Which of the following statements is true?
- A. Decision-making capacity can be determined only by a psychiatrist.
- B. A diagnosis of dementia precludes competent decision making.
- C. Lack of decision-making capacity should not be presumed if the patient goes against medical advice.
- D. Expression of a choice is sufficient to indicate decision-making capacity.
Correct Answer: C
Rationale: A patient's decision-making capacity cannot be assumed to be absent solely based on their refusal of medical advice.
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A 67-year-old woman with a history of A-fib and an ejection fraction of 48% has had normal digoxin levels. Which can cause a decrease in digoxin level?
- A. Decrease creatinine clearance
- B. Weight loss
- C. Increase exercise
- D. Regular use of antacid
Correct Answer: D
Rationale: Regular use of antacids can decrease the absorption of digoxin, potentially lowering its levels.
Which of the following is true about tolterodine?
- A. It should be avoided in men with prostatic hypertrophy.
- B. It increases the risk of constipation compared with oral oxybutynin.
- C. It acts by ablating detrusor spasms.
- D. It has greater risk of adverse effects with its twice-daily formulation.
Correct Answer: C
Rationale: Tolterodine is an anticholinergic that reduces detrusor spasms to alleviate symptoms of overactive bladder.
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.
A nurse is working with an older adult who is at risk for malnutrition. Which of the following interventions is the most appropriate?
- A. Administer high-calorie supplements.
- B. Encourage intake of a variety of foods rich in vitamins and minerals.
- C. Restrict caloric intake to prevent weight gain.
- D. Focus on protein supplements exclusively.
Correct Answer: B
Rationale: A balanced diet with a variety of foods helps ensure adequate nutrition, including vitamins and minerals, in older adults.
Examination of the hair reveals a fine silky appearance. This finding may be seen in patients that have:
- A. Hypothyroidism
- B. Hyperthyroidism
- C. Type 2 diabetes
- D. Celiac disease
Correct Answer: B
Rationale: Hyperthyroidism can lead to fine, silky hair due to the effects of thyroid hormones.
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