NR 601: Chamberlain Geriatric Class chapter questions for the
final Exam Questions with Verified Answers (Correct Update)
Question 1: . An 86-year-old female comes to your office for a wellness visit. Her blood pressure is
125/70 mmHg, pulse 69 beats per min, and respiratory rate 18 breaths per min. She is well appearing
and reports she is up to date on her routine vaccinations. She introduces her partner of 35 years
whom she would like to make medical decisions for her in case she becomes unable to make decisions
for herself. She reports that she and her partner are not married. She asks if she needs any further
documentation to ensure her goals of care are followed. Which one of the following would be the
most appropriate recommendation for this patient and her partner?
A. Advise them to complete a POLST.
B. Advise them that they have adequate documentation to be recognized legally.
C. Advise them to file an advanced directive.
D. Respond that although they lack documentation, her partner will be recognized de facto
Answer: C. Advise them to file an advanced directive.
Question 2: . An 81-year-old transgender female with history of depression and hyperlipidemia
presents to your clinic for routine care. She endorses a history of smoking, currently smoking 1 pack
per day, and occasionally drinks a glass of wine, although she denies illicit drug use. She reports she
takes atorvastatin 20 mg and subcutaneous estrogen therapy. Which of the following the most
important next step in this patient's primary care?
A. Counseling on starting aspirin
B. Counseling on alcohol cessation
C. Counseling on smoking cessation
D. Counseling on mammogram
Answer: C. Counseling on smoking cessation. is
Question 3: An 84-year-old male with history of stroke without residual deficit, systolic heart failure,
and type 2 diabetes presents to clinic for follow-up. He is independently living in a retirement
community and still works part time on a golf course. He currently takes aspirin 81 mg, metoprolol
tartrate 25 mg BID (twice a day), furosemide 20 mg BID, and lisinopril 10 mg daily. He reports his
last colonoscopy was 8 years ago, with no abnormality. He reports he is sexually active with men and
women, engaging in receptive oral, receptive anal, and penetrative sex. He states he has had over
three sexual partners in the last year with intermittent condom use. What sexually transmitted
infection testing should be offered?
A. Urine testing
B. Urine testing, blood testing
C. Urine testing, blood testing, anal swab
D. Urine testing, blood testing, anal swab, and oropharyngeal swab
Answer: D. Urine testing, blood testing, anal swab, and oropharyngeal swab
Page 1
,Question 4: Which of the following is true about tolterodine?
A. It should be avoided in men with prostatic hypertrophy.
B. It increases the risk of constipation compared with oral oxybutynin.
C. It acts by ablating detrusor spasms.
D. It has greater risk of adverse effects with its twice-daily formulation.
Answer: D. It has greater risk of adverse effects with its twice-daily formulation.
Question 5: An 82-year-old man, Mr. A, complains of worsening nocturia, occurring four times per
night. His other lower urinary tract symptoms are slow stream, occasional urgency, and
urgency-related leakage once weekly. Medical problems include poorly controlled hypertension,
diastolic heart failure, hyperlipidemia, osteoarthritis, and prediabetes. His medications include
lisinopril 20 mg daily, metoprolol succinate 75 mg daily, atorvastatin 10 mg daily, metformin 500 mg
twice daily, hydrocodone-acetaminophen as needed, and aspirin 81 mg daily. Amlodipine 5 mg daily
was recently added by his cardiologist. On review of systems, Mr. A complains that nocturia is
causing daytime fatigue, and he is more constipated. Physical examination is notable for blood
pressure 162/83 mmHg, heart rate 60 beats per minute, clear lungs, soft abdomen, enlarged prostate,
and 21 pretibial edema. Your next step in management should be:
A. Stop hydrocodone-acetaminophen and add naproxen
B. Stop amlodipine and increase lisinopril.
C. Add afternoon furosemide.
D. Add tamsulosin.
Answer: B. Stop amlodipine and increase lisinopril.
Question 6: 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 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?
A. Mrs. A's physician
B. Mrs. A's daughter
C. Day program staff
D. Physical therapist through a home care agency
Answer: C. Day program staff. of
Page 2
, Question 7: 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 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?
A. Bladder training
B. Referral for biofeedback training in pelvic muscle exercise
C. Trial of solifenacin
D. Trial of topical estrogen
Answer: A. Bladder training
Question 8: What is the most common cause of erectile dysfunction in older men?
A. Psychological stress
B. Adverse drug reaction
C. Atherosclerosis
D. Autonomic neuropathy
Answer: C. Atherosclerosis
Question 9: Which is the most reasonable first step in the treatment of older men with erectile
dysfunction?
A. Sex therapy
B. Testosterone
C. Yohimbine
D. Sildenafil
Answer: D. Sildenafil
Question 10: 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?
A. Stop glyburide
B. Stop chlorthalidone
C. Stop acetaminophen
D. Start topical vaginal lubricant
Answer: B. Stop chlorthalidone
Page 3
final Exam Questions with Verified Answers (Correct Update)
Question 1: . An 86-year-old female comes to your office for a wellness visit. Her blood pressure is
125/70 mmHg, pulse 69 beats per min, and respiratory rate 18 breaths per min. She is well appearing
and reports she is up to date on her routine vaccinations. She introduces her partner of 35 years
whom she would like to make medical decisions for her in case she becomes unable to make decisions
for herself. She reports that she and her partner are not married. She asks if she needs any further
documentation to ensure her goals of care are followed. Which one of the following would be the
most appropriate recommendation for this patient and her partner?
A. Advise them to complete a POLST.
B. Advise them that they have adequate documentation to be recognized legally.
C. Advise them to file an advanced directive.
D. Respond that although they lack documentation, her partner will be recognized de facto
Answer: C. Advise them to file an advanced directive.
Question 2: . An 81-year-old transgender female with history of depression and hyperlipidemia
presents to your clinic for routine care. She endorses a history of smoking, currently smoking 1 pack
per day, and occasionally drinks a glass of wine, although she denies illicit drug use. She reports she
takes atorvastatin 20 mg and subcutaneous estrogen therapy. Which of the following the most
important next step in this patient's primary care?
A. Counseling on starting aspirin
B. Counseling on alcohol cessation
C. Counseling on smoking cessation
D. Counseling on mammogram
Answer: C. Counseling on smoking cessation. is
Question 3: An 84-year-old male with history of stroke without residual deficit, systolic heart failure,
and type 2 diabetes presents to clinic for follow-up. He is independently living in a retirement
community and still works part time on a golf course. He currently takes aspirin 81 mg, metoprolol
tartrate 25 mg BID (twice a day), furosemide 20 mg BID, and lisinopril 10 mg daily. He reports his
last colonoscopy was 8 years ago, with no abnormality. He reports he is sexually active with men and
women, engaging in receptive oral, receptive anal, and penetrative sex. He states he has had over
three sexual partners in the last year with intermittent condom use. What sexually transmitted
infection testing should be offered?
A. Urine testing
B. Urine testing, blood testing
C. Urine testing, blood testing, anal swab
D. Urine testing, blood testing, anal swab, and oropharyngeal swab
Answer: D. Urine testing, blood testing, anal swab, and oropharyngeal swab
Page 1
,Question 4: Which of the following is true about tolterodine?
A. It should be avoided in men with prostatic hypertrophy.
B. It increases the risk of constipation compared with oral oxybutynin.
C. It acts by ablating detrusor spasms.
D. It has greater risk of adverse effects with its twice-daily formulation.
Answer: D. It has greater risk of adverse effects with its twice-daily formulation.
Question 5: An 82-year-old man, Mr. A, complains of worsening nocturia, occurring four times per
night. His other lower urinary tract symptoms are slow stream, occasional urgency, and
urgency-related leakage once weekly. Medical problems include poorly controlled hypertension,
diastolic heart failure, hyperlipidemia, osteoarthritis, and prediabetes. His medications include
lisinopril 20 mg daily, metoprolol succinate 75 mg daily, atorvastatin 10 mg daily, metformin 500 mg
twice daily, hydrocodone-acetaminophen as needed, and aspirin 81 mg daily. Amlodipine 5 mg daily
was recently added by his cardiologist. On review of systems, Mr. A complains that nocturia is
causing daytime fatigue, and he is more constipated. Physical examination is notable for blood
pressure 162/83 mmHg, heart rate 60 beats per minute, clear lungs, soft abdomen, enlarged prostate,
and 21 pretibial edema. Your next step in management should be:
A. Stop hydrocodone-acetaminophen and add naproxen
B. Stop amlodipine and increase lisinopril.
C. Add afternoon furosemide.
D. Add tamsulosin.
Answer: B. Stop amlodipine and increase lisinopril.
Question 6: 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 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?
A. Mrs. A's physician
B. Mrs. A's daughter
C. Day program staff
D. Physical therapist through a home care agency
Answer: C. Day program staff. of
Page 2
, Question 7: 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 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?
A. Bladder training
B. Referral for biofeedback training in pelvic muscle exercise
C. Trial of solifenacin
D. Trial of topical estrogen
Answer: A. Bladder training
Question 8: What is the most common cause of erectile dysfunction in older men?
A. Psychological stress
B. Adverse drug reaction
C. Atherosclerosis
D. Autonomic neuropathy
Answer: C. Atherosclerosis
Question 9: Which is the most reasonable first step in the treatment of older men with erectile
dysfunction?
A. Sex therapy
B. Testosterone
C. Yohimbine
D. Sildenafil
Answer: D. Sildenafil
Question 10: 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?
A. Stop glyburide
B. Stop chlorthalidone
C. Stop acetaminophen
D. Start topical vaginal lubricant
Answer: B. Stop chlorthalidone
Page 3
