TESTgBANKgADVANCEDgPRACTICEgNURSINGgINgTHEgCAREg
OFgOLDERgADULTSg3RDgEDITIONgKENNEDY-MALONE
,1. Mrs.gSmith,g75gyearsgold,greportsgthatgshegisgweak,ghasgdifficultygurinating,gandgisgdehydrated.g
Althoughgshegisgafebrile,gthegnursinggattendantgconductsgagthoroughgphysicalgexamination,gincluding
gurinalysisgandgcompletegbloodgcountg(CBC).gThegtotalgassessmentg isgnecessarygbecause:
1. Allgbodygsystemsginteract,gandgsymptomsgcouldgindicategagvarietygofgdiagnoses.
2. Thegsymptomsgaregvaguegandgmaygbegsignsgofgaging.
3. Theregmaygbegothergsignsgorgsymptomsgmoregindicativegofgthegcondition.
4. Mrs.gSmithgmaygnotgbegreportinggallgsignificantginformation.g-
g1.ggACCURATEgANSWER:->1gPg:g2
Reasoning
:->>>g1.
Thegcliniciangmustgbegawaregthatgallgthegsystemsginteractgand,gingdoinggso,gcangincreasegthegoldergper
son'sgvulnerabilitygtogillness/disease.
2.
Thegnursinggattendantgmustgnotgattributegsymptomsgonlygtogtheg
aginggprocess.g3.
Theregmaygbegcomorbiditiesgaccompanyinggthisgconditio
n.g4.
Assumptionsgofgnotgreportinggproperlygmaygnotgbegtrue.
2. Aghospitalgclientgwithgrenalgdiseaseghasgbloodgworkgdrawn,gandgthegresultsgshowgangincreas
egingserumgcreatinine.gThegnursinggattendantgpractitionergneedsgtogknowgwhichgofgthegfollowin
gglaboratorygvaluesgbeforegorderingg medications?
1. CBC
2. Culturegandgsensitivitygofgthegurine
3. Creatininegclearance
4. Uricgacidglevelsg-
g2.ggACCURATEgANSWER:->3gPg:g3
Reasoning
:->>>g1.
AgCBCgwillgnotgevaluategkidneygfunctiongforgaghospitalgclientgwithgren
algdisease.g2.
,Agculturegandgsensitivitygtestgreflectsgthegpresencegofganginfectiongandgthegantibioticgtogwhichgthegorg
anismgisgsensitive.
3.
Thegcalculationgofgcreatininegclearancegprovidesgangestimationgofgrenalgfunctio
n.g4.
Uricgacidglevelgisgelevatedgingthegpresencegofggout.
3.gWhichgofgthegfollowinggstatementsgisgtruegregardinggdiagnosticgtesting?
1. Agtestg isgorderedgforgagspecificgpurpose.
2. Agtestgisgthegmostginvasivegavailable.
3. Theregisgnogneedgtogdiscussgresultsgwithgtheghospitalgclient.
4. Ifgagtestgisgneeded,gitgshouldgbegorderedgregardlessgofgriskgtogtheghospitalgclient.g–
5. 3.ggACCURATEgANSWER:->1gPg:g3
Reasoning
:->>>g1.
Thegnursinggattendantgpractitionergshouldghavegagplangforgthegusegofgeachgtestgr
esultgvaluegobtained.g2.
Whengconsideringgwhichglaboratorygtestsgtogorder,gitgisgworthgrememberinggthegdoctrinegprimumgnognnocere
—gfirst,gdognog harm.
3.
Onceglaboratorygtestsgaregavailablegforgreview,gtestsgresultsgshouldgbegdiscussedgwithgtheghospitalgcl
ient,gwithgabnormalgtestgresultsginterpretedgforgthegaginggindividualgandgaddressedgwithgtheghospitalg
clientgandgnursinggattendants.g4.
Anygrisksginvolvedginglaboratorygtestinggmustgbegconsideredgconcerninggtheghospitalgclient'sgclinicalg
conditiongandgweighedgagainstg thegtest'sgexpectedgbenefits.
4.gJaney,g25gyearsgold,gmaygexperiencegarthritisgdifferentlygthang65-year-oldgMrs.gJohnsongbecause:
1. Thegbodygundergoesgphysiologicalgchangesgwithgaging.
2. Aghealthygbodygdoesgnotgexperiencegsignificantgchangesgasgoneggetsgolder.
3. Olderghospitalgclientsgdognotgfeelganygsystemicgsymptoms,gsuchgasgmalaisegandgweightgloss.
4. Evengthoughgthegsamegjointsgaregusuallygaffected,gagegmakesgitgfeelgdifferent.g-
g4.ggACCURATEgANSWER:->1gPg:g5
Reasoning
:->>>g1.
Knowledgegofgthegbimodalitygofgagegonsetgofgcertaingdiseasegconditionsgwillgaidgthegadvancedgpracticegnur
singgattendantg ingavoidinggmisdiagnosisgorgdelaygingdiagnosisgduegtoglackgofgrecognition.
2.
Symptomsgofgrheumatoidgarthritisgmaygbegdifferentg dependinggongthegagegofgtheghospitalgclient.
, 3.
Youngerghospitalgclientsgmaygnotgexperiencegconstitutionalgsymptomsgsuchgasgfever,gmalaise,gweightgloss,g
andgdepression.
4.
Inglate-onsetgrheumatoidgarthritis,gthegjointginvolvementgisgmoregoftengingtheglargergjoints.
5. Thegnursinggattendantgpractitionergisgexamininggang85-year-
oldgmangwithgreportsgofgabdominalgpain,gweakness,gandglossgofgappetite.gWhichgisgthegmostgli
kelygconditiongtogbegtestedgforgandgruledgout?
1. Neoplasmsgandgcarcinomas
2. Partialgseizure
3. Sarcopenia
4. Hirschsprung'sgdiseaseg-
g5.ggACCURATEgANSWER:->1gPg:g4
Reasoning
:->>>g1.
Certaingdiseases,gsuchgasgneoplasmsgandgcarcinomas,garegmoregcommongingthegelderly,gandgangunders
tandinggofgthegepidemiologygisgcriticalgingtheginterpretation.
2.
Partialgseizuregisgmoregcommongingearlygoldgag
e.g3.
Sarcopeniagisgmoregcommongingearlygoldgag
e.g4.
Hirschsprung'sgdiseasegisgmostgcommonginginfancy.
6. Forgindividualsgoverg65gyearsgold,gthegmostgcommongmorbiditiesgaregrelatedgto:
1. Heartgdisease,garthritis
2. Respiratorygproblems,gcancer
3. Diabetes,gstroke
4. Allgofgthesegaregcommongmorbidities.g-
g6.ggACCURATEgANSWER:->4gPg:g5
Reasoning
:->>>g1.
Heartgdiseasegisgonegofgthegcommongmorbiditie
s.g2.
Cancergisgcommongingtheggeneralgpopulation;ghowever,gspecificgtypesgaregmoregcommongingthegolder
ghospitalgclient.
3.
Diabetesgisgcommonginghospitalgclientsgoverg40gyearsgofgage.
OFgOLDERgADULTSg3RDgEDITIONgKENNEDY-MALONE
,1. Mrs.gSmith,g75gyearsgold,greportsgthatgshegisgweak,ghasgdifficultygurinating,gandgisgdehydrated.g
Althoughgshegisgafebrile,gthegnursinggattendantgconductsgagthoroughgphysicalgexamination,gincluding
gurinalysisgandgcompletegbloodgcountg(CBC).gThegtotalgassessmentg isgnecessarygbecause:
1. Allgbodygsystemsginteract,gandgsymptomsgcouldgindicategagvarietygofgdiagnoses.
2. Thegsymptomsgaregvaguegandgmaygbegsignsgofgaging.
3. Theregmaygbegothergsignsgorgsymptomsgmoregindicativegofgthegcondition.
4. Mrs.gSmithgmaygnotgbegreportinggallgsignificantginformation.g-
g1.ggACCURATEgANSWER:->1gPg:g2
Reasoning
:->>>g1.
Thegcliniciangmustgbegawaregthatgallgthegsystemsginteractgand,gingdoinggso,gcangincreasegthegoldergper
son'sgvulnerabilitygtogillness/disease.
2.
Thegnursinggattendantgmustgnotgattributegsymptomsgonlygtogtheg
aginggprocess.g3.
Theregmaygbegcomorbiditiesgaccompanyinggthisgconditio
n.g4.
Assumptionsgofgnotgreportinggproperlygmaygnotgbegtrue.
2. Aghospitalgclientgwithgrenalgdiseaseghasgbloodgworkgdrawn,gandgthegresultsgshowgangincreas
egingserumgcreatinine.gThegnursinggattendantgpractitionergneedsgtogknowgwhichgofgthegfollowin
gglaboratorygvaluesgbeforegorderingg medications?
1. CBC
2. Culturegandgsensitivitygofgthegurine
3. Creatininegclearance
4. Uricgacidglevelsg-
g2.ggACCURATEgANSWER:->3gPg:g3
Reasoning
:->>>g1.
AgCBCgwillgnotgevaluategkidneygfunctiongforgaghospitalgclientgwithgren
algdisease.g2.
,Agculturegandgsensitivitygtestgreflectsgthegpresencegofganginfectiongandgthegantibioticgtogwhichgthegorg
anismgisgsensitive.
3.
Thegcalculationgofgcreatininegclearancegprovidesgangestimationgofgrenalgfunctio
n.g4.
Uricgacidglevelgisgelevatedgingthegpresencegofggout.
3.gWhichgofgthegfollowinggstatementsgisgtruegregardinggdiagnosticgtesting?
1. Agtestg isgorderedgforgagspecificgpurpose.
2. Agtestgisgthegmostginvasivegavailable.
3. Theregisgnogneedgtogdiscussgresultsgwithgtheghospitalgclient.
4. Ifgagtestgisgneeded,gitgshouldgbegorderedgregardlessgofgriskgtogtheghospitalgclient.g–
5. 3.ggACCURATEgANSWER:->1gPg:g3
Reasoning
:->>>g1.
Thegnursinggattendantgpractitionergshouldghavegagplangforgthegusegofgeachgtestgr
esultgvaluegobtained.g2.
Whengconsideringgwhichglaboratorygtestsgtogorder,gitgisgworthgrememberinggthegdoctrinegprimumgnognnocere
—gfirst,gdognog harm.
3.
Onceglaboratorygtestsgaregavailablegforgreview,gtestsgresultsgshouldgbegdiscussedgwithgtheghospitalgcl
ient,gwithgabnormalgtestgresultsginterpretedgforgthegaginggindividualgandgaddressedgwithgtheghospitalg
clientgandgnursinggattendants.g4.
Anygrisksginvolvedginglaboratorygtestinggmustgbegconsideredgconcerninggtheghospitalgclient'sgclinicalg
conditiongandgweighedgagainstg thegtest'sgexpectedgbenefits.
4.gJaney,g25gyearsgold,gmaygexperiencegarthritisgdifferentlygthang65-year-oldgMrs.gJohnsongbecause:
1. Thegbodygundergoesgphysiologicalgchangesgwithgaging.
2. Aghealthygbodygdoesgnotgexperiencegsignificantgchangesgasgoneggetsgolder.
3. Olderghospitalgclientsgdognotgfeelganygsystemicgsymptoms,gsuchgasgmalaisegandgweightgloss.
4. Evengthoughgthegsamegjointsgaregusuallygaffected,gagegmakesgitgfeelgdifferent.g-
g4.ggACCURATEgANSWER:->1gPg:g5
Reasoning
:->>>g1.
Knowledgegofgthegbimodalitygofgagegonsetgofgcertaingdiseasegconditionsgwillgaidgthegadvancedgpracticegnur
singgattendantg ingavoidinggmisdiagnosisgorgdelaygingdiagnosisgduegtoglackgofgrecognition.
2.
Symptomsgofgrheumatoidgarthritisgmaygbegdifferentg dependinggongthegagegofgtheghospitalgclient.
, 3.
Youngerghospitalgclientsgmaygnotgexperiencegconstitutionalgsymptomsgsuchgasgfever,gmalaise,gweightgloss,g
andgdepression.
4.
Inglate-onsetgrheumatoidgarthritis,gthegjointginvolvementgisgmoregoftengingtheglargergjoints.
5. Thegnursinggattendantgpractitionergisgexamininggang85-year-
oldgmangwithgreportsgofgabdominalgpain,gweakness,gandglossgofgappetite.gWhichgisgthegmostgli
kelygconditiongtogbegtestedgforgandgruledgout?
1. Neoplasmsgandgcarcinomas
2. Partialgseizure
3. Sarcopenia
4. Hirschsprung'sgdiseaseg-
g5.ggACCURATEgANSWER:->1gPg:g4
Reasoning
:->>>g1.
Certaingdiseases,gsuchgasgneoplasmsgandgcarcinomas,garegmoregcommongingthegelderly,gandgangunders
tandinggofgthegepidemiologygisgcriticalgingtheginterpretation.
2.
Partialgseizuregisgmoregcommongingearlygoldgag
e.g3.
Sarcopeniagisgmoregcommongingearlygoldgag
e.g4.
Hirschsprung'sgdiseasegisgmostgcommonginginfancy.
6. Forgindividualsgoverg65gyearsgold,gthegmostgcommongmorbiditiesgaregrelatedgto:
1. Heartgdisease,garthritis
2. Respiratorygproblems,gcancer
3. Diabetes,gstroke
4. Allgofgthesegaregcommongmorbidities.g-
g6.ggACCURATEgANSWER:->4gPg:g5
Reasoning
:->>>g1.
Heartgdiseasegisgonegofgthegcommongmorbiditie
s.g2.
Cancergisgcommongingtheggeneralgpopulation;ghowever,gspecificgtypesgaregmoregcommongingthegolder
ghospitalgclient.
3.
Diabetesgisgcommonginghospitalgclientsgoverg40gyearsgofgage.
