CPC Geriatric Care and Fall Prevention 3

Question 1

The 'SPICES' framework used in geriatric nursing assessment stands for Sleep problems, Problems with eating, Incontinence, Confusion, Evidence of falls, and Skin breakdown.
In community paramedicine, this framework is used to:

Accepted Answer

Systematically identify common geriatric syndromes that require targeted interdisciplinary intervention

Answer

Replace the comprehensive geriatric assessment for billing purposes

Answer

Screen exclusively for fall risk in patients under age 65

Answer

Diagnose specific diseases based on reported symptoms

Question 2

A community paramedic's elderly patient reports increasingly frequent urinary urgency with involuntary leakage when they have the sudden urge to void. This presentation MOST describes which type of urinary incontinence?

Accepted Answer

Urge incontinence (overactive bladder)

Answer

Stress incontinence

Answer

Overflow incontinence

Answer

Functional incontinence

Question 3

Which of the following nutritional assessment findings in an elderly patient warrants referral for malnutrition intervention?

Accepted Answer

Unintentional weight loss of 10% body weight over 6 months

Answer

BMI of 26 kg/m² with stable weight

Answer

Albumin of 3.8 g/dL

Answer

Daily protein intake of 1.0 g/kg body weight

Question 4

When a community paramedic identifies an elderly patient with a new diagnosis of atrial fibrillation who has a CHA₂DS₂-VASc score of 3, the MOST appropriate care coordination action is:

Accepted Answer

Notify the supervising physician and coordinate urgent cardiology follow-up for anticoagulation evaluation

Answer

Administer aspirin as immediate stroke prevention

Answer

Schedule a routine primary care visit in 3 months

Answer

Advise the patient to monitor their pulse at home and report irregularities

Question 5

Which of the following BEST describes 'advance care planning' (ACP) as it applies to community paramedicine practice?

Accepted Answer

An ongoing conversation process helping patients clarify and document healthcare preferences and goals for future medical decisions

Answer

Directing the patient to sign a DNR form before the community paramedic can provide home services

Answer

A legal requirement that all elderly patients complete a living will by age 70

Answer

Providing patients with a list of available nursing home facilities in their area

Question 6

A community paramedic visits a 91-year-old patient with advanced COPD and CHF who has executed a valid POLST form indicating 'comfort-focused care' with 'no CPR' and 'do not hospitalize.' The patient develops respiratory distress and requests that the paramedic help them breathe. The MOST appropriate response is:

Accepted Answer

Honor the patient's current expressed wishes and POLST by providing comfort-focused care (oxygen, positioning, anxiolytics per standing orders) without invasive resuscitation or hospitalization

Answer

Disregard the POLST and transport the patient to the hospital for intubation

Answer

Contact family members to override the POLST before providing any care

Answer

Provide CPR as the default action when a patient appears distressed