Question

1. 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.

1. poor maintenance of home, poor personal care, and dietary neglect are all possible indicators of_older abuse.

a) physical
b) financial
c) emotional
d) psychological

1. 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 caused by a silent myocardial infarction.
d) rarely life threatening but should be evaluated by a physician.

1. 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 of the lower extremities and weakness.

1. 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 for the elderly.
d) provide clues about an elderly patients problem by observing his or her home.

1. down syndrome is a genetic defect that occurs as the result of:

a) an extra pair of chromosomes.
b) a separation of chromosome 21.
c) a triplication of chromosome 21.
d) a sperm that contains 24 chromosomes.

Explanation:

1.

• Heart failure (A): Main symptoms are short - ness of breath, fatigue, and fluid retention (edema), not productive cough, fever, and chills.
• Bronchitis (B): Usually presents with cough (may be productive), but less likely to have fever and chills in an immunocompromised patient compared to pneumonia.
• Emphysema (C): Characterized by chronic shortness of breath, not typically with fever and chills.
• Pneumonia (D): In an immunocompromised patient (like an 80 - year - old), symptoms such as productive cough, fever, and chills are classic for pneumonia.

• Physical abuse (A): Would involve signs like bruises, fractures, etc., not just home maintenance, personal care, and dietary issues.
• Financial abuse (B): Would relate to misappropriation of funds, not home and personal care.
• Emotional abuse (C): May involve psychological harm like isolation, but poor home maintenance, personal care, and dietary neglect are more indicative of physical neglect which is a form of physical abuse in the context of elder abuse (as physical abuse can include neglect).
• Psychological abuse (D): Focuses on mental harm like humiliation, not on the physical aspects of home and personal care.

• A: Syncope (fainting) is indeed caused by an interruption of blood flow to the brain (e.g., due to low blood pressure, arrhythmias).
• B: Syncope is a concern as it can be a sign of a serious underlying condition (e.g., cardiac or neurological), not just if the patient is injured.
• C: While a silent myocardial infarction can cause syncope, it is not the most common cause. Syncope has multiple etiologies.
• D: Syncope can be life - threatening (e.g., due to cardiac arrhythmias that cause it), so it should be evaluated promptly.

Answer:

D. pneumonia

2.