NR 601: Chamberlain Geriatric Class chapter questions
with verified answers
. 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 is 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 Ans✓✓✓ c
. 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 Ans✓✓✓ c
,. The remission rate of depressed patients who are 65 years and older to initial
antidepressant treatment is:
a. 30%
b. 40%
c. 70%
d. 80% Ans✓✓✓ a
1. A 67-year-old female with a history of congestive heart failure and myocardial
infarction is admitted to the hospital because of increasing altered mental status
and decreased arousal over the last week. Physical examination reveals a
confused woman with right lower lobe crackles and a pulse oximetry of 86% on
room air. While you are interviewing the patient, she is irritable, paranoid, and
inattentive, which her family tells you is out of character. You notice waxing and
waning in her alertness and impaired short-term memory during your
examination. Which one of the following features present in this patient best
distinguishes delirium from depression or dementia?
a. Irritability
b. Inattentiveness
c. Paranoia
d. Aggressiveness Ans✓✓✓ b
1. A 69-year-old female presents to your office for routine primary care. Her elder
sister was recently diagnosed with Alzheimer disease, and she wonders what
steps she can take to reduce her own risk of developing dementia. Which of the
following statements about the prevention of dementia is true? a. There is
moderate quality evidence to support daily use of vitamin B12 and fish oil to
prevent risk of cognitive decline.
,b. Risk of dementia is modulated by nonmodifiable risk factors, such as genetics,
family history, and educational attainment, and there are no behavioral
interventions that can be taken to reduce risk of developing dementia.
c. There is moderate quality evidence to suggest control of cardiovascular and
metabolic risk factors, such as blood pressure, weight, and blood sugar, may
reduce risk of dementia.
d. There is moderate to low quality evidence supporting cannabinoids may reduce
rates of progres Ans✓✓✓ c
1. A 75-year-old man presents with the chief concern, "I may have a bladder
infection." Further questioning reveals for several months he has been needing to
void every couple of hours (can't sit through a whole ball game), feels he must go
as soon as he feels the urge (he tried putting it off and had urinary leakage), and is
getting up two to three times at night to void. He denies delay in voiding or
straining to initiate voiding, slow stream, feeling of incomplete emptying, or
dribbling after completion of urination. He also denies dysuria and abdominal
pain. Which of the following best describes the category or type of his lower
urinary tract symptoms?
a. Prostatism
b. Overactive bladder
c. Postmicturition
d. Storage (irritative)
e. Voiding (obstructive) Ans✓✓✓ d
1. A 75-year-old man with lung cancer metastatic to the bones is receiving hospice
care in his home. His predominant symptom is nociceptive and neuropathic right
chest wall pain caused by a fourth rib metastasis. In recent days he has
experienced a dramatic increase in his pain, and hospice staff have titrated his
pain regimen to gabapentin 900 mg three times daily, extended release morphine
100 mg three times daily, and immediate release morphine 30 mg every 2 hours
, as needed. The hospice nurse calls you to ask about next steps, and reports that
he is still in severe pain but is now nonverbal, and his family is struggling to
administer his medication orally because of his somnolence. The patient's family
is exhausted. What is the best next step to assure the patient's comfort?
a. Admit to an inpatient facility under the General Inpatient Hospice benefit.
b. Discharge from hospice, admit to the hospital.
c. Call 9 Ans✓✓✓ a
1. A 79-year-old woman with a 1.5-cm breast cancer underwent lumpectomy.
Pathology revealed ductal carcinoma that is hormone receptor negative (estrogen
receptor 0%, progesterone receptor 1%) and HER2/neu negative. Surgical margins
were adequate and uninvolved with cancer. Sentinel lymph node sampling was
negative for lymph node involvement. She has good performance status and no
activities of daily living (ADL) or instrumental (IADL) dependencies. What
treatment would you recommend?
a. Adjuvant chemotherapy
b. Adjuvant chemotherapy with irradiation
c. Adjuvant irradiation only
d. Hormonal therapy only
e. None of the above Ans✓✓✓ d
1. A clinical prodrome of nonspecific symptoms of Parkinson disease (PD) include
all the following except:
a. Hyposmia
b. Bradykinesia
c. Constipation
d. Fatigue Ans✓✓✓ b
with verified answers
. 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 is 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 Ans✓✓✓ c
. 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 Ans✓✓✓ c
,. The remission rate of depressed patients who are 65 years and older to initial
antidepressant treatment is:
a. 30%
b. 40%
c. 70%
d. 80% Ans✓✓✓ a
1. A 67-year-old female with a history of congestive heart failure and myocardial
infarction is admitted to the hospital because of increasing altered mental status
and decreased arousal over the last week. Physical examination reveals a
confused woman with right lower lobe crackles and a pulse oximetry of 86% on
room air. While you are interviewing the patient, she is irritable, paranoid, and
inattentive, which her family tells you is out of character. You notice waxing and
waning in her alertness and impaired short-term memory during your
examination. Which one of the following features present in this patient best
distinguishes delirium from depression or dementia?
a. Irritability
b. Inattentiveness
c. Paranoia
d. Aggressiveness Ans✓✓✓ b
1. A 69-year-old female presents to your office for routine primary care. Her elder
sister was recently diagnosed with Alzheimer disease, and she wonders what
steps she can take to reduce her own risk of developing dementia. Which of the
following statements about the prevention of dementia is true? a. There is
moderate quality evidence to support daily use of vitamin B12 and fish oil to
prevent risk of cognitive decline.
,b. Risk of dementia is modulated by nonmodifiable risk factors, such as genetics,
family history, and educational attainment, and there are no behavioral
interventions that can be taken to reduce risk of developing dementia.
c. There is moderate quality evidence to suggest control of cardiovascular and
metabolic risk factors, such as blood pressure, weight, and blood sugar, may
reduce risk of dementia.
d. There is moderate to low quality evidence supporting cannabinoids may reduce
rates of progres Ans✓✓✓ c
1. A 75-year-old man presents with the chief concern, "I may have a bladder
infection." Further questioning reveals for several months he has been needing to
void every couple of hours (can't sit through a whole ball game), feels he must go
as soon as he feels the urge (he tried putting it off and had urinary leakage), and is
getting up two to three times at night to void. He denies delay in voiding or
straining to initiate voiding, slow stream, feeling of incomplete emptying, or
dribbling after completion of urination. He also denies dysuria and abdominal
pain. Which of the following best describes the category or type of his lower
urinary tract symptoms?
a. Prostatism
b. Overactive bladder
c. Postmicturition
d. Storage (irritative)
e. Voiding (obstructive) Ans✓✓✓ d
1. A 75-year-old man with lung cancer metastatic to the bones is receiving hospice
care in his home. His predominant symptom is nociceptive and neuropathic right
chest wall pain caused by a fourth rib metastasis. In recent days he has
experienced a dramatic increase in his pain, and hospice staff have titrated his
pain regimen to gabapentin 900 mg three times daily, extended release morphine
100 mg three times daily, and immediate release morphine 30 mg every 2 hours
, as needed. The hospice nurse calls you to ask about next steps, and reports that
he is still in severe pain but is now nonverbal, and his family is struggling to
administer his medication orally because of his somnolence. The patient's family
is exhausted. What is the best next step to assure the patient's comfort?
a. Admit to an inpatient facility under the General Inpatient Hospice benefit.
b. Discharge from hospice, admit to the hospital.
c. Call 9 Ans✓✓✓ a
1. A 79-year-old woman with a 1.5-cm breast cancer underwent lumpectomy.
Pathology revealed ductal carcinoma that is hormone receptor negative (estrogen
receptor 0%, progesterone receptor 1%) and HER2/neu negative. Surgical margins
were adequate and uninvolved with cancer. Sentinel lymph node sampling was
negative for lymph node involvement. She has good performance status and no
activities of daily living (ADL) or instrumental (IADL) dependencies. What
treatment would you recommend?
a. Adjuvant chemotherapy
b. Adjuvant chemotherapy with irradiation
c. Adjuvant irradiation only
d. Hormonal therapy only
e. None of the above Ans✓✓✓ d
1. A clinical prodrome of nonspecific symptoms of Parkinson disease (PD) include
all the following except:
a. Hyposmia
b. Bradykinesia
c. Constipation
d. Fatigue Ans✓✓✓ b
