26. Which of the following is the MOST common mechanism of injury in older patients? - ANSWER Falls 27. 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: - ANSWER attempt to resuscitate the patient. 28. An elderly patient may understate or minimize the symptoms of his or her illness because: - ANSWER he or she fears hospitalization. 29. A "silent" heart attack occurs when: - ANSWER the usual chest pain is not present. 30. You are responding to the dementia unit at a nursing home for respiratory distress. When you arrive, you notice that the patient is experiencing mild dyspnea and has an altered mental status. What can you do to help determine if the patient's altered mental status is appropriate for her underlying dementia? - ANSWER Find a staff member who can explain the patient's underlying mental status to you. 31. Causes of delirium in the older patients include all of the following, EXCEPT: - ANSWER Alzheimer disease. 32. Because of the complexity of the older patient and the vagueness of his or her complaint, you should: - ANSWER attempt to differentiate between chronic and acute problems. 33. Which of the following statements regarding depression is true? - ANSWER It is diagnosed three times more commonly in women than in men. 34. A 70-year-old man complains of a sudden onset of difficulty breathing. He has dried blood on his lips and is very anxious. His left leg is red, swollen, and painful. The EMT should: - ANSWER administer high-flow oxygen. 35. Clouding of the lenses of the eyes is called: - ANSWER cataracts. 36. Motor nerve neuropathy is characterized by: - ANSWER loss of balance, muscle weakness, and spasms. 37. Findings during the social assessment of an older patient include all of the following, EXCEPT: - ANSWER outdated medications. 38. Hip fractures are more likely to occur when bones are weakened by ___ or infection. - ANSWER osteoporosis 39. The "E" of the GEMS diamond stands for: - ANSWER environmental assessment. 40. The reduction in brain weight and volume increases an older person's risk for: - ANSWER head trauma. 41. When transporting a stable older patient to the hospital, the MOST effective way to reduce his or her anxiety is to: - ANSWER transport him or her to a hospital that he or she is familiar with. 42. In contrast to younger patients, older patients are more prone to a decrease in blood pressure upon standing because: - ANSWER the body is less able to adapt the BP to rapid postural changes. 43. An 84-year-old male fell a week ago and has been bedridden since then. Today, he presents with an altered mental status. His skin is pale and cold and his respirations are rapid and shallow. The EMT should suspect: - ANSWER a systemic infection. 44. EMTs are dispatched to a residence for an 80-year-old woman who is ill. The patient's daughter states that her mother almost fainted after going to the bathroom, and that her pulse was very slow. The patient's pulse rate is 80 beats/min and irregular and she is conscious and alert. The EMTs should suspect that the patient: - ANSWER experienced a vasovagal response. 45. An abdominal aortic aneurysm: - ANSWER is often the result of hypertension and atherosclerosis. 46. Upon entering the residence of a geriatric patient with a medical or trauma complaint, the EMT should: - ANSWER observe for conditions that may make the residence unsafe. 47. When assessing a 78-year-old female who complains of shortness of breath, the EMT should: - ANSWER determine the position in which the patient normally sleeps. 48. Blood levels of medications may rise in the elderly, sometimes to toxic levels. This is MOST likely due to: - ANSWER renal insufficiency. 49. With age, the spine stiffens as a result of shrinkage of the intervertebral disc spaces, and the vertebrae becomes brittle. This increases the risk of: - ANSWER compression fractures. 50. Many older victims of physical abuse may make false statements or lie about the origin of their injuries because: - ANSWER they fear retribution from the abuser. 51. You are assessing a 70-year-old female who complains of intense thirst, frequent urination, and dizziness. She has a history of type 2 diabetes, heart disease, rheumatoid arthritis, and gout. Her blood glucose reads "high." She is conscious, but confused. Her blood pressure is 92/52 mm Hg, her pulse rate is 130 beats/min and weak, and her respirations are 22 breaths/min and shallow. This patient's clinical presentation is MOST consistent with: - ANSWER hyperosmolar hyperglycemic nonketotic coma (HHNC). 52. A 75-year-old woman complains of shortness of breath. Which of the following findings should alert the EMT to the possibility of a pulmonary embolism? - ANSWER History of deep venous thrombosis 53. When assessing a geriatric patient who has possibly experienced an acute ischemic stroke, it is MOST important to: - ANSWER determine the onset of the patient's symptoms. 54. Poor maintenance of home, poor personal care, and dietary neglect are all possible indicators of ___ elder abuse. - ANSWER physical 55. To minimize distractions and confusion when assessing an older patient, you should: - ANSWER have only one EMT speak to the patient at a time. 56. Fractures of the pelvis in older patients often occur as the result of a combination of: - ANSWER osteoporosis and low-energy trauma. 57. When caring for an elderly patient who is hearing impaired, you should: - ANSWER recall that elderly patients have difficulty hearing high-frequency sounds. 58. Patients who have experienced even minor-appearing head injuries should be suspected of having a brain injury, especially if they: - ANSWER are taking blood-thinning medications. 59. During the natural process of aging, the number of functional cilia in the respiratory system decreases, resulting in: - ANSWER a decreased ability to cough A 77-year-old female presents with an acute onset of altered mental status. Her son is present and advises that she has a history of hypertension, atrial fibrillation, type 2 diabetes, and glaucoma. He further advises that she takes numerous medications and that she is normally alert. When you assess this patient, it is important to note that: - ANSWER the patient is experiencing delirious behavior, which suggests a new health problem.