1. A 73-year-old retired accountant comes to your office for
her annual examination. She has incontinence of urine when
she coughs or sneezes. She takes several medications for
control of hypertension and diabetes. You use the DIAPERS
mnemonic to assess the cause of her incontinence. All of the...
D) Copying intersecting pentagrams
NR 509 Questions with Ans: A
Rationale Answers If the patient is unable to remember three items after 1 minute
has passed, then this is a positive screening test and indicates a
1. A 73-year-old retired accountant comes to your office for
need for further testing.
her annual examination. She has incontinence of urine when
This is part of the "10-Minute Geriatric Screener."
she coughs or sneezes. She takes several medications for
control of hypertension and diabetes. You use the DIAPERS
3. Which of the following questions is part of the screening for
mnemonic to assess the cause of her incontinence. All of the
physical disability?
following are items represented by the mnemonic except for:
A) Are you able to go shopping for groceries or clothes?
A) Atrophic vaginitis
B) Are you able to walk one block?
B) Depression
C) Are you able to pass the driver's license test?
C) Pharmaceuticals
D) Are you able to perform light dusting and pick up after
D) Restricted mobility
yourself around the house?
Ans: B
Ans: A
Depression is not a risk factor for incontinence. The D in the
This is part of the Physical Disability screening portion of the
mnemonic stands for delirium.
10-Minute Geriatric Screener.
2. Which of the following brief screening measures is useful in
4. It is summer and an 82-year-old woman is brought to you
assessing memory?
from her home after seeing her primary care doctor 2 days ago.
A) Three-item recall
She was started on an antibiotic at that time. Today, she comes
B) Serial 7s
to the emergency room not knowing where she is or what year
C) Spelling "world" backward
it is. What could be a likely cause of this?
, A) Alzheimer's dementia Isolated systolic hypertension is common in the elderly
B) Stroke because of stiffening of the large arteries. This is often
C) Delirium accompanied by widening of the pulse pressure. Orthostatic BP
D) Meningitis changes are often seen with postural changes and can account
Ans: C for falls as well.
These are not signs of normal aging and seem to be of acute
onset. This makes Alzheimer's less likely. Stroke and 6. Which of the following represents age-related changes in the
meningitis could cause these symptoms as well, but the lungs?
combination of the heat and a recent infection make delirium A) Decrease in chest wall compliance
much more likely. Though she was prescribed an antibiotic, B) Speed of expiration increases
she may not have improved because of bacterial resistance or C) Increase in respiratory muscle strength
because of noncompliance due to cost, depression, or even an D) Increased elastic recoil of lung tissue
underlying mild dementia. Ans: A
Dementia should not result in an acute mental status change, The lungs age along with the rest of the body. These changes
although illness may cause a worsening of dementia. include decreased lung and chest wall compliance, increased
expiratory time, decreased muscle strength and cough, and
5. Blood pressure abnormalities found more commonly in decreased elastic recoil.
Western elderly include which of the following?
A) Isolated elevation of the diastolic BP 7. Which of the following changes are expected in vision as
B) Narrow pulse pressure part of the normal aging process?
C) Elevation of the systolic BP A) Cataracts
D) Elevation of the BP with standing B) Glaucoma
Ans: C C) Macular degeneration
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