Effective Communication and Assessment Strategies for Elderly Patients 36-67 Answers

36. Syncope in the older patient is: A. caused by an interruption of blood flow to the brain. B. generally of no concern unless the patient was injured. C. most commonly caused by a silent myocardial infarction. D. rarely life threatening but should be evaluated by a physician. Answer: A 37. Motor nerve neuropathy is characterized by: A. B. C. D. numbness, tingling, and severe muscle pain. loss of bladder control and sensitivity to touch. loss of balance, muscle weakness, and spasms. constipation, low blood pressure, and bradycardia. Answer: C 38. Common causes of syncope in older patients include all of the following, EXCEPT: A. B. C. D. venous pooling. vasoconstriction. acute hypotension. blood volume loss. Answer: B 39. An abdominal aortic aneurysm: A. B. C. D. is usually not repairable, even if discovered early. causes dull pain that often radiates to the shoulders. is often the result of hypertension and atherosclerosis. can sometimes be palpated as a mass in the groin area. Answer: C 40. 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: A. an aortic aneurysm. B. acute appendicitis. C. a strangulated bowel. D. myocardial infarction. Answer: A 41. 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: A. diabetic ketoacidosis. B. hyperglycemia with moderate dehydration. C. hyperosmolar hyperglycemic nonketotic coma (HHNC). D. acute renal failure with associated hyperglycemia. Answer: C 42. The stooped posture of some older people, which gives them a humpback appearance, is called: A. kyphosis. B. arthritis. C. scoliosis. D. miosis. Answer: A 43. Osteoporosis is MOST accurately defined as: A. increased flexibility of bone mass. B. decreased bone marrow production. C. a decrease in bone mass and density. D. an abnormality near the growth plate. Answer: C 44. The chief component of connective tissues and bones that deteriorates as people age is called: A. fibrin. B. elastin. C. sebum. D. collagen. Answer: D 45. Blood levels of medications may rise in the elderly, sometimes to toxic levels. This is MOST likely due to: A. pancreatic failure. B. renal insufficiency. C. intentional overdose. D. splenic dysfunction. Answer: B 46. When an elderly patient presents you with multiple over-the-counter medications that he or she is taking, it is MOST important to: A. recall that the patient is at risk for negative medication interactions. B. ask the patient to explain what each of the medications is used for. C. look up all of the medications before providing care to the patient. D. contact each of the physicians whose names are on the medications. Answer: A 47. The use of multiple prescription drugs by a single patient, causing the potential for negative effects such as overdosing or drug interaction, is called: A. potentiation. B. polypharmacy. C. drug tolerance. D. drug dependency. Answer: B 48. Common causes of depression in the elderly include all of the following, EXCEPT: A. B. C. D. chronic medical conditions. prescription medication use. an acute onset of dementia. alcohol abuse and dependence. Answer: C 49. Which of the following statements regarding suicide in the older patient is correct? A. B. C. D. Older patients tend to use more lethal means than younger patients. Older females have a higher rate of suicide than any other group. Depression and hopeless feelings are often not predisposing factors. Most suicidal patients readily seek care and do not deny the problem. Answer: A 50. Which of the following is the MOST common mechanism of injury in older patients? A. B. C. D. falls burns abuse suicide Answer: A 51. When performing your secondary assessment on an older patient who has been injured, it is important to: A. routinely perform a focused exam to minimize time at the scene. B. perform an in-depth physical exam prior to initiating any treatment. C. recall that it will take a less severe mechanism of injury to cause significant injuries. D. focus your assessment just on the area(s) of pain or obvious injury. Answer: C 52. Upon arriving at the residence of an elderly female who apparently fainted, you find the patient 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 gently tap the patient, she does not respond. You should: A. suction her airway, apply a cervical collar, administer high-flow oxygen via a nonrebreathing mask, and perform a rapid assessment. B. open her airway with the head tilt–chin lift maneuver, insert an oral or nasal airway, and assess her blood glucose level to rule out hypoglycemia. C. direct your partner to manually stabilize her head while you quickly visualize her chest for signs of breathing. D. begin assisting her ventilations with a bag-mask device while your partner auscultates her lung sounds to ensure adequate positive-pressure ventilation. Answer: C 53. When immobilizing a patient with a kyphotic spine to a long backboard, the EMT would MOST likely have to: A. force the head into a neutral alignment. B. place blankets behind the patient’s head. C. secure the patient’s head before the torso. D. use a scoop stretcher instead of a log roll. Answer: B 54. 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: A. she became dizzy or fainted before falling. B. she attempted to catch herself before falling. C. a family member regularly checks up on her. D. she takes medications for Alzheimer disease. Answer: A 55. 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): A. pathologic fracture. B. idiopathic fracture. C. compression fracture. D. comminuted fracture. Answer: A 56. Fractures of the pelvis in older patients often occur as the result of a combination of: A. B. C. D. osteoporosis and low-energy trauma. increased bone density and car crashes. arthritic joints and high-energy trauma. acetabular separation and severe falls. Answer: A 57. 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: A. severe kyphosis. B. distracting injuries. C. spinal cord tearing. D. compression fractures. Answer: D 58. You receive a call for a sick person. When you arrive, you find the patient, a 75-yearold 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. acute hyperglycemia. B. a subdural hematoma. C. acute ischemic stroke. D. diabetic ketoacidosis. Answer: B 59. Patients who have experienced even minor-appearing head injuries should be suspected of having a brain injury, especially if they: A. have minor abrasions to the head area. B. are taking blood-thinning medications. C. do not have deformities to the skull. D. have a history of Alzheimer disease. Answer: B 60. 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): A. statute of care. B. power of attorney. C. physician directive. D. advance directive. Answer: D 61. In contrast to a living will, a “do not resuscitate” (DNR) order becomes valid when: A. B. C. D. the patient has a terminal illness. the patient develops cardiac arrest. the patient is in a health care setting. it is signed by three or more physicians. Answer: B 62. 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: A. try to locate the documentation. B. attempt to resuscitate the patient. C. allow the patient to die in peace. D. contact medical control for advice. Answer: B 63. Which of the following is NOT a reason why the exact extent and prevalence of elder abuse is unknown? A. It has been largely hidden from society. B. The definitions of abuse and neglect vary. C. Human resource agencies fail to investigate. D. Victims of elder abuse are hesitant to report it. Answer: C 64. Poor maintenance of home, poor personal care, and dietary neglect are all possible indicators of ____________ elder abuse. A. physical B. financial C. emotional D. psychological Answer: A 65. Many older victims of physical abuse may make false statements or lie about the origin of their injuries because: A. they are protective of the abuser. B. they do not want to be bothersome. C. most elderly patients have dementia. D. they fear retribution from the abuser. Answer: D 66. When assessing an older patient who has multiple bruises in various stages of healing, the EMT should do all of the following, EXCEPT: A. factually document all findings. B. accuse a caregiver of physical abuse. C. ask the patient how the bruises occurred. D. review the patient’s activities of daily living. Answer: B 67. When documenting a case of suspected elder abuse, it is MOST important for the EMT to: A. theorize as to why the patient was abused. B. document his or her perceptions of the event. C. list the names of all of the suspected abusers. D. avoid documenting any unsupported opinions. Answer: D