{"id":1605,"date":"2013-10-11T09:52:14","date_gmt":"2013-10-11T09:52:14","guid":{"rendered":"http:\/\/jacobimed.org\/NS\/?page_id=1605"},"modified":"2013-10-11T09:52:14","modified_gmt":"2013-10-11T09:52:14","slug":"geriatrics-questions","status":"publish","type":"page","link":"https:\/\/jacobimed.org\/old\/ambulatory\/mlove\/curriculumwomengeri-2\/the-geriatric-evaluation\/geriatrics-questions\/","title":{"rendered":"Geriatrics Questions"},"content":{"rendered":"<p>&nbsp;<\/p>\n<div class=\"Section1\">\n<h1 class=\"MsoNormal\" style=\"margin-left: 0.5in;\">Geriatrics Questions<\/h1>\n<p class=\"MsoNormal\" style=\"margin-left: 0.75in; text-indent: -0.25in;\">1. A 90 year old woman living in a nursing home because of moderate dementia and lack of family caregiver has been frequently restrained in her bed and chair because of intermittent agitation and wandering behavior.<span>&nbsp; <\/span>One evening, after being unrestrained as part of the facility&rsquo;s &ldquo;restraint reduction&rdquo; policy, she fell while on her way to the bathroom, prompting the facility to re-examine the use of restraints and their relation to patients&rsquo; risk of falls.<\/p>\n<p class=\"MsoNormal\" style=\"margin-left: 0.75in;\">Which of the following statements concerning restraints and their relationship to falls is most consistent with what is known?<\/p>\n<p class=\"MsoNormal\" style=\"margin-left: 1.25in; text-indent: -0.25in;\">a.Restraints are not able to prevent falls.<\/p>\n<p class=\"MsoNormal\" style=\"margin-left: 1.25in; text-indent: -0.25in;\">b. Bedrails have been shown to be an effective alternative to physical restraints.<\/p>\n<p class=\"MsoNormal\" style=\"margin-left: 1.25in; text-indent: -0.25in;\">c. Restraint use can increase risk of falls by producing muscle weakness and deconditioning.<\/p>\n<p class=\"MsoNormal\" style=\"margin-left: 1.25in; text-indent: -0.25in;\">d.&nbsp; estraints are an acceptable method for managing wandering behavior.<\/p>\n<p class=\"MsoNormal\" style=\"margin-left: 1.25in; text-indent: -0.25in;\">e. Restraint reduction is not associated with increased risk of falls.<\/p>\n<p class=\"MsoNormal\" style=\"padding-left: 30px;\">2.&nbsp; An 80 year old woman was hospitalized after sustaining a hip fracture.<span>&nbsp; <\/span>Her hospital course has been complicated by the development of a nosocomial pneumonia and the new onset of seizure activity on day 4 of hospitalization.<span>&nbsp; <\/span>Current medications include:<span>&nbsp; <\/span>theophylline 300 mg twice daily; albuterol; beclomethasone and ipratropium inhalers; diltiazem 180mg daily; fluoxetine 20 mg daily; imipenim 500 mg IV every 8 hours and meperidine 75 mg IM every 6 hours since surgery.<span>&nbsp; <\/span>Her serum creatinine is 2.1 mg\/dl.<\/p>\n<p class=\"MsoNormal\" style=\"margin-left: 0.5in;\">Which medication is the most likely cause of her new seizure activity?<\/p>\n<p class=\"MsoNormal\" style=\"margin-left: 1.25in; text-indent: -0.25in;\">a. theophylline<\/p>\n<p class=\"MsoNormal\" style=\"margin-left: 1.25in; text-indent: -0.25in;\">b)<span style=\"font-family: &quot;Times New Roman&quot;; font-style: normal; font-variant: normal; font-weight: normal; font-size: 7pt; line-height: normal; font-size-adjust: none; font-stretch: normal;\">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; <\/span>meperidine<\/p>\n<p class=\"MsoNormal\" style=\"margin-left: 1.25in; text-indent: -0.25in;\">c)<span style=\"font-family: &quot;Times New Roman&quot;; font-style: normal; font-variant: normal; font-weight: normal; font-size: 7pt; line-height: normal; font-size-adjust: none; font-stretch: normal;\">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; <\/span>imipenim<\/p>\n<p class=\"MsoNormal\" style=\"margin-left: 1.25in; text-indent: -0.25in;\">d)<span style=\"font-family: &quot;Times New Roman&quot;; font-style: normal; font-variant: normal; font-weight: normal; font-size: 7pt; line-height: normal; font-size-adjust: none; font-stretch: normal;\">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; <\/span>fluoxetine<\/p>\n<p class=\"MsoNormal\">&nbsp;<\/p>\n<p class=\"MsoNormal\" style=\"padding-left: 30px;\">3. In an 82 year old man admitted to an acute medical unit with UTI and fever, which of the following is most suggestive of the diagnosis of delirium?<\/p>\n<p class=\"MsoNormal\" style=\"margin-left: 1.25in; text-indent: -0.25in;\">a)<span style=\"font-family: &quot;Times New Roman&quot;; font-style: normal; font-variant: normal; font-weight: normal; font-size: 7pt; line-height: normal; font-size-adjust: none; font-stretch: normal;\">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; <\/span>Inability to stay focused on questions.<\/p>\n<p class=\"MsoNormal\" style=\"margin-left: 1.25in; text-indent: -0.25in;\">b)<span style=\"font-family: &quot;Times New Roman&quot;; font-style: normal; font-variant: normal; font-weight: normal; font-size: 7pt; line-height: normal; font-size-adjust: none; font-stretch: normal;\">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; <\/span>Worsening of behavior at night.<\/p>\n<p class=\"MsoNormal\" style=\"margin-left: 1.25in; text-indent: -0.25in;\">c)<span style=\"font-family: &quot;Times New Roman&quot;; font-style: normal; font-variant: normal; font-weight: normal; font-size: 7pt; line-height: normal; font-size-adjust: none; font-stretch: normal;\">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; <\/span>Angry outbursts and claims the staff are trying to harm him<\/p>\n<p class=\"MsoNormal\" style=\"margin-left: 1.25in; text-indent: -0.25in;\">d)<span style=\"font-family: &quot;Times New Roman&quot;; font-style: normal; font-variant: normal; font-weight: normal; font-size: 7pt; line-height: normal; font-size-adjust: none; font-stretch: normal;\">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; <\/span>Mini-mental State Examination score of 18\/30<\/p>\n<\/div>\n","protected":false},"excerpt":{"rendered":"<p>&nbsp; Geriatrics Questions 1. A 90 year old woman living in a nursing home because of moderate dementia and lack of family caregiver has been frequently restrained in her bed and chair because of intermittent agitation and wandering behavior.&nbsp; One evening, after being unrestrained as part of the facility&rsquo;s &ldquo;restraint reduction&rdquo; policy, she fell while&#8230;.<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":1594,"menu_order":0,"comment_status":"open","ping_status":"open","template":"","meta":{"_bbp_topic_count":0,"_bbp_reply_count":0,"_bbp_total_topic_count":0,"_bbp_total_reply_count":0,"_bbp_voice_count":0,"_bbp_anonymous_reply_count":0,"_bbp_topic_count_hidden":0,"_bbp_reply_count_hidden":0,"_bbp_forum_subforum_count":0,"footnotes":""},"class_list":["post-1605","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/jacobimed.org\/old\/wp-json\/wp\/v2\/pages\/1605","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/jacobimed.org\/old\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/jacobimed.org\/old\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/jacobimed.org\/old\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/jacobimed.org\/old\/wp-json\/wp\/v2\/comments?post=1605"}],"version-history":[{"count":1,"href":"https:\/\/jacobimed.org\/old\/wp-json\/wp\/v2\/pages\/1605\/revisions"}],"predecessor-version":[{"id":1607,"href":"https:\/\/jacobimed.org\/old\/wp-json\/wp\/v2\/pages\/1605\/revisions\/1607"}],"up":[{"embeddable":true,"href":"https:\/\/jacobimed.org\/old\/wp-json\/wp\/v2\/pages\/1594"}],"wp:attachment":[{"href":"https:\/\/jacobimed.org\/old\/wp-json\/wp\/v2\/media?parent=1605"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}