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STUDY GUIDE FOR CHAMBERLAIN
UNIVERSITY NR601 MIDTERM EXAM
2025 UPDATE GRADED A+
What does CGA stand for? - Solution Complete Geriatric Assessment What is the purpose of the CGA? - Solution That physical health is related to psychosocial, functional ability, and a safe environment Who is a CGA more beneficial for? - Solution The vulnerable older adult What are the five domains of a CGA? - Solution physical health, functional health, psychological health, socioenvironmental support, and quality of life measures Functional health shows - Solution how the older adult can care for themselves day to day Who was the Beers Criteria created by? - Solution The American Geriatric Society What is the purpose of the Beers Criteria? - Solution improve medication selection and avoid dangerous medications Who is the Beers Criteria tailored for? - Solution 65 years or older in all setting except hospice and palliative care What is the except for Beers Criteria in all adults aged 65 years of age or older? - Solution Hospice and palliative care settings What is the reasoning that the Beers Criteria is not applicable in the hospice and palliative care settings? - Solution because in hospital and palliative care settings, we are focusing on keeping the patient comfortable What does the Beers Criteria stress? - Solution the importance of deprescribing to avoid polypharmacy and drug reactions
Geriatric patients do what differently than younger patients? - Solution metabolize drugs A 25-year-old and a 75-year-old are - Solution Completely different and should be treated and prescribed accordingly When should someone receive colorectal screenings - Solution ages 50- When should breast cancer screenings begin? - Solution Biennial screening for women from ages 50- Who is at a high risk for aneurysm? - Solution smokers Anytime we discuss exercise or strength training, we're going to - Solution tailor this to our patients Lab changes can be affected by - Solution dehydration Why is it important to know that lab changes can be affected by dehydration? - Solution Because older populations don't drink as much Why doesn't the older population drink as much? - Solution Because they don't want to get up and go to the bathroom The elderly may have an increased ESR because - Solution They have more inflammatory processes in the geriatric population What are reduced physiological reserves due to in the geriatric population?
- Solution thinner skin and less subq tissue and fat Nutrition may not be where it is supposed to be in what population? - Solution the geriatric population What is the Mini Nutritional Assessment primarily related to? - Solution Obesity It is always important to go back and check out the - Solution Physical domain of the CGA
Intermittent asthma is considered what stage of asthma? - Solution 1st How are intermittent asthma symptoms described? - Solution Intermittent symptoms less than 2 days per wek Intermittent symptoms less than 2 days per week - Solution Intermittent asthma NIghttime symptoms occur less than twice a month in - Solution intermittent asthma These patients have normal peak expiratory flow between exacerbations - Solution intermittent asthma FEV1>80%; PFT Variability >20% - Solution Intermittent asthma What will patients with intermittent asthma FEV1 and PFT variability look like? - Solution FEV1>80%, PFT variability >20% Do patient with intermittent asthma take daily medications? - Solution No These patients will use a SABA PRN less than twice a week - Solution Intermittent asthma How often will patient with intermittent asthma use a SABA? - Solution PRN less than twice a week If control is not achieved with intermittent asthma, what should the provider do? - Solution Step up the treatment If asthma is controlled for three months, what should the provider do? - Solution Step down the treatment Asthma symptoms more than 2 days per week, but still not daily - Solution Mild persistent asthma These patients will have symptoms at night several times per month - Solution Mild persistent asthma
How often will a patient with mild persistent asthma have symptoms? - Solution More than 2 days a week, but not daily How often will patients with mild persistent asthma have symptoms at night? - Solution Several times a month What will a patient with mild persistent asthma FEV1 andf PFT variability look like? - Solution FEV1>80%; PFT variability 20-30% These patients will use a daily low dose ICS, alternate LTRA, cromolyn, nedocromil, or theophylline - Solution mild persistent asthma What are the medications that a patient with mild persistent asthma would take daily? - Solution Daily low dose ICS, alternate LTRA, cromolyn, nedocromil, or theophylline How often would a patient with mild persistent asthma use a rescue inhaler? - Solution SABA PRN not to exceed 3-4 times per day How often will a patient with moderate persistent asthma have symptoms?
- Solution Daily, but not continual These patients will have daily symptoms, but not continual - Solution moderate persistent asthma Night time symptoms will occur more than once a week but not nightly - Solution Moderate persistent How often will patients with moderate persistent asthma have night time symptoms? - Solution More than once a week, but not nightly Exacerbations will affect sleep and activity - Solution Moderate persistent asthma What will the FEV1 and PFT variability look like for a patient with moderate persistent asthma? - Solution FEV1 60-80% predicted; PFT variability
30% FEV1 60-80% predicted; PFT variability >30% - Solution Moderate persistent asthma
What would you consider for a patient with severe persistent asthma? - Solution Course of oral steroids What is the gold standard for COPD? - Solution spirometry Mild COPD has what FEV1? - Solution >80% predicted Moderate COPD has what FEV1? - Solution 50%>FEV1<80% Severe COPD has what FEV1? - Solution 30%<FEV1<50% Very severe COPD has what FEV1? - Solution FEV1<30% Oxygen has been shown to what with COPD patients? - Solution Decrease mortality Can you give too much oxygen to a COPD patient? - Solution Yes What labs would you draw on a COPD patient to decide what medications you would prescribe? - Solution CBC to evaluate eosinophil level and an Alpha-1 Antitrypsin Level Acute inflammation of lung parenchyma which is usually infectious - Solution pathophysiology of community acquired pneumonia (CAP) 70-80% of patients with community acquired pneumonia (CAP) are what age? - Solution > 40% of patients diagnosed with CAP have what pathogen? - Solution S. Paeumoniae gram+ What are other pathogens besides S. Pneumonia-gram+? - Solution H. influenza and legionella What is the treatment for uncomplicated CAP? - Solution azithromycin, clarithromycin, or doxycycline What is the treatment for CAP when the patient has comorbidities? - Solution respiratory fluoroquinolone
Described as a temporary pause of breathing for at least 10 seconds in duration at least 5 times during an hour - Solution obstructive sleep apnea What are anatomical risks for obstructive sleep apnea? - Solution Septal deviation, macrognathia, tonsil hypertrophy, and obesity What should you instruct your patient to avoid with obstructive sleep apnea? - Solution Alcohol, sedatives, and narcotics Why should a patient with obstructive sleep apnea avoid sedatives? - Solution Sedatives alter REM sleep What are the complications of obstructive sleep apnea? - Solution Cardiac dysrhythmias What is a side effect of obstructive sleep apnea? - Solution Hypersomnolence resulting in a headache 25% of geriatrics suffer from - Solution insomnia Having trouble staying asleep is - Solution The most common complaint with insomnia If you try melatonin what should you do? - Solution Start out on a low dose What should you avoid with insomnia? - Solution Antihistamines What should you educate your patient on with insomnia? - Solution Proper sleep hygiene, train your body to get ready to sleep Insomnia can be an early sign of - Solution mental illness What should you ask your patients when assessing sleep? - Solution Are you having trouble falling asleep or trouble staying awake? What is the criteria for a major depressive episode? - Solution 5 or more symptoms for at least 4 weeks The prevalence of depression is 3-4x's more in - Solution nursing homes
Arthritis from overuse or wear and tear - Solution Osteoarthritis What does osteoarthritis look like? - Solution Asymmetrical, bouchard's and herbeden's nodes, morning stiffness that lasts less than 30 minutes What is osteoarthritis due to - Solution Repetitive microtrauma What is the treatment for osteoarthritis - Solution acetaminophen What are the labs that would need to be drawn for osteoarthritis - Solution CBC What is a major risk factor for osteoarthritis - Solution obesity The morning stiffness gets better during the day as the patient moves - Solution osteoarthritis What are the risk factors for osteoporosis - Solution alcohol and smoking At 65 years old, what can you do to screen for osteoporosis - Solution DEXA scan What is the gold standard for osteoporosis diagnosing? - Solution densitometry What is the most common presentation of osteoporosis? - Solution Bone fracture What is the treatment goal for osteoporosis - Solution pain control
