Maturing & Aged Practicum with Detailed Rationales | 100%
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Section 1: Geriatric Assessment & Health Promotion (15 Questions)
Q1: A 72-year-old female presents for her annual wellness visit. She has no significant
medical history and is up to date on all recommended immunizations. According to
USPSTF guidelines, which screening test is recommended for her at this visit?
A. Annual mammography until age 80
B. Colorectal cancer screening with colonoscopy every 10 years or stool-based testing
[CORRECT]
C. Annual PSA testing for prostate cancer
D. Routine screening for ovarian cancer with CA-125 and transvaginal ultrasound
Correct Answer: B
Rationale: USPSTF recommends colorectal cancer screening for adults aged 50-75 with
colonoscopy every 10 years or annual stool-based testing (FIT). Mammography is
recommended every 2 years for women 50-74 with shared decision-making for ages
75+. PSA screening is not routinely recommended for women. Ovarian cancer screening
is not recommended for average-risk women.
,Q2: A 68-year-old male former smoker (30 pack-years) asks about screening for
abdominal aortic aneurysm (AAA). What is the USPSTF recommendation?
A. All men age 65 and older should undergo one-time ultrasound screening
B. Men aged 65-75 who have ever smoked should undergo one-time ultrasound
screening [CORRECT]
C. Only men with a family history of AAA require screening
D. AAA screening is not recommended for any population
Correct Answer: B
Rationale: USPSTF recommends one-time ultrasound screening for AAA in men aged
65-75 who have ever smoked. Selective screening may be considered for men 65-75
who have never smoked. Routine screening is not recommended for women regardless
of smoking history because the prevalence is too low to justify screening.
Q3: A 70-year-old woman with no risk factors asks when she should have her next bone
density scan. According to guidelines, when should osteoporosis screening begin?
A. Age 50 for all women
B. Age 60 for women with risk factors only
C. Age 65 for all women, and earlier for those with risk factors [CORRECT]
D. Age 75 for all women
Correct Answer: C
Rationale: USPSTF recommends screening for osteoporosis with DEXA scan for women
65 years and older, and for younger women with risk factors (low body weight, smoking,
,alcohol use, family history, prior fracture). Men should be screened at age 70+ with risk
factors. Early detection allows for intervention to prevent fractures.
Q4: A 75-year-old patient asks which vaccines are recommended for older adults. Which
combination represents the standard adult immunization schedule for this age group?
A. Influenza annually, Pneumococcal (PCV20 once or PCV15 followed by PPSV23),
Tdap/Td booster, Zoster (Shingrix 2-dose series) [CORRECT]
B. Influenza annually, Pneumococcal every 5 years, Tdap once, Zoster live vaccine
C. Influenza every 2 years, Pneumococcal once, Tdap every 10 years, no Zoster needed
D. Only influenza and pneumococcal vaccines are recommended after age 65
Correct Answer: A
Rationale: Standard adult immunizations for adults 65+ include: annual influenza;
pneumococcal (either PCV20 once, or PCV15 followed by PPSV23); Tdap once, then Td
or Tdap every 10 years; and recombinant zoster vaccine (Shingrix) as a 2-dose series.
The live zoster vaccine (Zostavax) is no longer used in the U.S.
Q5: A comprehensive geriatric assessment (CGA) is best described as:
A. A focused physical examination performed by a single provider
B. An interdisciplinary evaluation addressing medical, functional, cognitive, and
psychosocial domains [CORRECT]
C. A medication review only, focusing on polypharmacy
D. A financial assessment for long-term care planning
Correct Answer: B
, Rationale: The Comprehensive Geriatric Assessment (CGA) is an interdisciplinary
evaluation that addresses multiple domains: medical conditions, functional status
(ADLs and IADLs), cognitive status, psychological health, social support, and
environmental factors. It involves collaboration among physicians, nurses, social
workers, physical therapists, and other professionals to develop a coordinated care
plan.
Q6: A 78-year-old patient lives alone and manages all household tasks independently
but requires assistance with grocery shopping and medication management. Which
statement best describes her functional status?
A. Fully independent in all ADLs and IADLs
B. Independent in ADLs but dependent in some IADLs [CORRECT]
C. Dependent in both ADLs and IADLs
D. Independent in IADLs but dependent in ADLs
Correct Answer: B
Rationale: ADLs (Activities of Daily Living) include basic self-care: bathing, dressing,
toileting, transferring, continence, and feeding. IADLs (Instrumental Activities of Daily
Living) include more complex tasks: managing finances, medications, shopping, meal
preparation, housekeeping, transportation, and telephone use. This patient is
independent in ADLs but requires assistance with IADLs (shopping, medication
management).
Q7: A 68-year-old male with hypertension and diabetes asks about prostate cancer
screening. What is the appropriate counseling?