NR 601 Midterm Exam
NR 601: Primary Care of the Maturing and Aged
Family
,2
1. The percentage of the FVC expired in one second is:
a. FEV1/FVC ratio
2. The aging process causes what normal physiological changes in the heart?
a. The heart valve thickens and becomes rigid, secondary to fibrosis and
sclerosis.
3. A 55yo 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?
a. Lisinopril
4. JM is a 68yo man who presents for a physical. He has T2DM x5yrs, smokes 1/2
PPD, BMI is 30. No other previous medical dx, no current complaints.
According to the AHA/ACC guidelines, JM is stage A HF. Treatment goals for
him include:
a. Heart healthy lifestyle
5. MJ presents with h/o structural damage with current s/s of HF. Treatment will
be based on his stage of HF, which is:
a. Stage C
6. 65yo Caucasian female presents with mitral valve stenosis, physical exam
unremarkable. You know her stage of HF is:
a. B
,3
7. DG, 65yo man, presents for eval of CP and L-sided shoulder pain, beginning
after strenuous activity, including walking. Pain is dull, aching, 8/10 during
activity, otherwise 0/10. Began few mo ago, intermittent, aggravated by
exercise, relieved by rest. Occasional nausea. Pain is retrosternal, radiating to
L shoulder, affects QOL by limiting activity. Pain is worse today, did not go
away after stopped walking. BP 120/80, HR 72 and regular. Normal heart
sounds, no murmur, S1, S2. Which differential dx would be most likely?
a. Coronary artery dz w/angina pectoris
8. The best way to dx structural heart dz/dysfunction non-invasively is:
a. Echocardiogram
9. Chronic pain can have major impact on pt's ability to function and have
profound impact on overall QOL. Ongoing pain may be linked to:
a. Depression, sleep disturbance, decreased socialization
10.The Beers criteria are appropriate for use in evaluating use of certain meds in
pts:
a. >65yo
11.Pt presents with c/o increasing SOB, cough w/occasional white sputum, fatigue.
As part of the plan you order labs. You know the likelihood of HF is low if the
BNP is:
a. <100
12.All of the following statements are true about lab values in older adults except:
, 4
a. Normal ranges may not be applicable to older adults
b. Abnormal findings are often due to physiological aging
c. Reference ranges are preferable
d. References values are not necessarily acceptable values
a. B
13.According to the 2017 ACC HTN guidelines, the recommended BP goal for a
65yo African American woman w/a h/o HTN and DM and no h/o CKD is:
a. <140/80
14.The pathophysiology of HF is due to:
a. Inadequate cardiac output to meet the metabolic and O2 demands of
the body
15.A 60yo woman w/30 pack yr hx, presents for eval of persistent, daily cough
w/increased sputum, worse in the AM, occurring over past 3 months. She tells
you, "I have the same thing year after year." Which of the following choices
would you consider strongly in your critical thinking process?
a. Chronic bronchitis
16.JM is a 68yo man who presents for a physical. He has T2DM x5yrs, diet
controlled. His BMI is 32. He has HTN, smoker (10 cigs/day x20yrs). He denies
other medical problems. Fam hx includes CAD, CABG x4 for dad, now
deceased; CHF, T2DM, HTN for mom. He is asymptomatic today, exam is
normal, EKG NSR. According to AHA/ACC guidelines, JM is at risk for what
stage of HF?
a. Stage A
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