Chapter 5: Symptoms and Syndromes
Multiple Choice
Identify the choice that best completes the statement or answers the question.
____ 1. The term “geriatric syndrome” is best described as:
A. A condition that has multiple underlying factors and involves multiple systems
B. A condition that has a discreet etiology that is difficult to pinpoint
C. Significant progress has been made in understanding geriatric syndromes,
especially falls and delirium
D. Therapeutic management of a geriatric syndrome can be accomplished once a
specific diagnosis is made
____ 2. The anal wink reflex is used to test:
A. Rectal prolapse
B. Sensation and pudental nerve function
C. Baseline and squeeze sphincter tone
D. Fissures and fistulas
____ 3. Atypical presentation of acute coronary syndrome is:
A. Most common in Hispanic females
B. More common in men
C. Most common in African American men
D. More common in females
____ 4. What disease can mimic and often co-exists with myocardial infarctions in elders with coronary
artery disease?
A. Hypertension
B. Esophageal disease
C. Diabetic gastroparesis
D. Vascular disease
____ 5. Thoracic aortic dissection presents typically as:
A. Sharp stabbing pain in the mid thorax
B. Pleuretic chest pain and dyspnea
C. Severe retrosternal chest pain that radiates to the back and both arms
D. Unilateral pleuretic chest pain and dyspnea
____ 6. Medications known to contribute to constipation include all of the following except:
A. Stimulant laxatives
B. Anticholinergic drugs
C. Broad-spectrum antibiotics
D. Iron
____ 7. Bordetella pertussis is best characterized by:
A. Sub-acute cough lasting greater than two weeks
B. Acute cough associated with a coryzal symptom
C. Chronic cough with post-nasal drip
D. Non-productive acute cough
____ 8. The routine testing of tuberculosis should occur in all of the following vulnerable populations
except:
A. Nursing home residents
B. Prison inmates
C. Hospitalized elderly
D. Immune-compromised patients
____ 9. Which of the following statements about fluid balance in the elderly is false?
A. Total body water decreases with age.
B. Thirst response decreases as a person ages.
C. African Americans have higher rates of dehydration than white Americans.
D. Assessment of skin turgor at the sternum is a reliable indicator of dehydration in
the elderly.
____ 10. Distinguishing delirium from dementia can be problematic since they may co-exist. The primary
consideration in the differential is:
A. Performance on the Mini Mental Status Exam
B. The Confusion Assessment is negative
C. Rapid change and fluctuating course of cognitive function
D. The presence of behavioral symptoms with cognitive impairment
____ 11. Presbystasis is best described as:
A. Impairment in vestibular apparatus that causes dizziness
B. Age-related disequilibrium of unknown pathology characterized by a gradual onset
of difficulty walking
C. The loss of high frequency tones with aging that can impair sensation
D. A disorder of the inner ear characterized by vertigo
____ 12. If dizziness has a predictable pattern associated with it, the clinician should first consider:
A. Hypoglycemia
B. Psychogenic etiology
C. Cardiovascular cause
D. Neurogenic cause
____ 13. All of the following are considered as contributors to dysphagia except:
A. Anticholinergics
B. Drugs that increase reflux symptoms
C. Inadequate intake of fluids with medications and meals
D. Smooth muscle relaxants
____ 14. Evidence shows that the most important predictor of a fall is:
A. Prior history of a fall
B. Cognitive impairment
C. Gait and balance disturbance
D. Proximal muscle weakness
____ 15. The most cost-effective interventions used to prevent falls are:
A. Use of sitters
B. Use of alarms (bed, chair, monitors)
C. Tai Chi exercises
D. Home modifications and vitamin D supplements
____ 16. Chronic fatigue syndrome is best described as:
A. Fatigue that is constant, lasting more than three months
B. Fatigue lasting longer than six months and not relieved by rest
C. Fatigue that waxes and wanes over a period of three months
D. Total exhaustion with inability to get out of bed
____ 17. Which form of headache is bilateral?
A. Cluster
B. Tension
C. Migraine
D. Acute angle closure glaucoma
____ 18. Microscopic hematuria is defined as:
A. Twenty or more RBCs on a urine sample
B. Three or more RBCs on a urine sample
C. Twenty or more RBCs on three or more samples of urine
D. Three or more RBCs on three or more samples of urine
____ 19. Risk factors associated with the finding of a malignancy in a patient with hemoptysis include all of
the following except:
A. Male sex
B. Smoking history
C. Over age 40
D. Childhood asthma
____ 20. Recent weight loss is defined as:
A. loss of >10 pounds over the past 3-6 months
B. loss of >2 pounds a week
C. 5% weight loss in three months
D. 10% weight loss in one year
____ 21. The most common cause of disability in the elderly is due to:
A. Diabetes
B. Arthritis
C. Heart disease
D. Chronic obstructive pulmonary disease
____ 22. Lipedema is best described as:
A. Bilateral accumulation of interstitial fluid
B. Bilateral distribution of fat in the lower extremities
C. Fluid retention caused by a compromised lymphatic system
D. Lipid molecules that break down and cause fluid retention
____ 23. Drug-induced pruritus is distinguished because it:
A. Occurs soon after a new drug is taken
B. Usually is a generalized rash
C. May occur right after the drug is taken or months later
D. Usually involves localized circumscribed lesions
____ 24. A form of syncope that is more common in the elderly than younger adults is:
A. Vasovagal
B. Carotid sinus sensitivity
C. Orthostatic hypotension
D. Arrhythmias
____ 25. All of the following statements about tremor are true except:
A. The most common tremor is the Parkinson tremor
B. Most individuals with tremor do not seek medical attention
C. Psychogenic tremor is uncommon
D. Tremor is more prevalent in whites than blacks
____ 26. Overflow incontinence is usually associated with:
A. Loss of urine that occurs with urgency
B. Cognitive impairment
C. Weak pelvic floor muscles
D. Bladder outlet obstruction
____ 27. Wandering is best described as:
A. Aimless excessive ambulatory behavior
B. Purposeful excessive ambulatory behavior
C. Risk-seeking behavior in the cognitively impaired
D. A result of boredom in those with dementia
Chapter 5: Symptoms and Syndromes
Answer Section
MULTIPLE CHOICE
1. ANS: A PTS: 1
2. ANS: B PTS: 1
3. ANS: D PTS: 1
4. ANS: B PTS: 1
5. ANS: C PTS: 1
6. ANS: C PTS: 1
7. ANS: A PTS: 1
8. ANS: C PTS: 1
9. ANS: D PTS: 1
10. ANS: C PTS: 1
11. ANS: B PTS: 1
12. ANS: A PTS: 1
13. ANS: D PTS: 1
14. ANS: A PTS: 1
15. ANS: D PTS: 1
16. ANS: B PTS: 1
17. ANS: B PTS: 1
18. ANS: D PTS: 1
19. ANS: D PTS: 1
20. ANS: A PTS: 1
21. ANS: B PTS: 1
22. ANS: B PTS: 1
23. ANS: C PTS: 1
24. ANS: C PTS: 1
25. ANS: A PTS: 1
26. ANS: D PTS: 1
27. ANS: B PTS: 1
