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NURS 601 FINAL EXAM QUESTIONS AND ANSWERS RATED A
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NURS 601 FINAL EXAM QUESTIONS AND ANSWERS RATED A
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NURS 601 FINAL EXAM QUESTIONS AND ANSWERS RATED A1. What is true about tolterodine? It has greater risk
of adverse effects
with its twice-daily
formulation.
2. An 82-year-old man, Mr. A, complains of worsening Stop amlodip-
nocturia, occurring four times per night. His other ine and increase
lower urinary tract symptoms are slow stream, oc- lisinopril
casional urgency, and urgency-related leakage once
weekly. Medical problems include poorly controlled
hypertension, diastolic heart failure, hyperlipidemia,
osteoarthritis, and prediabetes. His medications in-
clude 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 sys-
tems, Mr. A complains that nocturia is causing day-
time 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 to?
3. The daughter of a 79-year-old woman notes that her day care staff
mother, who has dementia and lives with her, is wet-
ting 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 cir-
cumstances of leakage, saying "it just comes." Leak-
age is uncommon at home. Her medications include
donepezil and acetaminophen. Physical examination
is normal. Initial treatment approach will require in-
tervention by which of the following
4. Ms. J, who is 82 years old, complains of urine leakage Bladder training
while playing golf. This has gotten worse over the
past year, and she rarely makes it through nine holes
, NURS 601 FINAL EXAM QUESTIONS AND ANSWERS RATED A
without feeling like she needs to "run into the bushes
and go." Leakage is usually small volume, but causes
her extreme embarrassment because she is afraid
she will smell of urine. She has tried limiting caffeine
in the morning before she golfs and avoiding drinking
water while playing, to no effect. She also tried "those
Kegler" exercises in the past without success. Which
of the following is the most appropriate recommen-
dation for Ms. J?
5. An 86-year-old female comes to your office for a well- They need to file
ness visit. Her blood pressure is 125/70 mmHg, pulse an advance direc-
69 beats per min, and respiratory rate 18 breaths per tive
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 un-
able 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 ap-
propriate recommendation for this patient and her
partner?
6. An 81-year-old transgender female with history of de- counseling on
pression and hyperlipidemia presents to your clinic smoking cessa-
for routine care. She endorses a history of smoking, tion
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.
7. An 84-year-old male with history of stroke without Urine testing,
residual deficit, systolic heart failure, and type 2 di- blood testing, anal
abetes presents to clinic for follow-up. He is inde- swab, and oropha-
pendently living in a retirement community and still ryngeal swab
works part time on a golf course. He currently takes
aspirin 81 mg, metoprolol tartrate 25 mg BID (twice
, NURS 601 FINAL EXAM QUESTIONS AND ANSWERS RATED A
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?
8. What is the most common cause of erectile dysfunc- Athersclosis
tion in older men?
9. Which is the most reasonable first step in the treat- sildenafil
ment of older men with erectile dysfunction
10. A 72-year-old woman reports vaginal dryness that Stop the
interferes with coitus. Her medical history includes chlorthalidone
type 2 diabetes, hypertension, and osteoarthritis.
Medications are glyburide, chlorthalidone, and aceta-
minophen. What would be your first step in therapy?
11. A 70-year-old woman reports sexual pain with deep High-tone pelvic
penetration only. What is the most likely cause of her floor dysfunction
problem?
12. A 79-year-old woman with a 1.5-cm breast cancer Hormonal therapy
underwent lumpectomy. Pathology revealed ductal only
carcinoma that is hormone receptor negative (es-
trogen receptor 0%, progesterone receptor 1%) and
HER2/neu negative. Surgical margins were adequate
and uninvolved with cancer. Sentinel lymph node
sampling was negative for lymph node involvement.
She has good performance status and no activities of
daily living (ADL) or instrumental (IADL) dependen-
cies. What treatment would you recommend?
13. An 86-year-old man with no ADL deficits who has repeat PSA in 6
stopped driving because of macular degeneration is months
evaluated for a urinary tract infection associated with
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