Deck 21: Older Patients

Question 1

A preliminary, concise test to screen patients for dementia in primary care is the:

A) Mini-Mental Status Examination
B) Mini-Cog Clock Drawing Test
C) Geriatric Depression Scale
D) Physical Self-Maintenance Scale

Answer 1

Mini-Cog Clock Drawing Test

Question 2

Obesity defined as a body mass index greater than ______ is an independent risk factor for functional decline in the elderly patient.

A) 20
B) 24
C) 30
D) 35

Answer 2

30

Question 3

A total weight of less than ______ pounds is an indicator for high risk for malnutrition.

A) 120
B) 115
C) 110
D) 100

Answer 3

100

Question 4

The most common reason for functional decline in nursing home patients is:

A) Heart failure
B) Stroke
C) Urinary tract infection
D) Myocardial infarction

Question 5

Based on the 2014 Census of the United States, the fastest growing segment of the population is:

A) Adults aged 65 to 75
B) Adults aged 75 to 85
C) Adults aged 85 to 95
D) Adults aged 100 or more

Question 6

The best indicator of fluid status in the elderly is _________________.

A) Patient thirst
B) Patient weight
C) Blood urea nitrogen/creatinine ratio
D) Serum creatinine

Question 7

The order of the physical examination in the older patient should:

A) Begin with gait observation or transfer ability from wheelchair to examination table
B) Begin with activities that cause the least expenditure of energy
C) Be performed in a head-to-toe sequence
D) Be a focused physical examination limited to the patient symptoms

Question 8

One of the most common causes for cognitive impairment in older patients suffering from infection is:

A) Delirium
B) Depression
C) Dementia
D) Pseudodementia

Question 9

A body mass index of less than ______ is an indicator of high risk for malnutrition.

A) 21
B) 22
C) 23
D) 24

Question 10

Which of the following tests of mobility can be included in a physical examination of older adults?

A) Get Up and Go Test
B) Tinetti Evaluation
C) Fall Toolkit
D) All of the above

Question 11

The most sensitive test for assessing cognitive impairment of the older patient is the:

A) Montreal Cognitive Assessment
B) Mini-Mental Status Examination
C) Mini-Cog Clock Drawing Test
D) Activities of Daily Living Index

Question 12

The rapid pace walk is a good screening test for driving ability of the elderly. The patient is timed to walk as swiftly as possible along a 10-foot path. A completion time of greater than ______________ indicates possible need for intervention.

A) 9 seconds
B) 8 seconds
C) 7 seconds
D) 6 seconds

Question 13

The functional reach test is a good predictor of:

A) Susceptibility to fall
B) Complete range of motion
C) Shoulder abduction
D) Shoulder extension against resistance

Question 14

During examination of the eyes, dilation of the pupil is needed to check for:

A) Distance vision
B) Macular degeneration
C) Cataracts
D) Peripheral vision

Question 15

Adults tend to lose 1 inch every ______ years after age 40.

A) 30
B) 25
C) 20
D) 15

Question 16

A useful laboratory measure that indicates protein-energy malnutrition in hospitalized elders includes a total cholesterol below _______.

A) 190 mg/dl
B) 180 mg/dl
C) 170 mg/dl
D) 160 mg/dl

Question 17

Useful laboratory measures that indicate protein-energy malnutrition in hospitalized elders include a serum albumin level below ________.

A) 3.4 g/dl
B) 4.2 g/dl
C) 5.2 g/dl
D) 6.4 g/dl

Question 18

A Get Up and Go Test involves having the patient rise from a chair, walk 20 feet, turn, and walk back to the examiner. This should be completed within ______ seconds.

A) 10
B) 15
C) 20
D) 25

Question 19

A functional assessment is the most appropriate type of evaluation of well older patients. A basic component of the functional assessment is:

A) Activities of daily living score
B) Instrumental activities of daily living score
C) 10-Minute Screener for Geriatric Conditions
D) All of the above

Question 20

Prior to giving clearance for an older adult to take part in an exercise regimen, the _______________________ assessment tool should be used by the clinician.

A) Get Up and Go Test
B) Tinetti Evaluation
C) MoCa Stress Test
D) PAR-Q

Question 21

Which of the following is regarded as a quality of care indicator?

A) Frequent episodes of dehydration
B) Pattern of weight loss
C) Chronic constipation
D) Repeat urinary tract infections

Question 22

Before calculating your patient's body mass index, you must adjust the weight to account for her below-the-knee amputation by:

A) Adding 6% to the weight obtained on the scale
B) Adding 9% to the weight obtained on the scale
C) Using her pre-surgery weight
D) Omitting body mass index as inaccurate

Question 23

The American Medical Association guidelines for assessing driving ability recommend focused assessment of all of the following except:

A) Vision
B) Cognition
C) Cardiac
D) Motor function

Question 24

Which of the following statements is true?

A) Women have a higher prevalence of functional decline than men at the upper end of body mass index.
B) Men have a higher prevalence of functional decline than women at the upper end of body mass index.
C) To be sure the elderly patient's fluid needs are met, the clinician should rely on the patient's thirst.
D) The Get Up and Go Test is a more accurate assessment of gait and balance than the Tinetti Mobility Scale.