TEST BANK
Advanced Practice Nursing in the Care of Older Adults 3rd Edition
by Laurie Kennedy-Malone, and Evelyn Groenke Duffy
,TABLE OF CONTENT
Chapter 1: Changes With Aging ................................................................................................................................. 1
Chapter 2: Health Promotion .................................................................................................................................... 11
Chapter 3: Exercise in Older Adults ......................................................................................................................... 20
Chapter 4: Nutritional Support in the Older Adult ................................................................................................... 29
Chapter 5: Settings of Care ....................................................................................................................................... 38
Chapter 6: Comprehensive Geriatric Assessment..................................................................................................... 47
Chapter 7: Symptoms and Syndromes ...................................................................................................................... 58
Chapter 8: Dermatological Disorders ....................................................................................................................... 69
Chapter 9: Head, Neck, and Face Disorders ............................................................................................................. 78
Chapter 10: Cardiovascular Disorders ...................................................................................................................... 89
Chapter 11: Respiratory Disorders............................................................................................................................ 98
Chapter 12: Peripheral Vascular Disorders............................................................................................................. 107
Chapter 13: Gastrointestinal Disorders ................................................................................................................... 116
Chapter 14: Urological and Renal Disorders .......................................................................................................... 128
Chapter 15: Gynecological Disorders ..................................................................................................................... 137
Chapter 16: Musculoskeletal Disorders .................................................................................................................. 148
Chapter 17: Central and Peripheral Nervous System Disorders ............................................................................. 164
Chapter 18: Endocrine and Metabolic Disorders.................................................................................................... 178
Chapter 19: Hematological Disorders..................................................................................................................... 191
Chapter 20: Psychosocial Disorders ....................................................................................................................... 202
Chapter 21: Polypharmacy...................................................................................................................................... 212
Chapter 22: Chronic Illness and the APRN ............................................................................................................ 221
Chapter 23: Palliative Care and End-of-Life Care.................................................................................................. 231
Bonus Chapter: Infectious Disease ......................................................................................................................... 241
,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:
a. All body systems interact, and symptoms could indicate a variety of diagnoses.
b. The symptoms are vague and may be signs of aging.
c. There may be other signs or symptoms more indicative of the condition.
d. Mrs. Smith may not be reporting all significant information.
ANS: A
Chapter number/title: Chapter 1 Changes With Aging
Learning objective: The learner will be familiarized with fundamental underpinnings that
serve to guide the approach to assessment and management of older adults.
Heading: Physiological Changes With Aging
Difficulty: Moderate
Feedback
A The clinician must be aware that all the systems interact and, in doing so, can
increase the older adult’s vulnerability to illness/disease.
B The nurse must not attribute symptoms only to the aging process.
C There may be comorbidities accompanying this condition.
D Assumptions of not reporting properly may not be true.
REF: Page: 2
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?
a. Complete blood count
b. Culture and sensitivity of the urine
c. Creatinine clearance
d. Uric acid levels
ANS: C
Chapter number/title: Chapter 1 Changes With Aging
Learning objective: The learner will understand how the changes that accompany aging
influence reference laboratory values.
Heading: Laboratory Values in Older Adults
Difficulty: Moderate
Feedback
A A complete blood count (CBC) will not evaluate kidney function for a patient
with renal disease. It shows how the bone marrow is producing and the growth
of blood components.
B A culture and sensitivity test reflects the presence of an infection and the
1|Page
, antibiotic to which the organism is sensitive.
C The calculation of creatinine clearance provides an estimation of renal function.
D Uric acid level is elevated in the presence of gout.
REF: Page: 3
3. Which of the following statements is true regarding diagnostic testing?
a. A test is ordered for a specific purpose.
b. More invasive tests are the best option.
c. There is no need to discuss results with the patient.
d. If a test is needed, it should be ordered regardless of risk to the patient.
ANS: A
Chapter number/title: Chapter 1 Changes With Aging
Learning objective: The learner will be familiarized with fundamental underpinnings that
serve to guide the approach to assessment and management of older adults.
Heading: Laboratory Values in Older Adults
Difficulty: Moderate
Feedback
A The APRN should have a plan for the use of each test result value obtained.
B When considering which laboratory tests to order, it is worth remembering the
doctrine primum no nnocere: First, do no harm.
C Once laboratory tests are available for review, test results should be discussed
with the patient. Abnormal test results should be interpreted for the aging
individual and addressed with the patient and caregivers.
D Any risks involved in laboratory testing must be considered concerning the
patient’s clinical condition and weighed against the test’s expected benefits.
REF: Page: 3
4. Janey, who is 25 years old, may experience arthritis differently than 65-year-old Mrs.
Johnson because:
a. The body undergoes physiological changes with aging, which changes how
diseases present.
b. A healthy body does not experience significant changes as one gets older.
c. Older adults do not feel any constitutional symptoms, such as malaise and weight
loss.
d. Even though the same joints are usually affected, age makes arthritis pain feel
different.
ANS: A
Chapter number/title: Chapter 1 Changes With Aging
Learning objective: The learner will develop a perspective in approaching the older adult
that is different from that of a younger adult.
Heading: Bimodality of Age of Onset of Clinical Conditions
Difficulty: Moderate
Feedback
A Knowledge of the bimodality of age onset of certain disease conditions, such as
2|Page
Advanced Practice Nursing in the Care of Older Adults 3rd Edition
by Laurie Kennedy-Malone, and Evelyn Groenke Duffy
,TABLE OF CONTENT
Chapter 1: Changes With Aging ................................................................................................................................. 1
Chapter 2: Health Promotion .................................................................................................................................... 11
Chapter 3: Exercise in Older Adults ......................................................................................................................... 20
Chapter 4: Nutritional Support in the Older Adult ................................................................................................... 29
Chapter 5: Settings of Care ....................................................................................................................................... 38
Chapter 6: Comprehensive Geriatric Assessment..................................................................................................... 47
Chapter 7: Symptoms and Syndromes ...................................................................................................................... 58
Chapter 8: Dermatological Disorders ....................................................................................................................... 69
Chapter 9: Head, Neck, and Face Disorders ............................................................................................................. 78
Chapter 10: Cardiovascular Disorders ...................................................................................................................... 89
Chapter 11: Respiratory Disorders............................................................................................................................ 98
Chapter 12: Peripheral Vascular Disorders............................................................................................................. 107
Chapter 13: Gastrointestinal Disorders ................................................................................................................... 116
Chapter 14: Urological and Renal Disorders .......................................................................................................... 128
Chapter 15: Gynecological Disorders ..................................................................................................................... 137
Chapter 16: Musculoskeletal Disorders .................................................................................................................. 148
Chapter 17: Central and Peripheral Nervous System Disorders ............................................................................. 164
Chapter 18: Endocrine and Metabolic Disorders.................................................................................................... 178
Chapter 19: Hematological Disorders..................................................................................................................... 191
Chapter 20: Psychosocial Disorders ....................................................................................................................... 202
Chapter 21: Polypharmacy...................................................................................................................................... 212
Chapter 22: Chronic Illness and the APRN ............................................................................................................ 221
Chapter 23: Palliative Care and End-of-Life Care.................................................................................................. 231
Bonus Chapter: Infectious Disease ......................................................................................................................... 241
,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:
a. All body systems interact, and symptoms could indicate a variety of diagnoses.
b. The symptoms are vague and may be signs of aging.
c. There may be other signs or symptoms more indicative of the condition.
d. Mrs. Smith may not be reporting all significant information.
ANS: A
Chapter number/title: Chapter 1 Changes With Aging
Learning objective: The learner will be familiarized with fundamental underpinnings that
serve to guide the approach to assessment and management of older adults.
Heading: Physiological Changes With Aging
Difficulty: Moderate
Feedback
A The clinician must be aware that all the systems interact and, in doing so, can
increase the older adult’s vulnerability to illness/disease.
B The nurse must not attribute symptoms only to the aging process.
C There may be comorbidities accompanying this condition.
D Assumptions of not reporting properly may not be true.
REF: Page: 2
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?
a. Complete blood count
b. Culture and sensitivity of the urine
c. Creatinine clearance
d. Uric acid levels
ANS: C
Chapter number/title: Chapter 1 Changes With Aging
Learning objective: The learner will understand how the changes that accompany aging
influence reference laboratory values.
Heading: Laboratory Values in Older Adults
Difficulty: Moderate
Feedback
A A complete blood count (CBC) will not evaluate kidney function for a patient
with renal disease. It shows how the bone marrow is producing and the growth
of blood components.
B A culture and sensitivity test reflects the presence of an infection and the
1|Page
, antibiotic to which the organism is sensitive.
C The calculation of creatinine clearance provides an estimation of renal function.
D Uric acid level is elevated in the presence of gout.
REF: Page: 3
3. Which of the following statements is true regarding diagnostic testing?
a. A test is ordered for a specific purpose.
b. More invasive tests are the best option.
c. There is no need to discuss results with the patient.
d. If a test is needed, it should be ordered regardless of risk to the patient.
ANS: A
Chapter number/title: Chapter 1 Changes With Aging
Learning objective: The learner will be familiarized with fundamental underpinnings that
serve to guide the approach to assessment and management of older adults.
Heading: Laboratory Values in Older Adults
Difficulty: Moderate
Feedback
A The APRN should have a plan for the use of each test result value obtained.
B When considering which laboratory tests to order, it is worth remembering the
doctrine primum no nnocere: First, do no harm.
C Once laboratory tests are available for review, test results should be discussed
with the patient. Abnormal test results should be interpreted for the aging
individual and addressed with the patient and caregivers.
D Any risks involved in laboratory testing must be considered concerning the
patient’s clinical condition and weighed against the test’s expected benefits.
REF: Page: 3
4. Janey, who is 25 years old, may experience arthritis differently than 65-year-old Mrs.
Johnson because:
a. The body undergoes physiological changes with aging, which changes how
diseases present.
b. A healthy body does not experience significant changes as one gets older.
c. Older adults do not feel any constitutional symptoms, such as malaise and weight
loss.
d. Even though the same joints are usually affected, age makes arthritis pain feel
different.
ANS: A
Chapter number/title: Chapter 1 Changes With Aging
Learning objective: The learner will develop a perspective in approaching the older adult
that is different from that of a younger adult.
Heading: Bimodality of Age of Onset of Clinical Conditions
Difficulty: Moderate
Feedback
A Knowledge of the bimodality of age onset of certain disease conditions, such as
2|Page
