Question 1

MJ presents to the clinic with the following history and presentation history of structural damage with current signs and symptoms of heart failure. Treatment will be based on MJ’s stage of heart failure which is:

· Stage C

· Stage D

· Stage B

· Stage A

Question 2

Aortic regulation requires medical treatment for early signs of CHF with:

· Beta blockers

· Hospitalization

· ACE inhibitors

· Surgery

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Question 3

A typical presentation of disease in the elderly is reflected by all the following except:

· Myocardial infraction with chest pain and diaphoresis

· Cardiac manifestations of typhoid disease

· Infection without fever

· Depression without cystoid mood

Question 4

Chronic pain can have a major impact on the patient’s ability to function and have profound impact on the overall quality of life of the patient. Ongoing pain may be linked to:

· All options are correct

· Sleep disturbance

· Decreased socialization

· Depression

Question 5

JM is a 68- year old man who presents to your primary care practice for a physical. JM has type 2 diabetes mellitus for a 5 years, smokes ½ pack of cigarretes a day, his BMI is 30. No other previous medical diagnosis, no current complaints. According to the AHA/ACC guidelines, JM is stage A heart failure. Treatment goals for JM include:

· Prevent rushed cardiac remodeling

· Heart healthy lifestyle

· Centrica symptoms

· Diuresis to relieve symptoms at congestion

Question 6

The percentage of the FVC expired in one second is:

· FVC

· FEV 1

· TLC totaling capacity

· FEV1/FVC ratio

Question 7

A patient presents to the office with complaints of an increasing SOB, cough with occasional white sputum and fatigue. As part of the plan the NP orders laboratory tests. The NP know the likelihood of heart failure is low if the BNP (Brain Natriuretic Peptide) is:

· >400

· 200-400

· <100

· 100-200

Question 8

The cytochrome p system involves enzymes that are generally:

· Inhibited by drugs

· Inhibited or induced by drugs

· Induced by drugs

· Associated with decreased liver perfusion

Question 9

The best recommendation for a patient who states that have no equipment to exercise would be:

· Improvise with recommended objects at home

· Have a personal trainer come home at least three times a week

· Sign a contract for a year’s gym membership

· Borrow the designs from friends and family

Question 10

The major impact of the physiological changes that occur with aging is:

· Impaired immunological response

· All options are correct

· Reduced physiological response

· Reduced homeostasis management

Question 11

The aging process causes what normal physiological changes in the heart?

· Cardiology occurs along with prolapse of the ventral valve and regulation

· Dilation of the right ventricle occurs with sclerosis of the pulmonic and tricuspid valve

· The heart valve thickens and becomes rigid secondary to fibrosis and sclerosis

· Hypertrophy of the right ventricle

Question 12

According to the 2017 American College of Cardiology (ACC) hypertension guidelines the recommended blood pressure goal for a65 year old African American woman with a history of HTN and diabetes and no history of chronic kidney disease is:

· <120/80

· <130/80

· <140/80

· <140/90

Question 13

LB is a 77 year old patient with chronic poorly controlled hypertension. As the primary care provider you know that goals include prevention of the target organ damage. During your evaluation you will assess for evidence of:

· Lipid abnormalities

· Left ventricular hypertrophy

· Clotting disorders

· Insulin resistance

Question 14

A 60 year old woman with a 30 pack year history presents to your primary care practice for evaluation of a persistent daily cough with increased sputum production, worse in the morning, occurring over the past three months. She tells you, “ I have the same thing year after year.” Which of the following choices would you consider strongly in your critical thinking process?

· Acute bronchitis

· Chronic bronchitis

· Seasonal allergies

· Bronchial asthma

Question 15

The NP knows the following statements regarding the pain of acute coronary syndrome are all true except:

· Present atypically more often in men than women

· May last longer than 20 minutes

· May radiate to arms, back, neck and jaw

· May be restrostemal or poorly localized

Question 16

Functional abilities are best assessed by:

· Self-report of function

· A comprehensive head to toe examination

· Observed assessment of function

· Family report of function

Question 17

A 65 year old Caucasian female presented to your clinic with the following history and symptoms: mitral valve stenosis, physical exam unremarkable. The NP knows this patient’s stage of heart failure is:

· Stage A

· Stage C

· Stage B

· Stage D

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Question 18

Polypharmacy is described as taking

· Even a single medication if there is not a clear indication for its use

· More than five medications per day

· All options are correct

· More than nine medications per day

Question 19

All the following statements are true about laboratory values in older adults except:

· Reference ranges are preferable

· Reference values are not necessarily acceptable values

· Abnormal findings are often due to physiological aging

· Normal ranges may not be applicable to older adults

Question 20

What is the most common valvular heart disease in the older adult?

· Aortic stenosis

· Mitral stenosis

· Aortic regurgitation

· Mitral regurgitation

Question 21

The best way to diagnose structural heart disease/dysfunction non-invasively is:

· EKG

· Heart catheterization

· Echocardiogram

· Chest x-ray

Question 22

The total volume of air a patient is able to exhale in the first second during maximal effort is:

· FEV 1

· TLC total lung capacity

· FVC

· FEV/FVC ratio

Question 23

According to the 2017 American College of Cardiology (ACC) hypertension guidelines, a normal blood pressure is:

· <140/80

· <140/90

· <120/80

· <130/90

Question 24

The organism most commonly responsible for community-acquired pneumonia in older adults is:

· Streptococcus pneumonia

· Streptococcus auteurs

· Pseudomonas

· Proteus mirapilis

Question 25

Preferred amount of exercise for older adults is:

· 30 minutes per day of aerobic activity five times a week

· 10 minutes of physical activity each morning

· Any increased physical activity over a sedentary lifestyle

· 60 minutes per day that includes 30 minutes of aerobic activity and 30 minutes of weight training five times a week