NR 601Final Verified Multiple Choice and
Conceptual Actual Emended Exam Questions
With Reviewed 100% Correct Detailed Answers
Guaranteed Pass!!Current Update!!
1. Which of the following is true about tolterodine (Detrol)?
*OAB
- ANSWER It has a greater risk of A.E. with its twice-daily
formulation.
2. An 82-year-old man, Mr. A, complains of worsening nocturia, occurring four
times per night. His other lower urinary tract symptoms are slow stream,
occasional urgency, and urgency-related leakage once weekly. Medical
problems include poorly controlled hypertension, diastolic heart failure,
hyperlipidemia, osteoarthritis, and prediabetes. His medications include
lisinopril 20 mg daily, metoprolol succinate 75 mg daily, atorvastatin 10 mg
daily, metformin 500 mg twice daily, hydrocodone-acetaminophen as
needed, and aspirin 81 mg daily. Amlodipine 5 mg daily was recently added
by his cardiologist. On review of systems, Mr. A complains that nocturia is
causing daytime fatigue, and he is more constipated. Physical examination is
notable for blood pressure 162/83 mmHg, heart rate 60 beats per minute,
clear lungs, soft abdomen, enlarged prostate, and 21 pretibial edema. Your
next step in management should be:
- ANSWER Stop amlodipine and increase lisonopril.
3. The daughter of a 79-year-old woman notes that her mother, who has
dementia and lives with her, is wetting herself when she attends her new
day program. Program staff have requested that "something be done" as
she is requiring a clothes change nearly every time she is there. She cannot
describe the circumstances of leakage, saying "it just comes." Leakage is
uncommon at home. Her medications include donepezil and
, acetaminophen. Physical examination is normal. Initial treatment approach
will require intervention by which of the following?
- ANSWER Day program staff
4. Ms. J, who is 82 years old, complains of urine leakage while playing golf.
This has gotten worse over the past year, and she rarely makes it through
nine holes without feeling like she needs to "run into the bushes and go."
Leakage is usually small volume, but causes her extreme embarrassment
because she is afraid she will smell of urine. She has tried limiting caffeine in
the morning before she golfs and avoiding drinking water while playing, to
no effect. She also tried "those Kegler" exercises in the past without
success. Which of the following is the most appropriate recommendation
for Ms. J?
- ANSWER Bladder training
5. 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?
- ANSWER Inattentiveness
6. A 72-year-old man with colonic diverticulosis was admitted to the hospital
with gastrointestinal bleeding and abdominal pain. He underwent
colonoscopy under conscious sedation using fentanyl and midazolam. The
following day, the patient was positive on the Confusion Assessment
Method performed by the geriatric consultation services. Presence of
delirium in this patient predisposes him to all of the following except:
, - ANSWER Shorter length of stay in the hospital
7. 78-year-old male who resides at a nursing home has Lewy Body dementia,
frequent falls, visual hallucinations, and sleep disturbances. He is
transferred to your hospital with poor oral intake and confusion of 3 days
duration. Physical examination reveals a thin man with dry mucous
membranes, tachypnea, tachycardia, and confusion. To reliably identify
delirium in this patient in a time-efficient manner (<5 minutes), what will be
your instrument of choice?
- ANSWER CAM- Confusion Assessment Method
8. An 84-year-old woman complains of nausea and vomiting for the past 3
days. She has a history of multiple abdominal surgeries, adhesions, and
recurrent hospitalizations for partial small bowel obstruction. She has visual
and hearing impairment and is currently taking oxybutynin for neurogenic
bladder. You recognize she is high risk for development of delirium.
Interventions that may prevent the onset of delirium among older adult
hospitalized patients include all of the following except:
- ANSWER Treating anxiety with lorazepam
9. 78-year-old man with multiinfarct dementia, chronic kidney disease,
congestive heart failure, and uncontrolled hypertension was hospitalized
with a heart failure exacerbation. He was initially treated with diuretics and
salt restriction and his condition stabilized. On day 3 of his hospital stay, he
developed confusion, restlessness, and combativeness. Utilization of sitter,
redirection, calming music, and reassurance are unsuccessful. When safety
of the patient and staff are in jeopardy and nonpharmacologic approaches
have failed, which of the pharmacologic agents would be the best choice for
treating the agitation associated with his delirium?
- ANSWER Haloperidol
10.A 78-year-old male was recently diagnosed with Alzheimer disease. He
scored 23/30 on his Montreal Cognitive Assessment (MoCA) and his clinical
presentation is consistent with mild disease. He returns to clinic with his
family to discuss possible initiation of pharmacotherapy. You consider
beginning donepezil 5 mg daily for 4 weeks, with a plan to increase to 10
, mg daily if he tolerates the lower dose. Which of the following is not a
common side effect of donepezil?
- ANSWER Thrombocytopenia
11.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?
- ANSWER 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.
12.Risk factors for Heart Dz:
- ANSWER Female, obesity, heart dz
13.OSA is diagnosed with polysomnography where the sum of apneas and
hypopneas (AHI) is greater than _____ per hr.
- ANSWER 5 events per hr
14.What is the best first-line management for primary insomnia in older
adults?
- ANSWER Cognitive behavioral therapy
A 78 yo w/ worsening CHF continues treatment for symptom management and
QOL. The NP would discuss
Palliative care because he is continuing treatment
A pt post-CVA has poorly controlled HTN & intolerant of oral anticoagulants. What
is the NPs highest priority?
Control HTN (#1 cause for stroke)
Best confirmation for a diagnosis of Parkinson's Dz
Improvement with Levodopa
Conceptual Actual Emended Exam Questions
With Reviewed 100% Correct Detailed Answers
Guaranteed Pass!!Current Update!!
1. Which of the following is true about tolterodine (Detrol)?
*OAB
- ANSWER It has a greater risk of A.E. with its twice-daily
formulation.
2. An 82-year-old man, Mr. A, complains of worsening nocturia, occurring four
times per night. His other lower urinary tract symptoms are slow stream,
occasional urgency, and urgency-related leakage once weekly. Medical
problems include poorly controlled hypertension, diastolic heart failure,
hyperlipidemia, osteoarthritis, and prediabetes. His medications include
lisinopril 20 mg daily, metoprolol succinate 75 mg daily, atorvastatin 10 mg
daily, metformin 500 mg twice daily, hydrocodone-acetaminophen as
needed, and aspirin 81 mg daily. Amlodipine 5 mg daily was recently added
by his cardiologist. On review of systems, Mr. A complains that nocturia is
causing daytime fatigue, and he is more constipated. Physical examination is
notable for blood pressure 162/83 mmHg, heart rate 60 beats per minute,
clear lungs, soft abdomen, enlarged prostate, and 21 pretibial edema. Your
next step in management should be:
- ANSWER Stop amlodipine and increase lisonopril.
3. The daughter of a 79-year-old woman notes that her mother, who has
dementia and lives with her, is wetting herself when she attends her new
day program. Program staff have requested that "something be done" as
she is requiring a clothes change nearly every time she is there. She cannot
describe the circumstances of leakage, saying "it just comes." Leakage is
uncommon at home. Her medications include donepezil and
, acetaminophen. Physical examination is normal. Initial treatment approach
will require intervention by which of the following?
- ANSWER Day program staff
4. Ms. J, who is 82 years old, complains of urine leakage while playing golf.
This has gotten worse over the past year, and she rarely makes it through
nine holes without feeling like she needs to "run into the bushes and go."
Leakage is usually small volume, but causes her extreme embarrassment
because she is afraid she will smell of urine. She has tried limiting caffeine in
the morning before she golfs and avoiding drinking water while playing, to
no effect. She also tried "those Kegler" exercises in the past without
success. Which of the following is the most appropriate recommendation
for Ms. J?
- ANSWER Bladder training
5. 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?
- ANSWER Inattentiveness
6. A 72-year-old man with colonic diverticulosis was admitted to the hospital
with gastrointestinal bleeding and abdominal pain. He underwent
colonoscopy under conscious sedation using fentanyl and midazolam. The
following day, the patient was positive on the Confusion Assessment
Method performed by the geriatric consultation services. Presence of
delirium in this patient predisposes him to all of the following except:
, - ANSWER Shorter length of stay in the hospital
7. 78-year-old male who resides at a nursing home has Lewy Body dementia,
frequent falls, visual hallucinations, and sleep disturbances. He is
transferred to your hospital with poor oral intake and confusion of 3 days
duration. Physical examination reveals a thin man with dry mucous
membranes, tachypnea, tachycardia, and confusion. To reliably identify
delirium in this patient in a time-efficient manner (<5 minutes), what will be
your instrument of choice?
- ANSWER CAM- Confusion Assessment Method
8. An 84-year-old woman complains of nausea and vomiting for the past 3
days. She has a history of multiple abdominal surgeries, adhesions, and
recurrent hospitalizations for partial small bowel obstruction. She has visual
and hearing impairment and is currently taking oxybutynin for neurogenic
bladder. You recognize she is high risk for development of delirium.
Interventions that may prevent the onset of delirium among older adult
hospitalized patients include all of the following except:
- ANSWER Treating anxiety with lorazepam
9. 78-year-old man with multiinfarct dementia, chronic kidney disease,
congestive heart failure, and uncontrolled hypertension was hospitalized
with a heart failure exacerbation. He was initially treated with diuretics and
salt restriction and his condition stabilized. On day 3 of his hospital stay, he
developed confusion, restlessness, and combativeness. Utilization of sitter,
redirection, calming music, and reassurance are unsuccessful. When safety
of the patient and staff are in jeopardy and nonpharmacologic approaches
have failed, which of the pharmacologic agents would be the best choice for
treating the agitation associated with his delirium?
- ANSWER Haloperidol
10.A 78-year-old male was recently diagnosed with Alzheimer disease. He
scored 23/30 on his Montreal Cognitive Assessment (MoCA) and his clinical
presentation is consistent with mild disease. He returns to clinic with his
family to discuss possible initiation of pharmacotherapy. You consider
beginning donepezil 5 mg daily for 4 weeks, with a plan to increase to 10
, mg daily if he tolerates the lower dose. Which of the following is not a
common side effect of donepezil?
- ANSWER Thrombocytopenia
11.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?
- ANSWER 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.
12.Risk factors for Heart Dz:
- ANSWER Female, obesity, heart dz
13.OSA is diagnosed with polysomnography where the sum of apneas and
hypopneas (AHI) is greater than _____ per hr.
- ANSWER 5 events per hr
14.What is the best first-line management for primary insomnia in older
adults?
- ANSWER Cognitive behavioral therapy
A 78 yo w/ worsening CHF continues treatment for symptom management and
QOL. The NP would discuss
Palliative care because he is continuing treatment
A pt post-CVA has poorly controlled HTN & intolerant of oral anticoagulants. What
is the NPs highest priority?
Control HTN (#1 cause for stroke)
Best confirmation for a diagnosis of Parkinson's Dz
Improvement with Levodopa
