NRNP 6540 Didactic - Questions With Correct
Solutions
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
,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
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
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
men have faster and more efficient biotransformation of drugs and this is
thought to be due to Correct Answer - testosterone
the cytochrome P system involves enzymes that are generally Correct
Answer - Inhibited or induced by drugs
a statement not shown to be true about pharmacodynamics changes with
aging Correct Answer - and hand sensitivity to central nervous system
drugs
drug responsiveness can be influenced by patients activity level
decreased sensitivity to beta blockers
Solutions
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
,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
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
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
men have faster and more efficient biotransformation of drugs and this is
thought to be due to Correct Answer - testosterone
the cytochrome P system involves enzymes that are generally Correct
Answer - Inhibited or induced by drugs
a statement not shown to be true about pharmacodynamics changes with
aging Correct Answer - and hand sensitivity to central nervous system
drugs
drug responsiveness can be influenced by patients activity level
decreased sensitivity to beta blockers
