AGNP Midterm EXAM QUESTIONS WITH
CORRECT ANSWERS
An 84-year-old woman, lives independently, concerned about driving.
| | | | | | | |
On 2 occasions, she had minor collisions when she was backing up her
| | | | | | | | | | | | |
car (she dislodged rearview mirror and struck a fire hydrant, each time
| | | | | | | | | | | |
on the passenger side).
| | |
• History: osteoarthritis of the cervical and lumbar spine and mild
| | | | | | | | | | |
hearing impairment |
• Medications: acetaminophen and calcium plus vitamin D
| | | | | | |
• Functional assessment: intact cognition and vision, with near-visual
| | | | | | | | |
acuity 20/30 in each eye. She fails the whisper test.
| | | | | | | | |
• Physical examination: Decreased range of motion in neck and back in
| | | | | | | | | | | |
all planes (unchanged from previous findings); Diffuse osteoarthritic
| | | | | | | |
deformities in the knees and hands; Decreased range of motion at the
| | | | | | | | | | | |
hips; Mild kyphosis; Motor strength and deep tendon reflexes are
| | | | | | | | | |
symmetric and intact | |
Which one of the following is the most appropriate next step?
| | | | | | | | | |
A. Obtain radiography of the cervical spine in 3 views.
| | | | | | | | |
B. Recommend that she no longer drive.
| | | | | |
C. Refer to physical therapy.
| | | |
,D. Refer to audiology.
| | |
E. Refer to occupational therapy.
| | | |
E. Refer to occupational therapy.
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An 80-year-old woman hospitalized after fall and hip fracture
| | | | | | | |
• History: stable osteoarthritis of the knees, peripheral neuropathy
| | | | | | | |
• Prior to fall, she lived alone and managed all instrumental activities of
| | | | | | | | | | | | |
daily living; occasionally used cane or walker for mild problems with
| | | | | | | | | | |
balance
• Current status, 4 days after surgery: Needs assistance of 2 persons for
| | | | | | | | | | | | |
transfer; Frequently incontinent of urine; Eating very little
| | | | | | |
Which one of the following is the most likely outcome for this patient 6
| | | | | | | | | | | | | |
months after the fracture?
| | |
A. Continued slow functional decline
| | | |
B. Recovery to her pre-fracture level of function
| | | | | | |
C. Partial recovery of function
| | | |
D. Stability at the level of function on hospital discharge
| | | | | | | | |
E. Death
|
B. Recovery to her pre-fracture level of function
| | | | | | |
,An 85-year-old man with 2 episodes of low-volume urinary incontinence
| | | | | | | | |
in the last year, when he "waited too long"
| | | | | | | | |
• Functional assessment: Near-visual acuity of 20/50 on the right and
| | | | | | | | | | |
20/60 on the left with correction; Fails whisper test in right ear ; Gait
| | | | | | | | | | | | | |
speed at usual pace is 0.9 m/sec ; Mini-Cog screen: 2 of 3 items on
| | | | | | | | | | | | | | |
recall, completes an accurate clock 36 CASE 3 (2 of 3)
| | | | | | | | | |
Which one of the following is the most appropriate next step for
| | | | | | | | | | | |
evaluation of functional disability? A. Refer to audiology.
| | | | | | |
B. Refer to ophthalmology.
| | |
C. Refer to physical therapy.
| | | |
D. Complete additional cognitive testing.
| | | |
E. Complete an incontinence evaluation.
| | | |
B. Refer to ophthalmology.
| | |
A 68-year-old woman describes vision problems.
| | | | |
• Progressive blurring of distance vision
| | | | |
• Increased difficulty with nighttime driving, which she attributes to
| | | | | | | | | |
worsening glare and haloes around lights | | | | |
• She no longer needs glasses for reading.
| | | | | | |
• History: hypertension, hypercholesterolemia
| | |
, Which one of the following is the most likely cause of the changes in her
| | | | | | | | | | | | | |
vision?
|
A. Uncontrolled hypertension
| |
B. Poorly controlled blood glucose C. Choroidal neovascularization
| | | | | | |
D. Cataract progression
| |
E. Increased intraocular pressure
| | |
D. Cataract progression
| |
A 72-year-old black man has right shoulder trauma after he fell in a
| | | | | | | | | | | | |
parking lot. He states that he was walking to his car when he suddenly
| | | | | | | | | | | | | |
tripped and fell forward onto his arm. He subsequently learned that he
| | | | | | | | | | | |
had tripped over a curb.
| | | |
• History: hypertension, high cholesterol, glaucoma
| | | | |
Which one of the following most likely contributed to his fall?
| | | | | | | | | |
A. Acute glaucoma
| |
B. Failure to use glaucoma drops that morning
| | | | | | |
C. Poor peripheral vision
| | |
D. Retinal embolus from a carotid plaque
| | | | | |
C. Poor peripheral vision
| | |
CORRECT ANSWERS
An 84-year-old woman, lives independently, concerned about driving.
| | | | | | | |
On 2 occasions, she had minor collisions when she was backing up her
| | | | | | | | | | | | |
car (she dislodged rearview mirror and struck a fire hydrant, each time
| | | | | | | | | | | |
on the passenger side).
| | |
• History: osteoarthritis of the cervical and lumbar spine and mild
| | | | | | | | | | |
hearing impairment |
• Medications: acetaminophen and calcium plus vitamin D
| | | | | | |
• Functional assessment: intact cognition and vision, with near-visual
| | | | | | | | |
acuity 20/30 in each eye. She fails the whisper test.
| | | | | | | | |
• Physical examination: Decreased range of motion in neck and back in
| | | | | | | | | | | |
all planes (unchanged from previous findings); Diffuse osteoarthritic
| | | | | | | |
deformities in the knees and hands; Decreased range of motion at the
| | | | | | | | | | | |
hips; Mild kyphosis; Motor strength and deep tendon reflexes are
| | | | | | | | | |
symmetric and intact | |
Which one of the following is the most appropriate next step?
| | | | | | | | | |
A. Obtain radiography of the cervical spine in 3 views.
| | | | | | | | |
B. Recommend that she no longer drive.
| | | | | |
C. Refer to physical therapy.
| | | |
,D. Refer to audiology.
| | |
E. Refer to occupational therapy.
| | | |
E. Refer to occupational therapy.
| | | |
An 80-year-old woman hospitalized after fall and hip fracture
| | | | | | | |
• History: stable osteoarthritis of the knees, peripheral neuropathy
| | | | | | | |
• Prior to fall, she lived alone and managed all instrumental activities of
| | | | | | | | | | | | |
daily living; occasionally used cane or walker for mild problems with
| | | | | | | | | | |
balance
• Current status, 4 days after surgery: Needs assistance of 2 persons for
| | | | | | | | | | | | |
transfer; Frequently incontinent of urine; Eating very little
| | | | | | |
Which one of the following is the most likely outcome for this patient 6
| | | | | | | | | | | | | |
months after the fracture?
| | |
A. Continued slow functional decline
| | | |
B. Recovery to her pre-fracture level of function
| | | | | | |
C. Partial recovery of function
| | | |
D. Stability at the level of function on hospital discharge
| | | | | | | | |
E. Death
|
B. Recovery to her pre-fracture level of function
| | | | | | |
,An 85-year-old man with 2 episodes of low-volume urinary incontinence
| | | | | | | | |
in the last year, when he "waited too long"
| | | | | | | | |
• Functional assessment: Near-visual acuity of 20/50 on the right and
| | | | | | | | | | |
20/60 on the left with correction; Fails whisper test in right ear ; Gait
| | | | | | | | | | | | | |
speed at usual pace is 0.9 m/sec ; Mini-Cog screen: 2 of 3 items on
| | | | | | | | | | | | | | |
recall, completes an accurate clock 36 CASE 3 (2 of 3)
| | | | | | | | | |
Which one of the following is the most appropriate next step for
| | | | | | | | | | | |
evaluation of functional disability? A. Refer to audiology.
| | | | | | |
B. Refer to ophthalmology.
| | |
C. Refer to physical therapy.
| | | |
D. Complete additional cognitive testing.
| | | |
E. Complete an incontinence evaluation.
| | | |
B. Refer to ophthalmology.
| | |
A 68-year-old woman describes vision problems.
| | | | |
• Progressive blurring of distance vision
| | | | |
• Increased difficulty with nighttime driving, which she attributes to
| | | | | | | | | |
worsening glare and haloes around lights | | | | |
• She no longer needs glasses for reading.
| | | | | | |
• History: hypertension, hypercholesterolemia
| | |
, Which one of the following is the most likely cause of the changes in her
| | | | | | | | | | | | | |
vision?
|
A. Uncontrolled hypertension
| |
B. Poorly controlled blood glucose C. Choroidal neovascularization
| | | | | | |
D. Cataract progression
| |
E. Increased intraocular pressure
| | |
D. Cataract progression
| |
A 72-year-old black man has right shoulder trauma after he fell in a
| | | | | | | | | | | | |
parking lot. He states that he was walking to his car when he suddenly
| | | | | | | | | | | | | |
tripped and fell forward onto his arm. He subsequently learned that he
| | | | | | | | | | | |
had tripped over a curb.
| | | |
• History: hypertension, high cholesterol, glaucoma
| | | | |
Which one of the following most likely contributed to his fall?
| | | | | | | | | |
A. Acute glaucoma
| |
B. Failure to use glaucoma drops that morning
| | | | | | |
C. Poor peripheral vision
| | |
D. Retinal embolus from a carotid plaque
| | | | | |
C. Poor peripheral vision
| | |
