Geriatric Quiz

Name: __________________________ Date: _____________

1. A geriatric patient's chief complaint: A) is typically grossly obvious to the EMT-B. B) is usually related to a single disease process. C) usually presents with fairly classic symptoms. D) may be an exacerbation of a chronic problem.

2. Which of the following statements regarding a decreased level of consciousness (LOC) in the elderly patient is MOST correct? A) A decreased level of consciousness is not a normal part of the aging process. B) Most elderly patients have some deterioration in their level of consciousness. C) A decreased level of consciousness is most often the result of chronic dementia. D) The AVPU scale is an ineffective tool when assessing an elderly patient's LOC.

3. When transporting a stable elderly 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. C) avoid the use of a long backboard, even if trauma is suspected. D) perform frequent detailed assessments to gain the patient's trust.

4. To obtain an accurate medical history when assessing an elderly patient, the EMT-B must: A) ask detailed questions about his or her history. B) always obtain medical history data from the family. C) be patient and have effective communication skills. D) contact the patient's physician to obtain information.

5. The MOST effective way to gain an elderly patient's trust and confidence is to: A) perform a detailed physical exam, regardless of the problem. B) treat the patient with respect and explain what you are doing. C) frequently reassure him or her that everything will be alright. D) address the patient by his or her first name to reduce anxiety.

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6. Which of the following is the BEST example of a question to ask an elderly patient with chest pain? A) Does the pain radiate to your arm? B) Is the pain sharp, dull, or stabbing? C) Does it feel like a pressure sensation? D) Can you describe how the pain feels?

7. To minimize distractions and confusion when assessing an elderly patient, you should: A) dismiss the family members from the room or area. B) have only one EMT-B speak to the patient at a time. C) elevate your voice and speak directly to the patient. D) perform a physical exam and then talk to the patient.

8. When an elderly patient presents you with multiple 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.

9. Because of the complexity of the geriatric 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 differentiate between chronic and acute problems. D) perform a rapid assessment on all geriatric patients you treat.

10. When determining whether to perform a focused physical exam or a rapid trauma assessment on an injured elderly patient, you should: A) routinely perform a focused exam to minimize time at the scene. B) perform a detailed physical exam prior to initiating any treatment. C) recall that it will take less of an MOI to cause significant injuries. D) focus your assessment just on the area(s) of pain or obvious injury.

11. Which of the following statements regarding an elderly patient's vital signs is MOST correct? A) Systolic blood pressure typically decreases by 1 mm Hg per year. B) The patient's pupils usually become more briskly reactive with age. C) Most patients over 65 years of age normally have an irregular pulse. D) Some drugs may prevent the heart rate from increasing when needed.

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12. The MOST effective way to monitor an elderly patient's level of consciousness is to: A) assess his or her response to pain. B) frequently converse with him or her. C) assess the pupils on a frequent basis. D) remind him or her of the time and date.

13. The leading cause of trauma, death, and disability in the elderly is: A) falls. B) burns. C) abuse. D) suicide.

14. Which of the following would you MOST likely encounter during your assessment of an uninjured elderly patient's neck and back? A) Severe kyphosis B) Point tenderness C) Spinal instability D) Vertebral deformity

15. Relatively minor hyperextension injuries to the spine can result in central cord syndrome, a dysfunction characterized by: A) permanent absence of sensory and motor functions to one side of the body. B) absent or weak sensory function more pronounced in the lower extremities. C) temporarily disabled sensory and motor functions in the lower extremities. D) weak or absent motor function more pronounced in the upper extremities.

16. The MOST common type of spinal injury seen in the elderly population, which may occur from relatively minor trauma, is a: A) burst fracture. B) distraction injury. C) compression fracture. D) vertebral dislocation.

17. When immobilizing a patient with a kyphotic spine to a long backboard, the EMT-B 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.

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18. 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's disease.

19. 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 falls.

20. Hip fractures in the elderly commonly involve injury to all of the following structures, EXCEPT the: A) acetabulum. B) femoral neck. C) femoral head. D) proximal femur.

21. An elderly patient may understate or minimize the symptoms of his or her illness because: A) the nervous system deteriorates. B) of decreased perception of pain. C) of conditions such as dementia. D) he or she fears hospitalization.

22. When assessing a 78-year-old female who complains of shortness of breath, the EMT-B 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 she sleeps. D) place the patient supine to see if the problem worsens.

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23. When taking an elderly patient's blood pressure in a supine position, a drop in the systolic blood pressure of more than ___ mm Hg when he or she sits or stands up suggests dehydration. A) 5 B) 10 C) 15 D) 20

24. Which of the following statements regarding altered mental status in the elderly is MOST correct? A) Acute psychotic episodes are the most common causes of altered mental status. B) Alzheimer's disease patients should not experience an acute mental status change. C) Most causes of altered mental status in the elderly population are not reversible. D) Altered mental status secondary to hyperglycemia can be reversed by the EMT-B.

25. Common signs and symptoms of an infection in the elderly patient include all of the following, EXCEPT: A) slow, weak pulse. B) cough or chills. C) hot, flushed skin. D) burning with urination.

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Answer Key
1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. 16. 17. 18. 19. 20. 21. 22. 23. 24. 25. D A B C B D B A C C D B A A D C B B A A D C B B A

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