RULE OF FOURTHS
• If the problem is disease, then medical treatment is indicated.
• If the problem is disuse, it can often be cured with an activity
... [Show More] regimen.
• If the problem is misuse, prior damage cannot be reversed but steps can be taken to prevent deterioration and to preserve function.
• If the problem is physiologic aging, then steps should be taken to adapt and compensate for the disability.
Test Questions
1. Which one of the following is most true about the rule of fourths?
a. One-fourth of geriatric problems are iatrogenic.
b. Little can be done to prevent three-fourths of the problems of aging.
c. For every medical complaint a patient presents with, a careful assessment can identify three other diagnoses.
d. What used to be called normal aging can be largely explained by processes that are not normal.
e. A good way to conduct a geriatric assessment is to use four categories: mental, physical, psychosocial, and environmental.
2. Which one of the following is most true about aging changes?
a. Stage 3 and 4 sleep decreases.
b. Renal perfusion is not reduced, but renal function is reduced.
c. Hearing acuity declines beginning in middle age.
d. Prostatic enlargement occurs only in a minority of men.
3. An old woman who is cared for by attentive, cautious, concerned family is particularly likely to suffer from which one 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
4. Which one of the following is most true about psychological aging?
a. Disengagement tends to promote better psychological health than continued engagement.
b. Most older adults do not worry about memory loss.
c. Happiness declines starting in middle age.
d. Ageism can lead to isolation and depression.
5. Of the following conditions, which one is most common and most often preventable?
a. Falls
b. Frailty
c. Cognitive impairment
d. Iatrogenic disease
e. Depression
Test Question Answers
1. d
2. a
3. a
4. d
5. d
CHAPTER 5
Wellness and Prevention
Immunizations Recommended for Older Adults
• Influenza inactive (IIV), or recombinant (RIV)1 dose annually
• Tetanus, diphtheria, pertussis (TDAP)1 dose after age 65 years then Td every 10 years
• Varicella recombinant (Shingrix)2 doses 2–5 months apart. Give to those who had zoster
• Pneumococcal1 dose of PPSV23 (Polysaccharide, Pneumovax); consider 1 dose PCV 13 in high-risk patients
• Hepatitis A/hepatitis BOnly if high risk, and at least once
Test Questions
1. The US Advisory Committee on Immunization Practices and the Centers for Disease Control currently recommend which one of the following?
a. All older adults be immunized against influenza annually and that they receive at least one pneumococcal vaccination.
b. All high-risk older adults should receive an additional pneumococcal vaccination 5 years or more after their first immunization.
c. Older adults should receive a one-time revaccination for pneumonia if they were initially vaccinated more than 5 years previously and were less than 65 years of age at the time of the initial vaccination.
d. All of these are recommended.
2. Healthcare providers should recommend that older adults engage in which one of the following?
a. 150 minutes of moderate intensity physical activity weekly
b. 20 minutes of moderate intensity physical activity 3 days per week
c. 10 minutes of vigorous physical activity most days of the week
d. 30 minutes of vigorous physical activity 3 days per week
3. Guidelines for the primary prevention of stroke recommend that aspirin be used in which one of the following?
a. Individuals whose risk is high enough for the benefits to outweigh the risks
b. Individuals regardless of risk level
c. Males regardless of risk level
d. Females who are also taking antihypertensives [Show Less]