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Kennedy-Malone
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, TestBank g
AdvancedPracticeNu
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rsingintheCareof
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nd
Older Adults2
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g Edition Kennedy- gg
Malone
,1. Mrs. Smith, 75 years old, reports that she is weak, has difficulty urinating, and is dehydrated.
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Although she is afebrile, the nurse conducts a thorough physical examination, including urinalysis and
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complete blood count (CBC). The total assessment is necessary because:
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1. All body systems interact, and symptoms could indicate a variety of diagnoses.
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2. The symptoms are vague and may be signs of aging.
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3. There may be other signs or symptoms more indicative of the condition.
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4. Mrs. Smith may not be reporting all significant information. - 1. Answer: 1
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The clinician must be aware that all the systems interact and, in doing so, can increase the older person's
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vulnerability to illness/disease.
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2.
The nurse must not attribute symptoms only to the aging process.
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3.
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There may be comorbidities accompanying this condition.
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4.
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Assumptions of not reporting properly may not be true. g g g g g g g g
2.A patient with renal disease has blood work drawn, and the results show an increase in serum
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creatinine. The nurse practitioner needs to know which of the following laboratory values before
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ordering medications?
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1. CBC
2. Culture and sensitivity of the urine g g g g g
3. Creatinine clearance g
4. Uric acid levels - 2. Answer: 3
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A CBC will not evaluate kidney function for a patient with renal disease.
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2.
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, A culture and sensitivity test reflects the presence of an infection and the antibiotic to which the
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organism is sensitive.
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3.
The calculation of creatinine clearance provides an estimation of renal function.
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4.
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Uric acid level is elevated in the presence of gout.
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3. Which of the following statements is true regarding diagnostic testing?
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1. A test is ordered for a specific purpose.
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2. A test is the most invasive available.
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3. There is no need to discuss results with the patient.
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4. If a test is needed, it should be ordered regardless of risk to the patient. - 3. Answer:
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The nurse practitioner should have a plan for the use of each test result value obtained.
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2.
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When considering which laboratory tests to order, it is worth remembering the doctrine primum no
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nnocere—first, do no harm.
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3.
Once laboratory tests are available for review, tests results should be discussed with the patient, with
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abnormal test results interpreted for the aging individual and addressed with the patient and caregivers.
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4.
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Any risks involved in laboratory testing must be considered concerning the patient's clinical condition
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and weighed against the test's expected benefits.
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4. Janey, 25 years old, may experience arthritis differently than 65-year-old Mrs. Johnson because:
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1. The body undergoes physiological changes with aging.
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2. A healthy body does not experience significant changes as one gets older.
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3. Older patients do not feel any systemic symptoms, such as malaise and weight loss.
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4. Even though the same joints are usually affected, age makes it feel different. - 4. Answer: 1
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Knowledge of the bimodality of age onset of certain disease conditions will aid the advanced practice
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nurse in avoiding misdiagnosis or delay in diagnosis due to lack of recognition.
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2.
Symptoms of rheumatoid arthritis may be different depending on the age of the patient.
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