Kennedy-Malone
Advanced Practice Nursing in the Care of Older Adults, 3e Test Bank | Chapters 1-23
Chapter 1 Changes With Aging
Multiple Choice :
1. Mrs. Smith, who is 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.
Which of the following laboratory values does the advanced practice registered nurse (APRN) need to know
before ordering medications?
1. Complete blood count
2. Culture and sensitivity of the urine
3. Creatinine clearance
4. Uric acid levels
3. Which of the following statements is true regarding diagnostic testing?
1. A test is ordered for a specific purpose.
2. More invasive tests are the best option.
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, who is 25 years old, may experience arthritis differently than 65-year-old Mrs. Johnson because:
1. The body undergoes physiological changes with aging, which changes how diseases present.
2. A healthy body does not experience significant changes as one gets older.
3. Older adults do not feel any constitutional symptoms, such as malaise and weight loss.
Page 1
,Kennedy-Malone
Advanced Practice Nursing in the Care of Older Adults, 3e Test Bank | Chapters 1-23
4. Even though the same joints are usually affected, age makes arthritis pain feel different.
5. The APRN is examining an 85-year-old man with reports of vague abdominal symptoms, new onset
constipation, and somatic complaints. These symptoms may be an atypical presentation of which illness?
1. Depression
2. Heart failure
3. Hypothyroidism
4. Malignancy
6. A gerontological patient is being examined for a report of pain in the shoulder. The APRN completes a
thorough systemic examination because:
1. Older adults with one morbidity often express difficulties in general.
2. Arthritis of the shoulders can be accompanied by other neurological symptoms.
3. Older adults with arthritis often experience pain in the lower extremities.
4. The older adult may not report significant signs and symptoms.
7. The APRN performs a thorough systemic examination of a patient who reports melena, weight loss,
intermittent confusion, and dyspepsia. The older adult denies abdominal pain. One possible diagnosis would
be:
1. Pneumonia
2. Ulcerative colitis
3. Appendicitis
4. Peptic ulcer disease
8. An older woman is being seen in the ambulatory clinic for a routine check-up. The patient asks about
results of her blood work compared to last year’s results. Which response is best for the clinician to offer?
1. They are likely to be the same if you have had no diseases since then.
2. Your results may be different because the body changes with disease and medications you are taking.
Page 2
,Kennedy-Malone
Advanced Practice Nursing in the Care of Older Adults, 3e Test Bank | Chapters 1-23
3. Blood work is not a reliable indicator of health because many things can affect your health that may not
show up in the results of your blood work.
4. There is likely no significant difference if your body remains stable in its functioning.
Multiple Response
9. For individuals over 65, the most common morbidities are related to which of the following? Select all
that apply.
1. Heart disease
2. Respiratory problems
3. Diabetes
4. Cancer
5. Stroke
10. A 70-year-old man is seeing an APRN because he is feeling weak and dizzy. The APRN is discussing a
care plan with him and should make 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. I want to wait to order further tests. Many older adults feel this way, but it may resolve.
5. I will assess you for the presence of other conditions.
11. The APRN is leading a class of older adults over age 65 years old 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 answers are helpful? Select all that apply.
Page 3
, Kennedy-Malone
Advanced Practice Nursing in the Care of Older Adults, 3e Test Bank | Chapters 1-23
1. I suggest that you exercise a little more than you are currently doing.
2. Older adults experience a decrease in reserve energy.
3. Older adults have immune system weakness.
4. More viruses are being spread throughout the community.
5. I suggest that you see your primary care giver for extensive testing.
12. An older adult couple is discussing health concerns with the APRN. The couple is concerned that each of
their individual blood studies show different results. One set of test results shows a significant decrease in
blood sugar, but the test results of the partner do not show an equal decrease. Their physician does not seem
concerned, and the couple is wondering why. How is it best for the APRN to respond? Select all that apply.
1. Studies show that each person’s pattern of chemical make-up is different.
2. There is no difference between one person’s range of blood results and that of any other person.
3. Each person’s chemical make-up is the same as that of others of the same gender and age group.
4. Many factors affect an individual’s chemical make-up.
5. Ranges of the values provided by the laboratory are correct for any age.
13. Adam, 70 years old, is admitted for possible myasthenia gravis (MG). The APRN knows that MG is
commonly seen in women between 20 and 40 years old. Adam, however, is experiencing an ocular form of
MG, has dysphonia, and does not have any thymus abnormalities. Adam asks why the nurse is concerned
about MG, as he is older and this is a “young person’s disease.” Which responses from the APRN are best?
Select all that apply.
1. We need to assess for anything, just in case.
2. Some diseases show up in two different age and gender groups.
3. Depending on your age, MG may present with different symptoms.
4. Your insurance will cover this, and we want to rule out as much as possible.
5. Signs and symptoms of illness are the same for each disease regardless of age.
14. Mrs. Smith is 75 years old and was diagnosed with type 2 diabetes mellitus 30 years ago. She sees her
APRN on a regular basis. Mrs. Smith asks the APRN why her treatment has not been changed even though
her lab values are seemingly out of the normal range. With which of the following statements would the
APRN respond? Select all that apply.
1. A decision to make changes must be based on a pattern and not on one set of lab results.
Page 4
Advanced Practice Nursing in the Care of Older Adults, 3e Test Bank | Chapters 1-23
Chapter 1 Changes With Aging
Multiple Choice :
1. Mrs. Smith, who is 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.
Which of the following laboratory values does the advanced practice registered nurse (APRN) need to know
before ordering medications?
1. Complete blood count
2. Culture and sensitivity of the urine
3. Creatinine clearance
4. Uric acid levels
3. Which of the following statements is true regarding diagnostic testing?
1. A test is ordered for a specific purpose.
2. More invasive tests are the best option.
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, who is 25 years old, may experience arthritis differently than 65-year-old Mrs. Johnson because:
1. The body undergoes physiological changes with aging, which changes how diseases present.
2. A healthy body does not experience significant changes as one gets older.
3. Older adults do not feel any constitutional symptoms, such as malaise and weight loss.
Page 1
,Kennedy-Malone
Advanced Practice Nursing in the Care of Older Adults, 3e Test Bank | Chapters 1-23
4. Even though the same joints are usually affected, age makes arthritis pain feel different.
5. The APRN is examining an 85-year-old man with reports of vague abdominal symptoms, new onset
constipation, and somatic complaints. These symptoms may be an atypical presentation of which illness?
1. Depression
2. Heart failure
3. Hypothyroidism
4. Malignancy
6. A gerontological patient is being examined for a report of pain in the shoulder. The APRN completes a
thorough systemic examination because:
1. Older adults with one morbidity often express difficulties in general.
2. Arthritis of the shoulders can be accompanied by other neurological symptoms.
3. Older adults with arthritis often experience pain in the lower extremities.
4. The older adult may not report significant signs and symptoms.
7. The APRN performs a thorough systemic examination of a patient who reports melena, weight loss,
intermittent confusion, and dyspepsia. The older adult denies abdominal pain. One possible diagnosis would
be:
1. Pneumonia
2. Ulcerative colitis
3. Appendicitis
4. Peptic ulcer disease
8. An older woman is being seen in the ambulatory clinic for a routine check-up. The patient asks about
results of her blood work compared to last year’s results. Which response is best for the clinician to offer?
1. They are likely to be the same if you have had no diseases since then.
2. Your results may be different because the body changes with disease and medications you are taking.
Page 2
,Kennedy-Malone
Advanced Practice Nursing in the Care of Older Adults, 3e Test Bank | Chapters 1-23
3. Blood work is not a reliable indicator of health because many things can affect your health that may not
show up in the results of your blood work.
4. There is likely no significant difference if your body remains stable in its functioning.
Multiple Response
9. For individuals over 65, the most common morbidities are related to which of the following? Select all
that apply.
1. Heart disease
2. Respiratory problems
3. Diabetes
4. Cancer
5. Stroke
10. A 70-year-old man is seeing an APRN because he is feeling weak and dizzy. The APRN is discussing a
care plan with him and should make 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. I want to wait to order further tests. Many older adults feel this way, but it may resolve.
5. I will assess you for the presence of other conditions.
11. The APRN is leading a class of older adults over age 65 years old 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 answers are helpful? Select all that apply.
Page 3
, Kennedy-Malone
Advanced Practice Nursing in the Care of Older Adults, 3e Test Bank | Chapters 1-23
1. I suggest that you exercise a little more than you are currently doing.
2. Older adults experience a decrease in reserve energy.
3. Older adults have immune system weakness.
4. More viruses are being spread throughout the community.
5. I suggest that you see your primary care giver for extensive testing.
12. An older adult couple is discussing health concerns with the APRN. The couple is concerned that each of
their individual blood studies show different results. One set of test results shows a significant decrease in
blood sugar, but the test results of the partner do not show an equal decrease. Their physician does not seem
concerned, and the couple is wondering why. How is it best for the APRN to respond? Select all that apply.
1. Studies show that each person’s pattern of chemical make-up is different.
2. There is no difference between one person’s range of blood results and that of any other person.
3. Each person’s chemical make-up is the same as that of others of the same gender and age group.
4. Many factors affect an individual’s chemical make-up.
5. Ranges of the values provided by the laboratory are correct for any age.
13. Adam, 70 years old, is admitted for possible myasthenia gravis (MG). The APRN knows that MG is
commonly seen in women between 20 and 40 years old. Adam, however, is experiencing an ocular form of
MG, has dysphonia, and does not have any thymus abnormalities. Adam asks why the nurse is concerned
about MG, as he is older and this is a “young person’s disease.” Which responses from the APRN are best?
Select all that apply.
1. We need to assess for anything, just in case.
2. Some diseases show up in two different age and gender groups.
3. Depending on your age, MG may present with different symptoms.
4. Your insurance will cover this, and we want to rule out as much as possible.
5. Signs and symptoms of illness are the same for each disease regardless of age.
14. Mrs. Smith is 75 years old and was diagnosed with type 2 diabetes mellitus 30 years ago. She sees her
APRN on a regular basis. Mrs. Smith asks the APRN why her treatment has not been changed even though
her lab values are seemingly out of the normal range. With which of the following statements would the
APRN respond? Select all that apply.
1. A decision to make changes must be based on a pattern and not on one set of lab results.
Page 4
