When is your final exam for this class?

The nurse practitioner is assessing an older adult and determines the patient is frail.  How does the nurse determine this? 

What are some actions you can do to prevent ageism? Select all that apply. 

A family member comes into the clinician’s office with her older mother, the patient. In the process of the examination, the nurse practitioner identifies the patient as “frail older adult.” The family member asks what that means. The nurse practitioner explains that this refers to:

List 3 risk factors that accelerate the epigenetic clocks.  

Ms. Foster is a 78 y.o. female who is brought to your office by her daughter. Ms. Foster lives alone in an apartment, and her daughter is concerned about her ability to carry on living independently. Her daughter tells you that her mother began having difficulty with her memory 2 years ago, and since that time she has deteriorated in a slow, steady manner. However, she is not totally incapacitated. She is able to perform some of the activities of daily living, including dressing and bathing. When she cooks for herself, however, she often leaves burners on, and when she drives the car she often gets lost. She has had four motor vehicle accidents in the past 3 months. Her daughter became alarmed when she learned that her mother had gone to the bank and withdrawn the entire contents of her $80,000 savings account to give to her new boyfriend. She had asked for the entire amount in $1 bills and argued with the bank teller when learning that this was impossible. The daughter states that her mother’s memory and confusion have been getting worse. Her personality has changed; her kind and caring mother now displays periods of both agitation and aggression. On exam, the patient’s MMSE is 15/30. Her blood pressure is 140/90 mmHg and her pulse is 84/min. The CV/Resp and abdominal system exams are normal. A detailed neurologic and musculoskeletal exam cannot be carried out because the patient could not follow instructions. Based on this history, what is the most likely diagnosis in this patient?

Which medication is associated with significant side effects in the elderly? 

Which of the following is true regarding STOPP/START criteria for prescribing medications? Select all that apply.

Based on the American Geriatrics Society 2023 Beers Criteria, what medications should be used with caution in older adults?  Select all that apply. 

Ms. Smith is 49 years old and sees her PCP for an annual physical. In addition, she is worried about getting Alzheimer’s because her mother was diagnosed with Alzheimer’s disease (AD) at 78 years of age. Ms. Smith has no memory issues. There are no other family members with AD. She states that she read on the internet that Alzheimer’s is related to the APOE 4 genetic mutation. What is the best explanation for Mr. Smith?