Chapter 45: Geriatrics

1. Which term describes the shift toward an older population in society?
   A) Age compression
   B) Graying of America
   C) Age displacement
   D) Geriatric expansion

B) Graying of America
Explanation: The “graying of America” refers to the growing proportion of elderly people in the U.S. (Ch. 45)

2. What is the GEMS diamond used for?
   A) Pediatric assessment
   B) Trauma scoring
   C) Geriatric assessment
   D) Stroke screening

C) Geriatric assessment
Explanation: The GEMS diamond is a framework for evaluating older adults. (Ch. 45)

3. Which letter of the GEMS diamond emphasizes environment?
   A) G
   B) E
   C) M
   D) S

B) E
Explanation: “E” stands for environment, considering living conditions and safety. (Ch. 45)

4. Which letter of the GEMS diamond focuses on medical assessment?
   A) G
   B) E
   C) M
   D) S

C) M
Explanation: “M” represents medical conditions and medications. (Ch. 45)

5. Which cardiovascular change is common with aging?
   A) Decreased systolic BP
   B) Increased arterial stiffness
   C) Thinner left ventricular wall
   D) Increased baroreceptor sensitivity

B) Increased arterial stiffness
Explanation: Vessels stiffen with age, contributing to systolic hypertension. (Ch. 45)

6. Which heart sound may indicate left ventricular hypertrophy in older adults?
   A) S1
   B) S2
   C) S3
   D) S4

D) S4
Explanation: An S4 gallop is common in the elderly due to stiff ventricles. (Ch. 45)

7. Which respiratory change is typical in geriatrics?
   A) Increased vital capacity
   B) Increased lung compliance
   C) Decreased chest wall elasticity
   D) Increased alveolar surface area

C) Decreased chest wall elasticity
Explanation: The chest wall stiffens with age, reducing ventilatory efficiency. (Ch. 45)

8. Which pulmonary function decreases most with aging?
   A) Residual volume
   B) Tidal volume
   C) Forced expiratory volume (FEV1)
   D) Dead space

C) Forced expiratory volume (FEV1)
Explanation: FEV1 declines due to airway narrowing and loss of elasticity. (Ch. 45)

9. Which renal change increases risk for dehydration in older adults?
   A) Increased thirst perception
   B) Decreased renal blood flow
   C) Increased glomerular filtration rate
   D) Increased renal tubular function

B) Decreased renal blood flow
Explanation: Renal perfusion decreases, lowering GFR and concentrating ability. (Ch. 45)

10. Which sensory change is most common with aging?
    A) Presbyopia
    B) Presbycusis
    C) Decreased taste sensitivity
    D) All of these occur with aging

A) Presbyopia
Explanation: Presbyopia (difficulty focusing on near objects) is a classic sensory change. (Ch. 45)

11. Which neurologic change is associated with normal aging?
    A) Faster reaction time
    B) Increased brain mass
    C) Slower conduction velocity
    D) Improved short-term memory

C) Slower conduction velocity
Explanation: Normal aging causes slower reflexes and responses. (Ch. 45)

12. Which condition is an abnormal finding, not just normal aging?
    A) Presbyopia
    B) Presbycusis
    C) Dementia
    D) Decreased skin elasticity

C) Dementia
Explanation: Dementia is a pathologic condition, not a normal part of aging. (Ch. 45)

13. Which GI change is common in geriatrics?
    A) Increased gastric acid
    B) Reduced peristalsis
    C) Increased taste bud sensitivity
    D) Larger liver size

B) Reduced peristalsis
Explanation: Slowed peristalsis contributes to constipation. (Ch. 45)

14. Which musculoskeletal change increases fall risk?
    A) Increased bone density
    B) Decreased muscle mass
    C) Stronger ligaments
    D) Increased joint fluid

B) Decreased muscle mass
Explanation: Loss of muscle mass (sarcopenia) contributes to instability. (Ch. 45)

15. Which integumentary change predisposes older adults to skin tears?
    A) Increased elasticity
    B) Thicker dermis
    C) Thinner dermis
    D) Increased sweat gland function

C) Thinner dermis
Explanation: The dermis thins with age, making skin fragile. (Ch. 45)

16. Which immune system change occurs with aging?
    A) Stronger T-cell function
    B) Increased fever response
    C) Immunosenescence
    D) More robust inflammation

C) Immunosenescence
Explanation: Aging causes decreased immune response and slower healing. (Ch. 45)

17. Which psychosocial factor is common in geriatric patients?
    A) Social isolation
    B) Increased economic stability
    C) Stronger support systems
    D) Reduced risk of depression

A) Social isolation
Explanation: Many older adults face isolation and loneliness, impacting health. (Ch. 45)

18. Which type of medication is most likely to cause adverse drug reactions in the elderly?
    A) Analgesics
    B) Cardiovascular drugs
    C) Sedatives and hypnotics
    D) All may contribute significantly

C) Sedatives and hypnotics
Explanation: Sedatives often lead to confusion, falls, and dependence. (Ch. 45)

19. Which atypical presentation is common in geriatric infection?
    A) Fever
    B) Tachycardia
    C) Hypotension
    D) Confusion

D) Confusion
Explanation: Infections often present with altered mental status, not classic signs. (Ch. 45)

20. Which condition is the leading cause of death in elderly Americans?
    A) Cancer
    B) Cardiovascular disease
    C) COPD
    D) Alzheimer’s disease

B) Cardiovascular disease
Explanation: Heart disease remains the top killer in the elderly population. (Ch. 45)

21. Which age-related cardiovascular change increases risk of arrhythmias?
    A) Decreased pacemaker cells in SA node
    B) Increased atrial size
    C) Decreased coronary perfusion
    D) Thickened AV valves

A) Decreased pacemaker cells in SA node
Explanation: Fewer pacemaker cells and fibrosis increase arrhythmia risk. (Ch. 45)

22. Which pulmonary change increases pneumonia risk in geriatrics?
    A) Strong cough reflex
    B) Increased ciliary function
    C) Decreased mucociliary clearance
    D) Increased alveolar macrophages

C) Decreased mucociliary clearance
Explanation: Ciliary slowing reduces airway clearance, predisposing to infection. (Ch. 45)

23. Which neurologic disorder is most common in the elderly?
    A) Parkinson’s disease
    B) Stroke
    C) Multiple sclerosis
    D) ALS

B) Stroke
Explanation: Stroke is the most common acute neurologic disorder in geriatrics. (Ch. 45)

24. Which endocrine disorder is most common in the elderly?
    A) Hypothyroidism
    B) Hyperthyroidism
    C) Addison’s disease
    D) Acromegaly

A) Hypothyroidism
Explanation: Hypothyroidism increases with age and may present subtly. (Ch. 45)

25. Which renal change contributes to adverse drug reactions in the elderly?
    A) Increased GFR
    B) Decreased creatinine clearance
    C) Increased renal mass
    D) Increased tubular secretion

B) Decreased creatinine clearance
Explanation: Slower clearance of drugs increases toxicity risk. (Ch. 45)

26. Which GI disorder is most common in older adults?
    A) GERD
    B) Pyloric stenosis
    C) Intussusception
    D) Appendicitis

A) GERD
Explanation: Reduced LES tone increases reflux symptoms in geriatrics. (Ch. 45)

27. Which musculoskeletal disorder is most common in older adults?
    A) Osteoporosis
    B) Osteogenesis imperfecta
    C) Paget’s disease
    D) Ankylosing spondylitis

A) Osteoporosis
Explanation: Bone density loss increases fracture risk, especially in women. (Ch. 45)

28. Which integumentary change makes skin more prone to infection?
    A) Increased collagen
    B) Thicker epidermis
    C) Thinner epidermis and reduced blood supply
    D) Increased sebaceous gland activity

C) Thinner epidermis and reduced blood supply
Explanation: Skin thins and heals more slowly, raising infection risk. (Ch. 45)

29. Which immune system change makes vaccines less effective in elderly?
    A) Stronger immune memory
    B) Decline in B and T cell function
    C) Increased cytokine production
    D) Increased natural killer cell activity

B) Decline in B and T cell function
Explanation: Immune senescence decreases vaccine effectiveness. (Ch. 45)

30. Which psychosocial factor worsens geriatric depression risk?
    A) Family support
    B) Chronic illness
    C) Active lifestyle
    D) Community involvement

B) Chronic illness
Explanation: Chronic disease is strongly linked to depression in the elderly. (Ch. 45)

31. Which atypical MI presentation is most common in elderly women?
    A) Crushing chest pain
    B) Severe dyspnea or fatigue
    C) Syncope
    D) Palpitations

B) Severe dyspnea or fatigue
Explanation: Elderly, especially women, often present without chest pain. (Ch. 45)

32. Which respiratory disease is the 4th leading cause of death in geriatrics?
    A) Asthma
    B) Pneumonia
    C) COPD
    D) Tuberculosis

C) COPD
Explanation: Chronic obstructive pulmonary disease is a major killer in elderly adults. (Ch. 45)

33. Which neurologic disease is the most common cause of dementia?
    A) Alzheimer’s disease
    B) Lewy body dementia
    C) Vascular dementia
    D) Frontotemporal dementia

A) Alzheimer’s disease
Explanation: Alzheimer’s accounts for the majority of dementia cases. (Ch. 45)

34. Which sign is a red flag in an elderly patient with suspected infection?
    A) High fever
    B) Altered mental status
    C) Localized pain
    D) Productive cough

B) Altered mental status
Explanation: Elderly may lack fever but show delirium as a primary sign. (Ch. 45)

35. Which endocrine condition often presents atypically in geriatrics?
    A) Diabetes mellitus
    B) Thyroid storm
    C) Addison’s disease
    D) Pheochromocytoma

A) Diabetes mellitus
Explanation: Older adults may have vague symptoms like fatigue and weight loss. (Ch. 45)

36. Which renal emergency is most common in geriatrics?
    A) Acute renal failure
    B) Kidney stones
    C) Hydronephrosis
    D) Pyelonephritis

A) Acute renal failure
Explanation: Reduced reserve makes elderly prone to acute renal dysfunction. (Ch. 45)

37. Which drug class is a major cause of renal failure in the elderly?
    A) NSAIDs
    B) Antibiotics
    C) Corticosteroids
    D) Antihypertensives

A) NSAIDs
Explanation: NSAIDs reduce renal perfusion, worsening renal decline. (Ch. 45)

38. Which endocrine emergency is more common in elderly diabetics?
    A) DKA
    B) HHNS (hyperosmolar hyperglycemic nonketotic syndrome)
    C) Addisonian crisis
    D) Myxedema coma

B) HHNS (hyperosmolar hyperglycemic nonketotic syndrome)
Explanation: HHNS is more common in elderly diabetics due to dehydration and poor intake. (Ch. 45)

39. Which integumentary disorder is most associated with pressure ulcers?
    A) Eczema
    B) Psoriasis
    C) Prolonged immobility
    D) Cellulitis

C) Prolonged immobility
Explanation: Bedridden elderly patients are at high risk for pressure injuries. (Ch. 45)

40. Which musculoskeletal disorder increases risk for hip fractures in geriatrics?
    A) Arthritis
    B) Osteoporosis
    C) Bursitis
    D) Fibromyalgia

B) Osteoporosis
Explanation: Osteoporotic bones fracture easily with minor trauma. (Ch. 45)

41. Which neurologic change increases fall risk in geriatrics?
    A) Faster reaction time
    B) Poor proprioception
    C) Improved reflexes
    D) Increased balance

B) Poor proprioception
Explanation: Decline in balance and reflexes leads to instability. (Ch. 45)

42. Which GI disorder is most common cause of lower GI bleeding in elderly?
    A) Diverticulosis
    B) Hemorrhoids
    C) Polyps
    D) Ulcers

A) Diverticulosis
Explanation: Diverticula rupture is a frequent cause of GI bleeding. (Ch. 45)

43. Which renal change predisposes elderly to hyponatremia?
    A) Impaired free water clearance
    B) Increased ADH release
    C) Decreased aldosterone
    D) All of these contribute

A) Impaired free water clearance
Explanation: Older kidneys struggle to excrete free water, leading to dilutional hyponatremia. (Ch. 45)

44. Which immune change increases risk for shingles?
    A) Loss of B-cell memory
    B) Decline in T-cell mediated immunity
    C) Increased cytokines
    D) Hyperactive neutrophils

B) Decline in T-cell mediated immunity
Explanation: T-cell decline allows latent varicella-zoster reactivation. (Ch. 45)

45. Which neurologic condition is a major cause of disability in geriatrics?
    A) Stroke
    B) ALS
    C) Epilepsy
    D) Multiple sclerosis

A) Stroke
Explanation: Stroke is a leading cause of long-term disability in elderly adults. (Ch. 45)

46. Which cardiac emergency is most likely to present without chest pain in geriatrics?
    A) STEMI
    B) NSTEMI
    C) Heart failure exacerbation
    D) Stable angina

B) NSTEMI
Explanation: Elderly often have silent or atypical NSTEMI presentations. (Ch. 45)

47. Which respiratory infection is most fatal in elderly adults?
    A) Bronchitis
    B) Influenza
    C) Tuberculosis
    D) Pneumonia

D) Pneumonia
Explanation: Pneumonia is a major cause of morbidity and mortality in geriatrics. (Ch. 45)

48. Which endocrine crisis has high mortality in elderly hypothyroid patients?
    A) Myxedema coma
    B) Thyroid storm
    C) Addisonian crisis
    D) SIADH

A) Myxedema coma
Explanation: Severe hypothyroidism in elderly can cause life-threatening coma. (Ch. 45)

49. Which psychiatric condition has the highest suicide risk in elderly men?
    A) Schizophrenia
    B) Bipolar disorder
    C) Depression
    D) Dementia

C) Depression
Explanation: Elderly men with depression have highest suicide completion rates. (Ch. 45)

50. Which form of abuse is most reported in geriatric patients?
    A) Physical abuse
    B) Neglect
    C) Sexual abuse
    D) Financial exploitation

D) Financial exploitation
Explanation: Financial abuse/exploitation is the most reported form of elder abuse. (Ch. 45)

51. Which musculoskeletal emergency is most common after a ground-level fall in geriatrics?
    A) Wrist fracture
    B) Hip fracture
    C) Shoulder dislocation
    D) Tibia fracture

B) Hip fracture
Explanation: Osteoporosis and fall mechanics make hip fractures very common. (Ch. 45)

52. Which complication of hip fracture is most life-threatening in the elderly?
    A) Chronic pain
    B) Pneumonia and DVT/PE
    C) Hip arthritis
    D) Muscle atrophy

B) Pneumonia and DVT/PE
Explanation: Immobility after hip fracture increases clotting and infection risk. (Ch. 45)

53. Which integumentary disorder is most preventable in geriatrics?
    A) Skin cancer
    B) Pressure ulcers
    C) Psoriasis
    D) Eczema

B) Pressure ulcers
Explanation: Pressure ulcers are preventable with repositioning and skin care. (Ch. 45)

54. Which cardiac rhythm is most common in elderly patients with atrial structural changes?
    A) Sinus tachycardia
    B) Atrial fibrillation
    C) Ventricular tachycardia
    D) Sinus bradycardia

B) Atrial fibrillation
Explanation: Fibrosis and atrial dilation increase AFib prevalence with age. (Ch. 45)

55. Which GI condition is the most common cause of upper GI bleeding in geriatrics?
    A) Mallory-Weiss tear
    B) Peptic ulcer disease
    C) Esophageal varices
    D) Gastric cancer

B) Peptic ulcer disease
Explanation: Ulcer disease from NSAIDs and H. pylori causes many bleeds. (Ch. 45)

56. Which renal disorder is most common in elderly men?
    A) Chronic kidney disease
    B) Benign prostatic hyperplasia (BPH)
    C) Kidney stones
    D) Pyelonephritis

B) Benign prostatic hyperplasia (BPH)
Explanation: BPH leads to urinary retention and infections in older men. (Ch. 45)

57. Which urologic emergency is most associated with BPH?
    A) Acute urinary retention
    B) Renal colic
    C) Hematuria
    D) Prostate cancer

A) Acute urinary retention
Explanation: Enlarged prostate may obstruct urine flow acutely. (Ch. 45)

58. Which electrolyte disturbance is most common in elderly patients on diuretics?
    A) Hypernatremia
    B) Hyponatremia
    C) Hyperkalemia
    D) Hypercalcemia

B) Hyponatremia
Explanation: Diuretics, reduced renal function, and poor intake predispose to hyponatremia. (Ch. 45)

59. Which condition is most likely to cause delirium in elderly hospitalized patients?
    A) Dementia
    B) Dehydration or infection
    C) Parkinson’s disease
    D) Depression

B) Dehydration or infection
Explanation: Acute delirium is often triggered by reversible systemic issues. (Ch. 45)

60. Which psychiatric condition is most underdiagnosed in elderly?
    A) Depression
    B) Bipolar disorder
    C) Schizophrenia
    D) PTSD

A) Depression
Explanation: Depression is common but often misattributed to normal aging. (Ch. 45)

61. Which neurologic disorder presents with resting tremor, rigidity, and bradykinesia?
    A) Stroke
    B) Alzheimer’s disease
    C) Parkinson’s disease
    D) ALS

C) Parkinson’s disease
Explanation: Parkinson’s disease is characterized by tremor, rigidity, and slow movement. (Ch. 45)

62. Which is the most common psychiatric condition leading to suicide in elderly men?
    A) Depression
    B) Psychosis
    C) Bipolar disorder
    D) Substance abuse

A) Depression
Explanation: Depression is strongly linked to suicide in elderly men. (Ch. 45)

63. Which sensory change contributes most to social isolation?
    A) Presbycusis (hearing loss)
    B) Presbyopia (vision loss)
    C) Reduced taste
    D) Decreased smell

A) Presbycusis (hearing loss)
Explanation: Hearing loss impairs communication and worsens isolation. (Ch. 45)

64. Which GI cancer is most common in elderly patients?
    A) Esophageal
    B) Gastric
    C) Colon
    D) Liver

C) Colon
Explanation: Colorectal cancer incidence rises sharply with age. (Ch. 45)

65. Which cardiovascular symptom is most often atypical in elderly MI patients?
    A) Severe chest pain
    B) Dyspnea, syncope, or confusion
    C) Palpitations only
    D) Epigastric burning

B) Dyspnea, syncope, or confusion
Explanation: Elderly often present with atypical MI symptoms. (Ch. 45)

66. Which endocrine emergency has very high mortality in elderly hyperthyroid patients?
    A) Myxedema coma
    B) Thyroid storm
    C) HHNS
    D) DKA

B) Thyroid storm
Explanation: Thyroid storm is a rare but life-threatening complication in elderly. (Ch. 45)

67. Which immune-related disease has increased severity in elderly?
    A) Pneumonia
    B) Influenza
    C) Shingles
    D) All of these

D) All of these
Explanation: Immunosenescence makes infections more severe in elderly. (Ch. 45)

68. Which medication type commonly causes GI bleeding in geriatrics?
    A) Antihypertensives
    B) NSAIDs
    C) Steroids
    D) Antipsychotics

B) NSAIDs
Explanation: NSAIDs increase risk of ulcers and upper GI bleeds. (Ch. 45)

69. Which common geriatric condition mimics depression?
    A) Alzheimer’s disease
    B) Dementia
    C) Stroke
    D) COPD

B) Dementia
Explanation: Dementia can present with apathy and withdrawal, resembling depression. (Ch. 45)

70. Which electrolyte disturbance is most associated with confusion in geriatrics?
    A) Hyperkalemia
    B) Hyponatremia
    C) Hypercalcemia
    D) Hypophosphatemia

B) Hyponatremia
Explanation: Low sodium levels commonly cause altered mental status. (Ch. 45)

71. Which type of abuse is least likely to be reported in elderly patients?
    A) Financial
    B) Sexual
    C) Physical
    D) Neglect

B) Sexual
Explanation: Sexual abuse is underreported due to stigma and vulnerability. (Ch. 45)

72. Which respiratory symptom is most common in COPD exacerbation in elderly?
    A) Pleuritic chest pain
    B) Cough, wheezing, and dyspnea
    C) Hemoptysis
    D) Stridor

B) Cough, wheezing, and dyspnea
Explanation: COPD flares present with worsening cough and breathlessness. (Ch. 45)

73. Which diagnostic tool is most useful in confirming Alzheimer’s disease?
    A) CT scan
    B) PET scan
    C) Clinical history and cognitive testing
    D) EEG

C) Clinical history and cognitive testing
Explanation: Alzheimer’s is a clinical diagnosis supported by neurocognitive evaluation. (Ch. 45)

74. Which renal disorder commonly presents with nocturia in elderly?
    A) CKD
    B) BPH
    C) Diabetes insipidus
    D) Acute tubular necrosis

B) BPH
Explanation: Enlarged prostate causes frequent nighttime urination. (Ch. 45)

75. Which integumentary condition increases with cumulative UV exposure?
    A) Melanoma
    B) Basal cell carcinoma
    C) Squamous cell carcinoma
    D) All skin cancers increase

D) All skin cancers increase
Explanation: UV exposure over a lifetime raises all skin cancer risks. (Ch. 45)

76. Which GI symptom should raise concern for colon cancer in elderly?
    A) Constipation only
    B) Occult blood in stool
    C) Belching
    D) Abdominal cramps only

B) Occult blood in stool
Explanation: Occult bleeding may be the only early sign of colon cancer. (Ch. 45)

77. Which neurologic symptom is most associated with TIA in geriatrics?
    A) Recurrent headaches
    B) Transient unilateral weakness or vision loss
    C) Tremor
    D) Seizure

B) Transient unilateral weakness or vision loss
Explanation: TIAs present with transient focal neurologic deficits. (Ch. 45)

78. Which cardiac condition often causes syncope in elderly patients?
    A) Aortic stenosis
    B) Mitral valve prolapse
    C) AFib
    D) Pericarditis

A) Aortic stenosis
Explanation: Severe aortic stenosis reduces cerebral perfusion, causing syncope. (Ch. 45)

79. Which respiratory disease is strongly associated with chronic smoking in elderly?
    A) Asthma
    B) COPD
    C) Tuberculosis
    D) Restrictive lung disease

B) COPD
Explanation: Smoking is the main cause of COPD in older adults. (Ch. 45)

80. Which psychosocial factor increases risk of malnutrition in elderly?
    A) Polypharmacy
    B) Poverty and isolation
    C) Dementia
    D) All of these

D) All of these
Explanation: Multiple social and medical factors contribute to poor nutrition. (Ch. 45)

81. Which neurologic disorder often coexists with depression in geriatrics?
    A) Alzheimer’s disease
    B) Stroke
    C) Parkinson’s disease
    D) All of these

D) All of these
Explanation: Depression often accompanies neurodegenerative disorders. (Ch. 45)

82. Which endocrine condition is a risk factor for osteoporosis in elderly women?
    A) Hypothyroidism
    B) Diabetes
    C) Estrogen deficiency
    D) Hyperprolactinemia

C) Estrogen deficiency
Explanation: Menopause-related estrogen loss accelerates bone loss. (Ch. 45)

83. Which renal emergency is associated with sepsis and hypotension in elderly?
    A) Acute tubular necrosis
    B) Kidney stones
    C) Hydronephrosis
    D) BPH

A) Acute tubular necrosis
Explanation: Poor perfusion during shock causes ATN. (Ch. 45)

84. Which integumentary change reduces heat tolerance in geriatrics?
    A) Increased sweat glands
    B) Decreased sweat gland function
    C) Thicker skin
    D) More hair follicles

B) Decreased sweat gland function
Explanation: Reduced sweat response impairs thermoregulation. (Ch. 45)

85. Which endocrine disorder increases fall risk in elderly women?
    A) Hyperthyroidism
    B) Diabetes mellitus
    C) Osteoporosis
    D) Addison’s disease

C) Osteoporosis
Explanation: Fragile bones lead to fracture risk after falls. (Ch. 45)

86. Which neurologic sign is most concerning for delirium in elderly?
    A) Slow progressive memory loss
    B) Acute fluctuating confusion
    C) Tremors
    D) Shuffling gait

B) Acute fluctuating confusion
Explanation: Delirium is acute and fluctuating, not progressive like dementia. (Ch. 45)

87. Which GI disorder is most associated with chronic NSAID use in elderly?
    A) GERD
    B) Peptic ulcers
    C) Hemorrhoids
    D) IBS

B) Peptic ulcers
Explanation: NSAIDs inhibit protective prostaglandins, leading to ulcers. (Ch. 45)

88. Which renal finding is expected with normal aging?
    A) Increased GFR
    B) Decreased renal mass
    C) Increased creatinine clearance
    D) Increased tubular reabsorption

B) Decreased renal mass
Explanation: Kidneys shrink with age, reducing overall function. (Ch. 45)

89. Which psychiatric symptom is often the first sign of Alzheimer’s disease?
    A) Delusions
    B) Memory loss for recent events
    C) Motor decline
    D) Hallucinations

B) Memory loss for recent events
Explanation: Short-term memory loss is an early hallmark. (Ch. 45)

90. Which infection is most common cause of sepsis in elderly?
    A) Pneumonia
    B) UTI
    C) Skin infections
    D) Bacteremia from IV lines

B) UTI
Explanation: Urinary tract infections are the leading cause of geriatric sepsis. (Ch. 45)

91. Which electrolyte imbalance is most associated with diuretic use in elderly CHF patients?
    A) Hypokalemia
    B) Hyperkalemia
    C) Hypernatremia
    D) Hypocalcemia

A) Hypokalemia
Explanation: Loop diuretics often cause potassium loss. (Ch. 45)

92. Which cardiac condition presents with sudden dyspnea and pink frothy sputum in elderly?
    A) Pneumonia
    B) Pulmonary embolism
    C) Acute heart failure
    D) COPD exacerbation

C) Acute heart failure
Explanation: Pulmonary edema in CHF causes frothy sputum. (Ch. 45)

93. Which anticoagulant is most often prescribed for elderly AFib patients?
    A) Aspirin
    B) Warfarin or DOACs
    C) Clopidogrel
    D) Heparin

B) Warfarin or DOACs
Explanation: Long-term anticoagulation reduces stroke risk in AFib. (Ch. 45)

94. Which GI disorder is most associated with severe constipation in geriatrics?
    A) Colon cancer
    B) Diverticulitis
    C) Medication side effects
    D) Appendicitis

C) Medication side effects
Explanation: Opioids, anticholinergics, and calcium channel blockers cause constipation. (Ch. 45)

95. Which integumentary disorder increases with age due to cumulative UV exposure?
    A) Basal cell carcinoma
    B) Squamous cell carcinoma
    C) Melanoma
    D) All skin cancers

D) All skin cancers
Explanation: All skin cancers rise with prolonged sun exposure. (Ch. 45)

96. Which psychiatric condition often mimics dementia in geriatrics?
    A) Depression
    B) Bipolar disorder
    C) Schizophrenia
    D) PTSD

A) Depression
Explanation: Pseudodementia from depression resembles dementia but is reversible. (Ch. 45)

97. Which respiratory symptom is most common in elderly pneumonia patients?
    A) Fever
    B) Productive cough
    C) Altered mental status
    D) Chest pain

C) Altered mental status
Explanation: Pneumonia may present atypically with confusion rather than fever. (Ch. 45)

98. Which neurologic finding distinguishes dementia from delirium?
    A) Progressive, irreversible decline
    B) Acute onset with fluctuating course
    C) Inattention and disorientation
    D) Hallucinations

A) Progressive, irreversible decline
Explanation: Dementia is chronic and progressive, unlike delirium. (Ch. 45)

99. Which renal disorder often presents with nocturia and incontinence in elderly?
    A) BPH
    B) CKD
    C) Nephrotic syndrome
    D) ATN

A) BPH
Explanation: Enlarged prostate causes obstructive urinary symptoms. (Ch. 45)

100. Which endocrine disorder increases fracture risk in geriatric women?
     A) Hypothyroidism
     B) Osteoporosis
     C) Addison’s disease
     D) Hyperaldosteronism

B) Osteoporosis
Explanation: Postmenopausal women lose bone mass, increasing fracture risk. (Ch. 45)