NURS 5461 Practice Test with 200
Questions and Correct Answers with
Rationales/ NURS 5461 Adult
Gerontology Management Across
the Continuum of Care UTA
may have taken past action. Preparing to make specific
change. Action - ANSWER//Action- Modify behavior,
experiences, or environment to overcome problem. Praise
any behavioral change. Maintenance/Relapse Prevention
- ANSWER//-Working to prevent relapse and consolidate
gains secured during action -Uses strategies to prevent
the problem from re-occurring. -Actively engaged in
continuing change efforts -"How do I keep going?" Three
Main Types of Clinical Preventative Care - ANSWER//-
screening -behavioral cousenling -preventative meds
Screening - ANSWER//Think risk factors for most likely
Diseases Identify- Age/Gender/Race/Ethnic/ FH/ Personal
Risk United States Public Services Task Force (USPSTF)
- ANSWER//Great tool for Prevention!! Utilize in clinical
Levels of Evidence (USPSTF) - ANSWER//• Levels of
Evidence: A: recommends the service. There is high
certainty that the net benefit is substantial. B:
recommends the service. There is high certainty that the
net benefit is moderate or there is moderate certainty that
the net benefit is moderate to substantial. C: recommends
against routinely providing the service -Benefit small if
present D: recommends against the service -harm >
benefit I: current evidence is insufficient What services are
considered preventive care & required by ACA in 2015? -
ANSWER//Items or services recommended with an A or B
rating by the U.S. Preventive Services Task Force
Immunizations recommended by the Advisory Committee
on Immunization Practices (ACIP) of the CDC Important A
,and B level Evidence - ANSWER//AAA screening ever-
smoking men 65-75 ASA Men 45-79, Women 55-79
Behavioral dietary-counseling (increased risk) HTN & Lipid
screening (> 18; M >35/20-45, W >45/20-45) Disc.
Chemoprevention Breast Cancer (High risk) Pap, Mammo
CRC screening Lung Cancer screening Depression
screening• *Family HX risk & referral BRCA eval Obesity -
intensive counseling & behavioral Tobacco HIV (pregnant,
all 15-65)• ETOH misuse & counsel Hep C screen (1945-
65) Changes in Selected Major Screening Guidelines -
ANSWER//Cervical cancer screening (PAP & HPV) Q 3
yrs 21-29 PAP, 30-65 Q3yrs Pap or Q5 yrs Pap and HPV
Prostate Cancer screening "D rating" Lung Cancer
screening: LDCT 55-80 yrs w 30 pkyr & smoke or quit
within 15 yrs (55/30/15) Colon cancer screening: 3 options
Counseling topics - ANSWER//Behavioral Dietary
counseling at risk B Intensive Dietary counseling risk for
CVD B Discussion chemoprevention breast cancer B
Prevention skin cancer 10-24 B Intensive counseling &
intervention re Obesity B Tobacco counseling &
intervention A Reduce alcohol misuse B Promote
breastfeeding B Preventative Medications and
Immunizations - ANSWER//Immunizations (see CDC
immunization guidelines!!!) www.CDC.gov Influenza
starting at 6 months TD q 10 years (Tdap at least once as
adult) to protect pertussis 1X Tdap >65 if around infants
(timing does not matter) Pneumovax (PPSV23)at 65
or >18 if smoker or any chronic pulmonary
condition(repeat if given <65 & at least 5 years ago) 11
Prevnar (PCV3) at 65 then PPSV23 6-12 months later OR
if PPSV23 first, Prevnar 6-12 months Hep B series as
indicated (new: diabetes) HPV4 vaccinate females &
males (9 to 26 years) best at 11-12 yo Zostavax for zoster
prevention at 60 yo (FDA approved at 50) Meningococcal
as indicated Pneumococcal Vaccines -
ANSWER//Pneumococcal conjugate vaccine (PCV13) is
recommended for all children younger than 5 years old, all
,adults 65 years or older, and people 6 years or older with
certain RFs (immunocompromised) Pneumococcal
polysaccharide vaccine (PPSV23) is recommended for all
adults 65 years or older. People 2 years through 64 years
of age who are at high risk of pneumococcal disease
should also receive PPSV23 (>18 smokers, chronic
diseases, etc). Preventative Meds - ANSWER//ASA as
indicated 81 mg "A" Men >45-79 for MI; Women >55-79
(reduced CVA) Assess risk for GI bleed and decide 2010
Omega 3 fatty acids (fish oil)?? DHA, EPA 1-2 grams QD
or fatty fish twice weekly (Vitamin C & E NOT indicated
and may cause harm) Calcium with vit D for FX prevention
"D" Many outstanding questions re MI risk Dietary sources
show no risk so encourage Mediterranean Diet & DASH
diet for everyone! Obesity BMI - ANSWER//Higher BMI >
risk for DM, CVD, HLD, HTN, OA Modest Weight loss of
5% can reduce? - ANSWER//Type II diabetes
Cardiovascular disease Hypertension Dyslipidemia
Osteoarthritis General Goals of Weight Loss -
ANSWER//Initial goal: reduce body weight by ~10% from
baseline in 6 months May attempt further weight loss if
successful Weight loss should be 1-2 lb per week for
period of 6 months with subsequent strategies Water
Intake Guideline - ANSWER//Water intake (1/2 your body
wt in ounces; e.g., 200 # person needs 100 ozs or 3000cc
(3 L) Beginning Calorie Goal - ANSWER//For weight loss,
a 1200 calorie meal plan for women and a 1500 calorie
meal plan for men is recommended to start Physical
Activity tips for Obesity - ANSWER//Accumulate up to 30
minutes per day (10 Step counters (pedometers) 2000
steps=1 mile Newer guidelines say 60 minutes daily
Average = 2000 6000 = maintain wt 10,000 = to lose wt (5
miles) Wt Training increases capacity to burn calories
(more muscle mass & inc BMR) Pharmacotherapy for
obesity - ANSWER//FDA approved meds may be part of
comprehensive program including diet & activity Xenical
Phentermine Newer: Qsymia (phentermine/topiramate)
, BMI >/= 30 w/o concomitant obesity related RFs or
diseases BMI >/= 27 w/ RFs or diseases Requires
continual monitoring Ozempic is not FDA approved for
weight loss Tobacco Prevention - ANSWER//• Tobacco is
the leading preventable cause of death • After 40 years of
progress, the decrease in adult smoking rates has stalled
in the past 6 yrs • But most people who have ever smoked
have already quit, and most of today's smokers want to
quit • Progress stalled starting in 2004 SCREEN FOR
RISK FACTORS Smoking Cessation Website -
ANSWER//Clinical Practice Guideline for Treating
Tobacco Use 2008 Update [ahrq.gov] smoking cessation
aids and drugs - ANSWER//(Zyban), Chantix, social
support, & skills training Nicotine replacement therapy,
bupropion 5 A's of tobacco cessation - ANSWER//1. Ask 2.
Advise 3. Assess 4. Assist 5. Arrange Pharmacotherapies
for smoking cessation - ANSWER//Seven first-line
medications (5 nicotine and 2 non-nicotine) reliably
increase long-term smoking abstinence rates:Bupropion
SRNicotine gumNicotine inhalerNicotine lozengeNicotine
nasal sprayNicotine patch, Varenicline (chantix) 5 R's to
increase motivation to quit smoking: -
ANSWER//Relevance Risks Rewards Roadblocks
Repitition What is Health Literacy - ANSWER//"the degree
to which individuals have the capacity to obtain, process,
and understand basic health information and services
needed to make appropriate health decisions" Malnutrition
- ANSWER//lack of proper nutrition 30-50% of hospitalized
patients have some sort of poor nutrition Marasmus
malnutrition - ANSWER//Body fat and muscle wasting
Kwashiorkor malnutrition - ANSWER//Loss of skin turgor,
loss of hair color and softness, edema, enlarged liver and
parotids Depletion of visceral protein mass Hamwi's
method to calculate IBW - ANSWER//Men add 106
pounds + 6 pounds for each inch over 5 feet Women add
100 pounds + 5 pounds for each inch over 5 feet Some
sources suggest adding 10% for large frame person and
Questions and Correct Answers with
Rationales/ NURS 5461 Adult
Gerontology Management Across
the Continuum of Care UTA
may have taken past action. Preparing to make specific
change. Action - ANSWER//Action- Modify behavior,
experiences, or environment to overcome problem. Praise
any behavioral change. Maintenance/Relapse Prevention
- ANSWER//-Working to prevent relapse and consolidate
gains secured during action -Uses strategies to prevent
the problem from re-occurring. -Actively engaged in
continuing change efforts -"How do I keep going?" Three
Main Types of Clinical Preventative Care - ANSWER//-
screening -behavioral cousenling -preventative meds
Screening - ANSWER//Think risk factors for most likely
Diseases Identify- Age/Gender/Race/Ethnic/ FH/ Personal
Risk United States Public Services Task Force (USPSTF)
- ANSWER//Great tool for Prevention!! Utilize in clinical
Levels of Evidence (USPSTF) - ANSWER//• Levels of
Evidence: A: recommends the service. There is high
certainty that the net benefit is substantial. B:
recommends the service. There is high certainty that the
net benefit is moderate or there is moderate certainty that
the net benefit is moderate to substantial. C: recommends
against routinely providing the service -Benefit small if
present D: recommends against the service -harm >
benefit I: current evidence is insufficient What services are
considered preventive care & required by ACA in 2015? -
ANSWER//Items or services recommended with an A or B
rating by the U.S. Preventive Services Task Force
Immunizations recommended by the Advisory Committee
on Immunization Practices (ACIP) of the CDC Important A
,and B level Evidence - ANSWER//AAA screening ever-
smoking men 65-75 ASA Men 45-79, Women 55-79
Behavioral dietary-counseling (increased risk) HTN & Lipid
screening (> 18; M >35/20-45, W >45/20-45) Disc.
Chemoprevention Breast Cancer (High risk) Pap, Mammo
CRC screening Lung Cancer screening Depression
screening• *Family HX risk & referral BRCA eval Obesity -
intensive counseling & behavioral Tobacco HIV (pregnant,
all 15-65)• ETOH misuse & counsel Hep C screen (1945-
65) Changes in Selected Major Screening Guidelines -
ANSWER//Cervical cancer screening (PAP & HPV) Q 3
yrs 21-29 PAP, 30-65 Q3yrs Pap or Q5 yrs Pap and HPV
Prostate Cancer screening "D rating" Lung Cancer
screening: LDCT 55-80 yrs w 30 pkyr & smoke or quit
within 15 yrs (55/30/15) Colon cancer screening: 3 options
Counseling topics - ANSWER//Behavioral Dietary
counseling at risk B Intensive Dietary counseling risk for
CVD B Discussion chemoprevention breast cancer B
Prevention skin cancer 10-24 B Intensive counseling &
intervention re Obesity B Tobacco counseling &
intervention A Reduce alcohol misuse B Promote
breastfeeding B Preventative Medications and
Immunizations - ANSWER//Immunizations (see CDC
immunization guidelines!!!) www.CDC.gov Influenza
starting at 6 months TD q 10 years (Tdap at least once as
adult) to protect pertussis 1X Tdap >65 if around infants
(timing does not matter) Pneumovax (PPSV23)at 65
or >18 if smoker or any chronic pulmonary
condition(repeat if given <65 & at least 5 years ago) 11
Prevnar (PCV3) at 65 then PPSV23 6-12 months later OR
if PPSV23 first, Prevnar 6-12 months Hep B series as
indicated (new: diabetes) HPV4 vaccinate females &
males (9 to 26 years) best at 11-12 yo Zostavax for zoster
prevention at 60 yo (FDA approved at 50) Meningococcal
as indicated Pneumococcal Vaccines -
ANSWER//Pneumococcal conjugate vaccine (PCV13) is
recommended for all children younger than 5 years old, all
,adults 65 years or older, and people 6 years or older with
certain RFs (immunocompromised) Pneumococcal
polysaccharide vaccine (PPSV23) is recommended for all
adults 65 years or older. People 2 years through 64 years
of age who are at high risk of pneumococcal disease
should also receive PPSV23 (>18 smokers, chronic
diseases, etc). Preventative Meds - ANSWER//ASA as
indicated 81 mg "A" Men >45-79 for MI; Women >55-79
(reduced CVA) Assess risk for GI bleed and decide 2010
Omega 3 fatty acids (fish oil)?? DHA, EPA 1-2 grams QD
or fatty fish twice weekly (Vitamin C & E NOT indicated
and may cause harm) Calcium with vit D for FX prevention
"D" Many outstanding questions re MI risk Dietary sources
show no risk so encourage Mediterranean Diet & DASH
diet for everyone! Obesity BMI - ANSWER//Higher BMI >
risk for DM, CVD, HLD, HTN, OA Modest Weight loss of
5% can reduce? - ANSWER//Type II diabetes
Cardiovascular disease Hypertension Dyslipidemia
Osteoarthritis General Goals of Weight Loss -
ANSWER//Initial goal: reduce body weight by ~10% from
baseline in 6 months May attempt further weight loss if
successful Weight loss should be 1-2 lb per week for
period of 6 months with subsequent strategies Water
Intake Guideline - ANSWER//Water intake (1/2 your body
wt in ounces; e.g., 200 # person needs 100 ozs or 3000cc
(3 L) Beginning Calorie Goal - ANSWER//For weight loss,
a 1200 calorie meal plan for women and a 1500 calorie
meal plan for men is recommended to start Physical
Activity tips for Obesity - ANSWER//Accumulate up to 30
minutes per day (10 Step counters (pedometers) 2000
steps=1 mile Newer guidelines say 60 minutes daily
Average = 2000 6000 = maintain wt 10,000 = to lose wt (5
miles) Wt Training increases capacity to burn calories
(more muscle mass & inc BMR) Pharmacotherapy for
obesity - ANSWER//FDA approved meds may be part of
comprehensive program including diet & activity Xenical
Phentermine Newer: Qsymia (phentermine/topiramate)
, BMI >/= 30 w/o concomitant obesity related RFs or
diseases BMI >/= 27 w/ RFs or diseases Requires
continual monitoring Ozempic is not FDA approved for
weight loss Tobacco Prevention - ANSWER//• Tobacco is
the leading preventable cause of death • After 40 years of
progress, the decrease in adult smoking rates has stalled
in the past 6 yrs • But most people who have ever smoked
have already quit, and most of today's smokers want to
quit • Progress stalled starting in 2004 SCREEN FOR
RISK FACTORS Smoking Cessation Website -
ANSWER//Clinical Practice Guideline for Treating
Tobacco Use 2008 Update [ahrq.gov] smoking cessation
aids and drugs - ANSWER//(Zyban), Chantix, social
support, & skills training Nicotine replacement therapy,
bupropion 5 A's of tobacco cessation - ANSWER//1. Ask 2.
Advise 3. Assess 4. Assist 5. Arrange Pharmacotherapies
for smoking cessation - ANSWER//Seven first-line
medications (5 nicotine and 2 non-nicotine) reliably
increase long-term smoking abstinence rates:Bupropion
SRNicotine gumNicotine inhalerNicotine lozengeNicotine
nasal sprayNicotine patch, Varenicline (chantix) 5 R's to
increase motivation to quit smoking: -
ANSWER//Relevance Risks Rewards Roadblocks
Repitition What is Health Literacy - ANSWER//"the degree
to which individuals have the capacity to obtain, process,
and understand basic health information and services
needed to make appropriate health decisions" Malnutrition
- ANSWER//lack of proper nutrition 30-50% of hospitalized
patients have some sort of poor nutrition Marasmus
malnutrition - ANSWER//Body fat and muscle wasting
Kwashiorkor malnutrition - ANSWER//Loss of skin turgor,
loss of hair color and softness, edema, enlarged liver and
parotids Depletion of visceral protein mass Hamwi's
method to calculate IBW - ANSWER//Men add 106
pounds + 6 pounds for each inch over 5 feet Women add
100 pounds + 5 pounds for each inch over 5 feet Some
sources suggest adding 10% for large frame person and
