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Aging and Long Term Care
1) Currently more than _____ elderly in the United States require some kind of
long-term care.
a) 1 million
b) 3 million
c) 6 million
d) 12 million
2) Currently, _____ finances medical care for almost all the elderly U.S. citizens.
a) AARP
b) Medicare
c) Pensions
d) Medicaid
3) As of 2012, there are _____ people age 65 and older who have been
diagnosed with Alzheimer’s disease.
a) 2.2 million
b) 5.2 million
c) 8.2 million
d) 11.2 million
4) It is estimated that approximately _____ of all home care is provided
informally without any monetary compensation.
a) 30%
b) 50%
c) 70%
d) 90%
5) Which type of care can be offered by individuals without medical training?
a) Skilled Nursing Care
b) Intermediate Nursing Care
c) Nursing Home Care
d) Custodial Care
6) For which stage of disease or frailty would financial and legal planning
consider a Medicaid eligibility assessment?
a) Early
b) Middle
c) Late
d) Bereavement
7) A patient needs to be a DNR to be eligible for hospice.
a) True
b) False
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8) Long-term care hospitals focus on providing care to patients who stay in the
facility for more than _____ days.
a) 14
b) 25
c) 50
d) 90
9) Which is an involuntary loss of muscle mass, which is primarily due to aging
and not the effect of age associated chronic or co-morbid disease?
a) Anorexia
b) Sarcopenia
c) Cachexia
d) Starvation
10) Which is a psychological risk factor for malnutrition in the elderly?
a) Dementia
b) Depression
c) Anxiety
d) All the above
11) Vitamin C deficiency can result in which disease?
a) Pellagra
b) Beriberi
c) Wernicke’s syndrome
d) Scurvy
12) The best way to measure the height of an elderly person is to use height at
the _____ to determine overall height.
a) Chin
b) Shoulder
c) Waist
d) Knee
13) In the “Meals on Wheels” mnemonic for undernutrition in older adults, which
is not one of the “E’s”?
a) Emotional
b) End of Life
c) Enteric problems
d) Eating problems
14) No biochemical marker or screening test can clearly indicate
malnourishment.
a) True
b) False
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15) Which may be seen in elderly people with diabetes mellitus and cancer who
are on diuretics.
a) Vitamin B12 deficiency
b) Niacin deficiency
c) Zinc deficiency
d) Iron deficiency
16) Which of the following is NOT a recommended interventions that may be
carried out in the institutional setting for the management of malnutrition in the
elderly.
a) Taking meals in the dining room
b) Encourage family to not be present at mealtime
c) Utensils should be kept unwrapped
d) Those with dementia may benefit from finger foods
17) Which nutrient deficiency is associated with spooning of the nails?
a) Vitamin B12 deficiency
b) Niacin deficiency
c) Zinc deficiency
d) Iron deficiency
18) Which nutrient deficiency is associated with ataxia?
a) Vitamin B12 deficiency
b) Niacin deficiency
c) Zinc deficiency
d) Iron deficiency
19) Which is defined as any impairment in the swallowing process?
a) Globus
b) Dysphagia
c) Achalasia
d) Gastroesophageal reflux
20) Which is not mentioned as a neurologic disease which may contribute to
dysphagia?
a) HIV/AIDS
b) Stroke
c) Dementia
d) Myopathy
21) Pneumonia accounts for approximately _____ of post-stroke morality.
a) 35%
b) 50%
c) 65%
d) 80%
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22) Which is considered to be the gold standard to study dysphagia?
a) Video fluoroscopy
b) fMri
c) Fiberoptic endoscopic evaluation
d) Swallow test
23) Which postural adjustment is intended to improve airway protection?
a) Head extension
b) Head flexion
c) Side lying
d) Lying down
24) Which level of a modified diet would include canned or cooked fruit and
vegetables?
a) Level 1
b) Level 2
c) Level 3
d) Level 4
25) Which exercise-based swallow rehabilitation approach is intended to
inncrease tongue strength?
a) Lingual resistance
b) Shaker/head-lift
c) EMST
d) MDTP
26) Unintentional injuries are on of the leading causes of death in the elderly with
falls accounting for _____ of such deaths.
a) 1/4
b) 1/3
c) 1/2
d) 2/3
27) Which in not mentioned as a non-modifiable risk factor for falls in older
persons?
a) Arthritis
b) History of cerebrovascular accident
c) Male sex
d) Recently discharged from the hospital
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28) At least _____ per day of vitamin D should be offered to elderly with
suspected vitamin D deficiency or who are otherwise at an increased risk for
falls.
a) 400 IU
b) 800 IU
c) 1200 IU
d) 1600 IU
29) Almost _____ of those elderly who are age 85 and older have AD.
a) 1/5
b) 1/4
c) 1/3
d) 1/2
30) Which is NOT a difference between normal age-related memory loss and
Alzheimer’s disease?
In normal age-related memory loss, the individual
a) might forget part of an experience
b) who forgets something will eventually remember the information
c) can generally follow verbal and written instructions without problems
d) becomes less able to benefit from memory aids
31) A pattern of cognitive decline similar to AD plus visual hallucinations and
parkinsonian signs could be due to
a) Frontotemporal dementia
b) Mild cognitive impairment
c) Cerebrovascular infarcts
d) Lewy body dementia
32) Which is a sign of memory loss due to other causes (not age related normal
memory loss)?
a) Not sure what day of the week it is during a routine schedule
b) Forgetting an appointment occasionally
c) Getting lost occasionally while in new circumstances
d) Making a regretful decision every once in a while
33) What is specifically meant and designed for individuals with a level of
cognitive impairment making it unsafe for them to continue to stay at home,
but who do not need the intensive care of a skilled nursing facility?
a) Adult Day Care
b) Outpatient Hospitalization
c) Home Health Care
d) Memory Care
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34) Depression affects over _____ of elderly nursing home residents.
a) 10%
b) 20%
c) 30%
d) 40%
35) Which is not mentioned as a common medical illness that is associated with
depression?
a) Cardiovascular disease
b) Diabetes
c) Stroke
d) Renal insufficiency
36) What are protective factors for depression in the elderly?
a) Heredity, Socio-emotional selectivity
b) Socio-emotional selectivity, Wisdom
c) Wisdom, Female gender
d) Female Gender, Heredity
37) In one research study conducted on the elderly in the 75 - 85 years age
group, it was found that around _____ of men compared to _____ of women
were sexually active.
a) 28.9%, 6.8%
b) 38.9%, 16.8%
c) 48.9%, 26.8%
d) 58.9%, 36.8%
38) With aging, free testosterone declines by 1-2% each year from the age of
_____ years.
a) 35 - 40
b) 40 - 45
c) 45 - 50
d) 50 - 55
39) ED is commonly caused by
a) Vascular disease and Neurologic disease
b) Neurologic disease and Low testosterone levels
c) Low testosterone levels and Cognitive decline
d) Cognitive decline and Vascular disease
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40) Which is a state of sudden confusion that can last days, weeks or even
months?
a) Delirium
b) Cognitive decline
c) Dementia
d) Psychosis
41) Surveys reveal that as many as _____ of the over-65 adults have an alcoholabuse problem.
a) 7%
b) 17%
c) 27%
d) 37%
42) A referenced study estimated that only 1 in _____ cases of elder abuse is
reported or comes to the attention of authorities.
a) 7
b) 14
c) 21
d) 28
43) What type of elder abuse includes desertion of an elderly person by care
providers?
a) Neglect
b) Rights abuse
c) Abandonment
d) Institutional abuse
44) All the following are risk factors for a perpetrator of elder abuse EXCEPT
a) Men in neglect cases
b) Depression
c) Financial problems
d) Caregiver burnout
45) Elders who undergo abuse have been found to have a _____ fold increased
risk of mortality.
a) 2
b) 3
c) 4
d) 5
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46) It is estimated that approximately _____ of Medicare’s annual $327 Billion
budget is spent in end of life care.
a) 7%
b) 17%
c) 27%
d) 37%
47) Which cultures believe that decision making is the responsibility of the
family?
a) American and Luxembourgian
b) Luxembourgian and Korean
c) Korean and Hispanic
d) Hispanic and American
48) Which is a record declaring a patient’s provisions for their care?
a) Living will
b) Executive order
c) Durable power of attorney
d) DNR order
49) For an older adult to utilize hospice care, a physician must certify that they
have greater probability of dying within _____ months if the terminal disease
follows its anticipated course.
a) 3
b) 6
c) 9
d) 12
50) Despite the Medicare Hospice Benefit, there is a tendency to provide _____
for end-of-life care.
a) ICU hospitalization
b) Medical Marijuana
c) Opioids
d) Nursing Home care
51) A research study conducted on CHF patients found that these patients live
longer, an average of _____ days under hospice care.
a) 19 days
b) 29 days
c) 39 days
d) 49 days
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52) Which of the following statements is NOT true?
a) In Euthanasia, only the physician performs the intervention
b) In a physician-assisted suicide, the patient performs the act
c) Euthanasia is illegal in every state
d) Physician-assisted suicide is illegal in every state
53) After an episode of major depression, the overall risk of myocardial infarction
increases by
a) 2 times
b) 3 times
c) 4-5 times
d) 6-8 times
54) A recent study reported that approximately _____ of all American adults are
family caregivers.
a) 6.5%
b) 16.5%
c) 26.5%
d) 36.5%
55) All the following are given as signs of stress in a caregiver EXCEPT
a) Drug abuse
b) Anhedonia
c) Missed work
d) Anxiety
56) The _____ is the most frequently and widely used scale for assessing
caregiver burden.
a) Zarit Burden Interview
b) Dougbert Caregiver Inventory
c) Burnout Questionnaire
d) Caregiver Tolerance Scale
57) Researchers have observed that if a clinician gives the patient their
undivided attention in the first _____, patients think that a meaningful amount
of time was spent interacting with them.
a) 15 seconds
b) 30 seconds
c) 45 seconds
d) 60 seconds
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58) For effective communication, healthcare staff should schedule older adults
a) earlier in the day.
b) at midday.
c) in the afternoon.
d) in the evening.
59) Elderly patients are the largest consumers of prescription medication and
_____ can be a particular concern.
a) Polypharmacy
b) Overdose
c) Financial burden
d) Stolen medications
60) Approximately _____ of hospital admission of elderly patients are medication
related.
a) 5%
b) 10%
c) 20%
d) 30%
61) What is the first step in helping the elderly in the medication management
process?
a) Medication reconciliation
b) Medication procurement
c) Medication knowledge
d) Medication necessity
62) What is mentioned as the treatment of choice for several psychiatric
disorders in the elderly?
a) Group therapy
b) Cognitive-behavioral therapy
c) Psychodynamic psychotherapy
d) Family therapy
63) Patients who are DNR would not continue to take chemotherapy
a) True
b) False
64) In a recent study of nursing home residents, which of the following was NOT
mentioned as one of the most important domains in achieving a high quality
of life?
a) Mobility
b) Dignity
c) Spiritual well-being
d) Enjoyment of food
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