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Test Bank For Health Promotion Questions And
Answers Verified 100% Correct
A 76-year-old patient who is very active has elevated cholesterol and LDLs. He had
been treated for hypertension for > 10 years with near normal blood pressures. What
is the current recommendation for managing his lipids?
No treatment should take place since his age exceeds 75 years.
He should be treated with an aspirin only.
He should be treated with a statin. Correct
The benefits of treating this patient do not exceed the risk of using a statin or aspirin.
Explanation:
Numerous studies (PROSPER, 2006) and learned authorities (including the USPSTF)
have found that lipid-lowering drug therapy decreases the incidence of coronary heart
disease and vascular events in middle-aged and older adults. The current
recommendation is to screen and treat lipid abnormalities in patients who are at risk for
a cardiac event. It is unclear whether treatment of middle-aged and older adults at low
risk for cardiac events is beneficial.
Question:
What is true regarding the shingles vaccine given to adults at or after age 50?
It is a weakened form of the chickenpox virus.
It is the same as the chickenpox virus.
It contains significantly more virus than the chickenpox vaccine. Correct
It is not related to the chickenpox immunization at all.
Explanation:
The shingles (Herpes zoster) vaccine contains 14 times the number of plaque-forming
units of virus than the varicella vaccine. The immunization has reduced the incidence of
shingles and postherpetic neuralgia in adults who received it. The vaccine is
recommended by CDC for all immunocompetent adults who are 60 years or older. It is
given once. The FDA has approved use of this vaccine at age 50 years. The vaccine is
only used to prevent shingles. It is not used to treat shingles or postherpetic neuralgia.
Question:
An oral antifungal agent is commonly used to treat tinea unguium. The difficulty in
treating an older adult with this is infection is:
,absorption of the
tolerability
of the medication. Correct
medication. applying the medication
twice daily. relative
ineffectiveness of oral agents.
Explanation:
The most efficacious agents used to treat toenail fungus are the oral antifungal agents.
They must be taken daily for 8-16 weeks (or longer) for adequate length of treatment.
Additionally, the real difficulty lies in the ability of the older adult's liver to handle this
medication. Oral antifungal agents require great amounts of the liver’s resources for
metabolism. A topical agent or toenail removal may be a better choice for an older
adult.
Question:
What is the recommendation for daily multivitamin supplementation in older adults?
Supplementation reduces morbidity.
Supplementation reduces mortality.
It decreases the relative risk of dementia.
It has no proven benefit. Correct
Explanation:
No studies have demonstrated specific benefit to daily consumption of multivitamins in
older adults. However, a daily multivitamin supplement ensures adequate intake of
essential vitamins and so should be considered for older adults.
Question:
In older adult females, which screening test has demonstrated greatest reduction in
mortality from cancer?
Breast Correct
Cervical
Ovarian
Lung
Explanation:
There are no recommendations for screening for ovarian or lung cancer in older
women. Cervical cancer is primarily a disease found in younger women. When it is
identified in older adults, there is usually a higher mortality rate than in younger
women. However, the incidence of cervical cancer is much lower in older adults.
Screening for breast cancer has demonstrated the highest reduction in mortality.
,Mammography should be performed every 1-2 years, according to the American
Geriatrics Society.
NEUROLOGICO (63)
Question:
1- A patient who is 82 years old is brought into the clinic. His wife states that he was
working in his garden today and became disoriented and had slurred speech. She
helped him back into the house, gave him cool fluids, and within 15 minutes his
symptoms resolved. He appears in his usual state of health when he is examined. He
states that although he was scared by the event, he feels fine now. How should the
nurse practitioner proceed?
Prescribe an aspirin daily.
Re-examine him tomorrow.
Send him to the emergency department. Correct
Order an EKG.
Explanation:
This patient likely suffered a transient ischemic attack. He needs urgent evaluation with
head CT and/or MRI, ECG, lab work (CBC, PTT, lytes, creatinine, glucose, lipids and
sedimentation rate); possible magnetic resonance angiography, carotid ultrasound,
and/or transcranial Doppler He is at increased risk of stroke within
ultrasonography. the
first 48 hours after an event like this one. On initial evaluation, the most important
determination to be made is whether the etiology of the stroke or TIA is ischemic or
hemorrhagic. After this determination, treatment can begin. Unfortunately, this
determination cannot be made in the clinic. The patient needs urgent referral to a
center where this evaluation and possible treatment can be performed.
Question:
2- The most common presenting sign of Parkinson’s disease is:
muscular rigidity.
tremor. Correct
falling. bradykinesia.
Explanation:
Approximately 70% of patients with Parkinson’s disease have tremor as the presenting
, symptom. The tremor typically involves the hand but can involve the legs, jaw, lips,
tongue. It seldom involves the head. Muscular rigidity and bradykinesia are two less
common presenting signs.
Question:
3- When should medications be initiated in a patient who is diagnosed with
Parkinson’s disease?
As soon as the disease is diagnosed
When symptoms interfere with life’s activities Correct
When nonpharmacologic measures have been exhausted
After MRI and CT have ruled out stroke or tumor
Explanation:
The medications used to treat patients who have Parkinson’s disease do not prevent
progression of the disease. Therefore, it is not necessary to start medications until
symptoms interfere with the patient's quality of life. Levodopa is often used initially at
the lowest dose that helps a patient manage symptoms. It can be titrated upward as
needed. Orthostatic hypotension is a common side effect of levodopa, so blood
pressure should be monitored closely.
Question:
4- A 72-year-old patient with history of polymyalgia rheumatica complains of new
onset, unilateral headache and visual changes. Her neurologic exam is otherwise
normal. What is the most likely reason for her symptoms?
Image 1
Image 2
Test Bank For Health Promotion Questions And
Answers Verified 100% Correct
A 76-year-old patient who is very active has elevated cholesterol and LDLs. He had
been treated for hypertension for > 10 years with near normal blood pressures. What
is the current recommendation for managing his lipids?
No treatment should take place since his age exceeds 75 years.
He should be treated with an aspirin only.
He should be treated with a statin. Correct
The benefits of treating this patient do not exceed the risk of using a statin or aspirin.
Explanation:
Numerous studies (PROSPER, 2006) and learned authorities (including the USPSTF)
have found that lipid-lowering drug therapy decreases the incidence of coronary heart
disease and vascular events in middle-aged and older adults. The current
recommendation is to screen and treat lipid abnormalities in patients who are at risk for
a cardiac event. It is unclear whether treatment of middle-aged and older adults at low
risk for cardiac events is beneficial.
Question:
What is true regarding the shingles vaccine given to adults at or after age 50?
It is a weakened form of the chickenpox virus.
It is the same as the chickenpox virus.
It contains significantly more virus than the chickenpox vaccine. Correct
It is not related to the chickenpox immunization at all.
Explanation:
The shingles (Herpes zoster) vaccine contains 14 times the number of plaque-forming
units of virus than the varicella vaccine. The immunization has reduced the incidence of
shingles and postherpetic neuralgia in adults who received it. The vaccine is
recommended by CDC for all immunocompetent adults who are 60 years or older. It is
given once. The FDA has approved use of this vaccine at age 50 years. The vaccine is
only used to prevent shingles. It is not used to treat shingles or postherpetic neuralgia.
Question:
An oral antifungal agent is commonly used to treat tinea unguium. The difficulty in
treating an older adult with this is infection is:
,absorption of the
tolerability
of the medication. Correct
medication. applying the medication
twice daily. relative
ineffectiveness of oral agents.
Explanation:
The most efficacious agents used to treat toenail fungus are the oral antifungal agents.
They must be taken daily for 8-16 weeks (or longer) for adequate length of treatment.
Additionally, the real difficulty lies in the ability of the older adult's liver to handle this
medication. Oral antifungal agents require great amounts of the liver’s resources for
metabolism. A topical agent or toenail removal may be a better choice for an older
adult.
Question:
What is the recommendation for daily multivitamin supplementation in older adults?
Supplementation reduces morbidity.
Supplementation reduces mortality.
It decreases the relative risk of dementia.
It has no proven benefit. Correct
Explanation:
No studies have demonstrated specific benefit to daily consumption of multivitamins in
older adults. However, a daily multivitamin supplement ensures adequate intake of
essential vitamins and so should be considered for older adults.
Question:
In older adult females, which screening test has demonstrated greatest reduction in
mortality from cancer?
Breast Correct
Cervical
Ovarian
Lung
Explanation:
There are no recommendations for screening for ovarian or lung cancer in older
women. Cervical cancer is primarily a disease found in younger women. When it is
identified in older adults, there is usually a higher mortality rate than in younger
women. However, the incidence of cervical cancer is much lower in older adults.
Screening for breast cancer has demonstrated the highest reduction in mortality.
,Mammography should be performed every 1-2 years, according to the American
Geriatrics Society.
NEUROLOGICO (63)
Question:
1- A patient who is 82 years old is brought into the clinic. His wife states that he was
working in his garden today and became disoriented and had slurred speech. She
helped him back into the house, gave him cool fluids, and within 15 minutes his
symptoms resolved. He appears in his usual state of health when he is examined. He
states that although he was scared by the event, he feels fine now. How should the
nurse practitioner proceed?
Prescribe an aspirin daily.
Re-examine him tomorrow.
Send him to the emergency department. Correct
Order an EKG.
Explanation:
This patient likely suffered a transient ischemic attack. He needs urgent evaluation with
head CT and/or MRI, ECG, lab work (CBC, PTT, lytes, creatinine, glucose, lipids and
sedimentation rate); possible magnetic resonance angiography, carotid ultrasound,
and/or transcranial Doppler He is at increased risk of stroke within
ultrasonography. the
first 48 hours after an event like this one. On initial evaluation, the most important
determination to be made is whether the etiology of the stroke or TIA is ischemic or
hemorrhagic. After this determination, treatment can begin. Unfortunately, this
determination cannot be made in the clinic. The patient needs urgent referral to a
center where this evaluation and possible treatment can be performed.
Question:
2- The most common presenting sign of Parkinson’s disease is:
muscular rigidity.
tremor. Correct
falling. bradykinesia.
Explanation:
Approximately 70% of patients with Parkinson’s disease have tremor as the presenting
, symptom. The tremor typically involves the hand but can involve the legs, jaw, lips,
tongue. It seldom involves the head. Muscular rigidity and bradykinesia are two less
common presenting signs.
Question:
3- When should medications be initiated in a patient who is diagnosed with
Parkinson’s disease?
As soon as the disease is diagnosed
When symptoms interfere with life’s activities Correct
When nonpharmacologic measures have been exhausted
After MRI and CT have ruled out stroke or tumor
Explanation:
The medications used to treat patients who have Parkinson’s disease do not prevent
progression of the disease. Therefore, it is not necessary to start medications until
symptoms interfere with the patient's quality of life. Levodopa is often used initially at
the lowest dose that helps a patient manage symptoms. It can be titrated upward as
needed. Orthostatic hypotension is a common side effect of levodopa, so blood
pressure should be monitored closely.
Question:
4- A 72-year-old patient with history of polymyalgia rheumatica complains of new
onset, unilateral headache and visual changes. Her neurologic exam is otherwise
normal. What is the most likely reason for her symptoms?
Image 1
Image 2
