NR601/ NR 601 Final Exam (Latest 2024/ 2025 Update)
Primary Care of the Maturing and Aged Family Review|
Questions and Verified Answers| 100% Correct |Grade
A – Chamberlain
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
a. 150 minutes of moderate intensity physical activity weekly
A 69-year-old female presents to your office for routine primary care. Her elder
sister was recently diagnosed with Alzheimer disease, and she wonders what
steps she can take to reduce her own risk of developing dementia. Which of the
following statements about the prevention of dementia is true?
a. There is moderate quality evidence to support daily use of vitamin B12 and fish
oil to prevent risk of cognitive decline.
b. Risk of dementia is modulated by nonmodifiable risk factors, such as genetics,
family history, and educational attainment, and there are no behavioral
interventions that can be taken to reduce risk of developing dementia.
c. There is moderate quality evidence to suggest control of cardiovascular and
metabolic risk factors, such as blood pressure, weight, and blood sugar, may
reduce risk of dementia.
d. There is moderate to low quality evidence supporting cannabinoids
maementia.y reduce rates of progression from mild cognitive impairment to
dementia.
,c. There is moderate quality evidence to suggest control of cardiovascular and
metabolic risk factors, such as blood pressure, weight, and blood sugar, may
reduce risk of dementia.
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?
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. Advise them to file an advanced directive.
A 78-year-old male was recently diagnosed with Alzheimer disease. He scored
23/30 on his Montreal Cognitive Assessment (MoCA) and his clinical presentation
is consistent with mild disease. He returns to clinic with his family to discuss
possible initiation of pharmacotherapy. You consider beginning donepezil 5 mg
daily for 4 weeks, with a plan to increase to 10 mg daily if he tolerates the lower
dose. Which of the following is not a common side effect of donepezil?
a. Thrombocytopenia
b. Bradycardia
c. Vivid dreams
d. Gastrointestinal distress
a. Thrombocytopenia
,.
An 84-year-old male with history of stroke without residual deficit, systolic heart
failure, and type 2 diabetes presents to clinic for follow-up. He is independently
living in a retirement community and still works part time on a golf course. He
currently takes aspirin 81 mg, metoprolol tartrate 25 mg BID (twice a day),
furosemide 20 mg BID, and lisinopril 10 mg daily. He reports his last colonoscopy
was 8 years ago, with no abnormality. He reports he is sexually active with men
and women, engaging in receptive oral, receptive anal, and penetrative sex. He
states he has had over three sexual partners in the last year with intermittent
condom use.
What sexually transmitted infection testing should be offered?
a. Urine testing
b. Urine testing, blood testing
c. Urine testing, blood testing, anal swab
d. Urine testing, blood testing, anal swab, and oropharyngeal swab
d. Urine testing, blood testing, anal swab, and oropharyngeal swab
2. An 81-year-old transgender female with history of depression and
hyperlipidemia presents to your clinic for routine care. She endorses a history of
smoking, currently smoking 1 pack per day, and occasionally drinks a glass of
wine, although she denies illicit drug use. She reports she takes atorvastatin 20 mg
and subcutaneous estrogen therapy.
Which of the following is the most important next step in this patient’s primary
care?
a. Counseling on starting aspirin
b. Counseling on alcohol cessation
c. Counseling on smoking cessation
d. Counseling on mammogram
, c. Counseling on smoking cessation
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.
d. It has greater risk of adverse effects with its twice-daily formulation.
An 82-year-old man, Mr. A, complains of worsening nocturia, occurring four times
per night. His other lower urinary tract symptoms are slow stream, occasional
urgency, and urgency-related leakage once weekly. Medical problems include
poorly controlled hypertension, diastolic heart failure, hyperlipidemia,
osteoarthritis, and prediabetes. His medications include lisinopril 20 mg daily,
metoprolol succinate 75 mg daily, atorvastatin 10 mg daily, metformin 500 mg
twice daily, hydrocodone-acetaminophen as needed, and aspirin 81 mg daily.
Amlodipine 5 mg daily was recently added by his cardiologist. On review of
systems, Mr. A complains that nocturia is causing daytime fatigue, and he is more
constipated. Physical examination is notable for blood pressure 162/83 mmHg,
heart rate 60 beats per minute, clear lungs, soft abdomen, enlarged prostate, and
21 pretibial edema. Your next step in management should be:
a. Stop hydrocodone-acetaminophen and add naproxen.
b. Stop amlodipine and increase lisinopril.
c. Add afternoon furosemide.
d. Add tamsulosin.
b. Stop amlodipine and increase lisinopril.
The daughter of a 79-year-old woman notes that her mother, who has dementia
and lives with her, is wetting herself when she attends her new day program.
Program staff have requested that “something be done” as she is requiring a
clothes change nearly every time she is there. She cannot describe the
circumstances of leakage, saying “it just comes.” Leakage is uncommon at home.
