Deck 20: Older Patients

Question 1

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

Answer 1

9 seconds

Question 2

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
B) Tinetti scale
C) PARmed-X
D) PAR-Q

Answer 2

PARmed-X

Question 3

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

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

Answer 3

Urinary tract infection

Question 4

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

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

Question 5

For measuring weight in patients in long-term care facilities:

A) Always use same scale
B) Record the patient's clothing
C) Calculate the body mass index (BMI)
D) All the above

Question 6

A BMI of less than is an indicator of high risk for malnutrition.

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

Question 7

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

A) Begin with gait observation or transfer ability from wheelchair to exam 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

Based on the 2010 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+

Question 9

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

A) Mini-mental status exam (MMSE)
B) Mini-Cog Clock Drawing test
C) Geriatric Depression Scale
D) Physical Self-Maintenance Scale

Question 10

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 11

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 12

Which of the following is a preventable condition in sedentary hospitalized older adults?

A) Falls
B) Decubitus ulcer
C) Delirium
D) All of the above

Question 13

The functional reach test is a good predictor of:

A) Susceptibility to fall
B) Complete range of motion
C) Dependence in ADLs
D) A & C

Question 14

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 15

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

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

Question 16

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 17

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 (ADL)score
B) Instrumental Activities of Daily Living (IADL)score
C) 10-minute Screener for Geriatric Conditions
D) All of the above

Question 18

After a preliminary screen for dementia,a highly sensitive test that should be used to assess for cognitive impairment of the older patient is:

A) The Montreal Cognitive Assessment (MoCA)
B) Mini-mental status exam (MMSE)
C) Mini-Cog Clock Drawing test
D) Activities of Daily Living (ADL)

Question 19

The MMSE has been criticized because:

A) Patients who are being tested require education
B) It is not applicable for patients from varied cultures
C) It cannot differentiate between delirium,dementia,and depression in the older patient
D) All of the above

Question 20

What are some tests of mobility to include in a physical examination of older adults?

A) Get up and go
B) Tinetti Evaluation
C) Fall toolkit
D) All of the above

Question 21

Obesity defined as a BMI greater than is an independent risk factor for functional decline in the elderly patient.

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

Question 22

Which of the following statements is true?

A) Women have a higher prevalence of functional decline than men at the upper end of BMI
B) Men have a higher prevalence of functional decline than women at the upper end of BMI
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.

Question 23

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

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

Question 24

The best indicator of fluid status in the elderly is.

A) Patient thirst
B) Patient weight
C) BUN/creatinine ratio
D) Serum creatinine

Question 25

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