NSG 6340 Adult Health Primary Care COMPLETED EXAM 2026/2027 (25pages)

1. What are the four main components of a comprehensive geriatric assessment (CGA) and why are they important? (4 marks) Answer: The four main components of a CGA are: medical assessment, functional assessment, mental status assessment, and social and environmental assessment. They are important because they help to identify the health needs, risks, and resources of older adults, and to plan appropriate interventions to optimize their quality of life and prevent adverse outcomes. (Rationale: A CGA is a multidimensional and interdisciplinary approach to evaluate the health status and needs of older adults. It can help to detect and manage common geriatric syndromes, such as falls, cognitive impairment, depression, polypharmacy, malnutrition, and incontinence.) 2. What are the three types of urinary incontinence (UI) and how can they be differentiated based on their symptoms and causes? (6 marks) Answer: The three types of UI are: stress UI, urge UI, and mixed UI. Stress UI is the involuntary leakage of urine due to increased abdominal pressure, such as during coughing, sneezing, laughing, or exercise. It is caused by weakness or damage of the pelvic floor muscles or the urethral sphincter. Urge UI is the involuntary leakage of urine accompanied by a sudden and strong urge to void, often triggered by certain stimuli, such as running water, cold temperature, or anxiety. It is caused by overactivity or instability of the detrusor muscle of the bladder. Mixed UI is the combination of both stress and urge UI symptoms and causes. (Rationale: UI is a common condition that affects many adults, especially older women. It can have significant impacts on physical, psychological, and social well-being. It is important to identify the type of UI to guide appropriate management strategies.) 3. What are the common signs and symptoms of chronic obstructive pulmonary disease (COPD) exacerbation and what are the recommended interventions to prevent and treat it? (5 marks) Answer: The common signs and symptoms of COPD exacerbation are: increased dyspnea, increased sputum volume or purulence, increased cough or wheeze, fever, chest tightness, or change in mental status. The recommended interventions to prevent and treat COPD exacerbation are: smoking cessation, influenza and pneumococcal vaccination, regular use of bronchodilators and corticosteroids as prescribed, oxygen therapy as needed, pulmonary rehabilitation, hydration, nutrition, and education on self-management and early recognition of exacerbation. In case of exacerbation, antibiotics may be indicated if there is evidence of bacterial infection. (Rationale: COPD is a chronic inflammatory lung disease that causes airflow limitation and respiratory distress. Exacerbation is a worsening of symptoms that requires prompt medical attention. It can lead to hospitalization, respiratory failure, or death if not treated properly.)