NMS Q&A Family Medicine

280 NMS Q&A Family Medicine5 Of the following persons, who is most likely to be anabuser of an elderly individual in the United States?(A) A spouse(B) A hired caretaker(C) A son(D) A daughter(E) A stranger who has broken into the home6 Which of the following hypertensive blood pressurereadings is most likely to be found particularly in apatient over the age of 65 years?(A) 210/110(B) 190/100(C) 120/95(D) 160/80(E) 140/907 A 75-year-old man is in good health and mentallycompetent to care for himself. He underwent a completeexamination 5 years ago that included a normalscreening colonoscopy, and he has submitted fecaloccult blood test (FOBTs) in the intervening years.He lives alone and wishes to undergo a routine healthmaintenance examination. Which of the followingwould be least fruitful as a screening test?(A) Flexible sigmoidoscopy and FOBTs(B) Thyroid-stimulating hormone test(C) Urinalysis(D) Blood pressure reading(E) “Up-and-go test”8 A 50-year-old patient brings in her dependentmother, aged 81. The elderly woman has been forgettingthings recently, but she is able to subtract sevensfrom 100 (she is a retired math teacher). She is wellgroomed and socially adept. The daughter wishes forher to be screened for Alzheimer disease (AD). Whichof the following would be the most relevant reasonfor screening for early diagnosis of AD?(A) Improve the intelligence quotient of the patient(B) Stop the progression of AD(C) Reverse the course of AD(D) Prepare caregiver(s) and family for managementand socioeconomic issues(E) Prevent strokes9 A family doctor chooses to screen for AD with theFolstein Mini-Mental State Examination, of whichthe sensitivity is known to be 87%. What approximatepercentage of those tested will exhibit a falsepositiveresult?(A) 10%(B) 20%(C) 40%(D) 50%(E) 60%10 Each of the following statements regarding falls in“older elderly” persons ( 75 years of age) is true,except for which one?(A) Most falls occur outside of the homeenvironment.(B) The risk of falls is directly related to the numberof medications the elderly patient is taking.(C) Alcohol is a contributing risk factor for falls.(D) The most common injuries incurred in fallsamong elderly individuals are wrist, hip, andvertebral fractures.(E) Falls often occur in mentally competent elderlypeople.11 An elderly couple ask several questions about livingwills while you are updating their health history.Which of the following statements is correct withrespect to living wills?(A) They are not usually honored by courts.(B) They are only appropriate for the terminally illindividual to communicate desires regardingspecific life-support measures.(C) The wishes of immediate family members takelegal precedence over the living will of theindividual.(D) They allow the individual to communicatedesires for or against specific life-supportmeasures toward the time when health statusmakes him or her unable to do so.(E) They must be prepared by attorneys.