NURS 601 FINAL EXAM: Ham’s Primary Care Geriatrics
QUESTIONS WITH ANSWERS 2023 UPDATE A+ PASS
GUARANTEED
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
,NURS 601 FINAL EXAM: Ham’s Primary Care Geriatrics
QUESTIONS WITH ANSWERS 2023 UPDATE A+ PASS
GUARANTEED
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 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
,NURS 601 FINAL EXAM: Ham’s Primary Care Geriatrics
QUESTIONS WITH ANSWERS 2023 UPDATE A+ PASS
GUARANTEED
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. 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
, NURS 601 FINAL EXAM: Ham’s Primary Care Geriatrics
QUESTIONS WITH ANSWERS 2023 UPDATE A+ PASS
GUARANTEED
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 c.
Atherosclerosis
d. Autonomic neuropathy
2. Which is the most reasonable first step in the treatment of older men with erectile dysfunction?
a. Sex therapy
b. Testosterone
c. Yohimbine
QUESTIONS WITH ANSWERS 2023 UPDATE A+ PASS
GUARANTEED
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
,NURS 601 FINAL EXAM: Ham’s Primary Care Geriatrics
QUESTIONS WITH ANSWERS 2023 UPDATE A+ PASS
GUARANTEED
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 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
,NURS 601 FINAL EXAM: Ham’s Primary Care Geriatrics
QUESTIONS WITH ANSWERS 2023 UPDATE A+ PASS
GUARANTEED
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. 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
, NURS 601 FINAL EXAM: Ham’s Primary Care Geriatrics
QUESTIONS WITH ANSWERS 2023 UPDATE A+ PASS
GUARANTEED
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 c.
Atherosclerosis
d. Autonomic neuropathy
2. Which is the most reasonable first step in the treatment of older men with erectile dysfunction?
a. Sex therapy
b. Testosterone
c. Yohimbine
