1
A nurse practitioner instructs a patient to spell world backward. Which of the following
tests is being performed?
A. MMPI B. CAGE C. MMSE D. PHQ-9
The nurse practitioner is instructing the patient to perform a task in the Mini-Mental
State Examination (MMSE), which assesses for cognitive impairment. The Cut,
Annoyed, Guilty, Eye (CAGE) questionnaire is used to screen for alcohol use disorder.
The Minnesota Multiphasic Personality Inventory (MMPI) is a personality test, and the
Patient Health Questionnaire-9 (PHQ-9) is used to screen for depression.
When evaluating a case of giant cell arteritis, the erythrocyte sedimentation rate (ESR)
is expected to be:
A. Normal B. Lower than normal C. Elevated D. Indeterminate
Headache is the most common chief complaint and presents in more than two thirds of
patients with giant cell arteritis. The headache tends to be new or different in character
from previous headaches and is typically sudden in onset, localizing to the temporal
region. Any new headache and fever in patients older than 50 years warrants a
consideration of giant cell arteritis. ESR greater than 50 mm/hr is suspect. The normal
ESR for male patients is 0 to 15 mm/hr, and for female patients it is 0 to 20 mm/hr. The
ESR can be slightly more elevated in older adults.
Which of the following is a cardinal clinical sign in a patient with Parkinson’s disease?
A. Pill-rolling tremors B. Inability to recognize familiar people or objects
C. Wide-based gait D. Increased facial movements due to tics
Clinical signs of Parkinson’s disease include pill-rolling tremors, difficulty initiating
voluntary movements, and shuffling gait with cogwheel rigidity. Facial movement
decreases, resulting in generalized rigidity with masked facies. Inability to recognize
familiar people or objects, or agnosia, is a sign of Alzheimer’s disease. Wide-based gait
is a sign of cerebellar ataxia.
A 68-year-old female patient complains of leaking a small amount of urine whenever
she sneezes, laughs, and/or strains. The problem has been present for many months.
The patient denies dysuria, frequency, and nocturia. The urine dipstick test is negative
for white blood cells, red blood cells, ketones, and urobilinogen. This clinical
presentation suggests which type of incontinence?
A. Urge B. Overflow C. Urinary D. Stress
The signs and symptoms of stress incontinence occur with increased abdominal
pressure caused by sneezing, laughing, and/or straining, which results in the leakage of
a small amount of urine through a weakened sphincter. It is more common in women
ages 45 to 49 years. The urethra and bladder neck fail to close completely because of
loss of connective tissue support.
This study source was downloaded by 100000901307859 from CourseHero.com on 10-16-2025 09:40:30 GMT -05:00
https://www.coursehero.com/file/250618455/Leik-Geriatrics-docx/
, 2
Which of the following cancers has the highest rate of mortality?
A. Lung and bronchus B. Colorectal C. Pancreatic D.
Breast
Lung and bronchus cancer accounts for the most deaths, with 130,180 people annually
expected to die from this type of cancer. Colorectal cancer is the second most common
cause of cancer death, followed by pancreatic cancer, which is the third deadliest
cancer. Breast cancer mortality has decreased due to increased screening, earlier
detection, awareness, and improved treatment.
A female patient is in the hospital recovering from a motor vehicle collision. The patient
sustained a femur fracture and is experiencing urinary incontinence due to impaired
mobility that delays access to the bathroom. Which of the following treatment options
would be appropriate for this patient?
A. Pelvic floor muscle (Kegel) exercises
B. Bedside commode and physical therapy
C. Duloxetine (Cymbalta), a serotonin-norepinephrine reuptake inhibitor
D. Bladder training
This patient’s clinical manifestations suggest functional incontinence, which involves
intact urinary storage and emptying functions; the patient has physical problems
reaching the bathroom in a timely manner. Treatment options include use of a bedside
commode and raised toilet seat with handles and physical therapy for strengthening and
gait. Pelvic floor muscle (Kegel) exercises are especially useful for patients
experiencing stress urinary incontinence. Bladder training is most effective for female
patients with urgency incontinence. Duloxetine (Cymbalta), a serotonin-norepinephrine
reuptake inhibitor, may be effective for stress urinary incontinence in some patients.
Which of the following is a category in the Katz Index of Independence in ADLs?
A. Housecleaning B. Dressing C. Preparing meals D. Exercising
The Katz Index of Independence in ADLs contains six items to assess a patient’s
independence: bathing, dressing, toileting, transferring, continence, and feeding. The
highest possible score is 6 (independent), and the lowest is 0 points (very dependent).
A patient presents with complaints of a bilateral action tremor in the arms and hands.
The patient reports that the tremor is activated by voluntary movement, especially
drinking from a glass. The tremor is absent when the affected body part is fully relaxed
and supported. These symptoms suggest which of the following disease conditions?
A. Parkinson’s B. Tardive dyskinesia C. Acute akinesia D. Essential
tremor
An essential tremor is an action tremor that often affects the hands and arms bilaterally.
It can also be seen in the head, voice, and face or trunk (rare). Common daily activities
are often affected, such as writing, drinking from a glass, and using utensils. Classically,
tremor due to Parkinson’s disease is a rest tremor that occurs unilaterally, distinguishing
it from an essential tremor. Tardive dyskinesia is a medication-induced hyperkinetic
movement disorder that causes oral, facial, and lingual dyskinesia. A sudden
This study source was downloaded by 100000901307859 from CourseHero.com on 10-16-2025 09:40:30 GMT -05:00
https://www.coursehero.com/file/250618455/Leik-Geriatrics-docx/
A nurse practitioner instructs a patient to spell world backward. Which of the following
tests is being performed?
A. MMPI B. CAGE C. MMSE D. PHQ-9
The nurse practitioner is instructing the patient to perform a task in the Mini-Mental
State Examination (MMSE), which assesses for cognitive impairment. The Cut,
Annoyed, Guilty, Eye (CAGE) questionnaire is used to screen for alcohol use disorder.
The Minnesota Multiphasic Personality Inventory (MMPI) is a personality test, and the
Patient Health Questionnaire-9 (PHQ-9) is used to screen for depression.
When evaluating a case of giant cell arteritis, the erythrocyte sedimentation rate (ESR)
is expected to be:
A. Normal B. Lower than normal C. Elevated D. Indeterminate
Headache is the most common chief complaint and presents in more than two thirds of
patients with giant cell arteritis. The headache tends to be new or different in character
from previous headaches and is typically sudden in onset, localizing to the temporal
region. Any new headache and fever in patients older than 50 years warrants a
consideration of giant cell arteritis. ESR greater than 50 mm/hr is suspect. The normal
ESR for male patients is 0 to 15 mm/hr, and for female patients it is 0 to 20 mm/hr. The
ESR can be slightly more elevated in older adults.
Which of the following is a cardinal clinical sign in a patient with Parkinson’s disease?
A. Pill-rolling tremors B. Inability to recognize familiar people or objects
C. Wide-based gait D. Increased facial movements due to tics
Clinical signs of Parkinson’s disease include pill-rolling tremors, difficulty initiating
voluntary movements, and shuffling gait with cogwheel rigidity. Facial movement
decreases, resulting in generalized rigidity with masked facies. Inability to recognize
familiar people or objects, or agnosia, is a sign of Alzheimer’s disease. Wide-based gait
is a sign of cerebellar ataxia.
A 68-year-old female patient complains of leaking a small amount of urine whenever
she sneezes, laughs, and/or strains. The problem has been present for many months.
The patient denies dysuria, frequency, and nocturia. The urine dipstick test is negative
for white blood cells, red blood cells, ketones, and urobilinogen. This clinical
presentation suggests which type of incontinence?
A. Urge B. Overflow C. Urinary D. Stress
The signs and symptoms of stress incontinence occur with increased abdominal
pressure caused by sneezing, laughing, and/or straining, which results in the leakage of
a small amount of urine through a weakened sphincter. It is more common in women
ages 45 to 49 years. The urethra and bladder neck fail to close completely because of
loss of connective tissue support.
This study source was downloaded by 100000901307859 from CourseHero.com on 10-16-2025 09:40:30 GMT -05:00
https://www.coursehero.com/file/250618455/Leik-Geriatrics-docx/
, 2
Which of the following cancers has the highest rate of mortality?
A. Lung and bronchus B. Colorectal C. Pancreatic D.
Breast
Lung and bronchus cancer accounts for the most deaths, with 130,180 people annually
expected to die from this type of cancer. Colorectal cancer is the second most common
cause of cancer death, followed by pancreatic cancer, which is the third deadliest
cancer. Breast cancer mortality has decreased due to increased screening, earlier
detection, awareness, and improved treatment.
A female patient is in the hospital recovering from a motor vehicle collision. The patient
sustained a femur fracture and is experiencing urinary incontinence due to impaired
mobility that delays access to the bathroom. Which of the following treatment options
would be appropriate for this patient?
A. Pelvic floor muscle (Kegel) exercises
B. Bedside commode and physical therapy
C. Duloxetine (Cymbalta), a serotonin-norepinephrine reuptake inhibitor
D. Bladder training
This patient’s clinical manifestations suggest functional incontinence, which involves
intact urinary storage and emptying functions; the patient has physical problems
reaching the bathroom in a timely manner. Treatment options include use of a bedside
commode and raised toilet seat with handles and physical therapy for strengthening and
gait. Pelvic floor muscle (Kegel) exercises are especially useful for patients
experiencing stress urinary incontinence. Bladder training is most effective for female
patients with urgency incontinence. Duloxetine (Cymbalta), a serotonin-norepinephrine
reuptake inhibitor, may be effective for stress urinary incontinence in some patients.
Which of the following is a category in the Katz Index of Independence in ADLs?
A. Housecleaning B. Dressing C. Preparing meals D. Exercising
The Katz Index of Independence in ADLs contains six items to assess a patient’s
independence: bathing, dressing, toileting, transferring, continence, and feeding. The
highest possible score is 6 (independent), and the lowest is 0 points (very dependent).
A patient presents with complaints of a bilateral action tremor in the arms and hands.
The patient reports that the tremor is activated by voluntary movement, especially
drinking from a glass. The tremor is absent when the affected body part is fully relaxed
and supported. These symptoms suggest which of the following disease conditions?
A. Parkinson’s B. Tardive dyskinesia C. Acute akinesia D. Essential
tremor
An essential tremor is an action tremor that often affects the hands and arms bilaterally.
It can also be seen in the head, voice, and face or trunk (rare). Common daily activities
are often affected, such as writing, drinking from a glass, and using utensils. Classically,
tremor due to Parkinson’s disease is a rest tremor that occurs unilaterally, distinguishing
it from an essential tremor. Tardive dyskinesia is a medication-induced hyperkinetic
movement disorder that causes oral, facial, and lingual dyskinesia. A sudden
This study source was downloaded by 100000901307859 from CourseHero.com on 10-16-2025 09:40:30 GMT -05:00
https://www.coursehero.com/file/250618455/Leik-Geriatrics-docx/
