Nursing in the Care of Older Adults

Chapter 1 Changes With Aging Multiple Choice 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. 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 3. Which of the following statementsGiRs AtruDeErSegMaOrdRinEg.dCiaOgnMostic 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. 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. 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 6. For individuals over 65 years old, the most common morbidities are related to: 1. Heart disease, arthritis 2. Respiratory problems, cancer 3. Diabetes, stroke 4. All of these are common morbidities. 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. 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: 1. Hirschsprung’s disease 2. Pancreatitis 3. Appendicitis 4. Gastrointestinal inflammatory bowel disease (GIBD) Multiple Response 9. A 70-year-old man is seeing a nurse practitioner because he is feeling weak and dizzy. The nurse practitioner is discussing a care plan with him and makes which of the following statements? Select all that apply. 1. I want to order a test for your heart to evaluate its function. 2. I will perform a thorough examination of your functional abilities. 3. I will order a blood sugar test to check for diabetes. 4. Many older people feel this way. It is to be expected. 5. I will assess you for the presence of other conditions. 10. The nurse practitioner is leading a class of seniors over age 65 years and is teaching about nutritional needs. One of the men asks why, even though he eats correctly according to the standards presented, he still feels weaker than he did 10 years ago. He also wonders why he gets more infections than he used to. Which of the following are helpful answers? Select all that apply. 1. I suggest that you exercise a little more than you are currently doing. 2. Some people experience a decrease in reserve energy. 3. For some people, the immune system weakens. 4. More viruses are being spread throughout the community. 5. I suggest that you see your primary caregiver for extensive testing. 11. An older woman is seen in the ambulatory clinic for a routine checkup. The patient asks about results of her blood work compared to last year’s results. How is it best for the clinician to respond? Select all that apply.