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NR601 MIDTERM PRIMARY CARE FOR THE MATURING AND AGED

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NR 601 MIDTERM EXAM 156 QUESTIONS AND ANSWERS. 1. The percentage of the FVC expired in one second is: a. FEV1/FVC ratio 2. The aging process causes what normal physiological changes in the heart? a. The heart valve thickens and becomes rigid, secondary to fibrosis and sclerosis. 3. A 55yo Caucasian male follows up after referral to cardiologist. He thinks his med is causing a cough and sometimes he has difficulty breathing. Which med was most likely prescribed? a. Lisinopril 4. JM is a 68yo man who presents for a physical. He has T2DM x5yrs, smokes 1/2 PPD, BMI is 30. No other previous medical dx, no current complaints. According to the AHA/ACC guidelines, JM is stage A HF. Treatment goals for him include: a. Heart healthy lifestyle 5. MJ presents with h/o structural damage with current s/s of HF. Treatment will be based on his stage of HF, which is: a. Stage C 6. 65yo Caucasian female presents with mitral valve stenosis, physical exam unremarkable. You know her stage of HF is: a. B 7. DG, 65yo man, presents for eval of CP and L-sided shoulder pain, beginning after strenuous activity, including walking. Pain is dull, aching, 8/10 during activity, otherwise 0/10. Began few mo ago, intermittent, aggravated by exercise, relieved by rest. Occasional nausea. Pain is retrosternal, radiating to L shoulder, affects QOL by limiting activity. Pain is worse today, did not go away after stopped walking. BP 120/80, HR 72 and regular. Normal heart sounds, no murmur, S1, S2. Which differential dx would be most likely? a. Coronary artery dz w/angina pectoris 8. The best way to dx structural heart dz/dysfunction non-invasively is: a. Echocardiogram 9. Chronic pain can have major impact on pt's ability to function and have profound impact on overall QOL. Ongoing pain may be linked to: a. Depression, sleep disturbance, decreased socialization 10. The Beers criteria are appropriate for use in evaluating use of certain meds in pts: a. 65yo 11. Pt presents with c/o increas

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NR 601 MIDTERM EXAM 156 QUESTIONS
AND ANSWERS.
1. The percentage of the FVC expired in one second is:
a. FEV1/FVC ratio

2. The aging process causes what normal physiological changes
in the heart?
a. The heart valve thickens and becomes rigid, secondary
to fibrosis and sclerosis.

3. A 55yo Caucasian male follows up after referral to cardiologist.
He thinks his med is causing a cough and sometimes he has
difficulty breathing. Which med was most likely prescribed?
a. Lisinopril

4. JM is a 68yo man who presents for a physical. He has T2DM
x5yrs, smokes 1/2 PPD, BMI is 30. No other previous medical
dx, no current complaints. According to the AHA/ACC
guidelines, JM is stage A HF. Treatment goals for him include:
a. Heart healthy lifestyle

5. MJ presents with h/o structural damage with current s/s of HF.
Treatment will be based on his stage of HF, which is:
a. Stage C

6. 65yo Caucasian female presents with mitral valve stenosis,
physical exam unremarkable. You know her stage of HF is:
a. B

7. DG, 65yo man, presents for eval of CP and L-sided shoulder
pain, beginning after strenuous activity, including walking. Pain
is dull, aching, 8/10 during activity, otherwise 0/10. Began few
mo ago, intermittent, aggravated by exercise, relieved by rest.
Occasional nausea. Pain is retrosternal, radiating to L shoulder,
affects QOL by limiting activity. Pain is worse today, did not go
away after stopped walking. BP 120/80, HR 72 and regular.

, lOMoARcPSD|27916040




2

Normal heart sounds, no murmur, S1, S2. Which differential dx
would be most likely?
a. Coronary artery dz w/angina pectoris

8. The best way to dx structural heart dz/dysfunction non-
invasively is:
a. Echocardiogram

9. Chronic pain can have major impact on pt's ability to function
and have profound impact on overall QOL. Ongoing pain may
be linked to:
a. Depression, sleep disturbance, decreased socialization

10.The Beers criteria are appropriate for use in evaluating use of
certain meds in pts:
a. >65yo

11.Pt presents with c/o increasing SOB, cough w/occasional white
sputum, fatigue. As part of the plan you order labs. You know
the likelihood of HF is low if the BNP is:
a. <100

12.All of the following statements are true about lab values in
older adults except:

a. Normal ranges may not be applicable to older adults
b. Abnormal findings are often due to physiological aging
c. Reference ranges are preferable
d. References values are not necessarily acceptable values
a. B

13.According to the 2017 ACC HTN guidelines, the recommended
BP goal for a 65yo African American woman w/a h/o HTN and
DM and no h/o CKD is:
a. <140/80

14.The pathophysiology of HF is due to:
a. Inadequate cardiac output to meet the metabolic and
O2 demands of the body

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15.A 60yo woman w/30 pack yr hx, presents for eval of persistent,
daily cough w/increased sputum, worse in the AM, occurring
over past 3 months. She tells you, "I have the same thing year
after year." Which of the following choices would you consider
strongly in your critical thinking process?
a. Chronic bronchitis

16.JM is a 68yo man who presents for a physical. He has T2DM
x5yrs, diet controlled. His BMI is 32. He has HTN, smoker (10
cigs/day x20yrs). He denies other medical problems. Fam hx
includes CAD, CABG x4 for dad, now deceased; CHF, T2DM,
HTN for mom. He is asymptomatic today, exam is
normal, EKG NSR. According to AHA/ACC guidelines, JM is at
risk for what stage of HF?
a. Stage A

The volume of air a pt is able to exhale for total duration of the
test during maximal effort is:
b. FVC

17.According to the 2017 ACC HTN guidelines, normal BP is:
a. <120/80

18.Functional abilities are best assessed by:
a. Observed assessment of function

19.LB is a 77yo pt w/chronic poorly controlled HTN. You know that
goals include prevention of target organ damage. During your
eval you will assess for evidence of:
a. L ventricular hypertrophy

20.Aortic regurgitation requires medical treatment for early signs
of HF with:
a. ACEi

21.The volume of air in the lungs at max inflation is:
a. TLC (total lung capacity)

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22.Preferred amount of exercise for older adults is:
a. 30min/day of aerobic activity 5 days/wk

23.The total volume of air a pt is able to exhale in the first second
during max effort is:
a. FEV1

24.You know the following statements regarding the pain of acute
coronary syndrome are true except:

a. Present atypically more often in men than women


25.Elderly pt presents w/new onset of feeling heart race, fatigue.
EKG reveals afib w/rate >100. Pt also has a new tremor in both
hands. Which of the following would you suspect?
a. Hyperthyroidism

26.62yo female c/o fatigue, lack of energy. Constipation increased,
pt gained 10lbs in past 3mo. Depression is denied although pt
reports lack of interest in usual hobbies. VS are WNL, skin is
dry/cool. Which of the following must be included in the DD?
a. Hypothyroidism

27.Mrs. Black, 87yo, has been taking 100mcg Synthroid x10yrs.
She comes for routine follow-up, feeling well. HR is 90. Your
first response is to:
a. Order TSH

28.Which pt is most likely to have osteoporosis?
29.80yo underweight male who smokes and has been on steroids
for psoriasis
30.When evaluating the expected outcome for hypothyroid elderly
pt on levothyroxine, you will:
a. Assess TSH in 4-6wks

31.Postmenopausal woman w/osteoporosis is taking
bisphosphonate daily PO. What action info statement would
indicate she understood your instructions regarding this med?

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