CMN 577 Unit 2 Exam Questions with 100%
Correct Answers
The World Health Organization (WHO) defines old age as the chronological age of __
years or older in developed world countries
65
Changes of old age include:
loss of muscle and tissue mass, sagging skin, increased risk for cancer and other illnesses,
loss of cellular replication, and survival of the fittest
When it comes to medical decision making, you must take certain factors into account,
such as:
the patient's prognosis, ability to function independently, and their values/preferences
Functional decline is associated with what?
aging,injury, and illness
the majority of those who do present with complaints of memory loss have
______________ rather than mild cognitive impairment or dementia of some type.
depression
There has to be short term memory impairment along with at least __ other factor such
as aphasia, apraxia, agnosia, or impaired executive function, in order to entertain the
idea of dementia according to Papadakis and McPhee
1
is a simple, three-word recall plus clock draw test that will provide initial screening for
memory impairment
,mini-cog
The Mini-Cog consists of what?
3 unrelated words and the drawing of the clock including setting the time
Scoring the Mini-Cog:
If the patient can recall all 3 words (apple, penny, table- or 3 unrelated words of your choice)
at the 3 minute mark, you can skip scoring the clock. If the patient cannot remember ANY of
the 3 words, then you have a positive test. Recall of 1 to2 items would be considered normal
and you must score the clock drawing. The clock must be in a circle form, have the numbers
labeled correctly, and the hands (long and short) set in the correct positions
NPH (Normal Pressure Hydrocephalus) is a different type of neurological process that
consists of a 'triad' of symptoms:
magnetic gait, urinary incontinence, and memory loss.
difficulty performing motor tasks
apraxia
difficulty with word finding
aphasia
difficulty recognizing/identifying common objects
agnosia
How is Normal Pressure Hydrocephalus (NPH) diagnosed?
thorough history as well as physical examination, lab work and a CT or MRI of the head
Laboratory orders for normal pressure hydrocephalus should include what?
, CBC, CMP, TSH, and B12
What med is indicated for the treatment of mild to moderate Alzheimer's disease and
may be helpful in patients with vascular or Lewy body dementia?
Acetylcholinesterase inhibitors: donepezil (Aricept), galantamine (Razadyne), and
rivastigmine (Exelon)
What med is indicated for mod to severe dementia?
Memantine (Namenda)
the life expectancy after diagnosis of dementia is ___-___ years, depending upon many
factors
3-15
The elderly depressed patient is more likely to present with ___________ complaints
somatic (medical complaints with no basis or foundation)
an elderly patient with depression, insomnia and weight loss may benefit more from
what meds?
Mirtazapine (Remeron). The SE profile of mirtazapine has weight gain and sleepiness which
would benefit this patient
___________ is generally discouraged in the over 65 year group due to the long half-life
of the medication
fluoxetine
The confusion assessment method (CAM) may be used for bedside assessment of the
patient with delerium. CAM requires the presence of 4 factors:
Correct Answers
The World Health Organization (WHO) defines old age as the chronological age of __
years or older in developed world countries
65
Changes of old age include:
loss of muscle and tissue mass, sagging skin, increased risk for cancer and other illnesses,
loss of cellular replication, and survival of the fittest
When it comes to medical decision making, you must take certain factors into account,
such as:
the patient's prognosis, ability to function independently, and their values/preferences
Functional decline is associated with what?
aging,injury, and illness
the majority of those who do present with complaints of memory loss have
______________ rather than mild cognitive impairment or dementia of some type.
depression
There has to be short term memory impairment along with at least __ other factor such
as aphasia, apraxia, agnosia, or impaired executive function, in order to entertain the
idea of dementia according to Papadakis and McPhee
1
is a simple, three-word recall plus clock draw test that will provide initial screening for
memory impairment
,mini-cog
The Mini-Cog consists of what?
3 unrelated words and the drawing of the clock including setting the time
Scoring the Mini-Cog:
If the patient can recall all 3 words (apple, penny, table- or 3 unrelated words of your choice)
at the 3 minute mark, you can skip scoring the clock. If the patient cannot remember ANY of
the 3 words, then you have a positive test. Recall of 1 to2 items would be considered normal
and you must score the clock drawing. The clock must be in a circle form, have the numbers
labeled correctly, and the hands (long and short) set in the correct positions
NPH (Normal Pressure Hydrocephalus) is a different type of neurological process that
consists of a 'triad' of symptoms:
magnetic gait, urinary incontinence, and memory loss.
difficulty performing motor tasks
apraxia
difficulty with word finding
aphasia
difficulty recognizing/identifying common objects
agnosia
How is Normal Pressure Hydrocephalus (NPH) diagnosed?
thorough history as well as physical examination, lab work and a CT or MRI of the head
Laboratory orders for normal pressure hydrocephalus should include what?
, CBC, CMP, TSH, and B12
What med is indicated for the treatment of mild to moderate Alzheimer's disease and
may be helpful in patients with vascular or Lewy body dementia?
Acetylcholinesterase inhibitors: donepezil (Aricept), galantamine (Razadyne), and
rivastigmine (Exelon)
What med is indicated for mod to severe dementia?
Memantine (Namenda)
the life expectancy after diagnosis of dementia is ___-___ years, depending upon many
factors
3-15
The elderly depressed patient is more likely to present with ___________ complaints
somatic (medical complaints with no basis or foundation)
an elderly patient with depression, insomnia and weight loss may benefit more from
what meds?
Mirtazapine (Remeron). The SE profile of mirtazapine has weight gain and sleepiness which
would benefit this patient
___________ is generally discouraged in the over 65 year group due to the long half-life
of the medication
fluoxetine
The confusion assessment method (CAM) may be used for bedside assessment of the
patient with delerium. CAM requires the presence of 4 factors:
