N607 Exam 3 Study Guide Page 1 of 67
607 Study Guide
Exam 3 (Modules 10-14) Spring 25
13th Ed/12th Ed
1. Screening for dietary intake – what are some red flags in the elderly – be able to
recognize the outlier
2. Falls - stance phase of gait – Chapter 23 chapter 16 (pg. 676: 16-2)
3. Skin lesions/rashes – id, treatments, complications, descriptions (you will id
pictures) – I would focus on tinea types, psoriasis, pityriasis rosea, scabies,
furuncles, scabies, actinic keratoses, actinic purpura. There are pics at the back of
the chapter. Also know characteristics of these and who they are most common in.
Don’t rely just on the pictures or the text. Know these. You will see these in practice.
4. Skin cancer – melanoma – know the risk factors
5. Somatic symptoms – pay special attention to Table 9-4 table 5-1
6. Hallucination, delusions, illusions
7. Depression screening
8. Screening for dementia
9. Look up hemianopsia through another resource – know what this is
10. Common or concerning symptoms in the health history: general approach for
cognition, behavior, and mental status
11. Evaluation of thought processes/communication/cognition – pay special attention to
box 9-7 p 161-162
12. PTSD
13. Types of aphasia – this is in Chapter 24 - know table 24-2 and how to apply in a
patient description chapter 17 table 17-6
14. Glaucoma diagnostic cup to disc ratio – yes again – learn it
15. Alcohol abuse in older adults – know the clues – big hint here
,N607 Exam 3 Study Guide Page 2 of 67
16. Asterixis
17. SGA/LGA – Intrauterine growth curve chart – look on p 951 and know values to be
able to interpret whether SGA, AGA, or LGA p 808
18. Pregnancy signs/issues – Braxton Hicks contractions, quickening, amenorrhea, linea
nigra, hyperemesis gravidarum, urinary frequency
19. Foods to avoid during pregnancy
20. Gestational diabetes – 1. What hormone may contribute to this? 2. When should we
screen for it?
21. Immunizations and pregnancy
22. Skin Lesion evaluation – look at pages 287-289 not just what is in bold!! Starting on
page 191
23. Signs of schizophrenia –
https://www.mayoclinic.org/diseases-conditions/schizophrenia/symptoms-causes/
syc-20354443
24. Nutrition in older adults
25. Nail abnormalities – Beau lines, pitting, Terry nails, onychomycosis
26. Common concerns during pregnancy Box 26-2
27. Fundal height – how to measure
28. Fetal demise
29. Age related changes in thorax and lungs, male and female genitourinary
30. Instrumental activities of daily living vs activities of daily living
31. Medication safety in older adults
32. Naegele’s Rule know this and be able to calculate
33. Suicide risk factors – be specific
34. Older adult immunizations – know box 27-10 tetanus/diptheria/pertussis, influenza,
zoster, pneumonia
,N607 Exam 3 Study Guide Page 3 of 67
N607 Study Guide for Exam 3
1. Screening for Dietary Intake in the Elderly
Red Flags in the Elderly:
Unintentional weight loss
Malnutrition indicators (low albumin, vitamin deficiencies)
Difficulty chewing/swallowing
Poor appetite
Limited access to food
Dependency on others for meals
Signs of dehydration
Example Question: What is a significant dietary red flag in an elderly patient who reports recent
weight loss and difficulty swallowing?
A) Increased appetite
B) Difficulty chewing and weight loss
C) High BMI
D) Increased thirst
Answer: B
2. Falls & Gait Stance Phase: refer to chapter 16 pg. 676 (16-2)
Key Points: During gait, the stance phase, when the foot is in contact
with the ground, is crucial for stability and can be altered in
individuals at risk for falls, with changes in double-support time and
variability in gait patterns being key indicators.
Stance phase abnormalities can indicate balance issues and potential fall risk
Ataxic gait: Wide-based, unsteady gait seen in cerebellar dysfunction
✅ Stance Phase of Gait and its components (60% of Gait Cycle)
Book: when the foot is in contact with the ground
Weight bearing phase of the gait cycle
Most hip problems appear during the weight bearing stance phase
, N607 Exam 3 Study Guide Page 4 of 67
The knee should be flexed throughout the Stance Phase except when the heel strikes
the ground to counteract motion at the ankle.
1. Heel Strike (Initial Contact):
o Heel makes contact with the ground.
o Muscles: Tibialis anterior (controls foot lowering), glute max (stabilizes hip).
2. Foot Flat (Loading Response):
o Entire foot comes into contact with the ground.
o Body begins to absorb shock.
o Quads work eccentrically to control knee flexion.
3. Midstance:
o Body weight is fully over the supporting leg.
o Hip abductors (glute med/min) stabilize pelvis.
o Tibialis posterior helps control foot pronation.
4. Push-Off (Terminal Stance → Pre-Swing):
o Heel lifts, weight shifts to forefoot, preparing to leave ground.
o Gastrocnemius and soleus provide propulsion.
o Big toe extension and plantar flexors critical.
✅ Swing Phase of Gait (40% of Gait Cycle)
Book: when the foot is lifted off of the ground and moving forward
Non-weight bearing phase
This phase occurs when the foot is off the ground and moving forward in preparation for the
next heel strike.
🦶 Sub-Phases:
1. Initial Swing (Acceleration):
o Begins when the foot leaves the ground.
o Hip flexors (iliopsoas, rectus femoris) and ankle dorsiflexors (tibialis anterior) lift
the leg and clear the foot.
2. Mid-Swing:
o The leg swings directly beneath the body.
607 Study Guide
Exam 3 (Modules 10-14) Spring 25
13th Ed/12th Ed
1. Screening for dietary intake – what are some red flags in the elderly – be able to
recognize the outlier
2. Falls - stance phase of gait – Chapter 23 chapter 16 (pg. 676: 16-2)
3. Skin lesions/rashes – id, treatments, complications, descriptions (you will id
pictures) – I would focus on tinea types, psoriasis, pityriasis rosea, scabies,
furuncles, scabies, actinic keratoses, actinic purpura. There are pics at the back of
the chapter. Also know characteristics of these and who they are most common in.
Don’t rely just on the pictures or the text. Know these. You will see these in practice.
4. Skin cancer – melanoma – know the risk factors
5. Somatic symptoms – pay special attention to Table 9-4 table 5-1
6. Hallucination, delusions, illusions
7. Depression screening
8. Screening for dementia
9. Look up hemianopsia through another resource – know what this is
10. Common or concerning symptoms in the health history: general approach for
cognition, behavior, and mental status
11. Evaluation of thought processes/communication/cognition – pay special attention to
box 9-7 p 161-162
12. PTSD
13. Types of aphasia – this is in Chapter 24 - know table 24-2 and how to apply in a
patient description chapter 17 table 17-6
14. Glaucoma diagnostic cup to disc ratio – yes again – learn it
15. Alcohol abuse in older adults – know the clues – big hint here
,N607 Exam 3 Study Guide Page 2 of 67
16. Asterixis
17. SGA/LGA – Intrauterine growth curve chart – look on p 951 and know values to be
able to interpret whether SGA, AGA, or LGA p 808
18. Pregnancy signs/issues – Braxton Hicks contractions, quickening, amenorrhea, linea
nigra, hyperemesis gravidarum, urinary frequency
19. Foods to avoid during pregnancy
20. Gestational diabetes – 1. What hormone may contribute to this? 2. When should we
screen for it?
21. Immunizations and pregnancy
22. Skin Lesion evaluation – look at pages 287-289 not just what is in bold!! Starting on
page 191
23. Signs of schizophrenia –
https://www.mayoclinic.org/diseases-conditions/schizophrenia/symptoms-causes/
syc-20354443
24. Nutrition in older adults
25. Nail abnormalities – Beau lines, pitting, Terry nails, onychomycosis
26. Common concerns during pregnancy Box 26-2
27. Fundal height – how to measure
28. Fetal demise
29. Age related changes in thorax and lungs, male and female genitourinary
30. Instrumental activities of daily living vs activities of daily living
31. Medication safety in older adults
32. Naegele’s Rule know this and be able to calculate
33. Suicide risk factors – be specific
34. Older adult immunizations – know box 27-10 tetanus/diptheria/pertussis, influenza,
zoster, pneumonia
,N607 Exam 3 Study Guide Page 3 of 67
N607 Study Guide for Exam 3
1. Screening for Dietary Intake in the Elderly
Red Flags in the Elderly:
Unintentional weight loss
Malnutrition indicators (low albumin, vitamin deficiencies)
Difficulty chewing/swallowing
Poor appetite
Limited access to food
Dependency on others for meals
Signs of dehydration
Example Question: What is a significant dietary red flag in an elderly patient who reports recent
weight loss and difficulty swallowing?
A) Increased appetite
B) Difficulty chewing and weight loss
C) High BMI
D) Increased thirst
Answer: B
2. Falls & Gait Stance Phase: refer to chapter 16 pg. 676 (16-2)
Key Points: During gait, the stance phase, when the foot is in contact
with the ground, is crucial for stability and can be altered in
individuals at risk for falls, with changes in double-support time and
variability in gait patterns being key indicators.
Stance phase abnormalities can indicate balance issues and potential fall risk
Ataxic gait: Wide-based, unsteady gait seen in cerebellar dysfunction
✅ Stance Phase of Gait and its components (60% of Gait Cycle)
Book: when the foot is in contact with the ground
Weight bearing phase of the gait cycle
Most hip problems appear during the weight bearing stance phase
, N607 Exam 3 Study Guide Page 4 of 67
The knee should be flexed throughout the Stance Phase except when the heel strikes
the ground to counteract motion at the ankle.
1. Heel Strike (Initial Contact):
o Heel makes contact with the ground.
o Muscles: Tibialis anterior (controls foot lowering), glute max (stabilizes hip).
2. Foot Flat (Loading Response):
o Entire foot comes into contact with the ground.
o Body begins to absorb shock.
o Quads work eccentrically to control knee flexion.
3. Midstance:
o Body weight is fully over the supporting leg.
o Hip abductors (glute med/min) stabilize pelvis.
o Tibialis posterior helps control foot pronation.
4. Push-Off (Terminal Stance → Pre-Swing):
o Heel lifts, weight shifts to forefoot, preparing to leave ground.
o Gastrocnemius and soleus provide propulsion.
o Big toe extension and plantar flexors critical.
✅ Swing Phase of Gait (40% of Gait Cycle)
Book: when the foot is lifted off of the ground and moving forward
Non-weight bearing phase
This phase occurs when the foot is off the ground and moving forward in preparation for the
next heel strike.
🦶 Sub-Phases:
1. Initial Swing (Acceleration):
o Begins when the foot leaves the ground.
o Hip flexors (iliopsoas, rectus femoris) and ankle dorsiflexors (tibialis anterior) lift
the leg and clear the foot.
2. Mid-Swing:
o The leg swings directly beneath the body.
