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1. A middle aged patient has been diagnosed with Parkinson's disease. What
influences the nurse practitioners decision to begin pharmacological
treatment for this patient?
a. medications initiated at first sign of unilateral involvement
b. gait instability requiring the use of a cane
c. intentional tremors
d. symptoms interfering with functional ability - ANSWER-d. symptoms
interfering with functional ability
2. Which of the following is a role of the advanced practice nurse in palliative
cancer care?
a. detecting cancer in asymptomatic patients or those with specific
symptoms
b. arranging for follow up including patients
c. identifying and managing complications of care
d. all of the above - ANSWER-d. all of the above
3. A 58 year old Caucasian mane with type 2 diabetes mellitus presents to the
clinic as a new patient. He takes metformin 500mg twice a day. His last Hgb
A1c was 7%. He is up to date on eye and foot examinations. His BP is
142/96. According to ACC 2017 guidelines for high blood pressure in adults,
what is the most appropriate first line medication?
a. lisinopril
b. furosemide
c. amlodipine
d. clonidine - ANSWER-a. lisinopril
,4. An older male patient is experiencing acute onset of right sided weakness,
slurred speech and confusion. What should the nurse practitioner do
promptly?
a. order an EKG and administer O2 by cannula immediately
b. Do a through medication review and stat blood sugar
c. evaluate for a stroke and arrange transport to the hospital right away
d. administer an aspirin by mouth - ANSWER-c. evaluate for a stroke
and arrange transport to the hospital right away
5. The NP knows that medications can trigger or worsen heart failure. With this
knowledge in mind, the NP will avoiding prescribing the following classes
of medications
a. benzodiazepines
b. macrolides
c. muscle relaxants
d. NSAIDS - ANSWER-d. NSAIDS
6. MG, a 60 year old female presents with complaints of her "heart flipping in
her chest" The NP wants to evaluate for arrhythmia. The nP knows that the
cornerstone for arrhythmia evaluation includes:
a. electrocardiogram
b. physical examination
c. all options are appropriate
d. history - ANSWER-c. all options are appropriate
7. The elderly are at high risk for delirium because of:
a. multiple medical problems
b. multisensory deficits
c. polypharmacy
d. all of the above - ANSWER-d. all of the above
8. A 68 year old woman presents with a complaint of urine leakage whenever
she sneezes, laughs or strains for the past 4 months. She denies dysuria,
frequency and nocturia. US dipstick is negative for RBC's leukocyte
esterase, nitrates, ketones and urobilinogen. What is the diagnosis?
, a. stress incontinence
b. urinary incontinence
c. urge incontinence
d. overflow incontinence - ANSWER-a. stress incontinence
9. Which of the following signs or symptoms are not characteristics of delirium
a. patient is coherent
b. short duration
c. sudden onset
d. symptoms are worse in the evenings - ANSWER-a. patient is coherent
10.A 52 year old female patient screened for diabetes has a fasting plasma
glucose level of 123 mg/dl. The nurse practitioners plan includes:
a. repeat fasting glucose in 1 month
b. prescribe metformin 500mg BID po
c. repeat fasting plasma glucose in one year
d. repeat fasting glucose in three years - ANSWER-c. repeat fasting
plasma glucose in one year
11.According to the palliative care presentation, most elderly patients die:
a. alone
b. at home
c. in institutions
d. in pain - ANSWER-c. in institutions
12.Older adults with dementia sometimes suffer from agnosia, which is defined
as the inability to
a. remember events and places
b. understand language
c. use language
d. recognize objects - ANSWER-d. recognize objects
13.When treating depression associated with dementia, which of the following
would be a poor choice and not be prescribed
, a. desipramine
b. amitriptyline
c. fluoxetine
d. mirtazapine - ANSWER-b. amitriptyline
14.Male patient presents with a BMI of 30 presents to the office for an annual
exam. You are reviewing the lab results. You ordered a CMP as part of
routine labs. The fasting glucose was 130. Your next action is:
a. repeat the fasting glucose
b. start metformin 500mg BID
c. repeat fasting glucose in 1 year
d. call the patient and report lab results as normal - ANSWER-a. repeat
the fasting glucose
15.The task of grieving include all of the following except
a. begin to disengage
b. acknowledge the reality of death
c. work through the pain of grief
d. restructure relationships - ANSWER-a. begin to disengage
16.All of the following are true statements regarding elder abuse except:
a. a new STI in an elderly patient can be a sign of abuse
b. persons over 80 years of age are at highest risk for abuse
c. missing scheduled appointments and delays in medical care are
common
d. common signs of abuse include decreased anxiety and depression -
ANSWER-d. common signs of abuse include decreased anxiety and
depression
17.Hospice care differs from palliative care in that:
a. it cannot be provided in the nursing home
b. the majority of those admitted to hospice die within 7 days
c. it is not covered by insurance
d. it is designed for the last six months of life - ANSWER-d. it is
designed for the last six months of life