1. Which of the following statements is NOT true about palliative care teams?
A: Provide weekly home visits
2. A 55-year-old women has type 2 DM she had three UTIs in the last 9 months and she is concerned
about her kidneys. She has no report of dysuria, frequency or urgency at this time. Which of the
following is the best action to follow?
A: Recheck UA dipstick today
3. According to the sexuality presentation, atrophic vaginitis (AV)
A: Is a contributing factor for frequent UTIs
4. Ms. L 55-year-old women with BMI of 28, has 20-year hx of primary HTN and has been on
hydrochlorothiazide 25 mg daily for years with excellent response. During follow up visit Mrs L
reports that for the last 6 months she has felt thirsty all of the time even though she drinks at least
10 glasses of water a day. Upon chart review the N notes that the last two fasting blood glucose
levels have been 136 mg/dl and 165 mg/dl. The NP checks a random blood glucose, which is 210
mg/dl. What is the next appropriate test?
A: Prescribe Metformin 500 mg PO BID
5. A patient has been prescribed Metformin (Glucophage). One week later he returns with lowered
blood sugars but complaints of some loose stools during the week. How should the NP respond?
A: Reassure the patient that this is an anticipated side effect
6. A 60-year-old obese male client has type 2 DM and a lipid panel of TC= 250, HDL = 32, LDL=
165. The NP teaches the patient about his modifiable cardiac risk factors which include:
A: Diabetes, obesity, and hyperlipidemia
7. Lifestyle approaches to postmenopausal symptom management include
A: avoiding sugar, coffee, chocolate and alcohol
8. When treating depression associated with dementia, which of the following would be a poor
choice and should not be prescribed?
9. How does women’s anatomy make them more susceptible to UTIs?
A: the urethra is shorter
10. Don’t have
11. don’t have
12. A 48-year-old male patient screened for diabetes has a fasting plasma glucose level of 120 mg/dl.
The NP plan includes
A: Educate the patient of lifestyle changes to lower blood glucose
13. Which of the following assessments are commonly noted in a client with Parkinson’s disease?
A: Micrographia and bradykinesia
14. A 76-year-old man is seen in the office for c/o urinary incontinence. The clinician should explore
which of these causes of incontinence in men?
A: Urinary Tract Infection (UTI)
15. Which of the following maneuvers is contraindicated in acute prostatis?
A: Massaging the infected prostate
16. Mrs. N a 65-year-old women with BMI of 29 on Medicare , has a 20-year hx of primary HTN and
has been on HCTZ 25 mg daily for years , reports that for the past 6 months she has felt thirsty all
of the time even though she drinks at least 10 glasses of water a day. Upon charting NP notes that
the last two fasting blood glucose levels have been 136 mg/dl and 165 mg/dl. What actions should
the NP perform next?
A: order a fasting blood glucose??? PRESCRIBE METFORMIN XR 500MG PO
17. According to the WHO analgesic ladder, which drug combination would be most appropriate in an
opiate-naïve patient who presents with moderate pain?
A: Indomethacin/ hydrocodone
18. The cornerstone of pharmacotherapy in treating Alzheimer’s disease is :
A: Cholinesterase inhibitors
19. The highest level of evidence to support interventions at the end of life is with:
A: opioids for dyspnea
20. The comorbid psychiatric problem with the highest frequency in dementia is:
21. All of the following are true statements regarding elder abuse EXCEPT:
A : common signs of abuse include decreased anxiety and depression
22. Which of the following is a role of the advanced nurse in ?????
A: All of the above
23. The proposed mechanism by which diphenhydramine causes delirium is:
A: Anticholinergic effect
24. A drug that can be used to treat two very common symptoms in a dying patient (pain and dyspnea)
A : Morphine
25. According to the Palliative Care presentation, hospice care may be provided to:
A: those with a life expectancy < 6 months
26. A 68-year-old women is being worked up for stress incontinence. UA reveals positive leukocyte
esterase, positive nitrites, 15 WBCs, no RBS, no protein, no casts. She denies frequency, urgency,
suprapubic pressure or urgency. What is the first treatment for her US results?
A: no treatment is necessary
27. The elderly are at higher risk for delirium because of:
A: All of the above
28. A 63-year-old man is seen in the clinic with a c/o nocturia. Which of the following should be
included in the differential diagnosis?
A: Benign prostatic hypertrophy (BPH)
29. A 75-year-old man is being treated as an outpatient for metastatic prostate cancer. Which of the
following statements is true regarding the management of pain with opioids in the elderly?
A: none of the above
30. The highest level of evidence with the use of adjuvant analgesics is with:
A: neuropathic pain patients are candidates for adjuvant analgesia
31. The 56-year-old man with chronic prostatis should initially be treated with antibiotics for how
A: 14 days
32. A 50-year-old female patient screened for diabetes has a fasting plasma glucose level of 124
mg/dl. The NP plan includes:
A: repeat fasting plasma glucose in one year
33. When assessing a patient who complains of a tremor, the NP must differentiate essential tremor
from the tremor of Parkinson’s disease. Which of the following findings are consistent with
A: The tremor occurs with purposeful movement
34. Which characteristic of delirium helps to distinguish it from dementia?
A: abrupt or Acute onset
35. According to the sexuality presentation, the biggest barrier to appropriate sexual evaluation in the
A: Ageist attitudes
36. Mrs. Smith a 65-year-old women presents to the clinic for the first time and c/o UI and
dyspareunia, she went through menopause 10 years ago without any hormone replacement therapy
and had a hysterectomy for fibroid. Her mother had a hip fracture at 82, pt had mammogram 5
years ago and no known fam hx of breast cancer……you decide to begin topical hormone
replacement therapy. Which of the following evaluations would be necessary prior initiating
hormone replacement therapy?
37. Mr. A experienced a brief onset of right-sided weakness, slurred speech and confusion yesterday.
The symptom has resolved. What should the NP do?
A: identify modifiable cardiovascular risk factors
38. Any women with a complicated cystitis or symptoms of upper tract disease needs a urine culture
A: sensitivity test
39. All of the following patients have a risk of adverse reaction from Metformin except:
A: patients with BMI >30
40. A middle-aged patient has been diagnosed with Parkinson’s disease. What influences the NP’s
decision to begin pharmacological treatment for this patient?
A: symptom interfering with functional ability
41. Which of the following medications can blunt the signs of hypoglycemia in diabetes?
A: beta blockers
42. The Mini-cog is a short screening tool used to assess cognition. Which of the following statements
pertaining to the test is a true statement?
A: A score of 0-2 is a positive screen for dementia
43. What is a sign of insulin resistance that can present in African American patients?
A: Acanthosis Nigricans
44. Age related changes in bladder, urethra and ureters include all of the following in older women