1. To minimize distractions and confusion when assessing an older patient, you should:
A. dismiss the family members from the room or area.
B. have only one EMT speak to the patient at a time.
C. elevate your voice and speak directly to the patient.
D. pe
Answer: B
Question Type: General Knowledge
Page: 1216
2. General communication techniques with the elderly include:
A. using medical terms to ensure patient understanding.
B. explaining procedures while you are performing them.
C. frequently asking the patient if he or she understands.
D. having at least two
Answer: C
Question Type: General Knowledge
Page: 1216
3. When explaining the need for a particular procedure to an elderly patient, you should:
A. use plain language and simple terms.
B. use the appropriate medical terminology.
C. be complex so the patient fully understands.
D. realize that he or she will no
Answer: A
Question Type: General Knowledge
Page: 1216
4. Talking about an elderly patient in front of him or her to other members of the family:
A. often causes the patient to become paranoid and untrusting of your help.
B. may cause the patient to think that he or she has no say in making decisions.
C. will
Answer: B
Question Type: General Knowledge
Page: 1216
5. Which of the following statements regarding communications with the elderly is correct?
A. The majority of elderly patients are hearing or visually impaired.
B. Attempt to calm the elderly patient by using his or her first name.
C. Explain the justific
Answer: D
Question Type: General Knowledge
Page: 1216
6. Sedentary behavior while healing from a hip fracture would MOST likely predispose the older patient to:
A. pneumonia.
B. osteoporosis.
C. heart failure.
D. ischemic stroke.
Answer: A
Question Type: General Knowledge
Page: 1217
7. The leading cause of death in the geriatric patient is:
A. hypertension.
B. altered mental status.
C. arthritis.
D. heart disease.
Answer: D
Question Type: General Knowledge
Page: 1217
8. When caring for a geriatric patient with a traumatic injury, it is important to consider that:
A. geriatric patients usually present with little to no pain.
B. decreased bone density often results in incomplete fractures.
C. the injury may have been pr
Answer: C
Question Type: General Knowledge
Page: 1218
9. Because of the complexity of the older patient and the vagueness of his or her complaint, you should:
A. limit your physical examination to the area of pain or injury.
B. rely exclusively on family members for the medical history.
C. attempt to differe
Answer: C
Question Type: General Knowledge
Page: 1218
10. When transporting a stable older patient to the hospital, the MOST effective way to reduce his or her anxiety is to:
A. allow at least two family members to accompany the patient.
B. transport him or her to a hospital that he or she is familiar with.
Answer: B
Question Type: General Knowledge
Page: 1219
11. An elderly patient may understate or minimize the symptoms of his or her illness because:
A. the nervous system has deteriorated.
B. of decreased perception of pain.
C. of conditions such as dementia.
D. he or she fears hospitalization.
Answer: D
Question Type: General Knowledge
Page: 1219
12. Which of the following statements regarding a decreased level of consciousness in the elderly patient is correct?
A. A decreased level of consciousness is not a normal part of the aging process.
B. Most elderly patients have some deterioration in thei
Answer: A
Question Type: General Knowledge
Page: 1219
13. 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:
A. determine th
Answer: A
Question Type: Critical Thinking
Page: 1219
14. 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
Answer: C
Question Type: Critical Thinking
Page: 1220
15. The purpose of the GEMS diamond is to:
A. help EMS personnel remember what is different about elderly patients.
B. provide the EMT with a standard format for assessing elderly patients.
C. replace the typical ABC approach to patient care when caring f
Answer: A
Question Type: General Knowledge
Page: 1221
16. Upon entering the residence of a geriatric patient with a medical or trauma complaint, the EMT should:
A. immediately seek out a family member or other caregiver.
B. observe for conditions that may make the residence unsafe.
C. begin his or her assess
Answer: B
Question Type: General Knowledge
Page: 1221
17. Which of the following observations or statements represents the "E" in the GEMS diamond?
A. Elderly patients present atypically and deserve your respect.
B. The patient's residence is cold due to a malfunctioning heater.
C. A patient is assisted with
Answer: B
Question Type: General Knowledge
Page: 1221-1222
18. Findings during the social assessment of an older patient include all of the following, EXCEPT:
A. interaction with others.
B. daily activity assistance.
C. outdated medications.
D. delays in obtaining meals
Answer: C
Question Type: General Knowledge
Page: 1221-1222
19. Which of the following statements regarding the aging process is correct?
A. Aging is a linear process; the rate at which a person loses functions does not increase with age.
B. Because he or she is younger and healthier, a 35-year-old person ages slo
Answer: A
Question Type: General Knowledge
Page: 1223
20. During the natural process of aging, the number of functional cilia in the respiratory system decreases, resulting in:
A. a decreased ability to cough.
B. baseline respiratory distress.
C. an increased risk of COPD.
D. air-trapping within the alveoli.
Answer: A
Question Type: General Knowledge
Page: 1223
21. A productive cough, fever, and chills in an 80-year-old patient with a compromised immune system should make you MOST suspicious for:
A. heart failure.
B. bronchitis.
C. emphysema.
D. pneumonia.
Answer: D
Question Type: General Knowledge
Page: 1223-1224
22. An older patient with significant dehydration would MOST likely present with:
A. an increase in blood pressure upon standing.
B. dizziness or fainting upon standing.
C. weakness to one side of the body.
D. a drop in heart rate upon standing.
Answer: B
Question Type: General Knowledge
Page: 1224
23. Which of the following patients is at highest risk for a pulmonary embolism?
A. 59-year-old male who is recovering from pneumonia
B. 66-year-old active female with a history of hypertension
C. 71-year-old male with recent surgery to a lower extremity
Answer: C
Question Type: General Knowledge
Page: 1224
24. In contrast to younger patients, older patients are more prone to a decrease in blood pressure upon standing because:
A. their red blood cells are destroyed at a faster than normal rate.
B. the aging process results in an overall increase in blood vol
Answer: C
Question Type: General Knowledge
Page: 1226
25. A "silent" heart attack occurs when:
A. sweating is the only presentation.
B. the usual chest pain is not present.
C. a sudden dysrhythmia causes death.
D. the patient minimizes the chest pain.
Answer: B
Question Type: General Knowledge
Page: 1226
26. The EMT should suspect left-sided heart failure in the geriatric patient who presents with:
A. fever and a cough that produces green sputum.
B. tachypnea and paroxysmal nocturnal dyspnea.
C. jugular venous distention and peripheral edema.
D. swelling
Answer: B
Question Type: General Knowledge
Page: 1227
27. When assessing a 78-year-old female who complains of shortness of breath, the EMT should:
A. give oxygen only if the patient has labored breathing.
B. conclude that the patient is experiencing a heart attack.
C. ask her how many pillows she uses when
Answer: C
Question Type: General Knowledge
Page: 1227
28. When assessing a geriatric patient who has possibly experienced an acute ischemic stroke, it is MOST important to:
A. determine the onset of the patient's symptoms.
B. ascertain about a history of atrial fibrillation.
C. administer 324 mg of aspirin a
Answer: A
Question Type: General Knowledge
Page: 1227
29. A 10% to 20% reduction in brain weight and volume would MOST likely increase an older person's risk for:
A. stroke.
B. delirium.
C. dementia.
D. head trauma.
Answer: D
Question Type: General Knowledge
Page: 1228
30. Clouding of the lenses of the eyes is called:
A. retinitis.
B. cataracts.
C. glaucoma.
D. conjunctivitis.
Answer: B
Question Type: General Knowledge
Page: 1228
31. When caring for an elderly patient who is hearing-impaired, you should:
A. speak directly into his or her ear with an elevated tone.
B. remember that most hearing-impaired patients can read lips.
C. request that he or she communicates with you by writ
Answer: D
Question Type: General Knowledge
Page: 1228
32. The slow onset of progressive disorientation, shortened attention span, and loss of cognitive function is known as:
A. delirium.
B. delusion.
C. paranoia.
D. dementia.
Answer: D
Question Type: General Knowledge
Page: 1229
33. In contrast to delirium, dementia:
A. is usually considered irreversible.
B. is the result of an acute condition.
C. is reversible with certain treatment.
D. often develops over a period of days.
Answer: A
Question Type: General Knowledge
Page: 1229
34. 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 medicatio
Answer: B
Question Type: Critical Thinking
Page: 1229
35. Causes of delirium in the older patient include all of the following, EXCEPT:
A. acute hypovolemia.
B. Alzheimer disease.
C. low blood sugar level.
D. decreased cerebral perfusion
Answer: B
Question Type: General Knowledge
Page: 1229-1230
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 ev
Answer: A
Question Type: General Knowledge
Page: 1230
37. Motor nerve neuropathy is characterized by:
A. numbness, tingling, and severe muscle pain.
B. loss of bladder control and sensitivity to touch.
C. loss of balance, muscle weakness, and spasms.
D. constipation, low blood pressure, and bradycardia.
Answer: C
Question Type: General Knowledge
Page: 1230
38. Common causes of syncope in older patients include all of the following, EXCEPT:
A. venous pooling.
B. vasoconstriction.
C. acute hypotension.
D. blood volume loss.
Answer: B
Question Type: General Knowledge
Page: 1231
39. An abdominal aortic aneurysm:
A. is usually not repairable, even if discovered early.
B. causes dull pain that often radiates to the shoulders.
C. is often the result of hypertension and atherosclerosis.
D. can sometimes be palpated as a mass in the g
Answer: C
Question Type: General Knowledge
Page: 1232
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 b
Answer: A
Question Type: Critical Thinking
Page: 1232
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
Answer: C
Question Type: Critical Thinking
Page: 1233
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
Question Type: General Knowledge
Page: 1234
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
Question Type: General Knowledge
Page: 1234
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
Question Type: General Knowledge
Page: 1234
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
Question Type: General Knowledge
Page: 1235
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 t
Answer: A
Question Type: General Knowledge
Page: 1235
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
Question Type: General Knowledge
Page: 1235
48. Common causes of depression in the elderly include all of the following, EXCEPT:
A. chronic medical conditions.
B. prescription medication use.
C. an acute onset of dementia.
D. alcohol abuse and dependence.
Answer: C
Question Type: General Knowledge
Page: 1236
49. Which of the following statements regarding suicide in the older patient is correct?
A. Older patients tend to use more lethal means than younger patients.
B. Older females have a higher rate of suicide than any other group.
C. Depression and hopeless
Answer: A
Question Type: General Knowledge
Page: 1236
50. Which of the following is the MOST common mechanism of injury in older patients?
A. falls
B. burns
C. abuse
D. suicide
Answer: A
Question Type: General Knowledge
Page: 1237
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. recal
Answer: C
Question Type: General Knowledge
Page: 1238
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 mo
Answer: C
Question Type: Critical Thinking
Page: 1238
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
Answer: B
Question Type: General Knowledge
Page: 1240
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 th
Answer: A
Question Type: Critical Thinking
Page: 1240
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. commi
Answer: A
Question Type: General Knowledge
Page: 1240
56. Fractures of the pelvis in older patients often occur as the result of a combination of:
A. osteoporosis and low-energy trauma.
B. increased bone density and car crashes.
C. arthritic joints and high-energy trauma.
D. acetabular separation and severe
Answer: A
Question Type: General Knowledge
Page: 1240
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
Question Type: General Knowledge
Page: 1240
58. 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,
Answer: B
Question Type: Critical Thinking
Page: 1240-1241
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 sk
Answer: B
Question Type: General Knowledge
Page: 1241
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
Answer: D
Question Type: General Knowledge
Page: 1242
61. In contrast to a living will, a "do not resuscitate" (DNR) order becomes valid when:
A. the patient has a terminal illness.
B. the patient develops cardiac arrest.
C. the patient is in a health care setting.
D. it is signed by three or more physicians
Answer: B
Question Type: General Knowledge
Page: 1243
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 resuscita
Answer: B
Question Type: General Knowledge
Page: 1243
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
Answer: C
Question Type: General Knowledge
Page: 1243
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
Question Type: General Knowledge
Page: 1244
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 retribut
Answer: D
Question Type: General Knowledge
Page: 1244
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 occu
Answer: B
Question Type: General Knowledge
Page: 1245
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 documenti
Answer: D
Question Type: General Knowledge
Page: 1245