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Skip Navigation LinksHome > April/June 2011 - Volume 22 - Issue 2 > Life-Threatening Injuries in Older Adults
AACN Advanced Critical Care:
doi: 10.1097/NCI.0b013e31821e6325
CE Test

Life-Threatening Injuries in Older Adults

Free Access

Test writer: Ann Lystrup, RN, BSN, CEN, CFRN, CCRN

Contact hour: 1.0

Synergy CERP: Category A

Passing score: 10 correct (71%)

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CE Test Instructions

To receive CE credit for this test (ID# ACC2222), mark your answers on the form below, complete the enrollment information, and submit it with the $10 processing fee (nonmembers only; payable in US funds) to the American Association of Critical-Care Nurses (AACN). Answer forms must be postmarked by June 1, 2013. Within 3 to 4 weeks of AACN's receiving your test form, you will receive an AACN CE certificate.

The American Association of Critical-Care Nurses (AACN) is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center's Commission on Accreditation. AACN has been approved as a provider of continuing education in nursing by the State Boards of Nursing of Alabama (#ABNP0062), California (#01036), and Louisiana (#ABN12). AACN programming meets the standards for most other states requiring mandatory continuing education credit for relicensure.

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CE Test Questions

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Objectives:

1. Identify the anatomic and physiological changes of aging and their relationship to the specific injuries most commonly sustained in motor vehicle collisions involving adults aged 65 years and older.

2. Describe the role of preexisting diseases and conditions in complications that occur in older adults following injury.

3. Discuss nursing implications associated with aggressive resuscitation and goal-directed therapy for older adults injured in motor vehicle collisions.

1. What consequence of aging plays the most significant role in postinjury mortality in older adults?

a. Increased functional and cognitive disabilities

b. Increased vulnerability to injury

c. Decreased cardiovascular sensitivity to intrinsic catecholamines

d. Decreased physiologic reserve

2. According to recent studies, what is the suggested systolic blood pressure cut point for predicted mortality in injured older patients?

a. Approximately 95 mm Hg

b. Approximately 100 mm Hg

c. Approximately 105 mm Hg

d. Approximately 110 mm Hg

3. What respiratory change occurring with age predisposes older adults to postinjury respiratory complications?

a. Decreased reserve volume

b. Increased alveolar surface area

c. Increased chest wall compliance

d. Increased maximum expiratory force

4. Which of these endocrine changes is expected to occur with age?

a. Increased cortisol production

b. Decreased cortisol production

c. Glucocorticoid excess

d. Glucocorticoid deficiency

5. Which of the following has been associated with a 30% increase in multiple organ failure in critically injured older adults?

a. Depressed antibody response

b. Early hyperglycemia

c. Decreased cardiac index and uneven blood flow to organs

d. Decreased compensatory response to hypercapnia and hypoxia

6. Which of the following statements regarding the assessment of older adults for neurologic injury is true?

a. Cognitive decline that occurs with aging frequently leads to misdiagnosis of neurologic injury by emergency medical services providers.

b. Pupil reactivity to light in older adults is an unreliable assessment of neurologic function because of the opacity of the lens that occurs with age.

c. Older adults with moderate to severe traumatic brain injuries rarely present with focal neurologic deficits.

d. Significant neurologic injuries in older adults are often masked by near-normal Glasgow Coma Scale scores.

7. Chronic low-grade inflammation in older adults is related to what?

a. Increased cytokine production

b. Zinc deficiency

c. Impaired T-cell function

d. Decreased PO2

8. Which of the following best describes motor vehicle crash injuries involving older drivers?

a. Most occur on weekdays.

b. Most occur on weekends.

c. Most occur at night.

d. Compared to younger drivers, twice as many older drivers were likely to be driving the vehicle that strikes another vehicle.

9. According to recent recommendations for resuscitation of older trauma patients, which of the following is one of the criteria for utilization of a pulmonary artery catheter to guide resuscitation?

a. Preexisting congestive heart failure (CHF)

b. Preexisting chronic obstructive pulmonary disease (COPD)

c. Fracture of one or more ribs

d. Glasgow Coma Scale score less than 14

10. Which of the following plays a key role in the prevention of disseminated intravascular coagulation (DIC) in older adult trauma patients?

a. Early correction of anticoagulation in patients taking anticoagulation medications therapeutically

b. Maintenance of anticoagulation within therapeutic parameters in patients taking anticoagulation medications therapeutically

c. Prevention and/or correction of hypothermia

d. Prevention and/or correction of hypoxia

11. Depletion of plasma protein C levels has been implicated as a risk factor for development of what postinjury complication in older trauma patients?

a. Multiple organ dysfunction syndrome (MODS)

b. Acute respiratory distress syndrome (ARDS)

c. Systemic inflammatory response syndrome (SIRS)

d. Ventilator-associated pneumonia (VAP)

12. Early hypothermia places an older trauma patient at increased risk of developing which of these complications?

a. Coagulopathies and MODS

b. Infection and SIRS

c. SIRS and ARDS

d. MODS and infection

13. Which of the following is a recommendation for resuscitation of unstable older trauma patients?

a. Judicious administration of intravenous fluids

b. Administration of intravenous fluids based on urinary output

c. Aggressive administration of intravenous fluids and blood

d. Administration of blood, blood products and inotropes, and limited administration of intravenous fluids

14. Which of the following statements regarding the mortality rates of older adults is true?

a. Older adults have higher mortality rates immediately (at the scene) and early (within 24–48 hours of injury), but they have delayed (after 48–72 hours) mortality rates similar to those of adults between 40 and 65 years of age.

b. Older adults have mortality rates similar to those of adults between 40 and 65 years of age immediately (at the scene), but they have higher mortality rates early (within 24–48 hours of injury), and delayed (after 48–72 hours).

c. The mortality rates of older adults are similar to those of adults between 40 and 65 years of age immediately (at the scene), early (within 24–48 hours of injury), and delayed (after 48–72 hours).

d. The mortality rates of older adults are higher than those of adults between 40 and 65 years of age immediately (at the scene), early (within 24–48 hours of injury), and delayed (after 48–72 hours).

© 2011 American Association of Critical–Care Nurses

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