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Final Exam Chapter Questions
nursing (Chamberlain University)
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Ham’s Primary Care Geriatrics Review Questions Weeks 5-8
Week 5
Chapter 4: Lesbian, Gay, Bisexual, Transgender Medicine in Older Adults
1. An 86-year-old female comes to your office for a wellness visit. Her blood
pressure is 125/70 mmHg, pulse 69 beats per min, and respiratory rate 18 breaths
per min. She is well appearing and reports she is up to date on her routine
vaccinations. She introduces her partner of 35 years whom she would like to make
medical decisions for her in case she becomes unable to make decisions for herself.
She reports that she and her partner are not married. She asks if she needs any
further documentation to ensure her goals of care are followed.
Which one of the following would be the most appropriate recommendation for
this patient and her partner?
a. Advise them to complete a POLST.
b. Advise them that they have adequate documentation to be recognized legally.
c. Advise them to file an advanced directive.
d. Respond that although they lack documentation, her partner will be recognized
de facto.
2. An 81-year-old transgender female with history of depression and
hyperlipidemia presents to your clinic for routine care. She endorses a history of
smoking, currently smoking 1 pack per day, and occasionally drinks a glass of
wine, although she denies illicit drug use. She reports she takes atorvastatin 20 mg
and subcutaneous estrogen therapy.
Which of the following is the most important next step in this patient’s primary
care?
a. Counseling on starting aspirin
b. Counseling on alcohol cessation
c. Counseling on smoking cessation
d. Counseling on mammogram
3. An 84-year-old male with history of stroke without residual deficit, systolic
heart failure, and type 2 diabetes presents to clinic for follow-up. He is
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independently living in a retirement community and still works part time on a golf
course. He currently takes aspirin 81 mg, metoprolol tartrate 25 mg BID (twice a
day), furosemide 20 mg BID, and lisinopril 10 mg daily. He reports his last
colonoscopy was 8 years ago, with no abnormality. He reports he is sexually active
with men and women, engaging in receptive oral, receptive anal, and penetrative
sex. He states he has had over three sexual partners in the last year with
intermittent condom use.
What sexually transmitted infection testing should be offered?
a. Urine testing
b. Urine testing, blood testing
c. Urine testing, blood testing, anal swab
d. Urine testing, blood testing, anal swab, and oropharyngeal swab
Chapter 23: Urinary Incontinence
1. Which of the following is true about tolterodine?
a. It should be avoided in men with prostatic hypertrophy.
b. It increases the risk of constipation compared with oral oxybutynin.
c. It acts by ablating detrusor spasms.
d. It has greater risk of adverse effects with its twice-daily formulation.
2. An 82-year-old man, Mr. A, complains of worsening nocturia, occurring four
times per night. His other lower urinary tract symptoms are slow stream,
occasional urgency, and urgency-related leakage once weekly. Medical problems
include poorly controlled hypertension, diastolic heart failure, hyperlipidemia,
osteoarthritis, and prediabetes. His medications include lisinopril 20 mg daily,
metoprolol succinate 75 mg daily, atorvastatin 10 mg daily, metformin 500 mg
twice daily, hydrocodone-acetaminophen as needed, and aspirin 81 mg daily.
Amlodipine 5 mg daily was recently added by his cardiologist. On review of
systems, Mr. A complains that nocturia is causing daytime fatigue, and he is more
constipated. Physical examination is notable for blood pressure 162/83 mmHg,
heart rate 60 beats per minute, clear lungs, soft abdomen, enlarged prostate, and 21
pretibial edema. Your next step in management should be:
a. Stop hydrocodone-acetaminophen and add naproxen.
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b. Stop amlodipine and increase lisinopril.
c. Add afternoon furosemide.
d. Add tamsulosin.
3. The daughter of a 79-year-old woman notes that her mother, who has dementia
and lives with her, is wetting herself when she attends her new day program.
Program staff have requested that “something be done” as she is requiring a clothes
change nearly every time she is there. She cannot describe the circumstances of
leakage, saying “it just comes.” Leakage is uncommon at home. Her medications
include donepezil and acetaminophen. Physical examination is normal. Initial
treatment approach will require intervention by which of the following?
a. Mrs. A’s physician
b. Mrs. A’s daughter
c. Day program staff
d. Physical therapist through a home care agency
4. Ms. J, who is 82 years old, complains of urine leakage while playing golf. This
has gotten worse over the past year, and she rarely makes it through nine holes
without feeling like she needs to “run into the bushes and go.” Leakage is usually
small volume, but causes her extreme embarrassment because she is afraid she will
smell of urine. She has tried limiting caffeine in the morning before she golfs and
avoiding drinking water while playing, to no effect. She also tried “those Kegler”
exercises in the past without success. Which of the following is the most
appropriate recommendation for Ms. J?
a. Bladder training
b. Referral for biofeedback training in pelvic muscle exercise
c. Trial of solifenacin
d. Trial of topical estrogen
Chapter 32: Sexual Health
1. What is the most common cause of erectile dysfunction in older men?
a. Psychological stress
b. Adverse drug reaction
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Final Exam Chapter Questions
nursing (Chamberlain University)
Studocu is not sponsored or endorsed by any college or university
Downloaded by bakr amar ()
, lOMoARcPSD|16248954
Ham’s Primary Care Geriatrics Review Questions Weeks 5-8
Week 5
Chapter 4: Lesbian, Gay, Bisexual, Transgender Medicine in Older Adults
1. An 86-year-old female comes to your office for a wellness visit. Her blood
pressure is 125/70 mmHg, pulse 69 beats per min, and respiratory rate 18 breaths
per min. She is well appearing and reports she is up to date on her routine
vaccinations. She introduces her partner of 35 years whom she would like to make
medical decisions for her in case she becomes unable to make decisions for herself.
She reports that she and her partner are not married. She asks if she needs any
further documentation to ensure her goals of care are followed.
Which one of the following would be the most appropriate recommendation for
this patient and her partner?
a. Advise them to complete a POLST.
b. Advise them that they have adequate documentation to be recognized legally.
c. Advise them to file an advanced directive.
d. Respond that although they lack documentation, her partner will be recognized
de facto.
2. An 81-year-old transgender female with history of depression and
hyperlipidemia presents to your clinic for routine care. She endorses a history of
smoking, currently smoking 1 pack per day, and occasionally drinks a glass of
wine, although she denies illicit drug use. She reports she takes atorvastatin 20 mg
and subcutaneous estrogen therapy.
Which of the following is the most important next step in this patient’s primary
care?
a. Counseling on starting aspirin
b. Counseling on alcohol cessation
c. Counseling on smoking cessation
d. Counseling on mammogram
3. An 84-year-old male with history of stroke without residual deficit, systolic
heart failure, and type 2 diabetes presents to clinic for follow-up. He is
Downloaded by bakr amar ()
, lOMoARcPSD|16248954
independently living in a retirement community and still works part time on a golf
course. He currently takes aspirin 81 mg, metoprolol tartrate 25 mg BID (twice a
day), furosemide 20 mg BID, and lisinopril 10 mg daily. He reports his last
colonoscopy was 8 years ago, with no abnormality. He reports he is sexually active
with men and women, engaging in receptive oral, receptive anal, and penetrative
sex. He states he has had over three sexual partners in the last year with
intermittent condom use.
What sexually transmitted infection testing should be offered?
a. Urine testing
b. Urine testing, blood testing
c. Urine testing, blood testing, anal swab
d. Urine testing, blood testing, anal swab, and oropharyngeal swab
Chapter 23: Urinary Incontinence
1. Which of the following is true about tolterodine?
a. It should be avoided in men with prostatic hypertrophy.
b. It increases the risk of constipation compared with oral oxybutynin.
c. It acts by ablating detrusor spasms.
d. It has greater risk of adverse effects with its twice-daily formulation.
2. An 82-year-old man, Mr. A, complains of worsening nocturia, occurring four
times per night. His other lower urinary tract symptoms are slow stream,
occasional urgency, and urgency-related leakage once weekly. Medical problems
include poorly controlled hypertension, diastolic heart failure, hyperlipidemia,
osteoarthritis, and prediabetes. His medications include lisinopril 20 mg daily,
metoprolol succinate 75 mg daily, atorvastatin 10 mg daily, metformin 500 mg
twice daily, hydrocodone-acetaminophen as needed, and aspirin 81 mg daily.
Amlodipine 5 mg daily was recently added by his cardiologist. On review of
systems, Mr. A complains that nocturia is causing daytime fatigue, and he is more
constipated. Physical examination is notable for blood pressure 162/83 mmHg,
heart rate 60 beats per minute, clear lungs, soft abdomen, enlarged prostate, and 21
pretibial edema. Your next step in management should be:
a. Stop hydrocodone-acetaminophen and add naproxen.
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b. Stop amlodipine and increase lisinopril.
c. Add afternoon furosemide.
d. Add tamsulosin.
3. The daughter of a 79-year-old woman notes that her mother, who has dementia
and lives with her, is wetting herself when she attends her new day program.
Program staff have requested that “something be done” as she is requiring a clothes
change nearly every time she is there. She cannot describe the circumstances of
leakage, saying “it just comes.” Leakage is uncommon at home. Her medications
include donepezil and acetaminophen. Physical examination is normal. Initial
treatment approach will require intervention by which of the following?
a. Mrs. A’s physician
b. Mrs. A’s daughter
c. Day program staff
d. Physical therapist through a home care agency
4. Ms. J, who is 82 years old, complains of urine leakage while playing golf. This
has gotten worse over the past year, and she rarely makes it through nine holes
without feeling like she needs to “run into the bushes and go.” Leakage is usually
small volume, but causes her extreme embarrassment because she is afraid she will
smell of urine. She has tried limiting caffeine in the morning before she golfs and
avoiding drinking water while playing, to no effect. She also tried “those Kegler”
exercises in the past without success. Which of the following is the most
appropriate recommendation for Ms. J?
a. Bladder training
b. Referral for biofeedback training in pelvic muscle exercise
c. Trial of solifenacin
d. Trial of topical estrogen
Chapter 32: Sexual Health
1. What is the most common cause of erectile dysfunction in older men?
a. Psychological stress
b. Adverse drug reaction
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