NRNP 6540 - ADVANCED PRACTICE CARE OF OLDER ADULTS’
DIDACTIC EXAM QUESTIONS AND ANSWERS LATEST
VERSION 2025 GRADED A+
There are benign and lethal murmurs. Which of the following are true of lethal murmurs
hospitalization is required when arrhythmias result from hemodynamic compromise
Cardioversion pre hospitalization may be needed
Aggressive therapeutic treatment is needed when symptomatic
Underlying cardiac problems need to be discovered
What are the classes of BMI for obesity
Class 1 30-35
Class II 35-39.9
Class morbid >40
What is the screening tool for alcohol
Cage
It is positive if they answer yes to two or more and then perform a SMAST-G screening tool
What are the hypertension guidelines for patients greater than 60 years of age
150/90 for patients without DM or CKD
140/90 for patients with DM or CKD
Why would you initiate statins on elderly patients
1-cvd
2 - LDL >190
3-in patients age 40-75, LDL of 70-189
Was what is a positive malnutrition score
Greater than 10 lb weight loss in 6 months
Use the MUST tool
Elderly population should you screen for hyperlipidemia
Patients that have known hypertension, smoking, or diabetes
,What is the scales nutrition screening tool
S-sadness, C-cholesterol, A-albumin, L- loss of weight E- eating problems, S - shopping
problems
What are the vision screening requirements of patients > 65
Snelling chart - annually
Patients with hypertension or diabetes must have a dilated exam annually
What are the hearing screening requirements of patients > 65
Asking questions about whether people say they appear to have problems with turning the
volume up
When should you screen for osteoporosis
Women >65
Men > 70
You must use a dual energy dxa x-ray
And perform at-score
What is the T score for osteoporosis?
Normal 1.0
Osteopenia -1 to -2.5
Osteoporosis -2.5
Severe osteoporosis < 2.5 and fragility fracture
What are the mammogram screening requirements
Age greater than 40-74
What are the colon cancer screening recommendations
All patients over the age of 50
Colonoscopy every 10 years
Sigmoidoscopy every 5 years
Occult blood yearly
What are the cervical cancer screening recommendations
Age 21-65
> age 65 is not required
What are the requirements for counseling patients > 65
Exercise, nutrition, tobacco, alcohol
,What are the requirements of exercise for patients 65
Aerobic exercise for 30 minutes three times a week
Strength exercise two times a week
What are the alcohol recommendations for an adult
one per day for women
Per day for men
What are the pneumonia immunization recommendations for patients >65
Pcv13 first
PPS 23 one year later
What are the zoster immunization recommendations
All patients over the age of 60-regardless if they have had shingles or chicken pox in the past
Contraindications-allergy to neomycin or gelatin
Bone marrow cancer - such as lymphoma
Current chemotherapy or steroids
AIDS patients
the major impact of the physiological changes that occur with aging is
Reduced physiological Reserve-Particularly the cardiac, respiratory, and renal systems
Reduced homeostatic mechanisms-That fail to adjust regulatory systems such as temperature
control and fluid and electrolyte balance
Changes in the sympathetic response-which contribute to orthostasis and Falls as well as a lack
of hypoglycemic response
Impaired immunologic response
the strongest evidence regarding normal physiological aging is available through
Longitudinal studies
the following statements are true about laboratory values in older adults
Reference ranges are preferable
Normal ranges may not be applicable for older adults
Reference ranges are not necessarily acceptable values
biochemical individuality is best described as
, Each individual's variation is often much smaller than that of a larger group
polypharmacy is best described as
Even a single med if there is not a clear indication for its use
pharmacokinetic changes with aging is reflective of
What the body does to the drug
All of the following statements are false about drug absorption except
Underlying chronic disease has little impact on drug absorption
all of the following statements are true about drug distribution in the elderly
drugs distributed in fat have less intense, more prolonged effect
drugs highly protein bound have greater potential to cause an adverse drug reaction
the fastest way to deliver a drug to the action site is by inhalation
men have faster and more efficient biotransformation of drugs and this is thought to be due
to
testosterone
the cytochrome P system involves enzymes that are generally
Inhibited or induced by drugs
a statement not shown to be true about pharmacodynamics changes with aging
and hand sensitivity to central nervous system drugs
drug responsiveness can be influenced by patients activity level
decreased sensitivity to beta blockers
they do not have a decrease sensitivity to oral anticoagulants
a typical presentation of disease in the elderly is reflected by all of the following
infection without fever
depression without dysphoric mood
cardiac manifestations of thyroid disease
DIDACTIC EXAM QUESTIONS AND ANSWERS LATEST
VERSION 2025 GRADED A+
There are benign and lethal murmurs. Which of the following are true of lethal murmurs
hospitalization is required when arrhythmias result from hemodynamic compromise
Cardioversion pre hospitalization may be needed
Aggressive therapeutic treatment is needed when symptomatic
Underlying cardiac problems need to be discovered
What are the classes of BMI for obesity
Class 1 30-35
Class II 35-39.9
Class morbid >40
What is the screening tool for alcohol
Cage
It is positive if they answer yes to two or more and then perform a SMAST-G screening tool
What are the hypertension guidelines for patients greater than 60 years of age
150/90 for patients without DM or CKD
140/90 for patients with DM or CKD
Why would you initiate statins on elderly patients
1-cvd
2 - LDL >190
3-in patients age 40-75, LDL of 70-189
Was what is a positive malnutrition score
Greater than 10 lb weight loss in 6 months
Use the MUST tool
Elderly population should you screen for hyperlipidemia
Patients that have known hypertension, smoking, or diabetes
,What is the scales nutrition screening tool
S-sadness, C-cholesterol, A-albumin, L- loss of weight E- eating problems, S - shopping
problems
What are the vision screening requirements of patients > 65
Snelling chart - annually
Patients with hypertension or diabetes must have a dilated exam annually
What are the hearing screening requirements of patients > 65
Asking questions about whether people say they appear to have problems with turning the
volume up
When should you screen for osteoporosis
Women >65
Men > 70
You must use a dual energy dxa x-ray
And perform at-score
What is the T score for osteoporosis?
Normal 1.0
Osteopenia -1 to -2.5
Osteoporosis -2.5
Severe osteoporosis < 2.5 and fragility fracture
What are the mammogram screening requirements
Age greater than 40-74
What are the colon cancer screening recommendations
All patients over the age of 50
Colonoscopy every 10 years
Sigmoidoscopy every 5 years
Occult blood yearly
What are the cervical cancer screening recommendations
Age 21-65
> age 65 is not required
What are the requirements for counseling patients > 65
Exercise, nutrition, tobacco, alcohol
,What are the requirements of exercise for patients 65
Aerobic exercise for 30 minutes three times a week
Strength exercise two times a week
What are the alcohol recommendations for an adult
one per day for women
Per day for men
What are the pneumonia immunization recommendations for patients >65
Pcv13 first
PPS 23 one year later
What are the zoster immunization recommendations
All patients over the age of 60-regardless if they have had shingles or chicken pox in the past
Contraindications-allergy to neomycin or gelatin
Bone marrow cancer - such as lymphoma
Current chemotherapy or steroids
AIDS patients
the major impact of the physiological changes that occur with aging is
Reduced physiological Reserve-Particularly the cardiac, respiratory, and renal systems
Reduced homeostatic mechanisms-That fail to adjust regulatory systems such as temperature
control and fluid and electrolyte balance
Changes in the sympathetic response-which contribute to orthostasis and Falls as well as a lack
of hypoglycemic response
Impaired immunologic response
the strongest evidence regarding normal physiological aging is available through
Longitudinal studies
the following statements are true about laboratory values in older adults
Reference ranges are preferable
Normal ranges may not be applicable for older adults
Reference ranges are not necessarily acceptable values
biochemical individuality is best described as
, Each individual's variation is often much smaller than that of a larger group
polypharmacy is best described as
Even a single med if there is not a clear indication for its use
pharmacokinetic changes with aging is reflective of
What the body does to the drug
All of the following statements are false about drug absorption except
Underlying chronic disease has little impact on drug absorption
all of the following statements are true about drug distribution in the elderly
drugs distributed in fat have less intense, more prolonged effect
drugs highly protein bound have greater potential to cause an adverse drug reaction
the fastest way to deliver a drug to the action site is by inhalation
men have faster and more efficient biotransformation of drugs and this is thought to be due
to
testosterone
the cytochrome P system involves enzymes that are generally
Inhibited or induced by drugs
a statement not shown to be true about pharmacodynamics changes with aging
and hand sensitivity to central nervous system drugs
drug responsiveness can be influenced by patients activity level
decreased sensitivity to beta blockers
they do not have a decrease sensitivity to oral anticoagulants
a typical presentation of disease in the elderly is reflected by all of the following
infection without fever
depression without dysphoric mood
cardiac manifestations of thyroid disease
