Deck 34: Geriatric Emergencies

Question 1

As you care for an elderly patient experiencing a serious medical condition,you would expect any deterioration to take place:

A) rapidly.
B) slowly, with a later shift to rapidly.
C) slowly and steadily.
D) rapidly, with a later shift to slowly.

Answer 1

slowly and steadily.

Question 2

While listening to an otherwise healthy elderly patient's lungs,you note decreased breath sounds.Which of the following may explain this finding?

A) Increased chest wall flexibility
B) Decreased lung capacity
C) Previous abdominal injuries
D) Decreased blood flow to the lungs

Answer 2

Decreased lung capacity

Question 3

Your patient is an 80-year-old male complaining of lower back pain that radiates through to the abdomen.He describes the pain as "ripping" in nature.He is pale,diaphoretic,and anxious,and has a blood pressure of 210/100 mmHg,a pulse of 112 beats per minute,and a respiratory rate of 20 breaths per minute.Which of the following conditions is MOST likely?

A) Gallbladder disease
B) Bowel obstruction
C) Diverticulitis
D) Abdominal aortic aneurysm

Answer 3

Abdominal aortic aneurysm

Question 4

While interviewing your patient,she tells you that her husband will be back from the store shortly and can get you a list of her medications.Her daughter tells you that the patient's husband died 15 years ago.This situation is known as:

A) hallucination.
B) imagination.
C) contemplation.
D) confabulation.

Question 5

Of the older patients seen in the emergency department due to a fall,________% will die within 1 year.

A) 50
B) 25
C) 10
D) 35

Question 6

The elderly patient will most likely experience ________ as he or she continues to age.

A) increased stomach acid secretion
B) decreased intestinal tract movement
C) increased food absorption
D) decreased chewing difficulty

Question 7

When an elderly patient complains of abdominal pain,the EMT should consider this symptom to be:

A) non-life-threatening unless accompanied by other symptoms.
B) cardiac-related until proven otherwise.
C) an indication of a potentially serious problem.
D) related to a gastrointestinal problem.

Question 8

You are assessing an 83-year-old female who is having hip pain.When you count her pulse you notice that the rate is irregularly irregular.What is your treatment for this patient?

A) The irregularity is not a reason for concern in itself.
B) Check distal circulation, sensory, and motor sensation, apply a pelvic wrap, place on a traction splint, and transport the patient.
C) Contact medical control for permission to have the patient transported by helicopter from the scene.
D) Alert paramedics to respond for a possible cardiac patient.

Question 9

Which of the following is important to remember when communicating with an elderly patient with a hearing impairment?

A) Speak directly into the patient's ear.
B) You may need to shout in order for the patient to hear you.
C) Make sure the patient can see you when you are speaking to him.
D) It is not worth the effort to try to get information from an elderly person with a hearing impairment.

Question 10

As an adult ages,the body experiences changes that cause:

A) disease processes to take place.
B) a decreased compensatory ability.
C) an increased blood pressure.
D) an inability to maintain homeostasis.

Question 11

You are assessing a 67-year-old male patient who is experiencing a dissecting abdominal aneurysm.Typically,such a patient will describe the pain as:

A) dull.
B) tearing.
C) sharp.
D) achy.

Question 12

When interviewing the elderly patient,the EMT can increase the accuracy of the information he or she gains by:

A) speaking louder than normal.
B) having his or her partner assist with asking questions.
C) allowing sufficient time for the patient to answer.
D) asking multiple questions at the same time.

Question 13

Which of the following questions is MOST helpful in distinguishing between normal age-related changes and the effects of an illness when assessing an elderly patient?

A) How do you feel today compared to last week?
B) How is your appetite?
C) Are you taking your medications the way you are supposed to be taking them?
D) When was the last time you had a bowel movement?

Question 14

Concerning aging,which of the following statements is NOT true?

A) The diastolic blood pressure tends to rise with age.
B) Many elderly patients have a high threshold for pain.
C) Some elderly people have a low threshold for pain.
D) The systolic blood pressure tends to increase with age.

Question 15

A diastolic blood pressure over ________ mmHg is considered hypertensive.

A) 80
B) 50
C) 90
D) 65

Question 16

Which of the following is meant by the "1 percent rule" of aging?

A) Our organ systems lose about 1 percent of function per year beginning at age 30.
B) We lose about 1 percent of our memory capacity every year beginning at age 50.
C) About 1 percent of the population older than age 65 has significant organ function decline.
D) About 1 percent of the population makes it to their 85th birthday.

Question 17

Which of the following is NOT a common cause of chest pain in the elderly?

A) Angina
B) Asthma
C) Pneumonia
D) Aneurysm

Question 18

A patient gives you a story of having gone out to the movies last night,but who according to family members,has not left the house in years.This condition is called?

A) Apoplexy
B) Confabulation
C) Depression
D) Lying

Question 19

A segment of the body associated with a specific nerve coming from the spinal cord,along which shingles can appear,is called a:

A) motor unit.
B) dermatome.
C) zoster.
D) myelin sheath.

Question 20

When palpating the pulse of an elderly patient,you notice that there is an irregular pulsation without any kind of pattern or cycle to it.This is called:

A) pulsus alternans.
B) heart failure.
C) an irregularly irregular pulse.
D) pulsus paradoxus.

Question 21

While assessing the mental status of an elderly patient who has been retired for several years,you notice he has difficulty answering your questions.He seems depressed.Based on this information,you should:

A) suspect a life-threatening neurological event.
B) acknowledge the patient's fears and try to put them in perspective.
C) consider his mental status as being decreased.
D) consider the need for advanced provider care.

Question 22

The main perpetrators of elder abuse are:

A) grandchildren
B) adult children
C) spouses
D) brothers and sisters

Question 23

The elderly population is at least ________ times as likely to use the EMS system as patients in other age groups.

A) 5
B) 0.5
C) 10
D) 2

Question 24

During your assessment of an unconscious,unresponsive 80-year-old female patient,you notice that she has dentures.Your assessment reveals she has an open airway,is breathing on her own at a rate of 12 per minute,is slightly pale,and has a bounding radial pulse.In managing this patient's airway,what would be your most appropriate action?

A) Prepare to insert an oral airway.
B) Remove the dentures.
C) Perform a jaw thrust as needed.
D) Tilt the head to a sniffing position.

Question 25

Upon your arrival for a medical call at a private residence,you find an elderly male patient complaining of difficulty breathing.Which of the following findings would provide you with the most valuable information about potential problems this patient may be experiencing?

A) Temperature in the house
B) Patient's positioning on the couch
C) Patient's mental status
D) Patient's vital signs

Question 26

The use of a made-up experience to replace lost memories with imaginary ones is called:

A) hysteria.
B) confusion.
C) denial.
D) confabulation.

Question 27

Which of the following statements is believed to be true regarding domestic elder abuse?

A) The elders are usually in good health.
B) The abusers are usually well-adjusted.
C) There is seldom a family history of elder abuse.
D) None of the above.

Question 28

You walk up the stairs of a house to respond to a call of an elderly man.You notice that the stairs do not have any handrails.After responding to the reason why he called 911,what suggestion would you give to this patient to avoid falls in the future?

A) It is illegal to not have a handrail on the front steps and it must be fixed immediately.
B) He should install a handrail on the front steps to avoid any falls.
C) It is a good idea there are no handrails on the front steps as this negatively impacts his balance as he walks up the stairs.
D) Nothing, there is no problem.

Question 29

Which of the following is the likely result of diminished thyroid function in the elderly?

A) Thin, dry, wrinkled skin
B) Decreased tolerance of heat and cold
C) Increased toxicity of medications
D) Difficulty chewing and swallowing

Question 30

Which of the following fractures is most common among elderly women due to falls?

A) Distal femur
B) Pelvis
C) Mid-shaft femur
D) Proximal femur

Question 31

An elderly patient who is experiencing a myocardial infarction is more likely to complain of which of the following symptoms than a younger patient would?

A) Shortness of breath without chest pain
B) Shortness of breath with chest pain
C) A rash caused by shingles
D) No chest pain or shortness of breath

Question 32

Which of the following may provide the EMT with an indication of physical neglect of an elderly patient?

A) Misuse of a person's personal belongings
B) Evidence of sexual assault
C) Injuries from a fall
D) Poor hygiene

Question 33

Which of the following groups is MOST likely to be successful in a suicide attempt?

A) Middle-aged men
B) Young women
C) Teenagers
D) Elderly men

Question 34

An elderly patient you are transporting to the hospital for complaints of feeling faint and having abdominal pain provides you with a list of medications he currently takes.Among the medications listed is naproxen.The patient's vital signs include a blood pressure of 148/92,pulse rate of 120,respiratory rate of 28,and clear bilateral breath sounds.Which of the following would be the most likely condition the patient is experiencing related to the abdominal pain?

A) Myocardial infarction
B) Constipation
C) Abdominal aortic aneurysm
D) Lower gastrointestinal bleeding

Question 35

Which of the following is NOT a form of elder abuse or neglect?

A) Social
B) Physical
C) Psychological
D) Financial

Question 36

Which of the following lung conditions is the fourth leading cause of death among the elderly?

A) Chronic bronchitis
B) Pneumothorax
C) Pneumonia
D) Tuberculosis

Question 37

Which of the following is a serious complication of a fall with chest injuries suffered by a 75-year-old male?

A) Pneumonia
B) Bruised ribs
C) Blood clots
D) Collapsed lungs