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NR 601 midterm (2025) Actual Exam
Questions and Answers A+ Graded
The .percentage .of .the .FVC .expired .in .one .second .is .- .CORRECT .ANSWER- FEV1/FVC .ratio The .aging .process .causes .what .normal .physiological .changes .in .the .heart .- .CORRECT .ANSWER-The .heart .valve .thickens .and .becomes .rigid, .secondary .to .fibrosis .and .sclerosis A. 55 .yo .Caucasian .male .follows .up .after .referral .to .cardiologist. .He .thinks .his .med .is .causing .a .cough .and .sometimes .he .has .difficulty .breathing. .Which .med .was .most .likely .prescribed? .- .CORRECT .ANSWER-Lisinopril MJ .presents .with .h/o .structural .damage .with .current .s/s .of .HF. .Treatment .will .be .based .on .his .stage .of .HF .which .is .- .CORRECT .ANSWER-Stage .C 65 .yo .Caucasian .presents .with .mitral .valve .stenosis, .physical .exam .is .unremarkable. .you .know .her .stage .of .HF .is .- .CORRECT .ANSWER-Stage .B The .best .way .to .diagnose .structural .heart .disease/dysfunction .noninvasively .is .- .CORRECT .ANSWER-Echocardiogram Chronic .pain .can .have .major .impact .on .patients .ability .to .function .and .have .profound .impact .on .overall .QOL. .Ongoing .pain .may .be .linked .to .- .CORRECT .ANSWER-Depression, .sleep .disturbance, .decreased .socialization The .Beers .criteria .are .appropriate .for .use .in .evaluating .use .of .certain .meds .in .patients .- .CORRECT .ANSWER->65 .y/o All .of .the .following .statements .are .true .about .lab .values .in .older .adults .except .- .CORRECT .ANSWER-Abnormal .findings .are .often .due .to .physiological .aging According .to .the. 2017 .ACC .HTN .guidelines, .the .recommended .BP .goal .for .a .65y/o .African .American .woman .with .a .h/o .HTN .and .DM .and .no .h/o .CKD .is .- .CORRECT .ANSWER-<140/ THe .pathophysiology .of .HF .is .due .to .- .CORRECT .ANSWER-Inadequate .cardiac .output .to .meet .the .metabolic .and .O2 .demands .of .the .body
The .volume .of .air .a .patient .to .exhale .for .total .duration .of .the .test .during .maximal .effort .is .- .CORRECT .ANSWER-FVC According .it .the. 2017 .ACC .HTN .guidelines, .normal .BP .is .- .CORRECT .ANSWER- <120/ Functional .abilities .are .best .assessed .by .- .CORRECT .ANSWER-Observed .assessment .of .function LB .is .a. 77 .yo .with .chronic .poorly .controlled .HTN. .You .know .that .goals .include .prevention .of .target .organ .damage. .During .your .eval .you .will .assess .for .evidence .of .- .CORRECT .ANSWER-Left .ventricular .hypertrophy Aortic .regurgitation .requires .medical .treatment .for .early .signs .of .HF .with .- .CORRECT .ANSWER-ACEi The .volume .of .air .in .the .lungs .at .max .inflation .is .- .CORRECT .ANSWER-TLC .(total .lung .capacity) Preferred .amount .of .exercise .for .older .adults .is .- .CORRECT .ANSWER- 30min/day .of .aerobic .exercise. 5 .days .a .week You .know .the .following .statements .regarding .th .pain .of .acute .coronary .syndrome .are .true .except .- .CORRECT .ANSWER-Present .atypically .more .often .in .men .than .women Elderly .patient .presents .with .new .onset .of .feeling .heart .race, .fatigue. .EKG .reveals .Afib .with .rate .>100. .Patient .also .has .a .new .tremor .in .both .hands. .Which .of .the .following .would .you .suspect .- .CORRECT .ANSWER- Hyperthyroidism Which .patient .is .more .likely .to .have .osteoporosis .- .CORRECT .ANSWER- 80 .y/o. .Underweight .male .who .smokes .and .has .been .on .steroids .for .psoriasis Post .menopausal .woman .with .osteoporosis .is .taking .bisphosphonate .daily .po. .What .action .info .statement .would .indicate .she .understood .your .instructions .regarding .this .med? .- .CORRECT .ANSWER-Take .med .with .full .glass .of .water .when .up .in .the .AM. 30 .min .before .other .food .and .meds 60 .y/o .obese .male .has .T2DM .and .lipid .panel .of .TC=. 250 .HDL=32, .LDL=165. .You .teach .him .about .his .modifiable .cardiac .risk .factors .which .include .- .CORRECT .ANSWER-DM, .obesity, .hyperlipidemia OA .of .cervical .and .lumbar .spine .causes .pain .related .to .all .of .the .following .except .- .CORRECT .ANSWER-Crystal .deposition In .differentiating .OA .from .chronic .gout, .pseudo .gout, .or .septic .arthritis, .the .most .valuable .diagnostic .study .would .be .- .CORRECT .ANSWER-Synovial .fluid .analysis
You .order .bilateral .wrist .XR .on. 69 .yo .man .with .c/o .both .wrists .x6 .weeks, .not .related .to .any .known .trauma. .You .suspect .early .RA. .The .initial .XR .finding .in .apatien .with .elderly .onset .RA .would .be .- .CORRECT .ANSWER-Soft .tissue .swelling A. 72 .female .has .been .diagnosed .with .gout. .She .also .has .chronic .HF. .The .most .likely .contributing .factor .to .development .of .gout .in .this .older .female .is .- .CORRECT .ANSWER-Thiazide .diuretics Which .of .the .following .statements .about .OA .is .true .- .CORRECT .ANSWER-It .affects .primarily .weight .bearing .joints In .considering .the .specificity .of .lab .data, .the .most .reliable .diagnostic .test .listed .below .would .be .- .CORRECT .ANSWER-Synovial .fluid .analysis .to .differentiate .between .infectious .versus .inflammatory .infusion When .examining .the .spine .of .an .older .adult .you .notice .a .curvature .with .a .sharp .angle. .This .is .referred .to .as .- .CORRECT .ANSWER-Gibbus The .prevalence .of .depression .in .nursing .home .residents .is .__________________ .greater .than .adults .living .in .the .community .- .CORRECT .ANSWER- 3 - 4 .times The .majority .of .depressed .older .adults .remain .untreated .because .of .- .CORRECT .ANSWER-Misdiagnosis, .social .stigma, .environmental .barriers Symptoms .of .depression .distinct .to .the .elderly .include .- .CORRECT .ANSWER- Lack .of .emotions The .justification .for .ordering .CBC, .TSH, .serum .B12 .for .a .patient .you .may .suspect .have .clinical .depression .is .- .CORRECT .ANSWER-Because .of .overlapping .symptoms .with .anemia, .thyroid .dysfunction, .and .nutritional .deficiencies One .major .difference .that .us .useful .in .the .DD .of .dementia .versus .delirium .is .that .- .CORRECT .ANSWER-Dementia .develops .slowly .and .delirium .develops .quickly Which .of .the .following .is .the .most .appropriate .screening .tool .for .delirium .- .CORRECT .ANSWER-Confusion .Assessment .Method The .proposed .mechanism .by .which .diphenhydramine .causes .delirium .is .- .CORRECT .ANSWER-Anticholinergic .effects The .elderly .are .at .risk .for .delirium .because .of .- .CORRECT .ANSWER- Multisensory .declines, .polypharmacy, .multiple .medical .problems A .consistent .finding .in .delirium .regardless .of .cause .i .- .CORRECT .ANSWER- Reduction .in .regional .cerebral .perfusion
Older .adults .with .Dementia .sometimes .suffer .from .agnosia, .which .is .defined .as .the .inability .to .- .CORRECT .ANSWER-Recognize .objects In .late .stages .of .dementia, .a .phenomenon .called .sun .downing, .in .which .cognitive .disturbances .tend .to .- .CORRECT .ANSWER-Become .worse .in .the .evening Of .the .following, .which .one .is .the .most .useful .clinical .eval .tool .to .assist .in .the .diagnosis .of .dementia .- .CORRECT .ANSWER-St. .Louis .Mental .Status .Exam .SLUMS The .cornerstone .of .pharmacotherapy .in .treating .Alzheimer's .is .- .CORRECT .ANSWER-Cholinesterase .inhibitors The .comoribid .psych .problem .with .the .highest .frequency .in .dementia .in .- .CORRECT .ANSWER-Anxiety WHen .treating .depression .associated .with .dementia, .which .of .the .following .would .be .a .poor .choice .and .should .not .be .prescribed .- .CORRECT .ANSWER- Amitriptyline Which .of .the .following .should .be .avoided .in .countries .where .food .and .water .precautions .are .to .be .observed .- .CORRECT .ANSWER-Salad .buffet What .insect .precautions .are .not .necessary .to .prevent .insect .borne .diseases .in .the .Tropics .- .CORRECT .ANSWER-Using .100% .DEET .on .skin .to .prevent .bites An .example .of .secondary .prevention .you .could .recommend/order .for .older .adults .would .be .to .- .CORRECT .ANSWER-Check .for .fecal .occult .blood Ali .is .a. 72 .year .old .male .who .recent .came .to .the .US .from .Nigeria. .He .reports .having .BCG .vax .as .a .child. .Which .of .the .following .is .correct .regarding .a .TB .skin .test .- .CORRECT .ANSWER-Vax .hx .is .irrelevant, .read .as .usual A .local .chapter .on .NP .organization .has .begun .planning .a .community .based .screening .for .HTN .at .a .local .congregate .living .facility. .The .organization .was .select3d .on .the .basis .of .- .CORRECT .ANSWER-A .regcognized .element .of .high .risk .within .this .group Performing .ROM .exercises .on .a .patient .who .has .had .a .CVA .is .an .example .of .which .level .of .prevention .- .CORRECT .ANSWER-Tertiary You .demonstrate .an .understanding .of .primary .prevention .of .falling .among .the .elderly .through .which .management .plan .- .CORRECT .ANSWER-Provide .info .about .meds, .SE .and .interactions
Drug-induced .pruritis .is .distinguished .because .it .- .CORRECT .ANSWER-May .occur .right .after .drug .is .taken .or .months .later A .key .symptom .of .ischemia .heart .disease .is .chest .pain. .However, .angina .equivalents .may .include .exertional .dyspnea. .Angina .equivalents .are .important .because .- .CORRECT .ANSWER-Women .with .ischemic .heart .disease .many .times .don't .present .with .chest .pain. .Some .patient's .may .have .no .symptoms .or .atypical .symptoms .so .diagnosis .may .only .be .made .at .the .time .of .the .actual .MI Which .test .is .clinic .standard .for .assessment .of .aortic .stenosis .- .CORRECT .ANSWER-Echocardiogram Ischemic .heart .disease .is .- .CORRECT .ANSWER-Defined .as .an .imbalance .between .O2 .supply .and .demand, .frequently .manifested .as .angina, .leading .cause .of .death .in .the .elderly Preceding .a .stress .test, .the .following .lab .work .might .include .- .CORRECT .ANSWER-CBC .with .diff .to .differentiate .ischemic .heart .disease .from .anemia, .thyroid .studies .to .rule .out .hyperthyroidism On .exam, .what .type .of .murmur .can .be .auscultation .with .aortic .regurgitation .- .CORRECT .ANSWER-Austin .Flint Which .of .the .following .statements .is .true .regarding .anti-arrhythmic .drugs .- .CORRECT .ANSWER-Most .anti-arrhythmic .have .low .toxic/therapeutic .ratio .and .some .are .exceeding .toxic In .mitral .stenosis, .p .waves .may .suggest .- .CORRECT .ANSWER-Left .atrial .enlargement Aortic .regurgitation .requires .medical .treatment .for .early .signs .of .CHF .with .- .CORRECT .ANSWER-ACEi The .best .evidence .rating .drugs .in .a .post .MI .pt .include .- .CORRECT .ANSWER- ASA, .ACEi/ARB, .BB, .aldosterone .blockade 55 .year .old .post-menopausal .woman .with .h/o .HTN .c/o .jaw .pain .on .heavy .exertion. .No .c/o .CP. .EKG .is .normal .sinus .rhythm .without .ST .segment .abnormalities. .Your .plan .may .include .- .CORRECT .ANSWER-Exercise .stress .test What .is .the .most .common .valvular .heart .disease .in .the .elderly .- .CORRECT .ANSWER-Aortic .stenosis Elderly .may .present .with .atypical .signs .of .pneumonia. .You .may .need .to .be .aware .that .clustering .of .all .of .the .following .s/s .may .indicate .pneumonia .in .the .elderly .except .- .CORRECT .ANSWER-Bradycardia
A .common .auscultory .finding .in .CHF .is .- .CORRECT .ANSWER-S The .most .common .organism .responsible .for .CAP .in .the .elderly .is .- .CORRECT .ANSWER-Strep .pneumoniae 72 .year .old .woman .and .her .husband .are .driving .cross .country. .After .a .long .day .of .driving, .they .stop .to .eat. .Midway .through .the .meal, .the .woman .because .very .SOB .with .CP .and .a .sense .of .panic. .Which .problem .is .most .likely .- .CORRECT .ANSWER-Pulmonary .embolism Exercise .recommended .for .elderly .should .include .activities .that .- .CORRECT .ANSWER-Strengthen .muscles Preferred .amount .of .exercise .for .elderly .is .- .CORRECT .ANSWER- 30 .min .of .aerobic .activity .a .day. 5 .days .a .week. Which .of .the .following .medical .conditions .is .not .considered .restrictive .for .engaging .in .physical .activity .- .CORRECT .ANSWER-Depression The .best .recommendation .for .patient .who .says .they .have .no .equipment .to .exercise .is .- .CORRECT .ANSWER-Improvise .with .recommended .objects .at .home .that .can .be .used When .you .recommend .exercise .for .the .elderly .which .of .the .following .pieces .of .advice .should .be .considered .for .all .types .of .exercise .- .CORRECT .ANSWER- Start .low .and .go .slow Biochemical .individuality .is .best .described .as .- .CORRECT .ANSWER-Each .individual's .variation .is .often .much .smaller .than .that .of .a .larger .group All .of .the .following .statements .about .drug .absorption .are .false .except .- .CORRECT .ANSWER-Underlying .chronic .disease .has .little .impact .on .drug .absorption The .cytochrome .p .system .involves .enzymes .that .are .generally: .- .CORRECT .ANSWER-Inhibited .or .induced .by .drugs A .statement .not .shown .to .be .true .about .pharmacodynamic .changes .with .aging .is .- .CORRECT .ANSWER-Decreased .sensitivity .to .oral .anticoagulants The .major .impact .of .the .physiological .changes .that .occur .w/aging .is: .- .CORRECT .ANSWER-Reduced .physiological .reserve, .reduced .homeostatic .mechanisms, .impaired .immunological .respons The .strongest .evidence .regarding .normal .physiological .aging .is .available .through .- .CORRECT .ANSWER-Longitudinal .studies Pharmacokinetic .changes .with .aging .is .reflective .of .- .CORRECT .ANSWER-What .the .body .does .to .the .drug
When .considering .Erikson's .developmental .stages, .the .task .for .later .life .is .referred .to .as .- .CORRECT .ANSWER-Ego .integrity What .is .the .method .of .action .of .anticholinergics .- .CORRECT .ANSWER-Block .the .effect .of .acetylcholine .on .muscarinic .type. 3 .receptors .resulting .in .bronchodilation What .is .the .method .of .action .of .beta .agonists .- .CORRECT .ANSWER-Stimulates .beta- 2 .adrenergic .receptors, .increasing .cyclic .AMP, .resulting .in .relaxing .airways What .is .tuberculosis .- .CORRECT .ANSWER-Chronic, .necrotizing .infection .caused .by .slow-growing .acid .fast .bacillus .(mycobacterium .tuberculosis). .Most .common .cause .of .death .related .to .infectious .disease .worldwise What .is .aortic .regurgitation? .- .CORRECT .ANSWER-Retrograde .blood .flow .through .an .incompetent .aortic .valve .into .left .ventricle .during .ventricular .diastole What .is .aortic .stenosis .- .CORRECT .ANSWER-abnormal .narrowing .of .the .aortic .valve What .is .mitral .stenosis .- .CORRECT .ANSWER-Abnormal .narrowing .of .the .mitral .valve .orifice What .is .mitral .regurgitation .- .CORRECT .ANSWER-Retrograde .blood .flow .during .systole .from .the .left .ventricle .into .the .left .atrium .through .incompetent .mitral .valve What .is .mitral .valve .prolapse? .- .CORRECT .ANSWER-Mitral .regurgitation .associated .with .bulging .of .one .or .both .mitral .valve .leaflets .into .the .left .atrium .during .ventricular .systole What .happens .in .valvular .regurgitation .- .CORRECT .ANSWER-Portion .of .the .ejected .blood .leaks .back .into .the .upstream .cardiac .chamber What .happens .in .valvular .stenosis .- .CORRECT .ANSWER-Usually .results .in .elevated .pressures .in .the .chamber .upstream .from .the .stenosis What .is .the .purpose .of .functional .assessment .of .the .elderly .- .CORRECT .ANSWER-Discovers .the .ability .to .care .for .themselves .on .a .daily .basis How .should .HTN .be .managed .- .CORRECT .ANSWER-Stage. 2 .and .up .should .be .given .consideration .for .pharm .treatment. .Others .can .wait .for .lifestyle .modification. What .is .first .line .meds .for .non-black .HTNpopulation .including .those .with .DM .- .CORRECT .ANSWER-Thiazide, .CCB, .ACEi .or .ARM .either .alone .or .in .combo
What .is .the .med .guideline .for .ASCVD .for .those .</=. 75 .y/o .- .CORRECT .ANSWER-High .intensity .statin, .atorvastatin-Lipitor. 40 - 80, .rosuvastatin/Crestor .20mg What .is .the .med .guideline .for .ASCVD .for .those .>75 .y/o .- .CORRECT .ANSWER- Moderate .statin .(atorvastatin .10mg, .rosuvastatin .5mg, .simvastatin. 20 - 40mg, .pravastatin. 40 mg, .lovastatin .40mg, .fluvastatin .40mg) What .is .the .guideline .for .meds .for .LDL>=190 .- .CORRECT .ANSWER-High .intensity .statin .(atorvastatin. 40 - 80mg, .rosuvastatin .20mg) What .is .the .bed .guideline .for .ASCVD .for. 40 - 75 .y/o .with .DM .- .CORRECT .ANSWER-Their. 10 .year .risk .is .>7.5% .so .high .intensity .statin What .is .the .med .guideline .for .LDL. 79 - 189 .- .CORRECT .ANSWER-Their. 10 .year .risk .is .,7.5% .so .moderate .intensity .statin What .is .the .ASCVD .med .guideline .for. 40 - 75 .y/o .without .ASCVD .or .DM .- .CORRECT .ANSWER-Their. 10 .year .risk .is .>7.5% .so .moderate .to .high .intensity .statin When .is .Zostavax .recommended .- .CORRECT .ANSWER-Anyone .over .60, .given .as .a .single .dose What .is .primary .prevention .- .CORRECT .ANSWER-Activities .to .prevent .occurrence .of .disease .or .adverse .health .condition, .including .mental .health. What .is .secondary .prevention .- .CORRECT .ANSWER-Activities .aimed .at .detection .of .disease .or .adverse .health .condition .in .asymptomatic .patient .who .has .risk .factors .but .no .detectable .disease What .is .teritiary .prevention .- .CORRECT .ANSWER-Management .of .existing .conditions .to .prevent .disability .and .minimize .complications, .striving .for .optimal .function .and .QOL The .symptoms .of .depression .may .encompass .what. 4 .domains .- .CORRECT .ANSWER-Affect/mood, .cognition, .physiological, .behavioral What .is .transient .insomnia .- .CORRECT .ANSWER-Lasts .a .few .night, .related .to .emotional .issues, .usually .resolved .without .meds .when .elderly .adapts .to .or .removes .change What .is .short-term .insomnia .- .CORRECT .ANSWER-Lasts .<1 .month, .related .to .acute .medical/psychological .condition .or .to .persistent .situational .stress What .is .chronic .insomnia .- .CORRECT .ANSWER-Lasts .> 1 .month, .results .from .age .related .changes .in .sleep .or .chronic .stressors.
You .examine .the .hands .of .a. 55 .year .old .woman .and .note .bilateral .spindle .shaped .deformities .on .middle .interphalangeal .joints. .These .are .known .as .- .CORRECT .ANSWER-Haygarth's .nodes The .comorbid .psych .problem .with .the .highest .frequency .in .dementia .is .- .CORRECT .ANSWER-Anxiety When .treating .depression .associated .with .dementia, .which .of .the .following .would .be .a .poor .choice .and .should .not .be .prescribed .- .CORRECT .ANSWER- Amitriptyline Performing .ROM .exercises .on .a .patient .who .has .had .a .CVA .is .an .example .of .which .level .of .prevention .- .CORRECT .ANSWER-Tertiary You .demonstrate .an .understanding .of .primary .prevention .of .falling .among .the .elderly .through .which .management .plan? .- .CORRECT .ANSWER-Provide .info .about .meds, .SE .and .interactions An .example .of .an .active .strategy .of .health .promotion .for .an .individual .to .accomplish .would .be .- .CORRECT .ANSWER-Beginning .stress .management .progrma You .are .working .with .an .older .adult .male .with .a .long .history .of .alcohol .abuse .and .a. 30 .year .history .of .smoking. .In .recommending .an .intervention, .your .responsibility .- .CORRECT .ANSWER-Promote .positive .change .in .lifestyle .choices Which .organism .that .can .be .prevented .by .immunization .is .most .often .responsible .for .an .infectious ."outbreak" .in .the .nursing .home .setting .- .CORRECT .ANSWER-Influenza .A What .disease .can .mimic .and .often .co-exists .with .MI .in .elderly .with .CAD .- .CORRECT .ANSWER-Esophageal .Disease Thoracic .aortic .dissection .presents .typically .as .- .CORRECT .ANSWER-Severe .retrosternal .CP .that .radiates .to .the .back .and .both .arms A .statement .not .shown .to .be .true .about .pharmacodynamic .changes .with .aging .is .- .CORRECT .ANSWER-Decreased .sensitivity .to .oral .anticoagulants
