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Which of the following is false about the Veterans Health Administration?
- A. It is an integrated network of service providers across the United States.
- B. It serves a population with an average age of nearly 65 years.
- C. It provides care management only for individuals with disabilities that are service-related.
- D. It can provide older adults home-based primary care, geriatric assessment, and long-term care.
Correct Answer: C
Rationale: The Veterans Health Administration provides care to all veterans, regardless of whether their disabilities are service-related.
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A 78-year-old man has an emergency partial colectomy for lower gastrointestinal bleeding. A localized colonic adenocarcinoma is completely resected. The surgeon did not dissect lymph nodes for metastatic sampling. The patient wants to know if he should have chemotherapy. Should he?
- A. Yes because without knowing his complete staging it would be safer.
- B. No because he can be followed with serial carcinoembryonic antigens and CT scans.
- C. Yes because the severe bleeding indicates advanced disease.
- D. No because he is too old and will not likely have any problems during his lifetime.
Correct Answer: B
Rationale: Follow-up with serial carcinoembryonic antigens and CT scans is appropriate after resection of localized disease.
Explain why late inspiratory crackles in the lower third of the chest are indicative of heart failure rather than other respiratory conditions.
- A. They indicate airway obstruction typical of asthma.
- B. They suggest fluid accumulation in the alveoli due to heart failure.
- C. They are a sign of chronic bronchial inflammation.
- D. They are associated with hyperinflation of the lungs in COPD.
Correct Answer: B
Rationale: Late inspiratory crackles indicate fluid in the alveoli, a hallmark of heart failure.
What term was historically used to refer to the medical professionals who specialized in the use of X-ray technology for diagnosis and treatment?
- A. Radiologists
- B. Roentgenologists
- C. Sonographers
- D. Nuclear Medicine Physicians
Correct Answer: B
Rationale: The term "Roentgenologists" was used historically to refer to specialists in the use of X-ray technology.
Joyce Mitchell is a 73-year-old frail female with a history of frequent falls, presenting with nausea, vomiting, sweating, and horizontal nystagmus. She is diagnosed with vestibular neuritis. What is the best initial course of treatment?
- A. Vestibular rehabilitation
- B. Supportive care with anti-nausea and anti-vertigo medication
- C. Fluids
- D. Epley maneuver
Correct Answer: B
Rationale: Supportive care with anti-nausea and anti-vertigo medication is appropriate for vestibular neuritis.
An older woman who is cared for by a concerned family is particularly likely to suffer from which of the following complications after an episode of gastroenteritis?
- A. Immobility related to overconcern
- B. Continued vomiting caused by too-rapid feeding
- C. Diarrhea resulting from administration of milk products
- D. Constipation related to overtreatment of diarrhea
Correct Answer: D
Rationale: Overtreatment of diarrhea can lead to constipation, especially in older adults.