Nr 601 Midterm Exam Questions And Answers
Complete Updated Solution
WEEK 1-CHAPTER QUESTIONS 1, 5, 6, 7
CHAPTER I
Principles of Primary Care of Older Adults
RULE OF FOURTHS
• If the problem is disease, then medical treatment is indicated.
• If the problem is disuse, it can often be cured with an activity regimen.
• If the problem is misuse, prior damage cannot be reversed but steps can be taken to
prevent deterioration and to preserve function.
• If the problem is physiologic aging, then steps should be taken to adapt and compensate for
the disability.
Test Questions
1. Which one of the following is most true about the rule of fourths?
a. One-fourth of geriatric problems are iatrogenic.
b. Little can be done to prevent three-fourths of the problems of aging.
c. For every medical complaint a patient presents with, a careful assessment can identify
three other diagnoses.
d. What used to be called normal aging can be largely explained by processes that are not
normal.
e. A good way to conduct a geriatric assessment is to use four categories: mental,
physical, psychosocial, and environmental.
2. Which one of the following is most true about aging changes?
a. Stage 3 and 4 sleep decreases.
b. Renal perfusion is not reduced, but renal function is reduced.
c. Hearing acuity declines beginning in middle age.
d. Prostatic enlargement occurs only in a minority of men.
3. An old woman who is cared for by attentive, cautious, concerned family is particularly likely to
suffer from which one of the following complications after an episode of gastroenteritis?
a. Immobility related to overconcern
b. Continued vomiting caused by too-rapid feeding
c. Diarrhea resulting from administration of milk products
d. Constipation related to overtreatment of diarrhea
4. Which one of the following is most true about psychological aging?
a. Disengagement tends to promote better psychological health than continued engagement.
b. Most older adults do not worry about memory loss.
,c. Happiness declines starting in middle age.
d. Ageism can lead to isolation and depression.
5. Of the following conditions, which one is most common and most often preventable?
a. Falls
b. Frailty
, c. Cognitive impairment
d. Iatrogenic disease
e. Depression
Test Question Answers
1. d
2. a
3. a
4. d
5. d
CHAPTER 5
Wellness and Prevention
Immunizations Recommended for Older Adults
• Influenza inactive (IIV), or recombinant (RIV)1 dose annually
• Tetanus, diphtheria, pertussis (TDAP)1 dose after age 65 years then Td every 10 years
• Varicella recombinant (Shingrix)2 doses 2–5 months apart. Give to those who had zoster
• Pneumococcal1 dose of PPSV23 (Polysaccharide, Pneumovax); consider 1 dose PCV 13 in
high-risk patients
• Hepatitis A/hepatitis BOnly if high risk, and at least once
Test Questions
1. The US Advisory Committee on Immunization Practices and the Centers for Disease
Control currently recommend which one of the following?
a. All older adults be immunized against influenza annually and that they receive at least
one pneumococcal vaccination.
b. All high-risk older adults should receive an additional pneumococcal vaccination 5 years
or more after their first immunization.
c. Older adults should receive a one-time revaccination for pneumonia if they were initially
vaccinated more than 5 years previously and were less than 65 years of age at the time of
the initial vaccination.
d. All of these are recommended.
2. Healthcare providers should recommend that older adults engage in which one of
the following?
a. 150 minutes of moderate intensity physical activity weekly
b. 20 minutes of moderate intensity physical activity 3 days per week
c. 10 minutes of vigorous physical activity most days of the week
d. 30 minutes of vigorous physical activity 3 days per week
3. Guidelines for the primary prevention of stroke recommend that aspirin be used in
which one of the following?
a. Individuals whose risk is high enough for the benefits to outweigh the risks
b. Individuals regardless of risk level
c. Males regardless of risk level
d. Females who are also taking antihypertensives
, 4. Even though older adults are less likely to get counseled for smoking cessation, they
have which one of the following?
a. The same quit rates as younger individuals
b. Approximately 50% better quit rates than younger individuals
c. Approximately 25% better quit rates than younger individuals
d. Much lower quit rates than younger individuals
Test Question Answers
1. d.
2. a.
3. a.
4. a.
CHAPTER 6
Cultural Competency and Cultural Humility in Caring for Older Adults
Test Questions
1. Which of the following is true about cultural humility?
a. It is typically accomplished through professional development courses.
b. It can only be achieved by underrepresented minority groups.
c. It places emphasis on power imbalances and promotes interpersonal sensitivity
through partnerships with and learning from patients.
d. It rarely considers the biologic, socioeconomic, and racial impacts of upstream
structural factors on health disparities.
2. Racial disparities have been a part of US healthcare for many decades. How might
this impact the expectations of older Black Americans?
a. Reluctance to participate in medical research because of unethical studies in the past
b. Underrepresentation of Black physicians in the geriatric workforce
c. Cumulative effects of differences in access to healthcare providers
d. All of these
3. Dementia is a relatively common condition in the geriatric population. It becomes
more common as people age. Which is the most appropriate description of
“personhood” as it relates to people with dementia?
a. Personhood is a universal concept that is defined the same way in all cultures.
b. The ability to relate to others as people, rather than preserving cognitive
independence, is an important aspect of “personhood.”
c. The ability to recognize family members by name is an important aspect of “personhood.”
d. A deterioration in cognitive function demonstrates the decreasing value of older adults
in society.
4. Immigrant families bring cultural traditions into healthcare decisions. With regard to
older adults, which of the following is true?
Complete Updated Solution
WEEK 1-CHAPTER QUESTIONS 1, 5, 6, 7
CHAPTER I
Principles of Primary Care of Older Adults
RULE OF FOURTHS
• If the problem is disease, then medical treatment is indicated.
• If the problem is disuse, it can often be cured with an activity regimen.
• If the problem is misuse, prior damage cannot be reversed but steps can be taken to
prevent deterioration and to preserve function.
• If the problem is physiologic aging, then steps should be taken to adapt and compensate for
the disability.
Test Questions
1. Which one of the following is most true about the rule of fourths?
a. One-fourth of geriatric problems are iatrogenic.
b. Little can be done to prevent three-fourths of the problems of aging.
c. For every medical complaint a patient presents with, a careful assessment can identify
three other diagnoses.
d. What used to be called normal aging can be largely explained by processes that are not
normal.
e. A good way to conduct a geriatric assessment is to use four categories: mental,
physical, psychosocial, and environmental.
2. Which one of the following is most true about aging changes?
a. Stage 3 and 4 sleep decreases.
b. Renal perfusion is not reduced, but renal function is reduced.
c. Hearing acuity declines beginning in middle age.
d. Prostatic enlargement occurs only in a minority of men.
3. An old woman who is cared for by attentive, cautious, concerned family is particularly likely to
suffer from which one of the following complications after an episode of gastroenteritis?
a. Immobility related to overconcern
b. Continued vomiting caused by too-rapid feeding
c. Diarrhea resulting from administration of milk products
d. Constipation related to overtreatment of diarrhea
4. Which one of the following is most true about psychological aging?
a. Disengagement tends to promote better psychological health than continued engagement.
b. Most older adults do not worry about memory loss.
,c. Happiness declines starting in middle age.
d. Ageism can lead to isolation and depression.
5. Of the following conditions, which one is most common and most often preventable?
a. Falls
b. Frailty
, c. Cognitive impairment
d. Iatrogenic disease
e. Depression
Test Question Answers
1. d
2. a
3. a
4. d
5. d
CHAPTER 5
Wellness and Prevention
Immunizations Recommended for Older Adults
• Influenza inactive (IIV), or recombinant (RIV)1 dose annually
• Tetanus, diphtheria, pertussis (TDAP)1 dose after age 65 years then Td every 10 years
• Varicella recombinant (Shingrix)2 doses 2–5 months apart. Give to those who had zoster
• Pneumococcal1 dose of PPSV23 (Polysaccharide, Pneumovax); consider 1 dose PCV 13 in
high-risk patients
• Hepatitis A/hepatitis BOnly if high risk, and at least once
Test Questions
1. The US Advisory Committee on Immunization Practices and the Centers for Disease
Control currently recommend which one of the following?
a. All older adults be immunized against influenza annually and that they receive at least
one pneumococcal vaccination.
b. All high-risk older adults should receive an additional pneumococcal vaccination 5 years
or more after their first immunization.
c. Older adults should receive a one-time revaccination for pneumonia if they were initially
vaccinated more than 5 years previously and were less than 65 years of age at the time of
the initial vaccination.
d. All of these are recommended.
2. Healthcare providers should recommend that older adults engage in which one of
the following?
a. 150 minutes of moderate intensity physical activity weekly
b. 20 minutes of moderate intensity physical activity 3 days per week
c. 10 minutes of vigorous physical activity most days of the week
d. 30 minutes of vigorous physical activity 3 days per week
3. Guidelines for the primary prevention of stroke recommend that aspirin be used in
which one of the following?
a. Individuals whose risk is high enough for the benefits to outweigh the risks
b. Individuals regardless of risk level
c. Males regardless of risk level
d. Females who are also taking antihypertensives
, 4. Even though older adults are less likely to get counseled for smoking cessation, they
have which one of the following?
a. The same quit rates as younger individuals
b. Approximately 50% better quit rates than younger individuals
c. Approximately 25% better quit rates than younger individuals
d. Much lower quit rates than younger individuals
Test Question Answers
1. d.
2. a.
3. a.
4. a.
CHAPTER 6
Cultural Competency and Cultural Humility in Caring for Older Adults
Test Questions
1. Which of the following is true about cultural humility?
a. It is typically accomplished through professional development courses.
b. It can only be achieved by underrepresented minority groups.
c. It places emphasis on power imbalances and promotes interpersonal sensitivity
through partnerships with and learning from patients.
d. It rarely considers the biologic, socioeconomic, and racial impacts of upstream
structural factors on health disparities.
2. Racial disparities have been a part of US healthcare for many decades. How might
this impact the expectations of older Black Americans?
a. Reluctance to participate in medical research because of unethical studies in the past
b. Underrepresentation of Black physicians in the geriatric workforce
c. Cumulative effects of differences in access to healthcare providers
d. All of these
3. Dementia is a relatively common condition in the geriatric population. It becomes
more common as people age. Which is the most appropriate description of
“personhood” as it relates to people with dementia?
a. Personhood is a universal concept that is defined the same way in all cultures.
b. The ability to relate to others as people, rather than preserving cognitive
independence, is an important aspect of “personhood.”
c. The ability to recognize family members by name is an important aspect of “personhood.”
d. A deterioration in cognitive function demonstrates the decreasing value of older adults
in society.
4. Immigrant families bring cultural traditions into healthcare decisions. With regard to
older adults, which of the following is true?
