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negative nitrates, negative protein, no ketones. Which test would you order next? • A: 24-hour urine for albumin 48. Hospice services and palliative services are underutilized due to: • A: All of the above (Services not well understood, confusion remains over when it is appropriate to consult palliative care, denial of impending death) 49. Which of the following would be an appropriate treatment for a patient with mild BPH? • A: reevaluate symptoms in 1-3 months 50. The most common neurological cause of seizures in an older adult is: • A: stroke 51. A 68-year-old women presents with a c/o urine leakage whenever she sneezes, laughs, or strains for the past 4 months. She denies dysuria, frequency and nocturia. US dipsticks is negative for RBCs, leukocytes esterase, nitrites, ketones and urobilinogen. What is the diagnosis? • A: stress incontinence 52. The tasks of grieving include all of the following EXCEPT: • A: begin to disengage 53. Acanthosis nigrans is associated with all of the following conditions except: • A: tinea versicolor 54. Which of the following statements is trueregarding pain? • A: pain is subjective experience related to actual or potential tissue damage 55. A 51-year-old male pt screened for diabetes has a fasting plasma glucose level of 98 mg/dl. The NP plan includes: • A: repeat fasting plasma glucose in 3 years 56. Increased risk factors for erectile dysfunction include all EXCEPT: • A: dominant personality 57. When assessing an elderly client who reports a tremor, which assessment findings would be most reliable in identifying Parkinson’s disease? • A: Resting tremor, slow unsteady gait, and cogwheel resistance 58. Which of the following is the most appropriate screening tool for delirium? • A: Confusion Assessment Method 59. An 82-year-old man is seen in the primary care office with complaints of dribbling urine, difficulty starting his stream. Which of the following should be included in the list of differential diagnosis? • A: all of the above (BPH, Parkinson’s disease, prostate cancer) 60. The patient with BPH is seen for follow up. He has been taking finasteride(Proscar) for 6 months. The clinician should assess this patient for which of the side effects? • A: Erectile dysfunction 61. Hospice care differs from palliative care in that: • A: supports patients and families through both the dying and the bereavement process
dysuria, frequency and strong odor of her urine for 5 days. This is the second occurrence this year. What is the appropriate next step to this patient? • A: order UA and urine culture and sensitivity and treat the patient with antibiotics today 71. All of the following patients should be screened for diabetes EXCEPT: • A: 44-year-old Caucasian with HTN 72. A male patient with a BMI of 33 presents to the office with c/o fatique, excessive hunger and excessive thirst. You suspect type 2 DM. initial testing to confirm diagnosis can include: • A: all of the above 73. An 87-year-old tells the NP that his grandson locks him in his bedroom when he goes out. The grandson withholds food if the patient does not give him money every week. The patient appears frail, ungroomed, and his clothes are visibly dirty and smell of urine. Which of the following is the best action for NP? • A: report the grandson to your state’s protective services 74. The leading cause of death in elderly travelers worldwide is: • A: accidents 75. The majority of depressed older adults remain untreated because of : • A: All of the above (misdiagnosis, social stigma, environmental…) 76. When examining the spine of an older adult you notice a curvature with a sharp angle. This is referred to as a: • A: scoliosis 77. Which of the following patients has the highest risk for the development of osteoporosis? • A: A 5’4” Asian female weighing 95 lbs 78. When assessing a patient’s mental health, the NP knows: • A: both A & B ( cognition affects mental status and affect reflects mood) 79. You are working with an older male adult with a long hx of alcohol abuse and a 30-yearhx of smoking. In recommending an intervention for this client, your responsibility is to: • A: Promote positive change in lifestyle choices 80. The pathophysiology of heart failure is due to: • A: inadequate cardiac output to meet the metabolic and oxygen demands of the body 81. The leading cause of disability worldwide is: • A: depression 82. Which of the following patients has the highest risk for the development of osteoporosis? • A: A 5’4” Asian female weighing 95 lbs 83. Mrs. G is a 65-year-old Caucasian female who presents for her yearly physical. A review of her chart reveals she smokes 1 pack of cigarettes a day, and drinks 2 beers every evening since she retired. She does not exercise, she likes to sit and knit. The NP know the NONMODIFIABLE risk factor for osteoporosis for Mrs. G is : • A: Age 84. The NP orders bilateral wrist X-rays on a 69-year-old gentleman c/o of pain in both wrists for the past 6 weeks not related to any known trauma. The NP suspects elderly onset RA. The initial radiographic finding in a patient with elderly onset RA would be: • A: soft tissue swelling 85. The NP is reviewing a patient chart prior to the start of the encounter. The NP notes that the patient is using topical CAPSAICIN. The NP knows that topical capsaicin id often used for treatment of: • A: Diabetic neuropathy 86. Which of the following statements about OA is true? • A: It affects primarily weight bearing joints 87. MJ presents to the clinic with the following hx and presentation: hx of structural damage with current s/s of HF. Treatment will be b a sed on M Js st age o f H F whi ch i s: • A: Sta ge C 88. Di etar y su pp le ment s su ch a s Omega 3 (fish oils) are often taken for cardioprotective benefit. The NP knows regarding Omega 3 consumption: • A: randomized control trials have found no reduction in morbidity or mortality 89. A 55-year-old Caucasian male pt follows up with you after referral to a cardiologist. The pt reports he thinks the medication is causing cough and sometimes he has difficulty breathing, which of the following medication was most likely prescribed? • A: Lisinopril 90. The prevalence of depression in nursing home residents is greater than adults living in the