NR601 | NR 601 Final Exam | Primary
Care of the Maturing and Aged Family
Final Exam | 2024/2025 Guide |
Chamberlain
A 60yo woman w/30 pack yr hx, presents for eval of persistent, daily
cough w/increased sputum, worse in the AM, occurring over past 3
months. She tells you, "I have the same thing year after year." Which of
the following choices would you consider strongly in your critical thinking
process?
- Correct Answer - Chronic bronchitis
JM is a 68yo man who presents for a physical. He has T2DM x5yrs, diet
controlled. His BMI is 32. He has HTN, smoker (10 cigs/day x20yrs). He
denies other medical problems. Fam hx includes CAD, CABG x4 for dad,
now deceased; CHF, T2DM, HTN for mom. He is asymptomatic today,
exam is normal, EKG NSR. According to AHA/ACC guidelines, JM is at
risk for what stage of HF?
- Correct Answer - Stage A
The volume of air a pt is able to exhale for total duration of the test
during maximal effort is:
- Correct Answer - FVC
According to the 2017 ACC HTN guidelines, normal BP is:
- Correct Answer - <120/80
,Functional abilities are best assessed by:
- Correct Answer - Observed assessment of function
LB is a 77yo pt w/chronic poorly controlled HTN. You know that goals
include prevention of target organ damage. During your eval you will
assess for evidence of:
- Correct Answer - L ventricular hypertrophy
Aortic regurgitation requires medical treatment for early signs of HF with:
- Correct Answer - ACEi
The volume of air in the lungs at max inflation is:
- Correct Answer - TLC (total lung capacity)
Preferred amount of exercise for older adults is:
- Correct Answer - 30min/day of aerobic activity 5 days/wk
The total volume of air a pt is able to exhale in the first second during
max effort is: - Correct Answer - FEV1
You know the following statements regarding the pain of acute coronary
syndrome are true except:
a. Present atypically more often in men than women
b. May be retrosternal or poorly localized
c. May last longer than 20min
d. May radiate to arms, back, neck, jaw
- Correct Answer - A
,Elderly pt presents w/new onset of feeling heart race, fatigue. EKG
reveals afib w/rate >100. Pt also has a new tremor in both hands. Which
of the following would you suspect?
- Correct Answer - Hyperthyroidism
62yo female c/o fatigue, lack of energy. Constipation increased, pt
gained 10lbs in past 3mo. Depression is denied although pt reports lack
of interest in usual hobbies. VS are WNL, skin is dry/cool. Which of the
following must be included in the DD?
- Correct Answer - Hypothyroidism
Mrs. Black, 87yo, has been taking 100mcg Synthroid x10yrs. She comes
for routine follow-up, feeling well. HR is 90. Your first response is to:
- Correct Answer - Order TSH
Which pt is most likely to have osteoporosis?
- Correct Answer - 80yo underweight male who smokes and has been on
steroids for psoriasis
When evaluating the expected outcome for hypothyroid elderly pt on
levothyroxine, you will:
- Correct Answer - Assess TSH in 4-6wks
Postmenopausal woman w/osteoporosis is taking bisphosphonate daily
PO. What action info statement would indicate she understood your
instructions regarding this med?
- Correct Answer - Take med w/full glass of water when up in the AM
30min before other food and meds
, Primary reason levothyroxine sodium is initiated at low dose in elderly pt
w/hypothyroidism is to prevent which of the following untoward effects?
- Correct Answer - Angina and arrhythmia
6mo ago an elderly pt was dx'd w/subclinical hypothyroidism. Today the
pt returns and has TSH of 11 and c/o fatigue. He has taken Synthroid
25mcg daily as prescribed. What is the best course of action?
- Correct Answer - Double the dose
A fluoroquinolone (Cipro) is prescribed for a male pt w/a UTI. What
should you teach him regarding this med?
- Correct Answer - Its effectiveness is decreased by antacids, iron, or
caffeine
Pt has been rx'd metformin (Glucophage). One wk later, he returns
w/lowered BGL but c/o loose stools during the week. How should you
respond? - Correct Answer - Reassure him that this is an anticipated SE
Which of the following s/s of hyperthyroidism commonly manifest in
younger populations, but is notably lacking in elderly?
- Correct Answer - Exopthalmos
60yo obese male has T2DM and lipid panel of TC = 250, HDL = 32, LDL
= 165. You teach him about his modifiable cardiac risk factors, which
include: - Correct Answer - DM, obesity, hyperlipidemia
Diabetic pt presents w/R foot pain but denies any recent known injury.
He states it has gotten progressively worse over past few months. On
exam, vibratory sense, as well as sensation tested w/monofilament, was
