Practice Exam Questions with
Rationalized Answers
A nurse is caring for an older adult client who has pneumonia. Which of the
following physiologic changes associated with aging places the client at a
greater risk for pneumonia?
A. Decreased anterior-posterior diameter
B. Increased diameter of the small airways
C. Decreased number of cilia
D. Increased alveolar surface area - ✔✔C. Decreased number of cilia
Decreased anterior-posterior diameterA physiologic change associated
with aging is a calcification of the bronchial and costal (rib) cartilage and
diminished chest wall compliance, leading to an increase in the anterior-
posterior diameter. The resultant reduced total lung capacity puts the client
at increased risk for hypoxemia.
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,Increased diameter of the small airwaysA physiologic change associated
with aging is a decreased diameter of the small airways. However, the
diameter of the large airways does increase with age, and these two factors
combined can lead to an increase in dead space, gas trapping, and
ventilation-perfusion imbalance.
Decreased number of ciliaMY ANSWERA physiologic change associated
with aging is a decreased number of cilia. This, along with a less effective
cough, leads to diminished efficiency of the normal defense mechanisms
for clearing the airway, putting the client at increased risk for infection, such
as pneumonia.
Increased alveolar surface areaA physiologic change associated with aging
is an increase in the size of the alveolar ducts and respiratory bronchioles,
leading to a decrease in the alveolar surface area. Consequently, there is
less surface area for gas exchange to occur, putting the client at an
increased risk for hypoxemia.
A nurse us contributing to the plan of care for a client who had a recent
stroke and a history of gastroesophageal reflux disease (GERD). For which
of the following disorders should the nurse plan to monitor this client?
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,A. Duodenal ulcer disease
B. Aspiration pneumonia
C. Viral pneumonia
D. Esophageal varices - ✔✔B. Aspiration pneumonia
Duodenal ulcer diseaseThe acidity of stomach contents that reflux back
into the esophagus results in an inflamed esophagus, not duodenum, which
is a section of the small intestine. With duodenal ulcer disease, there are
ulcers in the duodenum, usually associated with stress, COPD, pancreatic
disease, and chronic renal failure.
Aspiration pneumonia- results in reflux of gastric secretions from the
stomach into the lower esophagus. When regurgitation occurs, the client is
at high risk for pneumonia. Pneumonia occurs due to aspiration of gastric
contents into the airway. This client is at increased risk for dysphagia due
to the stroke and history of GERD; therefore, the nurse should monitor
closely for aspiration pneumonia.
Viral pneumonia- The cause of viral pneumonia is an inhaled virus that
settles in the lungs. GERD does not increase the risk of viral pneumonia.
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, Esophageal varices occur in clients who have portal hypertension, usually
due to hepatic cirrhosis.
A nurse is caring for an older adult client. Which of the following physiologic
changes associated with aging can affect medication dosage in this client?
A. Increased glomerular filtration rate
B. Decreased body fat
C. Decreased gastric motility
D. Decreased gastric pH - ✔✔C. Decreased gastric motility
Increased glomerular filtration rate- The aging process results in a
decreased glomerular filtration rate and causes the medications to filter at a
slower rate, causing them to remain in the body longer.
Decreased body fat- Body fat increases with aging. Medications that are
stored in adipose tissue will have an increased tissue concentration,
decreased plasma concentration, and a longer duration in the body.
Decreased gastric motility- Decreased gastric motility results in medications
remaining in the digestive tract for longer periods of time, leading to slow
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