NURS5461 Exam 1 – Adult Gerontology Management Across the Continuum of Care (Latest 2026/ 2027 Update) 100% Verified Questions & Answers {Grade A} - UTA

NURS5461 Exam 1 – Adult Gerontology Management Across the Continuum of Care (Latest 2026/ 2027 Update) 100% Verified Questions & Answers {Grade A} - UTA Primary thyroid disorders - correct answer dysfunction of the thyroid gland Effects of hypothyroidism - correct answer Increased cholesterol & weight gain. Puts pt at risk for CV disease Untreated hypothyroidism - correct answer myxedema coma and B12/folate deficiency anemia Endemic goiter - correct answer Results from dietary iodine deficiency Subclinical hypothyroidism - correct answer - ELEVATED TSH + NORMAL T3 + T4 Primary hypothyroidism - correct answer elevated TSH, low T3 and T4 Myxedema coma - correct answer extreme hypothyroidism(abrupt med cessation), rare with a high mortality rate = decreased cardiac output leads to decreased tissue perfusion which leads to brain and organ depletion leading to multi-organ failure Treatment for manic symptoms in dementia - correct answer DIVALPROEX SODIUM (DEPAKOTE) 1ST Or Carbamazapine Lamotrigine Lithium Normal TSH levels - correct answer 0.4-4 Secondary hypothyroidism - correct answer results when the pituitary gland is dysfunctional and does not secrete TSH - TSH maybe high, low, or normal. Treat hypothyroidism with - correct answer levothyroxine - follow up in 6-8 Amiodarone - correct answer Can induce hypothyroid Hyperthyroid - correct answer Too much T3 & T4 - can cause cardiac issues and osteoporosis Hashimoto's thyroiditis - correct answer an autoimmune disorder that attacks the thyroid gland causing hypothyroidism Graves disease - correct answer an autoimmune disorder that is caused by hyperthyroidism and is characterized by goiter and/or exophthalmos - increased iodine uptake. Subclinical hypethyroid - correct answer TSH low .4 and T3/T4 are normal. Hyperthyroid levels - correct answer low TSH, high T4 PTU (propylthiouracil) - correct answer Given to treat hyperthyroidism. Effective when TSH is within normal range. CAN be used in pregnancy women - BBW FOR LIVER FAILURE Physical effects of aging effect... - correct answer Absorption, Distribution, Metabolism, & Excretion Cachexia - correct answer a condition of physical wasting away due to the loss of weight and muscle mass that occurs in patients with diseases such as advanced cancer, AIDS, CHF. - key symptom is anorexia/loss of appetite Kwashiorkor Disease - correct answer protein deficiency with appropriate caloric intake - pts may have no weight loss and maybe over weight. Prealbumin & transferrin - correct answer Can be used to identify malnourishment Paroxitine (Paxil) - correct answer SSRI - sedative & anticholinergic effects. INTERACTS WITH DONEPEZIL In for pts who have hallucinations with Lewy body dementia, give... - correct answer Cholinesterase inhibitors - they have been reported to decreased visual hallucinations Anhedonia must be present for - correct answer 2 weeks to diagnosis depression Number of autosomes - correct answer 22 pairs Autosomal dominant disorders - correct answer Huntington disease and achondroplasia Autosomal recessive disorders - correct answer Tay-Sachs, Cystic fibrosis, sickle cell anemia, phenylketonuria. In autosomal recessive, if both parents are heterozygotes (carriers), their percentage of children will be.... - correct answer 25% chance the offspring will be affected. 25% will be normal. 50% will be heterozygotes (carriers) In autosomal recessive - if affected person marries a normal person, how will their offspring be effected ? - correct answer All offspring will be normal heterozygotes (carriers) X-linked recessive - correct answer What pattern of genetic transmission affects only M and has no M-to-M transmission, and mother is usually an unaffected carrier? Oncogenes - correct answer Present in everyone but remain inactivated Down Syndrome - correct answer Trisomy 21 - leukemia common and often have Alzheimer's dementia by 5th decade of life Edwards syndrome - correct answer Trisomy 18 - more common in females Turner's Syndrome (Monosomy X) - correct answer Complete or partial absence of 1 of the 2 X chromosomes in the female Klinefelter Syndrome (XXY) - correct answer - Extra X chromosome is present in male - infertility -normal until puberty then develops small testes and gynecomastia - treat with testosterone at puberty - may develop breast cancer and DM Marfan Syndrome - correct answer autosomal dominant - mutation in chromosome 15 Decreased platelets seen in - correct answer hemolytic, pernicious, and anaplastic anemia, hypersplenism, HIV, after transfusion, DIC. In less than 20k pt will have a petechial rash, ecchymosis, and spontaneous bleeding m PSP - correct answer Crazy eyes - early loss of postural balance and gait (lots of falls). Personality changes early on Dopamine receptor blockers - correct answer Risperidone / Haloperidol Tardive dyskinesia - correct answer A side effect of long-term use of traditional antipsychotic drugs causing the person to have uncontrollable facial tics, grimaces, and other involuntary movements of the lips, jaw, and tongue. Parkinson's disease - correct answer Resting tremor effecting one side 1st Alpha-synuclein - correct answer A protein that has been implicated in Parkinson's disease - CAUSE FORMATION OF LEWY BODYS Microcytic anemia - correct answer iron deficiency, usually due to malabsorption / occult blood loss, or lead poisoning. MCV 80 Normocytic anemia - correct answer due to hemorrhage or chronic disease. Aplastic anemia. MVC 80-92 Macrocytic anemia - correct answer due to folate or vitamin B12(cobalamin) deficiency (megaloblastic anemia) / pernicious anemia. /liver diseases Serum ferritin - correct answer Tests for iron stores. As serum ferritin falls, TIBC rises, and serum iron levels will eventually fall. Anemia of chronic disease - correct answer normocytic anemia with ↓ serum iron, ↓ TIBC, and normal iron stores. Treat with epoetin and give an iron supplement Schistocytes - correct answer Associated with hemolytic uremia syndrome Pernicious anemia - correct answer Macrocytic anemia caused by vitamin B12 deficiency. B12 is essential to maturation of erythrocytes - low levels will cause the RBC to expand. Ppis and histamine2 blockers can cause this. Increased homocysteine & methylmalonic acid level indicates ? - correct answer B12 deficiency Increased homocysteine levels - correct answer Folate deficiency Sperocytes - correct answer Appear as spheres, lack central pallor, smaller diameter, indicate immune-mediated process - can be seen after blood transfusion Aplastic anemia - correct answer a normocytic anemia characterized by the failure of bone marrow to produce red blood cells Low ferritin - correct answer iron deficiency anemia Transferrin - correct answer transports iron TIBC (total iron binding capacity) - correct answer Available transferrin that is left unbound (Represents the "empty seats on a train"). When iron is low, TIBC will be high. When iron is high, TIBC will be low MCHC (mean corpuscular hemoglobin concentration) - correct answer 32 - 36 g/dl Concentration of hemoglobin per RBC Alzheimer's disease - correct answer Gradual onset with early memory impairment. Most common form of dementia. Cholinesterase inhibitors for early treatment. Lewy body dementia - correct answer usually a rapidly progressive form of dementia seen with Parkinson syndrome. - VISUAL HALLUCINATION ARE SEEN. Frontal lobe dementia - correct answer Seen before age 60 w personality impairments. PDG-PET Scan testing. - decreased glucose uptake by the brain in frontal and temporal lobe PDG-PET SCAN - correct answer Measure brain metabolism of glucose. Decreaesd uptake by temporal and parital lobe in Alzheimer's Ssris - correct answer Fluoxetine, paroxetine, sertraline, citalopram. Cholinesterase inhibitors - correct answer Donepezil Rivastigmine Galantamine Cholinesterase inhibitors - correct answer Treatment of alzheimers dementia and dementia w Lewy body's - can reduce psychosis & behavior disturbances Delirium - correct answer Acute onset confusion caused by cholinergic deficiency / Anticholinergic overdose. HALDO TREATMENT OF CHOICE UNLESS PT HAS PARKINSONS OR DEMENTIA W LEWY BODYS - USE QUETIAPINE For Mania in dementia use - correct answer Divalproex (depokote) 1st recommended treatment for depression - correct answer Exercise Bipolar depression treatment - correct answer mood stabilizer - lamotrigine 1st Fluoxetine (Prozac) - correct answer SSRI - AVOID IN OLDER ADULTS - long half life and too energizing What neurotransmitter is lost in Alzheimer's - correct answer Acetylcholine Diagnosis for levy body / parkinson dementia - correct answer must include visual hallucinations and or parkinsons signs Memantine - correct answer Used for sever Alzheimer's and in combination with a cholinesterase inhibitor Citalopram (Celexa) - correct answer SSRI. Effective in treating agitation and psychosis - no more than 20mg due to prolonged QT . Treatment for mania in dementia - correct answer Divalproex Sodium (Depakot) - Keep an eye on the liver Cholinesterase inhibitors - correct answer Donepezil Rivastigmine Galantamine Delirium is cause by - correct answer Caused by cholinergic deficiency / anticholinergic deficiency Treatment for delirium - correct answer Haloperidol (Haldo) - unless the pt has parkinsons Or levy body dementia (Give seroquel) Antipsychotic drugs - correct answer Make parkinson symptoms worse due to their ability to block dopamine. Give parkinsons pts an atypical antipsychotic such as Quetiapine (seroquel) is they have delirium Preferred med for bipolar depression - correct answer Mood stabilizers - LAMOTRIGINE Sertraline (Zoloft) - correct answer SSRI good for treating geriatric depression Essential tremor - correct answer Is bilateral. ETOH will stop the tremor - present when the limbs are active - treat with beta blocker Chorea - correct answer Hyperkinetic movement - dysfunction of the striatum - treat with dopamine receptor blockers such as rispiridone or haldol - can be caused by Huntingtons - treat HD with tretrabenazine / Deutertrabanzine Multiple system atrophy - correct answer Most disabling symptom is orthostatic hypotension Dystonia - correct answer Hyperkinetic disorder that causes prolonged muscle contraction - treat with anticholinergics or muscle relaxants (baclofen) - injecting Botox can provide temporary relief Progressive Supranuclear Palsy - correct answer - Loss of voluntary eye movements (preservation of reflexive) - Bradykinesia - Rigidity - Axial dystonia - Pseudobulbar palsy - Dementia - Occurs later middle life TRAP - correct answer Tremor Rigidity Akinesia/bradykinesia Postural instability Parkinson's w hallucinations treatment - correct answer Quetiapine (Seroquel) or Clozapine MAO-B inhibitor drugs - correct answer Selegiline Rasagiline Used for mild to moderate parkinsons - can use with levodopa 1st line treatment for HTN in African americans - correct answer CCB or Thiazide Non-Dihydropyridine ccbs - correct answer They are negative inotropes (decrease contraction force) and negative chronotropes (decrease HR) DONT NOT COMBINE WITH A BETA BLOCKER Verapamil & Diltiazem Dihydropyridines CCB - correct answer Nifedipine Amlodipine Nicardipine CKD or diabetes - correct answer Give an ACE or an ARB ACE inhibitors - correct answer -pril Arbs - correct answer -sartan ACE & ARBS - correct answer Can cause renal failure if combined Beta blocked worsen... - correct answer Insulin resistance and decrease glucose uptake which will increase triglycerides Amylin - correct answer Deficient in Type 1 DM Keytones - correct answer Present in type 1 DM Diabetes drugs that wont decrease BG - correct answer Bihuanide, DPP4 inhibitors, GLP1 agonist, A-glucosidae inhibitors DPP4 inhibitor - correct answer Sitaglipin. "Gliptins" Diabetes drugs that lower BG - correct answer SGLT2 inhibitors, sulfonylureas SGLT2 inhibitors - correct answer Canagliflozin Dapagliflozin Empagliflozin DKA WARNING /FUNGLE WARNING/ OSTEOPOROSIS A1C X 3 - 6 , add a 0 - correct answer Glucose average over 3 months B12 deficiency anemia - correct answer Macrocytic. Pts will have neurological issues. Methylmalonic acid and homocysteine will be elevated Strength, DTR, and bainski - correct answer are normal in parkinsons Dopamine agonists - used for parkinsons - correct answer USED in Early PD before starting levodopa (if the pts younger) or can be added in late disease to levodopa to prevent dyskinesia's Non-ergot (preferred)—pramipexole, ropinirole These mimic dopamine Can cause impulse control disorder COMT inhibitors -used in parkinsons - correct answer preserve levodopa Levodopa/Carbidopa (Sinemet) - correct answer preserves dopamine - pt must get at least 75mg of carbidopa to prevent peripheral metabolism. - take on empty stomach and only last meal of the day should have protein - high fat and high calories meals can delay the absorption of levodopa MAO-B inhibitor drugs - correct answer Selegiline Rasagiline - can be added for end of dose "off" symptoms Preserve existing dopamine Dyskinesia - from levodopa - correct answer Use COMT or MAO-B inhibitors End - of - dose "off" symptoms - correct answer increase levopdopa frequency to q 3-4 hours or add Rasagiline (MAO-B) or entacapone (COMT) Rivastigmine - correct answer cholinesterase inhibitor - For hallucinations and dementia in parkinsons patients -increases ach -Alzheimer disease