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NR 601 Primary Care of the Maturing and Aged Family
Practicum Final Verified Exam QUESTIONS AND
ANSWERS ALREADY GRADED A+. 100% Verified
Solutions | Updated Per Latest Guidelines | Graded
A+||Newest Exam!!!
The daughter of a 79-year-old woman notes that her
mother, who has dementia and lives with her, is wetting
herself when she attends her new day program. Program
staff have requested that "something be done" as she is
requiring a clothes change nearly every time she is there.
She cannot describe the circumstances of leakage, saying
"it just comes." Leakage is uncommon at home. Her
medications include donepezil and acetaminophen.
Physical examination is normal. Initial treatment approach
will require intervention by which of the following? -
Answer-Day program staff
. Ms. J, who is 82 years old, complains of urine leakage
while playing golf. This has gotten worse over the past
year, and she rarely makes it through nine holes without
feeling like she needs to "run into the bushes and go."
Leakage is usually small volume, but causes her extreme
embarrassment because she is afraid she will smell of
urine. She has tried limiting caffeine in the morning before
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she golfs and avoiding drinking water while playing, to no
effect. She also tried "those Kegler" exercises in the past
without success. Which of the following is the most
appropriate recommendation for Ms. J? - Answer-Bladder
training
What is the most common cause of erectile dysfunction in
older men? - Answer-Atherosclerosis
Which is the most reasonable first step in the treatment of
older men with erectile dysfunction? - Answer-Sildenafil
A 72-year-old woman reports vaginal dryness that
interferes with coitus. Her medical history includes type 2
diabetes, hypertension, and osteoarthritis. Medications are
glyburide, chlorthalidone, and acetaminophen. What would
be your first step in therapy? - Answer-Stop chlorthalidone
A 70-year-old woman reports sexual pain with deep
penetration only. What is the most likely cause of her
problem? - Answer-High-tone pelvic floor dysfunction
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A 79-year-old woman with a 1.5-cm breast cancer
underwent lumpectomy. Pathology revealed ductal
carcinoma that is hormone receptor negative (estrogen
receptor 0%, progesterone receptor 1%) and HER2/neu
negative. Surgical margins were adequate and uninvolved
with cancer. Sentinel lymph node sampling was negative
for lymph node involvement. She has good performance
status and no activities of daily living (ADL) or instrumental
(IADL) dependencies. What treatment would you
recommend? - Answer-Hormonal therapy only
An 86-year-old man with no ADL deficits who has stopped
driving because of macular degeneration is evaluated for a
urinary tract infection associated with urinary retention.
The consulting urologist places a Foley catheter and
sends a prostate-specific antigen (PSA) level that comes
back 12 ng/mL. Three months later after the Foley has
been removed and he has had a good response to
tamsulosin, his PSA is still 10 ng/mL. What is the
appropriate next step in managing this man's prostate
problem? - Answer-Repeat PSA in 6 months
In which of the following patients is chemical or surgical
castration likely to prolong survival? - Answer-A 78-year-
old man who had a radical prostatectomy and external
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beam radiation therapy 10 years earlier now has a PSA
level of 24.5 ng/mL. A CT scan of the pelvis shows an
enlarged pelvic lymph node, and a bone scan is positive in
the pelvis.
On admission to the hospital, an 85-year-old woman was
found to have a fungating mass on her right breast. The
mass is 9 cm in diameter, partially ulcerated, and
associated with edema of the arm and obvious pain. The
patient has no children and had lived alone until recently,
when a neighbor became concerned for what appeared to
be a progressive loss of memory and neglect of the house.
A nephew living in another city eventually came to take
care of the situation and arranged for the admission. The
patient appears confused and withdrawn; her appearance
is disheveled, but she seems to be independent in her
ADLs. The medical history is negative for any serious
illnesses. She was able to drive her own car until shortly
before this admission. The nephew does not wish to
authorize hospice "right now." A positron-emission
tomography scan was negative for metastatic disease. In
addition to determining the cause of her deliri - Answer-
The mass should be biopsied to study hormone receptor
and HER2/neu antigen status.
NR 601 Primary Care of the Maturing and Aged Family
Practicum Final Verified Exam QUESTIONS AND
ANSWERS ALREADY GRADED A+. 100% Verified
Solutions | Updated Per Latest Guidelines | Graded
A+||Newest Exam!!!
The daughter of a 79-year-old woman notes that her
mother, who has dementia and lives with her, is wetting
herself when she attends her new day program. Program
staff have requested that "something be done" as she is
requiring a clothes change nearly every time she is there.
She cannot describe the circumstances of leakage, saying
"it just comes." Leakage is uncommon at home. Her
medications include donepezil and acetaminophen.
Physical examination is normal. Initial treatment approach
will require intervention by which of the following? -
Answer-Day program staff
. Ms. J, who is 82 years old, complains of urine leakage
while playing golf. This has gotten worse over the past
year, and she rarely makes it through nine holes without
feeling like she needs to "run into the bushes and go."
Leakage is usually small volume, but causes her extreme
embarrassment because she is afraid she will smell of
urine. She has tried limiting caffeine in the morning before
,2|Page
she golfs and avoiding drinking water while playing, to no
effect. She also tried "those Kegler" exercises in the past
without success. Which of the following is the most
appropriate recommendation for Ms. J? - Answer-Bladder
training
What is the most common cause of erectile dysfunction in
older men? - Answer-Atherosclerosis
Which is the most reasonable first step in the treatment of
older men with erectile dysfunction? - Answer-Sildenafil
A 72-year-old woman reports vaginal dryness that
interferes with coitus. Her medical history includes type 2
diabetes, hypertension, and osteoarthritis. Medications are
glyburide, chlorthalidone, and acetaminophen. What would
be your first step in therapy? - Answer-Stop chlorthalidone
A 70-year-old woman reports sexual pain with deep
penetration only. What is the most likely cause of her
problem? - Answer-High-tone pelvic floor dysfunction
,3|Page
A 79-year-old woman with a 1.5-cm breast cancer
underwent lumpectomy. Pathology revealed ductal
carcinoma that is hormone receptor negative (estrogen
receptor 0%, progesterone receptor 1%) and HER2/neu
negative. Surgical margins were adequate and uninvolved
with cancer. Sentinel lymph node sampling was negative
for lymph node involvement. She has good performance
status and no activities of daily living (ADL) or instrumental
(IADL) dependencies. What treatment would you
recommend? - Answer-Hormonal therapy only
An 86-year-old man with no ADL deficits who has stopped
driving because of macular degeneration is evaluated for a
urinary tract infection associated with urinary retention.
The consulting urologist places a Foley catheter and
sends a prostate-specific antigen (PSA) level that comes
back 12 ng/mL. Three months later after the Foley has
been removed and he has had a good response to
tamsulosin, his PSA is still 10 ng/mL. What is the
appropriate next step in managing this man's prostate
problem? - Answer-Repeat PSA in 6 months
In which of the following patients is chemical or surgical
castration likely to prolong survival? - Answer-A 78-year-
old man who had a radical prostatectomy and external
, 4|Page
beam radiation therapy 10 years earlier now has a PSA
level of 24.5 ng/mL. A CT scan of the pelvis shows an
enlarged pelvic lymph node, and a bone scan is positive in
the pelvis.
On admission to the hospital, an 85-year-old woman was
found to have a fungating mass on her right breast. The
mass is 9 cm in diameter, partially ulcerated, and
associated with edema of the arm and obvious pain. The
patient has no children and had lived alone until recently,
when a neighbor became concerned for what appeared to
be a progressive loss of memory and neglect of the house.
A nephew living in another city eventually came to take
care of the situation and arranged for the admission. The
patient appears confused and withdrawn; her appearance
is disheveled, but she seems to be independent in her
ADLs. The medical history is negative for any serious
illnesses. She was able to drive her own car until shortly
before this admission. The nephew does not wish to
authorize hospice "right now." A positron-emission
tomography scan was negative for metastatic disease. In
addition to determining the cause of her deliri - Answer-
The mass should be biopsied to study hormone receptor
and HER2/neu antigen status.
