The major impact of the physiological changes that occur w/aging is:
Reduced physiological reserve, reduced homeostatic mechanisms, impaired immunological
response
The strongest evidence regarding normal physiological aging is available through
Longitudinal studies
Pharmacokinetic changes with aging is reflective of
What the body does to the drug
Biochemical individuality is best described as
Each individual's variation is often much smaller than that of a larger group
All of the following statements are true about drug distribution in the elderly except
Drugs distributed in water have a lower concentration
Men have faster and more efficient biotransformation of drugs and this is thought to be due to:
Testosterone
The cytochrome p system involves enzymes that are generally:
Inhibited or induced by drugs
A statement not shown to be true about pharmacodynamic changes with aging is
Decreased sensitivity to oral anticoagulants
Atypical presentation of disease in elderly is reflected by all of the following except
MI with CP and diaphoresis
,Functional abilities are best assessed by
Observed assessment of function
The leading cause of death in elderly travelers worldwide is:
Accidents
Which of the following should be avoided in countries where food and water precautions are to
be observed:
Salad buffet
What insect precautions are not necessary to prevent insect borne diseases in the Tropics
Using 100% DEET on skin to prevent bites
An example of secondary prevention you could recommend/order for older adults would be to
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 TUBERCULOSIS skin test
Vax hx is irrelevant, read as usual
Ivan W. is a 65 year old man who is new to your practice. He has a hx of COPD, CAD,
hypertension, and Type 2 diabetes. He has had no immunizations since his DC from the military
at age 25. Childhood disease include chickenpox, measles, mumps, and german measles. He
presents for a disease management visits. What immunizations would you recommend.
Tdap, pneumococcal, influenza, Zostavax
Leo L. is a 62 year old African American male who comes for an initial visit to your clinic. PHH
includes smoking 1 pack day since 11, consuming a case of beer every week and working as
assembler for the past 10 years. Family hx in first degree relatives includes HTN, High
,cholesterol, heart attack, and Type 2 diabetes. Leo’s BMI is 32; BP 130/86. You order a fasting
glucose, lipid profile and return visit for BP check.
Secondary prevention
A local chapter on NP organization has begun planning a community-based screening for HTN at
a local congregate living facility. The organization was selected on the basis of
A recognized 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
Tertiary
You demonstrate an understanding of primary prevention of falling among the elderly through
which management plan
Provide info about meds, Side effects and interactions
You are working with an older male adult with a long history of alcohol abuse and a 30 year hx
of smoking. In recommending an intervention for this client, your responsibility is to:
Promote positive change in lifestyle choices
An example of an active strategy of health promotion for an individual to accomplish would be
Beginning stress management program
The 4 main domains of clinical preventive services that you will provide are
Counseling interventions, screening tests, immunizations, chemoprophylaxis
Which organism that can be prevented by immunization is most often responsible for infectious
outbreaks in the nursing home setting:
, Influenza A
What is the appropriate method for TUBERCULOSIS screening of an older adult entering a
nursing home
5 TBU intradermal PPD injection and if negative, repeat with same dose one week later
Exercise recommended for elderly should include activities that
Strengthen muscles
Preferred amount of exercise for elderly is
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
Depression
The best recommendation for patient who says they have no equipment to exercise is
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
Start low and go slow
The evidence reflects that comprehensive geriatric assessment should be conducted:
Targeting the vulnerable and frail elderly
Evidence-based geriatric assessment instruments available to the clinician:
Include screening, evaluation, and measurement instruments in multiple domains
When interviewing the older adult with a suspected dementia, it is most important that:
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