Ch. 42-45 Quiz Questions

Front 1

Cervical spondylosis is a degenerative change in the cervical spine that causes:

Back 1

narrowing of the spinal canal and pressure on the spinal cord

Front 2

Fall-related fractures in the elderly occur MOST often to the ___, usually in patients with underlying:

Back 2

hip, osteoporosis

Front 3

Delirium is MOST accurately defined as:

Back 3

an acute alteration in mentation that indicates an underlying condition

Front 4

Resting tremor of an extremity and bradykinesia are associated with:

Back 4

Parkinson’s disease

Front 5

A person taking beta blockers or calcium channel blockers would MOST likely present with:

Back 5

a slower than usual heart rate

Front 6

A decreased number of pacemaker cells in the sinoatrial node would MOST likely contribute to a decline in cardiac output secondary to:

Back 6

bradycardia

Front 7

Hypertensive emergencies in the geriatric population:

Back 7

require a controlled decline in blood pressure that often cannot be achieved in the prehospital setting.

Front 8

Elderly patients experience a slower physiologic response to hypoxemia and hypercarbia because of:

Back 8

decreased sensitivity to changes in arterial blood content

Front 9

In contrast to stress incontinence, urge incontinence is triggered by:

Back 9

cold fluids

Front 10

Decreased elasticity of the lungs and calcification of the costochondral cartilage results in:

Back 10

an increase in residual lung volume

Front 11

Which of the following is NOT a predisposing risk factor for trauma in the elderly?

Back 11

Decreased body water

Front 12

Which of the following cardiac dysrhythmias is associated with the HIGHEST risk of stroke?

Back 12

Atrial fibrillation

Front 13

The social assessment component of the GEMS diamond includes:

Back 13

determining if activities of daily living are being provided by another person

Front 14

Older men often experience difficulty urinating because of:

Back 14

urethral pressure from an enlarged prostate

Front 15

An elderly person is more likely to sustain serious injury following trauma due to:

Back 15

brittle, demineralized bone

Front 16

An 82-year-old man presents with confusion that has worsened progressively over the past 2 weeks. Because of his confusion and the fact that he is hearing impaired, you obtain the majority of your medical history information from his daughter. She tells you that her father has high blood pressure but refuses to take medication for it. She also tells you that she thinks he fell about 3 weeks ago, although he denies falling. The patient’s blood pressure is 168/98 mmHg, his pulse rate is 60 beats/min and occasionally irregular, and his respirations are 22 breaths/min and regular. This patient MOST likely:

Back 16

is experiencing a subdural hematoma

Front 17

The heart hypertrophies with age, MOST likely in response to:

Back 17

a chronically increased afterload caused by arteriosclerotic blood vessels

Front 18

Which of the following statements regarding Alzheimer’s disease is NOT correct?

Back 18

Age alone is thought to be the underlying cause of Alzheimer’s disease

Front 19

Adverse drug reactions in elderly people are the result of:

Back 19

changes in drug metabolism due to diminished hepatic function

Front 20

Cardiac dysrhythmias in older people are LESS commonly the result of:

Back 20

poorly controlled anxiety

Front 21

Physiologic age-related decreases in skin elasticity are the result of:

Back 21

decreased collagen and elastin production

Front 22

Elderly people are more susceptible to intracranial bleeding because of:

Back 22

enlargement of the subdural space

Front 23

Hypotension and orthostatic vital sign changes would MOST likely occur in elderly people who take:

Back 23

diuretics

Front 24

Therapeutic doses of certain drugs may reach toxic levels in older people due to deterioration of the:

Back 24

liver

Front 25

Aging is a linear process, which means that:

Back 25

the rate at which we lose functions does not increase with age

Front 26

Which of the following statements regarding aging is MOST correct?

Back 26

Health care providers may attribute genuine disease symptoms to age, resulting in inadequate care

Front 27

Which of the following is an extrinsic cause of falls in the elderly?

Back 27

An uneven sidewalk

Front 28

Typical signs and symptoms of Meniere disease include all of the following, EXCEPT:

Back 28

otorrhea

Front 29

When assessing an older person, you should remember that it is common for him or her to:

Back 29

respond slowly to questions

Front 30

After falls, ___ is/are the second leading cause of accidental death among the elderly people.

Back 30

motor vehicle accidents

Front 31

You are dispatched to an assisted living center for an 80-year-old woman who is vomiting bright red blood. Upon your arrival, you find the patient sitting in a chair. She is conscious and alert, but is markedly pale and diaphoretic. Her medical history is significant for hypertension, congestive heart failure, type 2 diabetes, hypothyroidism, and osteoarthritis. Her medications include Toprol, lisinopril, Glucophage, Synthroid, and ibuprofen. Her blood pressure is 76/56 mmHg, pulse is 76 beats/min and weak, and respirations are 24 breaths/min and shallow. Which of the following statements regarding this scenario is MOST correct?

Back 31

This patient, who is in shock, probably has a bleeding peptic ulcer secondary to ibuprofen use, and the lack of compensatory tachycardia is likely the result of the beta blocker she is taking.

Front 32

You are called to a residence for a 74-year-old woman who fainted. During your assessment, the patient’s son tells you that he was standing next to his mother when she fainted and that he caught her before she fell to the floor. He further tells you that his mother has angina pectoris and kidney disease. The patient is now conscious but confused. Her blood pressure is 80/50 mmHg, pulse is 110 beats/min and weak, and her respirations are 22 breaths/min and regular. As your partner administers supplemental oxygen to the patient, you should:

Back 32

assess for the presence of a nitroglycerin patch on the patient and remove it if she is wearing one.

Front 33

Which of the following factors would MOST likely cause vague or atypical signs of acute myocardial infarction?

Back 33

female sex and diabetes

Front 34

Aging brings a widespread disease in bone mass, especially:

Back 34

in postmenopausal women

Front 35

Untreated depression in people over 65 years of age:

Back 35

is associated with a higher suicide rate than any other age group

Front 36

Polypharmacy is MOST accurately defined as:

Back 36

the prescribing of multiple drugs to treat multiple conditions

Front 37

Which of the following disease processes would MOST likely present with signs and symptoms that mimic those seen with normal aging?

Back 37

hypothyroidism

Front 38

You respond to a residence for an unknown emergency involving an 83-year-old man. When you arrive, you find the patient, who is conscious and alert, sitting on his couch with his head held over a bowl. He tells you that his nose starting bleeding about 20 minutes ago and he cannot get it to stop. As your partner assists the patient in controlling the bleeding, you inquire about his medical history. He tells you that he has chronic atrial fibrillation, high blood pressure, and is occasionally depressed. When you ask him about compliance with his medications, he tells you, “I take my medicine every day, but the writing on the bottles is so small.” The patient’s blood pressure is 112/58 mmHg, pulse rate is 88 beats/min and irregular, and respirations are 18 and unlabored. This patient has MOST likely inadvertently:

Back 38

overdosed on his warfarin

Front 39

Considering the physiologic changes that occur with age, which of the following interventions would pose the GREATEST risk for harm when caring for an elderly patient with a severe burn that is complicated by a spinal injury?

Back 39

fluid replacement

Front 40

Which of the following central nervous system functions does NOT change as a person ages?

Back 40

intelligence level

Front 41

Which of the following is the MOST common respiratory infection that causes death in the elderly population?

Back 41

Pneumococcus bacteria

Front 42

In contrast to delirium, dementia is:

Back 42

a progressive disease that produces irreversible brain failure

Front 43

After obtaining an elderly patient’s chief complaint, gathering additional information about the history of present illness would MOST likely be complicated because:

Back 43

chronic problems may affect the acute problem

Front 44

In contrast to a 30-year-old man, if a 70-year-old were to consume an excessive amount of alcohol:

Back 44

he will experience a higher blood alcohol concentration due to decreases in body mass and total body water

Front 45

MOST age-related visual disturbances are the result of:

Back 45

cataracts or glaucoma

Front 46

When assessing an unresponsive older person’s airway, it is MOST important to remember that:

Back 46

delayed gastric emptying increases the risk of aspiration

Front 47

The relatively high use of nonsteroidal anti-inflammatory drugs by older patients predisposes them to:

Back 47

peptic ulcer disease

Front 48

Heat gain or loss in response to environmental changes is delayed in elderly people for all of the following reasons, EXCEPT:

Back 48

chronic hyperthyroidism

Front 49

In contrast to younger patients, elderly patients:

Back 49

tend not to complain, even when they have legitimate symptoms

Front 50

The son of a 76-year-old woman called 911 because his mother is “ill.” The patient presents with mild confusion, poor skin turgor, and tachycardia. She is incontinent of urine and asks you for a glass of water. Her son tells you that she had not been feeling well for the past several weeks, but would not allow him to take her to the doctor. Which of the following assessment parameters will MOST likely reinforce your suspicion regarding the underlying cause of this patient’s condition?

Back 50

blood glucose

Front 51

Men who have been abused by their female spouses:

Back 51

are often too humiliated to report the incident as it happened

Front 52

You receive a call to a residence for an “unknown injury.” Upon arrival at the scene, you are greeted at the door by a well-dressed man, who tells you that his 39-year-old wife fell down a small flight of stairs and is in the living room. As you are assessing the patient, you note multiple bruises to the left side of her face and an area of redness to her anterior neck. When her husband leaves the room for a brief period, she states, “Mike’s really a good man, but he does have somewhat of a temper.” You should:

Back 52

continue your assessment as your partner notifies law enforcement

Front 53

Which of the following injury patterns is MOST suggestive of child abuse?

Back 53

stocking-glove

Front 54

Signs of abuse in a nursing home resident include:

Back 54

undocumented decubitus ulcers

Front 55

Child neglect is MOST accurately defined as:

Back 55

harm or endangerment to a child that occurs when a caregiver fails to provide basic necessities or engages in dangerous child-rearing practices

Front 56

All of the following have been identified as potential complications of child maltreatment, EXCEPT:

Back 56

criminal behavior beginning in late adulthood

Front 57

In contrast to sexual assault, rape:

Back 57

involves penile penetration of the genitalia without the victim’s consent

Front 58

Your index of suspicion for elder abuse should increase if:

Back 58

a mentally competent patient allows the caregiver to respond to your questions

Front 59

Which of the following caregiver characteristics is LEAST suggestive of abusive behavior?

Back 59

underreaction to child misbehavior

Front 60

The deliberate withholding of medicine, food, or assistance with mobility is called?

Back 60

active neglect

Front 61

Bruises to a child’s ___ are LEAST suggestive of an intentionally inflicted injury.

Back 61

shins

Front 62

You are assessing a 79-year-old man who presents with an altered mental status. The patient’s 50-year-old son, who lives with the patient, tells you that his father’s present condition is “normal for him.” Your assessment of the patient reveals a large hematoma to the back of his head and numerous skin tears to his arms. You should:

Back 62

assess the patient and correct any immediately life-threatening conditions

Front 63

Because of the physical and psychological injuries that abused children experience:

Back 63

they may become abusive or neglectful caregivers as adults

Front 64

People who abuse their partner or spouse:

Back 64

may use intimidation and threats to maintain control

Front 65

Abused elders generally do not seek help for all of the following reasons, EXCEPT:

Back 65

disorders such as Parkinson’s disease

Front 66

Which of the following statements regarding the reporting of suspected child abuse is MOST correct?

Back 66

in most states, the paramedic is a mandated reporter in cases of child abuse and neglect

Front 67

The BEST indicator of possible child abuse is:

Back 67

evidence gathered from a thorough physical exam and case history

Front 68

During your assessment of a 7-year-old boy with a fractured arm, you note that the child has a flat affect and will not tell you how the injury occurred. The child’s father, who is in the same room, is clearly apprehensive and rudely interrupts you when you question the child by stating, “I’ll answer for my own kid; he can’t tell you what happened!” You should:

Back 68

continue your assessment as your partner discreetly returns to the ambulance to notify law enforcement

Front 69

Law enforcement requests your assistance to assess a 33-year-old woman who was sexually assaulted. When you arrive at the scene, you find the patient sitting on the curb outside her apartment complex. She is conscious and crying, but does not have any gross injuries. When you begin to assess her, she tells you that all she wants to do is go home and clean herself up. She further tells you that she does not need your help. You should:

Back 69

remain empathetic and advise the patient that she needs medical care, and that cleaning herself up may destroy any potential evidence.

Front 70

You are assessing an injured 9-year-old girl. The child’s father, who appears to be intoxicated, is sitting on the couch and does not seem concerned about his daughter’s injury. When asked when the injury occurred, the father tells you, “I can’t remember, but it’s been at least a few hours ago.” You should:

Back 70

elicit your partner’s help and conduct a thorough assessment of the child

Front 71

In most cases of child sexual abuse:

Back 71

the abuser knows the child and may be living with him or her

Front 72

Which of the following is NOT consistent with the profile of a person who abuses elders?

Back 72

younger than 50 years of age

Front 73

A child has probably NOT been abused if he or she:

Back 73

looks to the parent for reassurance after being injured

Front 74

Which of the following statements regarding an abusive parent is MOST correct?

Back 74

Abusive parents have unrealistic expectations of their children and try to control their children through negative and authoritarian means

Front 75

Elder abuse is generally substantiated by:

Back 75

adult protective services

Front 76

Down syndrome occurs when:

Back 76

a triplication of chromosome 21 occurs

Front 77

The speech pattern of a patient with a fluency disorder is generally NOT:

Back 77

slurred

Front 78

When assessing a patient with a developmental disability, the MOST effective way of determining the extent to which he or she can interact and understand is to:

Back 78

speak to the patient

Front 79

Most patients with muscular dystrophy:

Back 79

die as a result of pulmonary or cardiac complications

Front 80

When establishing communication with a conscious and alert patient who is speech impaired, you should FIRST:

Back 80

determine how he or she is most comfortable communicating with you

Front 81

In contrast to conductive deafness, sensorineural hearing loss:

Back 81

may be congenital or secondary to a birth injury

Front 82

When caring for a patient with cerebral palsy, it is MOST important to:

Back 82

be prepared for seizures and have suction ready

Front 83

Upon entering the residence of a vision-impaired patient, the FIRST thing you should do is:

Back 83

make your presence known

Front 84

Cerebral palsy is a:

Back 84

nonprogressive, bilateral neuromuscular disorder in which voluntary muscles are poorly controlled

Front 85

A morbidly obese 40-year-old man, whom you find lying supine in his bed, presents with respiratory distress. He is conscious, but can only speak in two-word sentences. His face is flushed and his ankles are notably edamatous. Your MOST immediate action should be to:

Back 85

place him in a semi-Fowler's position

Front 86

When assessing a patient who is disabled from a previous injury, you should:

Back 86

ask the patient's family what is normal for him or her

Front 87

Multiple sclerosis is:

Back 87

a chronic central nervous system disease caused by destruction of the myelin and nerve axons within the brain and spinal cord

Front 88

Which of the following statements regarding cancer is MOST correct?

Back 88

Cancer is defined as the uncontrolled growth of normal tissue cells

Front 89

Common complications associated with cerebral palsy include all of the following, EXCEPT:

Back 89

cardiovascular disease

Front 90

Which of the following is LEAST suggestive of hearing impairment?

Back 90

an inability to speak

Front 91

An example of conductive deafness is:

Back 91

temporary hearing loss caused by a ruptured membrane

Front 92

Rheumatoid arthritis is MOST accurately defined as:

Back 92

an autoimmune disorder that causes progressive joint destruction

Front 93

Which of the following statements regarding paralysis is MOST correct?

Back 93

A paralyzed patient has lost the ability to voluntarily move a body part

Front 94

Which of the following is an example of a speech production disorder:

Back 94

hoarseness

Front 95

A 16-year-old man presents with shortness of breath and a productive cough. During your exam, you note that the tips of his fingers are cyanotic and clubbed. His breath sounds reveal coarse crackles bilaterally and his oxygen saturation is 85% on room air. This patient MOST likely has:

Back 95

cystic fibrosis

Front 96

A female paramedic is attempting to ask a hearing-impaired man about his past medical history. However, when she asks him a question, he looks at her male partner and smiles. The male partner should:

Back 96

attempt to communicate with the patient, as his voice will likely have a lower pitch

Front 97

Which of the following is NOT an anatomic characteristic of a person with Down syndrome?

Back 97

small retracted tongue

Front 98

Which of the following outward signs is LEAST suggestive of a communicable disease?

Back 98

depression

Front 99

Two thirds of children born with Down syndrome:

Back 99

have congenital heart disease

Front 100

Obesity is often attributed to:

Back 100

a slow basal metabolic rate

Front 101

If you must move a vision-impaired patient, it is MOST important to:

Back 101

tell the patient what is happening

Front 102

When troubleshooting a hearing aid that is not working, you should:

Back 102

avoid attempting to clean the device

Front 103

Hypernasality would MOST likely be caused by conditions such as:

Back 103

cleft palate and enlarged adenoids

Front 104

When making initial contact with a mentally impaired patient, you should:

Back 104

have your team members remain at a distance until you can establish a rapport with the patient

Front 105

Upon arriving at the scene of a woman with shortness of breath, you find the patient, a 450-pound woman, lying in her bed. She is conscious and alert, but is experiencing obvious respiratory distress. As you begin your initial assessment, you should ask your partner to:

Back 105

request lifting assistance

Front 106

Pickwickian syndrome is characterized by all of the following except:

Back 106

anemia

Front 107

Dysarthia is:

Back 107

the inability to make speech sounds correctly

Front 108

When communicating with an aphasic patient, you should:

Back 108

use focused questions rather than open-ended questions

Front 109

Communicating with a hearing-impaired patient would MOST likely be enhanced by:

Back 109

using one person to ask interview questions

Front 110

Which of the following statements regarding stuttering is MOST correct?

Back 110

stuttering often worsens when the person is under stress

Front 111

Which of the following would MOST likely make intubation of a patient with Down syndrome difficult?

Back 111

small oral cavity

Front 112

If a vision-impaired patient who owns a service dog is hemodynamically unstable, you should:

Back 112

take the dog and the patient to the hospital

Front 113

You respond to call for a 67-year-old man with respiratory distress. When you arrive, the patient's wife greets you at the door. As she is escorting you to her husband, she tells you that he has myasthenia gravis and type 2 diabetes. As you begin your assessment of the patient, you note that he is responsive to pain only, is breathing at a slow rate with shallow depth, and has perioral cyanosis. You should:

Back 113

insert a nasopharyngeal airway and assist his ventilations with a bag-mask device

Front 114

When communicating with a patient who is hearing impaired, you should:

Back 114

avoid exaggerated lip movement

Front 115

Which of the following statements regarding poliomyelitis (polio) is NOT correct?

Back 115

any warm-blooded animal can be a host for the poliomyelitis virus

Front 116

Mental retardation is MOST accurately defined as:

Back 116

insufficient development of the brain that results in the inability to learn and socially adapt at the usual rate

Front 117

Cardiac dysrhythmias in patients with cystic fibrosis are MOST often secondary to:

Back 117

electrolyte imbalance

Front 118

What is the pathophysiology of cystic fibrosis?

Back 118

A defective gene that makes it difficult for chloride to move through the cells, which causes unusually high sodium loss and abnormally thick mucus secretions

Front 119

A 19-year-old man with Down syndrome presents with a decreased mental status. According to the patient's mother, this is not normal for him. She further tells you that he had not been feeling well lately and has not had an appetite. As your partner provides appropriate airway management, you should:

Back 119

assess his blood glucose level

Front 120

When establishing intravenous (IV) access in a patient with paralysis to the right side of the body, it would be MOST appropriate to:

Back 120

establish the IV on the side of the body that is not paralyzed

Front 121

The MOST significant complication associated with dysphagia is:

Back 121

compromise of the airway

Front 122

Spina bifida occurs when:

Back 122

the fetus's spinal column does not close properly or completely and vertebrae do not develop, leaving a portion of the spinal cord exposed

Front 123

Patients with a total laryngectomy would MOST likely present with:

Back 123

aphonia

Front 124

Which of the following statements regarding hearing aids is NOT correct?

Back 124

properly maintained hearing aids can restore hearing to normal

Front 125

Obesity is a result of an imbalance between:

Back 125

food eaten and calories used

Front 126

Progressive deterioration of the myocardium that results in a decreased ejection fraction is called:

Back 126

cardiomyopathy

Front 127

Upon arriving at the scene of a patient receiving home health care and conducting your scene size-up, it is MOST important to remember that:

Back 127

you must determine that the environment is safe for the patient

Front 128

The MOST significant complication associated with a full bladder in a patient with spinal cord disruption and paralysis is:

Back 128

a dangerous elevation in blood pressure

Front 129

The purpose of hospice care is to:

Back 129

provide quality end-of-life care through pain and symptom management

Front 130

Swelling of the arm, neck, or shoulder in a patient with a central venous catheter is MOST suggestive of:

Back 130

catheter thrombosis

Front 131

In contrast to serous exudate, purulent exudate is:

Back 131

pus that consists of white blood cells and bacteria

Front 132

Patients with an ileostomy:

Back 132

have a stoma that connects the small intestine to the outside of the abdomen where a collection bag is attached

Front 133

Unlike a midline venous catheter, a peripherally inserted central catheter (PICC) can be used for:

Back 133

long-term fluid therapy

Front 134

Common side effects of chemotherapy include all of the following EXCEPT:

Back 134

polycythemia

Front 135

In contrast to negative-pressure ventilation, positive-pressure ventilation:

Back 135

alters the body's hemodynamics by reducing the venous return to the heart

Front 136

A chronically ill patient who has been on home oxygen therapy for several years would MOST likely call EMS when:

Back 136

his or her oxygen demand exceeds the current supply

Front 137

Following removal of an ostomy device and cleansing the stoma, you should:

Back 137

place a clean gauze pad over the stoma

Front 138

Once you have arrived at the residence of a patient who receives home health care from his or her family:

Back 138

the law requires you to assume responsibility for care of the patient

Front 139

You are assessing a 70-year-old man with terminal cancer who is on home oxygen therapy. The patient is conscious and complains of severe generalized pain. His blood pressure is 108/68 mmHg, his pulse rate is 100 beats/min, and his respirations are 22 breaths/min. The patient's caregiver, a registered nurse, presents you with a valid out-of-hospital no not resuscitate order. On the basis of this document, you should:

Back 139

administer analgesia for pain relief and determine if the patient wishes to be transported to the hospital

Front 140

You are dispatched to a residence for an elderly woman with a decreased level of consciousness. When you arrive, the patient's caregiver tells you that the patient has Alzheimer's disease and was lucid 30 minutes earleir. Now, the patient responds only to painful stimuli. You should:

Back 140

administer high-flow oxygen as your partner assess the patient's blood glucose level

Front 141

A terminally ill patient with a valid do not resuscitate order would most likely NOT receive:

Back 141

epinephrine

Front 142

The MOST likely cause of shock in a patient with an indwelling urinary catheter is:

Back 142

urosepsis

Front 143

Which of the following statements regarding infection in immunocompromised patients is MOST correct?

Back 143

fever is often the only sign of infection in the immunocompromised patient

Front 144

After moving a bedridden 80-year-old man from his bed to your stretcher, you note an open wound to his lower back. Assessment of the wound reveals that it is red, inflamed, and is draining purulent exudate. The patient has a fever and chills, and complains of moderate pain to the wound. You should:

Back 144

cover the wound with a sterile dressing, make the patient comfortable, and transport him while providing reassurance en route

Front 145

Prior to replacing an ostomy device in a patient, it is MOST important to:

Back 145

wash your hands and take appropriate BSI precautions

Front 146

Several attempts to clear a plugged tracheostomy tube with suction have failed. The patient, who is on a mechanical ventilator, has a pulse rate of 150 beats/min and is making exaggerated attempts to breathe. You should:

Back 146

remove the tracheostomy tube, place a mask over the stoma, and ventilate with a bag-mask device

Front 147

You are transporting a 49-year-old man to the hospital for evaluation of a new onset of fever. The patient has renal carcinoma, is being treated with chemotherapy, and has a central venous access device in place. The patient is conscious, but complains of fatigue, slight nausea, and a decreased appetite. During transport, it is MOST important for you to:

Back 147

apply a mask on the patient to minimize his risk for infection

Front 148

When suctioning and cleaning the tracheostomy of a ventilator-dependent patient, it is MOST important to:

Back 148

keep the patient well-oxygenated

Front 149

When caring for a patient who has a central venous access device, you should:

Back 149

avoid taking a blood pressure on the arm with the access device

Front 150

What should you do prior to inserting an indwelling urinary catheter if a home health patient has sensation in the penile area?

Back 150

coat the end of the catheter with an anesthetic gel

Front 151

Common causes of a large bowel obstruction include all of the following, EXCEPT:

Back 151

improperly dissolved medications

Front 152

Which of the following statements regarding central venous access devices is MOST correct?

Back 152

flushing the device with heparin may cause heparin-induced thrombocytopenia

Front 153

Which of the following conditions would MOST likely result in dementia?

Back 153

Alzheimer's disease

Front 154

Indwelling urinary catheters predispose the patient to urinary tract infections because:

Back 154

the catheter keeps the bladder sphincter open and provides a continuous route of entry for bacteria

Front 155

Delirium in the chronically ill patient:

Back 155

is an acute alteration in mentation that is often reversible

Front 156

When urine becomes evident in the tubing during insertion of an indwelling urinary catheter in a male, you should:

Back 156

continue inserting the catheter until the Y between the drainage port and the balloon port is at the tip of the penis

Front 157

While you are drawing blood for lab analysis from an implanted venous access device, your 77-year-old male patient becomes acutely dyspneic and complains of chest pain. You should:

Back 157

administer high-flow oxygen, place the patient on his left side, and transport immediately

Front 158

If a chronically ill patient who is connected to a variety of medical devices experiences an acute exacerbation of his or her condition, you should:

Back 158

consider that the problem may be the result of medical equipment failure

Front 159

In contrast to an ureterostomy, a suprapubic catheter:

Back 159

allows the ureters to remain intact and continue to drain into the bladder

Front 160

The MOST significant long-term problem encountered in patients with a degernative neuromuscular disease is:

Back 160

hypovolemia

Front 161

In which of the following cases would a newborn probably NOT be discharged home with an apnea monitor?

Back 161

the infant was born at 36 weeks gestation

Front 162

Unlike a CPAP unit, a mechanical home ventilator:

Back 162

can be set to deliver a specified tidal volume

Front 163

To minimize the risk of regurgitation and aspiration in a patient with a gastric tube in place, you should:

Back 163

position the patient upright, at least to 30 degrees

Front 164

The purpose of an oxygen concentrator is to:

Back 164

concentrate the oxygen in ambient air and eliminate other gases

Front 165

Pain receptors are found in all the following locations, EXCEPT the:

Back 165

brain

Front 166

When a patient is receiving treatment with continuous positive airway pressure (CPAP), he or she:

Back 166

typically finds it difficult to exhale completely

Front 167

You respond to a residence for a 76-year-old woman who is ill. When you arrive, you find the patient in a hospital bed in her living room. She is responsive to pain only and has hot, moist skin. The patient has an indwelling urinary catheter in place, and the urine collection bag is empty. The patient's caretaker tells you that the patient has numerous medical problems and hands you an extensive list of medications. The patient's blood pressure is 80/48 mmHg, her pulse rate is 104 beats/min and irregular, and her respirations are 24 breaths/min and shallow. You should be MOST suspicious for:

Back 167

septic shock

Front 168

The purpose of the wafer that is included in an ostomy kit is to:

Back 168

protect the skin from irritation

Front 169

You are caring for chronically-ill 63-year-old woman who has a peripherally inserted central catheter (PICC) line in her left forearm. The patient, who has a history of cancer and severe osteoporosis, is showing signs of severe dehydration. Her blood pressure is 76/56 mmHg, pulse rate is 120 beats/min and weak, and respirations are 24 breaths/min and regular. To improve this patient's hemodynamic status, you should:

Back 169

establish peripheral vascular access in another location and administer crystalloid fluid boluses

Front 170

If you are unable to aspirate blood from a central venous catheter:

Back 170

you should suspect catheter occlusion

Front 171

Which of the following interventions is especially important when caring for a patient with a tracheostomy tube?

Back 171

suctioning

Front 172

Before drawing blood from a central venous catheter, you should:

Back 172

aspirate 5 mL of blood and discard it safely

Front 173

According to the Haddon matrix framework:

Back 173

injuries occur in a certain time sequence

Front 174

Unlike the insertion of an indwelling urinary catheter, insertion of an intermittent (straight) urinary catheter:

Back 174

does not involve inflation of a balloon to hold the catheter in place

Front 175

The female urinary meatus is located:

Back 175

just above the vaginal opening