OF OLDER ADULTS 3RD EDITION KENNEDY-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 nursing attendant conducts a thorough physical examination, including
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urinalysisand 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.
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ACCURATE ANSWER:->1 Pg: 2
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Reasoning
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The clinician must be aware that all the systems interact and, in doing so, can increase the olderperson's
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Pvulnerability to illness/disease. P P
2.
The nursing attendant must not attribute symptoms only to the
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agingprocess. 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. P P P P P P P P
2. A hospital client with renal disease has blood work drawn, and the results show an increase
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in serum creatinine. The nursing attendant practitioner needs to know which of the following
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laboratory values before ordering medications?
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1. CBC
2. Culture and sensitivity of the urine P P P P P
3. Creatinine clearance P
4. Uric acid levels - 2. ACCURATE
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ANSWER:->3Pg: 3
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Reasoning
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A CBC will not evaluate kidney function for a hospital client with renal
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disease.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.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 hospital client.
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4. If a test is needed, it should be ordered regardless of risk to the hospital client. –
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5. 3. ACCURATE ANSWER:->1 Pg: 3
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Reasoning
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The nursing attendant practitioner should have a plan for the use of each test
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Presult valueobtained. 2. P P P
When considering which laboratory tests to order, it is worth remembering the doctrine primum no nnocere—
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first, do no harm.
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3.
Once laboratory tests are available for review, tests results should be discussed with the hospital
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Pclient, with abnormal test results interpreted for the aging individual and addressed with the hospital
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Pclient and nursing attendants.4.
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Any risks involved in laboratory testing must be considered concerning the hospital client's clinical
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conditionand 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 hospital clients 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.
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ACCURATE ANSWER:->1 Pg: 5
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Reasoning
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Knowledge of the bimodality of age onset of certain disease conditions will aid the advanced practicenursing
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Pattendant 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 hospital client.
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, 3.
Younger hospital clients may not experience constitutional symptoms such as fever, malaise, weight loss, and
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depression.
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4.
In late-onset rheumatoid arthritis, the joint involvement is more often in the larger joints.
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5. The nursing attendant practitioner is examining an 85-year-old man with reports of
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abdominal pain, weakness, and loss of appetite. Which is the most likely condition to be tested
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for and ruled out?
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1. Neoplasms and carcinomas P P
2. Partial seizure P
3. Sarcopenia
4. Hirschsprung's disease - 5. ACCURATE P P P PP
ANSWER:->1Pg: 4
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Reasoning
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Certain diseases, such as neoplasms and carcinomas, are more common in the elderly, and an
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understanding of the epidemiology is critical in the interpretation.
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2.
Partial seizure is more common in early old age.
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3.
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Sarcopenia is more common in early old age. P P P P P P P
4.
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Hirschsprung's disease is most common in infancy. P P P P P P
6. For individuals over 65 years old, the most common morbidities are related to:
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1. Heart disease, arthritis P P
2. Respiratory problems, cancer P P
3. Diabetes, stroke P
4. All of these are common morbidities. - 6.
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ACCURATE ANSWER:->4 Pg: 5
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Reasoning
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Heart disease is one of the common morbidities.
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2.
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Cancer is common in the general population; however, specific types are more common in the older
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hospital client.
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3.
Diabetes is common in hospital clients over 40 years of age.
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