Geriatric services
Community Medicine · Topic 12
Source: NMC CBME Curriculum 2024 · Volume II · Community Medicine · Topic 12 · combined PDF page 277
Practice questions
- When applying the proposed systematic methodology to evaluate a geriatric service, what should be identified first?
- After identifying a target disability for a geriatric service evaluation, which step follows in the proposed methodology?
- A team has identified a target condition and described the geriatric service intended to address it. What should it establish before reviewing clinical studies?
- In the proposed evaluation framework, what is the purpose of reviewing published clinical research after defining effectiveness criteria?
- Once evidence has been reviewed against the specified criteria, what is the final step in the proposed methodology for assessing a geriatric service?
- A hospital introduces embedded geriatric care for older adults undergoing emergency general surgery. Which outcome was among the most frequently assessed in the available systematic review?
- A review included eight prospective pre–post studies of embedded geriatric services in emergency general surgery. Which finding was reported for length of stay?
- In the review of embedded geriatric services in emergency general surgery, what conclusion is best supported regarding mortality?
- A reviewer claims that embedded geriatric services have been shown to improve patient-reported outcomes in emergency general surgery. Which finding most directly qualifies this claim?
- Which statement most accurately reflects the overall evidence base for embedded geriatric care in emergency general surgery?
- An older adult with a pre-existing cognitive disorder is scheduled for surgery. Which perioperative implication is supported by the literature on geriatric services?
- Why should perioperative geriatric services document cognitive status before surgery in an older patient?
- Which care component is specifically described as part of perioperative geriatric services aimed at supporting early recovery?
- An older postoperative patient develops delirium. Which adverse consequence is recognized in the perioperative geriatric literature?
- A hospital is revising perioperative protocols after recognizing that postoperative delirium is frequently missed. Which approach is most consistent with the reviewed geriatric-service recommendations?
- A frail older adult with advanced chronic kidney disease has recurrent falls and declining mobility. Which service response best reflects the geriatric-nephrology collaboration advocated in the literature?
- A nephrologist caring for older adults with advanced chronic kidney disease is informally managing falls and rehabilitation needs without access to a geriatric team. What concern does the review raise about this arrangement?
- When setting goals of care for an older person with advanced chronic kidney disease and substantial comorbidity, which emphasis is supported by the geriatric-nephrology review?
- A geriatric ward identifies a patient as colonized with a multiresistant organism. Which action is among the infection-control measures described for geriatric services?
- A ward team is concerned that antimicrobial use may select for multiresistant organisms. Which practice is supported by the review of infection control in geriatric services?
- A geriatric ward uses the same basic infection-control measures as other wards, but implementation remains difficult. Which combination of factors is identified as contributing to this difficulty?
- Which statement best reflects the infection-control approach recommended for geriatric wards in the review?
- An older patient with multimorbidity and polypharmacy is receiving a geriatric assessment. Which oral-health concern is supported by the systematic review of geriatric patients?
- A community survey finds poorer oral-health-related quality of life among older adults with multimorbidity and functional impairment. Which interpretation aligns with the systematic review?
- A geriatric service is redesigning its routine assessment after reviewing evidence that oral disease is common and associated with multimorbidity and polypharmacy. Which service change is best supported?
- A service planner claims that the systematic review of geriatric oral health established one precise prevalence estimate applicable to all older adults. Which feature of the evidence most directly challenges this claim?
- A health system uses the emergency general surgery review to argue that embedded geriatric care definitively reduces readmission. What is the most appropriate interpretation?
- Which statement about the evidence base for geriatric services in emergency general surgery is most accurate?
- A hospital evaluates a new embedded geriatric service and observes shorter stays but no clear change in mortality or readmission. Which interpretation is most consistent with the existing review?
- A hospital team is considering an embedded geriatric service for emergency general surgery and asks whether shorter stays alone establish broad patient benefit. Which response is most evidence-based?