Chapter 41
Assisting in Geriatrics
Multiple Choice Questions
1. | When communicating with a patient with a visual impairment, ____.
A. | find a quiet area to talk |
B. | talk down to the patient |
C. | provide instruction sheets in large type |
D. | try to minimize background noise |
E. | use plenty of pictures |
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2. | When communicating with a patient who has a hearing impairment, ____.
A. | speak in higher tones to enhance understanding |
B. | make sure there is adequate lighting |
C. | speak in clear, low-pitched tones |
D. | position yourself to the side of the patient |
E. | shout so the patient can hear you clearly |
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3. | By the year 2030, medical assistants will be spending at least ____ percent of their time caring for older patients.
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4. | Which of the following tips will help make the communication with an older patient more effective?
A. | Supply a word when the patient stops to think of a word |
C. | Use a higher pitch when you speak |
D. | Interrupt the patient if your question was misunderstood |
E. | Look for a way to make a connection with the patient |
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5. | The appropriate way to speak to a patient who has a hearing impairment is to ____.
C. | repeat questions verbatim |
D. | use a higher tone of voice |
E. | speak in clear, low-pitched tones |
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6. | Which of the following is the appropriate way to address elderly patients?
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7. | Which of the following is a good way to help elderly patients remember their medications and the appropriate time to take each medication?
A. | Give the patient a prescription for each medication |
B. | Encourage the patient to use a medication organizer or a medication box |
C. | Instruct the patient on what each medication is for |
D. | Tell the patient what will happen if he forgets to take his medication |
E. | Call the patient periodically and inquire whether he has taken his medication |
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8. | Which of the following is a reason for the low rate of treatment for depression among elderly patients?
A. | There is no treatment for depression in the elderly. |
B. | Depression in the elderly is inevitable because of deteriorating brain function. |
C. | Elderly patients and their families believe depression is a normal consequence of growing old. |
D. | Elderly patients do not respond to antidepressants. |
E. | The available treatments are complex and difficult to implement. |
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9. | Which of the following is the specific diagnostic test for depression?
E. | There is no specific diagnostic test |
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10. | Which of the following are symptoms of depression in the elderly?
A. | Excessive energy and motivation |
B. | Feelings of self-worth |
C. | Recurrent feelings of happiness and hope |
D. | Indecisiveness and difficulty in concentrating |
E. | Showing an interest in other people |
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11. | Which of the following is an accurate statement about the treatment of depression in the elderly?
A. | Elderly patients respond more quickly than younger patients do. |
B. | Elderly patients may be frightened by the idea of taking medication for a mental problem. |
C. | Elderly patients notice a relief in the symptoms of depression within two weeks of treatment with medication. |
D. | Elderly patients are careful about taking their medications. |
E. | Treatment is generally confined to psychotherapy to avoid noncompliance problems with medication. |
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12. | Treatment for depression in elderly patients includes ____.
B. | antidepressants and psychotherapy |
C. | fiber and increased liquids |
D. | distraction and relaxation techniques |
E. | antibiotics and physical therapy |
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13. | The postural abnormality _____ often occurs in elderly women due to a loss of bone density, causing a characteristic curvature of the spine, known as "humpback."
C. | degenerative joint disease |
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14. | Elderly patients are defined as patients who are over the age of ____.
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15. | Medical specialists who specialize in the care of elderly people are ____.
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16. | Which of the following is a sign of aging in the integumentary system?
A. | Increased number of pigment cells (melanocytes) |
B. | Softening of the nails |
C. | Atrophy of the subcutaneous layer of skin |
D. | Increased inflammatory response |
E. | Increased amounts of collagen and elastin |
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17. | Which of the following is a sign of aging in the nervous system?
A. | Increased blood flow to the brain |
B. | Shortened attention span |
C. | Enlargement of the substantia nigra in the brain |
D. | Increase in acetylcholine |
E. | Improved thought processing |
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18. | Elderly patients experience postural hypotension, which is a sign of aging related to the ____.
B. | musculoskeletal system |
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19. | Another term for degenerative joint disease is ____.
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20. | Which of the following statements about cognitive-intellectual development in elderly patients is true?
A. | Most people can no longer learn after the age of 60. |
B. | Long-term memory is often less acute than in younger people. |
C. | Mature adults process information more quickly than young adults. |
D. | Short-term memory seems to remain intact. |
E. | Accumulated information and life experiences make them great teachers. |
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21. | Which of the following points is not included in patient education for geriatric patients?
A. | Encourage regular aerobic exercise |
B. | Provide information about balanced nutrition |
C. | Encourage regular healthcare checkups |
D. | Encourage avoidance of napping in the daytime |
E. | Encourage socialization |
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22. | A condition in which cholesterol and triglyceride levels are above normal is ____.
D. | coronary artery disease |
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23. | Which of the following treatments would be used for a patient who has congestive heart failure?
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24. | Which of the following conditions can be alleviated by encouraging elderly patients to eat more high-fiber foods and drink plenty of fluids?
A. | Coronary artery disease |
B. | Constipation-diarrhea cycle |
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25. | Which of the following conditions may cause increased thirst, increased urination, and fatigue?
B. | Congestive heart failure |
C. | Diabetes mellitus type II |
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26. | Which debilitating brain disorder commonly causes changes in personality, mood, or behavior and for which there is no cure?
E. | Degenerative joint disease |
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27. | Which of the following statements is true about nutrition in elderly patients?
A. | People over the age of 30 should decrease their caloric intake by 10% to 15%. |
B. | Elderly patients do not require as much protein as younger patients. |
C. | Elderly patients should increase their intake of high-fiber foods. |
D. | Energy and metabolic requirements usually increase with age. |
E. | Elderly patients should restrict their fluid intake to avoid nocturia. |
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28. | Which of the following is not a factor that may impair or impede nutritional intake in an elderly patient?
A. | Poorly fitting dentures |
C. | Lack of money for food |
E. | Reduced nutritional value of canned foods |
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29. | Against which of the following diseases are elderly patients encouraged to receive vaccination?
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30. | Mr. Hartman is 89 years old and has been living alone in a small apartment downtown since his wife died two years ago. His son Richard brought him to the office for a checkup, saying that when he checked on his father yesterday, Mr. Hartman seemed confused and could not tell Richard when he had last eaten. Mr. Hartman is very thin, but he states that he eats "whenever I am hungry." Which of the following conditions might you suspect?
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31. | Which of the following statements is not true regarding elder abuse?
A. | Elders can be abused physically, sexually, or psychologically. |
B. | Elder abuse is difficult to detect. |
C. | Bruises from falls and other accidents can be mistaken for abuse. |
D. | Most elder abuse victims are older men with chronic disabilities. |
E. | Some elders choose to neglect or abuse themselves. |
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32. | Mrs. Newford is a 74-year-old patient who lives in a retirement community, where she happily participates in activities with other residents. Her medications include a beta blocker, anti-inflammatories for arthritis, and a diuretic. She also says she takes over-the-counter antacids frequently for heartburn. When you ask how many times a day she takes the anti-inflammatories, she hesitates before answering, "Two, I think." Which of the following actions might you take to help Mrs. Newford?
A. | Talk to the doctor about simplifying her medication schedule |
B. | Instruct Mrs. Newford to take another dose of medication if she can't remember when she took the last one |
C. | Encourage Mrs. Newford to take her medications with meals |
D. | Provide medication instruction sheets for all of her medications |
E. | Recommend that Mrs. Newford move to a nursing facility |
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33. | Mr. Laufenberg is 81 years old. He has been living alone, but he admits that he just can't seem to get around as well as he used to. His daughter, Vera, and her husband have invited him to live with them, and Mr. Laufenberg is delighted. Vera has brought him to the office for a general checkup. While she is there, she asks if there is anything she needs to change in her home. Which of the following guidelines might you give to Vera?
A. | Remove all mats and rugs from the bathtub and shower |
B. | Install secure handrails near the bathtub and toilet |
C. | Reduce lighting near stairs and doorways to reduce glare |
D. | Remove carpeting from stairs |
E. | Place throw rugs on bare floors to help warm the feet |
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34. | Mrs. Worth is a 79-year-old patient who is in good general health and whose mind is sharp and clear. She has mild arthritis and is a little unsteady on her feet, but she has no major medical issues. Her son has asked her to move in with him and his wife and kids, but she prefers to remain independent. Which of the following guidelines would not be appropriate to help Mrs. Worth live safely on her own?
A. | Wear reading glasses while moving around the house |
B. | Use a cane or walker as necessary |
C. | Minimize clutter in the house |
D. | Use night-lights in the bedroom and bathroom |
E. | Wear shoes and slippers with non-slip soles |
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35. | Which of the following may cause memory loss associated with old age?
A. | Decreased blood flow to the brain |
B. | Decreased size of the frontal lobes of the brain |
C. | Shrinkage of the temporal lobes of the brain |
D. | Changes in the hippocampus in the brain |
E. | Shrinkage of the substantia nigra in the brain |
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36. | Suggestions that would help an elderly patient who has hyperlipidemia would be to increase exercise and eat foods with lower amounts of ____.
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37. | Which condition is caused by high cholesterol levels that can lead to the accumulation of fatty deposits along the inner walls of arteries?
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38. | For which of the following conditions is hormone replacement therapy commonly used?
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39. | Which of the following treatments is not commonly used to treat patients with coronary artery disease?
B. | Coronary artery bypass surgery |
E. | Cholesterol-lowering medications |
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40. | Which of the following is not considered a possible sign of neglect?
D. | Inappropriate clothing |
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41. | In general, what percentage of an elderly person's calories should come from fats?
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42. | Which of the following is not generally a factor that may interfere with collecting a 24-hour urine specimen?
E. | Chronic urine retention |
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43. | Which of the following is a possible result of loss of adipose tissue and decreased circulation in an elderly patient?
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44. | Which of the following should be done when applying thermotherapy to an elderly patient?
A. | Increase the amount of heat to increase patient comfort |
B. | Check the patient's skin frequently for excessive redness |
C. | Avoid applying heat to areas larger than 3 inches by 3 inches |
D. | Use moist heat only; do not apply dry heat |
E. | Check the patient's blood pressure at 5-minute intervals |
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45. | When interviewing an elderly patient to get her medical history, you ask her to describe the pain she feels in her abdomen, but she stops in the middle of a sentence and appears to be searching for the right word to use. What action should you take in this situation?
A. | Suggest a word you think she might want to use |
B. | Ask the question again, but rephrase it |
C. | Tell her the exact word does not matter |
D. | Be patient and wait for her to find the word |
E. | Go on to the next question in the interview |
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46. | Mr. Turner has come to the medical office because he has been having pain in his lower abdomen. During the patient interview, which of the following questions would be most appropriate to find out more details about the pain Mr. Turner is having?
A. | "Is the pain there all the time?" |
B. | "Is the pain confined to the lower right quadrant, or does it radiate laterally?" |
C. | "Does the pain seem sharp or dull?" |
D. | "Does the pain occur mostly after you eat?" |
E. | "How would you describe the pain you are having?" |
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47. | Which of the following is not a common treatment for hypertension?
B. | Medication to reduce blood pressure |
C. | Reducing fat and sodium in the diet |
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48. | Which of the following techniques is not likely to be effective when you are communicating with a geriatric patient?
A. | Showing respect for the patient's age |
B. | Calling the patient by his first name |
C. | Using active listening skills |
D. | Being patient when the patient answers slowly |
E. | Looking directly at the patient |
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Fill in the Blank Questions
49. | Elderly patients are adults and should be treated with ________ regardless of their physical or mental state.
________________________________________ |
50. | A curvature of the spine, known as ________ or "humpback," may occur in elderly patients due to degeneration of the spine from osteoporosis.
________________________________________ |
51. | The medical term for decreased bone density is ________.
________________________________________ |
52. | A condition in which the lens of the eye becomes cloudy and opaque, called ________, can be corrected by surgery to replace the lens.
________________________________________ |
53. | An endocrine and metabolic disorder of the musculoskeletal system, called ________, results in thinning of bone tissue and loss of bone density over time.
________________________________________ |
54. | A chronic, inflammatory disease of joint tissues that causes pain, swelling, and stiffness in joints is ________.
________________________________________ |
55. | A type of therapy that is based on an ancient therapy called the laying on of hands is known as ________ touch.
________________________________________ |
56. | Elderly patients commonly have involuntary leakage of urine, which is called urinary ________.
________________________________________ |
57. | Many elderly patients do not understand or do not practice the concept of ________, or measures taken to prevent illness.
________________________________________ |
58. | Patient ________, or obedience in following the practitioner’s orders, can help them remain healthier and get well faster.
________________________________________ |
59. | Excessive nighttime urination is known as _________.
________________________________________ |
60. | In an elderly patient, weakening of the supports of the uterus may cause the uterus to ________, or work its way down the vaginal canal.
________________________________________ |
61. | An elevation in blood pressure over 140 systolic and 90 diastolic, with or without symptoms is called ________.
________________________________________ |
62. | The practice of taking multiple medications at the same time is known as ________.
________________________________________ |
63. | When asking a patient to identify drugs she is taking, it is important to ask her to include all prescription medications, OTC drugs, dietary supplements, and ________ remedies.
________________________________________ |
64. | The three basic categories of elder abuse are ________ elder abuse, institutional elder abuse, and self-neglect or self-abuse.
________________________________________ |
65. | Treatment for depression generally combines a course of ________ drugs with psychotherapy.
________________________________________ |
66. | When interviewing a geriatric patient, practice ________ listening skills by paying attention to the patient's verbal and nonverbal cues and by repeating information back to the patient to make sure you understood it correctly.
________________________________________ |
67. | Signs of patient ________ may be the result of Alzheimer's disease, senility, depression, head injury, or misuse of medications or alcohol.
________________________________________ |
68. | Because some elderly patients have problems with memory, you should provide detailed ________ instructions that they and their family can refer to as necessary.
________________________________________ |
69. | Because there is no cure for the brain disorder called ________ disease, the primary role of caregivers for elderly patients who have this disease is to provide comfort and safety to the patient.
________________________________________ |
70. | Monitoring of blood ________ is an important part of controlling diabetes mellitus.
________________________________________ |
71. | A diet that is high in ________ may help prevent osteoporosis.
________________________________________ |
Multiple Choice Questions
72. | Sleep apnea is a sleep disorder in which a person stops breathing for several seconds while sleeping, which can cause conditions such as __________, depression, and even memory loss.
A. | cardiovascular disease |
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73. | What is the medical term for softening of the bones due to vitamin D and calcium deficiency?
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Fill in the Blank Questions
74. | A disorder in which a person stops breathing for several seconds at night is called ________.
________________________________________ |
75. | Melanocytes gather in common locations causing brown spots known as _______ or “liver spots.”
________________________________________ |