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A series of multiple-choice questions and answers related to the psychosocial needs of older adults, medication management, and common health concerns in geriatrics. It covers topics such as agitation, depression, cognitive decline, polypharmacy, and drug absorption in older adults. The questions are designed to assess understanding of key concepts and clinical considerations in geriatric care.
Typology: Exams
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Mrs. James is 78 years old and comes to the clinic for an annual checkup. The nurse practitioner addresses the psychosocial needs of older adults and specifically the need for which of the following?
Mr. Slobinsky, 80 years old, is unable to leave his home due to mobility problems. The nurse practitioner conducts a social support assessment because Mr. Slobinsky:
Mrs. Khan is 89 years old and is reported to have bouts of agitation. The nurse practitioner is counseling her family that these periods of agitation can be triggered by which of the following?
The nurse practitioner is considering ordering medications to help control an older patient's agitation. She chooses which of the following?
The nurse practitioner is conducting an admitting assessment of a 69-year-old man. He has diminished ability to ambulate and has difficulty with activities of daily living (ADLs). In the interview, the nurse practitioner asks him if he drinks alcohol. He says, "Yes." The practitioner follows up with a psycho-social evaluation because:
The daughter of a 70-year-old woman asks the nurse practitioner why her mother has had a change in functional ability recently. The mother has regularly been drinking for 40 years, however, her behavior is changing. The nurse practitioner replies that:
The son of a 72-year-old man brings his father into the practitioner to plan for treatment of the patient's alcoholism. The nurse practitioner has several options available. Which is the first choice?
4.Buspirone and gabapentin are used as first-line choices.
Elisabeth, 67 years old, comes to the practitioner with her daughter, who is her caregiver. The nurse practitioner notices that Elizabeth is very busy and always moving and placing things
in order within the waiting room. Along with this increase in energy, which of the following suggest bipolar with mania or hypomania? Select all that apply.
The nurse practitioner is assessing a 69-year-old man for possible bipolar disorder. Which of the following will contribute to diagnosing this patient? Select all that apply.
Mark, 82 years old, is in a rehabilitation center for therapy post- knee replacement. The nurse practitioner is visiting Mark and finds him confused, disoriented, and with speech difficulty. The staff nurse says that his condition changed quickly over the last few hours. The nurse practitioner orders which of the following? Select all that apply.
Larry is 69 years old and beginning to experience a cognitive decline. His son brings him to the practitioner asking for an
evaluation. The nurse practitioner assesses for which of the following signs or symptoms? Select all that apply.
Mr. Dan is 75 years old and suffering from depression. He tells the nurse practitioner that he is tired of feeling so low. He asks if depression is a normal part of aging. The nurse practitioner tells him that depression is which of the following? Select all that apply.
Ms. Smith, 70 years old, is being treated for geriatric depression. What choices does the nurse practitioner have to order? Select all that apply.
ALL
Mrs. Smith is 90 years old and has a daytime caregiver. Her daughter stays with her during the evening and nighttime. The daughter suspects her mother is being abused. Which of the
following statements would confirm this for the nurse practitioner? Select all that apply.
Mr. Hupp, 84 years old, lost his wife 2 months ago. He goes to his nurse practitioner and complains of the same symptoms that his wife had before she died. Possible treatment options available to the nurse practitioner include which of the following? Select all that apply.
Polypharmacy is a primary predictor for any undesired or unwanted consequences that can occur because of taking medications. Which is of the following is the correct term for these undesired or unwanted consequences?
Which of the following is related to the incidence of gastric acidity declining with age because of decreased intestinal blood flow?
Biotransformation means chemical alteration of things such as nutrients, amino acids, toxins, and drugs in the body. In which organ does biotransformation occurs?
Which of the following is most affected by pharmacokinetic change?
A patient is started on a low dose of a drug for safety but is never advanced to a therapeutic dose while another drug is added. Which of the following does this describe?
There are over 35 assessment tools currently available to assist providers with the prescribing of medications. Which of the following consists of a list of potentially inappropriate medications (PIMs) to be avoided in older adults?
After consultation with the patient, which of the following is prevented by prescribing only necessary drugs?
Initial and ongoing assessment should be the protocol when prescribing medications. Designating and training office staff to do the initial medication review can save time but still requires review by the provider. Which of the following terms refers to a patient bringing in all current medications for review?
The aging process may alter the dynamic processes that drugs undergo to produce therapeutic effects. Which of the following are terms that refer to these changes? Select all that apply.
Which of the following factors affect drug absorption? Select all that apply.
Drug distribution in the body is affected by aging and higher body fat. Which of the following is true regarding drugs distributed in fat? Select all that apply.
One of the things affecting drug distribution is the bioavailability of the drug. Which of the following factors may affect the amount of a drug that reaches the systemic circulation? Select all that apply.
It is important to know the pharmacodynamic influences of the drug. Which of the following statements are true regarding pharmacodynamics? Select all that apply.
A patient sees the nurse practitioner for a post-hospitalization follow-up and presents new complaints with change in
functional status. Which of the following should the nurse practitioner do? Select all that apply.
Which of the following is true regarding STOPP/START criteria for prescribing medications? Select all that apply.
The nurse practitioner is conducting a health of older adults in- service with a group of older adults at a community center. The first concept she presents is a definition of chronic illness. Which of the following is the best definition?
The nurse practitioner is speaking to a group of student nurses about the causes of death of older adults. Which of the following statements is true regarding mortality and morbidity of people older than 65 years?
While teaching a family about the risks of chronic illness for James, who is 69 years old and the patriarch of the family, the nurse practitioner includes which of the following information?
with low levels of smoking, excluding second-hand smoke.
The U.S. health-care system functions by managing and paying for illness by focusing on one problem at a time. The nurse practitioner analyzes this system and concludes it is ineffective because:
The nurse practitioner whose practice consists of geriatric-aged patients must consider which of the following when working with patients who experience multiple chronic illnesses?
Mrs. Jones, 80 years old, comes to the clinic for management of heart failure, diabetes, and depression. The nurse practitioner assesses that this patient is not compliant with the medication plan and has missed a couple of recent appointments. The nurse practitioner analyzes this information and concludes that perhaps Mrs. Jones is experiencing treatment burden because:
specific tasks.
Mr. Smith, 82 years old, is seen by a nurse practitioner and is potentially diagnosed with treatment burden. The nurse practitioner recommends the Chronic Disease Self-Management Program (CDSMP). This program addresses which of the following skills? Select all that apply.
ALL
Mrs. Hupp, 91 years old, lives with her daughter, Kim. Kim loves her mother and does everything she can to assist in providing a good quality life for her mother. Recently, Kim has been telling her nurse practitioner that she is experiencing lack of sleep, higher blood sugars, and anxiety. The nurse practitioner discusses which of the following with Kim? Select all that apply.
The nurse practitioner has conducted a thorough health assessment for Mr. York, who is 83 years old. As the nurse practitioner synthesizes the information and creates the discharge instructions, consideration must be given to which of the following? Select all that apply.
2.. His ability to provide self-care.
Mrs. Morrison is 85 years old and on Medicare with supplemental insurance. She is obese and has diabetes and heart failure. The nurse practitioner collaborates with a social worker and with a representative from Medicare about the cost of her treatment choices. The nurse practitioner analyzes treatment burden and the costs of care to develop a practical and cost- effective plan of care. Which of the following puts Mrs. Morrison at risk for a financial burden for health care? Select all that apply.
The nurse practitioner is conducting an initial history and physical examination, along with a health assessment on a new patient. Mr. Carter is African American and 68 years old. He presents with complaints of dizziness, unstable gait, and polyuria. This combination of symptoms is blamed for his frequent falling at home. The nurse practitioner analyzes the
findings of the examination and suggests which of the following diagnostics? Select all that apply.
Mrs. Kesler, 91 years old, is considered frail and yet she is active and lives alone with supervision from her daughter. Her frailty is based on which of the following? Select all that apply.