NR 509 CHAPTER 20 EXAM QUESTIONS WITH
COMPLETE SOLUTION
Which of the following changes are expected in vision as part of the normal aging
process?
A) Cataracts
B) Glaucoma
C) Macular degeneration
D) Blurring of near vision
D) Blurring of near vision
A 72-year-old retired truck driver comes to the clinic with his wife for evaluation
of hearing loss. He has noticed some decreased ability to hear what his wife and
grandchildren are saying to him. He admits to lip-reading more. He has a history
of noise exposure in his young adult years: He worked as a sound engineer at a
local arena and had to attend a lot of concerts. Based on this information, what is
the most likely finding regarding his hearing acuity?
A) Loss of acuity for middle-range sounds
B) Increase of acuity for low-range sounds
C) Loss of acuity for high-range sounds
D) Increase of acuity for high-range sounds
A) Loss of acuity for middle-range sounds
A 79-year-old retired banker comes to your office for evaluation of difficulty with
urination; he gets up five to six times per night to urinate and has to go at least
that often in the daytime. He does not feel as if his bladder empties completely;
the strength of the urinary stream is diminished. He denies dysuria or hematuria.
This problem has been present for several years but has worsened over the last 8
months. You
palpate his prostate. What is your expected physical examination finding, based
on this description?
A) Normal size, smooth
B) Normal size, boggy
C) Enlarged size, smooth
D) Enlarged size, boggy
C) Enlarged size, smooth
A 70-year-old retired auto mechanic comes to your office because his neighbor is
concerned about his memory. The patient himself admits to misplacing his keys
more often and forgets what he is supposed to buy from the grocery store and
where he has parked the car. He denies getting lost in familiar places. Upon
further questioning, he states that his wife of 40 years died 8 months ago; his
three children live in three different states; and he has limited his activities
because the people he interacted with were "his
wife's friends, not his." He drinks a six-pack of beer daily; he does not smoke or
use illicit drugs. You perform a mini-mental state examination and obtain a total
score of 24 out of 28. Based on this
, information, what is your most likely diagnosis?
A) Benign forgetfulness
B) Dementia
C) Meningitis
D) Depression
D) Depression
An 85-year-old retired teacher comes to your office for evaluation of weakness.
You obtain a complete history, perform a thorough physical examination, and
order laboratory tests. You diagnose her with hyperthyroidism. Based on her age,
which of the atypical symptoms of hyperthyroidism is more likely to be seen?
A) Fatigue
B) Weight loss
C) Tachycardia
D) Anorexia
D) Anorexia
A 78-year-old retired seamstress comes to the office for a routine check-up. You
obtain an ECG
(electrocardiogram) because of her history of hypertension. You diagnose a
previous myocardial infarction and ask her if she had any symptoms related to
this. Which of the following symptoms would be more common in this patient's
age group for an acute myocardial infarction?
A) Chest pain
B) Syncope
C) Pain radiating into the left arm
D) Pain radiating into the jaw
B) Syncope
An 88-year-old retired piano teacher comes for evaluation of fatigue. You notice
that her clothes are hanging loosely off her frame and that she has lost 15
pounds. She is unaware of this. Her husband of 63 years died a few months ago.
You ask the patient to complete a Rapid Screen for Dietary Intake. Which of the
following statements is considered to be part of this rapid screen?
A) I eat more than two meals per day.
B) I drink one glass of alcohol every day.
C) Without wanting to, I have lost or gained 10 pounds in the last 6 months.
D) I eat with at least one other person most of the time.
C) Without wanting to, I have lost or gained 10 pounds in the last 6 months.
An 89-year-old retired school principal comes for an annual check-up. She would
like to know
whether or not she should undergo a screening colonoscopy. She has never
done this before. Which of the following factors should not be considered when
discussing whether she should go for this screening test?
A) Life expectancy
B) Time interval until benefit from screening accrues
C) Patient preference
D) Current age of patient
D) Current age of patient
COMPLETE SOLUTION
Which of the following changes are expected in vision as part of the normal aging
process?
A) Cataracts
B) Glaucoma
C) Macular degeneration
D) Blurring of near vision
D) Blurring of near vision
A 72-year-old retired truck driver comes to the clinic with his wife for evaluation
of hearing loss. He has noticed some decreased ability to hear what his wife and
grandchildren are saying to him. He admits to lip-reading more. He has a history
of noise exposure in his young adult years: He worked as a sound engineer at a
local arena and had to attend a lot of concerts. Based on this information, what is
the most likely finding regarding his hearing acuity?
A) Loss of acuity for middle-range sounds
B) Increase of acuity for low-range sounds
C) Loss of acuity for high-range sounds
D) Increase of acuity for high-range sounds
A) Loss of acuity for middle-range sounds
A 79-year-old retired banker comes to your office for evaluation of difficulty with
urination; he gets up five to six times per night to urinate and has to go at least
that often in the daytime. He does not feel as if his bladder empties completely;
the strength of the urinary stream is diminished. He denies dysuria or hematuria.
This problem has been present for several years but has worsened over the last 8
months. You
palpate his prostate. What is your expected physical examination finding, based
on this description?
A) Normal size, smooth
B) Normal size, boggy
C) Enlarged size, smooth
D) Enlarged size, boggy
C) Enlarged size, smooth
A 70-year-old retired auto mechanic comes to your office because his neighbor is
concerned about his memory. The patient himself admits to misplacing his keys
more often and forgets what he is supposed to buy from the grocery store and
where he has parked the car. He denies getting lost in familiar places. Upon
further questioning, he states that his wife of 40 years died 8 months ago; his
three children live in three different states; and he has limited his activities
because the people he interacted with were "his
wife's friends, not his." He drinks a six-pack of beer daily; he does not smoke or
use illicit drugs. You perform a mini-mental state examination and obtain a total
score of 24 out of 28. Based on this
, information, what is your most likely diagnosis?
A) Benign forgetfulness
B) Dementia
C) Meningitis
D) Depression
D) Depression
An 85-year-old retired teacher comes to your office for evaluation of weakness.
You obtain a complete history, perform a thorough physical examination, and
order laboratory tests. You diagnose her with hyperthyroidism. Based on her age,
which of the atypical symptoms of hyperthyroidism is more likely to be seen?
A) Fatigue
B) Weight loss
C) Tachycardia
D) Anorexia
D) Anorexia
A 78-year-old retired seamstress comes to the office for a routine check-up. You
obtain an ECG
(electrocardiogram) because of her history of hypertension. You diagnose a
previous myocardial infarction and ask her if she had any symptoms related to
this. Which of the following symptoms would be more common in this patient's
age group for an acute myocardial infarction?
A) Chest pain
B) Syncope
C) Pain radiating into the left arm
D) Pain radiating into the jaw
B) Syncope
An 88-year-old retired piano teacher comes for evaluation of fatigue. You notice
that her clothes are hanging loosely off her frame and that she has lost 15
pounds. She is unaware of this. Her husband of 63 years died a few months ago.
You ask the patient to complete a Rapid Screen for Dietary Intake. Which of the
following statements is considered to be part of this rapid screen?
A) I eat more than two meals per day.
B) I drink one glass of alcohol every day.
C) Without wanting to, I have lost or gained 10 pounds in the last 6 months.
D) I eat with at least one other person most of the time.
C) Without wanting to, I have lost or gained 10 pounds in the last 6 months.
An 89-year-old retired school principal comes for an annual check-up. She would
like to know
whether or not she should undergo a screening colonoscopy. She has never
done this before. Which of the following factors should not be considered when
discussing whether she should go for this screening test?
A) Life expectancy
B) Time interval until benefit from screening accrues
C) Patient preference
D) Current age of patient
D) Current age of patient
