NR 601 Week 5 |320 questions with verified
answers
• Care for LGBT patients begins with your paperwork and interviews. Without a
welcoming space, they may not be empowered to share their full history.
• Collect patient data in a standardized fashion to collect a robust sexual, gender,
and social history.
• LGBT people are often part of families of choice, which may be vulnerable to
aging. Advocate for advanced care planning in your patients to respect their goals
of care. Ans✓✓✓ • Care for LGBT patients begins with your paperwork and
interviews. Without a welcoming space, they may not be empowered to share
their full history.
• Collect patient data in a standardized fashion to collect a robust sexual, gender,
and social history.
• LGBT people are often part of families of choice, which may be vulnerable to
aging. Advocate for advanced care planning in your patients to respect their goals
of care.
1. A 75-year-old man presents with the chief concern, "I may have a bladder
infection." Further questioning reveals for several months he has been needing to
void every couple of hours (can't sit through a whole ball game), feels he must go
as soon as he feels the urge (he tried putting it off and had urinary leakage), and is
getting up two to three times at night to void. He denies delay in voiding or
straining to initiate voiding, slow stream, feeling of incomplete emptying, or
dribbling after completion of urination. He also denies dysuria and abdominal
pain. Which of the following best describes the category or type of his lower
urinary tract symptoms?
a. Prostatism
b. Overactive bladder
c. Postmicturition
,d. Storage (irritative)
e. Voiding (obstructive) Ans✓✓✓ D
1. A 79-year-old woman with a 1.5-cm breast cancer underwent lumpectomy.
Pathology revealed ductal carcinoma that is hormone receptor negative (estrogen
receptor 0%, progesterone receptor 1%) and HER2/neu negative. Surgical margins
were adequate and uninvolved with cancer. Sentinel lymph node sampling was
negative for lymph node involvement. She has good performance status and no
activities of daily living (ADL) or instrumental (IADL) dependencies. What
treatment would you recommend?
a. Adjuvant chemotherapy
b. Adjuvant chemotherapy with irradiation
c. Adjuvant irradiation only
d. Hormonal therapy only
e. None of the above Ans✓✓✓ D
1. An 85-year-old man with chronic obstructive pulmonary disease presents to
your office with his daughter with the complaint of new onset chest pain,
shortness of breath, and cough. He is clearly tachypneic and has tactile fremitus
and egophany and crackles heard at the right lung base. His daughter just wants
you to give him an antibiotic pill so that she can take him home. You are
concerned that he might need to be hospitalized and require IV antibiotics. What
statement is true? Ans✓✓✓ a. All older adults with pneumonia must be treated
for methicillin-resistant Staphylococcus aureus (MRSA) and Pseudomonas
infection.
b. Treatment decisions for pneumonia are based on its severity, the presence of
comorbid illnesses, and a prior history of MRSA or Pseudomonas respiratory
infection.
c. All older adults with pneumonia must be treated in hospital.
,d. Pulse oximetry, respiratory rate, and chest radiography would not be helpful
for the diagnosis and management of pneumonia in older adults.
B
1. An 86-year-old female comes to your office for a wellness visit. Her blood
pressure is 125/70 mmHg, pulse 69 beats per min, and respiratory rate 18 breaths
per min. She is well appearing and reports she is up to date on her routine
vaccinations. She introduces her partner of 35 years whom she would like to
make medical decisions for her in case she becomes unable to make decisions for
herself. She reports that she and her partner are not married. She asks if she
needs any further documentation to ensure her goals of care are followed.
Which one of the following would be the most appropriate recommendation for
this patient and her partner? Ans✓✓✓ a. Advise them to complete a POLST.
b. Advise them that they have adequate documentation to be recognized legally.
c. Advise them to file an advanced directive.
d. Respond that although they lack documentation, her partner will be recognized
de facto.
C
1. What is the most common cause of erectile dysfunction in older men?
a. Psychological stress
b. Adverse drug reaction
c. Atherosclerosis
d. Autonomic neuropathy Ans✓✓✓ C
, 1. Which of the following is true about tolterodine?
a. It should be avoided in men with prostatic hypertrophy.
b. It increases the risk of constipation compared with oral oxybutynin.
c. It acts by ablating detrusor spasms.
d. It has greater risk of adverse effects with its twice-daily formulation. Ans✓✓✓
D
2. A 70-year-old man has bothersome lower urinary tract syndrome (LUTS)
associated with benign prostatic hyperplasia (BPH). His symptoms are no longer
well managed with lifestyle modifications. He is interested in medication to
reduce his urinary symptoms but is concerned about possible side effects. He
notes that he is recently married and sexual activity is very important to him.
Which of the following medications would be most appropriate for this patient?
a. Alfusozin
b. Ditropan
c. Dutasteride
d. Tamsulosin
e. Tadalafil Ans✓✓✓ A
2. An 80-year-old woman that you follow in a nursing home has an acute decline
in her mental status. She has a fever >100° F, but no other focal complaints or
findings on physical examination except for a chronic indwelling urinary catheter.
What statement is true?
a. Fever in an older adult with an indwelling urinary catheter is an appropriate
indication to start empiric antibiotic therapy.
b. Older adults with an indwelling urinary catheter are less likely to have
bloodstream infection than older adults without a catheter.
answers
• Care for LGBT patients begins with your paperwork and interviews. Without a
welcoming space, they may not be empowered to share their full history.
• Collect patient data in a standardized fashion to collect a robust sexual, gender,
and social history.
• LGBT people are often part of families of choice, which may be vulnerable to
aging. Advocate for advanced care planning in your patients to respect their goals
of care. Ans✓✓✓ • Care for LGBT patients begins with your paperwork and
interviews. Without a welcoming space, they may not be empowered to share
their full history.
• Collect patient data in a standardized fashion to collect a robust sexual, gender,
and social history.
• LGBT people are often part of families of choice, which may be vulnerable to
aging. Advocate for advanced care planning in your patients to respect their goals
of care.
1. A 75-year-old man presents with the chief concern, "I may have a bladder
infection." Further questioning reveals for several months he has been needing to
void every couple of hours (can't sit through a whole ball game), feels he must go
as soon as he feels the urge (he tried putting it off and had urinary leakage), and is
getting up two to three times at night to void. He denies delay in voiding or
straining to initiate voiding, slow stream, feeling of incomplete emptying, or
dribbling after completion of urination. He also denies dysuria and abdominal
pain. Which of the following best describes the category or type of his lower
urinary tract symptoms?
a. Prostatism
b. Overactive bladder
c. Postmicturition
,d. Storage (irritative)
e. Voiding (obstructive) Ans✓✓✓ D
1. A 79-year-old woman with a 1.5-cm breast cancer underwent lumpectomy.
Pathology revealed ductal carcinoma that is hormone receptor negative (estrogen
receptor 0%, progesterone receptor 1%) and HER2/neu negative. Surgical margins
were adequate and uninvolved with cancer. Sentinel lymph node sampling was
negative for lymph node involvement. She has good performance status and no
activities of daily living (ADL) or instrumental (IADL) dependencies. What
treatment would you recommend?
a. Adjuvant chemotherapy
b. Adjuvant chemotherapy with irradiation
c. Adjuvant irradiation only
d. Hormonal therapy only
e. None of the above Ans✓✓✓ D
1. An 85-year-old man with chronic obstructive pulmonary disease presents to
your office with his daughter with the complaint of new onset chest pain,
shortness of breath, and cough. He is clearly tachypneic and has tactile fremitus
and egophany and crackles heard at the right lung base. His daughter just wants
you to give him an antibiotic pill so that she can take him home. You are
concerned that he might need to be hospitalized and require IV antibiotics. What
statement is true? Ans✓✓✓ a. All older adults with pneumonia must be treated
for methicillin-resistant Staphylococcus aureus (MRSA) and Pseudomonas
infection.
b. Treatment decisions for pneumonia are based on its severity, the presence of
comorbid illnesses, and a prior history of MRSA or Pseudomonas respiratory
infection.
c. All older adults with pneumonia must be treated in hospital.
,d. Pulse oximetry, respiratory rate, and chest radiography would not be helpful
for the diagnosis and management of pneumonia in older adults.
B
1. An 86-year-old female comes to your office for a wellness visit. Her blood
pressure is 125/70 mmHg, pulse 69 beats per min, and respiratory rate 18 breaths
per min. She is well appearing and reports she is up to date on her routine
vaccinations. She introduces her partner of 35 years whom she would like to
make medical decisions for her in case she becomes unable to make decisions for
herself. She reports that she and her partner are not married. She asks if she
needs any further documentation to ensure her goals of care are followed.
Which one of the following would be the most appropriate recommendation for
this patient and her partner? Ans✓✓✓ a. Advise them to complete a POLST.
b. Advise them that they have adequate documentation to be recognized legally.
c. Advise them to file an advanced directive.
d. Respond that although they lack documentation, her partner will be recognized
de facto.
C
1. What is the most common cause of erectile dysfunction in older men?
a. Psychological stress
b. Adverse drug reaction
c. Atherosclerosis
d. Autonomic neuropathy Ans✓✓✓ C
, 1. Which of the following is true about tolterodine?
a. It should be avoided in men with prostatic hypertrophy.
b. It increases the risk of constipation compared with oral oxybutynin.
c. It acts by ablating detrusor spasms.
d. It has greater risk of adverse effects with its twice-daily formulation. Ans✓✓✓
D
2. A 70-year-old man has bothersome lower urinary tract syndrome (LUTS)
associated with benign prostatic hyperplasia (BPH). His symptoms are no longer
well managed with lifestyle modifications. He is interested in medication to
reduce his urinary symptoms but is concerned about possible side effects. He
notes that he is recently married and sexual activity is very important to him.
Which of the following medications would be most appropriate for this patient?
a. Alfusozin
b. Ditropan
c. Dutasteride
d. Tamsulosin
e. Tadalafil Ans✓✓✓ A
2. An 80-year-old woman that you follow in a nursing home has an acute decline
in her mental status. She has a fever >100° F, but no other focal complaints or
findings on physical examination except for a chronic indwelling urinary catheter.
What statement is true?
a. Fever in an older adult with an indwelling urinary catheter is an appropriate
indication to start empiric antibiotic therapy.
b. Older adults with an indwelling urinary catheter are less likely to have
bloodstream infection than older adults without a catheter.
