Question 1

A new EMT asks you why the elderly are at a higher risk for developing pneumonia, as compared to those of a younger age. You inform him that the elderly are more susceptible to respiratory infections because of a(n):

Accepted Answer

The elderly often have a decreased cough reflex, which makes it harder for them to clear secretions and pathogens from their airways, increasing the risk of respiratory infections like pneumonia.

Question 2

You have just arrived by the side of an elderly patient who took excessive amounts of his daily medications after becoming confused about what to take and when. Which one of the following is the immediate priority in caring for this patient?

Accepted Answer

The immediate priority in caring for this patient is to evaluate and support the patient's airway and breathing. Excessive medication may lead to respiratory depression, which can quickly progress to respiratory arrest. Therefore, ensuring the patient's airway is open and they are breathing adequately is crucial. Once the patient is stabilized, the healthcare team can go ahead to determine what medications were taken, the amount taken, and the patient's past medical history. Gathering up all medications for transport with the patient may be necessary, but it is not the immediate priority.

Question 3

When getting a medical history from a patient, you refer to him as Mr. Adamo. He stops you and asks you to call him Robert. You should:

Accepted Answer

It is appropriate to address patients by their preferred name, as long as it is professional and respectful. In this situation, the patient has requested to be called Robert, so it would be appropriate to honor his request.

Question 4

In reviewing prehospital care reports, you note that over 75 percent of the patients from a nursing home suffer from hypertension. As a knowledgeable EMT, you would recognize that:

Accepted Answer

Hypertension is a common condition among the elderly population. It is also known as high blood pressure and can be caused by many underlying conditions such as aging, genetics, poor diet, or lack of exercise. Therefore, it is not unusual to find a high percentage of nursing home patients with hypertension. Choices B, C, and D are incorrect because there is no evidence to support these assumptions based on the given information.

Question 5

When assessing a 91-year-old female who fell, what assessment finding should concern the EMT most?

Accepted Answer

Sudden onset of confusion in an elderly patient after a fall can be indicative of a head injury or internal bleeding. This finding should be concerning for the EMT and warrants further assessment and treatment.

Question 6

You have been called for a conscious and alert 83-year-old male complaining of a fever for three days. He has a history of peripheral vascular disease. When assessing the patient's circulation, you have a difficult time feeling his radial pulse. Your next action would be to:

Accepted Answer

If you are unable to feel a radial pulse, the next step would be to check the patient's carotid pulse. This will give you a better assessment of the patient's perfusion status. If the carotid pulse is present, it is likely that the radial pulse is just difficult to feel due to poor circulation. If the carotid pulse is absent, this could indicate a more serious problem with the patient's circulation.

Question 7

Family members tell you that 3 hours ago, their 76-year-old mother suddenly became confused and had great difficulty speaking. However, within 15 minutes she returned to normal. Based on this description, the EMT should be suspicious of:

Accepted Answer

The sudden onset of confusion and difficulty speaking followed by a return to normal within 15 minutes suggests a transient ischemic attack (TIA), also known as a "mini-stroke." It is important for the EMT to consider this possibility and transport the patient to the hospital for further evaluation and management. Other potential causes of confusion and speech difficulty, such as dementia or Alzheimer's disease, would not typically resolve within such a short period of time.

Question 8

You have been called to an assisted living facility to transport a patient who has been vomiting continuously for 6 hours. She is responsive to verbal stimuli. The patient suffers from arthritis and severe kyphosis. How should you transport this patient on the stretcher?

Accepted Answer

The left lateral recumbent position helps prevent aspiration in a vomiting patient and is suitable for someone with kyphosis, as it avoids putting pressure on the spine.

Question 9

You have been called for a 79-year-old female complaining of shortness of breath. Due to the increased respiratory rate, cough, and production of discolored sputum, you are suspicious of pneumonia. A family member asks you how she can have pneumonia, when her temperature is only 97.9°F. Your best response is:

Accepted Answer

The elderly population may have less of a fever response due to changes in their immune system, making them more susceptible to pneumonia without the classic signs of high fever or chills.

Question 10

You have been called for a 77-year-old male with chest pain. On scene the patient denies ever having chest pain and requests to sign a refusal. Before having the refusal signed, the EMT must consider that many geriatric patients may deny symptoms because of:

Accepted Answer

Many elderly patients may deny symptoms such as chest pain due to the fear of losing their independence and dignity. They may feel embarrassed or ashamed to admit that they are experiencing chest pain or other symptoms, as they may believe that it is a sign of weakness or frailty. As healthcare providers, we need to reassure the patient that seeking medical attention is the right decision, and that it does not make them any less capable or independent.

Question 11

A patient with advanced dementia cannot provide an accurate medical history. In this situation, the EMT's best course of action would be to:

Accepted Answer

In the absence of an accurate medical history from the patient, the EMT should rely on information provided by family members or caregivers who are familiar with the patient's past medical history. This can help guide the EMT's assessment and treatment decisions in the field.

Question 12

Your partner believes the 90-year-old male you are caring for is dehydrated. What sign best reinforces his suspicion?

Accepted Answer

Dry mouth and tongue are signs of dehydration.

Question 13

Which statement indicates an accurate understanding of administering positive pressure ventilation (PPV) to a geriatric patient?

Accepted Answer

Gentle ventilations that make the chest rise sufficiently are considered adequate for providing oxygen to the lungs, including in geriatric patients. This approach minimizes the risk of barotrauma or volutrauma that can occur with excessive force, especially in older patients who may have more fragile lung tissue.

Question 14

An elderly female fell down three steps and is complaining of back pain. After performing the primary assessment, what question would be most important to ask first?

Accepted Answer

The most important question to ask first in this scenario is if the patient became dizzy before the fall as this could indicate a potential medical condition that needs to be addressed urgently. It is important to rule out any life-threatening conditions before moving on to other questions.

Question 15

You have been asked to deliver a talk about EMS and its interaction with the geriatric population. Which point would you emphasize in your presentation?

Accepted Answer

Emphasizing the fact that many of the elderly have a combination of different diseases in various stages is important because it presents a challenge for EMS providers to identify and manage each health condition while providing emergency care. This highlights the need for specialized training and resources for EMS providers that interact with the geriatric population. The other options (A, C, and D) are not as significant or relevant to the topic at hand.

Question 16

You have just arrived by the side of a nonverbal patient with snoring respirations. The caregiver states that they were eating lunch when she suddenly collapsed face first onto the table. She also states that she has a history of a stroke, high blood pressure, and colon cancer. Your priority in caring for this patient at this time would be:

Accepted Answer

Given the patient's sudden collapse while eating and the presence of snoring respirations, the priority is to ensure an open airway. Snoring respirations indicate a partially obstructed airway, likely by the tongue or possibly obstructed by food. Opening and looking into the patient's mouth is the immediate action needed to address potential airway obstruction.

Question 17

A patient with kyphosis has fallen and is complaining of numbness in both arms. Regarding immobilization, you should:

Accepted Answer

Placing pillows in voids between the patient and the long board helps accommodate the patient's kyphosis while ensuring proper immobilization and spinal alignment during transport.

Question 18

Which one of the following statements demonstrates an accurate understanding of vital signs in relation to the geriatric patient?

Accepted Answer

The resting respiratory rate tends to be higher in the elderly due to changes in lung and chest wall mechanics, as well as a decrease in respiratory muscle strength, making this statement accurate in reflecting an understanding of vital signs in relation to geriatric patients.

Question 19

You have been called for an unknown medical emergency. On scene you are presented with an 84-year-old patient who is confused and does not obey commands. The best means of determining the patient's normal mental status would be to:

Accepted Answer

Questioning family members can give insight into the patient's baseline mental status and help determine if there has been a sudden change. Examining the patient's pupils, checking vital signs, and looking at medications can all provide additional information, but may not necessarily indicate the patient's normal mental status.

Question 20

The son of an 88-year-old patient states that he told his mother to double the dose of her antibiotic so she would "get better faster." This represents a problem given that the elderly have a(n):

Accepted Answer

The elderly often have decreased liver and kidney function, which can impair drug metabolism and clearance. Doubling the dose of medication can result in toxic levels of the drug and potentially harmful side effects.

Quiz 39: Geriatrics

A new EMT asks you why the elderly are at a higher risk for developing pneumonia, as compared to those of a younger age. You inform him that the elderly are more susceptible to respiratory infections because of a(n) :