Question :
The major impact of the physiological changes that occur with
aging is:
Student Reduced physiological reserve
Answer:
Reduced homeostatic mechanisms
Impaired immunological response
All of the above
Instructor The major impact of all of these physiological changes can be highlighted
Explanation: with three primary points. First, there is a reduced physiological reserve of
most body systems, particularly cardiac, respiratory, and renal. Second,
there are reduced homeostatic mechanisms that fail to adjust regulatory
systems such as temperature control and fluid and electrolyte balance.
Third, there is impaired immunological function: infection risk is greater,
and autoimmune diseases are more prevalent. (Kennedy-Malone 3)
Kennedy-Malone, Laurie, Kathleen Fletcher, Lori Martin-Plank. Advanced
Practice Nursing in the Care of Older Adults. F.A. Davis Company, 2014-
01-14. VitalBook file.
Points Received: 2 of 2
Comments:
-582355588 MultipleChoice 1 True
0 -582355588 MultipleChoice 1
Question 2 Question :
. Men have faster and more efficient biotransformation of drugs
and this is thought to be due to:
Student Less obesity rates than women
Answer:
Prostate enlargement
Testosterone
, 0 -582355586 MultipleChoice 3
Less estrogen than women
Question 4 Question :
Instructor Men have faster and more efficient biotransformation, presumably because . Functional abilities are best assessed by:
Explanation: of serum testosterone. Conditions of increased or decreased liver perfusion
alter the overall level of the drug that is absorbed and how it is
metabolized. (Kennedy-Malone 5) Student Self-report of function
Answer:
Kennedy-Malone, Laurie, Kathleen Fletcher, Lori Martin-Plank. Advanced Observed assessment of function
Practice Nursing in the Care of Older Adults. F.A. Davis Company, 2014-
01-14. VitalBook file.
A comprehensive head-to-toe examination
Points Received: 2 of 2 Family report of function
Comments:
Instructor Two well-established tools used to evaluate function in older adults are the
-582355587 MultipleChoice 2 True
Explanation: Katz Activities of Daily Living Scale (Katz et al., 1963) and the Lawton
0 -582355587 MultipleChoice 2 and Brody scale for Instrumental Activities of Daily Living (Lawton &
Brody, 1969). It is important to be cautious about self-report of function
Question 3 Question : (rather than direct observation of function) and to ask, “Do you …?”
. The cytochrome p system involves enzymes that are generally: instead of “Can you …?” in order to determine if patients actually perform
the activity. (Kennedy-Malone 40)
Student Inhibited by drugs Kennedy-Malone, Laurie, Kathleen Fletcher, Lori Martin-Plank. Advanced
Answer: Practice Nursing in the Care of Older Adults. F.A. Davis Company, 2014-
Induced by drugs 01-14. VitalBook file.
Inhibited or induced by drugs
Points Received: 2 of 2
Comments:
Associated with decreased liver perfusion
-582355585 MultipleChoice 4 True
Instructor Biotransformation occurs in all body tissues but primarily in the liver, 0 -582355585 MultipleChoice 4
Explanation: where enzymatic activity (cytochrome P [CYP] system) alters and
detoxifies the drug and prepares it for excretion. (Kennedy-Malone 5) Question 5 Question :
. Iron Deficiency Anemia (IDA) is classified as a microcytic,
Kennedy-Malone, Laurie, Kathleen Fletcher, Lori Martin-Plank. hypochromic anemia. This classification refers to which of the
Advanced Practice Nursing in the Care of Older Adults. F.A. Davis following laboratory data?
Company, 2014-01-14. VitalBook file.
Student Answer: Hemoglobin and Hematocrit
Points Received: 2 of 2
Comments: Mean Corpuscular Volume (MCV) and Mean Corpuscular
-582355586 MultipleChoice 3 True Hemoglobin (MCH)
, Serum ferritin and serum iron Points Received: 0 of 2
Comments:
Total iron binding capacity and transferrin saturation
-582355583 MultipleChoice 6 False
Instructor RBC indices reveal an MCV (mean corpuscular volume/RBC size) that 0 -582355583 MultipleChoice 6
Explanation: will be decreased to <80 fL in adults; MCH (mean corpuscular
Question 7 Question :
hemoglobin/RBC color) will show hypochromia or pale cells; RBC
. The pathophysiological hallmark of ACD is:
distribution width (RDW)/volume variation will be increased.
(Kennedy-Malone page 519)
Student Depleted iron stores
Kennedy-Malone, Laurie, Kathleen Fletcher, Lori Martin-Plank.
Answer:
Advanced Practice Nursing in the Care of Older Adults. F.A. Davis
Company, 2014-01-14. VitalBook file. Impaired ability to use iron stores
Chronic uncorrectable bleeding
Points Received: 0 of 2
Comments: Reduced intestinal absorption of iron
-582355584 MultipleChoice 5 False
Instructor The pathophysiological hallmark of ACD is a disregulation of iron
0 -582355584 MultipleChoice 5
Explanation: homeostasis, characterized by an increased uptake and retention of iron
Question 6 Question : within the cells of the reticuloendothelial system (liver/spleen), resulting in
. When interpreting laboratory data, you would expect to see the decreased RBC production. Essentially, iron is present but inaccessible for
following in a patient with Anemia of Chronic Disease (ACD): use in the production of Hgb with the erythrocytes (Bross et al., 2010). A
shortened RBC survival is also a contributing factor to ACD. (Kennedy-
Malone page 516-517)
Student Hemoglobin <12 g/dl, MCV decreased, MCH decreased
Answer: Kennedy-Malone, Laurie, Kathleen Fletcher, Lori Martin-Plank. Advanced
Practice Nursing in the Care of Older Adults. F.A. Davis Company, 2014-
Hemoglobin >12 g/dl, MCV increased, MCH increased 01-14. VitalBook file.
Hemoglobin <12 g/dl, MCV normal, MCH normal
Points Received: 0 of 2
Hemoglobin >12 g/dl, MCV decreased, MCH increased Comments:
-582355582 MultipleChoice 7 False
Instructor Hemoglobin (Hgb): <12 g/dL (120 g/L) women <13 g/dL (130 g/L) men
Explanation: Rarely <10 g/dL (100 g/L) Mean corpuscular volume: 80–96 mcm3 0 -582355582 MultipleChoice 7
(normocytic) Mean corpuscular hemoglobin Normochromic (normal
Question 8 Question :
color) RBC distribution width: normal (Kennedy-Malone page 517)
. The main focus of treatment of patients with ACD is:
Kennedy-Malone, Laurie, Kathleen Fletcher, Lori Martin-Plank.
Advanced Practice Nursing in the Care of Older Adults. F.A. Davis Student Replenishing iron stores
Company, 2014-01-14. VitalBook file. Answer:
, Providing for adequate nutrition high in iron (Kennedy-Malone page 518)
Management of the underlying disorder Kennedy-Malone, Laurie, Kathleen Fletcher, Lori Martin-Plank. Advanced
Practice Nursing in the Care of Older Adults. F.A. Davis Company, 2014-
01-14. VitalBook file.
Administration of monthly vitamin B12 injections
Instructor Treatment: Treatment of ACD focuses on management of the underlying Points Received: 2 of 2
Explanation: disorder. Iron supplementation is of no benefit in ACD, except in cases of Comments:
coexisting IDA. A therapeutic trial of iron supplementation of no longer
than 1 month may be useful in delineating between ACD and IDA. In -582355580 MultipleChoice 9 True
ACD, there would be no hematological response to iron therapy (Chen & 0 -582355580 MultipleChoice 9
Gandhi, 2004). (Kennedy-Malone page 518)
Question 10 Question :
Kennedy-Malone, Laurie, Kathleen Fletcher, Lori Martin-Plank. Advanced . Symptoms in the initial human immunodeficiency virus (HIV)
Practice Nursing in the Care of Older Adults. F.A. Davis Company, 2014- infection include all of the following except:
01-14. VitalBook file.
Student Sore throat
Points Received: 2 of 2 Answer:
Comments: Fever
-582355581 MultipleChoice 8 True
Weight loss
0 -582355581 MultipleChoice 8
Question 9 Question : Headache
. In addition to the complete blood count (CBC) with differential,
which of the following laboratory tests is considered to be most Instructor Signal symptoms: The initial HIV infection is characterized by
useful in diagnosing ACD and IDA? Explanation: mononucleosis-like illness with fever, sore throat, lymphadenopathy,
headache, and fatigue. A roseola-like rash may also develop. These initial
symptoms are followed by an asymptomatic phase, which may last 10 years or
Student Serum iron more. Later, if untreated, lymphadenopathy, weight loss, myalgias, and
Answer: diarrhea may develop (Cohen, Kuritzkes, & Sax, 2011). In advanced disease,
Total iron binding capacity malignancies and opportunistic infections occur. Co-infection with hepatitis B
or C is common (25% to 30%) in IV drug users, so hepatitis symptoms may
Transferrin saturation also appear (Centers for Disease Control and Prevention [CDC], 2010a).
(Kennedy-Malone page 521)
Serum ferritin Kennedy-Malone, Laurie, Kathleen Fletcher, Lori Martin-Plank. Advanced
Practice Nursing in the Care of Older Adults. F.A. Davis Company, 2014-01-
Instructor Treatment: Treatment of ACD focuses on management of the underlying 14. VitalBook file.
Explanation: disorder. Iron supplementation is of no benefit in ACD, except in cases of
coexisting IDA. A therapeutic trial of iron supplementation of no longer than
1 month may be useful in delineating between ACD and IDA. In ACD, there Points Received: 0 of 2
would be no hematological response to iron therapy (Chen & Gandhi, 2004).
The major impact of the physiological changes that occur with
aging is:
Student Reduced physiological reserve
Answer:
Reduced homeostatic mechanisms
Impaired immunological response
All of the above
Instructor The major impact of all of these physiological changes can be highlighted
Explanation: with three primary points. First, there is a reduced physiological reserve of
most body systems, particularly cardiac, respiratory, and renal. Second,
there are reduced homeostatic mechanisms that fail to adjust regulatory
systems such as temperature control and fluid and electrolyte balance.
Third, there is impaired immunological function: infection risk is greater,
and autoimmune diseases are more prevalent. (Kennedy-Malone 3)
Kennedy-Malone, Laurie, Kathleen Fletcher, Lori Martin-Plank. Advanced
Practice Nursing in the Care of Older Adults. F.A. Davis Company, 2014-
01-14. VitalBook file.
Points Received: 2 of 2
Comments:
-582355588 MultipleChoice 1 True
0 -582355588 MultipleChoice 1
Question 2 Question :
. Men have faster and more efficient biotransformation of drugs
and this is thought to be due to:
Student Less obesity rates than women
Answer:
Prostate enlargement
Testosterone
, 0 -582355586 MultipleChoice 3
Less estrogen than women
Question 4 Question :
Instructor Men have faster and more efficient biotransformation, presumably because . Functional abilities are best assessed by:
Explanation: of serum testosterone. Conditions of increased or decreased liver perfusion
alter the overall level of the drug that is absorbed and how it is
metabolized. (Kennedy-Malone 5) Student Self-report of function
Answer:
Kennedy-Malone, Laurie, Kathleen Fletcher, Lori Martin-Plank. Advanced Observed assessment of function
Practice Nursing in the Care of Older Adults. F.A. Davis Company, 2014-
01-14. VitalBook file.
A comprehensive head-to-toe examination
Points Received: 2 of 2 Family report of function
Comments:
Instructor Two well-established tools used to evaluate function in older adults are the
-582355587 MultipleChoice 2 True
Explanation: Katz Activities of Daily Living Scale (Katz et al., 1963) and the Lawton
0 -582355587 MultipleChoice 2 and Brody scale for Instrumental Activities of Daily Living (Lawton &
Brody, 1969). It is important to be cautious about self-report of function
Question 3 Question : (rather than direct observation of function) and to ask, “Do you …?”
. The cytochrome p system involves enzymes that are generally: instead of “Can you …?” in order to determine if patients actually perform
the activity. (Kennedy-Malone 40)
Student Inhibited by drugs Kennedy-Malone, Laurie, Kathleen Fletcher, Lori Martin-Plank. Advanced
Answer: Practice Nursing in the Care of Older Adults. F.A. Davis Company, 2014-
Induced by drugs 01-14. VitalBook file.
Inhibited or induced by drugs
Points Received: 2 of 2
Comments:
Associated with decreased liver perfusion
-582355585 MultipleChoice 4 True
Instructor Biotransformation occurs in all body tissues but primarily in the liver, 0 -582355585 MultipleChoice 4
Explanation: where enzymatic activity (cytochrome P [CYP] system) alters and
detoxifies the drug and prepares it for excretion. (Kennedy-Malone 5) Question 5 Question :
. Iron Deficiency Anemia (IDA) is classified as a microcytic,
Kennedy-Malone, Laurie, Kathleen Fletcher, Lori Martin-Plank. hypochromic anemia. This classification refers to which of the
Advanced Practice Nursing in the Care of Older Adults. F.A. Davis following laboratory data?
Company, 2014-01-14. VitalBook file.
Student Answer: Hemoglobin and Hematocrit
Points Received: 2 of 2
Comments: Mean Corpuscular Volume (MCV) and Mean Corpuscular
-582355586 MultipleChoice 3 True Hemoglobin (MCH)
, Serum ferritin and serum iron Points Received: 0 of 2
Comments:
Total iron binding capacity and transferrin saturation
-582355583 MultipleChoice 6 False
Instructor RBC indices reveal an MCV (mean corpuscular volume/RBC size) that 0 -582355583 MultipleChoice 6
Explanation: will be decreased to <80 fL in adults; MCH (mean corpuscular
Question 7 Question :
hemoglobin/RBC color) will show hypochromia or pale cells; RBC
. The pathophysiological hallmark of ACD is:
distribution width (RDW)/volume variation will be increased.
(Kennedy-Malone page 519)
Student Depleted iron stores
Kennedy-Malone, Laurie, Kathleen Fletcher, Lori Martin-Plank.
Answer:
Advanced Practice Nursing in the Care of Older Adults. F.A. Davis
Company, 2014-01-14. VitalBook file. Impaired ability to use iron stores
Chronic uncorrectable bleeding
Points Received: 0 of 2
Comments: Reduced intestinal absorption of iron
-582355584 MultipleChoice 5 False
Instructor The pathophysiological hallmark of ACD is a disregulation of iron
0 -582355584 MultipleChoice 5
Explanation: homeostasis, characterized by an increased uptake and retention of iron
Question 6 Question : within the cells of the reticuloendothelial system (liver/spleen), resulting in
. When interpreting laboratory data, you would expect to see the decreased RBC production. Essentially, iron is present but inaccessible for
following in a patient with Anemia of Chronic Disease (ACD): use in the production of Hgb with the erythrocytes (Bross et al., 2010). A
shortened RBC survival is also a contributing factor to ACD. (Kennedy-
Malone page 516-517)
Student Hemoglobin <12 g/dl, MCV decreased, MCH decreased
Answer: Kennedy-Malone, Laurie, Kathleen Fletcher, Lori Martin-Plank. Advanced
Practice Nursing in the Care of Older Adults. F.A. Davis Company, 2014-
Hemoglobin >12 g/dl, MCV increased, MCH increased 01-14. VitalBook file.
Hemoglobin <12 g/dl, MCV normal, MCH normal
Points Received: 0 of 2
Hemoglobin >12 g/dl, MCV decreased, MCH increased Comments:
-582355582 MultipleChoice 7 False
Instructor Hemoglobin (Hgb): <12 g/dL (120 g/L) women <13 g/dL (130 g/L) men
Explanation: Rarely <10 g/dL (100 g/L) Mean corpuscular volume: 80–96 mcm3 0 -582355582 MultipleChoice 7
(normocytic) Mean corpuscular hemoglobin Normochromic (normal
Question 8 Question :
color) RBC distribution width: normal (Kennedy-Malone page 517)
. The main focus of treatment of patients with ACD is:
Kennedy-Malone, Laurie, Kathleen Fletcher, Lori Martin-Plank.
Advanced Practice Nursing in the Care of Older Adults. F.A. Davis Student Replenishing iron stores
Company, 2014-01-14. VitalBook file. Answer:
, Providing for adequate nutrition high in iron (Kennedy-Malone page 518)
Management of the underlying disorder Kennedy-Malone, Laurie, Kathleen Fletcher, Lori Martin-Plank. Advanced
Practice Nursing in the Care of Older Adults. F.A. Davis Company, 2014-
01-14. VitalBook file.
Administration of monthly vitamin B12 injections
Instructor Treatment: Treatment of ACD focuses on management of the underlying Points Received: 2 of 2
Explanation: disorder. Iron supplementation is of no benefit in ACD, except in cases of Comments:
coexisting IDA. A therapeutic trial of iron supplementation of no longer
than 1 month may be useful in delineating between ACD and IDA. In -582355580 MultipleChoice 9 True
ACD, there would be no hematological response to iron therapy (Chen & 0 -582355580 MultipleChoice 9
Gandhi, 2004). (Kennedy-Malone page 518)
Question 10 Question :
Kennedy-Malone, Laurie, Kathleen Fletcher, Lori Martin-Plank. Advanced . Symptoms in the initial human immunodeficiency virus (HIV)
Practice Nursing in the Care of Older Adults. F.A. Davis Company, 2014- infection include all of the following except:
01-14. VitalBook file.
Student Sore throat
Points Received: 2 of 2 Answer:
Comments: Fever
-582355581 MultipleChoice 8 True
Weight loss
0 -582355581 MultipleChoice 8
Question 9 Question : Headache
. In addition to the complete blood count (CBC) with differential,
which of the following laboratory tests is considered to be most Instructor Signal symptoms: The initial HIV infection is characterized by
useful in diagnosing ACD and IDA? Explanation: mononucleosis-like illness with fever, sore throat, lymphadenopathy,
headache, and fatigue. A roseola-like rash may also develop. These initial
symptoms are followed by an asymptomatic phase, which may last 10 years or
Student Serum iron more. Later, if untreated, lymphadenopathy, weight loss, myalgias, and
Answer: diarrhea may develop (Cohen, Kuritzkes, & Sax, 2011). In advanced disease,
Total iron binding capacity malignancies and opportunistic infections occur. Co-infection with hepatitis B
or C is common (25% to 30%) in IV drug users, so hepatitis symptoms may
Transferrin saturation also appear (Centers for Disease Control and Prevention [CDC], 2010a).
(Kennedy-Malone page 521)
Serum ferritin Kennedy-Malone, Laurie, Kathleen Fletcher, Lori Martin-Plank. Advanced
Practice Nursing in the Care of Older Adults. F.A. Davis Company, 2014-01-
Instructor Treatment: Treatment of ACD focuses on management of the underlying 14. VitalBook file.
Explanation: disorder. Iron supplementation is of no benefit in ACD, except in cases of
coexisting IDA. A therapeutic trial of iron supplementation of no longer than
1 month may be useful in delineating between ACD and IDA. In ACD, there Points Received: 0 of 2
would be no hematological response to iron therapy (Chen & Gandhi, 2004).
