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An 80-year-old woman comes to the office to request a prescription for an antidepressant. Over the past 2 months she has been sleeping poorly, and her appetite has decreased. She describes feeling miserable all the time, crying often, and fighting with everybody. She has no somatic symptoms. History includes obesity, hypothyroidism, osteoarthritis, and longstanding bipolar disorder. Medications include levothyroxine and acetaminophen as needed. She has been asymptomatic off medication for bipolar disorder for 2 years; shortly before she stopped, she experienced lithium toxicity and was hospitalized. The patient and her family believe that the bipolar disorder has abated because of her age. Physical examination is unremarkable. She appears restless, starts to talk of a new hobby, but then switches topic. There is a substantial change from her baseline cognition: she is not sure of the date, and she makes mistakes about events that are familiar to her. CBC and basic chemistry panel are within normal limits. During the past week, she has become increasingly tearful, confused, and restless. Which of the following is most likely to be true?

The 9-item Patient Health Questionnaire (PHQ 9) and the Geriatric Depression Scale (GDS) are the screening tests for geriatric depression with the best validity to support their use in primary care practice. Which of the following statements is true?

A 75-year-old woman cared for her 78-year-old husband in their home until he died of metastatic cancer. Which of the following most strongly predicts an uncomplicated course of bereavement?

Depression is easily identified and readily treated in the terminally ill patient.  

For individuals over 65 years old, the most common morbidities are related to:

A 79-year-old man with a history of heart failure with preserved ejection fraction, gout and chronic insomnia is concerned about falling. His medication list indicates he takes furosemide, carvedilol, lisinopril, aspirin, allopurinol and temazepam. He lives alone and earlier in the year fell getting out of bed to go to the bathroom but did not suffer any injury. Last week, he missed a step and stumbled but did not fall. Which one of the following would most likely reduce this patient’s fall risk?

A 75 y/o patient reports weakness, difficulty urinating and feeling dehydrated. Although afebrile, the nurse practitioner conducts a thorough physical examination, including urinalysis and complete blood count (CBC). The total assessment is necessary because:

A 75 year old male cares for his wife, who has Alzheimer disease, in their home. Because his wife needs increasing help with activities of daily living, the husband reluctantly decides to place her in a nursing home. Which of the following factors predicts a more successful transition for the husband after his wife enters the nursing home?

A 78 year old patient asked the nurse practitioner what is meant by health promotion. Which of the following is the nurse practitioner’s best response? Health promotion:

Electrons have an electrical charge of +1.