CIEMT Quiz 11: Geriatrics and ALS Assist
Questions and answers latest update
1. Which physiological change of aging increases the risk of hypothermia in
geriatric patients?
A) Increased metabolic rate
B) Decreased subcutaneous fat and reduced shivering reflex
C) Increased muscle mass
D) Enhanced peripheral vasoconstriction
Correct ,,,,answer,,,,: B
Rationale: Loss of subcutaneous fat and diminished shivering response
reduce the body's ability to conserve and generate heat, predisposing elderly
patients to hypothermia.
2. An 82-year-old patient is found confused and febrile. The EMT should
suspect:
A) Normal aging process
B) Sepsis, as elderly may not mount a fever >100.4°F
C) Hypoglycemia only
D) Acute dementia onset
Correct ,,,,answer,,,,: B
Rationale: Elderly patients often have blunted febrile response; a
temperature even slightly above baseline may indicate serious infection.
Confusion is a common presenting sign of sepsis in geriatrics.
3. When performing a geriatric assessment, the term "polypharmacy" refers to:
A) Use of multiple pharmacies
B) Use of multiple medications, increasing risk of adverse drug reactions
C) Pharmacy compounding medications
D) Herbal supplement use only
, Correct ,,,,answer,,,,: B
Rationale: Polypharmacy, typically five or more medications, is common in
the elderly and raises the risk of drug interactions, falls, and cognitive
impairment.
4. A 78-year-old male with chest pain and a heart rate of 42 bpm is
unresponsive to atropine. The ALS assist skill the EMT should prepare for is:
A) Synchronized cardioversion
B) Transcutaneous pacing
C) Administration of adenosine
D) Manual defibrillation
Correct ,,,,answer,,,,: B
Rationale: Symptomatic bradycardia unresponsive to atropine requires
transcutaneous pacing. This is an ALS procedure for which EMTs can assist
by applying pads and monitoring.
5. Which fracture is most common in elderly patients after a ground-level fall?
A) Femoral shaft fracture
B) Hip fracture (proximal femur)
C) Distal radius fracture
D) Clavicle fracture
Correct ,,,,answer,,,,: B
Rationale: Osteoporosis makes the proximal femur highly susceptible to
fracture with minimal trauma. Hip fractures are a major cause of morbidity in
the elderly.
6. The EMT is assisting with endotracheal intubation of an elderly patient.
Which anatomical change makes visualization of the vocal cords more
difficult?
A) Decreased tongue size
B) Kyphosis and limited cervical extension
C) Atrophy of the vocal cords
D) Increased saliva production
, Correct ,,,,answer,,,,: B
Rationale: Thoracic kyphosis and arthritic changes reduce neck mobility,
making alignment for direct laryngoscopy challenging.
7. A geriatric patient is on multiple antihypertensives. The EMT must be alert for
orthostatic hypotension, defined as a drop in systolic BP of at least:
A) 5 mm Hg
B) 10 mm Hg
C) 20 mm Hg
D) 40 mm Hg
Correct ,,,,answer,,,,: C
Rationale: Orthostatic hypotension is a drop in systolic BP ≥20 mm Hg or
diastolic BP ≥10 mm Hg within 3 minutes of standing, often due to
medications and aging baroreceptors.
8. When applying an AED to a patient over 80 years old, the EMT should:
A) Use lower energy settings
B) Place pads as for any adult; consider anterior-posterior placement if
supine
C) Avoid defibrillation due to age
D) Only perform CPR, no AED
Correct ,,,,answer,,,,: B
Rationale: AED use is not contraindicated by age. Standard adult pad
placement is used. Anterior-posterior placement may be considered for frail
patients or those with pacemakers.
9. Delirium in the elderly differs from dementia primarily by:
A) Gradual onset over years
B) Acute onset with fluctuating consciousness and inattention
C) Irreversible memory loss
D) Lack of any underlying medical cause
Correct ,,,,answer,,,,: B
Rationale: Delirium is acute, often reversible, with altered consciousness
, and inattention. Dementia is chronic and progressive. Infection, medications,
or hypoxia can trigger delirium.
10. A 90-year-old patient with pneumonia is tachypneic with SpO2 88%.
The ALS intervention that improves oxygenation while awaiting definitive
airway is:
A) Bag-valve-mask with PEEP valve
B) Nasal cannula at 6 L/min
C) Simple face mask
D) Oxygen via non-rebreather
Correct ,,,,answer,,,,: A
Rationale: BVM with PEEP valve can recruit alveoli and improve oxygenation
in hypoxic respiratory failure, especially in the elderly with reduced lung
compliance.
11. The most common cause of death in the elderly from trauma is:
A) Head injury
B) Falls
C) Motor vehicle crashes
D) Burns
Correct ,,,,answer,,,,: B
Rationale: Falls are the leading cause of both fatal and nonfatal injuries in
older adults, often resulting in traumatic brain injury or hip fracture.
12. When assisting with IV access in a geriatric patient, the EMT should
consider that veins are often:
A) More elastic and easy to cannulate
B) Fragile, tortuous, and prone to rolling
C) Deeper and less visible
D) Thickened with no change in fragility
Correct ,,,,answer,,,,: B
Rationale: Aging causes loss of subcutaneous support, making veins fragile,
Questions and answers latest update
1. Which physiological change of aging increases the risk of hypothermia in
geriatric patients?
A) Increased metabolic rate
B) Decreased subcutaneous fat and reduced shivering reflex
C) Increased muscle mass
D) Enhanced peripheral vasoconstriction
Correct ,,,,answer,,,,: B
Rationale: Loss of subcutaneous fat and diminished shivering response
reduce the body's ability to conserve and generate heat, predisposing elderly
patients to hypothermia.
2. An 82-year-old patient is found confused and febrile. The EMT should
suspect:
A) Normal aging process
B) Sepsis, as elderly may not mount a fever >100.4°F
C) Hypoglycemia only
D) Acute dementia onset
Correct ,,,,answer,,,,: B
Rationale: Elderly patients often have blunted febrile response; a
temperature even slightly above baseline may indicate serious infection.
Confusion is a common presenting sign of sepsis in geriatrics.
3. When performing a geriatric assessment, the term "polypharmacy" refers to:
A) Use of multiple pharmacies
B) Use of multiple medications, increasing risk of adverse drug reactions
C) Pharmacy compounding medications
D) Herbal supplement use only
, Correct ,,,,answer,,,,: B
Rationale: Polypharmacy, typically five or more medications, is common in
the elderly and raises the risk of drug interactions, falls, and cognitive
impairment.
4. A 78-year-old male with chest pain and a heart rate of 42 bpm is
unresponsive to atropine. The ALS assist skill the EMT should prepare for is:
A) Synchronized cardioversion
B) Transcutaneous pacing
C) Administration of adenosine
D) Manual defibrillation
Correct ,,,,answer,,,,: B
Rationale: Symptomatic bradycardia unresponsive to atropine requires
transcutaneous pacing. This is an ALS procedure for which EMTs can assist
by applying pads and monitoring.
5. Which fracture is most common in elderly patients after a ground-level fall?
A) Femoral shaft fracture
B) Hip fracture (proximal femur)
C) Distal radius fracture
D) Clavicle fracture
Correct ,,,,answer,,,,: B
Rationale: Osteoporosis makes the proximal femur highly susceptible to
fracture with minimal trauma. Hip fractures are a major cause of morbidity in
the elderly.
6. The EMT is assisting with endotracheal intubation of an elderly patient.
Which anatomical change makes visualization of the vocal cords more
difficult?
A) Decreased tongue size
B) Kyphosis and limited cervical extension
C) Atrophy of the vocal cords
D) Increased saliva production
, Correct ,,,,answer,,,,: B
Rationale: Thoracic kyphosis and arthritic changes reduce neck mobility,
making alignment for direct laryngoscopy challenging.
7. A geriatric patient is on multiple antihypertensives. The EMT must be alert for
orthostatic hypotension, defined as a drop in systolic BP of at least:
A) 5 mm Hg
B) 10 mm Hg
C) 20 mm Hg
D) 40 mm Hg
Correct ,,,,answer,,,,: C
Rationale: Orthostatic hypotension is a drop in systolic BP ≥20 mm Hg or
diastolic BP ≥10 mm Hg within 3 minutes of standing, often due to
medications and aging baroreceptors.
8. When applying an AED to a patient over 80 years old, the EMT should:
A) Use lower energy settings
B) Place pads as for any adult; consider anterior-posterior placement if
supine
C) Avoid defibrillation due to age
D) Only perform CPR, no AED
Correct ,,,,answer,,,,: B
Rationale: AED use is not contraindicated by age. Standard adult pad
placement is used. Anterior-posterior placement may be considered for frail
patients or those with pacemakers.
9. Delirium in the elderly differs from dementia primarily by:
A) Gradual onset over years
B) Acute onset with fluctuating consciousness and inattention
C) Irreversible memory loss
D) Lack of any underlying medical cause
Correct ,,,,answer,,,,: B
Rationale: Delirium is acute, often reversible, with altered consciousness
, and inattention. Dementia is chronic and progressive. Infection, medications,
or hypoxia can trigger delirium.
10. A 90-year-old patient with pneumonia is tachypneic with SpO2 88%.
The ALS intervention that improves oxygenation while awaiting definitive
airway is:
A) Bag-valve-mask with PEEP valve
B) Nasal cannula at 6 L/min
C) Simple face mask
D) Oxygen via non-rebreather
Correct ,,,,answer,,,,: A
Rationale: BVM with PEEP valve can recruit alveoli and improve oxygenation
in hypoxic respiratory failure, especially in the elderly with reduced lung
compliance.
11. The most common cause of death in the elderly from trauma is:
A) Head injury
B) Falls
C) Motor vehicle crashes
D) Burns
Correct ,,,,answer,,,,: B
Rationale: Falls are the leading cause of both fatal and nonfatal injuries in
older adults, often resulting in traumatic brain injury or hip fracture.
12. When assisting with IV access in a geriatric patient, the EMT should
consider that veins are often:
A) More elastic and easy to cannulate
B) Fragile, tortuous, and prone to rolling
C) Deeper and less visible
D) Thickened with no change in fragility
Correct ,,,,answer,,,,: B
Rationale: Aging causes loss of subcutaneous support, making veins fragile,
