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Geriatric Health Assessment and Management, Exams of Gerontology

Devry University - MichiganGerontology

A range of topics related to the healthcare of elderly patients, including preventive care recommendations, common geriatric conditions and their management, and best practices for promoting health behaviors in older adults. The document delves into various aspects of geriatric medicine, such as the evaluation and treatment of hypertension, thyroid disorders, musculoskeletal issues, respiratory conditions, and gastrointestinal problems. It also addresses the importance of considering the unique physiological and psychosocial needs of the elderly population when providing care. The information presented can be valuable for healthcare professionals, particularly nurse practitioners, in developing a comprehensive understanding of the complex healthcare needs of geriatric patients and implementing effective strategies for their management.

Typology: Exams

2024/2025

Available from 09/13/2024

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AANP Adult-Gerontology Nurse
Practitioner (AGPCNP) PSI Exam 1 and
2, 2024 Review Questions and Answers
100% Pass
An 88-year-old presents with right-side weakness after being
unable to rise unassisted following a fall to the bathroom floor.
History includes aphasia and noncompliance with hypertension
medication regimen. What is the most likely diagnosis?
Left-sided or right-sided CVA? - Answer>> LEFT-SIDED CVA
Which of the following signs/symtpoms are often associated with
headahces due to intracranial tumor?
1) pain worse laying down, focal neurological signs
2) Hyperflexia, personality change
3) acute onset: hours to days
4) pupillary constriction; stupor - Answer>> 1) pain worse
laying down, focal neurological signs
Which of the following pharmacotherapeutics would be most
important to administer to a patient who has a corneal abrasion?
1) Timolol
2) Gentamicin ophthalmic
3) Cromolyn optha
4) Olopatadine - Answer>> 2) Gentamicin ophthalmic
(Genoptic)
A 25-year-old presents with the chief complaint of decreased
mobility and pain of the right shoulder exacerbated by movement.
The patient reports that he participated in extensive house
painting 24 hours prior to the onset of pain. He denies any
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Download Geriatric Health Assessment and Management and more Exams Gerontology in PDF only on Docsity!

AANP Adult-Gerontology Nurse

Practitioner (AGPCNP) PSI Exam 1 and

2, 2024 Review Questions and Answers

100% Pass

An 88-year-old presents with right-side weakness after being unable to rise unassisted following a fall to the bathroom floor. History includes aphasia and noncompliance with hypertension medication regimen. What is the most likely diagnosis? Left-sided or right-sided CVA? - Answer>> LEFT-SIDED CVA Which of the following signs/symtpoms are often associated with headahces due to intracranial tumor?

  1. pain worse laying down, focal neurological signs
  2. Hyperflexia, personality change
  3. acute onset: hours to days
  4. pupillary constriction; stupor - Answer>> 1) pain worse laying down, focal neurological signs Which of the following pharmacotherapeutics would be most important to administer to a patient who has a corneal abrasion?
  5. Timolol
  6. Gentamicin ophthalmic
  7. Cromolyn optha
  8. Olopatadine - Answer>> 2) Gentamicin ophthalmic (Genoptic) A 25-year-old presents with the chief complaint of decreased mobility and pain of the right shoulder exacerbated by movement. The patient reports that he participated in extensive house painting 24 hours prior to the onset of pain. He denies any

trauma. Passive ROM is intact. No redness or ecchymosis is present. What is the next step to be taken in order to make a diagnosis?

  1. Xray of shoulder
  2. Palpate structures around the shoulder.
  3. MRI of shoulder
  4. EMG - Answer>> 2) palpate structures A 16-year-old female in the first month of taking Ortho-Novum 7/7/7 complains of midcycle spotting. She has not missed any doses and uses no other medication. Which of the following is appropriate?
  5. Changing to Ortho-Novum 1/
  6. Discontinue use
  7. Providing reassurance
  8. Double dose-for two days - Answer>> 3) provide reassurance According to the Report of the U.S. Preventive Services Task Force, which of the following is NOT a current recommendation guideline for preventive care in elderly female patients?
  9. Mammogram and clinical breast exams
  10. Fecal Occult blood test and/or sig
  11. Rubella serology or vaccination history
  12. Pnuemo and influenza vaccines - Answer>> 3) Rubella serology or vaccination history 87 y/o NH patient is drowsy and barely responsive. Temp 95, BP: 110/70, Pulse 60, R 10. The best action is to:
  13. initiate passive warming
  14. apply a rebreather

Which of the following is a common presenting feature of hyperthyroidism in the elderly?

  1. elevated TSH
  2. Thyroid enlargement
  3. atrial fibrillation
  4. abnormal T3 suppression - Answer>> 3) atrial fibrillation A 35-year-old lawn maintenance worker presents reporting "something in my eye" since the previous day. The eye was rinsed with over-the-counter eyewash, without relief. The patient denies visual disturbances or drainage. In formulating a plan of care, the nurse practitioner would FIRST:
  5. send to ophthalmologists
  6. florescreen staining
  7. test visual field
  8. prescribe eyedrops - Answer>> 3) test visual field A 72-year-old patient presents with dry, itchy eyes. During the course of the physical examination, the nurse practitioner notes the presence of a gray band of opacity in the cornea that encircles the iris. The band is 1.0-1.5 mm wide. This finding is most consistent with a diagnosis of a/an:
  1. corneal abrasion
  2. arcus senilis
  3. corneal ulcer
  4. herpetic infection of the eye - Answer>> 2) arcus senilis A 26-year-old presents with reports of anorexia, fatigue, weight loss, malaise, fever, night sweats, and a cough that has been present for 4 weeks. The diagnostic study to perform first would be:
  1. xray
  2. pulmonary function test
  3. bronchoscopy
  4. H & H - Answer>> 1) xray (tb-night sweats) A 44-year-old female is complaining of frequent anxiety attacks with chest discomfort and fatigue. On physical examination, her lungs are clear bilaterally. There are a midsystolic click and a grade II/VI systolic murmur at the apex. Further evaluation would include which of the following?
  5. EKG, flat plate of the abdomen, lipid profile
  6. Echocardiogram, Doppler, EKG
  7. Labs and benzo's
  8. EEG, Anxiety Scale, and electrolytes - Answer>> 2) Echocardiogram, Doppler, EKG A healthy 84 y/o would like to start an exercise program, what would you do before this takes place?
  9. physical exam
  10. EKG
  11. knee xrays
  12. PT Stress test - Answer>> 1) Physical Exam 29 y/o has uncomplicated Chlamydia infection will exhibit:
  13. green penile discharge
  14. uticartia
  15. unremarkable symtpoms
  16. penile ulcer - Answer>> 3) unremarkable symptoms 37 has suspected PE. c/o anxiety and cough, CXR normal, the next test should be:
  1. whatever - Answer>> 2) 126 mg/dl In the elderly, one pathophysiologic mechanism of isolated systolic hypertension involves:
  2. decreased cardiac output.
  3. loss of vascular tissue elasticity.
  4. hyperactive baroreceptors - Answer>> 2) loss of vascular tissue elasticity A 58-year-old female presents with shoulder and pelvic girdle pain for the past 6 months. She reports recent unintentional weight loss. On physical examination, there is pain on ROM, with no weakness noted. Laboratory studies show a low hemoglobin and an elevated sedimentation rate. Which of the following is the most likely diagnosis?
  5. Polymyalgia rheumatica
  6. polymyositis
  7. osteoarthritis
  8. Fibromyalgia - Answer>> 1) polymyalgia rheumatica An 85-year-old male relates that on the way to his annual physical examination, he suffered a sudden loss of vision in his right eye characterized by "a bunch of lights" and a feeling that "a curtain came down." All of the following would be included in the differential diagnosis EXCEPT:
  9. opthalmolic migraine
  10. retinal detachment.
  11. diabetic retinopathy.
  12. TIA - Answer>> 3) diabetic retinopathy

A patient with diabetes mellitus who is on NPH and regular insulin split-dosing presents with complaints of early morning rise in fingerstick blood glucose. A review of self blood glucose monitoring reveals increased morning levels. After an increase in the evening insulin dose, the problem worsens. This is most likely an example of:

  1. insulin resistance
  2. the Somogyi effect.
  3. needing more insulin in the mornings
  4. Need to increase insulin at night - Answer>> 2) Somogyi effect In a healthy elder, which of the following TRADITIONALLY defines a positive urine culture?
  5. ≥100,000 colonies/mL of a single organism
  6. ≥10,000 colonies/mL of a single organism
  7. ≥100,000 colonies/mL of a two or more organisms - Answer>> ≥100,000 colonies/mL of a single organism A 55-year-old patient exhibits a verified serum calcium level of 13 mg/dL [normal = 8.9-10.2 mg/dL]. The next step in determining the presence of pathology is to order a:
  8. BUN and serum creatinine.
  9. 24 hour urine
  10. parathyroid hormone level.
  11. thyroid panel - Answer>> 3) parathyroid hormone level An 88-year-old female presents with a 3-day history of vertigo. The patient has a past medical history of hypertension controlled with metoprolol, 50 mg daily. She reports that the presenting

Which of the following wet-mount results confirms a preliminary diagnosis of bacterial vaginosis?

  1. Organisms about the size of white blood cells with undulating flagellum, occasional lactobacillus, many white blood cells
  2. Squamous epithelial cells with stippling appearance and indistinct borders, no lactobacillus rods, many white blood cells
  3. Squamous epithelial cells with stippling appearance and indistinct borders, many lactobacillus rods, few white blood cells - Answer>> 2) Squamous epithelial cells with stippling appearance and indistinct borders, no lactobacillus rods, many white blood cells Which of the following physical findings would best alert a nurse practitioner to the probability of a herniated lumbar disc?
  4. Positive Patrick's sign, decreased thoracolumbar ROM, positive straight-leg raise at 90°
  5. Decreased thoracolumbar ROM, positive crossed straight-leg raise, positive straight-leg raise at 30°
  6. Negative Patrick's sign, decreased thoracolumbar ROM, positive straight-leg raise at 80° - Answer>> 2) Decreased thoracolumbar ROM, positive crossed straight-leg raise, positive straight-leg raise at 30° An 87-year-old obese female presents with complaints of calf pain in her right leg. The patient reports that the pain is increased with ambulation and has been increasing over the past 24 to 48 hours. The patient denies the following: any recent injury to the leg,

smoking, or recent surgery. To assess this patient's symptoms, you would initially assess:

  1. calf circumference and perform Doppler studies.
  2. popliteal pulses and Doppler studies
  3. Femoral pulses and skin temperature
  4. Patrick's signs and popliteal pulses - Answer>> 1) calf circumference and perform Doppler studies What type of exercise would you recommend for a 74-year-old patient with hypertension and degenerative joint disease (DJD)?
  5. Stationary bike
  6. Aqua exercises
  7. aerobic walking - Answer>> 2) Aqua exercises Trigeminal neuralgia
  8. electric shock like unilateral pain
  9. jaw pain extending to the neck
  10. Bilateral burning pain - Answer>> 1) electric shock like unilateral pain A manifestation of autonomic neuropathy in a 70-year-old patient with diabetes mellitus is:
  11. tremors.
  12. orthostatic hypotension.
  13. hypertension
  14. color blindness - Answer>> 2) orthostatic hypotension The most common fluid and electrolyte imbalance in patients over 65 years of age is:

negative. While awaiting the results of ordered diagnostic tests, the practitioner should recommend all of the following EXCEPT:

  1. starting H2 blockers.
  2. taking off from work until the work-up is complete.
  3. Reporting nausea/vomiting
  4. Discontinue NSAIDS - Answer>> 2) taking off work until the work-up is complete A 32-year-old patient reports a 6-month history of intermittent symmetrical swelling of the wrists and daily morning stiffness lasting 1 hour or more in and around other joints. What is the most likely diagnosis?
  5. Rheumatoid arthritis
  6. Osteoarthritis
  7. Gouty arthritis - Answer>> 1) Rheumatoid arthritis An 18-year-old college student presents for an athletic physical. When asked about current medications, she mentions she takes "some herb" she bought at the health food store for migraines and menstrual cramps. Which of the following herbal remedies has been commonly used for these conditions?
  8. Echinacea
  9. St. JOhn's Wort
  10. ginko biloba
  11. Feverfew - Answer>> 4) Feverfew The most common bacterial agents responsible for pneumonia in older adults residing in the community are:
  12. Streptococcus pneumoniae and Haemophilus influenzae.
  1. staphylococcus aureas and Haemophilus influenzae.
  2. Psuedomonas aeruginosa and Klebsiella pneumonae
  3. Legionnaires and streptococcus pneumoniae - Answer>> 1) Streptococcus pneumoniae and Haemophilus influenzae. Which cranial nerves test the oculomotor eye movement and strabismus?
  4. CN I III, IV
  5. CV III, IV and VI
  6. CN III, V, VII - Answer>> 2) CV III, IV and VI The management of COPD in the elderly is best guided by:
  7. pulse oximetry
  8. arterial blood gases
  9. radiographic images
  10. symptomology - Answer>> 4) symptomology Which of the following is the most serious outcome of Barrett's esophagus?
  11. Esophageal adenocarcinoma
  12. esophageal varices
  13. GERD
  14. Stricture - Answer>> 1) Esophageal adenocarcinoma Which of the following is most important in enhancing a nurse practitioner's clinical assessment when promoting health behaviors in young adults?
  15. Personality
  16. Include the parents with the pateint
  17. Taking developmental stages into consideration
  1. Loss of peripheral vision
  2. hemianopsia bilateral - Answer>> 1) loss of central vision The approved therapeutic International Normalized Ratio (INR) for a patient on warfarin (Coumadin) therapy for atrial fibrillation is:
  3. 1.0-2.
  4. 2.0-3.
  5. 2.5-3.5 - Answer>> 2) 2.0-3. A 57-year-old patient presents for a physical examination. The patient has been in good health, takes no medications, has a family history of hypertension and heart disease, denies alcohol use, and has never smoked. The patient's last tetanus booster was 9 years ago. Which of the following vaccines is indicated at this time?
  6. TD
  7. Influenza
  8. PNA
  9. Hep B - Answer>> 2) Influenza A patient with a diagnosis of diverticulosis presents with localized left lower quadrant discomfort, a palpable mass, mild leukocytosis, and T = 100° (37.8°C). The patient does not appear toxic and can tolerate fluids. An appropriate plan should include:
  10. NPO, BARIUM enema
  11. low fiber diet and referral to GI
  12. clear liquids and oral antibiotics.
  13. admit to hospital - Answer>> 3) clear liquids and oral antibiotics.

A frail elder who is on total bed rest suddenly develops urinary and fecal incontinence. This condition is frequently an indication of:

  1. dementia.
  2. fecal impaction.
  3. cholecystitis.
  4. parkinsons. - Answer>> 2) fecal impaction. A 65-year-old female with diabetes mellitus presents for a routine follow up. BP is 142/88, Hgb A1c is 8.4%, fasting blood glucose is 160 mg/dL, and microalbumin is 60 mg/L (normal < 30 mg/L). In addition to changing the diabetes medications, the nurse practitioner would also ensure that the patient is taking:
  5. nifedipine 12.5mg daily
  6. Amlodipine 10mg daily
  7. benazepril, 10 mg daily.
  8. atenolol 25mg BID - Answer>> 3) benazepril, 10 mg daily. A 67-year-old patient with type 2 diabetes mellitus, congestive heart failure (CHF), and mild coronary artery disease is currently taking digoxin, 0.25 mg daily; hydrochlorothiazide, 25 mg daily; glipizide, 10 mg daily; and atorvastatin (Lipitor), 20 mg h.s. Which of the following is an accurate statement regarding this regimen?
  9. Glipizide will deplete potassium stores
  10. The hydrochlorothiazide will predispose the patient to digoxin toxicity.
  11. atorvastatin will worsen the diabetes - Answer>> 2) The hydrochlorothiazide will predispose the patient to digoxin toxicity.
  1. for the presence of right upper arm bulge ("Popeye muscle") and biceps strength.
  2. radial pulses and right biceps tendon
  3. right supination/pronation - Answer>> 2) for the presence of right upper arm bulge ("Popeye muscle") and biceps strength. Which of the following accurately describes the phenomenon of isolated systolic hypertension, as opposed to isolated diastolic or combined systolic/diastolic hypertension, in the elderly?
  4. Considered a significant risk factor for MI or stroke
  5. demonstrated to be related to smoking
  6. Occurs primarily in men
  7. Not considered to be a major risk - Answer>> 1) Considered a significant risk factor for MI or stroke An 87-year-old long-term care facility resident was hospitalized for an abdominal surgery procedure, and the incision has become infected with methicillin-resistant Staphylococcus aureus (MRSA). The hospital is planning to return the patient to the same facility, which has no private rooms. According to CDC guidelines, the alternative placement would be to:
  8. inform the hospital that the patient will have to go to another facility.
  9. have the patient share a room with a resident who also has MRSA.
  10. have the patient share a room with a resident who has VRSA.
  11. Delay discharge until the wound is clear - Answer>> 2) have the patient share a room with a resident who also has MRSA. Which of the following laboratory tests are most widely accepted as indicators of the progression of HIV infection?
  1. CD4 count and viral load
  2. CD4 and Western Blot
  3. CD4 and ELISA
  4. WBC count and viral load - Answer>> 1) CD4 count and viral load Which class of antihypertensive agents has been associated with acute renal failure, and is absolutely CONTRAINDICATED in patients with bilateral renal artery stenosis?
  5. Thiazide diuretics
  6. Angiotensin-converting enzyme (ACE) inhibitors
  7. Calcium channel blockers
  8. Potassium sparing diuretics - Answer>> 2) Angiotensin- converting enzyme (ACE) inhibitors In geriatric patients, the polyvalent pneumococcal vaccine:
  9. prevents or lessens the severity of 60%-70% of pneumococcal infections.
  10. has no affect on immunocompromised patients
  11. prevents pneumonia 100% of the time - Answer>> 1) prevents or lessens the severity of 60%-70% of pneumococcal infections A 39-year-old patient was diagnosed with acute bronchitis in the emergency department and treated with acetaminophen, dextromethorphan, and metaproterenol (Alupent). The patient's history reveals a smoking habit of 1 pack per day. He now presents to your office with a fever of 101.2°F (39.4°C) and a cough productive of thick, yellow-green, foul-smelling sputum. You would encourage smoking cessation and prescribe: