Advanced Practice Nursing in the Care of Older Adults
3rd edition by: Kennedy-Malone, (Ch 1 – 23)
TEST BANK
,Contents
CHAPTER 1: CHANGES WITH AGING ................................................................................................. 3
CHAPTER 2: HEALTH PROMOTION .................................................................................................... 7
CHAPTER 3: EXERCISE IN OLDER ADULTS ........................................................................................ 13
CHAPTER 4 NUTRITIONAL SUPPORT IN THE OLDER ADULT ............................................................. 15
CHAPTER 5 SETTINGS OF CARE....................................................................................................... 20
CHAPTER 6: COMPREHENSIVE GERIATRIC ASSESSMENT ................................................................. 27
CHAPTER 7: SYMPTOMS AND SYNDROMES .................................................................................... 31
CHAPTER 8 SKIN AND LYMPHATIC DISORDERS ................................................................................ 34
CHAPTER 9. HEAD, NECK, AND FACE DISORDERS ............................................................................ 42
CHAPTER 10 CARDIOVASCULAR DISORDERS ................................................................................... 47
CHAPTER 11 RESPIRATORY DISORDERS ........................................................................................... 54
CHAPTER 12. PERIPHERAL VASCULAR DISORDERS .......................................................................... 61
CHAPTER 13. ABDOMINAL DISORDERS ........................................................................................... 66
CHAPTER 14. UROLOGICAL AND GYNECOLOGIC DISORDERS ........................................................... 74
CHAPTER 15 GYNECOLOGIC DISORDERS ......................................................................................... 78
CHAPTER 16. MUSCULOSKELETAL DISORDERS ................................................................................ 84
CHAPTER 17. CENTRAL AND PERIPHERAL NERVOUS SYSTEM DISORDERS ....................................... 90
CHAPTER 18. ENDOCRINE, METABOLIC, AND NUTRITIONAL DISORDERS ......................................... 96
CHAPTER 19: HEMATOLOGIC AND IMMUNE SYSTEM DISORDERS ................................................. 102
CHAPTER 20: PSYCHOSOCIAL DISORDERS ..................................................................................... 107
CHAPTER 21: POLYPHARMACY ..................................................................................................... 112
CHAPTER 22: CHRONIC ILLNESS AND THE APRN ........................................................................... 117
CHAPTER 23: PALLIATIVE CARE AND END-OF-LIFE CARE ................................................................ 122
,────────────────────────────────────────────────────────
CHAPTER 1: CHANGES WITH AGING
────────────────────────────────────────────────────────
1. The major impact of the physiological changes that occur with aging is:
A. Reduced physiological reserve
B. Reduced homeosta=c mechanisms
C. Impaired immunological response
D. All of the above
• Answer: D
• REF (approx.): Ch. 1, pp. 4–6
• TOP: Physiological Changes with Aging
• Ra onale: Mul=ple organ systems undergo age-related changes that collec=vely lead to
diminished homeostasis, decreased reserve capacity, and less robust immune responses.
2. The strongest evidence regarding normal physiological aging is available through:
A. Randomized controlled clinical trials
B. Cross-sec=onal studies
C. Longitudinal studies
D. Case control studies
• Answer: C
• REF (approx.): Ch. 1, pp. 4–5
• TOP: Research Methods in Aging
• Ra onale: Longitudinal studies (following the same individuals over =me) provide the most
valid insights into age-related physiological change.
3. All of the following statements are true about laboratory values in older adults except:
A. Reference ranges are preferable
B. Abnormal findings are oFen due to physiological aging
C. Normal ranges may not be applicable for older adults
D. Reference values are not necessarily acceptable values
, • Answer: B (meaning statement B is actually false or “except”)
• REF (approx.): Ch. 1, p. 10
• TOP: Laboratory Values in Older Adults
• Ra onale: Not all abnormal lab findings can be automa=cally aIributed to “just aging.”
Clinicians must inves=gate abnormali=es rather than dismiss them as “normal aging.”
4. Biochemical individuality is best described as:
A. Each individual’s varia=on is oFen much greater than that of a larger group
B. The unique biochemical profile of a selected popula=on
C. The truly “normal” individual—falling within average range
D. Each individual’s varia=on is oFen much smaller than that of a larger group
• Answer: D
• REF (approx.): Ch. 1, p. 10
• TOP: Biochemical Differences / Individual Varia=on
• Ra onale: Older individuals can exhibit wide biochemical varia=ons outside of standard
popula=on norms, so a single “normal” or “average” range may not always apply.
5. Polypharmacy is best described as taking:
A. More than nine medica=ons per day
B. More than five medica=ons per day
C. Even a single medica=on if there is not a clear indica=on for its use
D. When a drug is given to treat the side effect of another drug
• Answer: C
• REF (approx.): Ch. 1, pp. 8–9
• TOP: Polypharmacy Defini=on
• Ra onale: While mul=ple defini=ons exist, one widely accepted concept is that
“polypharmacy” can occur with any unnecessary medica=on or medica=on without clear
indica=on.
6. Pharmacokine=c changes with aging is reflec=ve of:
A. What the drug does to the body
B. What the body does to the drug
C. The effect at the site of ac=on and the =me and intensity of the drug
D. The side effects commonly associated with the drug
• Answer: B
, • REF (approx.): Ch. 1, p. 7
• TOP: Pharmacokine=cs in Older Adults
• Ra onale: “Pharmacokine=cs” focuses on how the body absorbs, distributes, metabolizes,
and excretes a medica=on (“what the body does to the drug”), whereas “pharmacodynamics”
(answer A) addresses what the drug does to the body.
7. All the following statements are false about drug absorp=on except:
A. Antacids increase the bioavailability of digitalis
B. Gastric acidity decreases with age
C. An=cholinergics increase colonic mo=lity
D. Underlying chronic disease has liIle impact on drug absorp=on
• Answer: D (meaning that D is the “true” statement among “false” ones)
• REF (approx.): Ch. 1, p. 8
• TOP: Drug Absorp=on in Older Adults
• Ra onale: Although advanced age can alter drug absorp=on, it is more subtle compared to
changes in distribu=on or clearance. Chronic diseases can play a larger role than aging alone, so
the statement “Underlying chronic disease has liIle impact” is false—which matches “except”
format.
8. All of the following statements are true about drug distribu=on in the elderly except:
A. Drugs distributed in water have lower concentra=on
B. Drugs distributed in fat have less intense, more prolonged effect
C. Drugs highly protein bound have greater poten=al to cause an adverse drug reac=on
D. The fastest way to deliver a drug to the ac=on site is by inhala=on
• Answer: A (meaning A is “except”)
• REF (approx.): Ch. 1, pp. 8–9
• TOP: Drug Distribu=on Changes
• Ra onale: With less total body water and more fat propor=on, water-soluble drugs actually
tend to be more concentrated (not “lower concentra=on”), making Statement A incorrect for
older adults.
9. Men have faster and more efficient biotransforma=on of drugs and this is thought to be due
to:
A. Less obesity rates than women
B. Prostate enlargement
C. Testosterone
, D. Less estrogen than women
• Answer: C
• REF (approx.): Ch. 1, p. 9
• TOP: Drug Metabolism Differences
• Ra onale: Testosterone is oFen implicated in s=mula=ng certain enzyma=c pathways or
hepa=c blood flow but these dis=nc=ons are modest and vary widely among individuals.
10. The cytochrome p system involves enzymes that are generally:
A. Inhibited by drugs
B. Induced by drugs
C. Inhibited or induced by drugs
D. Associated with decreased liver perfusion
• Answer: C
• REF (approx.): Ch. 1, p. 9
• TOP: Pharmacokine=cs – Metabolic Pathways
• Ra onale: The hepa=c cytochrome P450 system can be either induced or inhibited by
different drugs, altering the metabolism of other medica=ons.
11. A statement not shown to be true about pharmacodynamics changes with aging is:
A. Decreased sensi=vity to oral an=coagulants
B. Enhanced sensi=vity to central nervous system drugs
C. Drug responsiveness can be influenced by pa=ent ac=vity level
D. There is a decreased sensi=vity to beta blockers
• Answer: A
• REF (approx.): Ch. 1, pp. 9–10
• TOP: Pharmacodynamics in Older Adults
• Ra onale: In reality, older adults oFen have increased sensi=vity to an=coagulants (opposite
of A), so “decreased sensi=vity” is incorrect.
12. Atypical presenta=on of disease in the elderly is reflected by all the following except:
A. Infec=on without fever
B. Depression without dysphoric mood
C. Myocardial infarc=on with chest pain and diaphoresis
D. Cardiac manifesta=ons of thyroid disease
, • Answer: C
• REF (approx.): Ch. 1, p. 6
• TOP: Atypical Disease Presenta=on
• Ra onale: Classic chest pain and diaphoresis (answer C) is the usual/typical presenta=on of
MI. Elders oFen present with more subtle or “silent” presenta=ons.
13. Func=onal abili=es are best assessed by:
A. Self-report of func=on
B. Observed assessment of func=on
C. A comprehensive head-to-toe examina=on
D. Family report of func=on
• Answer: B
• REF (approx.): Ch. 1, pp. 10–11
• TOP: Func=onal Assessment
• Ra onale: Although self-report or family-report can help, direct observed assessment (e.g.,
“get up and go test”) is more accurate for iden=fying true func=onal capacity.
────────────────────────────────────────────────────────
CHAPTER 2: HEALTH PROMOTION
────────────────────────────────────────────────────────
1. The leading cause of death in elderly travelers worldwide is:
A. Cardiovascular disease
B. Infec=ons
C. Accidents
D. Malaria
• Answer: A
• REF (approx.): Ch. 2, pp. 24–25
• TOP: Travel Health / Mortality in Older Adults Abroad
, • Ra onale: Cardiovascular events (e.g., heart aIacks, arrhythmias) represent the most
frequent cause of death among older travelers worldwide, surpassing accidents and infec=ons.
2. Which of the following should be avoided in countries where food and water precau=ons are
to be observed?
A. Hot coffee
B. BoIled water
C. Salad buffet
D. Unpeeled bananas
• Answer: C
• REF (approx.): Ch. 2, p. 26
• TOP: Travel Health / Food Safety
• Ra onale: Salad bars/buffets (fresh, raw produce that can be contaminated) should be
avoided. Hot beverages are oFen safe if thoroughly boiled, and sealed boIled water or fruits
that can be peeled are usually safer choices.
3. What insect precau=on is NOT necessary to prevent insect-borne diseases in the tropics?
A. Using approx. 20–50% DEET on skin to prevent bites
B. Trea=ng clothes with permethrin
C. Covering up exposed skin to lessen bi=ng surface
D. Taking malaria pills as directed for areas at risk for malaria
• Answer: (Depending on how the ques=on is intended, likely “None of the above” or “All are
necessary”)
• REF (approx.): Ch. 2, pp. 26–27
• TOP: Travel Health / Insect Protec=on
• Ra onale: All listed op=ons are standard precau=ons. Using extremely high concentra=ons
of DEET (e.g., 100%) is generally not advised, but around 20–50% is recommended. Trea=ng
clothes with permethrin, covering exposed skin, and using prophylac=c medica=ons for
malarious regions are essen=al.
4. An example of secondary preven=on you could recommend for older adults would be to:
A. Check for fecal occult blood
B. Wear seat belts in the car
C. Provide foot care for a diabe=c pa=ent
D. Administer a tetanus shot
, • Answer: A
• REF (approx.): Ch. 2, pp. 28–29
• TOP: Levels of Preven=on
• Ra onale: Secondary preven=on entails screening and early detec=on (e.g., fecal occult
blood tes=ng). Wearing seat belts or vaccines can be considered primary preven=on, while
con=nuous management of established disease (e.g., diabe=c foot care) can be ter=ary.
5. Ali is a 72-year-old man who recently arrived in the U.S. from Nigeria. He reports having the
BCG (bacille CalmeIe-Guérin) vaccina=on as a child. Regarding a tuberculin skin test (TST),
which of the following is correct?
A. It should not be done at all.
B. It should be read as smaller than it really is.
C. Vaccina=on history is irrelevant; read as usual.
D. It should be read as larger than it really is.
• Answer: C
• REF (approx.): Ch. 2, p. 30
• TOP: Immuniza=ons & Screening / TB Tes=ng
• Ra onale: Prior BCG vaccina=on may cause a false-posi=ve TST, but guidelines typically
recommend interpre=ng the TST by standard criteria, regardless of BCG history. An IGRA blood
test is an alterna=ve in some cases.
6. A 72-year-old woman becomes acutely short of breath with chest pain and panic aFer a long
day’s drive; which of the following is most likely?
A. Pulmonary edema
B. Heart failure
C. Pulmonary embolism (PE)
D. Pneumonia
• Answer: C
• REF (approx.): Ch. 2, p. 31
• TOP: Travel Health / Venous Thromboembolism Preven=on
• Ra onale: Long periods of immobility increase risk for deep vein thrombosis (DVT) and
subsequent PE, oFen presen=ng with sudden dyspnea, tachycardia, chest pain, and/or anxiety.
7. Which immuniza=on would you recommend for a 65-year-old man (Ivan) with COPD, CAD,
hypertension, and diabetes, who has not had immuniza=ons since age 25?
A. MMR, influenza, pneumococcal, Zostavax
3rd edition by: Kennedy-Malone, (Ch 1 – 23)
TEST BANK
,Contents
CHAPTER 1: CHANGES WITH AGING ................................................................................................. 3
CHAPTER 2: HEALTH PROMOTION .................................................................................................... 7
CHAPTER 3: EXERCISE IN OLDER ADULTS ........................................................................................ 13
CHAPTER 4 NUTRITIONAL SUPPORT IN THE OLDER ADULT ............................................................. 15
CHAPTER 5 SETTINGS OF CARE....................................................................................................... 20
CHAPTER 6: COMPREHENSIVE GERIATRIC ASSESSMENT ................................................................. 27
CHAPTER 7: SYMPTOMS AND SYNDROMES .................................................................................... 31
CHAPTER 8 SKIN AND LYMPHATIC DISORDERS ................................................................................ 34
CHAPTER 9. HEAD, NECK, AND FACE DISORDERS ............................................................................ 42
CHAPTER 10 CARDIOVASCULAR DISORDERS ................................................................................... 47
CHAPTER 11 RESPIRATORY DISORDERS ........................................................................................... 54
CHAPTER 12. PERIPHERAL VASCULAR DISORDERS .......................................................................... 61
CHAPTER 13. ABDOMINAL DISORDERS ........................................................................................... 66
CHAPTER 14. UROLOGICAL AND GYNECOLOGIC DISORDERS ........................................................... 74
CHAPTER 15 GYNECOLOGIC DISORDERS ......................................................................................... 78
CHAPTER 16. MUSCULOSKELETAL DISORDERS ................................................................................ 84
CHAPTER 17. CENTRAL AND PERIPHERAL NERVOUS SYSTEM DISORDERS ....................................... 90
CHAPTER 18. ENDOCRINE, METABOLIC, AND NUTRITIONAL DISORDERS ......................................... 96
CHAPTER 19: HEMATOLOGIC AND IMMUNE SYSTEM DISORDERS ................................................. 102
CHAPTER 20: PSYCHOSOCIAL DISORDERS ..................................................................................... 107
CHAPTER 21: POLYPHARMACY ..................................................................................................... 112
CHAPTER 22: CHRONIC ILLNESS AND THE APRN ........................................................................... 117
CHAPTER 23: PALLIATIVE CARE AND END-OF-LIFE CARE ................................................................ 122
,────────────────────────────────────────────────────────
CHAPTER 1: CHANGES WITH AGING
────────────────────────────────────────────────────────
1. The major impact of the physiological changes that occur with aging is:
A. Reduced physiological reserve
B. Reduced homeosta=c mechanisms
C. Impaired immunological response
D. All of the above
• Answer: D
• REF (approx.): Ch. 1, pp. 4–6
• TOP: Physiological Changes with Aging
• Ra onale: Mul=ple organ systems undergo age-related changes that collec=vely lead to
diminished homeostasis, decreased reserve capacity, and less robust immune responses.
2. The strongest evidence regarding normal physiological aging is available through:
A. Randomized controlled clinical trials
B. Cross-sec=onal studies
C. Longitudinal studies
D. Case control studies
• Answer: C
• REF (approx.): Ch. 1, pp. 4–5
• TOP: Research Methods in Aging
• Ra onale: Longitudinal studies (following the same individuals over =me) provide the most
valid insights into age-related physiological change.
3. All of the following statements are true about laboratory values in older adults except:
A. Reference ranges are preferable
B. Abnormal findings are oFen due to physiological aging
C. Normal ranges may not be applicable for older adults
D. Reference values are not necessarily acceptable values
, • Answer: B (meaning statement B is actually false or “except”)
• REF (approx.): Ch. 1, p. 10
• TOP: Laboratory Values in Older Adults
• Ra onale: Not all abnormal lab findings can be automa=cally aIributed to “just aging.”
Clinicians must inves=gate abnormali=es rather than dismiss them as “normal aging.”
4. Biochemical individuality is best described as:
A. Each individual’s varia=on is oFen much greater than that of a larger group
B. The unique biochemical profile of a selected popula=on
C. The truly “normal” individual—falling within average range
D. Each individual’s varia=on is oFen much smaller than that of a larger group
• Answer: D
• REF (approx.): Ch. 1, p. 10
• TOP: Biochemical Differences / Individual Varia=on
• Ra onale: Older individuals can exhibit wide biochemical varia=ons outside of standard
popula=on norms, so a single “normal” or “average” range may not always apply.
5. Polypharmacy is best described as taking:
A. More than nine medica=ons per day
B. More than five medica=ons per day
C. Even a single medica=on if there is not a clear indica=on for its use
D. When a drug is given to treat the side effect of another drug
• Answer: C
• REF (approx.): Ch. 1, pp. 8–9
• TOP: Polypharmacy Defini=on
• Ra onale: While mul=ple defini=ons exist, one widely accepted concept is that
“polypharmacy” can occur with any unnecessary medica=on or medica=on without clear
indica=on.
6. Pharmacokine=c changes with aging is reflec=ve of:
A. What the drug does to the body
B. What the body does to the drug
C. The effect at the site of ac=on and the =me and intensity of the drug
D. The side effects commonly associated with the drug
• Answer: B
, • REF (approx.): Ch. 1, p. 7
• TOP: Pharmacokine=cs in Older Adults
• Ra onale: “Pharmacokine=cs” focuses on how the body absorbs, distributes, metabolizes,
and excretes a medica=on (“what the body does to the drug”), whereas “pharmacodynamics”
(answer A) addresses what the drug does to the body.
7. All the following statements are false about drug absorp=on except:
A. Antacids increase the bioavailability of digitalis
B. Gastric acidity decreases with age
C. An=cholinergics increase colonic mo=lity
D. Underlying chronic disease has liIle impact on drug absorp=on
• Answer: D (meaning that D is the “true” statement among “false” ones)
• REF (approx.): Ch. 1, p. 8
• TOP: Drug Absorp=on in Older Adults
• Ra onale: Although advanced age can alter drug absorp=on, it is more subtle compared to
changes in distribu=on or clearance. Chronic diseases can play a larger role than aging alone, so
the statement “Underlying chronic disease has liIle impact” is false—which matches “except”
format.
8. All of the following statements are true about drug distribu=on in the elderly except:
A. Drugs distributed in water have lower concentra=on
B. Drugs distributed in fat have less intense, more prolonged effect
C. Drugs highly protein bound have greater poten=al to cause an adverse drug reac=on
D. The fastest way to deliver a drug to the ac=on site is by inhala=on
• Answer: A (meaning A is “except”)
• REF (approx.): Ch. 1, pp. 8–9
• TOP: Drug Distribu=on Changes
• Ra onale: With less total body water and more fat propor=on, water-soluble drugs actually
tend to be more concentrated (not “lower concentra=on”), making Statement A incorrect for
older adults.
9. Men have faster and more efficient biotransforma=on of drugs and this is thought to be due
to:
A. Less obesity rates than women
B. Prostate enlargement
C. Testosterone
, D. Less estrogen than women
• Answer: C
• REF (approx.): Ch. 1, p. 9
• TOP: Drug Metabolism Differences
• Ra onale: Testosterone is oFen implicated in s=mula=ng certain enzyma=c pathways or
hepa=c blood flow but these dis=nc=ons are modest and vary widely among individuals.
10. The cytochrome p system involves enzymes that are generally:
A. Inhibited by drugs
B. Induced by drugs
C. Inhibited or induced by drugs
D. Associated with decreased liver perfusion
• Answer: C
• REF (approx.): Ch. 1, p. 9
• TOP: Pharmacokine=cs – Metabolic Pathways
• Ra onale: The hepa=c cytochrome P450 system can be either induced or inhibited by
different drugs, altering the metabolism of other medica=ons.
11. A statement not shown to be true about pharmacodynamics changes with aging is:
A. Decreased sensi=vity to oral an=coagulants
B. Enhanced sensi=vity to central nervous system drugs
C. Drug responsiveness can be influenced by pa=ent ac=vity level
D. There is a decreased sensi=vity to beta blockers
• Answer: A
• REF (approx.): Ch. 1, pp. 9–10
• TOP: Pharmacodynamics in Older Adults
• Ra onale: In reality, older adults oFen have increased sensi=vity to an=coagulants (opposite
of A), so “decreased sensi=vity” is incorrect.
12. Atypical presenta=on of disease in the elderly is reflected by all the following except:
A. Infec=on without fever
B. Depression without dysphoric mood
C. Myocardial infarc=on with chest pain and diaphoresis
D. Cardiac manifesta=ons of thyroid disease
, • Answer: C
• REF (approx.): Ch. 1, p. 6
• TOP: Atypical Disease Presenta=on
• Ra onale: Classic chest pain and diaphoresis (answer C) is the usual/typical presenta=on of
MI. Elders oFen present with more subtle or “silent” presenta=ons.
13. Func=onal abili=es are best assessed by:
A. Self-report of func=on
B. Observed assessment of func=on
C. A comprehensive head-to-toe examina=on
D. Family report of func=on
• Answer: B
• REF (approx.): Ch. 1, pp. 10–11
• TOP: Func=onal Assessment
• Ra onale: Although self-report or family-report can help, direct observed assessment (e.g.,
“get up and go test”) is more accurate for iden=fying true func=onal capacity.
────────────────────────────────────────────────────────
CHAPTER 2: HEALTH PROMOTION
────────────────────────────────────────────────────────
1. The leading cause of death in elderly travelers worldwide is:
A. Cardiovascular disease
B. Infec=ons
C. Accidents
D. Malaria
• Answer: A
• REF (approx.): Ch. 2, pp. 24–25
• TOP: Travel Health / Mortality in Older Adults Abroad
, • Ra onale: Cardiovascular events (e.g., heart aIacks, arrhythmias) represent the most
frequent cause of death among older travelers worldwide, surpassing accidents and infec=ons.
2. Which of the following should be avoided in countries where food and water precau=ons are
to be observed?
A. Hot coffee
B. BoIled water
C. Salad buffet
D. Unpeeled bananas
• Answer: C
• REF (approx.): Ch. 2, p. 26
• TOP: Travel Health / Food Safety
• Ra onale: Salad bars/buffets (fresh, raw produce that can be contaminated) should be
avoided. Hot beverages are oFen safe if thoroughly boiled, and sealed boIled water or fruits
that can be peeled are usually safer choices.
3. What insect precau=on is NOT necessary to prevent insect-borne diseases in the tropics?
A. Using approx. 20–50% DEET on skin to prevent bites
B. Trea=ng clothes with permethrin
C. Covering up exposed skin to lessen bi=ng surface
D. Taking malaria pills as directed for areas at risk for malaria
• Answer: (Depending on how the ques=on is intended, likely “None of the above” or “All are
necessary”)
• REF (approx.): Ch. 2, pp. 26–27
• TOP: Travel Health / Insect Protec=on
• Ra onale: All listed op=ons are standard precau=ons. Using extremely high concentra=ons
of DEET (e.g., 100%) is generally not advised, but around 20–50% is recommended. Trea=ng
clothes with permethrin, covering exposed skin, and using prophylac=c medica=ons for
malarious regions are essen=al.
4. An example of secondary preven=on you could recommend for older adults would be to:
A. Check for fecal occult blood
B. Wear seat belts in the car
C. Provide foot care for a diabe=c pa=ent
D. Administer a tetanus shot
, • Answer: A
• REF (approx.): Ch. 2, pp. 28–29
• TOP: Levels of Preven=on
• Ra onale: Secondary preven=on entails screening and early detec=on (e.g., fecal occult
blood tes=ng). Wearing seat belts or vaccines can be considered primary preven=on, while
con=nuous management of established disease (e.g., diabe=c foot care) can be ter=ary.
5. Ali is a 72-year-old man who recently arrived in the U.S. from Nigeria. He reports having the
BCG (bacille CalmeIe-Guérin) vaccina=on as a child. Regarding a tuberculin skin test (TST),
which of the following is correct?
A. It should not be done at all.
B. It should be read as smaller than it really is.
C. Vaccina=on history is irrelevant; read as usual.
D. It should be read as larger than it really is.
• Answer: C
• REF (approx.): Ch. 2, p. 30
• TOP: Immuniza=ons & Screening / TB Tes=ng
• Ra onale: Prior BCG vaccina=on may cause a false-posi=ve TST, but guidelines typically
recommend interpre=ng the TST by standard criteria, regardless of BCG history. An IGRA blood
test is an alterna=ve in some cases.
6. A 72-year-old woman becomes acutely short of breath with chest pain and panic aFer a long
day’s drive; which of the following is most likely?
A. Pulmonary edema
B. Heart failure
C. Pulmonary embolism (PE)
D. Pneumonia
• Answer: C
• REF (approx.): Ch. 2, p. 31
• TOP: Travel Health / Venous Thromboembolism Preven=on
• Ra onale: Long periods of immobility increase risk for deep vein thrombosis (DVT) and
subsequent PE, oFen presen=ng with sudden dyspnea, tachycardia, chest pain, and/or anxiety.
7. Which immuniza=on would you recommend for a 65-year-old man (Ivan) with COPD, CAD,
hypertension, and diabetes, who has not had immuniza=ons since age 25?
A. MMR, influenza, pneumococcal, Zostavax
