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Flashcards in Chapter 31 Deck (39):
1

You have been asked to deliver a talk about the geriatric population to the new OEC class. Which of the following points would you emphasize in your presentation?

a. Assessment can be difficult because most individuals older than 70 suffer from dementia.
b. Many elderly individuals have a combination of different diseases in various stages.
c. Geriatric patients actually account for a small number of emergency medical calls and transports.
d. Dementia is an inevitable part of aging.

Assessment can be difficult because most individuals older than 70 suffer from dementia.
b. Many elderly individuals have a combination of different diseases in various stages.
c. Geriatric patients actually account for a small number of emergency medical calls and transports.
d. Dementia is an inevitable part of aging.

Answer: b
Objective: 31-1
Reference: 1002

2

A new OEC Technician asks you why the elderly are at higher risk for developing pneumonia than younger individuals. You inform him that the elderly are more susceptible to respiratory infections because of:

a. impaired swallowing of saliva.
b. decreased alveolar gas exchange.
c. a reduced cough reflex.
d. hardening of the major arteries.

a. impaired swallowing of saliva.
b. decreased alveolar gas exchange.
c. a reduced cough reflex.
d. hardening of the major arteries.

Answer: c
Objective: 31-1
Reference: 1002

3

The son of an 88-year-old patient states that he told his mother to increase the amount of an antibiotic she was taking so she would "feel better faster.” This represents a problem because the elderly have:

a. decreased respiratory function.
b. an increased risk for stroke.
c. decreased liver and kidney function.
d. an increased risk for cancer.

a. decreased respiratory function.
b. an increased risk for stroke.
c. decreased liver and kidney function.
d. an increased risk for cancer.

Answer: c
Objective: 31-1
Reference: 1002

4

Which of the following statements shows that an OEC Technician has an accurate understanding of vital signs in relation to geriatric patients?

a. "The typical resting heart rate in geriatric patients is less than 60 beats per minute."
b. "Fever tends to be more common and more severe in elderly patients."
c. "There is no difference between the vital signs of a geriatric patient and those of a young adult."
d. “Respiratory capacity is greatly reduced in geriatric patients."

a. "The typical resting heart rate in geriatric patients is less than 60 beats per minute."
b. "Fever tends to be more common and more severe in elderly patients."
c. "There is no difference between the vital signs of a geriatric patient and those of a young adult."
d. “Respiratory capacity is greatly reduced in geriatric patients."

Answer: d
Objective: 31-1
Reference: 988

5

Some elderly patients have osteoporosis, a condition that results in:

a. decreased bone density.
b. decreased renal output.
c. decreased insulin production.
d. gall stone production.

a. decreased bone density.
b. decreased renal output.
c. decreased insulin production.
d. gall stone production.

Answer: a
Objective: 31-1, 31-5
Reference: 989

6

An elderly woman has fallen down three steps and is complaining of back pain. After you perform a primary assessment, which of the following questions should you ask to illicit the next important piece of information?

a. "Did you become dizzy before you fell?"
b. "Why didn’t you use the ramp on the other side?"
c. "Do you have a history of high blood pressure?"
d. "Who is your family doctor?"

a. "Did you become dizzy before you fell?"
b. "Why didn’t you use the ramp on the other side?"
c. "Do you have a history of high blood pressure?"
d. "Who is your family doctor?"

Answer: a
Objective: 31-5
Reference: 996

7

Family members tell you that three 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, an OEC Technician should be suspicious of:

a. a stroke.
b. dementia.
c. Alzheimer's disease.
d. a transient ischemic attack.

a. a stroke.
b. dementia.
c. Alzheimer's disease.
d. a transient ischemic attack.

Answer: d
Objective: 31-3
Reference: 992

8

Which of the following statements about traumatic injuries in the elderly is true?

a. Motor-vehicle collisions are responsible for over 75 percent of deaths.
b. Head injuries are easier to detect in the elderly than in younger adults.
c. Hyperthermia is an early sign of trauma.
d. Injuries are most commonly caused by falls.

a. Motor-vehicle collisions are responsible for over 75 percent of deaths.
b. Head injuries are easier to detect in the elderly than in younger adults.
c. Hyperthermia is an early sign of trauma.
d. Injuries are most commonly caused by falls.

Answer: d
Objective: 31-5
Reference: 996

9

Which of the following statements concerning insulin pumps is false?

a. They have an external on/off button.
b. They are implanted in the patient’s chest.
c. They supply insulin via a catheter.
d. They are commonly found on a patient’s belt.

a. They have an external on/off button.
b. They are implanted in the patient’s chest.
c. They supply insulin via a catheter.
d. They are commonly found on a patient’s belt.

Answer: b
Objective: 31-3
Reference: 1000

10

Which of the following strategies is best for OEC Technicians for communicating with a geriatric patient who has diminished eyesight?

a. Write your questions in large print on paper.
b. Increase both the pitch and the volume of your voice.
c. Stand in front of the patient and talk calmly.
d. Obtain needed information from family members.

a. Write your questions in large print on paper.
b. Increase both the pitch and the volume of your voice.
c. Stand in front of the patient and talk calmly.
d. Obtain needed information from family members.

Answer: c
Objective: 31-2
Reference: 1000

11

A hearing-impaired patient wearing a hearing aid is having a great deal of difficulty hearing your questions. Which of the following actions should you take first?

a.. Ensure that their hearing aid is turned on.
b. Increase the pitch of your voice.
c. Write your questions on paper.
d. Position yourself in front of the patient and shout.

a.. Ensure that their hearing aid is turned on.
b. Increase the pitch of your voice.
c. Write your questions on paper.
d. Position yourself in front of the patient and shout.

Answer: a
Objective: 31-2
Reference: 1000

12

Which of the following conditions is associated with pulmonary embolism?

a. Infection
b. Hypertension
c. Pulmonary edema
d. Hypoxia

a. Infection
b. Hypertension
c. Pulmonary edema
d. Hypoxia

Answer: d
Objective: 31-3
Reference: 1001

13

A 77-year-old man got out of bed, became dizzy, and fell onto the floor, hitting the right side of his face. You find him sitting on the floor with his wife next to him. His wife states that he did not lose responsiveness and that this has happened several times over the past few days, ever since the doctor put him on a new blood pressure medication. Presently, the patient is alert and oriented and complaining of dizziness and a headache. He has a history of coronary artery disease, emphysema, and hypertension. Which of the following actions should you take first?

a. Check the patient’s airway and breathing.
b. Establish manual in-line spinal stabilization.
c. Position the patient supine with his feet elevated.
d. Provide oxygen at 15 LPM.

a. Check the patient’s airway and breathing.
b. Establish manual in-line spinal stabilization.
c. Position the patient supine with his feet elevated.
d. Provide oxygen at 15 LPM.

Answer: b
Objective: 31-5
Reference: 1003

14

You have been called by the caregiver of a 91-year-old woman with dementia. The patient is complaining of a possible fracture to her upper left arm. As you talk to the caregiver and note various bruises on the patient’s body, you become suspicious of elder abuse. Which of the following actions is most appropriate at this time?

a. Contact the police to report your suspicion.
b. Confront the caregiver regarding the bruises on the patient’s body.
c. Ask the patient if she is being abused.
d. Treat the patient for a possible broken arm.

a. Contact the police to report your suspicion.
b. Confront the caregiver regarding the bruises on the patient’s body.
c. Ask the patient if she is being abused.
d. Treat the patient for a possible broken arm.

Answer: d
Objective: 31-5
Reference: 998

15

You and your partner respond to the lodge to aid an elderly woman who is not feeling well. When you perform a secondary assessment:

a. you and your partner should take turns asking the patient questions.
b. you and your partner should ignore the patient and ask the family for information.
c. you should stand to the patient’s side and raise your voice so the patient can hear you.
d. only one of you should ask the patient questions to avoid confusion.

a. you and your partner should take turns asking the patient questions.
b. you and your partner should ignore the patient and ask the family for information.
c. you should stand to the patient’s side and raise your voice so the patient can hear you.
d. only one of you should ask the patient questions to avoid confusion.

Answer: d
Objective: 31-2
Reference: 1001

16

When communicating with a geriatric patient, OEC Technicians should:

a. use layman’s terms.
b. use medical terms to describe their findings and treatment plan.
c. use anatomical pictures and point to the affected areas as they explain.
d. touch the patient as they explain the patient’s medical issues and affected body areas.

a. use layman’s terms.
b. use medical terms to describe their findings and treatment plan.
c. use anatomical pictures and point to the affected areas as they explain.
d. touch the patient as they explain the patient’s medical issues and affected body areas.

Answer: a
Objective: 31-2
Reference: 1001

17

An effective way to interview a geriatric patient is to:

a. keep repeating your question if the patient is slow to respond.
b. use active listening skills.
c. write your questions down on paper and show them to the patient.
d. offer possible responses to assist the patient before she answers.

a. keep repeating your question if the patient is slow to respond.
b. use active listening skills.
c. write your questions down on paper and show them to the patient.
d. offer possible responses to assist the patient before she answers.

Answer: b
Objective: 31-2
Reference: 1001

18

A geriatric patient’s cardiovascular response to stress, illness, and injury is different than that of younger patients. Which of the following statements is false?

a. As the heart ages, the ventricles become stiffer.
b .The volume of blood in the body decreases in geriatric patients.
c. The heart slows due to decreased electrical conductivity in geriatric patients.
d. Blood vessels become stiffer from atherosclerosis in geriatric patients.

a. As the heart ages, the ventricles become stiffer.
b .The volume of blood in the body decreases in geriatric patients.
c. The heart slows due to decreased electrical conductivity in geriatric patients.
d. Blood vessels become stiffer from atherosclerosis in geriatric patients.

Answer: b
Objective: 31-3
Reference: 988

19

The lung capacity in a healthy 90-year-old patient is ________ that of a 30-year-old patient.

a. equal to
b. three-quarters of
c. one-quarter of
d. half of

a. equal to
b. three-quarters of
c. one-quarter of
d. half of

Answer: d
Objective: 31-1
Reference: 988

20

By age 85, the brain of a typical geriatric patient can shrink by as much as 10 percent due to:

a. reduced use in learning.
b. a decrease in brain cell numbers.
c. reduced fluid volume.
d. stroke activity.

a. reduced use in learning.
b. a decrease in brain cell numbers.
c. reduced fluid volume.
d. stroke activity.

Answer: b
Objective: 31-1
Reference: 988

21

In a typical geriatric patient, a reduction in cerebral blood flow can:

a. reduce the amount of glucose and oxygen that reaches the brain.
b. increase the patient’s pulse rate.
c. decrease the patient’s blood pressure.
d. increase the patient’s respiratory rate.

a. reduce the amount of glucose and oxygen that reaches the brain.
b. increase the patient’s pulse rate.
c. decrease the patient’s blood pressure.
d. increase the patient’s respiratory rate.

Answer: a
Objective: 31-1, 31-3
Reference: 988

22

For many geriatric patients, food is less appealing because:

a. they engage in less physical activity.
b. they sleep more and eat less.
c. their sense of smell is reduced and they have fewer taste buds.
d. they have less money for purchasing appealing food.

a. they engage in less physical activity.
b. they sleep more and eat less.
c. their sense of smell is reduced and they have fewer taste buds.
d. they have less money for purchasing appealing food.

Answer: c
Objective: 31-3
Reference: 988

23

You have been called to an unknown medical emergency. On scene you are presented with an 84-year-old patient who is confused and does not obey commands. Which of the following action would be most useful in determining the patient's normal mental status?

a. Examine the patient's pupils.
b. Question the patient’s family members.
c. Identify the patient's medications.
d. Check the patient’s vital signs.

a. Examine the patient's pupils.
b. Question the patient’s family members.
c. Identify the patient's medications.
d. Check the patient’s vital signs.

Answer: b
Objective: 31-6
Reference: 1002

24

In geriatric patients, strokes can be caused by a blockage or by:

a. a buildup of dopamine.
b. a buildup of epinephrine.
c. a rupture of a cerebral blood vessel.
d. trauma to the cortex.

a. a buildup of dopamine.
b. a buildup of epinephrine.
c. a rupture of a cerebral blood vessel.
d. trauma to the cortex.

Answer: c
Objective: 31-3
Reference: 992

25

Over 60 percent of abdominal pain problems in geriatric patients require:

a. a trip to the emergency department.
b. a prescription for a narcotic drug.
c. surgical intervention.
d. evaluation for hernia.

a. a trip to the emergency department.
b. a prescription for a narcotic drug.
c. surgical intervention.
d. evaluation for hernia.

Answer: c
Objective: 31-3
Reference: 993

26

Many elderly patients participate in a practice called “polypharmacy,” which is the:

a. use of mail-order pharmacies.
b. simultaneous taking of multiple medications.
c. use of generic drugs.
d. use of designer drugs.

a. use of mail-order pharmacies.
b. simultaneous taking of multiple medications.
c. use of generic drugs.
d. use of designer drugs.

Answer: b
Objective: 31-4
Reference: 993

27

To identify all the drugs, prescriptions, herbal supplements, and over-the-counter drugs that a patient may be taking in combination, OEC Technicians should use:

a. SAMPLE.
b. OPQRST.
c. DCAP-BTLS.
d. AEIOU.

a. SAMPLE.
b. OPQRST.
c. DCAP-BTLS.
d. AEIOU.

Answer: a
Objective: 31-6
Reference: 99

28

The class of medications that is most commonly prescribed to elderly patients is:

a. gastrointestinal medications.
b. respiratory medications.
c. neurological medications.
d. cardiovascular medications.

a. gastrointestinal medications.
b. respiratory medications.
c. neurological medications.
d. cardiovascular medications.

Answer: d
Objective: 31-3
Reference: 994

29

One group of drugs prescribed for geriatric patients is beta-blockers. This type of drug:

a. manages cardiac arrhythmias.
b. increases a patient’s pulse rate.
c. increases a patient’s cardiac preload.
d. thins a patient’s blood.

a. manages cardiac arrhythmias.
b. increases a patient’s pulse rate.
c. increases a patient’s cardiac preload.
d. thins a patient’s blood.

Answer: a
Objective: 31-3
Reference: 994

30

Geriatric patients may also have a prescription for a diuretic such as HCTZ or Lasix. The role of this type of drug is to:

a: increase a patient’s heart rate.
b. increase a patient’s respiratory rate.
c. decrease the volume of fluid circulating in the cardiovascular system.
d. increase the preload of the atria.

a: increase a patient’s heart rate.
b. increase a patient’s respiratory rate.
c. decrease the volume of fluid circulating in the cardiovascular system.
d. increase the preload of the atria.

Answer: c
Objective: 31-3
Reference: 994

31

Compared to younger patients, trauma in geriatric patients results in:

a. less-serious injuries due to the slower pace in older patients.
b. a higher mortality rate.
c. more bleeding.
d. more fractures of the extremities.

a. less-serious injuries due to the slower pace in older patients.
b. a higher mortality rate.
c. more bleeding.
d. more fractures of the extremities.

Answer: b
Objective: 31-5
Reference: 994

32

Falls result in ____ percent of all deaths in the geriatric population.

a. 5
b. 12
c. 40
d. 72

a. 5
b. 12
c. 40
d. 72

Answer: b
Objective: 31-5
Reference: 996

33

Which of the following conditions must OEC Technicians consider when evaluating hypotensive geriatric patients with altered mental status who show no signs of external bleeding, chest injury, or abdominal trauma?

a. A hip or pelvic fracture
b. A tib/fib fracture
c. A genetic hypotensive condition
d. Dehydration

a. A hip or pelvic fracture
b. A tib/fib fracture
c. A genetic hypotensive condition
d. Dehydration

Answer: a
Objective: 31-5, 31-6
Reference: 997

34

Compared to younger individuals, geriatric patients who fall have a higher incidence of fractures to the _____ region of the spine.

a. C4–C5
b. T1–T2
c. L1–L2
d. C1–C2

a. C4–C5
b. T1–T2
c. L1–L2
d. C1–C2

Answer: d
Objective: 31-5
Reference: 998

35

Because many elderly patients will not offer their medical history unless specifically asked to do so, OEC Technicians may have to:

a. ask yes-or-no questions.
b. ask open-ended questions.
c. search a patient’s medicine cabinet and kitchen cabinets for prescription bottles.
d. look for past surgical scars during a secondary assessment.

a. ask yes-or-no questions.
b. ask open-ended questions.
c. search a patient’s medicine cabinet and kitchen cabinets for prescription bottles.
d. look for past surgical scars during a secondary assessment.

Answer: b
Objective: 31-2
Reference: 1001

36

When taking the pulse of an elderly patient, it is recommended that OEC Technicians:

a. divert the patient’s attention with conversation.
b. repeat and document the pulse rate every 2 minutes.
c. take the radial pulse on both arms and compare the two rates.
d. use electronic devices only to obtain the pulse.

a. divert the patient’s attention with conversation.
b. repeat and document the pulse rate every 2 minutes.
c. take the radial pulse on both arms and compare the two rates.
d. use electronic devices only to obtain the pulse.

Answer: c
Objective: 31-6
Reference: 1003

37

Correcting a life-threatening condition such as external bleeding in elderly patients can be more problematic because:

a. the skin of elderly patients does not rebound as quickly as it does in younger patients.
b. the veins of elderly patients have weaker walls than those in younger patients.
c. elderly patients may be on Lasix.
d. many elder patients are taking warfarin or other blood thinners.

a. the skin of elderly patients does not rebound as quickly as it does in younger patients.
b. the veins of elderly patients have weaker walls than those in younger patients.
c. elderly patients may be on Lasix.
d. many elder patients are taking warfarin or other blood thinners.

Answer: d
Objective: 31-6
Reference: 994

38

The vital signs of elderly patients with excessive internal or external bleeding may not provide an indication of shock:

a. if these patients are taking beta-blockers or calcium-channel blockers.
b. because the hearts of elderly patients pump less due to inactivity.
c. because elderly patients have the ability to compensate for bleeding.
d. if these patients are taking blood thinners.

a. if these patients are taking beta-blockers or calcium-channel blockers.
b. because the hearts of elderly patients pump less due to inactivity.
c. because elderly patients have the ability to compensate for bleeding.
d. if these patients are taking blood thinners.

Answer: a
Objective: 31-3
Reference: 994

39

An advance directive is a:

a. court order directing prehospital providers to administer care.
b. directive provided by medical control.
c. protocol directed by a paramedic on scene.
d. legal document that provides medical direction for life-saving efforts.

a. court order directing prehospital providers to administer care.
b. directive provided by medical control.
c. protocol directed by a paramedic on scene.
d. legal document that provides medical direction for life-saving efforts.

Answer: d
Objective: 31-7
Reference: 1000