NURS 6540 Exam Study Guide | Advanced
Practice Care of
Frail Elders, Elders Final Review - Full Chapter
Questions & Answers
1. Mrs. Smith, 75 years old, reports that she is weak, has difficulty urinating, and
is dehydrated. Although she is afebrile, the nurse conducts a thorough physical
examination, including urinalysis and complete blood count (CBC). The total
assessment is necessary because:
1.All body systems interact, and symptoms could indicate a variety of
diagnoses.
2.The symptoms are vague and may be signs of aging.
3.There may be other signs or symptoms more indicative of the condition.
4.Mrs. Smith may not be reporting all significant information. - 1. Answer: 1
Page: 2
Feedback
1.
The clinician must be aware that all the systems interact and, in doing so,
can increase the older person's vulnerability to illness/disease. 2.
The nurse must not attribute symptoms only to the aging process.
3.
There may be comorbidities accompanying this condition.
4.
Assumptions of not reporting properly may not be true.
2. A patient with renal disease has blood work drawn, and the results show an
increase in serum creatinine. The nurse practitioner needs to know which of the
following laboratory values before ordering medications?
1.CBC
2.Culture and sensitivity of the urine
3.Creatinine clearance
4.Uric acid levels - 2. Answer: 3
Page: 3
777
,Feedback
1.
A CBC will not evaluate kidney function for a patient with
renal disease. 2.
A culture and sensitivity test reflects the presence of an infection and the
antibiotic to which the organism is sensitive. 3.
The calculation of creatinine clearance provides an estimation of renal function.
4.
Uric acid level is elevated in the presence of gout.
3. Which of the following statements is true regarding diagnostic testing?
1.A test is ordered for a specific purpose.
2.A test is the most invasive available.
3.There is no need to discuss results with the patient.
4.If a test is needed, it should be ordered regardless of risk to the patient. - 3.
Answer:
1 Page: 3
Feedback
1.
The nurse practitioner should have a plan for the use of each test result value
obtained.
2.
When considering which laboratory tests to order, it is worth remembering the
doctrine primum no nnocere—first, do no harm. 3.
Once laboratory tests are available for review, tests results should be discussed
with the patient, with abnormal test results interpreted for the aging individual
and addressed with the patient and caregivers.
4.
Any risks involved in laboratory testing must be considered concerning the
patient's clinical condition and weighed against the test's expected benefits.
4. Janey, 25 years old, may experience arthritis differently than 65-year-old Mrs.
Johnson because:
1.The body undergoes physiological changes with aging.
2.A healthy body does not experience significant changes as one gets older.
3.Older patients do not feel any systemic symptoms, such as malaise and
weight loss.
4.Even though the same joints are usually affected, age makes it feel different.
- 4. Answer: 1
777
,Page: 5
Feedback
1.
Knowledge of the bimodality of age onset of certain disease conditions will aid
the advanced practice nurse in avoiding misdiagnosis or delay in diagnosis due
to lack of recognition.
2.
Symptoms of rheumatoid arthritis may be different depending on the age of the
patient.
3.
Younger patients may not experience constitutional symptoms such as fever,
malaise, weight loss, and depression.
4.
In late-onset rheumatoid arthritis, the joint involvement is more often in the
larger joints.
5. The nurse practitioner is examining an 85-year-old man with reports of
abdominal pain, weakness, and loss of appetite. Which is the most likely
condition to be tested for and ruled out?
1.Neoplasms and carcinomas
2.Partial seizure
3.Sarcopenia
4.Hirschsprung's disease - 5. Answer: 1 Page: 4
Feedback
1.
Certain diseases, such as neoplasms and carcinomas, are more common
in the elderly, and an understanding of the epidemiology is critical in the
interpretation. 2.
Partial seizure is more common in early old age.
3.
Sarcopenia is more common in early old age.
4.
Hirschsprung's disease is most common in infancy.
6. For individuals over 65 years old, the most common morbidities are related
to:
1.Heart disease, arthritis
777
, 2.Respiratory problems, cancer
3.Diabetes, stroke
4.All of these are common morbidities. - 6. Answer: 4 Page: 5
Feedback
1.
Heart disease is one of the common morbidities.
2.
Cancer is common in the general population; however, specific types are more
common in the older patient.
3.
Diabetes is common in patients over 40 years of age.
4.
Heart disease, cancer, and diabetes combined are the most common
morbidities in older patients.
7. A gerontological patient is being examined for a report of pain in the shoulder.
The nurse practitioner completes a thorough systemic examination because:
1.Older patients with one morbidity often express difficulties in general.
2.Arthritis of the shoulder is accompanied by other neurological symptoms.
3.Older patients with arthritis often experience pain in lower extremities.
4.The patient may not report significant signs and symptoms. - 7. Answer: 1
Page: 5
Feedback
1.
Older patients with late-onset rheumatoid arthritis experience joint involvement
more often in the larger joints, such as the shoulder, and they also experience
systemic symptoms such as fever, malaise, weight loss, and depression.
2.
Older patients may express symptoms in any other physical systems.
3.
Patients more often experience arthritis in smaller joints.
4.
A thorough examination will detect objective indicators.
8. The nurse practitioner performs a thorough systemic examination of a patient
who reports diarrhea and pain in the upper left quadrant of the abdomen. One
possible diagnosis would be:
777
Practice Care of
Frail Elders, Elders Final Review - Full Chapter
Questions & Answers
1. Mrs. Smith, 75 years old, reports that she is weak, has difficulty urinating, and
is dehydrated. Although she is afebrile, the nurse conducts a thorough physical
examination, including urinalysis and complete blood count (CBC). The total
assessment is necessary because:
1.All body systems interact, and symptoms could indicate a variety of
diagnoses.
2.The symptoms are vague and may be signs of aging.
3.There may be other signs or symptoms more indicative of the condition.
4.Mrs. Smith may not be reporting all significant information. - 1. Answer: 1
Page: 2
Feedback
1.
The clinician must be aware that all the systems interact and, in doing so,
can increase the older person's vulnerability to illness/disease. 2.
The nurse must not attribute symptoms only to the aging process.
3.
There may be comorbidities accompanying this condition.
4.
Assumptions of not reporting properly may not be true.
2. A patient with renal disease has blood work drawn, and the results show an
increase in serum creatinine. The nurse practitioner needs to know which of the
following laboratory values before ordering medications?
1.CBC
2.Culture and sensitivity of the urine
3.Creatinine clearance
4.Uric acid levels - 2. Answer: 3
Page: 3
777
,Feedback
1.
A CBC will not evaluate kidney function for a patient with
renal disease. 2.
A culture and sensitivity test reflects the presence of an infection and the
antibiotic to which the organism is sensitive. 3.
The calculation of creatinine clearance provides an estimation of renal function.
4.
Uric acid level is elevated in the presence of gout.
3. Which of the following statements is true regarding diagnostic testing?
1.A test is ordered for a specific purpose.
2.A test is the most invasive available.
3.There is no need to discuss results with the patient.
4.If a test is needed, it should be ordered regardless of risk to the patient. - 3.
Answer:
1 Page: 3
Feedback
1.
The nurse practitioner should have a plan for the use of each test result value
obtained.
2.
When considering which laboratory tests to order, it is worth remembering the
doctrine primum no nnocere—first, do no harm. 3.
Once laboratory tests are available for review, tests results should be discussed
with the patient, with abnormal test results interpreted for the aging individual
and addressed with the patient and caregivers.
4.
Any risks involved in laboratory testing must be considered concerning the
patient's clinical condition and weighed against the test's expected benefits.
4. Janey, 25 years old, may experience arthritis differently than 65-year-old Mrs.
Johnson because:
1.The body undergoes physiological changes with aging.
2.A healthy body does not experience significant changes as one gets older.
3.Older patients do not feel any systemic symptoms, such as malaise and
weight loss.
4.Even though the same joints are usually affected, age makes it feel different.
- 4. Answer: 1
777
,Page: 5
Feedback
1.
Knowledge of the bimodality of age onset of certain disease conditions will aid
the advanced practice nurse in avoiding misdiagnosis or delay in diagnosis due
to lack of recognition.
2.
Symptoms of rheumatoid arthritis may be different depending on the age of the
patient.
3.
Younger patients may not experience constitutional symptoms such as fever,
malaise, weight loss, and depression.
4.
In late-onset rheumatoid arthritis, the joint involvement is more often in the
larger joints.
5. The nurse practitioner is examining an 85-year-old man with reports of
abdominal pain, weakness, and loss of appetite. Which is the most likely
condition to be tested for and ruled out?
1.Neoplasms and carcinomas
2.Partial seizure
3.Sarcopenia
4.Hirschsprung's disease - 5. Answer: 1 Page: 4
Feedback
1.
Certain diseases, such as neoplasms and carcinomas, are more common
in the elderly, and an understanding of the epidemiology is critical in the
interpretation. 2.
Partial seizure is more common in early old age.
3.
Sarcopenia is more common in early old age.
4.
Hirschsprung's disease is most common in infancy.
6. For individuals over 65 years old, the most common morbidities are related
to:
1.Heart disease, arthritis
777
, 2.Respiratory problems, cancer
3.Diabetes, stroke
4.All of these are common morbidities. - 6. Answer: 4 Page: 5
Feedback
1.
Heart disease is one of the common morbidities.
2.
Cancer is common in the general population; however, specific types are more
common in the older patient.
3.
Diabetes is common in patients over 40 years of age.
4.
Heart disease, cancer, and diabetes combined are the most common
morbidities in older patients.
7. A gerontological patient is being examined for a report of pain in the shoulder.
The nurse practitioner completes a thorough systemic examination because:
1.Older patients with one morbidity often express difficulties in general.
2.Arthritis of the shoulder is accompanied by other neurological symptoms.
3.Older patients with arthritis often experience pain in lower extremities.
4.The patient may not report significant signs and symptoms. - 7. Answer: 1
Page: 5
Feedback
1.
Older patients with late-onset rheumatoid arthritis experience joint involvement
more often in the larger joints, such as the shoulder, and they also experience
systemic symptoms such as fever, malaise, weight loss, and depression.
2.
Older patients may express symptoms in any other physical systems.
3.
Patients more often experience arthritis in smaller joints.
4.
A thorough examination will detect objective indicators.
8. The nurse practitioner performs a thorough systemic examination of a patient
who reports diarrhea and pain in the upper left quadrant of the abdomen. One
possible diagnosis would be:
777
