NR 601 Midterm Q&A 2 Latest Versions Updated
Spring 2022.
The percentage of the FVC expired in one second is
(answer) - FEV1/FVC ratio
The aging process causes what normal physiological changes in the heart
(answer) - The heart valve thickens and becomes rigid, secondary to fibrosis and
sclerosis
A 55 yo Caucasian male follows up after referral to cardiologist. He thinks his med is
causing a cough and sometimes he has difficulty breathing. Which med was most likely
prescribed?
(answer) - Lisinopril
MJ presents with h/o structural damage with current s/s of HF. Treatment will be based
on his stage of HF which is
(answer) - Stage C
65 yo Caucasian presents with mitral valve stenosis, physical exam is unremarkable.
you know her stage of HF is
(answer) - Stage B
The best way to diagnose structural heart disease/dysfunction noninvasively is
(answer) - Echocardiogram
Chronic pain can have major impact on patients ability to function and have profound
impact on overall QOL. Ongoing pain may be linked to
(answer) - Depression, sleep disturbance, decreased socialization
The Beers criteria are appropriate for use in evaluating use of certain meds in patients
(answer) - >65 y/o
All of the following statements are true about lab values in older adults except
(answer) - Abnormal findings are often due to physiological aging
According to the 2017 ACC HTN guidelines, the recommended BP goal for a 65y/o
African American woman with a h/o HTN and DM and no h/o CKD is
(answer) - <140/80
THe pathophysiology of HF is due to
(answer) - Inadequate cardiac output to meet the metabolic and O2 demands of the
body
The volume of air a patient to exhale for total duration of the test during maximal effort is
(answer) - FVC
,According it the 2017 ACC HTN guidelines, normal BP is
(answer) - <120/80
Functional abilities are best assessed by
(answer) - Observed assessment of function
LB is a 77 yo with chronic poorly controlled HTN. You know that goals include
prevention of target organ damage. During your eval you will assess for evidence of
(answer) - Left ventricular hypertrophy
Aortic regurgitation requires medical treatment for early signs of HF with
(answer) - ACEi
The volume of air in the lungs at max inflation is
(answer) - TLC (total lung capacity)
Preferred amount of exercise for older adults is
(answer) - 30min/day of aerobic exercise 5 days a week
You know the following statements regarding th pain of acute coronary syndrome are
true except
(answer) - Present atypically more often in men than women
Elderly patient presents with new onset of feeling heart race, fatigue. EKG reveals Afib
with rate >100. Patient also has a new tremor in both hands. Which of the following
would you suspect
(answer) - Hyperthyroidism
Which patient is more likely to have osteoporosis
(answer) - 80 y/o. Underweight male who smokes and has been on steroids for
psoriasis
Post menopausal woman with osteoporosis is taking bisphosphonate daily po. What
action info statement would indicate she understood your instructions regarding this
med?
(answer) - Take med with full glass of water when up in the AM 30 min before other
food and meds
60 y/o obese male has T2DM and lipid panel of TC= 250 HDL=32, LDL=165. You teach
him about his modifiable cardiac risk factors which include
(answer) - DM, obesity, hyperlipidemia
OA of cervical and lumbar spine causes pain related to all of the following except
(answer) - Crystal deposition
,In differentiating OA from chronic gout, pseudo gout, or septic arthritis, the most
valuable diagnostic study would be
(answer) - Synovial fluid analysis
Patients with OA of the hip and knee often have a distinguishable gait described as
(answer) - Antalgic
Which of the following best describes pain associated with OA
(answer) - Begins upon arising and after prolonged weight bearing and or use of the
joint
Joint effusions typically occurs later in the course of OA, especially in the
(answer) - Knee
You ordered CBC for your patient you suspect has polymyalgia rheumatica. Which 2
clinical findings are common in patients with PMR
(answer) - Normochromic, normocytic anemia and thrombocytosis
You suspect your patient has PMR and now are concerned that they may have Giant
Cell Arteritis too. Which of the following 2 symptoms are most indicative of GCA and
PMR
(answer) - Scalp tenderness and aching in shoulder and pelvic girdle
63 yo Caucasian patient with PMR will begin tx corticosteroids until the condition has
resolved. You look over her records and it has been 2 years since her last physical
exam and any labs or diagnostic tests as she relocated and had not yet ID'd a provider.
In prioritizing your management plan your first orders should include
(answer) - Duel energy X-ray scan and updating immunizations
Which of the following DD for patients presenting with PMR can be ruled out with a
muscle biopsy
(answer) - Polymyositis
In reviewing lab results for patients with suspected PMR, you realize there is no
definitive test to diagnose PMR, rather clinical response to treatment. Results you would
expect to see include:
(answer) - ESR >50
Which of the following is the most appropriate lab test for monitoring gout therapy over
the long-term
(answer) - Serum urate level
In providing health teaching related to dietary restrictions, you should advise a patient
with gout to avoid which of the following dietary items
(answer) - Beer, sausage, fried seafood
, The best method of verifying gout diagnosis in a joint is which of the following(answer) -
Joint aspiration and polarized light microscopy
The most appropriate first line treatment for acute gout flare, assuming no kidney
disease or elevated bleeding risk(answer) - Indomethacin 50mg TID x2 days, then
25mg TID x3 days
You order bilateral wrist XR on 69 yo man with c/o both wrists x6 weeks, not related to
any known trauma. You suspect early RA. The initial XR finding in apatien with elderly
onset RA would be(answer) - Soft tissue swelling
A 72 female has been diagnosed with gout. She also has chronic HF. The most likely
contributing factor to development of gout in this older female is(answer) - Thiazide
diuretics
Which of the following statements about OA is true(answer) - It affects primarily weight
bearing joints
In considering the specificity of lab data, the most reliable diagnostic test listed below
would be(answer) - Synovial fluid analysis to differentiate between infectious versus
inflammatory infusion
When examining the spine of an older adult you notice a curvature with a sharp angle.
This is referred to as(answer) - Gibbus
The prevalence of depression in nursing home residents is __________________
greater than adults living in the community(answer) - 3-4 times
The majority of depressed older adults remain untreated because of(answer) -
Misdiagnosis, social stigma, environmental barriers
Symptoms of depression distinct to the elderly include(answer) - Lack of emotions
The justification for ordering CBC, TSH, serum B12 for a patient you may suspect have
clinical depression is(answer) - Because of overlapping symptoms with anemia, thyroid
dysfunction, and nutritional deficiencies
One major difference that us useful in the DD of dementia versus delirium is
that(answer) - Dementia develops slowly and delirium develops quickly
Which of the following is the most appropriate screening tool for delirium(answer) -
Confusion Assessment Method
The proposed mechanism by which diphenhydramine causes delirium is(answer) -
Anticholinergic effects
Spring 2022.
The percentage of the FVC expired in one second is
(answer) - FEV1/FVC ratio
The aging process causes what normal physiological changes in the heart
(answer) - The heart valve thickens and becomes rigid, secondary to fibrosis and
sclerosis
A 55 yo Caucasian male follows up after referral to cardiologist. He thinks his med is
causing a cough and sometimes he has difficulty breathing. Which med was most likely
prescribed?
(answer) - Lisinopril
MJ presents with h/o structural damage with current s/s of HF. Treatment will be based
on his stage of HF which is
(answer) - Stage C
65 yo Caucasian presents with mitral valve stenosis, physical exam is unremarkable.
you know her stage of HF is
(answer) - Stage B
The best way to diagnose structural heart disease/dysfunction noninvasively is
(answer) - Echocardiogram
Chronic pain can have major impact on patients ability to function and have profound
impact on overall QOL. Ongoing pain may be linked to
(answer) - Depression, sleep disturbance, decreased socialization
The Beers criteria are appropriate for use in evaluating use of certain meds in patients
(answer) - >65 y/o
All of the following statements are true about lab values in older adults except
(answer) - Abnormal findings are often due to physiological aging
According to the 2017 ACC HTN guidelines, the recommended BP goal for a 65y/o
African American woman with a h/o HTN and DM and no h/o CKD is
(answer) - <140/80
THe pathophysiology of HF is due to
(answer) - Inadequate cardiac output to meet the metabolic and O2 demands of the
body
The volume of air a patient to exhale for total duration of the test during maximal effort is
(answer) - FVC
,According it the 2017 ACC HTN guidelines, normal BP is
(answer) - <120/80
Functional abilities are best assessed by
(answer) - Observed assessment of function
LB is a 77 yo with chronic poorly controlled HTN. You know that goals include
prevention of target organ damage. During your eval you will assess for evidence of
(answer) - Left ventricular hypertrophy
Aortic regurgitation requires medical treatment for early signs of HF with
(answer) - ACEi
The volume of air in the lungs at max inflation is
(answer) - TLC (total lung capacity)
Preferred amount of exercise for older adults is
(answer) - 30min/day of aerobic exercise 5 days a week
You know the following statements regarding th pain of acute coronary syndrome are
true except
(answer) - Present atypically more often in men than women
Elderly patient presents with new onset of feeling heart race, fatigue. EKG reveals Afib
with rate >100. Patient also has a new tremor in both hands. Which of the following
would you suspect
(answer) - Hyperthyroidism
Which patient is more likely to have osteoporosis
(answer) - 80 y/o. Underweight male who smokes and has been on steroids for
psoriasis
Post menopausal woman with osteoporosis is taking bisphosphonate daily po. What
action info statement would indicate she understood your instructions regarding this
med?
(answer) - Take med with full glass of water when up in the AM 30 min before other
food and meds
60 y/o obese male has T2DM and lipid panel of TC= 250 HDL=32, LDL=165. You teach
him about his modifiable cardiac risk factors which include
(answer) - DM, obesity, hyperlipidemia
OA of cervical and lumbar spine causes pain related to all of the following except
(answer) - Crystal deposition
,In differentiating OA from chronic gout, pseudo gout, or septic arthritis, the most
valuable diagnostic study would be
(answer) - Synovial fluid analysis
Patients with OA of the hip and knee often have a distinguishable gait described as
(answer) - Antalgic
Which of the following best describes pain associated with OA
(answer) - Begins upon arising and after prolonged weight bearing and or use of the
joint
Joint effusions typically occurs later in the course of OA, especially in the
(answer) - Knee
You ordered CBC for your patient you suspect has polymyalgia rheumatica. Which 2
clinical findings are common in patients with PMR
(answer) - Normochromic, normocytic anemia and thrombocytosis
You suspect your patient has PMR and now are concerned that they may have Giant
Cell Arteritis too. Which of the following 2 symptoms are most indicative of GCA and
PMR
(answer) - Scalp tenderness and aching in shoulder and pelvic girdle
63 yo Caucasian patient with PMR will begin tx corticosteroids until the condition has
resolved. You look over her records and it has been 2 years since her last physical
exam and any labs or diagnostic tests as she relocated and had not yet ID'd a provider.
In prioritizing your management plan your first orders should include
(answer) - Duel energy X-ray scan and updating immunizations
Which of the following DD for patients presenting with PMR can be ruled out with a
muscle biopsy
(answer) - Polymyositis
In reviewing lab results for patients with suspected PMR, you realize there is no
definitive test to diagnose PMR, rather clinical response to treatment. Results you would
expect to see include:
(answer) - ESR >50
Which of the following is the most appropriate lab test for monitoring gout therapy over
the long-term
(answer) - Serum urate level
In providing health teaching related to dietary restrictions, you should advise a patient
with gout to avoid which of the following dietary items
(answer) - Beer, sausage, fried seafood
, The best method of verifying gout diagnosis in a joint is which of the following(answer) -
Joint aspiration and polarized light microscopy
The most appropriate first line treatment for acute gout flare, assuming no kidney
disease or elevated bleeding risk(answer) - Indomethacin 50mg TID x2 days, then
25mg TID x3 days
You order bilateral wrist XR on 69 yo man with c/o both wrists x6 weeks, not related to
any known trauma. You suspect early RA. The initial XR finding in apatien with elderly
onset RA would be(answer) - Soft tissue swelling
A 72 female has been diagnosed with gout. She also has chronic HF. The most likely
contributing factor to development of gout in this older female is(answer) - Thiazide
diuretics
Which of the following statements about OA is true(answer) - It affects primarily weight
bearing joints
In considering the specificity of lab data, the most reliable diagnostic test listed below
would be(answer) - Synovial fluid analysis to differentiate between infectious versus
inflammatory infusion
When examining the spine of an older adult you notice a curvature with a sharp angle.
This is referred to as(answer) - Gibbus
The prevalence of depression in nursing home residents is __________________
greater than adults living in the community(answer) - 3-4 times
The majority of depressed older adults remain untreated because of(answer) -
Misdiagnosis, social stigma, environmental barriers
Symptoms of depression distinct to the elderly include(answer) - Lack of emotions
The justification for ordering CBC, TSH, serum B12 for a patient you may suspect have
clinical depression is(answer) - Because of overlapping symptoms with anemia, thyroid
dysfunction, and nutritional deficiencies
One major difference that us useful in the DD of dementia versus delirium is
that(answer) - Dementia develops slowly and delirium develops quickly
Which of the following is the most appropriate screening tool for delirium(answer) -
Confusion Assessment Method
The proposed mechanism by which diphenhydramine causes delirium is(answer) -
Anticholinergic effects
