NR601/NR 601 Midterm Exam Questions With Correct Answers

NR601/NR 601 Midterm Exam Questions With Correct Answers In reviewing lab results for patients with suspected PMR, you realize there is no definitive test to diagnose PMR, rather clinical response to treatment. Results you would expect to see include: - ANSWER -ESR 50 Which of the following is the most appropriate lab test for monitoring gout therapy over the long-term - ANSWER -Serum urate level In providing health teaching related to dietary restrictions, you should advise a patient with gout to avoid which of the following dietary items - ANSWER -Beer, sausage, fried seafood The best method of verifying gout diagnosis in a joint is which of the following - ANSWER Joint aspiration and polarized light microscopy The most appropriate first line treatment for acute gout flare, assuming no kidney disease or elevated bleeding risk - ANSWER -Indomethacin 50mg TID x2 days, then 25mg TID x3 days You order bilateral wrist XR on 69 yo man with c/o both wrists x6 weeks, not related to any known trauma. You suspect early RA. The initial XR finding in apatien with elderly onset RA would be - ANSWER -Soft tissue swelling A 72 female has been diagnosed with gout. She also has chronic HF. The most likely contributing factor to development of gout in this older female is - ANSWER -Thiazide diuretics Which of the following statements about OA is true - ANSWER -It affects primarily weight bearing joints In considering the specificity of lab data, the most reliable diagnostic test listed below would be - ANSWER -Synovial fluid analysis to differentiate between infectious versus inflammatory infusion When examining the spine of an older adult you notice a curvature with a sharp angle. This is referred to as - ANSWER -Gibbus The prevalence of depression in nursing home residents is __________________ greater than adults living in the community - ANSWER -3-4 times The majority of depressed older adults remain untreated because of - ANSWER -Misdiagnosis, social stigma, environmental barriers Symptoms of depression distinct to the elderly include - ANSWER -Lack of emotions The justification for ordering CBC, TSH, serum B12 for a patient you may suspect have clinical depression is - ANSWER -Because of overlapping symptoms with anemia, thyroid dysfunction, and nutritional deficiencies One major difference that us useful in the DD of dementia versus delirium is that - ANSWER Dementia develops slowly and delirium develops quickly Which of the following is the most appropriate screening tool for delirium - ANSWER Confusion Assessment Method The proposed mechanism by which diphenhydramine causes delirium is - ANSWER Anticholinergic effects The elderly are at risk for delirium because of - ANSWER -Multisensory declines, polypharmacy, multiple medical problems A consistent finding in delirium regardless of cause i - ANSWER -Reduction in regional cerebral perfusion Older adults with Dementia sometimes suffer from agnosia, which is defined as the inability to - ANSWER -Recognize objects In late stages of dementia, a phenomenon called sun downing, in which cognitive disturbances tend to - ANSWER -Become worse in the evening Of the following, which one is the most useful clinical eval tool to assist in the diagnosis of dementia - ANSWER -St. Louis Mental Status Exam SLUMS The cornerstone of pharmacotherapy in treating Alzheimer's is - ANSWER -Cholinesterase inhibitors The comoribid psych problem with the highest frequency in dementia in - ANSWER -Anxiety WHen treating depression associated with dementia, which of the following would be a poor choice and should not be prescribed - ANSWER -Amitriptyline Which of the following should be avoided in countries where food and water precautions are to be observed - ANSWER -Salad buffet What insect precautions are not necessary to prevent insect borne diseases in the Tropics - ANSWER -Using 100% DEET on skin to prevent bites An example of secondary prevention you could recommend/order for older adults would be to - ANSWER -Check for fecal occult blood Ali is a 72 year old male who recent came to the US from Nigeria. He reports having BCG vax as a child. Which of the following is correct regarding a TB skin test - ANSWER -Vax hx is irrelevant, read as usual A local chapter on NP organization has begun planning a community based screening for HTN at a local congregate living facility. The organization was select3d on the basis of - ANSWER A regcognized element of high risk within this group Performing ROM exercises on a patient who has had a CVA is an example of which level of prevention - ANSWER -Tertiary You demonstrate an understanding of primary prevention of falling among the elderly through which management plan - ANSWER -Provide info about meds, SE and interactions An example of an active strategy of health promotion for an individual to accomplish would be - ANSWER -Beginning stress management program The 4 main domains of clinical preventive services that you will provide are - ANSWER Counseling interventions, screening tests, immunizations, chemoprophylaxis What is the appropriate method for TB screening of an older adult entering a nursing home - ANSWER -5 TBU intradermal PPD injection and if negative, repeat with same dose one week later The term "geriatric syndrome" is best described - ANSWER -Condition that has multiple underlying factors and involves multiple systems Atypical presentation of acute coronary syndrome is - ANSWER -More common in females