NRNP 6540 Didactic
There are benign and lethal murmurs. Which of the following are true of lethal
murmurs - correct answer 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 - correct answer Class 1 30-35
Class II 35-39.9
Class morbid >40
What is the screening tool for alcohol - correct answer 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 -
correct answer 150/90 for patients without DM or CKD
140/90 for patients with DM or CKD
Why would you initiate statins on elderly patients - correct answer 1-cvd
2 - LDL >190
3-in patients age 40-75, LDL of 70-189
Was what is a positive malnutrition score - correct answer Greater than 10 lb
weight loss in 6 months
Use the MUST tool
Elderly population should you screen for hyperlipidemia - correct answer
Patients that have known hypertension, smoking, or diabetes
,NRNP 6540 Didactic
What is the scales nutrition screening tool - correct answer 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 - correct answer
Snelling chart - annually
Patients with hypertension or diabetes must have a dilated exam annually
What are the hearing screening requirements of patients > 65 - correct answer
Asking questions about whether people say they appear to have problems with
turning the volume up
When should you screen for osteoporosis - correct answer Women >65
Men > 70
You must use a dual energy dxa x-ray
And perform at-score
What is the T score for osteoporosis? - correct answer Normal 1.0
Osteopenia -1 to -2.5
Osteoporosis -2.5
Severe osteoporosis < 2.5 and fragility fracture
What are the mammogram screening requirements - correct answer Age greater
than 40-74
What are the colon cancer screening recommendations - correct answer 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 - correct answer Age
21-65
> age 65 is not required
,NRNP 6540 Didactic
What are the requirements for counseling patients > 65 - correct answer
Exercise, nutrition, tobacco, alcohol
What are the requirements of exercise for patients 65 - correct answer Aerobic
exercise for 30 minutes three times a week
Strength exercise two times a week
What are the alcohol recommendations for an adult - correct answer one per day
for women
Per day for men
What are the pneumonia immunization recommendations for patients >65 -
correct answer Pcv13 first
PPS 23 one year later
What are the zoster immunization recommendations - correct answer 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 - correct
answer 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
, NRNP 6540 Didactic
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 -
correct answer Longitudinal studies
the following statements are true about laboratory values in older adults -
correct answer 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 - correct answer Each individual's
variation is often much smaller than that of a larger group
polypharmacy is best described as - correct answer Even a single med if there is
not a clear indication for its use
pharmacokinetic changes with aging is reflective of - correct answer What the
body does to the drug
All of the following statements are false about drug absorption except - correct
answer Underlying chronic disease has little impact on drug absorption
all of the following statements are true about drug distribution in the elderly -
correct answer 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
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