Question 15
Edited: Aug 17, 2018
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A 76 year old man with a history of an ischemic stroke with persistent right
hemiparesis, has had recurrent pressure sores on his lower back and
buttocks. He spends a good part of each day in a wheelchair. Which of the
following measures/devices is contraindicated to prevent pressure sores in a
patient who is wheelchair-bound?
donut-seat cushions
Question 21
Edited: Aug 17, 2018
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An 88-year-old man was admitted 4 days ago to a skilled nursing facility under
your care. He was transferred from the hospital following a large left middle
cerebral stroke. On your initial examination, you noted a 3 × 4 cm grade 2
sacral pressure ulcer. The ulcer had a clean base without significant drainage
or surrounding erythema. You asked the nurse to place a semi-occlusive
membrane covering on it.
On today's visit, a nurse alerts you to the culture results of the wound. When
she examined the ulcer 2 days ago, there was copious, purulent-appearing
material under the dressing. She elected to remove the dressing and culture
the discharge. The cultures grew moderate Staphylococcus epidermidis,
moderate Corynebacterium, and small-growth Staphylococcus aureus.
What should you do after hearing of these culture results?
Instruct the nurse to apply a new dressing.
Question 22
Edited: Aug 17, 2018
,Report Question
A 93-year-old woman is readmitted to a skilled nursing facility after a 10-day
hospital stay for sepsis with a urinary source. She has bilateral heel pressure
ulcers--stage 2 on the left and stage 3 on the right--as well as a right-sided
stage 2 trochanteric pressure ulcer. She ate little while in the hospital and lost
12 pounds.
On examination, she is thin with sallow skin, and she has significant bruising
on both arms. Her vital signs are: blood pressure 112/62 mm Hg, temperature
97.4 °F, respiratory rate 14 breaths/minute, and pulse 82 beats/minute. Her
weight is 96 pounds.
Her ulcers all have clean bases with the exception of the right hip ulcer, which
has a minimal amount of necrotic tissue at the base. There is a minimal
amount of erythema around this ulcer as well.
You begin wet-to-dry dressings on this ulcer and continue the wet-to-wet
dressings on the heel ulcers. You institute frequent turning and positioning to
relieve pressure to all ulcers.
What additional measures might promote wound healing?
nutritional supplementation with protein or amino acids
Question 2
Edited: Aug 17, 2018
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A 79-year-old woman reports eating fewer than 2 meals a day and consuming
few fruits, vegetables, or milk products. Her body mass index (BMI) is 17
kg/m2. Which of the following strategies should you try first to improve
nutrition?
Identify ways in which the patient can enhance her nutrition. Rescreen her status in 3 months.
,Question 3
Edited: Aug 17, 2018
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An 82-year-old healthy woman who resides in Florida and has an adequate
consumption of calcium asks you what over-the-counter supplement would
provide her with the most beneficial combination of nutrients. She has no
history of falls. What is your recommendation?
discourage use of vitamin supplements, instead encouraging a healthy diet
Question 8
Edited: Aug 17, 2018
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Which of the following symptoms are known to be an adverse event of
selective serotonin reuptake inhibitors (SSRIs)?
extrapyramidal syndromes, insomnia, and serotonin syndrome
Question 9
Edited: Aug 17, 2018
Report Question
An elderly individual with which of the following characteristics is at the
GREATEST risk of completing suicide?
previous suicide attempts
Question 19
, Edited: Aug 17, 2018
Report Question
A 74 year-old male presented to his physician with complaint of a sharp pain
on the bottom of his right foot on ambulation. The pain had been getting worse
over a period of some weeks. The patient was in otherwise good health. On
examination, there was a hard circular thickening on the plantar surface of the
right foot. It was tender to the touch but without erythema or warmth. Which of
the following is the chief distinguishing feature between a corn and a callus?
appearance
Question 16
Edited: Apr 2, 2019
Report Question
A 74-year-old man is brought to your office by his daughter who is concerned
about whether her father is capable of remaining independent. She thinks his
gait is slow and unsteady. He feels that his walking is “fine”. You use the "get
up and go" test. The patient takes 18 seconds to get up, walk 10 feet, turn
around, and walk back to the chair.
Which of the following best describes the patient's mobility performance?
He is fairly mobile.
Question 1
Edited: Aug 17, 2018
Report Question
In men with erectile dysfunction, if an evaluation of endocrine abnormalities is
pursued, then which of the following is MOST LIKELY to be abnormal?
Edited: Aug 17, 2018
Report Question
A 76 year old man with a history of an ischemic stroke with persistent right
hemiparesis, has had recurrent pressure sores on his lower back and
buttocks. He spends a good part of each day in a wheelchair. Which of the
following measures/devices is contraindicated to prevent pressure sores in a
patient who is wheelchair-bound?
donut-seat cushions
Question 21
Edited: Aug 17, 2018
Report Question
An 88-year-old man was admitted 4 days ago to a skilled nursing facility under
your care. He was transferred from the hospital following a large left middle
cerebral stroke. On your initial examination, you noted a 3 × 4 cm grade 2
sacral pressure ulcer. The ulcer had a clean base without significant drainage
or surrounding erythema. You asked the nurse to place a semi-occlusive
membrane covering on it.
On today's visit, a nurse alerts you to the culture results of the wound. When
she examined the ulcer 2 days ago, there was copious, purulent-appearing
material under the dressing. She elected to remove the dressing and culture
the discharge. The cultures grew moderate Staphylococcus epidermidis,
moderate Corynebacterium, and small-growth Staphylococcus aureus.
What should you do after hearing of these culture results?
Instruct the nurse to apply a new dressing.
Question 22
Edited: Aug 17, 2018
,Report Question
A 93-year-old woman is readmitted to a skilled nursing facility after a 10-day
hospital stay for sepsis with a urinary source. She has bilateral heel pressure
ulcers--stage 2 on the left and stage 3 on the right--as well as a right-sided
stage 2 trochanteric pressure ulcer. She ate little while in the hospital and lost
12 pounds.
On examination, she is thin with sallow skin, and she has significant bruising
on both arms. Her vital signs are: blood pressure 112/62 mm Hg, temperature
97.4 °F, respiratory rate 14 breaths/minute, and pulse 82 beats/minute. Her
weight is 96 pounds.
Her ulcers all have clean bases with the exception of the right hip ulcer, which
has a minimal amount of necrotic tissue at the base. There is a minimal
amount of erythema around this ulcer as well.
You begin wet-to-dry dressings on this ulcer and continue the wet-to-wet
dressings on the heel ulcers. You institute frequent turning and positioning to
relieve pressure to all ulcers.
What additional measures might promote wound healing?
nutritional supplementation with protein or amino acids
Question 2
Edited: Aug 17, 2018
Report Question
A 79-year-old woman reports eating fewer than 2 meals a day and consuming
few fruits, vegetables, or milk products. Her body mass index (BMI) is 17
kg/m2. Which of the following strategies should you try first to improve
nutrition?
Identify ways in which the patient can enhance her nutrition. Rescreen her status in 3 months.
,Question 3
Edited: Aug 17, 2018
Report Question
An 82-year-old healthy woman who resides in Florida and has an adequate
consumption of calcium asks you what over-the-counter supplement would
provide her with the most beneficial combination of nutrients. She has no
history of falls. What is your recommendation?
discourage use of vitamin supplements, instead encouraging a healthy diet
Question 8
Edited: Aug 17, 2018
Report Question
Which of the following symptoms are known to be an adverse event of
selective serotonin reuptake inhibitors (SSRIs)?
extrapyramidal syndromes, insomnia, and serotonin syndrome
Question 9
Edited: Aug 17, 2018
Report Question
An elderly individual with which of the following characteristics is at the
GREATEST risk of completing suicide?
previous suicide attempts
Question 19
, Edited: Aug 17, 2018
Report Question
A 74 year-old male presented to his physician with complaint of a sharp pain
on the bottom of his right foot on ambulation. The pain had been getting worse
over a period of some weeks. The patient was in otherwise good health. On
examination, there was a hard circular thickening on the plantar surface of the
right foot. It was tender to the touch but without erythema or warmth. Which of
the following is the chief distinguishing feature between a corn and a callus?
appearance
Question 16
Edited: Apr 2, 2019
Report Question
A 74-year-old man is brought to your office by his daughter who is concerned
about whether her father is capable of remaining independent. She thinks his
gait is slow and unsteady. He feels that his walking is “fine”. You use the "get
up and go" test. The patient takes 18 seconds to get up, walk 10 feet, turn
around, and walk back to the chair.
Which of the following best describes the patient's mobility performance?
He is fairly mobile.
Question 1
Edited: Aug 17, 2018
Report Question
In men with erectile dysfunction, if an evaluation of endocrine abnormalities is
pursued, then which of the following is MOST LIKELY to be abnormal?
