ch. 33

Created by jrmyrick 

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A 73-year-old female experienced a syncopal episode while watching TV. She is now conscious, but is diaphoretic, tachycardic, and hypotensive. Your assessment reveals abdominal tenderness and a pulsating mass to the left of her umbilicus. You should be MOST suspicious for:

an aortic aneurysm

A productive cough, fever, and chills in an 80-year-old patient with a compromised immune system should make you MOST suspicious for:

pneumonia

. An older patient with significant dehydration would MOST likely present with:

dizziness or fainting upon standing.

Causes of delirium in the older patient include all of the following, EXCEPT:

Alzheimer disease.

Common causes of syncope in older patients include all of the following, EXCEPT:

vasoconstriction.

Fractures of the pelvis in older patients often occur as the result of a combination of:

osteoporosis and low-energy trauma

In contrast to delirium, dementia:

. is usually considered irreversible

Poor maintenance of home, poor personal care, and dietary neglect are all possible indications of ____________ elder abuse.

physical

The EMT should suspect left-sided heart failure in the geriatric patient who presents with:

tachypnea and paroxysmal nocturnal dyspnea.

The stooped posture of some older people, which gives them a humpback appearance, is called:

kyphosis

You are dispatched to a residence for an 80-year-old female who fell. When you arrive, you find the patient conscious, lying in a recumbent position on the floor in her living room. In addition to providing the appropriate treatment, you should ask the patient if:

she became dizzy or fainted before falling

The purpose of the GEMS diamond is to:

help EMS personnel remember what is different about elderly patients.

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

pathologic fracture

In contrast to younger patients, older patients are more prone to a decrease in blood pressure upon standing because

the baroreceptors have become less sensitive to blood pressure

A 10% to 20% reduction in brain weight and volume would MOST likely increase an older person's risk for:

head trauma

Which of the following is the MOST common mechanism of injury in older patients?

falls

Because of the complexity of the older patient and the vagueness of his or her complaint, you should:

attempt to differentiate between chronic and acute problems

An abdominal aortic aneurysm:

is often the result of hypertension and atherosclerosis.

When transporting a stable older patient to the hospital, the MOST effective way to reduce his or her anxiety is to:

transport him or her to a hospital that he or she is familiar with

Marks: 1
You are dispatched to a skilled nursing care facility for an 80-year-old female with abnormal behavior. The patient is clearly confused and asks you if you are her husband. As your partner administers oxygen to the patient, you should:

determine the patient's baseline mental status

Clouding of the lenses of the eyes is called:

cataracts

An elderly patient may understate or minimize the symptoms of his or her illness because:

he or she fears hospitalization

Which of the following is NOT a reason why the exact extent and prevalence of elder abuse is unknown?

Human resource agencies fail to investigate

Syncope in the older patient is

caused by an interruption of blood flow to the brain

During the natural process of aging, the number of functional cilia in the respiratory system decreases, resulting in

a decreased ability to cough

The leading cause of death in the geriatric patient is:

heart disease

In contrast to a living will, a "do not resuscitate" (DNR) order becomes valid when:

the patient develops cardiac arrest

When explaining the need for a particular procedure to an elderly patient, you should

use plain language and simple terms

When caring for an elderly patient who is hearing-impaired, you should:

recall that elderly patients have difficulty hearing high-frequency sounds

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:

attempt to resuscitate the patient.

The slow onset of progressive disorientation, shortened attention span, and loss of cognitive function is known as:

dementia

When performing your secondary assessment on an older patient who has been injured, it is important to:

recall that it will take a less severe mechanism of injury to cause significant injuries

With age, the spine stiffens as a result of shrinkage of the intervertebral disc spaces, and the vertebrae become brittle. This increases the risk of:

compression fractures

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 an

advance directive

Upon entering the residence of a geriatric patient with a medical or trauma complaint, the EMT should:

observe for conditions that may make the residence unsafe.

You receive a call for a sick person. When you arrive, you find the patient, a 75-year-old male, lying unresponsive in his bed. His respirations are slow and irregular and his pulse is slow and weak. His daughter tells you that he fell the day before, but refused to allow her to call 9-1-1. His past medical history is significant for hypothyroidism, deep vein thrombosis, heavy alcohol use, and liver cirrhosis. His medications include blood thinners and vitamins. You should be MOST suspicious that this patient is experiencing:

a subdural hematoma

Which of the following statements regarding communications with the elderly is correct?

Older patients have difficulty understanding when they are stressed.

Which of the following statements regarding the aging process is correct?

Aging is a linear process; the rate at which a person loses functions does not increase with age.

Which of the following statements regarding a decreased level of consciousness in the elderly patient is correct?

a decrease level of consciousness is not a normal part of the aging process ????? or Avpu scale is an in ineffective tool when assessing an elderly patient

Findings during the social assessment of an older patient include all of the following, EXCEPT:

outdated medications.

When documenting a case of suspected elder abuse, it is MOST important for the EMT to:

avoid documenting any unsupported opinions

When caring for a geriatric patient with a traumatic injury, it is important to consider that:

the injury may have been preceded by a medical condition.

A "silent" heart attack occurs when:

the usual chest pain is not present

Which of the following statements regarding suicide in the older patient is correct?

Older patients tend to use more lethal means than younger patients.

Which of the following observations or statements represents the "E" in the GEMS diamond?

The patient's residence is cold due to a malfunctioning heater.

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 level is 450 mg/dL. 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:

hyperosmolar hyperglycemic nonketotic coma (HHNC).

When an elderly patient presents you with multiple over-the-counter medications that he or she is taking, it is MOST important to:

recall that the patient is at risk for negative medication interactions.

When assessing a geriatric patient who has possibly experienced an acute ischemic stroke, it is MOST important to:

determine the onset of the patient's symptoms

which of the following patients is at a higher risk for pulmonary embolism

71 yr old male wth recent surgery of the lower extremity

sedentary behavior while healing from a hip fracture would most like predispose the old patient to

pneumonia

the chief component of connective tissue and bones that deteriorates as people age is called?

collagen

motor nerve neuropathy is characterized by?

loss of balance, muscle weakness, and spasms

upon arriving at the residence of an elderly female who apparently fainted, you find her lying supine on her living room floor. she is not moving and her eyes are closed. a neighbor tells you that she found the patient this way. but did not move her. when you talk to the patient she does not respond you should?

direct your partner to manually stabilize her head while you open her airway and ensure that her oropharynx is clear of secretions or blood

many older victims of physical abuse may make false statements or lie about the origin of there injuries because?

they fear retribution from the abuser

which of the following statements regaurding a decreased level of consciousness in the elderly patient is correct?

a decreased level of consciousness is not a normal part of the aging process

when assessing a 78 yr old female who complains of shortness of breath the emt should?

ask her how many pillows she uses when she sleeps

to minimize distraction and confusion when assessing an older patient you should?

have only one emt speak to the patient at a time

a 77 yr old female presents with an acute onset of altered mental status. her son is present and advises that she has a history of 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?

the patient is experiencing delirious behavior, which suggests a new health problem

when assessing an older patient who has multiple bruises in various stages of healing the emt should do all of the following except?

accuse the caregiver of physical abuse

osteoporosis is most accurately defines as?

a decrease in bone mass and density

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